Test levels years later...

[DRCinNY]

I stumbled upon this website and wanted to know if anyone has had a situation similar to the following:

I had TC at age 25 (stage I pure seminoma), had my right testicle removed and radiation treatment. A year after this, I had reported a lower libido to my oncologist and urologist, back then my test level was 750 which was considered normal. Years went by, I always felt like my libido was never like pre-surgery levels but still was able to have sex and normal erections. Turning the clock ahead, entering into my 30s I felt as if my libido declined more and more.......and I also had moved from Boston to NY getting new doctors and forgot about most my prior tests having gotten all new doctors in NY.

Now I am age 36 and in the last 3 years Ive been in and of doctors having forgotten about my previous testosterone levels, it was not till I had requested copies of all my reports from one oncologist to bring to another doctor, I had read them over, and remembered that I had complained about a low libido at age 26, 10 years earlier, and my test level was 750. I had a doctor take several test levels in the last 3 years and they are typically in the low 500's which is 'normal' yet apparently not 'my normal' range. Apparently this is a big drop even over 10 years. In the last 3 years Ive had even LESS libido and my erections became less and less 'firm' and it seemed I was less energetic, tired, grumpy, easily irritated, depressed.....This went on for the last 3 years till I finally pieced together from old lab reports and recent ones that it may be my test levels. My doctors always told me I had a normal test level based on lab reports but being that I didnt come across my test level from 1996 till recently was not able to figure it out. SO, based on this, my GP agreed to finally try to boost my test levels even though a urologist I went to did not want to. So I got a shot of cypinate in the office and he prescribed me AndroGel which I started this week. He wants to see me in a few weeks to re-test my levels and see how my libido is.

Based on this, has anyone had a similar experience having happened so long after surgery/treatment? I guess my low libido was reported back in 1996, one year after surgery, but it was bearable, I would have to assume my test levels pre-surgery were higher than the 750 which was recorded one year after surgery, but of course I can only theorize as there seems that doctors don't test this pre-surgery?

Also, if this is why Ive been the way I've been for 3 years, how long does it take the AndroGel to begin to take effect? Ive been on it only 2 days. My doctor prescribed a month supply (4 pumps) and I apply the 10mg/day which is 8 pumps. He said hed see how I was after a month, and if there was positive results, hed keep me on that and monitor me, or do that in tandem with shots, essentially whatever works for me if its helping.

Sorry about rambling on but does this sound possible? a drop from test of 750ish at age 26 post-surgery by one year to low 500s at age 36 seems like a big drop, I would think it could cause my 'issues' the last 3 years or more and I hope Ive found the problem.

I feel a little better having found this website, in the fact Im not alone. Thanks for any feedback.

Don

[IowaBrian]

I am 6 months out but your age and feel the same way no way are things the same as before. I requested a T check 2 months ago since the doctors didn't really care I think they feel if you can still get it up and produce sperm then you can wait. I asked my ONC yesterday about low T and he stated that he sees it in the prostate CA cases where is goes to zero, but with that cancer I don't think they are going to give you any T at all so he was no help. I have a visit with the URO mid Dec to see what he thinks now.. I called him after the first T test that was 2.3 and he said to test again and call back in 6 weeks well tested it again last month and it was 1.9 ONC said don't worry. Had test yesterday still waiting for the labs they should be in tomorrow. All I can say is that I slowly turned into a giant A hole and the sex drive was there but not normal sort of like someone is using a dimmer switch and it is just not like it was. They want to treat with drugs to make you happy and numb but at 36 I don't want to take those for 50 years if there is a better cure out there plus the crap that goes along with the drugs can be as bad as what they are trying to help sort of odd if you ask me.
Good Luck
Brian

[Michael112]

750 is a good level although with elevated LH from post surgery it may or may not of boosted E2 levels, you could have 750 T and high E2 and you would have a worse sex drive then 650 T and normal E2(estrogen) for you to of been 750 post surgery, you would of been higher pre surgery but any drop in T level will obviously drop libido even if it is a drop to a reasonable level wich is anything above 650. low 500s is not good I am 550 at the moment and I am not happy, it was because of my low T that I discovered I had testicular cancer as even the tumour itself putting pressure on the leydig cells can lower testosterone.

Get a blood test for T level in the morning along with E2.
Your E2 should be between 10-30 pg/ml. Even if its in range, keep in mind a level of low 500s is the average level of a 70-80 year old man.
Everyone is difrrent if your body runs on 900ng/dl of T and youve gone down to low 500s ur gonna feel it.
I suggest you use the higher dose of androgel as low dose only boosts to 500-550 where as the higher dose boosts to around 700-750, and these levels stay constant throughout the day.

You will start to feel benefits within a week or 2. Unless your E2 is high wich I am suspecting it is, Go out and buy a natural suppliment called DIM(I heard indoplex is good wich is a brand) this lowers E2 naturaly. Take 100-200mg a day With vegetables(brocoli, sprouts or cauliflower) or any natural source of DIM. Also get your DHT checked.

TRT isnt about just testosterone, other factors become involved, if your endo cant understand this, find a new one.

[DRCinNY]

Thanks for the advice. What is E2 exactly? Is that estrogen? I don't have an endo, I had asked my regular doctor when i was at my wits end last week in his office if I should go to one because I had enough of feeling sexually like i was 60+. He understood, said he would do any tests I needed and was willing to work through all of this.

He does have me on the max AndroGel which is 10mg/day, 8 pumps out of the pump bottle. My insurance appears to cover a month supply for a 25$ copay which seems decent. I just have to go back every month to the doctor to get a new Rx because it seems they do not allow refills. My GP seems willing to try other methods if my insurance does not cover it.

Thanks so much for the feedback, it annoyes me ive been going through this for years and not a single doctor was willing to do a damn thing.

[Michael112]

You are lucky you have a doctor who will do any test you want, in that case, I will give you a list of tests wich will thouroughly evaluate your endocrine system and you can show this to your endo but post results here and I will comment.

E2 is Estradiol, the main estrogen, there is E1 and E2 and maybe a 3rd, I have low E1 possibly due to low testosterone, and high E2 possibly due to being overweight. E1 does not really matter if it is high as it is not potent. When E2 is high you get brain fog and panic attacks along with nervousness and agitation, and also erectile dysfunction and low libido.

Request these labs:

Adrenals:
ACTH stim test, DHEA-s, progesterone, serial saliva cortisol tests done 4 times in a 24hour period(the last test will be at midnight if possible)
Thyroid:
TSH, Free T3 Free T4

Others:
Total Testosterone
Bioavailable Testosterone (AKA “Free and Loosely Bound”)
Free Testosterone (if Bioavailable T is unavailable)
SHBG
DHT
Estradiol (specify “ultrasensitive” assay for males)
LH
FSH
Prolactin
CBC
IGF-1
Comprehensive Metabolic Panel (Complete liver and kidney function, including Urea, Calcium, Glucose etc)
Lipid Profile (this is HDL, LDL, Triglycerides, Total Cholestrol)


Have these tests done 2 hours after applying the gel in the morning. Make sure you get your blood taken from the oposite arm you applied the gel, this is incase they take blood from where the gel was applied, if that happens your total T will falsly come back at something like 1500-3000ng/dl.

Also, when applying androgel, apply it to 1 arm(alternating each day) and try use it in as little surface area as possible, this will make it so it does not convert to DHT and E2 as much.

[DRCinNY]

Mike,

thanks for your post, I will show this to my GP, and see what he can do. What do some of these show or prove as Id like to let my GP know. Ive had things recently such as CBS and the liver panels, test levels but not sure exactly which one and HGH levels.

the E2 number id be curious to see, the side effects this would cause are EXACTLY what ive experienced for the last 3 or more years.

Also, i find it hard to alternate the AndroGel as im on 10mg which is 8 full pumps from the dispenser which seems a lot, but they are measured pumps and its hard enough getting it to absorb as it is. any pointers on this? ive tried to rub in 2 pumps at a time to let it absorb and see how that goes.

again thanks for your help, i will make my apt with the GP monday and get the blood work done. i just want to be able to explain what some of the numbers may/may not show.

My only other concern with the test replacement is that i dont want my remaining testicle to stop produciging test, is there a way to avoid this? i think i saw something in another post about taking something to avoid this? any advice?

thanks again
don

[Michael112]

IGF-1 represents your growth hormone level, wich tells the cells in your body to grow, this starts to decline at age 30 and is linked to aging.

Adrenals is your cortisol level wich is the stress hormone, this brings brings oxygen to cells or something, not too sure, but it regulates alot of things in the body, having this at a low level you will have concerntration problems, you will shake under pressure, and feel exhuasted, its common to have this low in todays society.


What happens when your testosterone is out is it messes with other hormones.

if IGF-1 is low you will age quicker, but cancer will also grow more slowly then it would.


Thyroid is a gland in your neck wich is part of the endocrine system.
If thyroid is out it can cause all sorts of side effects like nervousness flushing heart rate problems, blood pressure problems, sleep disturbances. If adrenals are out, you can get headaches, tiredness, moodswings, basicly the effects of all these are very simular. But I am pretty sure your E2 is too high, you might aswell order online some Calcium D-Glucarate and Indoplex DIM now.

[DRCinNY]

mike,

ill get that all checked, ive read that some side effects of AndroGel, and I imagine any T therapy, is that it actually raises E2 levels? If that is true, I assume this level needs to be regulated somehow as well. Perhaps mine was high to begin with and this will raise it more?

ughh, this stuff is like a vicious cycle.

[Michael112]

Testosterone raises blood pressure, hemocrit, dopamine, it lowers prolactin, serotonin in some areas of the brain, it does a lot of things because its a powerfull hormone, by keeping testosterone in range it should keep all the above in range, thats why testosterone is an important hormone and thats why you really dont want to be low.

All those should be in range for you. What most likely wont be is E1 E2 and DHT. High DHT will accelerate male pattern baldness. You counter it with saw palmetto wich inhibits DHT although havent heard of any success with it.


Along with the other effects I mentioned, E2 enlarges the prostate, lowers cortisol, causes fat to store in feminized places such as chest and thighs.
E2 is controlled with DIM and Calcium D-Glucarate. Its not really a viscious cycle, once you get your dosages right its smooth sailing.
People who uses steroids have to deal with these issues so theres a big market for suppliments wich may or may not help, also a lot of people who arnt on TRT have E2 problems, if you ever see a guy with ***** **** or a pear shaped body you can garuntee he has high E2.

Idealy You want Total T in the upper 3rd of the range so 750-1000 ng/dl although anything above 650 is acceptable, but whatever you feel better at should be your goal.
E2 should be between 10-30 pg/ml But you should aim for 20, because its difficult to tune, 25 would be acceptable. Being overweight will increase E2 also.

My only other concern with the test replacement is that i dont want my remaining testicle to stop produciging test, is there a way to avoid this? i think i saw something in another post about taking something to avoid this? any advice?

HCG(not to be confused with HGH) at about 250IU 2-3 days a week will help with that. It also acts on other receptors in the body and helps with general wellbeing, so even for the bilateral guys, its still a good idea to take.

hCG is an LH analogue meaning it acts in the same way as LH in the body. It is derived from the urine of pregnant women. LH is the hormone secreted from the pituitry gland in the brain when E2 and T are both low, it tells the leydig cells in the testes to produce more testosterone, and also acts elsewhere in the body, not sure where though as I am yet to look into its other effects. But anyone who is already on TRT who takes it will tell you it improves there general wellbeing.

[Michael112]

I think everyone on TRT needs to look on a bright side of things, I have noticed a lot of guys having regrets about needing it and consider it a hassle.

A lot of normal guys out there are gonna be on the bottom end of the average level, and even more are going to have high E2 and not even know why they are having panic attacks or erectile dysfunction. With proper TRT you will be at optimum levels and your entitled to be at 1000-1200ng/dl so long as your blood count stays within range, some guys would kill for these levels. A lot of guys take steroids in order to put on muscle, having a level of 1000ng/dl all year round would be safer and more beneficial then illegal steroids themselves. If bodybuilding isnt your thing, then consider the general wellbeing aspect of it. All these guys are running around getting viagra scripts, anti depressents, going on big diets etc, when in a lot of cases it could be a hormonal issue, most doctors dont consider testosterone/E2 levels in male patients who are suffering the symptoms of hormone issues.

So, personally I think until the medical community wake up to testosterone deficiency, guys on TRT should consider themselves very fortunate.

[Scott]

With proper TRT you will be at optimum levels and your entitled to be at 1000-1200ng/dl so long as your blood count stays within range, some guys would kill for these levels.

I don't see why anyone should be encouraged to feel "entitled" to be at the upper end of a broad reference range.

[Michael112]

If he was 750 post surgery, I am pretty sure he would be ok at 1000-1200.
Theoreticly, when something is broken and you fix it, there is this human behaviour to not only fix it but make it better.

Medications tend to raise things higher then what they NORMALLY were(meaning before the problem arose). SSRIs raise serotonin above normal levels, Adderal raises dopamine higher then normal levels. The point being they dont bring them up to normal levels.
This is why people on anti-depressents have a pleasant chemical labotomy, and people with ADD usually top there class. Why shouldnt someone doing TRT be at the top of the range? being on TRT you are now on medication you might aswell be bought above average levels, you are putting in the effort every day or week for this, while other people get it done for them automaticly, shouldnt that medical bill, 5 mins every day/week, trips to the pharmacy, pay off in some way?
1200 and even 1500 is fine as long as other blood results stay within range.

Its is well known that higher testosterone levels in males are biologically/genetically superior to lower levels, just like a six pack is physiologicly supior to a beer gut. if a doctor was to take the testosterone level of a guy and see them at the high end of the range, the doctor would tell the person there lucky and have good genetics. Testosterone boosts both physical and mental ability.
How Lance Armstrong could even compete let alone win is beyond me, but what I am stating above are facts.

http://www.diagnose-me.com/cond/C569738.html

Higher levels of testosterone can have significant health benefits for some men, such as being less vulnerable to high blood pressure, heart attacks, frequent colds and obesity. These men are also more likely to rate their health as "good to excellent" rather than "fair to poor". (Studies show self ratings of health correlate highly with physicians' assessments.) On the downside, some - but not all - men with higher levels of testosterone are more likely to engage in behavior that cancels out the beneficial effects of testosterone.

Those with higher levels of testosterone are more inclined to smoke, drink alcohol excessively and indulge in risky behavior that leads to injury. The biggest detriment to health by far is the tendency for high testosterone men to smoke.

In a study published 1997, researchers studied testosterone and health in a sample of 4,393 men between the ages of 32 and 44 who had served in the military between 1965 and 1971. The men were interviewed and medically examined. Testosterone was measured in plasma from blood drawn at 8AM. Concentrations ranged from 53 to 1,500 ng/dl with an average of 679. Comparison of men with slightly average levels of testosterone (400 ng/dl) with men with slightly above average levels (800 ng/dl) revealed significant differences in health indicators.

Men at the higher level were 45% less likely to have high blood pressure, 72% less likely to have experienced a heart attack, 8% less likely to have 3 or more colds in a year, and 45% less likely to rate their health as fair or poor.

On the other hand, men at higher levels were 25% more likely to report one or more injuries, 32% more likely to imbibe 5 or more drinks in a single day and 151% more likely to smoke.

It is not yet fully understood how testosterone benefits health or leads to behavior detrimental to health. It is clear, however, that men with higher testosterone levels are at higher risk for negative health outcomes. But there are many men with higher testosterone who don't engage in health risk behavior and who do realize testosterone-related health benefits.

[Scott]

We clearly aren't going to agree on this.

Funny that you should bring up Lance Armstrong's performance on the same day that this report came to my attention through the TC-NET mailing list. Its abstract includes this commentary.

We propose that his dramatic improvement in recovery between stages, the most important factor in winning multi-day stage races, is due to his unilateral orchiectomy, a procedure that results in permanent changes in serum hormones. Likewise, his loss of body weight during the racing season (4-6 kg), which increases his power to weight ratio, also may be facilitated by these hormonal changes. These hormonal changes, specifically an increase in gonadotropins required to maintain serum testosterone, alter fuel metabolism; increasing hormone sensitive lipase expression and activity, promoting increased free fatty acid (FFA) mobilization to and utilization by muscles, thereby decreasing the requirement to expend limiting glycogen stores. Such changes also are associated with improvements in muscle repair and haematocrit levels. Taken together, these hormonal changes act to delay fatigue and enhance recovery. These insights provide the foundation for future studies on the endocrinology of exercise metabolism.

[DRCinNY]

mike,

thanks for your help....I just orderd the DIM which made sense when i researched it. I will have my doctor test my E2 this week if i can get an apt. I will be on the 10mg/day of AndroGel for one week as of wednesday. i do already feel a slight boost, erections beginning for no reason, so hopefully this will continue and get even better.

What does Calcium D-Glucarate do???

[Michael112]

I am not too clear on how CDG(calcium d-glucarate) works, but it works via natural enzymes, it causes estrogen in the blood to excreted before they can bind to estrogen receptors. In rats it lowered E2 by upto 23%.

If you want something you can take now or tommorow, go out and get zinc, take about 30mg, it should say like zinc 250mg (equiv to 25mg elemental zinc) or zinc sulfate 25mg (zinc 6mg) Its the amount in brackets that count, take from 20-50mg a day with b6 containing food(meat). This should lower estrogen. I started zinc yesterday and feel better.