Low Testosterone Levels & Concerned

JD-Max

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Feb 23, 2014
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9
Hey, this is my first post but have been lurking for a little, decided to reach out for some help & suggestions.

I just had a comprehensive blood test done and I requested testosterone testing to be done as well. Testing was done by Quest and it says:
Test, Free & total, LC/MS/MS: 252 ng/dl (Their normal ranges are: 250-1100)
Free Test: 62.5pg/ml (their normal ranges are: 35.0-155.0)
Globulin: 2.5g/dl (calc)
Albumin: 4.9g/dl
Albumin/Globulin Ratio 2.0 (calc)

My MD said I'm fine in the low normal range because my free test balances things out. I decided to check this out more and I'm gathering that I should be closer to 600 and up for my age. I'm 37, 6'1 & 186 lbs (kinda skinny fat).

Also, I've been taking 1,000 mg of Inositol for the last 6 months (helps with my anxiety) and have read that this supp could dramatically lower test in women, couldn't find any info for men though. Needless to say I just stopped taking that! I'd also like to mention I do have elevated cholesterol & triglycerides other than that everything looks good according to Quests values.

I don't feel like I'm suffering many of the typical low T symptoms. Except, I have some excess abdomen fat, I'm easily irritated, maybe less social, slight fatigue, but I chalked this all up to my anxiety. I recently & quickly impregnated my wife and have no problems in the bedroom...


I'm concerned about this, recommendations on who I should see? Assuming either Endocrinologist or a Urologist? Or is everything OK?
 

Ben

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Joined
Dec 13, 2013
Messages
497
Haha, I'm much younger than you and have about the same testosterone level as you do. Here's the thread I created about it:

viewtopic.php?f=56&t=3049

I have decided not to go for testosterone replacement therapy. When you increase testosterone, estrogen also increases because estrogen is created from testosterone. Then estrogen reduces progesterone. I have a big problem with a poor progesterone-estrogen ratio and testosterone would only worsen it. One of my superficial indicators is blood pooling into limbs (bulging veins) and orthostatic hypotension. It has also resulted in rosacea and thyroid autoimmunity, both more common in women due to estrogen. Some more indicators are acne, dandruff, manboobs, and abdominal fat (like you) despite normal build. Testosterone would worsen acne and it's known for causing gynecomastia.

I plan on correcting the progesterone-estrogen ratio. I started taking progest-E, and I'll take vitamin E for estrogen once I buy it. I doubt the importance of testosterone anyway. Who needs muscle, masculinity, or aggression these days? Instead of these traits which are often disruptive to society, I think the body's energy would be better reserved for more important things.
 
Joined
Apr 21, 2013
Messages
176
JD-Max said:
Hey, this is my first post but have been lurking for a little, decided to reach out for some help & suggestions.

I just had a comprehensive blood test done and I requested testosterone testing to be done as well. Testing was done by Quest and it says:
Test, Free & total, LC/MS/MS: 252 ng/dl (Their normal ranges are: 250-1100)
Free Test: 62.5pg/ml (their normal ranges are: 35.0-155.0)
Globulin: 2.5g/dl (calc)
Albumin: 4.9g/dl
Albumin/Globulin Ratio 2.0 (calc)

My MD said I'm fine in the low normal range because my free test balances things out. I decided to check this out more and I'm gathering that I should be closer to 600 and up for my age. I'm 37, 6'1 & 186 lbs (kinda skinny fat).

Also, I've been taking 1,000 mg of Inositol for the last 6 months (helps with my anxiety) and have read that this supp could dramatically lower test in women, couldn't find any info for men though. Needless to say I just stopped taking that! I'd also like to mention I do have elevated cholesterol & triglycerides other than that everything looks good according to Quests values.

I don't feel like I'm suffering many of the typical low T symptoms. Except, I have some excess abdomen fat, I'm easily irritated, maybe less social, slight fatigue, but I chalked this all up to my anxiety. I recently & quickly impregnated my wife and have no problems in the bedroom...


I'm concerned about this, recommendations on who I should see? Assuming either Endocrinologist or a Urologist? Or is everything OK?

In order to make a proper assessment I would urge you to get a more complete thyroid and testosterone (and estrogen) panel. Also consider measuring your blood glucose. Make sure your blood work is done in the morning since testosterone levels decline appreciably by the evening. For details, please see my comments here: viewtopic.php?f=56&t=3202 .
 
Joined
Apr 21, 2013
Messages
176
Ben said:
Haha, I'm much younger than you and have about the same testosterone level as you do. Here's the thread I created about it:

viewtopic.php?f=56&t=3049

I have decided not to go for testosterone replacement therapy. When you increase testosterone, estrogen also increases because estrogen is created from testosterone. Then estrogen reduces progesterone. I have a big problem with a poor progesterone-estrogen ratio and testosterone would only worsen it. One of my superficial indicators is blood pooling into limbs (bulging veins) and orthostatic hypotension. It has also resulted in rosacea and thyroid autoimmunity, both more common in women due to estrogen. Some more indicators are acne, dandruff, manboobs, and abdominal fat (like you) despite normal build. Testosterone would worsen acne and it's known for causing gynecomastia.

I plan on correcting the progesterone-estrogen ratio. I started taking progest-E, and I'll take vitamin E for estrogen once I buy it. I doubt the importance of testosterone anyway. Who needs muscle, masculinity, or aggression these days? Instead of these traits which are often disruptive to society, I think the body's energy would be better reserved for more important things.

While high estrogen often accompanies low testosterone (since estrogen is itself suppressive to the HPTA), high testosterone does not necessarily lead to high estrogen on account of merely an increased amount of substrate for aromatization. If the metabolic rate is good (low inflammation, adequate thyroid & progesterone levels, efficient gut), aromatization of testosterone to estrogen is limited. Indeed, that is the situation in the young and otherwise healthy.

Testosterone is not something you want to be low in. Besides aiding muscle growth that itself supports a healthy metabolism, it is a precursor to DHT that has important CNS activity and is a very potent antagonist of estrogen in itself. Low testosterone levels are associated with hypothyroidism.

Having said that, since many here have experimented with thyroid or pro-thyroid food or substances, they find that the initial increase in testosterone is too abrupt and not properly compensated by the hormones countervailing estrogen leading to a persistent estrogen-dominant state.
 

Ben

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Joined
Dec 13, 2013
Messages
497
unexamined_whimsy said:
Ben said:
Haha, I'm much younger than you and have about the same testosterone level as you do. Here's the thread I created about it:

viewtopic.php?f=56&t=3049

I have decided not to go for testosterone replacement therapy. When you increase testosterone, estrogen also increases because estrogen is created from testosterone. Then estrogen reduces progesterone. I have a big problem with a poor progesterone-estrogen ratio and testosterone would only worsen it. One of my superficial indicators is blood pooling into limbs (bulging veins) and orthostatic hypotension. It has also resulted in rosacea and thyroid autoimmunity, both more common in women due to estrogen. Some more indicators are acne, dandruff, manboobs, and abdominal fat (like you) despite normal build. Testosterone would worsen acne and it's known for causing gynecomastia.

I plan on correcting the progesterone-estrogen ratio. I started taking progest-E, and I'll take vitamin E for estrogen once I buy it. I doubt the importance of testosterone anyway. Who needs muscle, masculinity, or aggression these days? Instead of these traits which are often disruptive to society, I think the body's energy would be better reserved for more important things.

While high estrogen often accompanies low testosterone (since estrogen is itself suppressive to the HPTA), high testosterone does not necessarily lead to high estrogen on account of merely an increased amount of substrate for aromatization. If the metabolic rate is good (low inflammation, adequate thyroid & progesterone levels, efficient gut), aromatization of testosterone to estrogen is limited. Indeed, that is the situation in the young and otherwise healthy.

Testosterone is not something you want to be low in. Besides aiding muscle growth that itself supports a healthy metabolism, it is a precursor to DHT that has important CNS activity and is a very potent antagonist of estrogen in itself. Low testosterone levels are associated with hypothyroidism.

Having said that, since many here have experimented with thyroid or pro-thyroid food or substances, they find that the initial increase in testosterone is too abrupt and not properly compensated by the hormones countervailing estrogen leading to a persistent estrogen-dominant state.
So testosterone replacement therapy wouldn't be a good idea if a person has a problem with excessive aromatization of it, like in my case. Is your opinion that if the metabolism is healthy, introducing exogeneous testosterone would increase health and boost lifespan, but otherwise not because of aromatization? Men have high testosterone, but they live shorter than women.
 
Joined
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Messages
176
I agree in that testosterone is a double-edged sword; too much goes easily to testosterone and by middle age most men have greater amounts of estrogen than their female counterparts.

It really depends on the reason for low testosterone in the first place. If you're young and relatively normally developed (your testicles are OK) it's probably hypothyroidism that is keeping your testosterone low. Other, rarer causes are hyperprolactimia typically due to a microadenoma, or hypopituitarism - when the oituitary doesn't signal the testes with LH.

I think one should aim for a balance with testosterone. A level of about 500 being the loose minimum where the reference range is (250 -- 1150). If your testosterone is responsive to thyroid, one way to check excessive aromatization is by using progesterone or DHT.

TRT is a very dodgy business since very few males are content with their treatment, primarily, because of difficulty controlling the aromatization of T to E2. Find a doctor who is ready to prescribe you TRT and you're likely to find a glorified quack. I think Peat said this somewhere that its usually people using 3-4 times as much testosterone as they need is the problem. What is called for is a sane, physiological dose such that your E2 stays within range.
 

JD-Max

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unexamined_whimsy said:
In order to make a proper assessment I would urge you to get a more complete thyroid and testosterone (and estrogen) panel. Also consider measuring your blood glucose. Make sure your blood work is done in the morning since testosterone levels decline appreciably by the evening. For details, please see my comments here: viewtopic.php?f=56&t=3202 .

Thank you unexamined_whimsy for your advice. I'd like to handle this in the most efficient way possible, so not to order one blood test then seeing another doctor who recommends I get another type of test and my insurance not covering all of them. With that being said, do you think I should see a specialist and if so which kind? Then I could request that in addition to whatever tests he wants done I add the ones you mention? FWIW, I did have my last test done in the AM...


Ben said:
Haha, I'm much younger than you and have about the same testosterone level as you do. Here's the thread I created about it:

viewtopic.php?f=56&t=3049

I have decided not to go for testosterone replacement therapy. When you increase testosterone, estrogen also increases because estrogen is created from testosterone. Then estrogen reduces progesterone. I have a big problem with a poor progesterone-estrogen ratio and testosterone would only worsen it. One of my superficial indicators is blood pooling into limbs (bulging veins) and orthostatic hypotension. It has also resulted in rosacea and thyroid autoimmunity, both more common in women due to estrogen. Some more indicators are acne, dandruff, manboobs, and abdominal fat (like you) despite normal build. Testosterone would worsen acne and it's known for causing gynecomastia.

I plan on correcting the progesterone-estrogen ratio. I started taking progest-E, and I'll take vitamin E for estrogen once I buy it. I doubt the importance of testosterone anyway. Who needs muscle, masculinity, or aggression these days? Instead of these traits which are often disruptive to society, I think the body's energy would be better reserved for more important things.

Interesting post. This is all new to me and quite confusing! I too have sporadic bouts of acne (cystic) that comes and goes for no apparent reason, another thing I chalked up to stress and anxiety. I'm not sure if all this is related or not. Regarding the importance of testosterone, it appears important. From some of the research I've done, low T is linked to prostate cancer, bone loss/osteoporosis, fatigue, increase in body fat while reducing muscle mass. All that can't be healthy long term!
 
Joined
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Messages
176
JD-Max said:
unexamined_whimsy said:
In order to make a proper assessment I would urge you to get a more complete thyroid and testosterone (and estrogen) panel. Also consider measuring your blood glucose. Make sure your blood work is done in the morning since testosterone levels decline appreciably by the evening. For details, please see my comments here: viewtopic.php?f=56&t=3202 .

Thank you unexamined_whimsy for your advice. I'd like to handle this in the most efficient way possible, so not to order one blood test then seeing another doctor who recommends I get another type of test and my insurance not covering all of them. With that being said, do you think I should see a specialist and if so which kind? Then I could request that in addition to whatever tests he wants done I add the ones you mention? FWIW, I did have my last test done in the AM...


Ben said:
Haha, I'm much younger than you and have about the same testosterone level as you do. Here's the thread I created about it:

viewtopic.php?f=56&t=3049

I have decided not to go for testosterone replacement therapy. When you increase testosterone, estrogen also increases because estrogen is created from testosterone. Then estrogen reduces progesterone. I have a big problem with a poor progesterone-estrogen ratio and testosterone would only worsen it. One of my superficial indicators is blood pooling into limbs (bulging veins) and orthostatic hypotension. It has also resulted in rosacea and thyroid autoimmunity, both more common in women due to estrogen. Some more indicators are acne, dandruff, manboobs, and abdominal fat (like you) despite normal build. Testosterone would worsen acne and it's known for causing gynecomastia.

I plan on correcting the progesterone-estrogen ratio. I started taking progest-E, and I'll take vitamin E for estrogen once I buy it. I doubt the importance of testosterone anyway. Who needs muscle, masculinity, or aggression these days? Instead of these traits which are often disruptive to society, I think the body's energy would be better reserved for more important things.

Interesting post. This is all new to me and quite confusing! I too have sporadic bouts of acne (cystic) that comes and goes for no apparent reason, another thing I chalked up to stress and anxiety. I'm not sure if all this is related or not. Regarding the importance of testosterone, it appears important. From some of the research I've done, low T is linked to prostate cancer, bone loss/osteoporosis, fatigue, increase in body fat while reducing muscle mass. All that can't be healthy long term!

The tests I mentioned are usually prescribed by an Endocrinologist. Often they can be very stingy with the tests they prescribe so try and do some reconnaissance and find someone who's relatively generous.
 

Lin

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My son had low testosterone. He tried TRT, and said it made him feel more like himself, but he wanted to find a way to raise his levels naturally. So he started doing yoga, and backed off a little with his workouts at the gym. He now has normal testosterone levels without drugs, but more % body fat (I think he looks good though, certainly not fat). He was really ripped looking before!

I think excess cortisol depletes testisterone, doesn't it? Anyway, that's what I think may be the cause.
 

Blossom

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My husband didn't do well on androgel. He started having difficulty walking and noticed when he ran out that his walking returned to normal. It's interesting that I had a similar issue when on estrogen. This was all years before I knew about Peat. Haidut one of the forum members here has posted on how he raised his testosterone by various supplements that antagonize estrogen. Sorry I don't have a link but you could do a search or pm him.
 

JD-Max

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Lin said:
My son had low testosterone. He tried TRT, and said it made him feel more like himself, but he wanted to find a way to raise his levels naturally. So he started doing yoga, and backed off a little with his workouts at the gym. He now has normal testosterone levels without drugs, but more % body fat (I think he looks good though, certainly not fat). He was really ripped looking before!

I think excess cortisol depletes testisterone, doesn't it? Anyway, that's what I think may be the cause.

That's great to hear, I'm one that would prefer to also do it naturally & safely if possible. I also wonder how much stress/anxiety can lower testosterone. I quit smoking & stopped taking Lexapro over 1.5 years ago and since then my stress and anxiety has been much higher. I would imagine my cortisol levels are elevated which could potentially prove your theory.
 

JD-Max

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When searching for an Endocrinologist, any recomendations on what their specialty/Endocrine Focus should be for my concern?
 
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Anti-aging docs that preface themselves as 'interventional' endocrinologists are usually game on doing a good workup of your labs, but they are usually private-only and costly. Most regular endos will tell you that you are just fine; that its all part of healthy aging. I guess you have to ferret out the ones that aren't quite so blase.
 

Ben

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What I find odd is that I have a decent amount of muscle mass despite such a low testosterone level, and high cortisol which causes muscle atrophy. Maybe what RP said about the muscles of children swelling because of estrogen can apply to me as well.

JD-Max said:
unexamined_whimsy said:
In order to make a proper assessment I would urge you to get a more complete thyroid and testosterone (and estrogen) panel. Also consider measuring your blood glucose. Make sure your blood work is done in the morning since testosterone levels decline appreciably by the evening. For details, please see my comments here: viewtopic.php?f=56&t=3202 .

Thank you unexamined_whimsy for your advice. I'd like to handle this in the most efficient way possible, so not to order one blood test then seeing another doctor who recommends I get another type of test and my insurance not covering all of them. With that being said, do you think I should see a specialist and if so which kind? Then I could request that in addition to whatever tests he wants done I add the ones you mention? FWIW, I did have my last test done in the AM...


Ben said:
Haha, I'm much younger than you and have about the same testosterone level as you do. Here's the thread I created about it:

viewtopic.php?f=56&t=3049

I have decided not to go for testosterone replacement therapy. When you increase testosterone, estrogen also increases because estrogen is created from testosterone. Then estrogen reduces progesterone. I have a big problem with a poor progesterone-estrogen ratio and testosterone would only worsen it. One of my superficial indicators is blood pooling into limbs (bulging veins) and orthostatic hypotension. It has also resulted in rosacea and thyroid autoimmunity, both more common in women due to estrogen. Some more indicators are acne, dandruff, manboobs, and abdominal fat (like you) despite normal build. Testosterone would worsen acne and it's known for causing gynecomastia.

I plan on correcting the progesterone-estrogen ratio. I started taking progest-E, and I'll take vitamin E for estrogen once I buy it. I doubt the importance of testosterone anyway. Who needs muscle, masculinity, or aggression these days? Instead of these traits which are often disruptive to society, I think the body's energy would be better reserved for more important things.

Interesting post. This is all new to me and quite confusing! I too have sporadic bouts of acne (cystic) that comes and goes for no apparent reason, another thing I chalked up to stress and anxiety. I'm not sure if all this is related or not. Regarding the importance of testosterone, it appears important. From some of the research I've done, low T is linked to prostate cancer, bone loss/osteoporosis, fatigue, increase in body fat while reducing muscle mass. All that can't be healthy long term!
Yes, stress is correlated with acne and dandruff. I think the stress hormone cortisol allows fungus to feed on the scalp because it's immunosuppressive. Acne also consists of local infections, and stress makes it worse.

High estrogen is linked to prostate cancer, hence why black people have a higher rate (but they also have higher DHT, a strong estrogen antagonist, and it counterbalances some of its effects). They have higher estrogen. Estrogen causes bone loss (read RP's articles about estrogen and bone loss). It can cause fatigue by a variety of mechanisms. It increases bodyfat (the reason why feminine women are more likely to be "curvy"). Estrogen increases activity of the stress hormone system, which is associated with muscle atrophy. All of these effects can be opposed by progesterone and other estrogen antagonists.
 
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Many body builders have lowish testosterone ~300 and still pack a good deal of muscle. Estrogen definitely helps with muscle hypertrophy. Also, certain hypothyroid people find it very easy to gain muscle, probably because of a very low SHBG and therefore high Bio-T.
 

JD-Max

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unexamined_whimsy said:
Anti-aging docs that preface themselves as 'interventional' endocrinologists are usually game on doing a good workup of your labs, but they are usually private-only and costly. Most regular endos will tell you that you are just fine; that its all part of healthy aging. I guess you have to ferret out the ones that aren't quite so blase.

All the Endocrinologists that I find nearby seem to specialize in Adult Endocrinology, Diabetes & Pitiuitary disorders. Do you think that would work for starters? Also, you mention that most regular endos will say that I am just fine...could that be the case? That I just am someone that has lower than average T levels and may have most of my life without knowing. Or beings my total levels were at 252 I should definitely proceed with further testing? My wife is starting to make me double guess because she thinks I'm fine :?

unexamined_whimsy said:
Many body builders have lowish testosterone ~300 and still pack a good deal of muscle. Estrogen definitely helps with muscle hypertrophy. Also, certain hypothyroid people find it very easy to gain muscle, probably because of a very low SHBG and therefore high Bio-T.

This is very intersting, I would never guess bodybuilders with solid mass could ever have low T!
 
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JD-Max said:
unexamined_whimsy said:
Anti-aging docs that preface themselves as 'interventional' endocrinologists are usually game on doing a good workup of your labs, but they are usually private-only and costly. Most regular endos will tell you that you are just fine; that its all part of healthy aging. I guess you have to ferret out the ones that aren't quite so blase.

All the Endocrinologists that I find nearby seem to specialize in Adult Endocrinology, Diabetes & Pitiuitary disorders. Do you think that would work for starters? Also, you mention that most regular endos will say that I am just fine...could that be the case? That I just am someone that has lower than average T levels and may have most of my life without knowing. Or beings my total levels were at 252 I should definitely proceed with further testing? My wife is starting to make me double guess because she thinks I'm fine :?

unexamined_whimsy said:
Many body builders have lowish testosterone ~300 and still pack a good deal of muscle. Estrogen definitely helps with muscle hypertrophy. Also, certain hypothyroid people find it very easy to gain muscle, probably because of a very low SHBG and therefore high Bio-T.

This is very intersting, I would never guess bodybuilders with solid mass could ever have low T!

Those endos would be OK. Yes, I do think most of them will do a limited set of tests and find you falling 'within range', give you some encouragement and have you on your way.

Lowish T levels when you're otherwise fine respond well to stress reduction and measures to reduce estrogen. Perhaps you could try a month or two of extra zinc and see where you stand.
 

Ben

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unexamined_whimsy said:
Many body builders have lowish testosterone ~300 and still pack a good deal of muscle. Estrogen definitely helps with muscle hypertrophy. Also, certain hypothyroid people find it very easy to gain muscle, probably because of a very low SHBG and therefore high Bio-T.
Where did you hear about bodybuilders sometimes having low testosterone? Would be good material to post on bodybuilding message boards. "Estrogen will make you more muscular, RAAAH!" lol

Estrogen helps with muscle growth by increasing growth hormone, right? Or is the effect due to making them swell and look bigger? I know that DHT makes muscles look "dry" and makes them feel harder, I think it accomplishes this by antagonizing estrogen.
 
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Haha yeah. Actually a google search "estrogen hypertrophy bodybuilding" should keep you engaged.

I have personally seen the labs of several of my bodybuilding and powerlifting friends complaining of low libido. Their T levels are often surprisingly low, with moderately high estrogen but with good free-T numbers and low SHBG.

I don't think I understand the mechanism of why estrogen aids hypertrophy but my guess would be that the induced swelling causes microruptures in the muscle tissue that once repaired result in a larger muscle. Regarding DHT, it would be an oversimplification to reduce its effects as purely an antagonism of estrogen. Incidentally, DHT also strongly inhibits prolactin. While it is true that the conventional thinking is that DHT is not anabolic, recent studies in mice have shown that mesterolone (Proviron) or 1-methyl DHT is clearly anabolic. In any case, experience shows that DHT and its derivatives are definitely anabolic.
 

Blossom

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RP wrote in his March 2000 newsletter that the " polyunsaturated fats promote estrogen retention in the cell". You might be better off focusing on lowering estrogen especially since your wife has no complaints. Haidut posted on how he achieved higher testosterone through lowering estrogen.
 
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