Low T - Seeing urologist today

Low testosterone issues, impacts on health & marriage, treatments, etc.
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VTS19823
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Low T - Seeing urologist today

Postby VTS19823 » Fri Nov 20, 2015 12:16 am

So I'm seeing my urologist today to let him know I've now decided that it's time to give TRT a go. I've had symptoms of low T for a long time, tiredness, struggling to focus, low sex drive, etc, and went to him last year. He wasn't too keen on TRT at the time and after we did blood (free test is 180...) he suggested I use clomid for some time. The clomid didn't do much for me and I just left it there, but now I've decided it's time to take the plunge, not purely for sexual reasons but also I'm struggling to cope with the tiredness at work and the lack of ability to focus. Would love a boost in sex drive as well though, although ED is not a problem for me.

Anyway... any advice on how to approach my dr on this matter? As mentioned he wasn't too keen on the idea of TRT last time, saying that although 180 is low it is within the 170 to 700 scope. I'm hoping that I don't have to go in there and try and convince him today.

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Re: Low T - Seeing urologist today

Postby txtwindad » Fri Nov 20, 2015 5:22 am

180 mins ridiculously low. It is only low average if you don't use age corrected norms. Frankly if he didn't see the need at 180, you are wasting your time. You just need another doctor.
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Re: Low T - Seeing urologist today

Postby SquarePants » Fri Nov 20, 2015 5:28 am

VTS19823 wrote: after we did blood (free test is 180...)

Are you certain that this was Free Testosterone? What was your Total Testosterone level? 180 would be extremely low for Total Testosterone. It wouldn't be as bad if it were Free Testosterone, though, I don't remember right now what health Free levels should be.

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Re: Low T - Seeing urologist today

Postby txtwindad » Fri Nov 20, 2015 5:53 am

Yes, you're right SP, I missed that.
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Re: Low T - Seeing urologist today

Postby VTS19823 » Fri Nov 20, 2015 6:11 am

Sorry, total test was tested at 9.3 nmol/l, free test at 181 pmol/l tested last year at 32 years old. Going to do blood again next week. He says it's in a grey area, not that low. Doesn't really want to do trt but would consider it.

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Re: Low T - Seeing urologist today

Postby SquarePants » Fri Nov 20, 2015 6:45 am

According to the unit calculator at http://www.menshormonalhealth.com/normal-testosterone-levels.html

9.3 nmol/L = 268 ng/dl Total Testosterone
6.35 nmol/L = 183 ng/dl Free Testosterone

That isn't even close for Total Testosterone . You are probably near the lowest 1% percentile for your age.
Free testosterone is low too, maybe closer to the lowest 5% for your age.

I don't have time for the calculations, so I'm just estimating, but they are both very low for your age. Doctors who are not very knowledgeable in testosterone therapy tend to look at the standard reference levels, which do not consider age. Your levels may be more typical to someone MUCH loder.

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Re: Low T - Seeing urologist today

Postby txtwindad » Fri Nov 20, 2015 8:01 am

Yeah, 268 is very low. I was 229 when I started and I remember when I looked that up, it was low normal for someone in the late 70s. I was 49 at the time.
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Re: Low T - Seeing urologist today

Postby Nvr2Late » Sat Nov 21, 2015 3:20 pm

And herein lies one of my biggest aggravations with modern medicine. Treating LABS and not the human being. What about all those symptoms? Did he acknowledge them at all? Your quality of life is suffering, and the doctor is more concerned with numbers on a page. Yikes.
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Re: Low T - Seeing urologist today

Postby VTS19823 » Mon Nov 23, 2015 12:28 am

txtwindad wrote:Yeah, 268 is very low. I was 229 when I started and I remember when I looked that up, it was low normal for someone in the late 70s. I was 49 at the time.

The idea that I'm getting is that as long as you're not completely flat lined (metaphorically speaking - in reference to their "scientifically" established perimiters) then you're ok, even if you're literally 10 points above the "flatline" and 600odd points from being at the top end of their established spectrum. It makes no sense. It's as if optimal functioning and quality of life isn't a priority to them. Their priority is just keeping you allive...

Anyway, enough of a rant. Doing the blood tomorrow. Seeing him again on 4 December. Found an online reference to a T clinic here in RSA, thinking of making an appointment there rather but I also do want to keep it medically safe and controlled, and my medical aid (insurance) will probably also not cover the T clinic costs. The urologist has said that we could consider trt if the results from the blood tests are similar or worse than the previous ones. He has hinted at a 1 year on 6 months off cycle. He mentioned that this way your natural production wont shut down completely, but has admitted that for the 6 months that you're off you'll have all of the symptoms of low test again. I guess my relatively young age (33) and the fact that DW possibly wants another baby could play a role in this protocol being suggested. The symptoms are also not unbearable (so if I have to live with them for 6 months after each year I guess it wouldn't be the end of the world), although highly undesirable - constant tiredness (even when we go to bed very early), serious lack of focus at work, periodic / on-off depressive moods / states, etc, etc. I also have periods, 1 or 2 weeks where I desire my wife every day and would want to make love to her daily, and then go into a week or 2 slump where my drive just isn't the same. These symptoms were what promted me to look for help, I dont exactly want to live with them again for 6 months after every 12 month cycle.

Anyway, I think I'll go for the blood tests and see what the results are, then make a serious decision as to where to from there.

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Re: Low T - Seeing urologist today

Postby txtwindad » Mon Nov 23, 2015 6:35 am

That sounds crazy. Pairing T therapy with hcg will allow your body to produce what it can.
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Can't you see you've got me burnin' hotter
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Re: Low T - Seeing urologist today

Postby SquarePants » Mon Nov 23, 2015 7:33 am

The first month or so of your six months off will be significantly WORSE than what you are experiencing now. After being on testosterone treatment for six months (without HCG), your body’s production of testosterone will plummet, and within 1 or 2 weeks of stopping, your levels will be lower than they are now. They will eventually return to your current levels, but you will be extra miserable until they do.

HCG treatment is standard practice these days among doctors who are knowledgeable about hormone replacement therapy. A small dose of HCF will prevent the testicles from atrophying, and will boost your body’s production of testosterone. There is no need to cease testosterone treatment at all. I’ve been doing it continuously for years.

I’d suggest giving the T clinic a call and ask about prices. Ask them what the total cost for the first year of treatment should be, and then ask them the cost for subsequent years. There will likely be an extensive initial lab workup, which may be expensive. (You may be able to save some money if you have your records for recent labs that your urologist may have ordered.) There will then be periodic labs every few months or so which will be cheaper. These cheaper labs will only check a fewer things, such as testosterone, estrogen, and blood counts. There are also consultation/doctor costs. Again, the initial consultation may be the most expensive, and the follow up visits will be cheaper. Then ask about prices for the medications: testosterone and HCG. You may need Arimidex to control estrogen levels, but it’s cheap. They should be able to give a cost estimate of typical treatment plan. If they don’t have numbers readily available, as them for costs for the initial visit and labs, costs and frequency for follow up visits, and typical costs for medications.

Ask the clinic whether they give our prescriptions for medication, or whether you have to buy medications from them. If they prescribe injections, do they require you to get them at their clinic, or can you do them yourself at home. It’s MUCH cheaper and more convenient if you can do them yourself. Do they allow subcutaneous injections? Some clinics have cheap consultation prices, but require you to get your medications at inflated prices from them. Injectable testosterone should only be $30-$50/month if you do the injections yourself.

I highly recommend Dr. John Crisler’s book “Testosterone Replacement Therapy: A Recipe for Success.”

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Re: Low T - Seeing urologist today

Postby VTS19823 » Thu Nov 26, 2015 8:43 pm

Thanks SQ. I went to see the Dr at the T Clinic. Got my results back from the lab as well. Results are slightly better than last year with total test at 13.1 nmol/l and free test 258.9 pmol/l.

Dr says it's still much lower than where he wants it. He however suspects that the aromatization of androgen in estrogen is a bigger problem with me taking my particular symptoms into account. We are doing additional blood tests today and I'm seeing him again on Tuesday. Must say he asks a lot more relevant questions than the urologist and also speaks about optimal functioning insead of just being within an identified parimiter.

He indicated that we would be doing 1 shot of Depo Test per week with Masteron to block the aromatization and something called ITP141. Also some vitamins and other supplements, will get the details from him next Tuesday.

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