Low *free* T and symptoms

Low testosterone issues, impacts on health & marriage, treatments, etc.
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reillyj
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Low *free* T and symptoms

Postby reillyj » Sat Oct 07, 2017 1:19 pm

My 69 y/o H has had symptoms for literally years but we've been w/o health insurance and only recently remembered to ask docs to test his levels.

(i give him 50 mg DHEA and 9 mg boron which may have raised the levels a bit) but here are his results:

T: 304 normal range : 250-1100. Obviously he's very low
FREE T: 23 normal range: 35-155 so it's not even on the charts...

Wondering if low free T is responsible for more of the symptoms if that makes sense??

His symptoms:
Aches and pains that are unexplainable (some of them)
Brain fog
Fatigue
Low libido (that started 15 yrs ago and there were yrs we didn't have sex more than 4x a year :( )
Soft erections
More belly fat, etc. etc....

His Urologist referred us to an Endo but in the meantime rx'd Androgel as they don't do shots in their office, insurance balked at covering Androgel of course but we have an appeal in and they'll most likely cover (I HOPE), he's going to do this for a couple weeks or so until we get into the Endo and i am guessing he will rx shots? Don't know until we get there but i am really PRAYING HARD that this starts changing his life for the better. I do understand it's going to be a learning curve but i'm his advocate and will do everything i can but i'm wondering about the very low free T and others experiences (i know it means the available circulating testosterone.)

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Re: Low *free* T and symptoms

Postby ledgemoor » Sat Oct 07, 2017 5:32 pm

Hi--

Not sure about the aches and pains, but low testosterone will definitely affect everything else you mention.

Don't get too hung up over total vs free. Free is difficult to measure, and readings from one lab cannot be compared with those of another. For comparison with other men and for tracking purposes, just look at total. They're not sure what the bound testosterone does, but it's probably a storehouse for what eventually becomes free.

Don't take any solace in his total testosterone being in the low "normal" range. That is low low low too. I don't know where the labs get their "normal" range. If he were at 600, then we would be having a discussion along the lines of "he might be a little low". I can't function in bed hardly at all if I am at 600. His proper level will ultimately have to be determined by experimentation. It is an individual thing. But 300 is LOW. My target is 750 or 800. Older men supposedly get by ok on a lower level than younger men. I am 10 years younger than your husband.

Shots are the way to go. They are the most effective, most convenient, and cheapest. I inject at home (my wife does it actually, but I can do it :D). Women generally absorb hormones thru their skin pretty well, but men oftentimes don't. With creams and gels, you never know what your actual dosage is due to variability in absorption. With injections, you KNOW. Androgel will work ok for a while, but he will probably stop absorbing it as well eventually. Most guys that start off on Androgel and the like end up in injections.

If insurance won't cover it, pay for it out-of-pocket. The expensive thing is the labs and doctor's visit. The syringes (get them online from allegromedical.com) and testosterone aren't that expensive.

I also recommend he try a little progesterone. It is working great for me.
viewtopic.php?f=23&t=67701

DHEA won't help unless his DHEA is low. If he had just one dosage, I doubt it would have any effect.

Boron, I have never heard of anyone taking that for anything. Please educate me :D.

Praying for ya'll. Let me know if any questions.
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Re: Low *free* T and symptoms

Postby reillyj » Sat Oct 07, 2017 6:13 pm

Thank you, Ledgemoor,

Oddly enough, i know it was very low but you saying it is low low low gives me a lot of hope simply because of the anticipation of him FINALLY having the chance to feel better and some things to actually improve in his life instead of going downhill and what seemingly is never ending trials of health issues.
Only wish we could have done this years ago but it is what it is, i am just wanting the Lord to redeem the time.

I imagine his Endo will put him on shots which is fine, i will help him with it, hopefully insurance will approve the gel this week so he could at least get started on something, the Endo visit is 2 wks out.

AFA progesterone, i have the cream and remember yrs ago telling him to put a small amount on his scrotum and his doctor was aghast. We never continued.

Boron: (i give him 9 mg a day, which might be why his testosterone isn't testing even lower) I also take it and i think it has an effect on my libido
https://www.anabolicmen.com/boron-testosterone/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712861/

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Re: Low *free* T and symptoms

Postby OldMarriedLady » Sat Oct 07, 2017 6:15 pm

DH got no help at all from an endocrinologist, and I've read plenty of threads here that say the same thing. My DH had T at 432 at 53 years old, and the endo said that was "robust". :roll:

You should probably look into someone who specializes in biodentical hormone therapy (sometimes they advertise as an "anti-aging" practice). If you're near a major metro area, BodyLogic MD might help you. (My DH sees a BodyLogic doctor for his bHRT.)
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Re: Low *free* T and symptoms

Postby Hoosier52 » Mon Oct 09, 2017 5:54 am

I would not recommend pellets via BodyLogic or anyone else. Expensive and hard to control dosage. Self-injections of Testosterone Cypionate are MUCH cheaper and can be better regulated. It take a few months to get zeroed in. Pellets can't be adjusted once inserted unless you want to go through the pain of adding more or having some taken out using a scalpel. Self-injection is virtually painless. I use small insulin needles.

The leader on TRT in the country is Defy Medical. Very thorough and very professional. Licensed in all 50 states. They have 10,000 patients and I have yet to hear read of a serous complaint. I've scores of compliments.

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Re: Low *free* T and symptoms

Postby ledgemoor » Mon Oct 09, 2017 7:24 am

Thanks for the boron info Reilly. I ordered some, and will let you know how it goes. Interestingly, I visited here not too long ago :-).
https://en.wikipedia.org/wiki/Rio_Tinto_Borax_Mine

There was a guy named John Lee who was a big proponent of progesterone in both men and women. I had the privilege of attending one of his lectures before he died. Men are supposed to have progesterone (and estrogen for that matter) in our bloodstream. In case you didn't read the progesterone link I provided, I dosed until I felt and performed best, and a lab test revealed that I was right smack in the middle of the normal range. The normal range starts at 0, so I don't take that too seriously. But don't worry, it isn't going to cause him to grow boobs or start menstruating or anything :D.

I agree with OldMarriedLady -- I am surprised that you got as far as you did with an endocrinologist.

BodyLogic will get the job done, but they tend to be rather expensive. They used to be real big on implantable pellets. Expensive, and not a good idea to begin with. They want you to get the labs from them. I don't think Defy Medical cares where you get the labs.

I prefer a local doctor. There is a directory at a4m.com, or perhaps better yet look for a local compounding pharmacy, and ask for a referral to a physician who prescribes testosterone cypionate.
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Re: Low *free* T and symptoms

Postby OldMarriedLady » Mon Oct 09, 2017 7:40 am

My DH started out with pellets from BodyLogic, but after just one implantation which didn't work, the BodyLogic doctor prescribed twice-weekly self-injections of testosterone cypionate instead. The doctor even mentioned that he wasn't surprised the pellets didn't work well. I wonder if they are required by the franchise or whatever to offer pellets first. BodyLogic does cost a bit (and is not covered by our insurance), but the care that DH gets from his doctor is top notch, and he is very thorough in his testing and "tweaking" things for the best results.

We don't get the testosterone cypionate from a compounding pharmacy; it's a generic that we get from a regular pharmacy and fortunately is covered by our insurance. I don't think you can call a regular pharmacy though and ask who has been prescribing testosterone cypionate. You could ask the compounding pharmacy who has been prescribing bioidenticals though, to find out who has that kind of practice.
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Re: Low *free* T and symptoms

Postby Hoosier52 » Mon Oct 09, 2017 7:52 am

When I was looking for a TRT doctor I asked my Sam's Club pharmacy which docs were prescribing Test Cyp and they gave me a list of names. I also first went to a Body Logic Dr. who wanted me to do pellets but agreed to let me self-inject. Problem was, he had limited knowledge on TRT. Did little or no blood work and wasn't up to speed on the latest TRT protocols.

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Re: Low *free* T and symptoms

Postby ledgemoor » Mon Oct 09, 2017 1:22 pm

Testosterone cypionate is not compounded obviously, but doctors who prescribe compounded prescriptions are likely to be more up on things than doctors who don't. I do get my testosterone cypionate from the same compounding pharmacy that my wife uses. They beat Sam's club and most other pharmacies on price.
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Re: Low *free* T and symptoms

Postby reillyj » Mon Oct 09, 2017 1:52 pm

ledgemoor wrote:There was a guy named John Lee who was a big proponent of progesterone in both men and women.

Yes i've been aware of John Lee for quite awhile, i used to use topical progesterone and my body doesn't like it - bloating, breast tenderness, etc.
I mentioned that i used to give it to my H and his doctor freaked so i stopped. I have some cream left so i'm instructing him to use about 1/8 of a teaspoon rubbed onto his scrotum, it would be really NICE if it worked! Also i'm hoping maybe he could get off the med that helps him pee (reduces prostate size).... and yes i did read the link you provided.

There's a doctor (Wray) who advocates 100 mg in men which i personally think is crazy. Some websites tout progesterone as the be all end all and i really don't like sites like that: http://www.progesteronetherapy.com/prog ... -life.html

We haven't seen the Endo yet. He went to a Urologist for enlarged prostate (no cancer, no elevated PSA) and i emailed him and asked him for a T test which he did and said he's low T and referred us to an Endo. Asked GP if he would rx and he said he'd do the maintenance (whatever that means) but intially needs to be seen by Endo (this is the way insurance co's operate, unfortunately) so i emailed the Urologist back asking if he could at least RX the cream in the meantime until the Endo appt. He said he doesn't do shots in his office (i'm sure Endo does) but yes, would rx cream in the meantime so i'm thankful for that at least. I imagine he'd end up on shots, i'd like him on SOMETHING in the meantime!!

Ledgemoor...what about the peaks/valleys w/injectables? How do avoid that? You're not doing them twice a week?

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Re: Low *free* T and symptoms

Postby Unfulfilled » Tue Oct 10, 2017 10:49 am

The link for borax led me to nothing other than discussion of a mine in CA. Am I missing something?

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Re: Low *free* T and symptoms

Postby reillyj » Tue Oct 10, 2017 1:37 pm

Unfulfilled wrote:The link for borax led me to nothing other than discussion of a mine in CA. Am I missing something?


That is really strange!!

Here's the link:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712861/

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Re: Low *free* T and symptoms

Postby ledgemoor » Tue Oct 10, 2017 9:41 pm

The link for borax led me to nothing other than discussion of a mine in CA. Am I missing something?

I thought someone else might be interested in where the boron in those pills probably came from, that's all.

Ledgemoor...what about the peaks/valleys w/injectables? How do avoid that? You're not doing them twice a week?

I did it twice a week for a while, but it didn't work much better than once a week. It takes about a month for any given injection to get out of your system, so weekly is enough. The instructions that come with the bottle say to inject every two weeks. Very few if any doctors that are up on trt would recommend that, though.

My testosterone levels still naturally fluctuate based on time of day, how my marriage and work are going, how often we do it, etc.
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Re: Low *free* T and symptoms

Postby ghostrider » Wed Oct 11, 2017 1:59 pm

Hoosier52 wrote:The leader on TRT in the country is Defy Medical. Very thorough and very professional. Licensed in all 50 states. They have 10,000 patients and I have yet to hear read of a serous complaint. I've scores of compliments.


Aren't they one of those private clinics that don't take insurance? I've heard horror stories of hundreds to thousands per year being spent, sometimes with results and sometimes without.

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Re: Low *free* T and symptoms

Postby reillyj » Wed Oct 11, 2017 6:40 pm

OK Ledgemoor, i'll do once weekly and ask the doc to monitor his estradiol.

i just had him at the doc for another issue and pointedly asked for a thyroid test. I myself am on Armour but am not going to pursue natural thyroid for him at this point because no $ to go to naturopath and frankly i don't have the energy, i believe it's better than Synthroid but it has a learning curve, anyway, his thyroid numbers are abysmal which of course will account for a lot of his symptoms and in addition he has low T, so he's quite a mess now and probably has been for years. So looking forward to getting him on thyroid and T but not looking forward to the delicate balance, i'm having a heck of a time myself w/my hormones and managing just ME! But i'll have hope...

And THANK YOU for your other reply, i appreciate it very much.

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Re: Low *free* T and symptoms

Postby reillyj » Wed Oct 11, 2017 11:50 pm

I forgot to ask about "morning wood".

i haven't asked my H about this but honestly i don't think he's had a morning erection in literally years and probably decades!
Is it still normal for him (if he is in good health) at age 69 to have them?

Really wish we could have had this testosterone issue addressed long, long ago :( Well at least now we are going to get treatment for him and also his low thyroid. Not really looking forward to the learning curve but am looking forward to him FEELING BETTER hopefully more than he has in years.

Now, too bad we just had that sad argument about sex and ME needing help in that area and him feeling less like a man (me wanting to use a vibrator with him, not solo, because i'm having difficulty myself). I feel like treating his low T and thyroid are going to be much easier than overcoming this..... :(

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Re: Low *free* T and symptoms

Postby Unfulfilled » Thu Oct 12, 2017 9:20 am

Any Dr CAN prescribe Armour thyroid or any natural dessicates thyroid medicine. You just have to be adamant! Or go find another Dr your insurance co honors who WILL prescribe it.

Low Thyroid will dramatically or can dramatically affect libido. Low thyroid also common side effect is depression and/or anxiety, fatigue, lathargy etc. all of which you have I believe described him having.

In fact I would probably recommend starting with thyroid if low before considering Testosterone replacement right off the bat. Could do both.

When you say his thyroid numbers are abysmal, what specifically do you mean? What teats were run? You may already mnkw this, but in order to really know abt the thyroid status is, you MUST have more than just useless TSH test. You also have to demand if not gotten already is Free T4 AND Free T3.
Both of these levels have for most people to feel well be at or above 50% of the range. Do NOT let the Dr tell you that being anywhere in the lower half of the range is "good enough". It is complete lie for many, if not the cast majority of the population. Also Vitamin D3 is also related and is in fact really a hormone as mjch as a vitamin and lower levels can cause fatigue and is cery common to be deficient in the USA especially in winter months.

Unfortunately due to my wife, and my thyroid levels, I have become by necessity a layman quasi-expert after intense study, reading and research over more than a decade on thyroid. Please feel free to PM me if you would like to discuss more. So we don't have to clutter up the forum boards with these details.

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Re: Low *free* T and symptoms

Postby reillyj » Thu Oct 12, 2017 11:21 am

Thank you, Unfulfilled,

i'll reply publicly because i'm sure this will help some

I'm on Armour and am part of a Yahoo NDT group and so i well know all of this! Doc didn't test free T3 but free T4 and it's LOW so really don't need T3 right this minute to know that he needs thyroid replacement therapy.

I know they put WAY too much weight on TSH. Mine is very surpressed on Armour (.02) and i'm sure my doctors are aghast but everything else is right on.

H's TSH is 6, much higher than the highest range limit of 4. And that is HORRIBLE. So RIGHT NOW, he's being put on Synthroid which has to be better than nothing until i can get him into a Naturopath, she doesn't take our insurance but she's not expensive and i know she'll rx NDT

I am just praying that in the short meantime, the Synthroid will help and we can go from there. His T is very low also so i know both will at least do something to help him climb out of this pit

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Re: Low *free* T and symptoms

Postby ledgemoor » Thu Oct 12, 2017 11:22 am

Unfulfilled, right on about the D3. My reading indicates it is that if you live north of Atlanta, it is impossible to get enough sun for natural D production in the winter months, even if you ran around naked all the time.

Reillyj, my wife and I are on thyriod supplementation too. When DW was going thru cancer, we both felt tired and unmotivated all the time. DW had low T4, so was put on Lavoxyl.

The doctor also tested our reverse T3, which was cutting-edge at the time. We both had elevated reverse T3. A reverse T3 molecule is a mirror image of a regular T3 molecule. They plug into T3 receptors and do nothing except block normal T3 from plugging in. It is the body's way of dealing with stress. So her T3 test came back normal. Everything came back normal for me, except reverse T3. I was put on Cytomel (T3), and felt much much better.

With treatment and lowering stress in your life, the reverse T3 problem corrected itself. Neither of us take T3 any more. DW still takes the T4. I started taking T4 because it was low even though the reverse T3 problem corrected itself.

We have found that Cytomel/Lavoxyl works fine. It is bioidentical human T3 and T4. Spring for the name brand, however. We normally buy generics, but the doctor said that the generics do not work as well in this case. Our experimentation confirms this. Lavoxyl isn't expensive. Cytomel was about $1 per tablet, so glad we don't need that anymore.

Unfulfilled is right about dosage. Don't worry about the levels in lab tests. They are necessary in that they will tell you whether he is low in T3, high in reverse T3, or low T4. But dosages have to be determined experimentally. If you get too little or too much, it's pretty obvious.

Not really looking forward to the learning curve but am looking forward to him FEELING BETTER hopefully more than he has in years.
His hormones will be a lot easier to deal with than yours.

I forgot to ask about "morning wood".
When my testosterone was low, I rarely did. But now at late 50's and with testosterone supplementation, it never fails.

I would think that a healthy man of any age should have morning wood. Our doctor says that if we stay on the bHRT, we should both have great sex lives until we die.

I was discussing testosterone with my dad. He was in his 80s, and his testosterone level was in the 400's. I mentioned that my level was under 300, and that I was taking shots for it, and how happy it made my wife. Mom rolled her eyes and said "He doesn't need that" :D.

Try once-weekly shots on your husband. If the lows are a problem, you can always switch to half a dose twice a week. Just order extra syringes. It is my opinion that letting yourself run a little low boosts natural testosterone production and prevents testicular shrinkage. We used to schedule my shots for two days before DW was most likely to want it. That's supposedly when your levels peak. But most of the time I can miss a dose and not notice for several days.

While I'm thinking about it, when you get his testosterone level checked after he starts injections, take the test the morning of the day his shot is due, before the shot. I don't know why they want it tested in the morning when your levels are the highest. Most people make love at night. But that's what they insist on. I guess just for consistency and comparison purposes.
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Re: Low *free* T and symptoms

Postby Unfulfilled » Thu Oct 12, 2017 7:49 pm

Thyroid:
Combination of synthetic T4 such as synthroid or Levo along with Synthetic T3 (cytomel) is fine. And it is actually somewhat easier to optimize and you can change doses of each individually to more directly affect either.

Typically even people who are on NDT or Armour, may also have to take synthetic T4 as it is common to be low in Free T4 while your free T3 levels are fine and you may feel OK. However some people to feel well need to have Ample Free T4 levels as well.

The rule of thumb which fits most peoe NOT everyone. Is to have BOTH of the following:

1) Free T 4 to be at or slightly anove 50% of the so called "normal range".

And -that means in Addition to

2) Free T3 to be between 50% to 67% of the "normal range". Most people seem to need to be closer to the 67% (top 1/3 ) of the range.

Your body at the cellular level ONLY utilize the Free T3 molecule. T4 is the "storage" hormone. It is not used directly, rather it has to convert into T3 which is done mostly in the liver. Of the T3 that is made, a large share is bound to a protein and is rendered useless. Some of the T4 is also converted to reverse T3. And as stated above stress mental or physical stress increases the rate of reverse T3 production. It is also a protective mechanism if the body believes it is going hyper (too high of thyroid) it will convert the T4 i to useless reverse T3 to keep from going hyper. Or at least that is the theory.

So remember that the ONLY way to have recerse T3 is from the conversion process. And as stated anove, the reason why during the cancer stress and the high reverse T3 levels resulted i. Switching to cytomel which is synthetic T3. Cutting the amount of T4 medicine, cut the amount of T4 in the shstem to convert i to the reverse T3. In essence they starved the body of the T4, less conversion which resulted in less production of reverse T3. Whole the direct cytomel T3 allowed for sufficient free T3 to cleare the receptors and also provide sufficient free T3 to be available to be used at the cellular level.

I once read and I think I still have the paper somewhere that states that the Breakdown of T4 results in some sort of enzymes or chemical that helps prevent tumors. And the ONLY way this chemical is created in the body. Thus, even if you feel well with Armour by providing enough Free T3 cellularly, if your Free T4 levels are too low, you will not be producing this important beneficial biologic chemical. And is why it may be a good idea to consider adding in synthetic T4 in order to bring up the Free T4 levels to about the middle of the range. This may, or may not require lowering your Armour dosage. As your body may convert some of the T4 into free T3 and has the potential to start to make you hyper thyroid.

T4 being a "storage" hormone and not used directly means that it has a long half life. What this means in practicality is that it takes about 6 WEEKS to build up and stabilize. T3 on the other hand is IMMEDIATELY available for use. The T3 levels peak in the bloodstream about 4 HOURS after taking it and is all used up by about 8 hours. And as a result you want to usually split your dose to take twice a day. Otherwise you can "flood" your body with a "rush" of T3 and temporarily maybe even go hyper, then a few hours later "crash" as the T3 is all used up. So you will be full of energy around noon or so and then hit the wall and run out of gas by dinner time. Splitting the dose in half where you take the 2nd dose around noon to say 3pm Llows the 2nd dose to start ramping up, at about the same time the morning dose is tapering out. So your energy level and blood level of T3 remains more constant, rather than a roller coaster.

Also if on Armour or T3 medication, do NOT take your medicine prior to getting blood drawn for thyroid levels. As the T3 is immediately a ailable, you can get a false high reading due to taking the medication and the Dr will flip out.

Simce Armour has a LOT of T3 and smaller amounts of T4 in It, it is therefore generally a good kdea to sit the dose of Armour . Again everyone is different and some folks do OK and do not crash with taking a single morning dose a day.

It is important to note that anyone who is on Armour or any larger amount of T3 medication will almost certainly cause TSH to be supressed. This freaks out most Dr's because they are only taught immaculate TSH belief and do not have a clue about how thyroid really works and think you are hyper when in fact you are not.


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