"Normal T" test results but...

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Job29Man
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"Normal T" test results but...

Postby Job29Man » Tue Sep 16, 2014 7:32 am

My Sarah counsels people on their health and nutrition, as her personal ministry. Nutrition and health is her passion, and she shares it with those who want to learn.

One of the couples she is working with has a 50 year old husband with many of the classic symptoms of low T. She asked him to get a test and his blood levels show in the mid-normal range, but he has no ambition, no morning erections, absolutely no sex drive. He's been like this over 10 years. He can do sex "for her," but has no desire. He was on depression meds for several years but has been off them now for about a year. He has a physical job 40 hours a week, but it's not strenuous. He says he's always tired and feels like a 70 year old.

I know there have been many great discussions on TMB about low T, but I never read up on them. Now I want "catch up" and also be able to point Sarah to some good information and discussions and real life experiences with low T.

I have four questions.

1. Could anyone here link me to the best discussions and information please.
2. I'm especially interested in what anyone has found about the accuracy of this "normal range" of T results. I do recall reading here a bit about some folks who said "I have "normal T" but have symptoms of Low T" and I think I've read of guys who said "I have "low T" test results but seem to do just fine in the sex and ambition department."
3. What is the latest finding on boosting low T with diet and exercise, vs with HRT? (Not saying she's opposed to HRT, just wants to know options.)
4. Does this guy's case sound like a problem with some other gland or hormone? (i.e. not T)

In much of her recent research Sarah is finding that blood serum tests can sometimes be of little value, and (if it would cause no harm) it is sometimes efficacious to ignore the test result and treat the symptoms anyway.

[Edited to change age from 40 to 50 years old, and say that he's had these symptoms for over 10 years.]
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Re: "Normal T" test results but...

Postby SquarePants » Tue Sep 16, 2014 9:39 am

#1:
In my opinion, Life Extension Foundation probably has the best grasp on the situation. Here’s a link with one of their articles. http://www.lef.org/magazine/mag2012/jun2012_Testosterone-Controversy_01.htm
http://www.lef.org/magazine/mag2014/mar2014_Response-To-Media-Reports-Associating-Testosterone-Treatment-With-Greater-Heart-Attack-Risk_01.htm

Their rule of thumb (based on research publications), is that men begin exhibiting serious negative health effects if their levels are below ~500-550 .

#2:
A popular chart of average testosterone levels vs age can be found at. The chart that is second from the bottom is usually the most helpful. For a 40 year old man, the average levels of Total Testosterone are around 600.
http://www.mens-hormonal-health.com/normal-testosterone-levels-in-men.html

A typical doctor’s office will determine whether your levels are low by looking at the published reference range that is returned with the lab results, usually from Quest Diagnostics or LabCorp. This report will show a high limit which is a bit high for an 18 year old, and low limit which would be low for a 90 year old. If you are 30 years old, but have testosterone levels that are almost too low for a 90 year old, your doctor will typically tell you that your levels are “normal.” This is absurd. My doctor told me that my levels were “normal,” yet they were in the bottom 3 percentile for my age.

Not every man exhibits the same symptoms, at least initially. I had no problems with libido or erections, but I had extreme fatigue, very low exercise tolerance, suppressed mood, and brain fog. There were many things that I “wanted” to do, but it took too much effort to expend any energy. In the evenings, getting up off the couch felt like comparable to lifting weights or running a marathon.

In my opinion, good doctors will consider both blood tests and symptoms in deciding on treatment options. If levels are borderline, but he has significant symptoms, then treatment makes sense. If levels are optimum, yet he still has symptoms, then double check for secondary causes (see #3 below) or other ailments (see #4 below).

#3:
I don’t have any links for you, but I’ve heard from multiple doctors that while diet and exercise will typically raise levels a little, but it won’t be nearly enough to help a man whose levels are really low. There are two primary mechanisms can cause levels to be low: Primary and secondary. A secondary problem may be due to obesity or sleep apnea. Fix the problem and testosterone levels will rise. In primary hypogonadism, the testicles simply aren’t able to produce much more testosterone, regardless of sleep, rest, diet, or exercise. A young person with low testosterone is more likely to have a secondary cause that could be fixed. An older person is more likely to have primary hypogonadism, which requires replacement therapy in order to achieve optimum testosterone levels.

#4:
Symptoms of thyroid problems and sleep apnea can also overlap with some symptoms of low testosterone, so they should often be considered as well. For the person you mentioned, the lack of morning erections and the feeling like a 70 year old man sound like low testosterone to me.

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Re: "Normal T" test results but...

Postby Deelmo » Tue Sep 16, 2014 9:48 am

Job,

This really caught my eye. My DW also counsels men and women at church regarding health and nutrition. She is even more passionate about it now because of her own failing health. And the fact that she has about dozen doctors guiding her on this.

As for the man you speak of - could it be that he is not really 'depressed' but simply has a 'negative' personality? This 'negative' personality is something that DW's doctors find fascinating in the fact that some people are simply negative. No amount of therapy can CHANGE that. The person has to learn to recognize this as who they are and then cater their actions to the appropriate response they need to make. He may be acting simply the way his personality is. Perhaps he could take the same advise that is given here so often to wives. Maybe he doesn't want to - but then maybe he'll enjoy it once he starts. Just do it. When you said 'do it for her', I'm guessing you mean PIV and that he does orgasm. Right? If so, then he definitely is enjoying it - he just doesn't desire it. He may be simply an LD person.

And Square Pants had a very good point about sleep apnea. A lot of men snore, and snore loudly. But yet they don't think it's a problem and never have sleep studies done for sleep apnea.
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Re: "Normal T" test results but...

Postby Job29Man » Tue Sep 16, 2014 10:15 am

Here are the testosterone test results. And I got his age wrong earlier, he's really 50 years old. Sorry.

........ ITEM............................RESULT.................... REFERENCE
Free Testosterone.......................127.........................(35-155)
Total Testosterone.......................678........................(250-1100)
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Re: "Normal T" test results but...

Postby SquarePants » Tue Sep 16, 2014 10:20 am

Those look like decent levels to me. I'd suspect a non-testosterone issue first.

Is he overweight? Does he snore? Does he have insomnia? Has he been checked for hypothyroidism, anemia?

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Re: "Normal T" test results but...

Postby Job29Man » Tue Sep 16, 2014 10:24 am

SquarePants wrote:Those look like decent levels to me. I'd suspect a non-testosterone issue first.


SquarePants wrote:Is he overweight? Does he snore?
No (pretty fit actually), and no.
SquarePants wrote: Does he have insomnia?
He falls asleep OK at 10 pm but wakes up at 3 a.m. and can't go back to sleep. Then is tired all day.
SquarePants wrote: Has he been checked for hypothyroidism, anemia?
He had tests for both and was in the "normal range" but Sarah definitely suspects thyroid problems anyway.
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Re: "Normal T" test results but...

Postby seeking perspective » Tue Sep 16, 2014 2:10 pm

My husband does have low T, but even before that diagnosis he began to experience similar symptoms due to other conditions. Does this man have high blood pressure? Does he have sleep apnea? My husband has severe sleep apnea, and within a couple days of beginning treatment for that, many of these symptoms improved for him.
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"Normal T" test results but...

Postby TheHubby » Wed Sep 17, 2014 11:18 am

http://www.artofmanliness.com/tag/testosterone/

Background and he increased his naturally.
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Re: "Normal T" test results but...

Postby spiritfire777 » Wed Sep 17, 2014 12:22 pm

I have found Peak testosterone interesting... http://peaktestosterone.com/

theres a ton of info on there... mostly I have been reading the parts on Estradiol

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Re: "Normal T" test results but...

Postby SquarePants » Wed Sep 17, 2014 1:50 pm

Job29Man wrote:
SquarePants wrote:Is he overweight? Does he snore?
No (pretty fit actually), and no.
SquarePants wrote: Does he have insomnia?
He falls asleep OK at 10 pm but wakes up at 3 a.m. and can't go back to sleep. Then is tired all day.

Sleep quality can still be affected by High Upper Airway Resistance. I know someone who has this. He sleeps with a CPAP machine, even though he doesn't have true apnea. He is a light sleeper, and a sleep study showed that he was awakening from a perpetually stuffy nose when he lies down. Even if he doesn't snore, you could ask his wife whether he makes "heavy breathing noises" when he sleeps.

Job29Man wrote:
SquarePants wrote: Has he been checked for hypothyroidism, anemia?
He had tests for both and was in the "normal range" but Sarah definitely suspects thyroid problems anyway.

I know that mainstream endocrinologist have finally admitted to what others have been saying for years: The upper limit for "normal" TSH is too high. (Hypothyroidism results in high TSH values.) I think that the upper limit of TSH used to be around 4.5. I think that the official limit is now about 3.0 or 3.5, though many doctors (mine included ) are now treating many patients with a TSH above 2.0.

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Re: "Normal T" test results but...

Postby SquarePants » Wed Sep 17, 2014 1:52 pm

(sorry, I meant to edit the previous post and add the following sentence.)

With a total testosterone of 687, I'm thinking that testosterone is not the issue, and that HRT wouldn't affect him significantly at all.


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