At sixty two I have started to experience all the low T symptoms.
My free T is 6.9 (6.6-18 is normal). I have checked further and I do not have a pituitary problem , it seems to be in the testes. They simply aren't making enough T, I'm told.
I hate the symptoms, daily mild headache, muscle aches, insomnia, anxiety, depression, loss of muscle tone, and of course low sex drive etc. but should I medicate this "condition"?

Anyone my age or so out there with advice?

Thanks,
Mot

If I learned that I had your free T number I'd sure without hesitation get
furthur testing done, at least LH, FSH, E2 and total T as well. I started
TRT ten months ago without even the benefit of any tests except total T,
free T, and SHBG. I was truly naive and just trusted my doctor but I'm
really glad I did and here's why:

1) During the first month all those symptoms you described faded away and
I was inspired to exercise and change my diet and enjoy some good sex.
And I'm more than a decade older than you. Unfortunately I have been on the same dosage the whole time and by the third month everything just flattened out and by the sixth I was going downhill...at which time my doctor was no longer available to me. Really a drag.

2) The eventual decline I experienced inspired me to begin studying and
researching the topic and I have learned a great deal. And thanks to
boards like this I know with certainty what kind of treatment is up to
date and how so many stone age physicians out there can really get
you into trouble. So I encourage you from my perspective to go forward
if you really want relief from those unnecessary and unpleasant symptoms.

If I learned that I had your free T number I'd sure without hesitation get
furthur testing done, at least LH, FSH, E2 and total T as well. I started
TRT ten months ago without even the benefit of any tests except total T,
free T, and SHBG. I was truly naive and just trusted my doctor but I'm
really glad I did and here's why:

1) During the first month all those symptoms you described faded away and
I was inspired to exercise and change my diet and enjoy some good sex.
And I'm more than a decade older than you. Unfortunately I have been on the same dosage the whole time and by the third month everything just flattened out and by the sixth I was going downhill...at which time my doctor was no longer available to me. Really a drag.

2) The eventual decline I experienced inspired me to begin studying and
researching the topic and I have learned a great deal. And thanks to
boards like this I know with certainty what kind of treatment is up to
date and how so many stone age physicians out there can really get
you into trouble. So I encourage you from my perspective to go forward
if you really want relief from those unnecessary and unpleasant symptoms.

So what kind of therapy did you end up doing, and what were the side effects if any? From my perusal of these boards it seems it is really difficult to find a doctor who understands this stuff. I am a little hesitant to just "dive in" with my GP at the helm, and go for the jell or shots.. I have a urologist who I could see, or perhaps find a endocrine specialist, but from what I have read ,many haven't benefitted from an endo.
Does it require a lot of monitoring with blood tests, etc.?

Thanks!
Mot

I confess I'm not a good example of optimal therapy. I pretty well know
what I need to look for in professional help. But I have not as yet been
able to find it so I am struggling along with a new endo who is simply
continuing what my previous doctor started. Optimally I need someone
who will use regular blood testing to keep my androgens in balance. Not
just T supplementation as I am getting now but monitoring E2, FSH and
LH so as to keep my HPTA functioning and my free T up where it prevents
all the symptoms you described and E2 low enough not to aggravate my
BPH and other unpleasant effects. There have been a few such described
in past threads, but far too few. And far too distant.
If you manage to find a good one in your neck of the woods please let me
know as I would be willing to travel that far for skillful care.

I confess I'm not a good example of optimal therapy. I pretty well know
what I need to look for in professional help. But I have not as yet been
able to find it so I am struggling along with a new endo who is simply
continuing what my previous doctor started. Optimally I need someone
who will use regular blood testing to keep my androgens in balance. Not
just T supplementation as I am getting now but monitoring E2, FSH and
LH so as to keep my HPTA functioning and my free T up where it prevents
all the symptoms you described and E2 low enough not to aggravate my
BPH and other unpleasant effects. There have been a few such described
in past threads, but far too few. And far too distant.
If you manage to find a good one in your neck of the woods please let me
know as I would be willing to travel that far for skillful care.

Your post just underscores how difficult this whole T therapy is. All this fine tuning and then what about side effects down the road?
I am new at this search for an answer, but so far I don't hear anyone raving about T Therapy. Am I wrong?:confused:
How about a really strenuous exercise program?
Mot:)

Mot,
You are not going to find a magic bullet. T therapy is difficult and you do have to monitor your levels, especially when you start it. Monthly to begin with and then possibly less frequently after you get dosages right. But you will feel a great benefit from it. To take a short cut on doctors, you could look for an anti-aging doctor. They quite often can treat this but also some of them are obviously in it for the money so you have to be somewhat careful. As a benchmark I would be concerned if they insist on selling the drugs to you versus giving you a prescription. If you are willing to travel there are a few excellent doctors and you would only need to see them once a year at most.

You say it's your testicles that have failed but give no test results to back that up. Do you have any test results you can post?

I agree, Mot, that it's something of a hassle doing the TRT but at least in
my view and experience, weighing non-therapy and it's miserable symptoms
and hazard to heart problems and stroke against the hassles of therapy, I
choose TRT hands down. And as to exercise, my low energy and stamina
prior to therapy made exercise out of the question. I think you really need
to weigh your negative symptoms against the hassle of good treatment and
decide from there.

Mot,
You are not going to find a magic bullet. T therapy is difficult and you do have to monitor your levels, especially when you start it. Monthly to begin with and then possibly less frequently after you get dosages right. But you will feel a great benefit from it. To take a short cut on doctors, you could look for an anti-aging doctor. They quite often can treat this but also some of them are obviously in it for the money so you have to be somewhat careful. As a benchmark I would be concerned if they insist on selling the drugs to you versus giving you a prescription. If you are willing to travel there are a few excellent doctors and you would only need to see them once a year at most.

You say it's your testicles that have failed but give no test results to back that up. Do you have any test results you can post?

Hi Hay,
Here are the results I have:
FSH=7.9
LH=8.5
Prolactin=4.9
Cortisol =8.3
Free T=6.9
Serum T=561

What is your read on these numbers?

Thanks!
Mot

Your numbers arnt that bad besides free t. Did you ever get SHBG tested?

Your numbers arnt that bad besides free t. Did you ever get SHBG tested?

No I haven't, but I just came back from the urologist and he says that my numbers are more or less normal. He said the free T may go up and down during the day but my serum T was very good. I told him my symptoms and he said to try an A/D like Zoloft on a very low dose. Man, I guess it really depends on who interprets the numbers. My GP says the numbers don't reflect the necessity for T Therapy, but my symptoms do. I have a happy home life and no money probs, as he said, I am in very good shape for my age, and I am on NO MEDS. so this is one for Mystery Diagnoses, I guess! Oh the uro guy said drink a lot of water 3/4 to 1 gallon a day and the depression and anxiety might lift. Odd....

Mot

Well, your serum T is good but free T is low. This may be due to high Sex hormone binding globulin which binds to testosterone. Im not sure how high SHBG will effect free T on a blood test, but its worth getting done.

Well, your serum T is good but free T is low. This may be due to high Sex hormone binding globulin which binds to testosterone. Im not sure how high SHBG will effect free T on a blood test, but its worth getting done.

Joe,

Are you saying the free T is the determining factor as to whether you can benefit from T Therapy?

Thanks,
MOT

Free T is usually what is regarded as what determines how you are
feeling as the rest of it is bound up with SHBG or albumin, etc.
Your numbers are better than mine when I started on TRT. I was at
521 total but my free T was measured on a different scale than yours.
But your FSH and LH are both up there so if your free T is really low
it would make one concerned about your leydig cells doing their job.
Curious to see what HF has to say about it.

To be honest i dont think its a good idea for guys in the 500's to be going on trt. Theres probably not a problem with your system, as shown by your good LH and FSH numbers. My numbers are around 160, whole different story. But you could probably up your numbers by exercising and better diet. 6-8 weeks of good exercise ups Testosterone by 20%. However, theres a chance your testicles may be failing since your LH and FSH are good, meaning primary hypogonadism. They are still producing T, but they might be getting worn out.

I agree your numbers do not look like you have hypogonadism.....yet. It is possible the testicles are not working as well as they used to so you are starting to see T decline from where it used to be. You definitely do not have secondary hypogonadism....that is where LH is too low. But your free T is low which is why you don't feel that great (or could be why). I agree you should check SHBG and also Estradiol (also called E2) as well as total estrogen. I'm betting your SHBG is on the high side. The reason to check E2 in particular is that high E2 can help raise SHBG. I don't think you can have dramatic effects on lowering SHBG but you can lower it by lowering estrogen. This can be done but losing body fat and taking anti-estrogens like DIM, Resveratrol (which are supplements) or even by taking Rx's like arrimidex. You may only need to lower your SHBG slightly to feel much better.

I agree your numbers do not look like you have hypogonadism.....yet. It is possible the testicles are not working as well as they used to so you are starting to see T decline from where it used to be. You definitely do not have secondary hypogonadism....that is where LH is too low. But your free T is low which is why you don't feel that great (or could be why). I agree you should check SHBG and also Estradiol (also called E2) as well as total estrogen. I'm betting your SHBG is on the high side. The reason to check E2 in particular is that high E2 can help raise SHBG. I don't think you can have dramatic effects on lowering SHBG but you can lower it by lowering estrogen. This can be done but losing body fat and taking anti-estrogens like DIM, Resveratrol (which are supplements) or even by taking Rx's like arrimidex. You may only need to lower your SHBG slightly to feel much better.

Hayfarmer and Joe , thanks very much. For the last 4 years, I have had a spoonfull of
flax seed. I am wondering whether the plant estrogen in the flax seed(raw)
could have lowered my free T? What do you think, is it possible? I stopped taking it and I swear I am experiencing some kind of withdrawal!

Best,
Mot

flaxseed has estrogenic properties and could be harming you, stop taking it.

Thanks HF,Lalov,and Joe,
I think my depression, etc. must be caused by some other factor that I am not aware of! Thanks for your knowledge and help. I will post here where I get to the bottom of this. My urologist says my numbers are really good and that the free T while low is not indicative of a disorder. He thinks I am just depressed!LOL!!!!

Mot

One of the classic symptoms of low free T is depression. All your other
numbers may look reasonable but low free T results in many nasty
symptoms all by itself. True, that may not be the real cause, but then
again it might.