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Old 08-20-2007, 11:11 AM   #1
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AlanVA HB User
Low Testosterone - what to expect with first visit to endo

I am a fairly new diabetic (since Jan 07) and have made decent progress getting this controlled. Also a mild case of hypertension since about the same time when I was prescribed 5mg of lisinopril. About two months ago, I started to have an ED problem (maintaining more than anything else) and after talking with a diabetes nurse educator, she suspected the blood pressure med was probably the cause, and when I went for a follow up with my primary doc, I asked for a testosterone check and the results showed:

Testosteone, Serum 237 ng/dL (limit 241-827)
Free Testosterone (Direct) 8.4 pg/mL (limit 8.7 - 25.1)

The primary doc's office called and told me to go see an Endo and gave me the contact info and I have an appt a month from now. Was just wondering if anyone could tell me what to expect on the first visit and perhaps an understanding of what the above numbers mean.

I'm 37 and take glyburide and atacand for the diabetes and blood pressure and occasional vicodin (2 or 3 per week) for sciatica / blown disc in my back.

The doc changed the BP med to one that isn't supposed to have any ED side effects (but haven't really noticed any change yet).

Thanks in advance for any thoughts or comments.

A.

 
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Old 08-20-2007, 03:54 PM   #2
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Re: Low Testosterone - what to expect with first visit to endo

Dont expect too much.... Call the office and ask if they are knowledgealbe on male hormone replacment... Then do alot of research and write a list of questions too ask them....Things like Testosterone replacment converting to Estradiol and DHT, and if they try to tell you it is nothing to worry about then they are clueless...visit androgel and testim websites and get info from there...these are probably the two most prescribed TRT products... I know for a fact that the Androgel lit mentions that at 10g a day AG can convert heavily to Estradiol and DHT...a Testostorone to estradiol balance that is out of whack can cause problems like ED... do not believe that you can just slap on T gel and your cured...that is what they want you to believe but it takes a lot of trial and error... you need to be proactive in your approach... if you do net based research from now until your appt, there is a good chance you will know more about the subject than your doctor....

good luck...

 
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Old 08-20-2007, 08:45 PM   #3
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Re: Low Testosterone - what to expect with first visit to endo

Well said by Jinxy. Is fertility an issue for you? I have many posts on this board and you can view them by right clicking on my screen name. Read up on my posts and others and let us know specific questions. THis will take a lot of time and work on your part but your health and sexual health are at stake so it is well worth the time and effort. Keep in mind as Jinxy said, very few doctors know how to treat this right or even take it very seriously. They will tend to blow you off completely or just slap on androgel and you're done. This approch not only does not work but in some cases can do more harm than good.

 
Old 09-02-2007, 07:19 AM   #4
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Re: Low Testosterone - what to expect with first visit to endo

Hello All...........

Wanted to give you all some history on my Testosterone Therapy. Maybe this will help some others. I started the Therapy early June 2007 after a vacation to Denver, Colorado. Before my vacation I had my yearly physical and discussed with my Doctor how I was feeling. I am 49 years old and really had no energy and no drive or interest in doing the things I used to like doing, working out, SEX, etc. Since I had already researched some on the WEB about Testosterone Therapy I asked my Doctor could I be a candidate to start this Therapy? He said he would need to do a Blood Test and determine what my Testosterone levels were before making a decision. When my results came back within two (2) days my level was at 310 which is considered in the Lower Normal Range. At that time, my Doctor suggested waiting for my next check up in six (6) months and re-check my levels again! After three (3) months I requested the levels to be checked again and not much improvement. Since my mood and sex life had not changed, my Doctor started me on the TESTIM gel and I feel great now. The first thirteen (13) days were pretty ruff because I was sick to my stomach which can happen with some patients. Now, two months after starting the Testosterone Therapy, I feel great and glad I made the decision. I would suggest talking to your Doctor and making sure he or she has some experience in this area. If they do not, find a good Doctor who will understand and start you on a good Testosterone Therapy. Good Luck all...................

 
Old 09-04-2007, 06:31 PM   #5
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krb613 HB User
Re: Low Testosterone - what to expect with first visit to endo

I too have low T and I'm only 32 years old. My doctor is a pill pusher and was very quick too put me on Androgel. He gave me zero alternatives. I was on it for a while and decided too stop taking it. I just asked myself "Do I really want to take this stuff everyday for the rest of my life?" First it's expensive and secondly I really didn't feel that much of an improvement on this crap. I workout and run, but I've always been able too do that before and after androgel. Yes, it did increase my sex drive but was it worth the huge cost and possible side effects down the road? Nah. My doctor is really ******* me off. I'm thinking of finding a new one. If he wasn't such a pill pusher for every ailment I might keep him. He's draining my pocket book with his prescriptions for every little thing.

Anyway how do I get more information on Testosterone Therapy? I'd like too find out more about it.

 
Old 09-05-2007, 04:25 AM   #6
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JinL HB UserJinL HB User
Re: Low Testosterone - what to expect with first visit to endo

Self injection of testosterone cyp, & HCG is not expensive. The T is about $15 per month & the HCG is about $60 per month with no insurance.

Both require a prescription.

 
Old 09-05-2007, 07:54 AM   #7
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AlanVA HB User
Re: Low Testosterone - what to expect with first visit to endo

Hayfarmer, thank you for the comments and for pointing me towards your other replies. I've been reading a lot of what you have written. I still have about 2 more weeks until the appt with the endo (although I am going for a follow up with the GP tomorrow - don't really have any change in my ED issue since switching the type of blood pressure med which was what the 6 week follow up was supposed to check while waiting for endo).

Fertility is not a concern for me - I am 37 with two kids already and do not want any more.

So, still reading and reading at this point.

Thanks,
a.

 
Old 09-06-2007, 07:02 AM   #8
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hayfarmer HB User
Re: Low Testosterone - what to expect with first visit to endo

Feel free to ask questions specific to your situation.

 
Old 09-06-2007, 07:05 AM   #9
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hayfarmer HB User
Re: Low Testosterone - what to expect with first visit to endo

KRB, to get more info, read up on this board, search the internet using words like hypogonadism treatment and andropause, buy the book The Testosterone Syndrome by Eugene Shippen.

 
Old 09-21-2007, 07:49 AM   #10
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AlanVA HB User
Re: Low Testosterone - what to expect with first visit to endo

Just a small update of sorts - saw the endo on Monday and I think things went well and he is proceeding slowly trying to determine what the problem is instead of just throwing androgel at me and sending me on my way (like I've read on another post someone else experienced recently).

the endo ordered additional blood tests for LH, prolactin, free and total T, and probably a few other "check marks" on the lab form that I don't remember now.

He gave me a fairly comprehensive physical exam and I think his biggest concern from the exam seemed to be fairly high blood pressure that morning(which may have been a case of white coat syndrome on my part) and then said the next action was to determine if the problem was with the testes or with the pituitary (or perhaps some 3rd reason).

So, I suppose I'll hear the results of blood tests next week and go from there for another visit and/or additional tests.

It did sort of sound as if the endo was going to be heading towards HRT as a solution since that seemed to be the solution when he was telling me about with either a problem with testes or pituitary if he could determine why the T was low in the first place.

 
Old 10-03-2007, 07:58 AM   #11
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AlanVA HB User
Re: Low Testosterone - what to expect with first visit to endo

Met with the endo again yesterday for a short follow up on lab work and I have to say I'm a little more confused now than before.

The first testosterone test was 2 months back was 237. The test a couple of weeks ago was 441.

The other results

LH 2.5
Albumin 4.5
Prolactin 2.4
Sex horm binding glob 19

Based on these numbers, the endo said I'm basically normal and gave me a script for levitra and said to come back in Jan for another appt.

I told him that I still had some problems I felt was due to low testosterone such as no energy, lack of desire for most anything and some general type of depression but his view was that based on the last set of numbers as well as some other diagnostic program he ran my numbers through, didn't feel as if testosterone therapy was appropriate at this time.

I've read that T levels can vary from reading to reading but is a 237 to a 441 a range that is within the bounds of what the values could reasonable be? The first test was done near 11am and the second test was probably 9:30am and I've read the numbers are higher in the morning but I wouldn't think that an hour and half would have made that much of a difference.

So for now - I guess I can try the ED pill but I think the ED issue was just a part of the overall health issues.

Other meds are glyburide for diabetes, lisinopril for BP and occasional vicodin for back pain - none of which I think would have had any noticable impact on T levels.

My next appt is with my PCP early december for regular follow up diabetes check and since she will pull blood for that, I'll ask her to include testosterone and probably the above other items as well just to start charting levels. After that, I have a follow up with the endo for early Jan.

I guess I just had it in my head that testosterone was low and replacement therapy was going to be an almost done deal - and was sort of looking at it as a way to improve things for me.

Any thoughts on the above numbers or comments would as always be welcome.

alan.

The endo said that if on a follow up test, the numbers are low again then he may consider replacement therapy but for now, one low reading and one

 
Old 10-03-2007, 02:57 PM   #12
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JustDave4now HB User
Re: Low Testosterone - what to expect with first visit to endo

Hey Alan
I read a good book about this subject and it stated
That T levels are Subjective to the individual. So low for you just might be anything under 500 instead of 300

I don't Know if you have tried this, but you might want to try Zinc. many People have allot of luck with two 50 mg tabs a day. It stops the body from turning you bodies natural T into estrogen.

normally this isn't an issue, but if you have a spare tire around the middle your T going to nose dive and your estrogen is going to go up. always a bad idea.

Another Common Problem besides low Testosterone in men is Sleep Apnea.it has almost the Same Syptoms, tired, grumpy, low sex drive ,ED. People with Apnea have low T allot, because you need to sleep to regulate it.
Do you snore? do people say you breathe funny when you sleep? Do you take naps?

Many People get T treatment and treat the Syptom, but the not the Cause, because doctors never think of Apnea.it is extremely Common, and mimics many Diseases. That would lower you T make you a Canadate for Diabetes, high blood pressure and heart Disease,

Just another option on your radar. Look it up, testosterone and Apnea

 
Old 10-03-2007, 04:08 PM   #13
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hayfarmer HB User
Re: Low Testosterone - what to expect with first visit to endo

Seems to me at 441 your T is still on the low side of normal. I'm not surprised you have symptoms at that level but at that level I would try to find out why its low and try everything else before T replacement which is for life.

 
Old 10-04-2007, 07:28 AM   #14
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AlanVA HB User
Re: Low Testosterone - what to expect with first visit to endo

Dave,

Thank you for your words on zinc and apnea. In a look at my diet, I'd say I probably have a low intake of zinc and picked up a zinc supplement last night and will start trying that.

I'm not aware of any sleep apnea issues - I use to snore a decent amount with my wife having to tell me to roll over midway through the night a few times a week but that hasn't been an issue for a long while (unless she just gave up on it and learned to sleep through my noise after all these years). I think these days, usually I will snore only if I sleep on my back but if I am on my side, then I don't think I still have such a snore problem.

I am probably short-changing my sleep most days and sleeping around 6 hours a night during the week but I will try to increase that amount.

I've got a bit of spare time (5'11" at 194lbs) - I was down to an even 180 not too long ago but when I switched diabetes meds, my weight went up a few pounds. Mostly due to the diabetes I have a fairly low-carb diet with mostly lean meats and veggies for most meals.

As hayfarmer mentioned, 441 could still be a bit on the low side and I would like to know the reason for this and I will ask the docs to include the T checks for me so that I can chart and try to determine the cause.

Part of me wants to start replacement therapy but then having to do that for life does sort of put some serious concerns into that idea.

Thanks,
Alan.

 
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