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Old 01-22-2010, 08:55 AM   #1
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asmacumber HB User
Testosterone shots not working. PLEASE HELP!!!!

Here is my story:

I am a 34 year old male that was diagnosed with hypogonadism in September of last year. I was exhibiting the classic symptoms; very low energy, no sex drive, ED, low ejaculate levels, depression, moodiness, increased belly fat and weight gain, etc. My total testosterone level came back as 198ng/dl, which is very low for someone my age.

My PCP put me on Androgel, but for some reason had me on only two pumps a day, which is hardly anything. Needless to say, after the first week or so I stopped feeling the effects of it. When I spoke with my PCP about it they referred me to an endocrinologist.

The new doctor had me go off the gel for 5 weeks and retested me. My total testosterone had gone up to just over 250ng/dl which prompted him to say that the gel had been doing it's job as I was back into the "normal" range. (I hardly think that 250ng/dl is "normal" for someone my age ... shouldn't it be over 500ng/dl?)

I told him that I didn't feel any effect from the gel and we decided to try doing the IM injections. (My wife is a nurse, thank God, so I don't have to self inject ... one of life's little mercy's!) However, he put me on only 1ml every 3 weeks. To help level out the peaks and valleys we had heard about we decided to cut the dose in thirds and do it every 6-7 days.

I can honestly say that the first two shots I had I could feel the difference for the fist day or 2 after, but beyond that I went right back to being tired and exhausted all the time. And now, two months out, I can't even tell when I get the shot anymore. I don't feel any different from one day to the next. I am tired, moody, no sex drive to speak of, no spontaneous erections, morning wood every 3-4 days, and when I do get it up it's only about 3/4 full.

Add on top of this I am starting to have some side effects that have me alarmed. My testicles, which used to be full and would hang down a little further than my penis tip, have shrunk and are constantly drawn up next to my body. They don't always have that "tight" feeling (guys, you know what I'm talking about), but they're always sucked up close to my body, even after a warm shower, which always used to make them hang down low. And get this, the other day I was trying to masturbate and went to fondle my boys and I couldn't find my left testicle!!! It had rolled up inside my body and I had to move it back down again!!! Needless to say, I freaked out. Add to that the fact I hardly ejaculate ANYTHING anymore. Sometimes it's more than others, but never very much. Also, when urinating, I have to stand there a minute more just to make sure I drain completely. I learned my lesson when at work I zipped up too quick and got a leak-spot on my pants! I don't seem to be emptying all the way ...

I am really at a loss and don't know what to do. I'm not worried about being able to have kids or anything (I already have 2 of my own and had a vasectomy when I was 28) but I am so sick of being so down and tired feeling all the time. Plus I am silly and worry about the aesthetics of my testicles.

Someone please give me some advice. I am really unsure of what to do and where to go from here. Thanks for your time.

Last edited by asmacumber; 01-22-2010 at 08:57 AM.

 
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Old 01-22-2010, 12:22 PM   #2
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athleticdept HB User
Re: Testosterone shots not working. PLEASE HELP!!!!

I think all your problems are caused by too much MSG in food. All fast food, all processed food and especially in diet soda. Cut out the diet soda (I suspect you are drinking a lot of it) and all your problems should reverse.

 
Old 01-23-2010, 03:57 AM   #3
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redness HB User
Re: Testosterone shots not working. PLEASE HELP!!!!

I don't have any answers, but I'm in a similar position. Using gel, and noticed some difference initially, but nothing now. Endo told me it takes 3-4 months to get the full effects, so have no follow-up planned until March. I have read quite a few posts on here of people whose levels come into the low end of "normal", which the endo considers good enough and then refuses to increase the dose.

I don't eat fast food, processed food, or drink diet soda.

 
Old 01-25-2010, 03:39 PM   #4
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hangiron HB User
Re: Testosterone shots not working. PLEASE HELP!!!!

your shrinking testes is due to atrophy and is gonna remain as long as you are on trt or unless you get your doc/endo to approve HCG.....no no not not hgh....HCG....google it

also keep on your doc about wanting to be in the mid upper range and get E2 evaluated regularly 1/2cc every weeks is about a a norm for most
p

Last edited by moderator2; 01-25-2010 at 05:01 PM. Reason: please do not post websites except as described in the Posting Policy

 
Old 01-25-2010, 03:41 PM   #5
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Re: Testosterone shots not working. PLEASE HELP!!!!

also it is common that docs/endos refuse to increase patients test levels due to all the abuse and regulations that have been stepped on regarding testosterone

 
Old 01-25-2010, 03:50 PM   #6
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Re: Testosterone shots not working. PLEASE HELP!!!!

1/2 cc per week would be a more realistic starting range...if you have insurance demand getting your blood levels done again also evaluate E2 range and demand you dont want to be in the low end of the testosterone spectrum

the testes shrinkage is due to atrophy and can be combated with the use of HCG....not HGH...HCG good luck with getting your endo on board

Last edited by moderator2; 01-25-2010 at 05:00 PM. Reason: please do not post websites except as described in the Posting Policy

 
Old 01-27-2010, 08:48 AM   #7
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asmacumber HB User
Re: Testosterone shots not working. PLEASE HELP!!!!

Here's where we are now:

I went to my doc again and told him I felt nothing from the shots so he increased to 1cc every 2 weeks (.5 per wk as stated by hangiron).

I spoke with him about the testicle and penile shrinkage and he insists that they "are a good size and placement is fine" (a direct quote). When I told him I know my body as I've had it for 34 years he said that it's winter and they are probably retracted due to the cold. I told him it's never happened before and he just smiled at me.

He did schedule a testicular ultrasound to check for any issues since I've had some pain, too.

I can't believe that he is not listening to me when I tell him I know my own body and that things don't look or feel like they used to.

Aren't I young to be having these issues? What are the chances it's related to a pituitary problem?

I'm sorry to vent here, but I'm really frustrated. Thanks for everything.

 
Old 02-01-2010, 07:50 PM   #8
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Re: Testosterone shots not working. PLEASE HELP!!!!

Hangiron is right. You need HCG. It is almost identical to the LH your pituitary should be sending to your testicles to tell them to make more T. At 34 you are almost certainly secondary hypogonadal which means your pituitary is not sending enough LH. In addition once you start T replacement your pituitary will stop sending the little LH it was. So your "boys" are not getting their exercise are are beginning to atrophy. I am on T shots too and mine did the same thing as far as hugging my body or going up inside. The HCG (human chorionic gonadotropin) will resolve it and keep them firmer. For some men they get down to the size of a pea without it. Pay no attention to the diet soda idea. Many men have this and there is no known cause for many of them. I rarely drink any sodas and eat almost no MSG. There is not likely any connection. You could spend your whole life trying to figure out a dietary cause and get nowhere. That said you should try to find the root cause but it can not be done while on replacement. You must test all your hormones (and other things) while off any replacement to do this. This is important because you could have this due to some serious other health issue like hemochromatosis for example. Have you wife look that up. It can cause hypogonadism and there are other serious conditions that can cause it. They should all be ruled out before treatment begins. Most doctors are clueless on this and just treat the symptom of low T.

One other caution. Be prepared to find a new doctor and to have to travel to one who knows how to treat this. Very few do.

Edit: I missed your last post but it certainly could be a pituitary issue. It could be an adenoma or empty sella syndrome. These are two more of the serious conditions I spoke of above. Your doctor sounds useless to me. You are going to have to find another. You have a long road here at only 34 and need to get some competent help.

Last edited by Mod-S4; 05-30-2010 at 01:24 PM.

 
Old 02-05-2010, 10:24 PM   #9
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orion HB Userorion HB Userorion HB Userorion HB Userorion HB User
Re: Testosterone shots not working. PLEASE HELP!!!!

Definitely have your thyroid checked as well as cortisol, prolactin, DHEA and IGF-1. Low thyroid can cause many of the symptoms you speak about and will render testosterone useless. Low cortisol can do the same thing but is usually associated with symptoms like morning backache, loose stool, brain fog and memory problems.

Low DHEA is a sign of low cortisol, and low IGF-1 is associated with low growth hormone and low testosterone.

Last edited by orion; 02-05-2010 at 10:25 PM.

 
Old 02-10-2010, 07:57 AM   #10
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asmacumber HB User
Re: Testosterone shots not working. PLEASE HELP!!!!

I really appreciate all of the responses. I found a new doctor and told him everything that is going on. When I told him what my other Dr. said he looked at me like I was from another planet. On top of that, my previous Dr. didn't send my records over like they were supposed to, so now I have to go back next week after then request them.

He said pretty much the same as Hayfarmer and Orion ... he said that if my last blood work was inadequate (I know he tested thyroid but don't remember him saying anything about pituitary) then I will have to go off my T shots for 2 months and then get the labs done again. He said that the 5-week lag between gel application and my last labs was probably too short as it should be at least 2-months between your last supplement and lab work.

He also said that there is always a reason and you can't treat low T without knowing what is causing it. He said low T is the symptom, not the problem, and if you treat the symptom the original problem just gets worse.

He wouldn't even discuss HCG with me until I he gets my last labs and/or he knows what is going on.

I'll check back when I know more. And again, thanks!

 
Old 02-12-2010, 10:01 PM   #11
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orion HB Userorion HB Userorion HB Userorion HB Userorion HB User
Re: Testosterone shots not working. PLEASE HELP!!!!

Sounds like this new doc actually was awake during med school lectures on hormones. Hopefully he proves useful.

 
Old 02-13-2010, 01:38 PM   #12
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DIAL HB User
Re: Testosterone shots not working. PLEASE HELP!!!!

your first doctor sounds like an idiot.

Testosterone Levels

Probably the most common questions I get are:

1) Are my testosterone levels normal?

2) What should my testosterone levels be?

Well, normal is relative as we all know. But, even so, we can come up with some solid guidelines that will help you know where you stand.

However, I first want to encourage you to throw out the completely lame and utterly useless “normal” range that your doctor or lab technician will give you. A typical range give is 260 -1080 ng/dl as normal (which corresponds to about 8.8 - 36.7 nmol/l). Well, to that I can only say that you can call any level you want normal, but 260 is nothing but ugly. In fact 300 and 350 are ugly. Virtually every email that I get where a guy is struggling is from some guy with total testosterone under 400 ng/dl. And younger guys, based on numerous emails that I have received, struggle with testosterone less than 500. I have never received any email from someone complaining with testosterone levels over 500.

CONVERSION FACTORS: On this page I am only talking about total testosterone and in all cases I use values given in ng/dl. If you want to convert to, say, nmol/l, you must use a conversion factor of 29.4 or .034 going the other direction. Yes, that high school chemistry may pay off for you if you’re from a country or reading a journal article that uses moles. If you are interested in normal free testosterone levels, please see this link on Free Testosterone.

So the normal pain threshold is about 500, depending on a guy’s age and history. (Below 400 is almoast always a free pass to hormonal hell.) That is why I am so disgusted with the medical profession when they tell one of my brothers that a total testosterone level of 280 is fine and normal. In fact, I encourage you to go to hundred doctors until you find one that does not have such antequated beliefs. It can definitely be difficult at times! (Please read my link on Testosterone Symptoms if you do not know how dangerous low testosterone levels are to your health.)

That said, I want to make several important points about testosterone levels and lab readings. First of all, you should keep in mind that it’s unwise to go by one reading, because your testosterone fluctuates considerably from week to week and even from day to day. Stress, lack of sleep and many other things that are a normal part of life – see my link Common Things That Lower Testosterone for examples – can whack testosterone levels. It is entirely possible, for example, for your testosterone to be 350 one week and 600 the next. Lifestyle issues can whack even normal testosterone 20-40% or more.

You should also try to get your testosterone levels read in the morning if at all possible. Your testosterone levels peak in the morning and then steadily decline until late evening. This decline from am to pm is, on average, about 50% for most guys. Baseline testosterone levels, which are those in the early morning, is what your doctor and you should be after.

In addition, it’s worth pointing out that labs aren’t perfect either. I had one testosterone reading that was three times any previous reading that I had ever received! Of course, that explained why I had been running around the streets naked trying to hump telephone poles. No, seriously, there is no reasonable explanation for that reading and it was surely an outlier from normal as they say in the stats world.

All cautions aside, though, we can come to some conclusions and you can assess your testosterone levels against the average. For example, there was a 1999 study that examined 4,393 men between the ages of 32 and 44 and found that their average testosterone level (at 8 a.m.) was 679 ng/dl. [1] It should be noted that in this study the men with testosterone levels slightly above 800 were 42% and 72% less likely to have high blood pressure and a heart attack, respectively, than those with testosterone a little less than 400. Again, solid testosterone is good for you!

Do you know the foods and drinks that boost Nitric Oxide and repair the veins and artieries to your penis? Then check out the Peak Erectile Strength Diet Program where I show you how to dramatically improve your erectile strength.

So you may be wondering what exactly are normal testosterone levels? Well, again, let’s go to another study, the NERI (New England Research Institute) study. [2] This study examined, amoung other things, men in the age bracket of 65-69 and found that in 1988 average testosterone levels were 503 ng/dl but in 2003, fifteen years later, the average levels had fallen to 423. This corresponds to what other studies have found: testosterone levels are falling steadily with time. I speculate that the leading factors for such a decline are diet, mitochondrial damage, excitoxins and pesticides. See my links to the left for more information on what can sabotage normal testosterone. Or maybe you just watch too much Barney as a kid - I don't know.

So if you put these studies together you can start to get a good picture of reasonable values by age. Studies have found that total testosterone levels decrease, in the average male, by about 1.0-1.2% per year and free testosterone by about 1.2-1.3% per year. This decline, by the way, is normal and a part of aging the great majority of us guys. What you don't want is to venture significantly below these normal numbers - low testosterone is "nuthin' but trouble" for us males.

NOTE ABOUT EXCITOTOXINS: Some researchers, suspecting excitotoxin damage, have shown evidence of rates greater than this in the last two decades. Read here for evidence of Rapid Excitoxin Damage and my link on Testosterone and Excitotoxins as well.

Even so, let me throw out an "average" testosterone level table by age to start out with simply by starting with a peak of 700 and decreasing by 50 ng/dl each decade:
Age Tot. Test.
25 700
35 650
45 600
55 550
65 500
75 450
85 400

As a verification, one can look at this link and find a normal or average testosterone level chart by age. [3]
Avg Age Tot. Test.
30 617
40 668
50 606
60 562
70 524
80 471
93 376

If you do enough research, you will find other similar results and average values can indeed get a good feel for the age-related decline in testosterone levels.

Now let's jump to some important points when comparing your numbers to these kind of average or "normal" testosterone levels. First of all, you must remember not to panic if your testosterone is a little below what is given above. For example, there are many guys with testosterone in the 400's that are doing great with solid libido, erections and heart health. In fact, guys like this probably have no idea that their testosterone is below "normal" and are doing just fine.

Although let me jump in and say that many young guys have written in that are struggling with testosterone levels in the 400's as I mentioned. Young guys seem to be particularly sensitive or perhaps it's the relative value compared to age that really counts. Regardless, I have known several younger guys who have reported dramatically improved erections and libido when given supplemental testosterone even though they were in the 400's.

There is something else you should keep in mind if your testosterone reading is below the average values mentioned above. If you are eating a Low Fat, Ornish, vegan or vegetarian diet, your testosterone levels may be lower than the typical omnivore. (I cover this in my link on The Two F's of Testosterone.) However, this is not, in general, a bad thing as vegetarians, for example, have excellent health outcomes. You will for example, likely have solid erections on a Low Fat Diet because it boost nitric oxide levels so powerfully even though your testosterone levels are lower than a meat eater.

So if your testosterone level is below average, regardless of whether you are experiencing classic Low Testosterone Symptoms, you may want to take corrective action. I cover many dietary and lifestyle factors on my site that can naturally boost testosterone. Read this link, for example, on How to Boost Your Testosterone Naturally. And, yes, that even includes Sex! It may be possible to boost your testosterone levels 20-40%, and possibly get them into the normal and acceptable range, simply by changing certain lifestyle factors.

Last edited by DIAL; 02-13-2010 at 01:44 PM.

 
Old 03-06-2010, 10:29 AM   #13
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fireant222 HB User
Re: Testosterone shots not working. PLEASE HELP!!!!

DIAL,

What is your website??

 
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