T Nation

46, Low Total T, In Range Free T, Some Symptoms

I’m 46 and very active. 6’, approx 12-13% BF, 195 lbs.

Testosterone, Serum 318 ng/dL [Low] range 348-1197
Free Testosterone(Direct) 8.3 pg/mL range 6.8-21.5
DHEA-Sulfate 112.6 ug/dL range 44.3-331.0
Estradiol 10.0 pg/mL range 7.6-42.6
TSH 2.980 uIU/mL range 0.450-4.500
Did not test LH and FSH.

I have BPH and a high PSA. Take Flomax daily for BPH. Just had a biopsy a month ago and it came back fine.

My symptoms are real, but not sever:

  • Some brain fog,
  • Some decreased libido, but not terrible.
  • Some limited ED, but occasional only. Gets up fine, but doesn’t stay occasionally.
  • Some tiredness.
  • I’ve retained my strength and body comp.
  • Testes look full and don’t hurt.
  • Average body hair, but has gotten more prevalent in the last 10 years.

I read a magazine article about some guys just doing HCG without test to up their natural test. Wondering if that’s worth a try before trying full blown TRT. I’m not opposed to full TRT.

Any general thoughts and feedback appreciated!

You will have a very difficult time finding a doc to treat you with BPH and high PSA–these are two of the biggest red flags while on treatment thta docs look for.

Now that you have an established low T, you need to get LH/FSH tested to find out if oyu are primary or secondary. If primary, HCG won’t help you.

Also, what time of day were the labs taken?

[quote]VTBalla34 wrote:
You will have a very difficult time finding a doc to treat you with BPH and high PSA–these are two of the biggest red flags while on treatment that docs look for.

Now that you have an established low T, you need to get LH/FSH tested to find out if oyu are primary or secondary. If primary, HCG won’t help you.

Also, what time of day were the labs taken?[/quote]

Hey VTB. Thanks for your response.

I am going to see my urologist for the low T - the same one who treats me for BPH and did the biopsy (that was a load of fun). He’s young and pretty progressive - and played rugby in college - so we’ll see. My appointment is on the 30th.

Blood work was done at 830 AM - was fasting for blood lipid test.

I’ve read about secondary vs primary, but I don’t understand it. Would you mind explaining and also how/what the LH/FSH test will show? Thanks man!

Don’t expect too much help form a urologist–they’re good with the plumbing, but usually rather clueless when the hormones are involved.

830 am is good for the test–just have to make sure its not done in the afternoon, as we get sometimes (I wish we could get an update to the stickeys to reflect this)

Primary basically means your nuts can’t produce testosterone, regardless of how much stimulation (through LH/FSH) they receive. This is usually associated with high LH but low T. But if LH and T are both low, you can’t rule out one or the other since both may be inadequate. This is when an HCG or a SERM challenge comes in handy (I now prefer HCG challenge as I see this more viable for long term therapy). If they don’t respond, your only option is exogenous Testosterone.

Secondary means that your testicles are capable, but aren’t receiving the signal (LH/FSH) from the pituitary. This is a bit more tricky and can be caused by many factors. This is when you have to get your hands dirty and get to the root of the problem.

Thanks again VTB.

If my urologist doesn’t go for it, I know another doc locally who is progressive and part of the “Renewman” network. http://www.renewman.com/ He is actually a ortho surgeon who works on a lot of athletes and does this on the side.

I guess the question is will TRT have a negative effect on my BHP. Since I have a clean biopsy, I don’t think feeding any prostate cancer is an issue. I’ve read studies that suggest BHP is NOT affected by test and that low test may actually be bad or a contributing cause of BHP. However, there is no consensus on this issue.

^^^I agree with your comment about BPH being negatively affected by Low Test. I think most of those ills associated with high test (or more specifically, high DHT) are more attritbutable to estrogen and other hormones than DHT.

My basis for this is deeply rooted in bro science, I admit, but tkae a look at your normal 19 year old male. Virile, healthy, and chock full of Test and DHT, with no hairline or prostate problems to speak of. Compared to a middle age, balding, overweight male, with Estrogen as high as his wifes and low T/DHT to boot, that seems to be when the problems start. Why is this if DHT is the culprit? It just doesn’t add up to me.