T Nation

Bone Density

Small Bio. I am an MD that has had to battle my own low T levels for quite some time. Endocrinology is not my specialty. I will not be able to provide lab analysis (i.e Ksman) for everyone.

This forum has been an excellent resource for me personally and for educating my own doctor and several colleagues. I have used some of the protocols here to guide my personal MD on injection regimens, lab values and monitoring estrogen.
(To keep everyone awake, I just deleted a long story about my personal battles with my own doctors etc.) So I will try to briefly share some info.

After finally achieving an acceptably low T level for me to begin therapy, I had to switch MD’s to find one that would work with me. He did surprise me by ordering a bone density (DEXA) scan. I was a bit skeptical that it would be abnormal because I did fight through some fatigue to exercise. Well I couldn’t be more wrong. I was nearly osteoporotic and a pretty high risk for fracture.

This result was relayed to my original Doctor to let him know that I had low T for a very long time. ( I hope he learned something)

I know my case may not be typical, but if you are suspicious of having low T, but had “acceptable” lab levels it may to your benefit to : 1. Have your lab drawn at the latest acceptable time for a “morning draw” -usually 10 am. 2. ask your provider for a DEXA scan so even if your labs may be “low normal” it may also serve as a marker that your actual levels may have been low for quite some time.

If you have been on therapy for some time, it may also be wise to have your provider check your bone density to see if you are at risk for fracture. It can also serve as a long term method to assess your therapeutic response.

Osteoporotic fractures in men have a much higher morbidity an mortality rate than women.

Cheers!

Interesting, DocRad. I’ve been on T replacement therapy for a couple years now, and I remember once diagnosed my general doctor immediately ordered a bone density scan. Turns out I was okay - I wonder if the fact that I had been lifting heavy for the year or two prior to the low T diagnosis had a positive impact on bone density.

My general doctor never checked T levels until I asked him to, which led to him trying injections (he was far too conservative with the dosages and they were spread too far apart for sustainability). He was only trying to get me into the “acceptable” range, though. It took an endo to finally treat the condition correctly (I am on a daily gel - levels are better and seem more consistent).

Thank you for the informative post.

A good read on osteoporosis.

https://www.lef.org/protocols/metabolic_health/osteoporosis_01.htm#introduction