T Nation

Hypogonadism After Testicular Cancer


#1

Within the last year I have gained 80 lbs, and my body has ballooned up. In June of last year I was diagnosed with testicular cancer, and had one testicle removed which is when the weight gain really started. I noticed that my clothes weren't fitting anymore cause my waistline was growing. After the surgery my energy levels were depleted significantly, my overall mood was dull, and I really noticed that my focus was gone. I have been an athlete my whole life, and I played football for a major D-1 school, so I have always been in really good shape. In my playing days I weighted 285 then shortly after I was done my weight went down to 265. This new weight on my body is killing my joints, and bringing about pain in my body.

I had my hormone levels checked by doctors, and my androgen was below normal, and my estradiol was three times higher then normal which lead to a diagnosis of hypogonadism. Due to my financial status I could not afford to go through TRT through the hospital, and doctor route so I have had to battle this deficiency by other means. Right now I am supplementing with 300mg Depotest every 10 days, 20 mg of Tamoxifen everyday, and also clenbuterol for fat loss. Does anyone know of anything that works better to combat hypogonadism? If not is this something that I am going to have to do for the rest of my life?


#2

Just had patient with testicular cancer, T levels where low before surgery. The urologist wanted for radiation to get over and with the oncologist clearance would commence TRT. Since we had him as a patient and know TRT better then urologist (wanted to use 300 mgs every 3 weeks) LOL. If you levels where low before beginning they will be low after wards. Proper TRT protocol (100 mgs total to start) would be 2 times weekly or EOD depending on how many times you want to stick your self. Proper evalutation after 5 weeks of e2 and T then if e2 is check then add in hcg small dosages then revisit T and e2 in another 3 weeks. If e2 goes up drastically (x2 or more the normal level) then reconsidering dropping HCG.


#3

I don't think that my levels were low before because I was a collegiate athlete, and I was big, strong, and fast naturally. The problem is that my estrogen levels are very high, and my androgen levels are low so the testosterone wasn't have much of an impact, because it wasn't making it to the cells. I have to lower my estrogen, do you have any suggestions for lowering my estrogen without damaging my androgen receptors? Also I never had radiation or any kind of treatment, I found it in a very early stage. You are right about urologists they don't know about the endocrine system, because he told me that removing a testicle would have no impact on my hormones. And he told me that I might have a tumor on my pituitary gland, but an endocrine doctor confirmed that it is hypogonadism.


#4

I have a keen interest in this thread as I am about to have an orchiectomy due to testicular cancer as well...

I have suffered hormone issues for the past couple years now, with T levels all over the place from 350 up to mid 600's, but most recently falling sharply back into the 300s (maybe coincident with the tumor becoming more active, thus leading me to seek treatment due to the pain?)...

Regardless, from what I have read, hormone levels are expected to fall by around 10%, but the remaining testicle is usually able to keep up with the demands for the most part...

I have also had high estrogen counts and arimidex does not seem to help all that much...possible explanation is that the tumor is an estrogen secreting one, which would in turn suppress T levels, so its even possible that my T will RISE after the removal...

Sorry to interject my own case into your thread, hopefully you can gain some benefit from my plight and I as well from yours...

Also, you should really post your labs (with units and ranges) to get a complete picture of where you need to go from here...at this point, its all just speculation...

Cheers mate...


#5

VT, watch over him.

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If stimulation of the teste[s] is too high from hCG or a SERM, E2 can go out of control. In this situation, anastrozole cannot reduce T-->E2 inside the teste. So the dose needs to be lowered. These situations also can degrade the LH receptors.

Drop the Nolvadex, take 1mg anastrozole for every 100mg test per week. Understand what an anastrozole over-responder is and what to do.

Injecting T every 10 days is very wrong, inject twice a week, see the protocol for injections sticky. The way that you are injecting now is making estrogen much worse and you cannot use anastrozole to manage T-->E2 when T levels are all over the maps.

You are injecting too much T. Typical is 100mg/week. That works for a 160 pound base line and you may have to scale the dose to your body weight. Sometimes more is less. 300mg is a really stupid start!

Need to see the labs and post exactly what else you are doing.

Scale back your calories to your current activity/training levels. You metabolism has changes and you may be able to get some of that back. You should have labs that are broader to see what else is going on. Get all of your lab reports from docs and always retain. You have to actively manage your own health care, we all do.

Read the posts of others to see how things progress.

Read the advice for new guys sticky and come back with more info. Need to know current waist size and where it was when you were lean and fit. Also read the protocol for injections sticky.


#6

Thanks guys, i'll get back to you with the labs


#7

I found my test results...I took The Male Hormone Panel saliva test from Diagnos-techs,

Progesterone 18 pg/ml (5-95 pg/ml) Range
Androstenedione 128 pg/ml (151-350 pg/ml)
Estrone 47 pg/ml (30-58 pg/ml)
Testosterone 75 pg/ml (60-110 pg/ml)
Estradiol 9 pg/ml (1-3 pg/ml)
FSH levels were elevated no number given
LH levels were elevated as well
DHEA 7 ng/ml (3-10 ng/ml)

I see now that the test is very vague, and it doesn't go into great detail, hope this works for now.


#8

My waistline was 38 when I was in college 3 years ago, and now it is up to 48.


#9

We have a hard time working with saliva test results here, simply little experience.

With one teste, ideally, the HPTA will increase LH/FSH to get higher T production from the remaining teste. Your results seem to indicate that this is happening. However, if the lab work is while on TRT, LH/FSH should approach zero.

Saliva testosterone is a measure of free testosterone. Your result appears to be decent.

Your high E1 and E2 suggest that your liver is not clearing estrogens or E2 production is very high or massive amounts of aromatization from high dose T injections -if labs are post TRT.

Lab work that measures "liver markers" can help with the possible liver issue.

High LH might be prompting extreme T-->E2 in your teste - a possibility.

A TRT protocol in-line with what is recommended here may resolve the E2 issue.

When you inject every three weeks, the lab results are more a function of when you do the labs than anything else. The results suck and the lab results are mostly meaningless. Lab results should be highlighting problems, but most of all should be guiding dose refinements... that is impossible.

You need new lab work, blood work, but first switch to suggested protocols.

Many here will suspect that there are other problems. Test fT3, fT4, TSH, morning cortisol, ferritin and a lab panel similar to: http://www.lef.org/Vitamins-Supplements/ItemLC322582/Male-Panel-Blood-Test.html
which also incorporates: http://www.lef.org/Vitamins-Supplements/ItemLC381822/Chemistry-Panel-Complete-Blood-Count-CBC-Blood-Test.html

You can pay for the above lab work out-of-pocket for a lot less than what a doc would charge if not covered by insurance. We can do a better job of working with your labs than almost all doctors.

Aches and pains: Lyme disease is a technical possibility. http://en.wikipedia.org/wiki/Lyme_disease

Have you traveled to any tropical countries prior to all of this starting?


#10

There is a website I found that has section on low T , you might be interested in your case
TC-Cancer.dot.

Mitch


#11

Was your E2 done prior to or after your orchiectomy?

If done prior, I would think your E2 results an estrogen producing tumor,w hich in turn supresses your testicular production.

If done after you started taking exogernous testosterone, I concur that it looks like too much T->E2 conversion, and the correspondingly high LH/FSH is concerning (could be function of lab timing)...