Low T - 24 years old male (post-cancer)

Pharma / TRT Testosterone Replacement
1

Hey guys,

First off, I lost a testicle to cancer a year ago, and underwent three months of chemotherapy afterwards, which I completed in September 2010. So I just had some blood work done to see if my hormones are back where I want them to be, and I’m not too thrilled with the results. Its far from an exhaustive list given that I wasn’t familiar at all with any of this until today, but here are the relevant ones I had measured:

LH: 4.2 IU/L (range: 2.5-16.3)
FSH: 13.0 IU/L (range: 1.2-18.5)
TT: 9.09 nmol/L (range: 2.8-21.6) - if my conversion calculation is accurate, 9.09 nmol/L = 262.1828 ng/dL
Cortisol Random: 550 nmol/L (range: 120-535)

Some facts to consider:
-24 years old man
-Height: 5’8"
-Weight: 155lbs
-Lost a testicle to cancer a year ago and finished chemo in September.
-I’ve lost 5 pounds in the last month as a result of increased exercise and a switch in diet. I’ve been eating paleo for the last month (high protein, high fat, low carbs), and I’d say I’ve stuck to it at about 80%. Definitely not a fanatic follower, but good enough overall.
-I feel the lifestyle switch has done some good as far as how I look (although it may just be the increased exercise that is responsible), but my libido has definitly been lower (no morning wood, weaker erections). I’m tempted to switch back to a more balanced diet (ie, decrease fat, increase carbs) because of that alone.
-The only supplement I take is Whey Protein.
-I don’t think I’ve had enough sleep recently (and certainly not the day before the blood test), so I think my results are poorer than they should have been.
-I don’t feel stressed, so I find it a little strange that my cortisol is so high. Maybe I have a high threshold for pain and I just don’t notice it?

Thoughts/Advice?

Thanks fellas

2

No your testosterone is probably around 500ng/dL not around 200 (a guess). The low for the range of ng/dL begins at 250ng/dL I believe and you are almost in the middle. Everything looks fine/ Your T could be higher…losing one testicle won’t influence your testosterone levels. The chemo may have shut down production but you seem to have bounced back. What are your symptoms? Those are most important

3

How are you converting from nmol/L to ng/dL? The only conversion calculation I’ve seen so far brings me to 261-262.

The only recent symptom I can think of has been lower libido… Weaker erections and no morning wood. It’s also never been easy for me to pack on huge amounts of muscle, but that’s pretty much always been the case.

4

[quote]Retinoid wrote:
No your testosterone is probably around 500ng/dL not around 200 (a guess). The low for the range of ng/dL begins at 250ng/dL I believe and you are almost in the middle. Everything looks fine/ Your T could be higher…losing one testicle won’t influence your testosterone levels. The chemo may have shut down production but you seem to have bounced back. What are your symptoms? Those are most important
[/quote]

Yet again you give terrible “advice” and make it readily apparent that you have little clue what you are talking about.

Let me disprove your two points:

  1. OP’s math was correct, in that 9.09 converts to about 261 in SI units. Do not GUESS when you are giving “advice”. I can almost let this slide since the range is heavily screwed up (OP are you sure you posted the range correctly?) and the high end is only about 620 on this lab, but then you go on to state:

  2. “losing one testicle won’t influence your testosterone levels”…this is complete and utter bullshit…there is a reason that many men who have undergone Testicular Cancer end up on TRT (myself included) and its not because we just suddenly feel like jabbing ourselves a couple times for the rest of our lives…again, if you have nill clue what you are talking about, you should refrain from giving advice

I didn’t want to bring up all the other times you have given absolutely piss poor advice on here that has no basis in reality, but this post put me over the edge.

OP: Please check the ranges on Testosterone–they definitely don’t seem right. neither do the ranges for your LH/FSH either. What lab did you use? What country are you in?

Why was your chemo 3 months long? Did they have evidence of metastisizing elsewhere? Most common adjuvant therapy when there is no evidence of metastization is two rounds of Carboplatin spaced 21 days apart–anything more than this is probably overkill.

No radiation correct?

When I lost my nut, my LH and FSH sky rocketed to 2-3 times the upper level, indicating my remaining guy just couldn’t get the job done despite my body’s best efforts. This doesn’t seem to be the case with you.

One good thing that Retinold managed to get out was: what are your symptoms? This is very important.

Did you not have bloodwork done before the orchiectomy?

5

Do you feel fatigued or get cold easily? When was the blood drawn (relevant for cortisol)?

Low libido could be a result of low DHT. I would test TSH, Total T, Free T, DHT, E2, and maybe another 8am cortisol at the minimum.

6

[quote]VTBalla34 wrote:
OP: Please check the ranges on Testosterone–they definitely don’t seem right. neither do the ranges for your LH/FSH either. What lab did you use? What country are you in?

Why was your chemo 3 months long? Did they have evidence of metastisizing elsewhere? Most common adjuvant therapy when there is no evidence of metastization is two rounds of Carboplatin spaced 21 days apart–anything more than this is probably overkill.

No radiation correct?

When I lost my nut, my LH and FSH sky rocketed to 2-3 times the upper level, indicating my remaining guy just couldn’t get the job done despite my body’s best efforts. This doesn’t seem to be the case with you.

One good thing that Retinold managed to get out was: what are your symptoms? This is very important.

Did you not have bloodwork done before the orchiectomy?[/quote]

I can confirm to you that the ranges are all correct. I’ll scan a copy of the results this afternoon and post it or send it to you by PM.

I live in Montreal and was treated at Montreal General Hospital, and had my blood work done there. As per the abdominal CT scan, there was evidence that the cancer had spread to the abdominal lymph nodes. The protocol in this case was either 4xEP of 3xBEP. I ended up going with 4xEP, due to the bleomycin’s (B) potential to cause long-term lung damage. No radiation.

Regrettably, the only things I had measured pre-orchiectomy and during chemo were the tumor markers (beta hCG, alpha feto protein, and maybe one or two others), so I don’t have a pre-cancer reference point for total testosterone and all of the other hormones.

As for symptoms, in truth, other than the lower libido as of late, I can’t say that I feel all that different than the way I did pre-cancer. For all I know, perhaps my TT has always been on the low-ish side, and the cancer has had no long-term effects. Whatever the case may be, poor results aren’t any more acceptable.

In layman’s terms, what can I infer from the relation between my current levels of LH/FSH/TT/Cortisol? What do these tell me, and what else should I absolutely have measured?

7

[quote]scj119 wrote:
Do you feel fatigued or get cold easily? When was the blood drawn (relevant for cortisol)?

Low libido could be a result of low DHT. I would test TSH, Total T, Free T, DHT, E2, and maybe another 8am cortisol at the minimum.[/quote]

I had the blood drawn at approximately 9h30AM. If I get enough sleep (8 hours or so), I don’t feel fatigued, and I never get cold.

Thanks for the advice.

8

[quote]shoryuken wrote:

[quote]scj119 wrote:
Do you feel fatigued or get cold easily? When was the blood drawn (relevant for cortisol)?

Low libido could be a result of low DHT. I would test TSH, Total T, Free T, DHT, E2, and maybe another 8am cortisol at the minimum.[/quote]

I had the blood drawn at approximately 9h30AM. If I get enough sleep (8 hours or so), I don’t feel fatigued, and I never get cold.

Thanks for the advice.[/quote]

Cortisol is very high for 9:30. Given that you aren’t stressing yourself out to the point of physical pain, I’d say it’s pretty likely your body is fighting off an infection of some type.

9

[quote]shoryuken wrote:

In layman’s terms, what can I infer from the relation between my current levels of LH/FSH/TT/Cortisol? What do these tell me, and what else should I absolutely have measured?[/quote]

Interesting case.

Honestly mate, it looks like your body recovered pretty well on its own. Your T levels are at a decent spot on the range (though I am still skeptical of the actual value, which on paper is very very low). It could be that the range is made up of very sick people, shifting it to the left, or it may be a difference in the way they perform the assay. Very strange though.

SCJ119 pretty much nailed the tests that you need to get done for your poor libido symptoms. Talk to your doctor (probably GP or urologist, not oncologist) about ordering these tests based on your symptoms.

Your high cortisol is also interesting. Were you ill at all at the time of the test? We don’t see many guys here with too high cortisol that are also experiencing symptoms of low T, but TC is a game changer in that regard and becomes a wild card. I would retest cortisol with the other blood tests to see if its fallen.

10

Is it possible that a large reduction in carbs as I’ve done over the last month could have had an effect on my libido, or is it unlikely that the two are related?

11

[quote]shoryuken wrote:
Is it possible that a large reduction in carbs as I’ve done over the last month could have had an effect on my libido, or is it unlikely that the two are related?[/quote]

Carb-phobia can negatively affect thyroid function (downregulating T4->T3 conversion)… but I don’t know how strict you have to be, or for how long, for the effects to be seen.

12

To be honest, I wouldn’t have predicted a low T score prior to taking the test. I’ve got a small frame, but I look good and most people say I look pretty jacked. I need to shave every 1-2 days if I want to stay clean-cut, and I’ve got plenty of hair all over the place. I’ll concede that I’m never very motivated to go out, but I think that might be the product of an introverted personality more than a symptom of low T. I’ve always had a bit of a baby face though.

I’ll ask to have the blood work done again in a month or so w/ the other tests you guys have suggested, and I’ll make a couple of lifestyle adjustments until then (such as get more sleep).

If you guys have anything more to add, please go right ahead. Thanks.

13

[quote]VTBalla34 wrote:

[quote]shoryuken wrote:

In layman’s terms, what can I infer from the relation between my current levels of LH/FSH/TT/Cortisol? What do these tell me, and what else should I absolutely have measured?[/quote]

Your high cortisol is also interesting. Were you ill at all at the time of the test? We don’t see many guys here with too high cortisol that are also experiencing symptoms of low T, but TC is a game changer in that regard and becomes a wild card. I would retest cortisol with the other blood tests to see if its fallen.[/quote]

I wasn’t ill, but I did work out the night before (not even 12 hours before the test), which I just read somewhere is not something you should do before having cortisol measured. I’ll have the whole thing taken again soon and we’ll see what it says then.

14

[quote]VTBalla34 wrote:

  1. OP’s math was correct, in that 9.09 converts to about 261 in SI units. Do not GUESS when you are giving “advice”. I can almost let this slide since the range is heavily screwed up (OP are you sure you posted the range correctly?) and the high end is only about 620 on this lab, but then you go on to state:
    [/quote]

For one thing if the range is correct as he says, then his testosterone is NOT 262. I said I guess as I didn’t do the math just based on the range.

Actually losing one testicle does NOT decrease testosterone production. So I do have a clue what I am talking about.

Please do so…besides you are one to talk telling me to take prenenolone to increase my cortisol when I actually have HIGH cortisol. I never attacked you ass.

15

Here VT educate yourself before using your feelings to attack:

“Injury to the scrotum: If the testes are injured, they may not be able to produce adequate testosterone. Damage to one testicle does not often to lead to low levels if the other testis remains normal.”

http://www.medicinenet.com/low_testosterone/page2.htm

16

Retinoid:

What is your method for converting nmol/L to ng/dL?

17

[quote]shoryuken wrote:
Retinoid:

What is your method for converting nmol/L to ng/dL?[/quote]

I didn’t calculate it shoryuken, so you may be right (which is why I said I am guessing) however the range for testosterone with ng/dL is like 250-1100 ng/dL so if you are at like 9 nmol/L with a low of the range as 2nmol/L I would assume you aren’t that low (268). Unless, like VT said, the range was different than a normal person’s or you misprinted it then you may be 268.

18

Shoryuken are you sure it isn’t FREE testosterone and not TOTAL? If it is free then the range would make sense.

19

[quote]Retinoid wrote:
Here VT educate yourself before using your feelings to attack:

“Injury to the scrotum: If the testes are injured, they may not be able to produce adequate testosterone. Damage to one testicle does not often to lead to low levels if the other testis remains normal.”

http://www.medicinenet.com/low_testosterone/page2.htm [/quote]

Educate myself???

I lost a nut to testicular cancer earlier this year you bloody idiot. My T went from the 500’s to the 200’s, LH and FSH rose to double and triple the top ends of the range after being relatively stable within range for the past year…I am no on Testosterone REplacement Therapy entirely due to testicular cancer

There are MANY others in my exact same situation…so you can quote the theory and whatever the hell else it is you want to base your opinions on, but you need to realize they have no basis in reality, especially if someone is coming online after TC (with no problems before) suddenly complaining of low T symptoms…

There is a reason we get the outliers on these types of forums and its because the ones who fall into the normal percentile range (which I’m sure your study is applicable to) have no need to come online to seek help because they are doing just fine (same with those that are on terrible TRT protocols and still manage to live their lives)…we get the rest…