Low T? Need Some Advice!

I know from lurking here awhile that there’s a lot of knowledge that can hopefully do me some good. I’m 41 (dad to a 2 yr old boy).

I’ve been feeling REEEAALY tired, low mood, lethargy, low libido, lots of muscle/joint pain, weakness, etc., and have been finding it very hard to keep up the workouts and training especially the last 3-4 years. I’ve been feeling old! Last summer I committed to training for a 10K run cuz i felt maybe i was just out of shape. That almost ‘killed’ me tho. Sheer force of will got me out the door most days for training runs and I was sore ALL the time from it. Ran the race (51:15). Couldn’t get the energy to keep up the training after that. Then, it happened…

Heading to work one morning, i innocently slipped on some black ice outside my home on the street and busted my right ankle badly (bi-malleolar fx needed surgical repair). One of the nurses in the hospital suggested i follow up with my family doc for osteoporosis since it was a low trauma fracture… I go get the bone density (dexa) test and sure enough - I have it. Go figure. Freaked me out as you can imagine. So my doc sent me for all the labwork you can think of and referred me to an endocrinologist.

Now, the endo looks at my labs and says, all your labs are normal but you’ve got Total Test in the low-normal range - and for a 41 year old guy it looks suspicious(350 nm/ml). So then he sends me for a Free T test to confirm. Meanwhile i’m researching like crazy on low T and TRT and getting quite excited at the prospect of feeling a lot better!

Then came the follow up visit and the bad news/good news: My free T is normal (mid-range; can’t recall the actual value). He then goes on to tell me that he believes the ankle fracture wasn’t related to my osteoporosis. He says i’ve probably had low bone density all my life and that TRT wouldn’t do me any good - that any improvement to mood, etc. would be ‘placebo’ effect. He’s not going to recommend any treatment at this time!

WTF??? That brings me to you all here looking for possible answers or advice. My plan now will be to get my family doc’s opinion; although he’s pretty conservative and i doubt he’d be willing to do anything either.

Sorry for the long post. I’m wondering if anyone has any info about experience with TRT and idiopathic osteoporosis. Thanks.

Get a second opinion and find someone who will work with you to get your free T in the top quartile. This may or may not require TRT. Your first mistake was going to an endo. They are notoriously clueless.

Idiopathic or not, most of the time bone density improves as free T increases. All you can do is work with someone who will treat your symptoms rather than your numbers. Osteopaths tend to do this more than most.

Have you read Dr. Crisler’s protocol at www.allthingsmale.com ? If you could make a trip to see him in Michigan, it might save you a lot of time finding a competent physician.

[quote]stupc1968 wrote:
I know from lurking here awhile that there’s a lot of knowledge that can hopefully do me some good. I’m 41 (dad to a 2 yr old boy).

I’ve been feeling REEEAALY tired, low mood, lethargy, low libido, lots of muscle/joint pain, weakness, etc., and have been finding it very hard to keep up the workouts and training especially the last 3-4 years. I’ve been feeling old! Last summer I committed to training for a 10K run cuz i felt maybe i was just out of shape. That almost ‘killed’ me tho. Sheer force of will got me out the door most days for training runs and I was sore ALL the time from it. Ran the race (51:15). Couldn’t get the energy to keep up the training after that. Then, it happened…

Heading to work one morning, i innocently slipped on some black ice outside my home on the street and busted my right ankle badly (bi-malleolar fx needed surgical repair). One of the nurses in the hospital suggested i follow up with my family doc for osteoporosis since it was a low trauma fracture… I go get the bone density (dexa) test and sure enough - I have it. Go figure. Freaked me out as you can imagine. So my doc sent me for all the labwork you can think of and referred me to an endocrinologist.

Now, the endo looks at my labs and says, all your labs are normal but you’ve got Total Test in the low-normal range - and for a 41 year old guy it looks suspicious(350 nm/ml). So then he sends me for a Free T test to confirm. Meanwhile i’m researching like crazy on low T and TRT and getting quite excited at the prospect of feeling a lot better!

Then came the follow up visit and the bad news/good news: My free T is normal (mid-range; can’t recall the actual value). He then goes on to tell me that he believes the ankle fracture wasn’t related to my osteoporosis. He says i’ve probably had low bone density all my life and that TRT wouldn’t do me any good - that any improvement to mood, etc. would be ‘placebo’ effect. He’s not going to recommend any treatment at this time!

WTF??? That brings me to you all here looking for possible answers or advice. My plan now will be to get my family doc’s opinion; although he’s pretty conservative and i doubt he’d be willing to do anything either.

Sorry for the long post. I’m wondering if anyone has any info about experience with TRT and idiopathic osteoporosis. Thanks.
[/quote]

Good luck to you. I am 6 years younger with the same symtoms and lower t numbers. 2 doctors have shown no interest in treating me. Although they did show interest in charging me $1k for the consultation and testing.

In natural guys, FT varies during the day. What time of day was the lab work for FT?

What is your vitamin-D intake?

Do you use iodized salt?

You need trace minerals as well for bone health.

You also need to look at thyroid and adrenals.

You might have had high T levels when younger and your current levels may simply not be high enough for you.

[quote]ProfBush wrote:
Get a second opinion and find someone who will work with you to get your free T in the top quartile. This may or may not require TRT. Your first mistake was going to an endo. They are notoriously clueless.

Idiopathic or not, most of the time bone density improves as free T increases. All you can do is work with someone who will treat your symptoms rather than your numbers. Osteopaths tend to do this more than most.

Have you read Dr. Crisler’s protocol at www.allthingsmale.com ? If you could make a trip to see him in Michigan, it might save you a lot of time finding a competent physician.[/quote]

Thanks Bush… I’ll have to look into the osteopath like you suggest. Ya, i’ve seen Crisler’s stuff and i do find it very interesting. An ontario MD is doing similar things (mastersmensclinic.com) and he apparently can do email consults… something i’d consider doing also.
Cheers.

[quote]KSman wrote:
In natural guys, FT varies during the day. What time of day was the lab work for FT?[/quote]

Thanks KSman - Yes, the FT lab was at the recommended time in the morning - before 10am (supposed peak)

It’s good now (1-3000 iu/d); my vit d initially was only slightly below the recommended level… (the docs were not concerned about it).

I’m not a huge salt user but it is in my salt shaker, yes. My diet is pretty decent, i think. I should mention that i’ve been hypertensive for about 8 years now and on meds to control the high blood pressure. I can’t help but think it’s a related symptom??? I’m not overweight now and at the time I was in really decent shape - it didn’t add up. Doc said it’s probably hereditary.

My thyroid tests were normal. I am going to get a cortisol test, however, as that was not previously tested. The endo was skeptical, but i’ve since read that there is a thing called ‘subclinical hypercortisolism’ that could fit what i’m experiencing…

You know, that’s exactly what I was thinking too. From my internet research it appears as though guys’ T levels are HIGHLY variable and individualized. I read there’s also variability in the sensitivity at the receptor level from one guy to the next… One MD in Ontario specializes in TRT (mastersmensclinic.com) and his approach is to treat the patient not the labs. His diagnosis is made via a long questionnaire (80%) and labs (20%). If only i could find a doc like this here in Alberta…

One other thing i need to check - about 4 years ago i told my doc that my wife was complaining about my libido so he tested me for T. I can’t recall what the level was but all he said was that it ‘was in the normal range’. So he asks me if i get interested in attractive women on the street and i said ‘hell ya’. So he said it probably had to do with ‘familiarity’ with my spouse in the bedroom. I believed him at the time… now, i’m not too sure. Something tells me that that initial lab test came back in the low end of the normal range but it was so long ago now i’ll need to follow up with him.

Thanks again for your thoughts on this.

Thyroid tests were normal? You really need the numbers. Docs will pronounce you normal for any numbers within the lab range. That leaves many cases undiagnosed.

Get and retain all of your lab reports!!!

Blood pressure meds:

“Propanolol, Quinidine, Mehyldopa, Coumadin, Aminodarone[also directly decreases T]” increase estrogens.
The Testosterone Syndrome" Shippen, Page 211-212.

The above list is old. New drugs may also create similar problems.

Low T can promote heart disease and TRT can lower cholesterol and lower BP.

Read this cover to cover:

[quote]KSman wrote:
Thyroid tests were normal? You really need the numbers. Docs will pronounce you normal for any numbers within the lab range. That leaves many cases undiagnosed.

Get and retain all of your lab reports!!!

Blood pressure meds:

“Propanolol, Quinidine, Mehyldopa, Coumadin, Aminodarone[also directly decreases T]” increase estrogens.
The Testosterone Syndrome" Shippen, Page 211-212.

The above list is old. New drugs may also create similar problems.

Low T can promote heart disease and TRT can lower cholesterol and lower BP.

Read this cover to cover:

[/quote]

…then get pellets. I’m having Testopel pellets inject tomorrow.

Does anyone know of a doc/clinic in Edmonton, Alberta, Canada that is versed in trt. It may be challenging to get a regular doctor to co-operate with trt regiment that I’ve found in this forum. Thanks.