Low Testosterone, Still in Range?

Hello everyone. New to this forum, could use some advice. A little background info, 27 year old male, 6 feet 2 inches high,250lbs, 38 inch waist, body hair: small amount on arms, moderate amount on legs, moderate amount in arm pits, small amount on face (can’t grow a beard, used to have to shave every other day, but lately I can go almost a week without shaving), been gaining weight the last 4 or 5 months,noticing more fat in chest, uppers arms (on the inside near armpits),hips and thighs.

So far no health conditions to speak of other than seasonal allergies, taking claritan daily. Been on keto diet for the last few months trying to cut this weight (without much success), eating around 2,000 calories per day which according to myfitnesspal I should be losing 1.5-2lbs per week. Training at least 4 days per week sometimes 6, strength training/bodybuilding type exercises(becoming difficult due to fatigue).

The last week or so my testicles have been feeling odd, they don’t really hurt they just feel full, but they don’t feel swollen, if that makes sense, they’re not tender to touch either. No morning wood for last few weeks, sex drive is gone, can still get it up when the wife is in the mood, but I can’t remember the last time I felt like I needed to have sex. I work as a nurse, and asked one of the doctors I work with if I could get my thyroid checked a few months ago when I first began to feel tired all the time. TSH was 1.30, T4 was 1.01.

Then last week after reading about low testosterone, I asked a doctor to write me an order to get my T level checked. He almost wouldn’t do it because I’m 27 and that couldn’t be the cause, but finally agreed, but only wrote for my total testosterone level. It came back at 344ng/dl. Which is still considered in range. I told him all the symptoms I was having (fatigue,no libido,weight gain,(testicles weren’t feeling weird yet)), and he said it could be depression.

I don’t feel like my mood has changed too much, I never feel like going out or doing anything, but it’s because I’m exhausted, not because I feel sad. I’ve made an appointment with a family practice doctor that I’ve gone to before to see if she’ll let me get the labs drawn that are recommended in the stickie. So far that’s all the info I’ve got. Just looking for any advice I can get. Really getting sick of feeling this way all the time. Thanks for listening.
J

Just tell the Doctor all of your symptoms and if they don’t respond well, try someone else. I’m 25, had test of 397, and had my doctor treat me because all of the symptoms were from low T. I wasn’t even looking for it; he suggested it. That’s why I’m here :slight_smile: Anyway brother, I wish you the best of luck in everything.

Order your own labs from lef.org

Read the advice for new guys sticky and the lab testing sticky for now.

Even though you’re a nurse you still most likely have a lot to learn, keep an open mind and don’t get T tunnel vision…

Low T is a symptom of a problem and not a cure all, often we see guys who don’t feel better and the proper protocol for administration of trt is a bigger pain in the ass then you think.

Trt to find out what your link is… If you post all the requested labs people here can set you In the right direction

Welcome!!

Went to the doctor today. She seemed to agree with me that it’s most like low testosterone. Drew labs for total test, free test, e2, b12, CMP, CBC and hemoglobin a1c. She said she wants to rule out diabetes or some kind of anemia. Should get the labs back sometime at the beginning of next week. Will keep you posted.
J

Lh and fsh
Dhea-s
Tsh ft3 ft4
Prolactin
Vit-d

Should have read the stickies before you went :slight_smile:

Total test and free test are going to tell us you’re low but not why

Fixing T and thyroid [if needed] will allow you to loose weight.

Are you vit-D deficient? - you can test Vit-D25

You need:
TT
FT
E2
LH/FSH
TSH
fT3
fT4
DHEA-S
CBC
fasting total cholesterol
ALT/AST - liver marker, if elevated, might be Claritin
Can you connect Claritin to when problems started?

You can eval your thyroid function by taking your body temperature, see the thyroid basics sticky.

Please review this:

This is standard advice maintained here:

There is a huge amount of knowledge in the stickies. Please study these. Start with the advice for new guys sticky.

There is a lot to read there, so read carefully. There are suggestions for things that are root causes of low testosterone [T]. Low T is a symptom, not a root cause itself. But low T itself is a root cause of many of the symptoms one experiences. Note that other things cause the same spectrum of symptoms, so do not have T tunnel vision. Many docs are guilty of that and they only treat the symptom [low T] and do not attempt to find the real problem. If you go to a clinic that specializes in low T, you will get T tunnel vision for sure.

Post info about yourself as suggested in the above sticky. We need labs, almost all of your labs, not just hormones. We also need the lab ranges.

We see a very high number of thyroid issues in the population of guys that show up here. So there is a strong focus on that. Most people are iodine deficient to some degree. Your history of iodine intake from iodized salt and vitamins that list iodine is important. If you become iodine deficient, the RDA [recommended daily allowance] is inadequate for recovery of iodine stores. Please see the thyroid basics sticky for more information.

You do not want to suffer from subclinical hypothyroidism or get Rx thyroid meds to treat iodine deficiency.

If you are injecting T or contemplating that, read the protocol for injections sticky.

There are stickies for finding a TRT doc, estradiol [E2] and lab work.

Do not place your history or treatment details in the stickies! That belongs in your thread. Keep all of your posts in your thread so we can have a clear picture of your situation and needs.

Finally got my labs back from last week.
Cholesterol :195
Triglycerides: 76
HDL: 43
LDL: 137

WBC: 4.72
RBC: 5.17
Hemoglobin: 15.7
Hematocrit: 47
Estradiol: 29
Ferritin:120
Vit B12: 906
Free Testosterone: 39

My doctor said I could start on depo testosterone every 2 weeks. I asked about Arimidex or some type of anti-estrogen. Was told it’s not needed. Asked about taking the shot once a week or twice a week to prevent peaks and valleys. Doc said the people who she’s treated in the past complained of great right after a shot, and crappy after two weeks, but when they checked levels, they were always 600-800. I’ve got an appointment with a urologist on Wednesday, so I think I’m gonna wait to see what he has to say. And try to get the rest of the labs I need drawn. Wish me luck.

** Are the any signs/symptoms that would mean a pituitary tumor vs primary hypogonadism? I’m kinda getting worried about a tumor or something. I don’t feel any lumps under my nipples, and nothing comes out of them, so my prolactin should be okay, right?

Prolactin should be checked and not disguarded because you don’t have discharge from your nipples.

Read the lab work sticky and get the labs suggested

Do not even start on a 2 week protocol this isn’t correct and your doctor is wrong

Quick update. Saw a urologist today. Not happy at all. I waited for 90 minutes before being seen, and when he finally showed up it was less than 10 minutes. I told him what’s been going on symptom-wise, he had my free T results but not my total T. When I told him my total T was 344, he said it was fine. I told him I’d read that even though its technically in range, someone my age that’s having these symptoms , that level could be too low.

He disagreed, and said he was going to refer me to another urologist in his group that does more men’s health/hormone type stuff. I did manage to convince him to have the lab check my FSH and LH. I asked about prolactin, and he said “Sure we can do that too.” Got to the lab to have them drawn, and he had only written for FSH and LH. Now I’m supposed to go back this Friday to see another guy. Hopefully he’s a little more knowledgeable.
End rant.

J

Patience is key, friend. Be firm in your requests for labs - it doesn’t cost him anything. Assuming you have insurance, it likely won’t cost you anything else. If you have to - get them done yourself as mentioned above. Many of us have had to go to several doctors/endos/uros to get one that knows anything - or is willing to learn.

Saw a different family practice doctor today. He was agreeable to replacement therapy once my FSH and LH and prolactin finally come back. The only problem is he will only prescribe Androgel. I explained to him I was worried about contact with family members/expense. He told me that due to it being a controlled substance, there was too much liability on his end if he prescribed it. I asked him if it would make any difference if I self injected, and kept the testosterone at my house. He said it made no difference, it was gel or nothing. Has this happened to anyone else for this reason?

You have T tunnel vision…

You don’t even have lh and fsh labs yet and your ready to jump on injections without knowing what is wrong… If you feel like shit still 3 months after injections start don’t say I didn’t tell you so…

Low T is a symptom of a problem…

Got some labs back today:
LH: 2.8
FSh: 3.4
Prolactin 5.9

These were drawn around noon on Wednesday the 17th.
Had them redrawn today at 0730 today (Friday the 19th), because I saw on here that they need to be checked in the morning. Silly me. Fingers crossed that there’s not something wrong in my brain.

Those were the only labs?? Please add units and ranges when you post labs.

[quote]iw84aces wrote:
Those were the only labs?? Please add units and ranges when you post labs.

[/quote]
That was all the urologist I saw Wednesday would order. Don’t know what units they used, the person who called me the labs was a tech, and didn’t know.

Lol… Another idiot doctor

It has been more than a decade of increasing suffering including the following: severe physical fatigue, lack of ability to build any muscle despite daily cycling, low decreasing to no sexdrive, deadly fatigue after orgasm for 2-4 days afterward including daytime sleepiness, increasing crackling and pain in all joints with no family history of arthritis or swelling, loss of bodyweight despite massive intake of carbs and high-quality fish protein (cachexia, aka. wasting disease), weak immune system, poor sleep quality. No morning wood since over fifteen years ago. An increasing feeling of femaleness inside which was at first relaxing but now just pure fatigue and gross.

Five months ago I purchased online the unregulated molecule Clomiphene and it arrived in the manufacturer’s original sealed blister-pack of tablets. It’s supposed to trick the body into producing more Testosterone by fooling it into thinking Estrogen levels are higher than they are. I took 50mg/day for a week. Chewed the tablets to taste the distinctive flavour of this molecule. At the end of the week: suicidally depressed with zero relief of any symptoms. Therefore I realized that I am primary hypogonadal: balls can’t produce any more even if commanded to do so. Flushed the rest.

Finally I decided to get Total Testosterone tested despite my hatred of needles. The test was performed on 2013/07/16:

Total Testosterone: 11.8 nmol/L
‘Normal’ Range [0-100 years old]: 9.9 - 27.8 nmol/L

From: “Endocrinology Conversion Factors.pdf”: Divide nmol/L by 0.0347 to get ng/ml
= 340 ng/dl

TSh = 2

Weight: 150lbs
Age: 35
No alcohol/caffeine
Sleep: 7.5hr/day, wake when done sleeping - no alarm
Vitamin D3: 10,000 IU/day (potentiates testosterone)

From: Testosterone Week: What’s a “Normal” Testosterone Level and How to Measure Your T

Measurements in Conventional Units (ng/dl)
Date of Samples: 1996

Age # Subj. Total T

25-34 45 617
35-44 22 668
45-54 23 606
55-64 43 562
65-74 47 524
75-84 48 471
85-100 21 376

The three emotions of joy, shock and sadness competed for dominance as I computed the ng/dL value. My level of 340 puts me in the 85-100 year old normal. I feel like it too. Should have been tested a decade ago. There is an epidemic of low Testosterone ravaging at least the populations of North America - perhaps the entire World.

Not wanting to waste a second more of suffering I immediated journeyed by bus back to the hospital to obtain my Testosterone prescription. There are no GPs or specialists taking patients in my area and I have no vehicle and limited funds. I spoke with the attending GP and outlined both my symptoms in detail and the computed results.

Predictably, he said that since I was still in the ‘normal’ range [0-100 years old remember] that I was ‘paranoid’, it was ‘all in my head’ and that he would not prescribe anything. I predicted his reply would be this type with 80% confidence before even arriving at the hospital. I politely told him about the low Testosterone epidemic and he suggested that all my online data sources were illegitimate. Further, he informed me that even if I were to obtain a prescription, only regular and painful intramuscular [IM] depot injections were paid for free under my current disability coverage unless I could afford to pay out-of-pocket the completely and impossibly unaffordable $200/month for a Testosterone patch. Those words alone decided the case for self-medication with orals.

I have never met a doctor who has gone through severe/chronic illness. Not having experience themselves they have no clue as to the suffering of their unlucky patients. He was one of this type as well - though I could tell by observing his physique [his age is about mine or at most five to seven years older - a young guy] that he was himself a lesser victim of said low-T epidemic.

I smiled at this creature of the System and told him my plan: to cure myself. Of course he disrecommended such action and suggest I wait a year or more for a hoped-for endocrinologist to appear in my area. I told him that my life would be over before then and then asked him the final question: will you keep my plan in confidence as the medicine is scheduled in my country? Yes was his reply. I walked out of the hospital with only one path left and feeling a magnificent high. Knowing the only path left I now had the final confirmation to walk it.

Having fought off the daily brain fatigue with nootropics such as Piracetam and Oxiracetam since 2008, I had built the Racetam Prices list to find affordable racetam suppliers. After tiring of paying Western reseller prices I had begun to build my own ‘company’ and learned all the ropes of negotiating directly with Chinese chemical companies. After obtaining over a thousand suppliers for nootropic powders from these negotiations and compiling them into this list I had decided to publish it online [http://users4.jabry.com/isochroma/Racetam%20Prices.htm]. By good fortune many of these companies had also provided full pricelists of other molecules including sex hormones :slight_smile:

It took only a few days to dig up six excellent quotes for ten grams of 99% pure Dianabol [Methandrostenolone]. I have a 1mg-accurate digital scale for measurement but insufficient funds to buy from resellers so decided to go directly to the sources. As of today I have chosen the supplier: $91 USD for 10g including EMS [fully tracked door-to-door Express Mail] fee with reship if the product does not arrive for any reason. It will take only 7-10 days to transit from China to my country.

Considering my joint dryness/cracking/pain and the fact that estrogens are made via aromatization from Testosterone, I decided to use Dianabol due to its aromitization - I’m deficient in estrogens too. The proposed dose is 10mg each morning during what should be the normal Testosterone spike - both for its naturally correct timing and to minimize any suppression.

As for hepatotoxicity - I will get a monthly liver panel at the hospital. With no alcohol, other liver-stressing drugs (I take zero Aspirin/Tylenol and no caffeine) and no family history of liver disease - the risk is worthwhile. Suicide risk and chronic disease certainty are far higher. With no cure the already-planned painless suicide is looming so hepatic concerns are a fluffy white cloud on the distant horizon.

The dosing is to be daily and perpetual. Perhaps EOD at 15mg. At 10mg/day the ten grams will last for 2.7 years - this potent molecule is highly affordable.

I may need to switch to a steroid which has higher aromitization if joint pains persist. After thorough research I know what is needed to avoid problems and will employ an Aromatase inhibitor if needed.

For any male with suspected symptoms: don’t wait another day - get tested now.

Suggestions and feedback appreciated.

New morning labs back
Fsh 4.4 (1.4-18.1)
Lh 3.1 (1.5-9.3)
Prolactin 14 (2.1-17.1)

Any thoughts?

Spoke to an internal medicine doctor earlier this week. After I told him all of my symptoms and showed him the lab work that I had already had drawn he said he needed a few days to research. I spoke with his nurse yesterday (Friday) and she said on Monday he wants me to go in for more labs (don’t know which ones yet, because she didn’t have the lab requisition in front of her when she called), and then get a chest x-ray. Not exactly sure what he’d be looking for with the chest x ray, but I guess I’ll ask when I pick up the orders on Monday.

I’m primary hypogonadal - I tested 50mg Clomiphene for a week six months ago - at the end, suicidal depression of a kind never before encountered and no change to any symptoms.

Once again my stats:

Weight: 151lbs
Height: 6’ 2"
Age: 35
Total T: 11.8 nmol/L /0.0347 = 340ng/dl [Tested 2013/07/16]
TSH: 2 [Thyroid is normal]

Drugs: No Alcohol, No Caffeine, Sunifiram 25mgx6/day, Oxiracetam 500mgx6/day
Protein: 213g Wild Pacific Canned Salmon/day [16g fishoil/day, potentiates Testosterone]
Exercise: No Car, long hilly bicycle journeys every few days

Thyroid testing is important because the symptoms of hypothyroid partially overlap the symptoms of hypogonadism. These are: general weakness, easily tired, low core temperature, low extremities temperature, dry skin. My thyroid’s been tested about a half-dozen times since age 10 and all tests were normal. They kept testing because my symptoms matched hypothyroid and the underinformed physicians apparently had no clue about hypogonadism.

If you suspect your case similar to mine you must get both Testosterone and Thyroid function tested.

After only eight days in transit by Express Mail, on 2013/08/07 I received 10g of pure Dianabol [Methandrostenolone] powder with 99% purity directly from the Chinese manufacturer. The cost was $121.12 including EMS fee. At 10mg ED the cost is very affordable: this 1000-day supply will last 2.7 years. Costs at 10mg ED are $0.12/day or $3.63/month. Do note however that as I will explain below this dosing is higher than needed - likely double. 10mg EOD will cut these costs in half.

I decided the pure powder route due to cost efficiency and also already owning an excellent 1mg digiscale - the HORIZON Pro-20B. Because I already have to measure out two milligram-level molecules each morning I decided the extra work to measure one more wouldn’t be a problem.

On that fateful Thursday as I rode to the post office to collect the parcel I thought about how very soon cycling would become a pleasure again rather than constant pain that never results in gains - even endurance.

The parcel was well packed and it took some time to find the product. The weight and solubility matched Dianabol’s properties - insoluble in water.

Carefully measured out 10mg, noted the time and ate it. Not particularly much flavor - certainly not the strong bitter of junk methyltestosterone.

Racetams usually take 40 minutes but I was rather shocked because at the 35-minute mark something rather dramatic began to occur.

My entire life has been a kind lived in deficiency. No matter the amount or quality of food consumption, vitamins, minerals, etc. deficient symptoms plagued me. Deficient: poor food absorption, inability to maintain weight, can’t hold muscle even with daily exercise, constant chronic fatigue and bones sticking out everywhere - ribs, knees. Can’t sleep without a cushion between my knees due to protruding kneebones covered with insufficient flesh.

Metabolic deficiency has also kept me long company: cold extremeties, tiredness, slow metabolism are all daily features of life. I mean corpse-cold hands and feet all the time.

Back to the time. I’m at some random place - in the washroom - and suddenly I realize something. My hands aren’t just warm - they’re slightly sweaty. My feet are warm. And inside my core is something rather new - a furnace is burning warmly where before it was just chill.

The excess of heat was so great that over the next hour that sweat made a mess of my mouse :frowning:

Over the next few hours more effects became apparent: minor pains from exertions disappeared. The most stunning thing was the mental effects. Almost more powerful than the physical. I just can’t describe it but if I could use lying words I would say that a feeling of what should be normal overcame me in a gradual fashion. This feeling of peace, correctness, happiness and confidence was completely unexpected. Even if the World would end tomorrow and I knew it today nothing could make me unhappy.

The effects persisted very long - longer than the anticipated four hours and into the night making sleep a little difficult.

Now for the sides:

  1. The sweating was annoying. Fix: lower dose / EOD dosing.

  2. Hair is slightly greasier. Showers every 5 instead of 7 days.

  3. The level of tension that 10mg created was fine for everyday activities but the superfine highspeed motor coordination needed to fling the show on the PC wasn’t there. A bit of tremble consistently manifests too, but it’s the coordination that counts. I’ve had similars on nootropics and adaptation / dosemod always fix it. Fix: 10mg EOD instead of ED.

  4. This is the only really bad side and one that - luckily - has already faded by 80% since last week. A couple days after starting I found myself opening my usual tasty Salmon can for dinner. Something went wrong when I put the first spoonful in my mouth though. The taste was wrong and I had to work hard to eat it. It was like chewing paper fibres that had been poorly flavored. Note that I only encoutered this kind of effect on a few foods and also note that appetite was and is minimally if at all affected. Last night - the last night of dosing as I’m on break today - the same salmon tasted fine and it was easy to eat it.

  5. In an isolated occurrence, yesterday morning I dealt with extreme nausea about an hour after waking. It was bad enough that I had to run to the washroom and stand over the sink three times but luckily did not lose breakfast. It has not recurred. I don’t know if it was due to the Dianabol because it only happened once and all of Dianabol’s other sides manifested consistently.

These are all short-term sides. The long-term picture is very different. There we are dealing with a negative-feedback loop within the body causing a decrease in endogenous Testosterone production. My own production is already so low at 341nm/dl - and naturally declining at such a high rate - that it’s not exactly a shining star but nevertheless I have spent an enormous amount of time reasearching how to prevent the downregulation of production.

Testosterone is naturally released in the morning (4a - 8a typical) in a spike. It is theorized on various forums that a short-acting androgen taken in a tiny dose at that time will co-incide with the Testosterone spike and therefore the negative-feedback loop won’t see it as much or will be programmed to ignore it. I think that theory has a good chance of being true. If the negative feedback loop had the same sensitivity at all times of the day as the morning then the morning spike would naturally result in some awful downregulation. Dianabol is a short-acting androgen - according to some sources anyway.

So I decided to use the Dianabol 10mg + Morning Dosing method. Seems to be working so far.

Every day and at the end of the week today I checked both balls and breast area. Remember, a deficiency of Testosterone implies an Estrogen deficiency too since a man makes it from Testosterone. With every joint in my body crackling but no classic arthritis symptoms or family history I guessed that the joint issue is the same as those on bodybuilding forums who report the same symptoms after taking non-aromatizing androgens. Oddly, after a week of Dianabol the cracking has only declined slightly but the pains are 90% gone.

I specifically chose Dianabol because it aromatizes moderately. Ironically, the unnatural form of Estradiol produced by the aromatization of Dianabol is a far more potent estrogen then natural Estradiol. So while less is produced due to its lower rate of aromatization, what is produced has a far stronger estrogenic effect.

Naturally one must be concerned about feminizing effects. However, cases like mine are unique: with a severe combined Testosterone and Estrogen deficiency and using a low dose of Dianabol (10mg ED switching to 10mg EOD), the result is a repletion of both hormones’ receptor activities which is precisely what is needed. The ratios may need tweaking and it can be done using various methods.

This is very different from what someone who bodybuilds is going for and where they’re starting from. They’re starting from relatively normal levels and aiming for supranormalcy. That means having to deal with higher doses, higher costs, side effects and stacking anti-estrogens, aromatase inhibitors, SERMs, SARMs, etc.

Frankly, it’s a totally different picture from the deficient individual aiming for normalcy. It is possible for deficient individuals to get to normalcy using the synthetic androgen Dianabol [Methandrostenolone] with minimal to no side effects - remember I have an unusually sensitive and weak body - and very low financial costs. The legal risks with high-density pure powder are also minimal since hiding is easy.

The liver is the other health matter of import. Yet after thousands of hours research I cannot find any kind of hepatic symtoms reported on any forum or study from only Dianabol 10mg ED - never mind my planned 10mg EOD or even every third day. I don’t take any alcohol - quite unusual - aspirin, tylenol, caffeine or any other liver-stressing drugs and I also don’t take any ‘liver support’ supplements. I’m not on any prescription drugs or liver-stressing herbs either. With this dosing pattern I just can’t see hepatic issues in my future and none exist in my family. I could get enzymes tested at the local hospital but am lazy.

My kind of looseness would be a problem on a bodybuilder’s regimen but with the tiny amount and other factors I’m confident that safety is relatively assured but will of course monitor regulary for symptoms.

Today I am off Dianabol and am amazed that the effects continue at about 80%!

Except now the heat is moderated. It is a low fire that keeps me moving efficiently and quickly. Coordination and speed on the PC are back up to 90%.

The sweating is down to decent levels too. It’s closing in on perfection.

The next step down the dose trituration curve is 10mg EOD - every other day - half the previous dosing. That new dosing will begin tomorrow.
Today is the first alternating day-off of the new dosing schedule.

My only question for others is which dosing pattern would provide most effects and be least suppressive: 10mg EOD or 5mg ED?