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Low Testosterone

I am 54 and have been lifting for the past 6 months in an attempt to keep advancing age at bay. 5 ft 9 and 155. Waist stays stable at 32.
I have just had blood work done and free testosterone is 3.8, total is 269. In other words-LOW.
Any comments on testosterone therapy and the costs? Also, I have noticed muscle gains…how is that possible with such low numbers?

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[quote]fedorov wrote:
Also, I have noticed muscle gains…how is that possible with such low numbers?[/quote]

I don’t have specifics on your other questions, but women gain muscle also. It is a false belief to think that lower testosterone means you won’t gain muscle at all. You probably won’t gain AS MUCH as you would with HRT, but changes in body composition aren’t based on testosterone alone.

I too was able to gain a little muscle w a test level of 239. But that did not mean that I was not suffering (and man was I suffering) from low testosterone.

As to costs it depends on your insurance coverage. With mine for example

Androgel cost $295.00 a month at the pharmacy, but my actual out of pocket was only $20.00

Brand name injectible testosterone was $95.00 at the pharmacy for a month and a half(?), but my actual out of pocket was 10.00.

Now I am on a generic injectible testosterone, which costs 65.00 at my pharmacy, but my actual out of pocket is 0 dollars.

So it depends on how your insurance is set up. With mine the most expensive treatment worked out to 20.00 a month.

There are tons of great threads here on T-Nation re low test. . .dig around, great reading!

Just one word of warning. . .it takes a while for the treatment to work and your body to stabilize. You will not get instant results, so don’t be discouraged. Just keep plugging away.

GOOD LUCK

Just thought I’d add the ADAM prescreening test for low testosterone – should give you an idea of the symptoms:


  1. Have you experienced a decrease in your sex drive (libido)?

  2. Do you lack energy?

  3. Have you lost height?

  4. Has your strength and/or endurance decreased?

  5. Have you noticed yourself enjoying life less?

  6. Are you frequently sad or irritable?

  7. Are your erections less strong?

  8. Have you noticed a recent deterioration in your athletic ability?

  9. Do you find yourself falling asleep after dinner?

  10. Has there been a recent deterioration in your work performance?


Costs: If you self inject, the costs can be quite low. If your insurance covers stuff, still low cost. Blood work and doctor consults can be a lot of money, again, depends on insurance.

Doctors: Some know sh1t about HRT/TRT. Some specialize in that and they do not need to be endo’s to be good. Some docs are transdermal only. Some docs will not script HCG and your nuts will shrink and/or hurt as a result and some doc’s do not know how to deal with estrogen side effects. You should find a doc who is open to injections, transdermals, HCG and aromatase inhibitors AI (do control estrogen). And you need a doc who will treat your symptoms and not your lab reports. So you get the picture, the doctor is the most important 1st step and at that point you do not yet know what you need to know.

If you find a doc, then make sure that he is in-network for and insurance plans.

Best costs without insurance for test cyp, HCG and syringes is Sam’s Club with the BUSINESS MEMBERSHIP. example Watson’s test cyp* $42 VS $100 at Walgreen’s.

*10ml 200mg/ml

Different labs will use different tests to determine levels so you will need a copy of the lab report which will show normal target ranges. My lab shows the “normal” range for testosterone to be 241-827 and so at so at 269 my HMO would still call your level normal and not cover TRT.

It might actually be to your benefit to do what you can to lower your level a bit more. Eliminating fat from your diet for a while, taking liquorice root extract, gaining a few pounds of fat, etc. might get you low enough to qualify if you don’t now.

The Life Extension Foundation has a “Directory of Innovative Doctors” that might be a good place to find a doctor in your area that is up on hormone therapy.

ferdorov – I forgot to give you the best search terms to find all the great threads on low testosterone.

TRT

HRT

Also look for an article on T-Nation called something like “Get Your Mojo Back”. That is pretty informative too about the different treatments.

Typically the doctor’s protocol is to start you on a transdermal gel. That works for losts of people. But If that doesn’t work, they increase the dosage. that too works for lots of people. However, If that doesn’t work, they may try another transdermal method or switch you to injections.

[quote]fedorov wrote:
I am 54 and have been lifting for the past 6 months in an attempt to keep advancing age at bay. 5 ft 9 and 155. Waist stays stable at 32.
I have just had blood work done and free testosterone is 3.8, total is 269. In other words-LOW.
Any comments on testosterone therapy and the costs? Also, I have noticed muscle gains…how is that possible with such low numbers?[/quote]

Suppression of endogenous testosterone production attenuates the response to strength training: a randomized, placebo-controlled, and blinded intervention study.

Author(s): Kvorning T; Andersen M; Brixen K; Madsen K
Author’s Address: Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark. thuekvorning@hotmail.com
Source: American Journal Of Physiology. Endocrinology And Metabolism [Am J Physiol Endocrinol Metab] 2006 Dec; Vol. 291 (6), pp. E1325-32. Date of Electronic Publication: 2006 Jul 25.
Publication Type: Journal Article; Research Support, Non-U.S. Gov’t
Language: English

Journal Information: Country of Publication: United States NLM ID: 100901226 Publication Model: Print-Electronic Cited Medium: Print ISSN: 0193-1849 (Print) NLM ISO Abbreviation: Am. J. Physiol. Endocrinol. Metab. Subsets: In Process; MEDLINE

Abstract: We hypothesized that suppression of endogenous testosterone would inhibit the adaptations to strength training in otherwise healthy men. Twenty-two young men with minor experience with strength training participated in this randomized, placebo-controlled, double-blinded intervention study. The subjects were randomized to treatment with the GnRH analog goserelin (3.6 mg) or placebo (saline) subcutaneously every 4 wk for 12 wk.

The strength training period of 8 wk, starting at week 4, included exercises for all major muscles [3-4 sets per exercise x 6-10 repetitions with corresponding 6- to 10-repetition maximum (RM) loads, 3/wk]. A strength test, blood sampling, and whole body DEXA scan were performed at weeks 4 and 12.

Endogenous testosterone decreased significantly (P < 0.01) in the goserelin group from 22.6 +/- 5.5 (mean +/- SD) nmol/l to 2.0 +/- 0.5 (week 4) and 1.1 +/- 0.6 nmol/l (week 12), whereas it remained constant in the placebo group. The goserelin group showed no changes in isometric knee extension strength after training, whereas the placebo group increased from 240.2 +/- 41.3 to 264.1 +/- 35.3 Nm (P < 0.05 within and P = 0.05 between groups). Lean mass of the legs increased 0.37 +/- 0.13 and 0.57 +/- 0.30 kg in the goserelin and placebo groups, respectively (P < 0.05 within and P = 0.05 between groups). Body fat mass increased 1.4 +/- 1.0 kg and decreased 0.6 +/- 1.2 kg in the goserelin and placebo groups, respectively (P < 0.05 within and between groups).

We conclude that endogenous testosterone is of paramount importance to the adaptation to strength training.

Your testosterone levels will affect how much muscle mass you can carry. Is this really a concern for you? If your training goals are health related, then I don’t see that it should be a factor.

My point is simply that HRT is serious shit. If you’re going to get into it, you need to be really clear about what you’re doing and why. If your only reason is to improve muscle mass, then my personal opinion is that HRT isn’t really for you because you’re a bodybuilder and if you’re going to monkey about with your hormones you may as well do a steroid cycle. Not that I consider that a bad thing, I just think you need to really think carefully about what you’re doing. If you decide that you are a bodybuilder and you want to do a steroid cycle, then you need to seriously educate yourself and I wouldn’t even think about it until I was sure that I had already maximized my physique to it’s natural limit.

Just my two cents…

[quote]happydog48 wrote:
Your testosterone levels will affect how much muscle mass you can carry. Is this really a concern for you? If your training goals are health related, then I don’t see that it should be a factor.

My point is simply that HRT is serious shit. If you’re going to get into it, you need to be really clear about what you’re doing and why. If your only reason is to improve muscle mass, then my personal opinion is that HRT isn’t really for you because you’re a bodybuilder and if you’re going to monkey about with your hormones you may as well do a steroid cycle. Not that I consider that a bad thing, I just think you need to really think carefully about what you’re doing. If you decide that you are a bodybuilder and you want to do a steroid cycle, then you need to seriously educate yourself and I wouldn’t even think about it until I was sure that I had already maximized my physique to it’s natural limit.

Just my two cents…[/quote]

However, when someone [older anyways] has low T and has for a while, they have lost muscle mass and gained fat. Sometimes body weight does not change as that happens. TRT that gets one in the upper normal range can be expected to easily regain muscle and for some, gain more muscle than they ever had when young. So the objective of gaining muscle can be re-gaining muscle and more. The increased lean tissue has many health benefits as well.

Interesting responses…
I should add that the T test was done because my sex drive has completely gone down the tubes.
I am hypothyroid as well and for 5 years have thought that was the cause of the reduced sex drive.
So, I am after the sex drive and if good levels of T can do that, great.
Stronger bone mass and better musculature are icing on the cake.
And, what the hell…if I can look good at my age then I am going for the good body as well.
I also feel stronger and more fit than when I was 25, just from 6 months of lifting.

[quote]fedorov wrote:
Interesting responses…
I should add that the T test was done because my sex drive has completely gone down the tubes.
I am hypothyroid as well and for 5 years have thought that was the cause of the reduced sex drive.
So, I am after the sex drive and if good levels of T can do that, great.
Stronger bone mass and better musculature are icing on the cake.
And, what the hell…if I can look good at my age then I am going for the good body as well.
I also feel stronger and more fit than when I was 25, just from 6 months of lifting.[/quote]

Well you have to admit, this is a rather different story than your original post which only mentioned numbers and muscle gain. I’m convinced that numbers tell you very little about testosterone. In my admittedly limited experience, testosterone is about quality of life and if you have the quality of life issues that low test brings, then your test is low regardless of the numbers and if you don’t, then the same deal holds.

BTW - Listen to KSman and search out all his previous posts.

I used to be a real mess. Fat, depressed, limp, it was all bad. Suicidally bad. I’m here to tell you from personal experience that you can have it all back, so keep working at it.

Hey bro,
Don’t let the low test get you down!!!..I’m 33, and recently found out that I have a total test level of 102ng/dl!!!(No steroid use within 6 years)… I’m 6’0, 215lbs, I lift weights 5 x a week and have 17.5 inch arms, and bench 245x10 on a decent day. Not bad 4 a “10 year old boy”…Keep up the hard work!!!
Billblass

[quote]fedorov wrote:
Interesting responses…
I should add that the T test was done because my sex drive has completely gone down the tubes.
I am hypothyroid as well and for 5 years have thought that was the cause of the reduced sex drive.
So, I am after the sex drive and if good levels of T can do that, great.
Stronger bone mass and better musculature are icing on the cake.
And, what the hell…if I can look good at my age then I am going for the good body as well.
I also feel stronger and more fit than when I was 25, just from 6 months of lifting.[/quote]

Are you ok as far as thyroid treatments go?

Everything showing up normal as far as t3 free and t4 free?

How is your TSH?

These are more important things to get straightened out than TRT, and thankfully, alot easier and straightforward to treat.

[quote]V R wrote:
Are you ok as far as thyroid treatments go?

Everything showing up normal as far as t3 free and t4 free?

How is your TSH?

These are more important things to get straightened out than TRT, and thankfully, alot easier and straightforward to treat. [/quote]

Very true. The adrenals are even more important to address prior to thyroid, followed by testosterone.

Most times optimizing adrenal and thyroid health will fix the underlying problem. Taking thyroid hormones alone will raise testosterone as well.

Thyroid is under control with 200 mc of synthroid a day. Every 6 months or so I get blood work done for this…it is always kept in the range.
Two hormones that have the most impact on well being, energy levels and sex drive are thyroid and testosterone.
The thyroid is good and now I am getting the testosterone in order. Started androgel a week ago.
Hell, with the double whammy of the 2 low hormones, It’s a wonder I even get out of bed in the morning.
I am raising the T into the upper range-the doc is willing to work with me on this.

A problem with “normal ranges” and interpreting a value within them is that generally the values are NOT based on research of what is good, healthy, or optimal.

Rather, in the general public, the value that is at the 5th percentile – that is to say, 96 out of 100 people are better – is defined as the bottom of the “normal range.” It has to do with statistics, not any demonstration that everything’s perfectly fine while near the bottom of the range.

Sadly, while this is fairly basic knowledge, most doctors don’t seem to think about it and feel anything within “the normal range” doesn’t need improvement.

On the free testosterone, what was the normal range given? The reason this question is important is that different testing methods give different results, particularly according to whether being true free testosterone or free plus weakly bound testosterone. An average value for true free testosterone is about 7 pg/dL but I can’t assume from your number of 3 what that means.

Incidentally, it’s possible to have a fairly low total but be absolutely fine because free T is good and SHBG is low. So go by the free T.

total testosterone range: 181-758 ng/dl
mine was 269.
free testosterone range 7.2-23.0 pg/ml
mine was 3.8

[quote]fedorov wrote:
total testosterone range: 181-758 ng/dl
mine was 269.
free testosterone range 7.2-23.0 pg/ml
mine was 3.8[/quote]

These are the before numbers I assume.

Are you getting any insurance benefits to cover the costs of the androgel?

How much androgel are you using?

If the androgel works, your testes will get smaller and scrotum may pull up tight. That comes with any effective TRT. But some get an ache in their testes. HCG will restore size, hanging and stop the ache.

It is injected under the skin (SC or SQ), 250iu twice a week is common, but 250iu EOD is also effective. If one is to inject HCG, then injection of testosterone becomes more of an option. HCG is cheap (as is injectable T). Many report improved mood with HCG. HCG may have an action on the CNS.

Androgel and all transdermals (TD) create higher amounts of DHT, estrogen and SHBG than injections. The higher amounts of E lead to the higher amounts of SHBG.

The DHT can increase hair loss for those who have the genetics for that. The DHT is also very androgenic, which will increase body hair and sex drive. The DHT also helps with ED. Some on injections get a good DHT response as well.

E levels above normal range can lead to breast tissue development (gyno). Some men are have high rates of T–>E aromatization and some are are sensitive to things like gyno, while some are not.

But without things like gyno or high levels of E, some guys find that mid-high normal range E causes all kinds of trouble. These E problems can be ED, low libido, brain fog, depression, carrying of fat or bloat, lack of energy.

Those are all types of things that are associated with low T before TRT. But these problems can occur even when T levels are in the high end of normal range, with strong androgenic and anabolic signs. So restoring T levels to high normal range is not good enough for some guys.

In those cases, even though E levels are “normal”, lowering E levels will often take care of those problems. Most guys will find that 1mg or arimidex/anastrozole will reduce their E levels and provide improved quality of life (QOL).

You need a doc that will treat your symptoms, not your lab work. Your doc needs to be open to the use of HCG and/or anastrozole. Some docs do not understand these issues and will not do what is needed.

When you start TRT, you may go through a stage of hyper sexuality. That goes away as your CNS gets used to the T levels and more T–>E and SHBG levels increase. Some will go through that then after 2 or 3 months feel like they did before TRT or worse. If there is downturn like that, E levels should be your first concern.

KSMan knows his stuff. I think this post should be stickied.