I am asking this, because "normal" testosterone levels are reported as ranging from 300 to 1200 ng/dL, with no values given for age. Why the hell is the range so wide? Isn't there an optimal testosterone level for a person's age? I've also read extensively on the benefits of HIGH testosterone, such as lower risks of heart disease, high blood pressure, insulin resistance, etc, as well as the fact that women are more attracted to masculine (high testoterone) men.
So can't the medical community come to a consensus on optimal levels of testosterone? If they can come to a consensus on cholesterol, blood sugar, and the like, why the hell can't they do something similar for testosterone?
I read that they used to prescribe testosterone for depression! Of course, the 1990 Steroid Control Act changed that all.
Another thing I don't understand: they know that drugs like Clomid can significantly increase endogenous testosterone levels, simultaneously improving fertility; they also know that the most cases of hypogonadism are SECONDARY in nature (problem w/ pituitary gland, not testes). I've heard that there's a drug coming out called Androxal which is related to Clomid, only that it's for men w/ hypogonadism.
Why the hell is it taking so long; doesn't it make sense to ENHANCE the body's abilities to produce testosterone, rather than destroy it using replacement?
I'm surpised that since there are so many steroid users out there, and that it's relatively easy to get steroids, that more men don't "self-medicate" w/ testoterone, when their doctors don't prescribe it.
This is a situation I found myself in. I am 28 years old and hypogonadal.
I can first hand testify that much of what Bushy writes is very true, sadly. And unfortunately, many Drs do have to play the numbers game, both with their lab values and prescriptions. My GP had no experience with Testosterone Replacement, my Endocrinologist has one other patient currently using a topical preparation.
Having tracked my Total and free T over a 10 month period, along with other typical blood chemistry, E2 etc etc, I was able to convince my Drs that I was secondary Hypogonadal. Some of my values remained 'in range', some of them were below. Typically I had values ranging from 180 - 300.
I was lucky. I was able to objectively demonstrate my condition witha series lab values, documented subjective evidence of my state of mind, evidence of reduced libido, fatigue, depression,loss of body mass, loss of hair etc etc. I presented my case with empricial data sourced from a variety of Journals also, for corroboration.
My GP in her ignorance tried to convince my I was suffering from ME or CFS LOL.
In the U.K my case is very much the exception.
So to answer your question, it depends. In my case several values were very much within lab range data, my symptoms were very much present throughout the whole ordeal, however. Problems arise when we attempt to articulate what symptoms persist - and they are very much vague and easily confused with other disorders - and how they affect us.
Been injecting for a while and doing so made my hematocrit and hemaglobin shoot throught the roof.
I think young guys should have enough testosterone to make you competitive for females. Young guys have high test for that reason. Thus your 'level' is whatever makes you mildly aggressive, to the point where you are extroverted and competitive. Don't exceed this or you'll become too aggressive and kill someone. Keep increasing your dose until it feels right.
Old guys like me require lower Test. We're done in the baby making game. For us, we just want to feel good.
Good post, HH. Pretty much makes perfect sense as you describe it.
Unintentionally perhaps, that model accounts for the need for variance in T levels that OP questions, as it allows for the avoidance of unbending duels to the death between males that all carry the highest possible levels of T in their blood. Presumably those with lower T levels will tend to back off sooner, or pursue females that aren't as actively sought by others.
We need a pecking order that isn't solely based on actual combat.
I laugh about this now, but at the time I was furious, and unfortunately, desperate. I will hold my hands up and say that those 10 months of travelling the U.K to speak to 'specialists' and trying to formulate a case for my treatment, all the time feeling incredibly low, 'fragile' and emaciated (physically and emotionally: I dropped 20 lbs or so) were the darkest moments of my life.
The loss of bodymass and strength is one thing, but at one point my cognitive functioning had diminished to the point that, when visiting a post office to send a letter, I could'nt recall my return address. That was very, very upsetting and scary.
Being somewhat informed I was aware of what was wrong and was adamant that I was not suffering from either condition, and to have various random conditions thrown at me as prognonis was very, very frustrating!
I had to battle a system and inform the Drs around me. What scares me most though, is that there could quite easily be people around, suffering as I did, who have been convinced that they have depression, CFS or whatever, when in fact they have low T.
Headhunter, you hit on a couple of great points. Number one has to be how we subjectively monitor how we feel. Lab data is all well and good - but if your values are in range but you feel like shit - then your quality of life is still diminished, even if it keeps your Drs happy.
The second point is Hematocrit. Test will increase hematocrit and hemoglobin. Initially, prior to treatment, my hematocrit was pretty low, hemoglobin too. After several months of therapy these increased, and I imagine that they will continue to do so. This, I imagine, will be my next hurdle to cross. I suspect that during my next set of tests, in a couple of months, they will have increased once more, and seeing this increase will likely cause some concern for my Drs.
I tried to head off the blood trouble by giving blood. The Red Cross wouldn't accept my blood though because of the high hemaglobin. A phlebotomy is the classic therapy for high H and H. So...the doctor of course wants to cut the T (possibly altogether) and test for bone marrow disease. The med for that is some sort of stuff with horrible sides.
More and more over the next 10 years I think we are going to see that Testosterone is somewhat of a miracle drug for men. The medical world and government would never want to admit to this but I think it will be the case.
Not only does low test create a series of issues such as depression, low libido, lethargy etc. I think it also creates an environment where disease such as prostate cancer can form. Think about it, men do not usually start getting checked for prostate cancer until about 40 years old. This is generally when their test levels are significantly lower than when they basically had no chance of getting prostate cancer ie. their 20's. It seems too much of a coincidence and in time I believe everyone with low test will be advised to be on HRT.
And Testosterone is already concidered a miracle drug when it comes to muscle wasting diseases such as aids. People with it are now living normal lives where 15 years ago their outlook was pretty grim beyond a couple years...
Low Test might also turn you into Leonardo DiCaprio or Tobey Maguire; LOL!
Seriously, though, my belief is that they should really push for treatment for SECONDARY hypogonadism; that should be the standard treatment. In the future, actual testosterone replacement should be only for AIDS patients and people w/ chromosomal abnormalities.
okay no offense by this is terribly wrong. First, I certainly do not believe that prostate cancer is linked to low testosterone levels. This can first be demonsrated by the fact that castrated boys, have never been noted to have suffered from any type of prostate cancer or benign hyperplasia (the source is a medical textbook). Another fact that causes me to disagree with this idea is that prostate cancer/growth has greater association with the western civilizations. Implying a cultural or diet factor. Studies of twins in Scandinavia suggest that forty percent of prostate cancer risk can be explained by inherited factors. Also, There are also some links between prostate cancer and medications, medical procedures, and medical conditions. Daily use of anti-inflammatory medicines such as aspirin, ibuprofen, or naproxen may decrease prostate cancer risk. Use of the cholesterol-lowering drugs known as the statins may also decrease prostate cancer risk. I have a problem with puttin such uninformed speculation on the internet for others to see, and perhaps believe. (God knows there are ignorant people who believe everything they read).
Lichtenstein, P; Holm NV; Verkasalo PK; Iliadou A; Kaprio J; Koskenvuo M; Pukkala E; Skytthe A; Hemminki K (July 13 2000). "Environmental and heritable factors in the causation of cancer?analyses of cohorts of twins from Sweden, Denmark, and Finland". N Engl J Med 343 (2): 78?85. doi:10.1056/NEJM200007133430201. PMID 10891514.
Shannon, J; Tewoderos S, Garzotto M, Beer TM, Derenick R, Palma A, Farris PE (August 15 2005). "Statins and prostate cancer risk: a case-control study". Am J Epidemiol 162 (4): 318?25. doi:10.1093/aje/kwi203. PMID 16014776. Epub 2005 July 13
I agree with most of what you say! There are many factors which determine a persons risk for cancer, age, family history diet etc. But there are many studies now showing that people aged 40-75 having a 30% decrease in the chance of all diseases including cancer!
Here is one studies findings:
"Researchers conducted a nested-case control study (meaning controls were chosen from the same population group) of 11,606 men ages 40 to 79 years who were free of known cancer and cardiovascular disease. The men participated in the European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk Study) from 1993?97. Their blood samples were taken at initial clinical examinations and frozen for later evaluation. Among 10,423 men who had no known heart disease or cancer when they entered the study, 825 died over the 10-year follow-up period, which included 369 cardiovascular deaths and 304 cancer deaths.
Researchers analyzed frozen blood samples from the 825 and compared them to samples from 1,489 study participants who were still alive at follow-up, classifying samples from both groups into four categories based on testosterone levels. The average testosterone level for men in the study was about 16?17 nmol/L. Men who had testosterone levels of 12.5 nmol/L or less were in the bottom 25 percent, while those in the top 25 percent had testosterone levels of 19.6 nmol/L or higher.
Khaw said the findings might prompt questions about prostate cancer since suppression of testosterone is a recognized treatment for prostate cancer; however, there is little strong evidence to show that endogenous testosterone levels are associated with prostate cancer risk.
In this study, too few prostate cancer deaths occurred ?to examine the question statistically,? Khaw said. ?But at least in terms of mortality from any cancer, there was no evidence of any adverse relationship with testosterone; in fact, there was an inverse association."
From personal experience I would have to agree that suppresion of testosterone is not the way prostate cancer should be treated. My father who recently passed away from cancer which originated in his prostate had his testosterone levels checked and his test levels were extremely low! If suppression of testosterone is a treatment for prostate cancer, that is to suggest that it is the cause of prostate cancer. I know it's not this simple but that is the basic understanding of it.
This experience has lead me to do a lot more research on the topic for personal reasons and more and more studies are showing that aging men with lower testosterone levels have a significant increase in developing disease of all forms, not just prostate cancer.
There have been a number of interesting points brought up by you, and of course egnatiosj and others. Sometimes it can be difficult to work through the dogma, deficiencies in experimental design, as well as the strong feelings on both sides wrt hormone therapy.
There are problems in going from the effects of T (or DHT for that matter) on patients who already have prostate cancer to those that don't have cancer. That is to say, there can be many reasons why exogenous T can have an affect on someone with cancer but not have that same deleterious effect on a healthy person.
Similarly, extrapolating from castrati to those of us still lugging a pair is also dangerous. Suggesting causality beyond simply that there is a 'hormonal link of some sort' with prostate cancer is stretching things IMO. Naturally if you don't have androgen activity in the prostate, things are going to be quiet. It doesn't necessarily have any implication for you or I.
Still, no matter what, there may be increased risk with the adoption of widespread hormonal therapy simply because there are many people that have undiagnosed, early-stage prostate issues. It seems wise to really stay on top of prostate health if undergoing HRT.
I know that I haven't really crystallized any point here, other than to say that one can easily find papers, scientists and arguments to support one view or another, and the reality may be that we're all wrong and it's actually multi-factorial, or involves changes in 5AR activity or who knows what.
Okay first let me apologize for being rude, I did not mean to come off that way. Second, my condolences about your father. Thirdly let me apologize for assuming that you had no research behind your opinion, I was clearly wrong on that one! ; P.
I was very fascinated by that study; it was the first time I have seen it, is there anyway you could post the bib so I could look it up?
I still think that caution should be urged caution when considering hormone therapy for older men. I would propose the Women?s Hormone replacement as an example. Studies found that estrogen and progestin therapy did not reduce the risk of cardiovascular disease, but did leave the patients at increased risk of stroke, thrombotic events and cancer.
egnatiosj you did not come off as rude! I am here to debate and learn lol.
First let me say that I do not think that HRT is the ultimate solution to disease. But in healthy individuals it is possible that it could prevent disease. This is assuming one is in good cardiovascular health, been screened for cancer etc.
There are many studies that show an almost direct link between testosterone and prostate cancer. But there are now studies suggesting that lower testosterone levels could be whats responsible for creating an environment in which disease can spread. I find it fascinating that what seemed like common knowledge for so many years could be wrong, to a degree.
I am not 100% either way and it is why I do a lot of research on the subject, but I am leaning toward lower testosterone could increase the risk of all disease.
The study I referenced was actually from the American Heart Association. It was done by Kay-Tee Khaw.
What I meant to say was that for people w/ hypogonadotropic hypogonadism (the majority of hypogonadism sufferers), something like Clomid for men should be the first line of treatment; if that doesn't work, then they should start actual replacement.
The things I've read about Clomid and other SERMs, in medical studies and anecdotally, is that they can up your T-levels by 100-200%. If this drug Androxal finally comes onto the market, it could seriously change the way in which hypogonadism is treated.