T Nation

Several Medical Problems



I am a 27 yr old man who has been diagnosed with low testosterone almost 2 years ago. After unexplained weight gain (75 lbs in 2 years) and severe fatigue, it took several professionals to properly diagnose me. After never using any steriods it appears my pituitary gland magically shut down and my testosterone level was 80. MRI's did not tell anything and brain scans appear to be normal. Endocrinologist after endogcrinologist I am still struggling to find a doctor aggressive enough to treat me properly. After using 5mg/day for several months of topical Androgel, then 10mg/day of Androgel, I was able to increase my test levels over 9 months to 350 then eventually to 405. The doctor would not prescribe any more as he felt the levels were "borderline high". Please note at this point I am 6'2 315lbs @ 27 yrs old. THe next doctor went with injections of test cypionate on the order of 200mg, once every 2 weeks. This teaser was hardly enough to get me going and after 4 months at this treatment level my test levels fell again to 167. The doctor then switched me to 100mg once per week as this increased me to 207. The current doctor does not have any patients currently taking higher dosages and is neverous to increase the treatment level. I am now on doctor # 6 in 2 years and am in the same spot. As a result of the low testosterone I have developed the gout, which somedays I cannot walk out of bed, and often miss work, and I also developed a fatty liver with elevated AST/ALT liver enzymes. Recently I have been diagnosed with sleep apnea as well due to the excessive weight. Recently I have been to exhausted to drive a car after work, let alone go to the gym. Through all of this pain I manage to keep a S/B/D of 600/315/650 raw with test levels lower than most post menapausal women.

I am now in search of a new doctor, however none will properly treat me. My problem is 2 fold. 1 understanding why the pituitary gland suddenly stopped working and 2 how to treat. Metabolism problems such as these often lead to diabetes and more cardovascular disease. The answer is not in simply buying some test which is the easiest solution of them all. Does anyone know of anyone with naturally low test, not coming off cycles etc, or could offer any more suggestions. I have been to all the top doctors listed for endocrinology in the new york/new jersey area.

Any advice would be helpful.

The Defeated One


Bro, sounds like you are in a pickle of sorts.

As of now, I have no answers for you, but I will do some looking into it and see what I can find out.

This will be interesting to see if someone else has anything to bring to the table for you.

Don't give up, I'm sure something will come through. And you're right, just getting "Test" would be the easiest thing to do, but you want to get the problem fixed if possible and not just "treated".


Oh how we take our health for granted!

It looks to me like your test production isn't your only problem. If it is indeed the pituatary that is the culprit - it is the 'master gland' responsible for much more than one hormone secreted. It sounds to me like you probably have thyroid issues as well. It also sounds like you may have diabetes too, but I don't know anything other than what you have posted, just speculating. I advise the first thing you do is become more proactive regarding your condition. See a dietician, as you need control your weight and eat foods less prone to causing bouts of gout. Does your doc at least have you on allipuronol? As it sounds to me that you have liver issues as well, as your body is unable to elliminate the uric acid.

Anyways you seem to have multiple amount of issues. I suggest you forget about a 'cure' for your low testosterone. Take the best test replacement that your doc is willing to offer, and then go see an internalist, to have your many other multiple diseases treated.

Disease in the body is like a house of cards. When one organ fails to operate, it will bring down the rest.


Thanks for responding to my post. I think the dietician ideas is great. I'm going to look into that one right away. The doc does not have me on the allipurnol, he says my gout episodes are not frequest enough and that those medicines cause stomach bleeding etc.

Hopefully this new doc I'm seeing will give me the amount of test I need. What would a decent dose be for 6'2 315 guy just looking to normalize my levels? 300-500mg/week?


It's hard to say without bloodtests, but 300mg per week should definitely do it. No doctor should be afraid to at least try to achieve a high-normal range of testosterone in your body...

If doctor's aren't willing to prescribe more, keep in mind that there's plenty of longevity clinics out there that'd probably prescribe more.


Well I posted this study in the Anthony Roberts PCT thread, as it proved my points, however I believe it has definite usefull applications for you as well...

Am J Physiol Endocrinol Metab 281: E1172-E1181, 2001;

Vol. 281, Issue 6, E1172-E1181, December 2001

Testosterone dose-response relationships in healthy young men

Shalender Bhasin1, Linda Woodhouse1, Richard Casaburi3, Atam B. Singh1, Dimple Bhasin3, Nancy Berman3, Xianghong Chen4, Kevin E. Yarasheski4, Lynne Magliano2, Connie Dzekov1, Jeanne Dzekov1, Rachelle Bross3, Jeffrey Phillips3, Indrani Sinha-Hikim1, Ruoquing Shen1, and Thomas W. Storer2
1 Division of Endocrinology, Metabolism, and Molecular Medicine, Charles R. Drew University of Medicine and Science, Los Angeles 90059; 2 Laboratory for Exercise Sciences, El Camino College, and 3 Harbor-University of California Los Angeles Medical Center, Torrance, California 90502; and 4 Biomedical Mass Spectrometric Research Resource, Department of Internal Medicine, Washington University, School of Medicine, St. Louis, Missouri 63110


Testosterone increases muscle mass and strength and regulates other physiological processes, but we do not know whether testosterone effects are dose dependent and whether dose requirements for maintaining various androgen-dependent processes are similar. To determine the effects of graded doses of testosterone on body composition, muscle size, strength, power, sexual and cognitive functions, prostate-specific antigen (PSA), plasma lipids, hemoglobin, and insulin-like growth factor I (IGF-I) levels, 61 eugonadal men, 18-35 yr, were randomized to one of five groups to receive monthly injections of a long-acting gonadotropin-releasing hormone (GnRH) agonist, to suppress endogenous testosterone secretion, and weekly injections of 25, 50, 125, 300, or 600 mg of testosterone enanthate for 20 wk. Energy and protein intakes were standardized. The administration of the GnRH agonist plus graded doses of testosterone resulted in mean nadir testosterone concentrations of 253, 306, 542, 1,345, and 2,370 ng/dl at the 25-, 50-, 125-, 300-, and 600-mg doses, respectively. Fat-free mass increased dose dependently in men receiving 125, 300, or 600 mg of testosterone weekly (change +3.4, 5.2, and 7.9 kg, respectively). The changes in fat-free mass were highly dependent on testosterone dose (P = 0.0001) and correlated with log testosterone concentrations (r = 0.73, P = 0.0001). Changes in leg press strength, leg power, thigh and quadriceps muscle volumes, hemoglobin, and IGF-I were positively correlated with testosterone concentrations, whereas changes in fat mass and plasma high-density lipoprotein (HDL) cholesterol were negatively correlated. Sexual function, visual-spatial cognition and mood, and PSA levels did not change significantly at any dose. We conclude that changes in circulating testosterone concentrations, induced by GnRH agonist and testosterone administration, are associated with testosterone dose- and concentration-dependent changes in fat-free mass, muscle size, strength and power, fat mass, hemoglobin, HDL cholesterol, and IGF-I levels, in conformity with a single linear dose-response relationship. However, different androgen-dependent processes have different testosterone dose-response relationships.

sexual function; testosterone effects on muscle; cognitive function; plasma lipids; prostate-specific antigen; testosterone effects on insulin-like growth factor I; testosterone and hemoglobin