Very low test

[zygleth]

Well I finally went in and got my complete bloodwork done and will pick up and post the full results tomorrow. My general prac called and said my test level was extremely low, like 7.5 when minimum is 250. He was floored by the low results and immediately talked about gel or cream. Obviously I want injections.
Any advice on what to do next? I have read a little bit here and many recommend seeing a urologist rather than having the gen prac deal with it. How have you all dealt with this? Any advice would be appreciated.
I guess the good news is I'm on my way to HRT, finally. Thanks!

[Kale]

Jesus that is almost ridiculously low. I think you need to get on injections ASAP. I dont have your problems because my HRT is all self administered, but you need to get on at least 125mg Test a week to start with. Dont let them try and talk you into monthly shots you need to do this weekly.

[Dobie-BOY]

my doctor prescribed it to me and I told him I knew how to do the injections myself from past steroid use . He was cool with it and even gave me the points for the T.

[InsaneInTheMembrane]

Have u ever cycled? When did u take the bloodtest (what time of day)? How were your sleep patterns 1-2 wks before the test?

These variables all effect your testosterone level so don't immediately get on the HRT train. Few yrs ago, my test was at 49ng/dl (range 250-1000) 6 months after i finished a deca cycle... last month it was at 500 ng , 6 months after a tren cycle... I credit that to a good PCT and sleep patterns...

wait a few weeks, do PCT (if u came off a cycle in the last 6 months), get 8 hrs of sleep a night and retake the bloodtest at 8-9 am...see how you fare.... also take test for free testosterone, LH and FSH... it will help the doctor determine whether your hypogonadism (if u have it) is hypogonadotropic (primary: problem with/damage to the pituitary or hypothalamic glands in the brain) or testicular (secondary: problem/damage to the testes)

cheers

[ottomaddox]

Well said^^^^^^^

Have u ever cycled? When did u take the bloodtest (what time of day)? How were your sleep patterns 1-2 wks before the test?

These variables all effect your testosterone level so don't immediately get on the HRT train. Few yrs ago, my test was at 49ng/dl (range 250-1000) 6 months after i finished a deca cycle... last month it was at 500 ng , 6 months after a tren cycle... I credit that to a good PCT and sleep patterns...

wait a few weeks, do PCT (if u came off a cycle in the last 6 months), get 8 hrs of sleep a night and retake the bloodtest at 8-9 am...see how you fare.... also take test for free testosterone, LH and FSH... it will help the doctor determine whether your hypogonadism (if u have it) is hypogonadotropic (primary: problem with/damage to the pituitary or hypothalamic glands in the brain) or testicular (secondary: problem/damage to the testes)

cheers

[zygleth]

Thanks all for the replies, what a great help you all are.

I have not cycled for years, not for lack of desire but lack of being connected as I was out of the loop for several years.
I am a poor sleeper but really do not remember how I slept the night before.
All in all I feel like crap and this forum opened my eyes to HRT and that low test may be a root cause for my condition. I am looking forward to it actually.
A few facts of myself- I like to lift heavy and returned to the weight game after 4 years off in December '07. I am 6'2" at 275#, large boned, 51 years young. Since returning I have been dealing with several small aggrivating issues- tendonitis in right arm, some hip inflamation, puled tendon in r shoulder. What bothered me the most is that I could not "feel" myself healing which is another reason for the blood work.
Don't mean to ramble but weight lifting is a passion for me and I do not want to get sidelined for a while yet. Thanks for listening.

[JASA]

you need the shots 200mg of test. the gel don't work not whith me & my urologist didn't to andocrinologist is the best.

[Teegunn]

Agree on the shots over the cream. Agree that you should do weekly, or twice a week injections. And I've never seen a test level that low - mine was a whopping 31 a couple of years back. I was able to increase it to the high 300's with fadogia agrestis (*******), but I was taking a shitload of those horse pills a day to do this. I finally talked to my doc and he has prescribed 200mg weekly of cyp, which I have done for the last 4 months. It has made a huge difference in how I feel overall.

[zygleth]

Thanks again for the replies.

Do I push my doc to see a urologist? I don't think he's aggresive enough to start me on injections. Then again I really don't know any urologists either.

[Teegunn]

With test that low, a doc would be crazy NOT to do SOMETHING to get your levels back to at least low-normal levels. If the doc you are using isn't willing, or doesn't know much about TRT - find another doc. Having levels that low isn't healthy long-term.

[Teegunn]

Also - if you don't want the cream or patch, just tell your doc either your kids, wife or GF are in contact with you frequently. The injections are much easier and better overall anyway.

[zygleth]

Thanks TG- I want to get the highest possible dose and not just settle for a low level. I've gathered from this forum that a uro will try to get one to a medium to high level.

[Teegunn]

Actually, you many not NEED 200mg a week. Some consider that a mild cycle. Others need that much to get into the high-normal levels. Others only need 100mg a week to do so. Just varies person to person. Find the level that works best for you and stick with it.

[zygleth]

Thanks TG. I'm going to pick up the bloodwork results hopefully tomorrow as I missed today and post them.
I think my doc would refer me to an uro so I'll try that next week also. He's new and we get along pretty well so he may just admit that it's not his expertise and let me move on to an "expert".

[Teegunn]

Yeah - post the blood work - it will be telling. My doc is pretty old. Really nice guy though and has actually been great to work with. Pretty much every suggestion I made he agreed with and prescribed what I wanted. Maybe I just got lucky with my doc - I know some are not willing to do TRT therapy.

[zaggahamma]

good luck bro...dont count out your primary doc....i get my trt from mine...but obviously there is need for concern....i'm sure you'll get another bloodtest to confirm and make it clear to him that you want injections and go from there

[MATTMAN01]

Dude those levels are almost nonexistant did you have any sex drive?
Good luck man. You are going to notice a huge difference. Again unusually low be careful.

[zygleth]

MMAN- I have no drive whatsoever. You could stand a dozen beautiful naked women in front of me and I'd go back to reading a Dean Koontz book.

[zygleth]

Here are the high points of the blood work:
They did not break down free test but total test was a whopping 7.8
Estradiol was 21
Everything else was in the proper range except cholesterol, LDL, Trig were all high.
RBC was at 5.85 and labeled as high but I don't know if that's a concern or not.
Thoughts? I see my GP on Thursday to discuss. Thanks

[Kale]

Some good info for you guys that I found while researching

Interpretation of Free Testosterone, Estrogen, and Total Testosterone Blood Test Results.

One can easily determine if they need testosterone replacement or estrogen suppression by adhering to the following guidelines.

Free Testosterone. Free testosterone blood levels should be at the high-normal of the reference range. We define high-normal range as the upper one third of the reference range. Under no circumstances should free or total testosterone be above the high end of the normal range.

What too often happens is that a standard laboratory "reference range" deceives a man (and his physician) into believing that proper hormone balance exists because the results of a free testosterone test fall within the "normal" range. The following charts show a wide range of so-called "normal" ranges of testosterone for men of various ages. While these normal ranges may reflect population "averages," the objective for most men over age 40 is to be in the upper one-third tes-tosterone range of the 21- to 29-year-old group. Based on the following reference range chart from LabCorp, this means that optimal free testosterone levels should be between 21-26.5 nanogram/dL in aging men.

Reference Intervals for Free Testosterone from LabCorp

* 20-29 years 9.3-26.5 picogram/mL
* 30-39 years 8.7-25.1 picogram/mL
* 40-49 years 6.8-21.5 picogram/mL
* 50-59 years 7.2-24.0 picogram/mL
* 60+ years 6.6-18.1 picogram/mL

An example of how this chart can be deceptive would be if a 50-year-old man presented symptoms of testosterone deficiency (depression, low energy, abdominal obesity, angina, etc.), but his blood test revealed his free testosterone to be 9 picogram/mL. His doctor might tell him he is fine because he falls within the normal "reference range." The reality may be that to achieve optimal benefits, testosterone levels should be between 21-26.5 picogram/mL. That means a man could have less than half the amount of testosterone needed to overcome symptoms of a tes-tosterone deficiency, but his doctor will not prescribe testosterone replacement because the man falls within the "average" parameters. That is why it is so important to differentiate between "average" and "optimal." Average 50-year-old men often have the symptoms of having too little testosterone. Yet since so many 50-year-old men have lower than desired testosterone levels, this is considered to be "normal" when it comes to standard laboratory reference ranges.

The Life Extension Foundation would like to point out that there is disagreement between clinicians and laboratories on the best method for measuring tes-tosterone status. There are different schools of thought as to which form of testosterone should be measured and which analytical procedure provides the most accurate assessment of metabolic activity.

To illistrate this point, the reference values for measuring free testosterone from Quest Diagnostics follow.

Adult Male (20-60+ years): 1.0-2.7% 50-210 pg/mL

Optimal Range: 150-210 pg/mL for aging men without prostate cancer.

We believe that direct testing for free testosterone is the best way to test for testosterone activity, as free testosterone is active testosterone and consists of only 1-2% of total testosterone. Total testosterone can be good for general testing. The four main methods presently used for analyzing free testosterone are:

* Direct, Free Testosterone by Direct Analog/Radioimmunoassay (RIA)
* Testosterone Free by Ultrafiltration (UF)
* Testosterone Free by Equilibrium Tracer Dialysis (ETD)
* Testosterone Free and Weakly Bound by Radioasssay (FWRA)

The latter three test methods are older, more complicated methods that are technically demanding. The direct RIA test has a number of commercial test kits available, and they are better used in today's automated equipment, making this test less tedious and requiring a smaller (less) sample. These advantages have convinced many laboratories and clinics to prefer direct RIA testing for free testosterone. The Life Extension Foundation agrees with this assessment, and therefore uses and recommends the direct free testosterone test with the above-mentioned reference levels.

Consequently, if your doctor tests your free tes-tosterone, be sure you know the analytical method used. If your test results have a reference range as follows, you have probably been tested with one of the other test methods:

Male Reference Range - Test Type

* 66-417 nanogram/dL FWRA
* 12.3-63% %FWRA
* 5-21 nanogram/dL UF or ETD
* 50-210 picogram/mL UF or ETD
* 1.0-2.7% % of free by UF or ETD

No matter what test method is used to determine your free testosterone status, the optimal level (where you want to be) is in the upper one-third of normal for a 20-29 year old male.

Estrogen

Estrogen (measured as estradiol) should be in the mid- to lower-normal range. If estradiol levels are in the upper one-third of the normal reference range, or above the normal reference range, this excessive level of estrogen should be reduced. Labcorp lists a reference range of between 3-70 picogram/mL for estradiol while Quest states a reference range of between 10-50. For optimal health, estradiol should be in the range of 10-30 picogram/mL for a man of any age.

The fact that most aging men have too much estrogen does not mean it is acceptable for a man to have low estrogen. Estrogen is used by men to maintain bone density, and abnormally low estrogen levels may increase the risk for prostate cancer and osteoporosis. The objective is to achieve hormone balance, not to create sky-high testosterone levels without enough estrogen. The problem is that, if we do nothing, most men will have too much estrogen and far too little testosterone.

Total Testosterone

Some men have their total testosterone measured. Standard reference ranges are between 241-827 nanograms/dL for most laboratories. Many older men are below 241. Optimal levels of total testosterone for most men are between 500-827 nanograms/dL. If your levels are lower than 500 nanograms/dL or even a little higher and you still have symptoms, you should check your free testosterone by the Direct (RIA) method.

For other hormone tests, the following are considered to be optimal:

Where You Want to Be - Comment

PSA Under 2.6 ng/mL - (optimal range) Standard reference range is up to 4, but if your level is persistently 2.6 or above, have a blood test to measure the percentage of free vs. bound PSA and a digital rectal exam to help rule out prostate cancer.

DHEA 400-560 mcg/dL - (optimal range) For older men, standard DHEA ranges are very low. It is important for men without prostate cancer to restore them to the youthful range (400-560).

DHT 20-50 nanogram/dL - (optimal range) Reference range is 30-85. DHT is 10 times more androgenic than testosterone and has been implicated in prostate problems and hair loss.

Luteinizing hormone (LH) Age 20-70: 1.5-9.3 mIU/mL 70+: 3.1-34.6 mIU/mL (standard reference ranges) - Under 9.3 mIU/mL - (optimal range) If these levels are high, it is an indication of testicular testosterone production deficiency. LH tells the testes to produce testosterone. If there is too little testosterone present, the pituitary gland secretes more LH in a futile effort to stimulate testicular testosterone production. Testosterone replacement therapy should suppress excess LH levels. Low LH can also be a sign of estrogen overload, since too much estrogen can suppress LH activity. This could mean using an estrogen blocker like Arimidex could solve a testosterone deficiency problem.

Sex Hormone Binding - Under 30 nanomoles/L - (optimal range) Reference range is 13-71 nanomole/L. Excessive binding inactivates testosterone (297).

There are five possible reasons why free testosterone levels may be low-normal (below the upper third of the highest number of the reference range):

* Too much testosterone is being converted to estradiol by excess aromatase enzyme and/or the liver is failing to adequately detoxify surplus estrogen. Excess aromatase enzyme and/or liver dysfunction is likely the cause if estradiol levels are over 30.
* Remember, aromatase converts testosterone into estradiol, which can cause estrogen overload and testosterone deficiency.
* Too much free testosterone is being bound by SHBG (sex hormone binding globulin). This would be especially apparent if total testosterone levels were in the high normal range, while free testosterone was below the upper one-third range.
* The pituitary gland fails to secrete adequate amounts of luteinizing hormone (LH) to stimulate testicular production of testosterone. Total testosterone in this case would be in the bottom one-third to one-half range. (On LabCorp's scale, this would be a number below 241-500 ng/dL.)
* The testes have lost their ability to produce testosterone, despite adequate amounts of the testicular-stimulating luteinizing hormone. In this case, LH would be above normal, and total testosterone would in very low normal or below normal ranges.
* Inadequate amounts of DHEA are being produced in the body. (DHEA is a precursor hormone to tes-tosterone and estrogen) (250).

[BANKAI*zanpakutō]

wow kale that is a lot of good info ... thank you .

[zygleth]

Kale- wow that is a lot of info. I will have to digest that tonight. You are definitely way ahead of the pack on this stuff. Thanks!

[Ntpadude]

You know whats ****ed up? I used to qualify for HRT before I ever took any steroids ... went on Androgel and then test cyp... then later I hooked up with a gym source... did deca and other stuff... basically went oh about 4 or 5 years shut down contiuously due to HRT and some sneak in cycles... finally after 5 yrs straight... take 3 months off and want to qualify for HRT again (had to get different doctor, old one retired), well low and behold 2 months off and I didnt use any clomid or nolva to get restarted, I come back at the age of 43 with 410 nl testosterone and a decent free test count. Basically fully disqualifying me for any more HRT.

Somehow I been low all my life... came in with 125 nl test before ever touching the stuff, but now seems all that steroid use and HRT made my body want more? Doctor actually suggested the lack of LH in my blood for so long under HRT may have made my testicles "more" sensative and more responsive to it therefore making more... years ago I had high LH levels and low testosterone .

What sucks is even viagra and cialis cant help me get a hard on for nothing. When I was on 150 mg a week of teststerone I had no problems getting hard, but now cant qualify for any more HRT program, my source went out of business, and viagra and cialis arent working at all. This really sucks.