help needed with doctors

**zap427** · 06-12-2009, 07:47 PM

Hello,

I am a 54 year old male with the symptoms of low T, most importantly, low libido and lack of “hardness” in erections. In addition, I have been taking variety of antidepressants (currently cymbalta 60 mg, buspar 15 mg for the past 18 months) since the spring of 06. I am fully aware of the sexual side effects of these meds but feel what I have been experiencing is out of the ordinary.

At a recent appointment with my doctor I convinced her to order a blood test. Even though I printed out the recommended tests from an article written by Dr Crisler, she would not order them all. The following is a partial list of what I was able to gather:

Cortisol 15.9 UG/DL
Estradiol 21.4 PG/ML
Testosterone 754.7 (250-950) NG/DL
TSH 2.04 (0.38-7.0) UIU/ML
Free Testosterone 10.7 PG/ML
Reference range
Age
20-29 9.3-26.5
30-39 8.7-25.1
40-49 6.8-21.5
50-59 7.2-24
ALK Phosphatase 63 (26-126) U/L
Bilirubin Total 0.4 (0.2-1.2) MG/DL
Direct Bilirubin 0.1 (0-0.3) MG/DL
AST (SGOT) 29 (0-46) U/L
ALT (SGPT) 30 (6-40) U/L

From what I have researched, it appears my Free Testosterone could be low. I asked my doctor and her answer was “yes, it is on the low side but still normal”. I would like opinions on if I should pursue raising my free T numbers or accept them as being in the “normal” range?

I have received a second opinion from an urologist; he is not concerned about my free testosterone because my total T number is so high. He blames my symptoms entirely on the anti-depressants.

Should I accept the AD meds as the cause or look into a third opinion on my testosterone levels ? Any help would be greatly appreciated.

Thank you

**Papa Smurf** · 06-12-2009, 08:08 PM

What is your estrogen level. That can cause your free test to be low, if it is high.

**zap427** · 06-12-2009, 08:28 PM

The only number I have is Estradiol 21.4 PG/ML, which I thought was near ideal. I have researched for a while and it seems that high SHBG could be the problem, but I am totally new at this and getting confused by conflicting information provided by the doctors.

**Papa Smurf** · 06-12-2009, 08:39 PM

Sounds like you did your own homework Zap! Time for a new doctor bro!

**zap427** · 06-12-2009, 08:50 PM

Well I know there are many much more qualified then I on this forum and I hope they weigh in.

**CHAP** · 06-12-2009, 09:43 PM

I feel that it is probably the othe meds that your on because I have used them before. The one you are on currently F@CKED me bad. I couldnt even piss. Had to have a uroligist do a cath . And get out about 1700 cc of urine. I have found that most docs will treat the symptom and not the cause. I would try getting off as many meds as you can. Then starting from scratch. Finding a new dr for another opinion is a great idea aswell.

**seriousmass** · 06-12-2009, 09:49 PM

anti-depressants can definitely suppress free test in the body. The only way to know is to get a bloodtest now, and go off the meds, and see if your test levels rebound once the cymbalta, and buspar clear your system.

IMO you aren't low test right now though. Your total test levels are excellent for your age. I'd wait a couple of years, and then go on TRT once your natural test levels begin to crash.. just my .02

**zap427** · 06-13-2009, 05:33 AM

Guys,

Thanks for the advice it is exactly what I am looking for. The more research I do the more confusing it becomes. I have read repeatedly, that when free T is not towards the upper end of the scale it does not matter what total T is. But I also read posts where guys have no where near the total T I have and I begin to wonder if I am chasing a ghost or try to force an issue.

One thing for sure this is not a simple science.

**CRACKER** · 06-13-2009, 03:30 PM

im 24 my test was 254 and my free was off the charts on the high side there is so many differing opinions good luck man

**ZonaDave** · 06-16-2009, 01:13 AM

did they determine the reason for your depression? i had mild depression symptoms and my TT was in the mid 600's. when my dick stopped working i finally went to see the doc and by that time my TT was 366. my doc put me on medication for anxiety but i was more interested in finding the cause of the anxiety. it wasn't until i started TRT that my symptoms went away. my new doc wants my TT around 1,500. some people need higher levels. it's such an individual thing that you can't go by what other people numbers are. you need to get off those meds and treat what's causing the depression.

**ecsaaron** · 06-16-2009, 03:40 PM

Originally Posted by ZonaDave

did they determine the reason for your depression? i had mild depression symptoms and my TT was in the mid 600's. when my dick stopped working i finally went to see the doc and by that time my TT was 366. my doc put me on medication for anxiety but i was more interested in finding the cause of the anxiety. it wasn't until i started TRT that my symptoms went away. my new doc wants my TT around 1,500. some people need higher levels. it's such an individual thing that you can't go by what other people numbers are. you need to get off those meds and treat what's causing the depression.

for me low test 190,was like being in a black hole.THE DEPRESSION WAS UNBEARABLE

**ZonaDave** · 06-17-2009, 12:11 AM

my older brother went to see a doc about his text book low T symptoms and he diagnosed him as having ADD and depression so he loaded him up with all kinds of crap meds that really jacked him up bad. his marriage was failing because of his symptoms so they went to therapy and after hearing all the issues the therapist said it sounded like he had low T. he got it check out and sure enough he was low. he dropped the other meds and went on TRT and his symptoms went away.