Questions for the Experts

[Priapism]

Just some questions on my thinking and logic. Answer the ones you know:

1) I had a total testosterone level of 435 at age 34 and felt like crap. Even though 435 is higher than most here, its possible that for me, 435 is extremely low, right?

2) Lets say in my 20's my natural T level was "900" consistently. And now I am at 435. For me, I would probably notice that change and for me, it would be dramatic, correct?

3) Do I want to get my levels back to 900, or is that level probably too high?

4) How do I determine what level I want to get to and stay at? Just how I feel?

5) Are there indicators for having gone too high? Or is it all based on numbers.

6) Is the philosophy just to "up" it enough to feel better? As little as possible?

7) Where do you guys go to get repeated tests done if you have to pay out of pocket? LEF offers a male hormone panel here:
8) How do you test something that changes drastically throughout the day? I've heard you should always get tested 1st thing in the morning when its highest. I've also heard you should do it late afternoon when its lowest. Which is correct?

9) I was on testogel (self diagnosed and administered) for a week and discontinued it about 7 days ago. How long do I need to wait so that I know the numbers are the "real me" ? Only used it for 7 days...

10) Vague question: If it takes me 3-4 days just to get over-all horny after sex, and my ejaculate volume is 1/4 of what it was at age 23, is that an indicator that something is wrong, or am I just a normal 36 year old ... ?

Thanks everyone. I know some of these questions have been addressed elsewhere, but I wanted to get some reiteration for confirmation.

-P-

[flatscat]

Just some questions on my thinking and logic. Answer the ones you know:

I am no expert but here a shot at it...

1) I had a total testosterone level of 435 at age 34 and felt like crap. Even though 435 is higher than most here, its possible that for me, 435 is extremely low, right? Yes
2) Lets say in my 20's my natural T level was "900" consistently. And now I am at 435. For me, I would probably notice that change and for me, it would be dramatic, correct? Yes

3) Do I want to get my levels back to 900, or is that level probably too high? Not too high. 800 is an average of top range. I would say most of us on trt are between 700 and 1200.
4) How do I determine what level I want to get to and stay at? Just how I feel? Combo of how you feel and BW results. You might feel awesome at 1600, but that is too high for trt purposes.
5) Are there indicators for having gone too high? Or is it all based on numbers. Yes, no, not all based on numbers.6) Is the philosophy just to "up" it enough to feel better? As little as possible? Yes - up enough to feel your best.
7) Where do you guys go to get repeated tests done if you have to pay out of pocket? LEF offers a male hormone panel here:

I will let others comment on their experiences - several option out there.

8) How do you test something that changes drastically throughout the day? I've heard you should always get tested 1st thing in the morning when its highest. I've also heard you should do it late afternoon when its lowest. Which is correct?

Once you are on trt, no drastic changes throughout the day. Mornings are best to check before you start trt.
9) I was on testogel (self diagnosed and administered) for a week and discontinued it about 7 days ago. How long do I need to wait so that I know the numbers are the "real me" ? Only used it for 7 days...

Three to four weeks.

10) Vague question: If it takes me 3-4 days just to get over-all horny after sex, and my ejaculate volume is 1/4 of what it was at age 23, is that an indicator that something is wrong, or am I just a normal 36 year old ... ?

Could be a hundred things causing this from diet to hormones to dehydration and on and on.Thanks everyone. I know some of these questions have been addressed elsewhere, but I wanted to get some reiteration for confirmation.

-P-

No prob Bro. Good luck.

[Alloy]

1. Get a full CBC and Metabolic blood work done. This will give you a good picture of what's going on. Things like TT, Free-T, E2, LH, FSH, etc are key players here.

2. I'm not a doctor but if you have low ejaculate volume, that would be typical of low FSH. Once again, a blood test is needed.

3. If it takes you days to get up to speed again, it could be a number of factors. Stress, nutrition, not enough sleep, low-test....etc. Blood work once again is needed.

4. Most healthy men are pretty up there when they were between 18-23 when it comes to test. Most clinical reports list between 800ish to 1100ish. If you're in the 400s now and get that to 900-1000, well yes you're going to see a radical difference. Also remember the key to all of this is to keep that E2 down. Would you like to **** up a good balance....just let your E2 elevate out of range. High E2 is what ****s up most everything, keeping it between 20-30 is key.

Also this may be a futile effort, but in good faith try to work with a doctor. If after your 2nd opinion they just tell you your getting old or your perfectly fine and it's all in your head, only then seek the help of an AA clinic. At least they'll look at your BW and give you an honest answer along with the fact that you're getting US made meds. Don't be foolish and roll the dice with foreign made stuff, hospital stays are never fun.

[Priapism]

So LEFs $400 blood panel is reasonable and covers everything? (see link above)

[Alloy]

$400 is ok, but if you have insurance.....I would go through you're primary care. When I need BW, I just make an appointment with my PC to get everything done. Not only does he get a copay when I show up, but I can get any non-hrt scripts filled at the same time.
I would look around but $400 is ok considering that a full cbc/metabolic can run well over that.

[Priapism]

Does the list of what you get for $400 cover everything I need for a complete baseline set of numbers?

[forrest_and_trees]

I agree with everything above, especially the comment about E2. A *must* to keep in check!

As for your tests, $400 is a bit high. If you use one of the online blood testing sites, you can get "the works" for $299 which includes the following:
-Lipid Cholesterol Profile
-Complete Blood Count w/ Differential
-Estradiol
-Hemoglobin A1c
-Cardiac C-Reactive Protein Test, High Sensitivity
-Insulin Growth Factor (IGF-1)
-Thyroxine-Stimulating Hormone (TSH)
-Gamma Glutamyl Transpeptidase (GGT)
-Insulin, Fasting
-Comprehensive Metabolic Panel
-Luteinizing Hormone(LH)
-Testosterone Serum
-Sex Hormone binding Globulin, Serum
-Urinalysis, Routine
-Follicle-Stimulating Hormone (FSH)
-Magnesium, Serum
-Thyroxine (T4) Free, Direct
-Ferritin, Serum
-Prostate-Specific Antigen (PSA)
-Iron Serum w/TIBC
-Dehydroepiandrosterone Sulfate (DHEA)

It's simple and they refer you to a local lab who draws the blood and sends it out to be tested. All you do is fill out your info and pay online, print your receipt, take it to the lab to get your draw, and they e-mail you a secure link to your results in about 4 days. There labs are all over too; so you should be able to find one pretty close to home. Mine was less than a mile away. **There were nearly 50 labs within 50 miles.** Even my own doctor could not believe how affordable and convenient they were. So much so that he took down their info to recommend to his other patients. Plus, as an added bonus, unlike other typical labs, *you* get to keep your lab results.

Best o luck.

P.S. Not sure how you managed to get your hands on Gel without a script, but I'd be careful about self medicating. This is a serious thing and if you do indeed have LowT, it's a *life long* commitment, not just something you start and stop at will. Get a doc to manage your program but stay educated with this site and other resources. I *highly* recommend you read the 'perm posts' at the top of this site on HRT etc. You will learn much valuable info!

[Priapism]

When I feel amazing from a quarter to a half gel pack of Testogel applied daily, I know that all I need is a little kick to be "back where I should be". And Im not too worried about starting and stopping something quantities so minor, because I'm not convinced that it means permanent damage to your natural testosterone production. Besides, what doctor is goin to approve me to be on HRT when all I need is such a tiny kick? I suppose I could get put on a half packet of Testogel per day with an Aromatase Inhibitor to keep things in cheque, but from what I've seen - doctors say "NO" because they too believe its not something you should mess with unless you "desperately" need it. Well for me, if I am not raging horny or at least healthily horny on a daily basis, then I feel like I am not living life. I have an aversion to "blah". I hope that doesnt mean I will end up harming myself with this stuff.

The next step is to get the numbers though, and see if I am lucky enough to have an LH or FSH abnormality to point to. No more speculation. However you didn't say what online testing site offers the above list for only $200 ? By the way - I have a wholesale account with LEF because I run an alopecia site and was thinking of selling some of their other stuff - so that $400 price probably will come down quite a bit. But I dont think their hormone panel has half the stuff you've listed above.

SOME MORE QUESTIONS FOR THE EXPERTS....................................

1) Id like my hormone levels to be as accurate as possible when I get the blood drawn. I guess I should go in the morning when they are highest. Someone above suggested that. First off, why? How I feel at 11pm is far more important than how I feel when I first wake up when everything might be closer to hunky dory. Why not test at your lowest, or better yet - at mid range, for accuracy?

2) Very weird question but humor me: Also along the lines of the test numbers being accurate - *I KNOW* my hormone levels fluctuate significantly based on whether or not I have masturbated lately. At this point I dont really start to get horny at all until 2-3 days post masturbation. By day 4 I can be back to my normal 25 year old self. So when do I want to get this test? At which point on this sliding scale would be best? Day 4 testosterone levels are going to be noticeably higher than day 1. But neither, in my mind, qualify as accurate.

3) Nobody has suggested any online testing sites. Can someone?

-P-

-P-

[forrest_and_trees]

Just for the record, I'm no "expert" on HRT, I only know what I've learned in my own dealings however, if I had to guess, I would suspect the reason for testing first thing in the morning is two-fold. 1st is consistency. When dealing with a tangent that gradually changes throughout the day, it's best to to have a common ground for all subjects. Otherwise you may have one patient test in the morn, while another does it later in the day. The two could be identical physically, however the test results would show otherwise. Secondly, I'd suspect it's better to know the "best case scenario"; or what your highest point is so there's no doubt if you do have low levels, that it's not just a matter of circumstances rather than fact. ...Then again I could be entirely wrong, so perhaps one of our more informed members can step up and chime in.

As far as the site for testing, try priviatemdlabs.com; and just to set the record straight, the price was $299 for the test referenced above. [Not $200]

[Priapism]

Hey guys I was looking at this test:

http://www.privatemdlabs.com/lp/Horm...al_Changes.php

Doesnt seem to contain "E2" right? Am I missing it? Where to get it ... ?

-P-

[forrest_and_trees]

Estradiol = E2

[Priapism]

Thanks. So "Estrogen" proper, isnt one of the items I want my numbers on? Estradiol covers it fully?

-P-

[Alloy]

Thanks. So "Estrogen" proper, isnt one of the items I want my numbers on? Estradiol covers it fully?

-P-

Yes, Estradiol is what you want checked. If you're unsure, call and confirm with the lab.

[forrest_and_trees]

Essentially... [as I understand it] for the sake of testing and as it applies to men, Estorgen = Estradiol = E2 which is sometimes also referred to simply as E.

If anyone else would like to comment on this further, please do.

[flatscat]

Once you are on trt, it doesn't matter when you get your bw done. First thing in the morning before you start is so you will know your high point to determine initial treatment.

[Priapism]

Doublepost.

[Priapism]

Essentially... [as I understand it] for the sake of testing and as it applies to men, Estorgen = Estradiol = E2 which is sometimes also referred to simply as E.

If anyone else would like to comment on this further, please do.

http://www.privatemdlabs.com/lab_tes...ategory_result

On this page they separate the tests as

Estradiol
Estrogen Testing, Comprehensive Panel
Estrogens (Total), Serum

So i guess they are different....

Interestingly, the Comprehensive Estrogen includes: "Estradiol, Total Estrogens, Serum Estriol"

Estriol?

[Priapism]

Anyways I got my results back.

Let me just preface this again: Im comparing myself at age 36 with how I felt at age 23 when I was a raging hormone monster. So for me, natural may have been 1000 testosterone. When I felt like HELL I was 435. So I know that's my lowest of low. For me. I did some testogel and came off it. Had a bit of a dropoff and then felt my body kicking into gear again. Was actually feeling pretty horny but "not quite there" this past week. I knew I'd be higher than 435. But not where I want to be.

So that's when I got the tests done. Here are the results:

Disclaimer: I am in range with everything. Any suggestions?


Serum Testosterone: 505
Estradiol: 33
LH: 3.2
FSH: 3.0
DHEA: 246
Sex Horm Bind Glob: 27.2

A little high on E2 ... low on FSH ....

Small Clomid dose clear me right up?

I'd really dig being at about 800 or so on Testosterone. Oddly enough it said the range was 200-800. Never seen 800 as the high end of the range before. Ever.

-P-

[zaggahamma]

Anyways I got my results back.

Let me just preface this again: Im comparing myself at age 36 with how I felt at age 23 when I was a raging hormone monster. So for me, natural may have been 1000 testosterone. When I felt like HELL I was 435. So I know that's my lowest of low. For me. I did some testogel and came off it. Had a bit of a dropoff and then felt my body kicking into gear again. Was actually feeling pretty horny but "not quite there" this past week. I knew I'd be higher than 435. But not where I want to be.

So that's when I got the tests done. Here are the results:

Disclaimer: I am in range with everything. Any suggestions?


Serum Testosterone: 505
Estradiol: 33
LH: 3.2
FSH: 3.0
DHEA: 246
Sex Horm Bind Glob: 27.2

A little high on E2 ... low on FSH ....

Small Clomid dose clear me right up?

I'd really dig being at about 800 or so on Testosterone. Oddly enough it said the range was 200-800. Never seen 800 as the high end of the range before. Ever.

-P-

yeh i've seen range to 800...to me the diff ranges on test dont matter much as the both measure in ng/dl so i cant fathom how the ranges vary anyway....but i agree...i would seek 800 as well....and depending on how you dose your test (i dont know much about testopel)(and not sure how you take to injections) but dont think your e2 is that high and i wouldnt myself want to take anything that might bring it too low....u did mention small clomid dose (also, no personal exp with clomid) but u also said "clear me right up" when, imo, 33 isnt real high once again.....my best advice...since you said your starting to feeling better is to introduce one thing at a time...my.02

[Vettester]

I'm trying to clarify ... Are you taking TRT right now, or are you taking nothing and that is your baseline numbers?

Your E2 is right about perfect IMO. No need to do anything with it at this time.

Your LH/FSH is def. on the lower end, but not in the gutter. I presume you are not taking any exogenous test, because your total "T" score is about what I would expect to see based on the amount of LH that your gland is producing.

In your case, you could probably add a little HCG every week and bring your score up a few hundred points. Also, by reducing your SHBG you will increase your bio-available free testosterone, which is really the relevant variable when talking about how much testosterone you have. Think about it, would you rather be the guy that has a total serum score of 500 with a 3% free testosterone level, or the guy with a 700 serum score, but 1.5% free testosterone?

[Priapism]

All the info is above but here's a recap again vette:

My number when im at my worst was 435. Felt terrible.
I did Androgel for a week.. then stopped.
Waited 3 weeks after stopping.
I could feel my natural testosterone production kicking in again.
Probably should have waited for it to bottom out to where i felt like crap again.
Got tested anyways.
As expected, testosterone is about 100 points higher than my worst.
As I commented, when I go off a week of Testogel, I tend to have a surge in natural T production. That's whats going on now.
But even with this surge, I dont feel like I want to. A little better, but not quite.
Not surprisingly my numbers were "a little better, but not quite" 800 ...
505 ...
So the numbers youre seeing are me, feeling a little better naturally. Because my T production is kicking back into gear again after Androgel ...

The assumption is that they will be worse given a few more weeks of doing nothing.

But im definitely in range, and just want a little kick.

Sounds like Clomid is the best idea. Microdose for awhile. I assume i want to get an E2 test to make sure it doesnt increase on clomid? Or does Clomid work as an AI by default ....?

-P-