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Dealing with Low Testosterone - Hypogonadism

67K views 184 replies 48 participants last post by  raven2000 
#1 · (Edited)
I have been hesistant to post this thread for some time. While dealing with the dying days of my marriage and then struggling with whether or not my symptoms and issues were a result of stress and coping with the divorce I wasn't sure if my problems were physiological or psychological. But ... testing has confirmed what I would never have suspected were it not once again, for discoveries I made here on this forum. So in that vein, I hope sharing my information will be useful to others.

The website below is a great one-stop resource for learning about all things testosterone. What it is, what it does, what the measurements mean, and methods of addressing and treating the issue of deficiency. Without getting into existential discussion, testosterone is the hormone produced in the testes that basically, defines male sexual characteristics, bone mass, muscle mass, and influences energy levels and feelings of well being.

Mens Hormonal Health

These are other threads on TAM addressing this question - that from a guy's perspective isn't going to be an enthusiastic conversation - but probably is a necessary one, especially if it is having a negative impact on your relationship.

Any man out there having a mid-life crisis?

Could it be low testosterone?

Low testosterone, how to deal

In my case, what I have found most troubling about the diagnosis, is wondering how long it has been an issue. I have shared previously that I was diagnosed with Attention Deficit Disorder in my thirties. I struggled tremendously through college and at times in the work environment with attention and fatigue issues. I took medication for over a decade to treat my inability to focus that led to prostate problems, and utterly crashed my libido, ability to achieve or maintain an erection, or to have an orgasm. Basically the side effects of the medication I was taking increased the symptoms of hypogonadism or low test. To me, the kicker, and hope is the possibility that my ADD symptoms will be resolved by testosterone therapy.

For the benefit of others, in considering low test as a possible issue, my symptoms are as follows:

- Erectile Dysfunction
- Decreased Libido, I still have desire but not that driving urge. And even with desire, my body won't cooperate.
- Decreased penile sensitivity
- Difficulty achieving orgasm, This has almost always been an issue for me. I have the opposite of premature ejaculation.
- Depression, I want to qualify this as feeling more like an emotional trough. I don't feel that it comes anywhere close to clinical depression, although depression still feels like the best word. I feel like there is a damper on my emotions, and at times my energy level is zero.
- Insomnia, I've had bouts of this throughout my adult life. I usually chalked it up to stress - even when there were no apparent stressors in place.
- Fatigue, I'm not talking about feeling a little tired or having a hard time staying alert through the afternoon, I'm talking about a really weird inability to take action in the morning. It's like this low waking state, where I'm aware, but my mind doesn't engage to say - 'time to get up'. I will literally think that I have been awake in bed for 10 minutes or so, and discover when I actually do get up that I had been laying there for close to an hour.
In the evening, between 5 and 8 pm I am exhausted as in want to go to sleep for the night tired, have nearly fallen asleep behind the wheel tired. Occasionally I do doze off and awake a few hours later.

The reason I feel that laying this stuff out there is important, is that so much of it can easily be categorized as other conditions - thus missing the correct one. My physician and urologist never posited the possibility of low testosterone. I asked them to do a screening based upon my symptoms after reading about the subject here, particularly based on contributions and exchanges with Simply Amorous.The screening is a simple blood test.

Testosterone generally begins to drop once a man is in his thirties, the presumption is that the drop is about 1% per year. In my case, my symptoms became far more pronounce approaching my mid-forties. What complicated things in my mind, was this also coincided with the timing of the end of my marriage and divorce. So, based upon the results of my blood screening, I am pursuing treatment on the physiological side. If testosterone therapy doesn't yield any results in terms of the sexual or emotional symptoms, I'll be looking at options on the psychological side.

Frankly, the symptoms and consequences of this condition are humiliating. They are demoralizing. If you feel like crap, it makes you feel crappier. If you are generally confident and upbeat, it's tough to maintain that outlook. All of a sudden the inability to perform one of the most definitive of male traits - becomes the center of anxiety, fear and disappointment - especially if you are trying to forge new intimate relationships. I do want to forge new intimate relationships, and I do want to be back to my confident, upbeat self. So, I have no plans to ignore or deny the issue hoping it will go away, I'm opting for treatment, and would encourage any man on the fence, to get screened and pursue treatment as well.

Treatment takes several forms:

- Pills (Generally considered least effective)
- Transdermal Gels, this is a gel rubbed into the skin where the hormone is then absorbed into the blood stream.
- Injections, intramuscular injections via syringe
- Subdermal Implant, this is the option I chose. The medication is pelletized and inserted beneath the skin where a steady dose of the medication is absorbed for up to 4 months.

My therapy will likely start in early January. Benefits if any, should likely start to appear by February, within 4 to 6 weeks.

I will certainly try to post experiences and progress in the interim, and with ongoing treatment. I'll be happy to answer any questions either on the open forum or via PM.
 
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#76 ·
Don't 'feel' normal.

Fatigue. Joint pain. low energy, sex issues ... my plan is to 'explore' HRT to see if increasing my T has some positive impact.

The pellets are a pain in the a$$, literally. Following my leg workouts, I invariably have a good deal of soreness, and even continued bruising in the area they were implanted on my derrier.

Think I'm going to try injections.
 
#81 ·
Some pretty miss-informed responses.

1) tests are all different in terms of ranges. The majority use a 200-1000 range.

2) 800 IS NOT abuse. The range is 200 - 1000. By that logic, if 800 is abuse, 430 could be termed neglect.

3) Most men feel better in the range or 600-900, at 400 most if not all feel sluggish, lazy, fat gain, tired. Almost all I have worked with (90&) had those symptoms disappear when they were in the upper range.

4) Shots do not need to be given by a nurse. They will instruct you on how to perform them.

5) "800, good luck", if a male is at say 300/400, a level of 700/800 can easily be acheived by a single shot of 200mg test a week. About 90% of males can acheive this result. A few require more, a few less. A estimate does is first given, and peformed for a min. of 4 weeks, and blood is retested. Then adjustments are made.

I need to qualify some of my comments. Testosterone therapy is not the solution and end all for all your symptoms. At the age of 40-60, you will not feel like 20 again. It will make you feel better, but dont expect a miracle.

I have been around HRT for almost 17 years and help/worked with many folks (also women). Modern day medicine is based on making money, not helping lives. Pellets, gels do work, but thier intent is a re-marketing of an old product. This really isnt that difficult to do as doctors make you believe. But, it is critical to find a doctor or anti aging clinic that deals soley with this. Most doctors today simply dont get it.
 
#83 ·
RLD, honest to God, many of your posts make me laugh out loud ... in a good way. I like your humor. I also think your wife is crazy but that's for another thread ...

I have sincerely tried to do my due diligence in this regard. Minncouple has been a great resource and sounding board.

I am hopeful that HRT will mitigate some of my symptoms. I have no expectation of magical elixir results.

I would like to resolve my sexual issues. I would like to be able to continue working out without the joint pain I have picked up in the last 2 years, and I would like to know if it has an impact on my energy level and ability to stay focused.

Watched a documentary on Netflix called Bigger, Stronger, Faster
Great documentary about performance enhancing drugs, told (in my opinion) equitably and fairly, by a non-user. 'Roid Rage' and the Benoit case, along with others, was addressed. They even showed footage from some old Ben Affleck movie where he busts up rooms and throws women around ... all due to taking anabolic steroids. According to the research, this simply isn't true. Again, I don't state that as an advocate. I don't know if I'm an advocate yet. But I do want to be informed.

I have been trying to do more research online, and have found Minncouple's opinion echoed elsewhere. That the pellets and gels although different methods of delivery, accomplish the same thing as intramuscular injections ... only they are much more pharma friendly, meaning they are cash cows.

I did discover an Aging Center in Boston, and I may make an appointment with these folks. My urologist just hasn't been terribly responsive. Can't shake the feeling that he is more into marketing than problem solving.
 
#85 ·
@ Runs like Dog - Completely ignorant statement. Benoit was an abuser of many many recreational drugs. The media jumps of the steroid issue every chance it gets. They neglected to discuss the extasy, cocaine, opiates, and other prescip drugs he was using in very high doses. In addition, the autopsy's show brain damage due to the years of abuse on his body due to wrestling, of which are a factor in his behaviors Similiar to how football players are now in the limelight.

Deejo - Bigger, faster, stronger is not bad documentary, but be clear in watch yoru watching. These guys were part of the bodybuilding world and using very high doses. While HRT is like having one cup of coffee, these guys were drinking gallons of coffee. It really needs to be looked at for what it is.

I was/am those guys in that movie. I began steroid use at age 22, and have not stopped. I have though, educated myself through trial and error and also through inside the body building community. These guys are the leading edge in steroid use, they are the subjects through trial and error. Sad for sure, but its the truth.

I stopped using high amounts at age 35, and now simply maintain with HRT. I can attest to many pro bodybuilders usage, it is unbelievable. HRT is in the range of 200-300 mg's of test a week, and maybe an anti estogen. Pro's/wrestlers are using on average of 2000-3000 mg test, 400-600 mg's Tren, Anadrol 50's at 3 a day, and 6-10 IU's of growth a day. A pro will maintain a blood level of at least 2500-3000, yes that is right. While you are shooting for 800, these guys are 3-4 times that. I have sppken with many top athelete's, they sweep it under the carpet, but it happens.

Main stream doctors are not properly educated in HRT, maybe 10% out there understand it. A reputable anti-aging clinic is the best source.

I'm not trying to be an advocate for HRT or steroids, I really dont care if someone wants help or not. But, I will speak the truths about it if asked.

It's not the use thats wrong, its the abuse.
 
#86 ·
It occurs to me you're using some kind of different test other than the one typically employed by a urologist for your baselines or you're looking at an un normalized distribution. 1000 is in the 95% for a healthy non diabetic man age 25. A median value for a normal distribution for a man age 40 is about 450. There are some doctors who work with HIV patients who recommend very high values. And of course the MDs who work with iron monkeys tinkering with anabolics are advocating numbers higher than 1000-1200.

I'm not an MD AFAIK no one here is. I recommend you find one.
 
#87 ·
@ Runs like dog

It is actually a universally used test, and peformed through Labcorp.

Tests are: Testosterone (free & total), complete CBC with differential /platelet, comp. metabolic panel (14), lipid profile, estradiol, prostate-specific ag, serum, Ambig abbrev CMP14 default.

The distribution is one in the same as you metion in your post below. Based on a Labcorp test range (200-1000), I am really not sure or clear on your points. In addition, your percentages are incorrect. Based on a (labcorp/Mayo clinic) blood panel the range is 200-1000, thus 600 is a median and 1000 is 100 percentile of the range. I really cant tell you what a "normal" range is for a 40yo male, but I do know that most 40 yo males experience the side effects of lower testosterone levels. Thus, raising blood levels (still within medically acceptable "normal" limits) does help the individual.

I think you are believing that "normal" and "feeling better" are one in the same, they are not. We are discussing two seperate issues here.

As far as AIDS research and muscle waisting is concerned, the primary medications being used are; Anadrol, Anavar, and HGH, not soley testosterone. Testosterone used alone did not combat muscle waisting in AIDS.

My doctor is one of the leading authors on Anti-aging means/methods/practices, no need to be replaced.
 
#95 ·
I’ve lived in Portugal for the past 4 years. In that time I got very used to going to the market for fruit and veg. At first I couldn’t work out what was going on. I’d get to the market and one week there weren’t any oranges, next week no strawberries, then no grapefruit. It took a while to dawn on me that everything was seasonal and the fruit and veg were picked when they were “ready to eat”. So more or less it was the same as picking an orange off the tree etc.

I used to buy enough fruit for a week or two as I did in England. Sometimes oranges etc. would “last” more than a month. In Portugal I now buy for no more than three days because after that time fruit quickly “goes off”.

I’ve been back in England for a few months and I’ve given up the thought of getting my vitamins and minerals from the fruit and veg here. I actually don’t think it has any so I’ve put myself on supplements. That is of course until I get back to Portugal. In the UK one of Tescos “claims to fame” is that they can keep an orange for 12 months before it goes on the shelves. An orange is supposed to have around 120 mg vit C in it. Don’t think there’s any in these oranges.

Bob
 
#97 · (Edited)
I'm a new member to this site and forum. I found it from among the results that scrolled up when I googled "attention deficit disorder" along with "testosterone" in the same search.

This post is about testosterone, but please read my intro.

I am 50. When I was 30, I lost my right nut to testicular cancer.

From the time I was 30 to about 37 or so, things were fine. Then I ran into some events of low lying depression. I was prescribed with Zoloft at the time, and it seemed to help. I also started working out. I got to feeling pretty good and decided on my own to taper off the Zoloft. After a short while, my mental state seemed to slip. So, I went back on, but my second "tour" with Zoloft didn't seem to help at all. I seemed to recover on my own.

A long-time bachelor, I married at 39. A year or so into my marriage, my high-paying job crumbled in a perfect storm of political upheaval.

Since I married a widow with two young kids, my evenings in the gym had long since curtailed. I started sleeping in and putting on weight. My wife started losing interest in having sex with me. (Imagine that.)

Over the years, I was diagnosed with depression or ADD (the inattentive kind -- not the hyperactive kind). Adderall, Wellbutrin, and other drugs were doled out to me, along with cheap co-pays to fill 'em up at my local CVS pharmacy.

Years clicked off from 2000 to 2008, my marriage gradually eroding and degrading. I began to accept a marriage that had no sex as exactly what people told me would happen before I got married. When there were attempts, I found that I had lost my libido and skills. I had been very good with my hands for example, but I lost the connection between my fingertips and the clitoris. It was like my hand had turned to stone. You lady readers know the frustration of being with a man who doesn't know how to touch you. It is perhaps even more frustrating to be the man who once knew how to touch but then could no longer do it. Sadly, neither of us ever had the thought to look into a retreat or get medical attention for "this" aspect of the marriage. Other counseling routed us into a social worker who could only seem to harp on how I need to cope with my alleged ADD.

A word about Adderall.. it created this early day sensation and belief that I could accomplish anything. It was like being high without feeling like I was on a high. In the late afternoon, however, I would come off of it and become highly irritable. This was very bad with kids (or anyone), so I dumped this stuff, too. There were some other drugs, too, and I can't even think of all of them right now. Focalin... if I post again, maybe I'll have the laundry list... one of them was very hard to get off of, and I remember having "knocking sounds" in my ears for a week or so while it was working its way out of my system.

Anyway, in 2008, my wife filed for divorce. I had gone from job to job, and she was handling the finances at this point. My ability to concentrate on conversations, responsibilities, and more had at this point gone out the window. Still I plodded on.

In early 2009, I saw my general doc about fatigue. He did some blood work and noted that my T count was in the cellar. Something like 27 or something... I don't remember if this was "free" testosterone or what, but I knew that 27 was in the toilet. He said, "This is out of my area of expertise, so I am going to send you to an endrocrinologist."

Cutting to the chase, I have been seeing this endocrinologist about three times/year. He first had me on Testim, but then when Solvay came out with Androgel in the pump bottle, we switched to that.

Where I'm at today: things are much improved. I take about 4 pumps of Androgel daily. My thinking is much clearer than it has been in years. Even though I am a uniballer, my libido is back. I am using words that I haven't used in years -- it's like I got my vocabulary back. My ex-wife still doesn't want to have much to do with me, but I wouldn't mind one turn in the sack with her just to let her remember the good times one more night.

My career is not yet repaired. It's hard to find a job when your "resume" for the last ten years is hardly worth the paper it's printed on. I did have a nice job for the first quarter of this year, but I lost it when I had to blow the whistle on some illegal activity. I rocked the boat, but of course had I not rocked it, I was going to end up wrapped up in the very thing I found myself uncovering.

I have long been off the ADD meds, as well as the SSRIs. And SSRI's... that stuff really screws up libido, sheesh. So, today it's just testosterone. As a result, I am getting re-introduced to myself, a guy who has probably been missing for about ten years or so.

Well, that's my brief story and intro. I have not re-read this or proofed it, so I hope it reads well and makes sense. It's a little after midnight right now, and it's time to turn in.
 
#98 ·
Hi all! I been on Androgel for @7 months. About 1.5 months into It I started to feel great. Would awake in the morning and exclaim "Im Back!" Well that only lasted for a few days and I could feel myself going back down. Mild depression, joint pain, life sucks, etc.
I still have 5 weeks to wait for an endochronologist to see me.
I called my GP thinking I needed an estrogen blocker. He said no, my levels are fine.
He's had me on Effexor for a few years now. Recently raising from 75mg to 150mg. I know that stuff isnt working!
So, 2 days ago, after no improvement in 7 months, I have quit Andro and Effexor. When this all began my Free T was 227 and GP says its now over 800.
Im 47yrs old, over weight and know i dont eat right. Things i need to change.
But until then im hoping my Endo will be my savior. Gonna be a long 5 weeks!
Whew! Got that off my chest! Thanks!
 
#99 ·
Did you have your red cell count checked? Androgel can send it into the high zone. Also make sure you didn't wind up with hypertension. Your T# is at the high normal range for a man of any age. Any higher you're in the Barry Bonds zone. It is possible that high T# is causing mood disorders. That's not uncommon.

A few comments on Effexor/Pristiq. Venlafaxine or
Desvenlafaxine have the shortest half life of any of the common anti-d's. They metabolize very rapidly. This means that missing a day or even missing a few hours can make you feel like crap. They are also the hardest of that family of anti-'s to quit. Harder than Citalopram. You can get pretty messed up trying to quit. Patients have checked themselves in the hospital, thought they were dying, having strokes, etc. Also one significant side effect of Effexor is significant weight gain. To its credit, Effexor is a good last line defense. It works better than almost anything to pull you out of black hell. 150mg/d is at the top of the range for self administration. You can't go any higher if you wanted to.

My lay opinion is that you were given too much of both. Less of both might have worked better.
 
#100 ·
Runs Like Dog: Thanks so much for your reply. Although Ive become frustrated and impatient, after reading your reply i realized i was overreacting.
I have no idea what my red blood cell count is.
Venlafaxine does have terrible side effects getting off it. When i first started it my GP claimed it was ok to start and stop it. The nasty side effects of coming off lasted me 2 weeks. That was 2 years ago. Been back on it ever since.
I was on 7.5g Androgel and 150mg Venlafaxine. I recently quit Androgel for 2 days, and yesterday started using 2.5g Andro and 75mg Venlafaxine.
I feel better today than i have in a long time.
Hopefully this works better until i get in to see the Endo.
You were spot on with the hypertension. I've been treated for it for many years. Recently it has been getting worse and my GP doubled the dose of Avapro. That started about the same time he doubled the Venlafaxine! Go figure...

Thanks, Dale
 
#101 ·
There may be a correlation between the Effexor and the testosterone. Effexor is sometimes given to women for hot flashes. It's usually given to those who have had breast cancer and can't be given estrogen supplements.

Definitely see an endocrinologist to get the meds worked out.
 
#105 ·
I wanted to avoid the transdermals because I have young children that I am often in contact with. Just made me nervous.

I used Testim for a week. The fragrance was pretty overwhelming. So much so that it set off my asthma.

The testopel experiment was disappointing. Even moreso, it's not like they could correct it on the fly. Once it's in ... it's in. Also kept re-bruising the area where the pellets were inserted if I did heavy exercise. If I understand 'trocar' correctly, I believe testopel is likely inserted with such a device. Reminds me of the Ron Popeil, Solid Flavor Injector ...

I have no fear of needles, and from a convenience perspective, I am less likely to forget due to ADD ... I think once a week injections sound pretty good.
 
#106 ·
Best of luck to you hon! You and your doctor will find the right solution so please don't give up.
I had to laugh at the Ronco flavor injector part. We got back yesterday from a weekend away and none of us could sleep. It was nearly 4 am and we all sprung up like daisies and the only thing on was the infomercial for the flavor injector. I literally turned to my husband and said "You could shove pills in that thing". Who knew somebody else had the same idea. :lol:
 
#109 ·
FWIW there's a new spin on Androgel @ 1.62% concentration. It requires far fewer pumps and uses a smaller coverage area - upper arms only. Androgel is known to not have awful aroma of Testim. It's 98% alcohol gel. The only downside is it will explode if you smoke while you apply it.
 
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