Test Results

[Guest guest]

On Fri, 23 Apr 2004 21:50:14 -0000, you wrote:

>Please look at the AACE clinical guidelines which you can find among

>the Links.

>

>Page 5 includes the following observation:

>

> " In addition, a high prolactin level can reduce libido and potency

>even in men treated with therapeutic doses of testosterone. "

>

>Were I in your shoes, I would attend to the prolactin level before

>trying other things.

Good catch!

[Guest guest]

It is quite low for 10gms of AG. Perhaps injections are in order.

Brad

> > Here are some test results that came back abnormal. What do you

> > think and where do I go from here?

> >

> > T-4 (free) 1.24 .08-1.9NGDL

> > FSH <0.3 .09-15.0 MIU/ML

> > Lutenizing Hormone <.07 2.4-5.9 MUI/ML

> > Prolactin 32.5 3-16NG/ML

> > T Testosterone 227 241-827

> > % Free Testosterone 4.39 1.00-2.70%

> >

> > I reaize my Prolactin is double and my Total T is low. I am

> taking

> > Bromocriptene for the Prolactin and 10 grs of Androgel. I have no

> > get up and go, no drive, no morning wood,nada. Could the Total

> > Testosterone alone cause all of that?

> >

> > I don't really know how well the Androgel is working on that. I

> go

> > back for more blood work this June. I keep hearing about HCG,

> > Deprenyl and a whole host of other other options. What do you

> > suggest? By the way, my E2 came back normal. I am only 41 and

> it

> > is starting to wear me down.

> > Thanks

[Guest guest]

Re: Test results

On Fri, 23 Apr 2004 21:07:20 -0000, you wrote:

>Here are some test results that came back abnormal. What do you

>think and where do I go from here?

>

>T-4 (free) 1.24 .08-1.9NGDL

>FSH <0.3 .09-15.0 MIU/ML

>Lutenizing Hormone <.07 2.4-5.9 MUI/ML

>Prolactin 32.5 3-16NG/ML

>T Testosterone 227 241-827

>% Free Testosterone 4.39 1.00-2.70%

>

>I reaize my Prolactin is double and my Total T is low. I am taking

>Bromocriptene for the Prolactin and 10 grs of Androgel. I have no

>get up and go, no drive, no morning wood,nada. Could the Total

>Testosterone alone cause all of that?

>

>I don't really know how well the Androgel is working on that. I go

>back for more blood work this June. I keep hearing about HCG,

>Deprenyl and a whole host of other other options. What do you

>suggest? By the way, my E2 came back normal. I am only 41 and it

>is starting to wear me down.

What was the E2 number and SHBG?

------------------------------------------------------------------------------

[Guest guest]

My E2 was 16. <50PG/ML I do not believe I have ever had my SHBG checked. I

will the next go round. Is this morre important than T levels or a contributing

factor?

Ned

Re: Test results

On Fri, 23 Apr 2004 21:07:20 -0000, you wrote:

>Here are some test results that came back abnormal. What do you

>think and where do I go from here?

>

>T-4 (free) 1.24 .08-1.9NGDL

>FSH <0.3 .09-15.0 MIU/ML

>Lutenizing Hormone <.07 2.4-5.9 MUI/ML

>Prolactin 32.5 3-16NG/ML

>T Testosterone 227 241-827

>% Free Testosterone 4.39 1.00-2.70%

>

>I reaize my Prolactin is double and my Total T is low. I am taking

>Bromocriptene for the Prolactin and 10 grs of Androgel. I have no

>get up and go, no drive, no morning wood,nada. Could the Total

>Testosterone alone cause all of that?

>

>I don't really know how well the Androgel is working on that. I go

>back for more blood work this June. I keep hearing about HCG,

>Deprenyl and a whole host of other other options. What do you

>suggest? By the way, my E2 came back normal. I am only 41 and it

>is starting to wear me down.

What was the E2 number and SHBG?

------------------------------------------------------------------------------

[Guest guest]

On Fri, 23 Apr 2004 19:17:08 -0400, you wrote:

>

>My E2 was 16. <50PG/ML I do not believe I have ever had my SHBG checked. I

will the next go round. Is this morre important than T levels or a contributing

factor?

Your E2 seems a bit on the low side. My lab has range as 8 to 43 so

you're likely in the bottom 10 to 20% . I don't know if that's enough

to affect things. SBHG essentially latches on to free testosterone, as

I understand it, to keep a portion of it unavailable. If it gets high

it can defeat things some.

But this is an area I don't know a lot about. But as your other

numbers seem to look relatively what one would expect (excepting of

course the prolactin) I was curious about these. But I think the

fellow who pointed you to the AACE guidelines on prolactin has the

best info probably:

>Please look at the AACE clinical guidelines which you can find among

>the Links.

>

>Page 5 includes the following observation:

>

> " In addition, a high prolactin level can reduce libido and potency

>even in men treated with therapeutic doses of testosterone. "

I'd bet that's the issue. Looks like if you when you get that in

control you'll likely being doing much better.

[Guest guest]

Just spoke to the surgery again and have more details:

Oestradiol: 108 pmol/l (no normal range)

Serum sex hormone binding glob: 20 nmol/l (normal: 10-80)

Serum testosterone: 15.9 nmol/l (normal: 10-30)

The results seem low compared to the 'normal' range. I am a 36 yr old male.

Cheers, Gwyn

Test results

Hi, I posted a while back and just had some tests done.

I asked for testosterone, free testosterone and E2 as suggested on this

forum. The results have come back as " normal " but I'm not sure what the

figures relate to... perhaps someone here will know as they do not seem to

have come back with the same names

Oestradiol: 108 (presumably this is E2)

Serum sex hormone binding glob: 20

Serum testosterone: 15.9

No units given to me over the phone but presumably they will be some sort

of

metric unit!

Can anyone help make sense of these?

Regards, Gwyn

[Guest guest]

Hi Gwyn,

Here are some ranges plugged in with your numbers. Reference ranges may

vary between laboratories, so your doctor might use slightly different ones.

Serum testosterone: 15.9 (11-36 nmol/L, males)

(Converted: 458 (317-1037 ng/dL)

Oestradiol (E2): 108 (50-200 pmol/L, males**)

(Converted: 29.4 (13.6 - 54.5 pg/mL)

SHBG: 20 ( " Reference values in men are 10-80 nmol/L measured by

immunoassay, and 6-44 nmol/L using a binding assay. " *** So 20 nmol/L is in

range for both test methods. SI units, nmol/L, are used in the U.S. for SHBG)

References

* http://www.gpnotebook.co.uk/simplepage.cfm?ID=208339011

** http://www.gpnotebook.co.uk/simplepage.cfm?ID=570818627

*** http://www.hopkins-menshealth.org/labs_article.php3?type=labs & id=56

Anyway, that's the math. Does someone else want to offer interpretation?

Bruce

> Just spoke to the surgery again and have more details:

>

> Oestradiol: 108 pmol/l (no normal range)

> Serum sex hormone binding glob: 20 nmol/l (normal: 10-80)

> Serum testosterone: 15.9 nmol/l (normal: 10-30)

>

> The results seem low compared to the 'normal' range. I am a 36 yr old male.

>

> Cheers, Gwyn

> Test results

>

>

> Hi, I posted a while back and just had some tests done.

>

> I asked for testosterone, free testosterone and E2 as suggested on this

> forum. The results have come back as " normal " but I'm not sure what the

> figures relate to... perhaps someone here will know as they do not seem to

> have come back with the same names

>

> Oestradiol: 108 (presumably this is E2)

> Serum sex hormone binding glob: 20

> Serum testosterone: 15.9

>

> No units given to me over the phone but presumably they will be some sort

> of

> metric unit!

>

> Can anyone help make sense of these?

>

> Regards, Gwyn

>

>

>

[Guest guest]

I think the next step would be for you to read this link and then print it and

give it to the Dr. you need to know why you are so low your levels of T are to

low.

http://www.aace.com/clin/guidelines/hypogonadism.pdf

Phil

Gwyn Carwardine <gwyn@...> wrote:

Just spoke to the surgery again and have more details:

Oestradiol: 108 pmol/l (no normal range)

Serum sex hormone binding glob: 20 nmol/l (normal: 10-80)

Serum testosterone: 15.9 nmol/l (normal: 10-30)

The results seem low compared to the 'normal' range. I am a 36 yr old male.

Cheers, Gwyn

Test results

Hi, I posted a while back and just had some tests done.

I asked for testosterone, free testosterone and E2 as suggested on this

forum. The results have come back as " normal " but I'm not sure what the

figures relate to... perhaps someone here will know as they do not seem to

have come back with the same names

Oestradiol: 108 (presumably this is E2)

Serum sex hormone binding glob: 20

Serum testosterone: 15.9

No units given to me over the phone but presumably they will be some sort

of

metric unit!

Can anyone help make sense of these?

Regards, Gwyn

[Guest guest]

I read that link and even produced a copy to my doctor but she doesn't have

the time or desire to read such things. I think doctors are a bit busy in

the UK so you get your 10 minutes and that's it and you get the definite

impression they're trying to get you out of the door asap so they can claw

back some of the time they overran earlier in the day. Looking at their

watch would be too obvious but they don't need to because they're used to

the pace that a session should go at and they instinctively know when things

are going too slowly for their liking!

Anyway.... I would take the document back in but her response at lunchtime

was " everything's normal, stop worrying about it and get on with your life " .

I asked her to define " normal " , as they specified on the test results, and

was that " normal for a male " or " normal adjusted for my age " ? She wasn't

able to properly answer this so blustered a bit and reiterated " normal " and

said it would " probably have been adjusted for age " . Great. Really

confidence inspiring. Again she seemed rather keen to get me out of her

hair.

If I could find something that suggests that shows my figures as being low

or lower than expected or at least cause for further consideration then I'd

go back. I think after my questions and nagging that she's going to refer me

to an endo so I can give them all the questions instead!

Are these figures expected for my age? They seem on the low side... but

where's the age adjusted ranges? I can't find them.

Also I saw something about FAI which can be calculated by TT/SHBG x 100 but

I get about 80% which from what I could find suggests I should be balding,

suffer from acne and have the bodyhair of a chimpanzee which is exactly the

opposite. Again I can't find any good info. on this on the net. Apart from

something that says that calculating FAI in males this way isn't reliable.

Is there any info. available?

Then I found an Australian site which suggested that low SHBG (<30) was

optimal. Which mean I should be thinking this is good.

I'm more confused than anything else!!! And reading the posts on here it

sounds like there's a good chance the endo won't know shit about this

anyway...

g

Test results

Hi, I posted a while back and just had some tests done.

I asked for testosterone, free testosterone and E2 as suggested on this

forum. The results have come back as " normal " but I'm not sure what the

figures relate to... perhaps someone here will know as they do not seem

to

have come back with the same names

Oestradiol: 108 (presumably this is E2)

Serum sex hormone binding glob: 20

Serum testosterone: 15.9

No units given to me over the phone but presumably they will be some

sort

of

metric unit!

Can anyone help make sense of these?

Regards, Gwyn

[Guest guest]

More thoughts!

When I was speaking to the doctor who was trying to tell me to " stop looking

for a problem that doesn't exist " I didn't have the presence of mind to say

" so I'm normal then? " . " so having a span 5 inches greater than your height

is normal? " " Having a lack of body/facial hair is normal for a man? " " Having

osteopenia at my age is normal? " . These are all obvious, undeniable,

physical symptoms which are anything but fucking normal. So why does she

insist on keep telling me " you're normal " .

Sorry for the outburst. Got to get the frustration out of my system!!!!!

Test results

Hi, I posted a while back and just had some tests done.

I asked for testosterone, free testosterone and E2 as suggested on

this

forum. The results have come back as " normal " but I'm not sure what

the

figures relate to... perhaps someone here will know as they do not

seem

to

have come back with the same names

Oestradiol: 108 (presumably this is E2)

Serum sex hormone binding glob: 20

Serum testosterone: 15.9

No units given to me over the phone but presumably they will be some

sort

of

metric unit!

Can anyone help make sense of these?

Regards, Gwyn

[Guest guest]

This link is from the Life Extension Foundation and it is a very

comprehensive report on exactly how to do Male Hormone Replacement.

Any person and especially a doctor, should know what to do after

reading this. Your problem will be finding a doctor that cares enough

to help you. http://www.lef.org/protocols/prtcls-txt/t-prtcl-130.html

> Just spoke to the surgery again and have more details:

>

> Oestradiol: 108 pmol/l (no normal range)

> Serum sex hormone binding glob: 20 nmol/l (normal: 10-80)

> Serum testosterone: 15.9 nmol/l (normal: 10-30)

>

> The results seem low compared to the 'normal' range. I am a 36 yr

old

> male.

>

> Cheers, Gwyn

> Test results

>

>

> Hi, I posted a while back and just had some tests done.

>

> I asked for testosterone, free testosterone and E2 as suggested

on this

> forum. The results have come back as " normal " but I'm not sure

what the

> figures relate to... perhaps someone here will know as they do

not seem

> to

> have come back with the same names

>

> Oestradiol: 108 (presumably this is E2)

> Serum sex hormone binding glob: 20

> Serum testosterone: 15.9

>

> No units given to me over the phone but presumably they will be

some

> sort

> of

> metric unit!

>

> Can anyone help make sense of these?

>

> Regards, Gwyn

>

>

>

[Guest guest]

>Hi, I posted a while back and just had some tests done.

>

>I asked for testosterone, free testosterone and E2 as suggested on this

>forum. The results have come back as " normal " but I'm not sure what the

>figures relate to... perhaps someone here will know as they do not seem to

>have come back with the same names

>

>Oestradiol: 108 (presumably this is E2)

>Serum sex hormone binding glob: 20

>Serum testosterone: 15.9

>

>No units given to me over the phone but presumably they will be some sort of

>metric unit!

>

>Can anyone help make sense of these?

>

>Regards, Gwyn

Forgive me, but are you a guy? The only Gwyns I know are girls, short

for gwendalyn. I suspect that's a US vs. UK thing. But talking

hormones I feel a need to be sure.

For guys the serum T in nmol/l range is 10.4 to 38.2.

for Oestradiol it's 55 to 150 pmol/l.

By age and with SHBG you can find numbers here:

http://www.alt-support-impotence.org/hormone_charts.htm

- - - -

Just another albino black sheep

[Guest guest]

On Thu, 16 Sep 2004 16:24:56 +0100, you wrote:

>Anyway.... I would take the document back in but her response at lunchtime

>was " everything's normal, stop worrying about it and get on with your life " .

>I asked her to define " normal " , as they specified on the test results, and

>was that " normal for a male " or " normal adjusted for my age " ? She wasn't

>able to properly answer this so blustered a bit and reiterated " normal " and

>said it would " probably have been adjusted for age " . Great. Really

>confidence inspiring. Again she seemed rather keen to get me out of her

>hair.

Take her (or her replacement) this table:

http://www.alt-support-impotence.org/hormone_charts.htm

Your levels are below average for an 84 year old man. Maybe that will

get her attention. It is extremely likely that getting your T levels

elevated will negate all the reasons you took the various

anti-depression drugs.

Keep coming back here. You'll get help and that extra support to push

for what you need.

- - - -

Just another albino black sheep

[Guest guest]

On Thu, 16 Sep 2004 16:33:49 +0100, you wrote:

>When I was speaking to the doctor who was trying to tell me to " stop looking

>for a problem that doesn't exist " I didn't have the presence of mind to say

> " so I'm normal then? " . " so having a span 5 inches greater than your height

>is normal? " " Having a lack of body/facial hair is normal for a man? " " Having

>osteopenia at my age is normal? " . These are all obvious, undeniable,

>physical symptoms which are anything but fucking normal. So why does she

>insist on keep telling me " you're normal " .

Arg!! You have my total empathy. I didn't see you mention the

Osteopenia before. This is a direct symptom of low T. It's how I

discovered my low T. Over 2.5 years I broke 8 ribs. On rib 7 (third

incident) I was pleading with the Doc that something was wrong. She

essentially patted me on the head and said you're an active guy and

not young anymore. (46) Things will happen to you. I remember writing

her an e-mail that I wanted to follow this up and did not want to be

back in 6 months with another broken rib. I was back in 5. The last

rib cracked leaning over a car seat. I finally got a doctor who did

bone scans and ordered the right tests. Fortunately my first tests

were outside " normal " . Later when they edged into " normal " they tried

to say I may not need therapy anymore and I had to remind them I

needed it to recapture my bone density. " Oh yeah " .

You're mentioning lack of facial and body hair may indicate you have

Klinefleters syndrome as a cause of your low T, or else that it is

something you developed very early.

But low " normal " T and Osteopenia demands treatment with T.

Give these sites a looking over:

http://tinyurl.com/4o5vk

- - - -

Just another albino black sheep

[Guest guest]

One of our members Nick O'Hara is in the UK and has a helpful

website:

http://www.androids.org.uk/index.html

His contact info is on the site. Perhaps you could email him to see

if he knows a suitable doc or has some other helpful suggestions.

Best Wishes,

Brad

> More thoughts!

>

> When I was speaking to the doctor who was trying to tell me to " stop

looking

> for a problem that doesn't exist " I didn't have the presence of mind

to say

> " so I'm normal then? " . " so having a span 5 inches greater than your

height

> is normal? " " Having a lack of body/facial hair is normal for a man? "

" Having

> osteopenia at my age is normal? " . These are all obvious, undeniable,

> physical symptoms which are anything but fucking normal. So why does she

> insist on keep telling me " you're normal " .

>

> Sorry for the outburst. Got to get the frustration out of my system!!!!!

[Guest guest]

G here is a link on T. levels for different ages.

http://www.alt-support-impotence.org/hormone_charts.htm

Get the book form this link it is Dr. Shippens The Testosterone Syndrome.

http://www.maxsportsmag.com/science/issue14/14s1.htm

This link talks about testing and reading the result I will give you the link

and a cut & paste.

http://www.lef.org/protocols/prtcl-130.shtml#too

In this they talk about your test levels should be in the upper 1/3 of the

range.

Phil

CORRECTING A HORMONE IMBALANCE

Step 1- Blood Testing

Step 2- Interpretation Blood Test Results

Step 3-When Results Are Not Optimal

A male hormone imbalance can be detected through use of the proper blood tests

and can be corrected using available drugs and nutrients. The following

represents a step-by-step program to safely restore youthful hormone balance in

aging men:

Step 1: Blood Testing

The following initial blood tests are recommended for any man over age 40:

Complete blood count and chemistry profile to include liver-kidney function,

glucose, minerals, lipids, and thyroid (TSH)

Free and Total Testosterone

Estradiol (estrogen)

DHT (dihydrotestosterone)

DHEA

PSA

Homocysteine

Luteinizing hormone (LH) (optional)

Sex Hormone Binding Globulin (SHBG) (optional)

Step 2: Interpretation of Free Testosterone,

Estrogen, and Total Testosterone Blood Test Results

Free Testosterone

Estrogen

Total Testosterone

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 LabCorp20-29 years9.3-26.5

picogram/mL30-39 years8.7-25.1 picogram/mL40-49 years6.8-21.5 picogram/mL50-59

years7.2-24.0 picogram/mL60+ years6.6-18.1 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/mLOptimal 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 Type66-417 nanogram/dL

FWRA12.3-63%

%FWRA5-21 nanogram/dL

UF or ETD50-210 picogram/mL

UF or ETD1.0-2.7%

% 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.

Male Hormone Modulation Therapy

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

CommentPSA 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).

Referring to Table 1, 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.

emember, 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).

Step 3: What to Do When Results Are Less Than Optimal

If estradiol levels are high (above 30), total testosterone is mid- to

high-normal, and free testosterone levels are low or low-normal (at the bottom

one third of the highest number on the reference range), you should:

Make sure you are getting 80 mg a day of zinc. (Zinc functions as an

aromatase inhibitor for some men.)

Consume 400 mg of indole-3-carbinol to help neutralize dangerous estrogen

metabolites. Cruciferous vegetables, such as broccoli and cauliflower, can also

stimulate the liver to metabolize and excrete excess estrogen.

Reduce or eliminate alcohol consumption to enable your liver to better

remove excess estrogens (refer to the Liver Degenerative Disease protocol to

learn about ways to restore healthy liver function).

Review all drugs you are regularly taking to see if they may be

interfering with healthy liver function. Common drugs that affect liver function

are the NSAIDs: ibuprofen, acetaminophen, aspirin, the " statin " class of

cholesterol-lowering drugs, some heart and blood pressure medications, and some

antidepressants. It is interesting to note that drugs being prescribed to treat

the symptoms of testosterone deficiency such as the statins and certain

antidepressants may actually aggravate a testosterone deficit, thus making the

cholesterol problem or depression worse.

Lose weight. Fat cells, especially in the abdominal region, produce the

aromatase enzyme, which converts testosterone into estrogen (242).

Take a combination supplement providing a flavonoid called chrysin (1000

mg) along with piperine (10 mg) to enable the chrysin to be absorbed into the

blood stream. Chrysin has been shown to be a mild aromatase inhibitor. This

combination of chrysin and peperine can be found in a product called Super

MiraForte.

If all of the above fail to increase free testosterone and lower excess

estradiol, ask your doctor to prescribe the potent aromatase inhibiting drug

Arimidex (anastrozole) in the very low dose of 0.5 mg twice a week. Arimidex is

prescribed to breast cancer patients at the dose of 1-10 mg a day. Even at the

higher dose prescribed to cancer patients, side effects are rare. In the minute

dose of 0.5 mg twice a week, a man will see an immediate drop in estradiol

levels and should experience a rise in free testosterone to the optimal range.

If free testosterone levels are in the lower two thirds of the highest number

in the reference range, but total testosterone is high-normal, and estradiol

levels are not over 30, you should

Consider following some of the recommendations in the previous section to

inhibit aromatase because many of the same factors are involved in excess SHBG

activity.

Take 320 mg a day of the super-critical extract of saw palmetto and 240 mg

a day of the methanolic extract of nettle (Urtica dioica). Nettle may

specifically inhibit SHGB (42-44, 251, 252), while saw palmetto may reduce the

effects of excess estrogen by blocking the nuclear estrogen receptor sites in

prostate cells, which in turn activate the cell-stimulating effects of

testosterone and dihydrotes-tosterone. Saw palmetto also has the effect of

blocking the oxidation of testosterone to androstenedione, a potent androgen

that has been implicated in the development of prostate disease (253).

If total testosterone is in the lower third of the reference range or below

normal, and free testosterone is low, and estradiol levels are under 30, you

should

Initiate therapy with the testosterone patch, pellet, or cream. Do not use

testosterone injections or tablets.

or

See if your luteinizing hormone (LH) is below normal. If LH is low, your

doctor can prescribe an individual dose of chorionic gonadotropin (HCG) hormone

for injection. Chorionic gonadotropic hormone functions similarly to LH and can

re-start testicular production of testosterone. Your doctor can instruct you

about how to use tiny 30-gauge needles to give yourself injections 2-3 times a

week.

After 1 month on chorionic gonadotropic hormone, a blood test can determine

whether total testosterone levels are significantly increasing. You may also see

your testicles growing larger.

Before initiating testosterone replacement therapy, have a PSA blood test and a

digital rectal exam to rule out detectable prostate cancer. Once total

testosterone levels are restored to a high-normal range, monitor blood levels of

estradiol, free testosterone, and PSA every 30-45 days for the first 6 months to

make sure the exogenous testosterone you are using is following a healthy

metabolic pathway and not causing a flare-up of an underlying prostate cancer.

The objective is to raise your levels of free testosterone to the upper third of

the reference range, but to not increase estradiol levels beyond 30.

Excess estrogen (estradiol) blocks the production and effect of testosterone

throughout the body, dampens sexuality, and increases the risk of prostate and

cardiovascular disease. Once you have established the proper ratio of free

testosterone (upper third of the highest number in the reference range) and

estradiol (not more than 30), make sure your blood is tested every 30-45 days

for the first 5 months. Test every 6 months thereafter for free testosterone,

estradiol, and PSA. For men in their 40s-50s, correcting the excess level of

estradiol is often all that has to be done.

Gwyn Carwardine <gwyn@...> wrote: I read that link and even produced

a copy to my doctor but she doesn't have

the time or desire to read such things. I think doctors are a bit busy in

the UK so you get your 10 minutes and that's it and you get the definite

impression they're trying to get you out of the door asap so they can claw

back some of the time they overran earlier in the day. Looking at their

watch would be too obvious but they don't need to because they're used to

the pace that a session should go at and they instinctively know when things

are going too slowly for their liking!

Anyway.... I would take the document back in but her response at lunchtime

was " everything's normal, stop worrying about it and get on with your life " .

I asked her to define " normal " , as they specified on the test results, and

was that " normal for a male " or " normal adjusted for my age " ? She wasn't

able to properly answer this so blustered a bit and reiterated " normal " and

said it would " probably have been adjusted for age " . Great. Really

confidence inspiring. Again she seemed rather keen to get me out of her

hair.

If I could find something that suggests that shows my figures as being low

or lower than expected or at least cause for further consideration then I'd

go back. I think after my questions and nagging that she's going to refer me

to an endo so I can give them all the questions instead!

Are these figures expected for my age? They seem on the low side... but

where's the age adjusted ranges? I can't find them.

Also I saw something about FAI which can be calculated by TT/SHBG x 100 but

I get about 80% which from what I could find suggests I should be balding,

suffer from acne and have the bodyhair of a chimpanzee which is exactly the

opposite. Again I can't find any good info. on this on the net. Apart from

something that says that calculating FAI in males this way isn't reliable.

Is there any info. available?

Then I found an Australian site which suggested that low SHBG (<30) was

optimal. Which mean I should be thinking this is good.

I'm more confused than anything else!!! And reading the posts on here it

sounds like there's a good chance the endo won't know shit about this

anyway...

g

Test results

Hi, I posted a while back and just had some tests done.

I asked for testosterone, free testosterone and E2 as suggested on this

forum. The results have come back as " normal " but I'm not sure what the

figures relate to... perhaps someone here will know as they do not seem

to

have come back with the same names

Oestradiol: 108 (presumably this is E2)

Serum sex hormone binding glob: 20

Serum testosterone: 15.9

No units given to me over the phone but presumably they will be some

sort

of

metric unit!

Can anyone help make sense of these?

Regards, Gwyn

[Guest guest]

Supplying units and reference ranges provides a better context.

I am no expert in thyroid issues but has he made no comments about

your low tsh? Why would this not be treated?

Were you previously on AG before trying the patches? Why did you

change to patches? I wouldn't care for patches either.

655 isn't a bad result. Do you feel undertreated? Continue to have

symptoms?

Applying the gel to thinner skin is a plausible suggestion. If that

doesn't work, I'd consider injectible testosterone.

Brad

> Hi All,

>

> Went to the doc today to find out my latest results from t and tsh

tests last week. He gave me a copy of the last three reports..here are

the results

>

> 6/14/04

> Total T 87

> Free 2.3

> % Free 0.30

>

> TSH .02

>

> 7/16/04

> Total T 94

> Free 3.5

> % Free .40

>

> TSH < 0.01

>

> 9/9/04

> Total T 655

> Free 29.8

> % Free .50

>

> TSH < 0.01

>

> The difference between the second and third test is that he had

switched me over to wearing two patches of androderm from the

androgel. I told him today I can't wear this patches. They are

uncomfortable, awkward, ugly and a few other things. He switched me to

a higher dose of the Androgel again and told me to try putting it on

where I have thinner skic like under my bicep or inner thigh or inner leg.

>

> What do you all make of these results?

>

>

>

[Guest guest]

Hi Gwyn,

Outbursts about doctors are permitted. Yours was comparatively gentle.

1. As far as the official medical community goes, your tests prove that a

diagnosis of hypogonadisn should not be made.

2. I don't know if there are D.O.s (osteopaths) practicing in the UK. In the

U.S.

they'll bend the rules some if it helps the patient. I'm thinking one might

diagnosis fatigue and prescribe hormone therapy for it.

3. Your T is low enough to cause symptoms. You would probably see some

improvement from hormone therapy. But...

4. In my opinion, your worst symptoms are caused by something else. Low T

is making that worse.

5. I took another look at your first post (msg. 17236), and selected some

symptoms that jumped out at me:

" For the last few years I've been feeling lethargic...and depressed.

Consequently suffering low libido. "

" ... my doctor...declared me normal, and then gave me some anti-depressants

which I was on for a year or so before stopping (and suffering withdrawal - not

what they said would happen). "

" * I feel depressed, but more so I seem to suffer mood swings.. and

suffer the change between incredible highs and lows.

* I'm often very lethargic and have terrible difficulty getting up

in the mornings. My brain is very active but physically I always

feel tired... * I often find it difficult to concentrate and am easily

disturbed. "

6. From 55 years of personal experience, the above strongly suggests bipolar

disorder. Here's why I think that:

7. All of these symptoms can be expected with bipolar disorder.

8. While low T would explain depression, it is not expected to cause your

elevated moods.

9. You wrote: " I feel depressed, but more so I seem to suffer mood swings..

and suffer the change between incredible highs and lows. " That is a textbook

description of bipolar disorder.

10. I've had a doctor tell me I'm " normal " while giving me anti-depressants.

(Typical but not diagnostic).

11. It's typical for bipolar patients to discontinue medications. The meds often

make people feel " different " and uncomfortable. They miss the highs, the

free-flowing creativity.

12. Anti-depressants need to be discontinued gradually, some over as long as

4 weeks. My guess is you stopped rather quickly. That can result in a crash to

a painful level, worse than when the meds were started. The discomfort

lightens after a while. There's a very thin line between withdrawal and the

effects of discontinuing a needed medication. After withdrawal one eventually

starts feeling better. After discontinuing a needed anti-depressant, one

eventually gets depressed again.

I think the very leasy you should do is get an opinion from a psychiatric

doctor.

What do you think?

By the way, bipolar disorder is a whole-body biochemical thing. Anybody who

says it's all in someone's head probably doesn't have one of his own.

With best regards,

Bruce

> More thoughts!

>

> When I was speaking to the doctor who was trying to tell me to " stop looking

> for a problem that doesn't exist " I didn't have the presence of mind to say

> " so I'm normal then? " . " so having a span 5 inches greater than your height

> is normal? " " Having a lack of body/facial hair is normal for a man? " " Having

> osteopenia at my age is normal? " . These are all obvious, undeniable,

> physical symptoms which are anything but fucking normal. So why does she

> insist on keep telling me " you're normal " .

>

> Sorry for the outburst. Got to get the frustration out of my system!!!!!

> RE: Test results

>

>

> I read that link and even produced a copy to my doctor but she doesn't

> have

> the time or desire to read such things. I think doctors are a bit busy in

> the UK so you get your 10 minutes and that's it and you get the definite

> impression they're trying to get you out of the door asap so they can claw

> back some of the time they overran earlier in the day. Looking at their

> watch would be too obvious but they don't need to because they're used to

> the pace that a session should go at and they instinctively know when

> things

> are going too slowly for their liking!

>

> Anyway.... I would take the document back in but her response at lunchtime

> was " everything's normal, stop worrying about it and get on with your

> life " .

> I asked her to define " normal " , as they specified on the test results, and

> was that " normal for a male " or " normal adjusted for my age " ? She wasn't

> able to properly answer this so blustered a bit and reiterated " normal "

> and

> said it would " probably have been adjusted for age " . Great. Really

> confidence inspiring. Again she seemed rather keen to get me out of her

> hair.

>

> If I could find something that suggests that shows my figures as being low

> or lower than expected or at least cause for further consideration then

> I'd

> go back. I think after my questions and nagging that she's going to refer

> me

> to an endo so I can give them all the questions instead!

>

> Are these figures expected for my age? They seem on the low side... but

> where's the age adjusted ranges? I can't find them.

>

> Also I saw something about FAI which can be calculated by TT/SHBG x

100

> but

> I get about 80% which from what I could find suggests I should be balding,

> suffer from acne and have the bodyhair of a chimpanzee which is exactly

> the

> opposite. Again I can't find any good info. on this on the net. Apart from

> something that says that calculating FAI in males this way isn't reliable.

> Is there any info. available?

>

> Then I found an Australian site which suggested that low SHBG (<30) was

> optimal. Which mean I should be thinking this is good.

>

> I'm more confused than anything else!!! And reading the posts on here it

> sounds like there's a good chance the endo won't know shit about this

> anyway...

>

> g

[Guest guest]

The tsh result is low but since I having no adverse effects, he is going to keep

me on the same level. He knows of my wish to drop some weight and we hoping

that with the lower tsh and the normal t maybe it will finally happen.I was on

AG before the patches and the level wasn't getting up there. It will be curious

to see if it drops down again in three weeks. I'm wondering if the T figure is

correct since I started the patches about 3 weeks ago and haven't been wearing

them every day because they bugged me so much.

test results again with units and ref ranges

t 87 ng/dl (245-1836)

f 2.3 ng/ml (12.4-40)

% .30 (.20-.68)

t 94 ng/dl (245-1836)

f 3.5 pg/ml (12.4-40)

%f .40 K(.20-.68)

t 655 ng/dl (245-1836)

f 29.8 pg/ml (12.4-40)

% .50 (.20-.68)

brad999us <no_reply > wrote:

Supplying units and reference ranges provides a better context.

I am no expert in thyroid issues but has he made no comments about

your low tsh? Why would this not be treated?

Were you previously on AG before trying the patches? Why did you

change to patches? I wouldn't care for patches either.

655 isn't a bad result. Do you feel undertreated? Continue to have

symptoms?

Applying the gel to thinner skin is a plausible suggestion. If that

doesn't work, I'd consider injectible testosterone.

Brad

> Hi All,

>

> Went to the doc today to find out my latest results from t and tsh

tests last week. He gave me a copy of the last three reports..here are

the results

>

> 6/14/04

> Total T 87

> Free 2.3

> % Free 0.30

>

> TSH .02

>

> 7/16/04

> Total T 94

> Free 3.5

> % Free .40

>

> TSH < 0.01

>

> 9/9/04

> Total T 655

> Free 29.8

> % Free .50

>

> TSH < 0.01

>

> The difference between the second and third test is that he had

switched me over to wearing two patches of androderm from the

androgel. I told him today I can't wear this patches. They are

uncomfortable, awkward, ugly and a few other things. He switched me to

a higher dose of the Androgel again and told me to try putting it on

where I have thinner skic like under my bicep or inner thigh or inner leg.

>

> What do you all make of these results?

>

>

>

[Guest guest]

Seeing that the top of the reference range is 1836 changes my opinion

a bit. It's usually ~800 to ~1100.

Some people simply don't absorb drugs that well across the skin. See

how it goes. Don't be afraid of injectibles if it proves necessary.

If your metabolism is ramped up, might you not also be clearing

testosterone from your system at an accelerated pace?

Brad

> > Hi All,

> >

> > Went to the doc today to find out my latest results from t and tsh

> tests last week. He gave me a copy of the last three reports..here are

> the results

> >

> > 6/14/04

> > Total T 87

> > Free 2.3

> > % Free 0.30

> >

> > TSH .02

> >

> > 7/16/04

> > Total T 94

> > Free 3.5

> > % Free .40

> >

> > TSH < 0.01

> >

> > 9/9/04

> > Total T 655

> > Free 29.8

> > % Free .50

> >

> > TSH < 0.01

> >

> > The difference between the second and third test is that he had

> switched me over to wearing two patches of androderm from the

> androgel. I told him today I can't wear this patches. They are

> uncomfortable, awkward, ugly and a few other things. He switched me to

> a higher dose of the Androgel again and told me to try putting it on

> where I have thinner skic like under my bicep or inner thigh or

inner leg.

> >

> > What do you all make of these results?

> >

> >

> >

[Guest guest]

Gwyn,

The only thing I've come accross about span to height ratio is Marfan

Syndrome. That's the only symptom that matches the criteria. It's very rare, and

if you had it, you'd know by now. I bring it only so you can cross it off your

list.

Site: http://www.marfan.org/

" Many people will have one or more of the features of the Marfan syndrome,

but not have enough features to meet the diagnostic criteria for the Marfan

syndrome. "

Bruce

> " so having a span 5 inches greater than your height

> is normal? "

______

[Guest guest]

Hi Bruce, thanks for your posts!

A candidate for span is Hypogonadism... this was from the AACE doc (and seen

many other places):

With prepubertal onset of hypogonadism, the stature

may assume eunuchoid proportions, with a crown-to-pubis

divided by a pubis-to-floor ratio of <0.92 and an arm span

more than 3 cm greater than the height.

I've been testing my friends, pretty much they're all equal height & span...

the only one that isn't differs by 3 inches... funnily enough he's also a

low/sparse beard growth sort of chap too.

Re: Test results

Gwyn,

The only thing I've come accross about span to height ratio is Marfan

Syndrome. That's the only symptom that matches the criteria. It's very

rare, and

if you had it, you'd know by now. I bring it only so you can cross it off

your list.

Site: http://www.marfan.org/

" Many people will have one or more of the features of the Marfan

syndrome,

but not have enough features to meet the diagnostic criteria for the

Marfan

syndrome. "

Bruce

> " so having a span 5 inches greater than your height

> is normal? "

______

[Guest guest]

Hi Gwyn,

Nice research. I'm not going to mention it to my wife: if she start measuring

one thing, I don't know where she'll go next...

My father left me a few oddities too. I remember an old cartoon from New

Yorker magazine. A young man and an older one are walking together. Both

have enormous butts (bums?). The young one is saying: " Thanks, Dad, for

almost everything. "

You're probably way ahead of me on research on UK medicine, but I'll share

what I found. I was trying to find a UK version of the AACE. For hypogonadism

(and unusual growth disorders) the best organization may be The Pituitary

Foundation:

http://www.pituitary.org.uk/resources/hypogon-m.htm#pitgland

They are keenly aware of hypogonadism and it's treatments. They seem to

promote hCH treatment as much or more than TRT. They emphasize the

osteoporosis issue. I like their attitude: The goal at the top of their list is

" Restoration of feeling of well-being " . That includes issues like self-esteem

and providing patients with adequate information. It's so refreshing to see

interest in treating patients, not their lab test numbers.

They mention pituitary related depression. At least one pituitary disorder

causes mood swings.

What I haven't found is a list of doctors who believe in this. The medical

" specialty " is probably endocrinology. I don't know how the NHS handles

referrals to specialists. I imagine they would regard a pituitary problem more

seriously than a testosterone problem.

Best regards,

Bruce

>

> > " so having a span 5 inches greater than your height

> > is normal? "

> ______

>

>

>

[Guest guest]

I was told by my Dr. that changes in meds. that raise or lower your T or E2 can

temporally put your Thyroid out of balance.

Phil

Doug Gould <valhalla_69@...> wrote:

Hi All,

Went to the doc today to find out my latest results from t and tsh tests last

week. He gave me a copy of the last three reports..here are the results

6/14/04

Total T 87

Free 2.3

% Free 0.30

TSH .02

7/16/04

Total T 94

Free 3.5

% Free .40

TSH < 0.01

9/9/04

Total T 655

Free 29.8

% Free .50

TSH < 0.01

The difference between the second and third test is that he had switched me over

to wearing two patches of androderm from the androgel. I told him today I can't

wear this patches. They are uncomfortable, awkward, ugly and a few other things.

He switched me to a higher dose of the Androgel again and told me to try putting

it on where I have thinner skic like under my bicep or inner thigh or inner leg.

What do you all make of these results?

[Guest guest]

Doug,

I had a lot of trouble at first with absorption of Androgel. I'm also

very hairy, which probably doesn't help. However, I experimented with

different application sites and got good results applying to inner

thighs and the center of the chest (solar plexus). I alternate legs

each day just to keep the skin from getting " fatigued " . I also apply

some to the shaft of my penis - just the top! Getting it on your

balls is not pleasant. Anyway, this was recommended to me by someone

a while back and it does seem to give you a rather quick surge of T.

I guess the skin there is very thin and absorbant. I take 12.5 grams

a day - 10GM in the morning, and 2.5GM at night. My levels stay in

the 600-700 range.

Regards,

K4

> Hi All,

>

> Went to the doc today to find out my latest results from t and tsh

tests last week. He gave me a copy of the last three reports..here

are the results

>

> 6/14/04

> Total T 87

> Free 2.3

> % Free 0.30

>

> TSH .02

>

> 7/16/04

> Total T 94

> Free 3.5

> % Free .40

>

> TSH < 0.01

>

> 9/9/04

> Total T 655

> Free 29.8

> % Free .50

>

> TSH < 0.01

>

> The difference between the second and third test is that he had

switched me over to wearing two patches of androderm from the

androgel. I told him today I can't wear this patches. They are

uncomfortable, awkward, ugly and a few other things. He switched me

to a higher dose of the Androgel again and told me to try putting it

on where I have thinner skic like under my bicep or inner thigh or

inner leg.

>

> What do you all make of these results?

>

>

>