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On a hunch, I asked my GP to check T and Free T while performing lab work for a

well-care visit. I had not seen the lab results until after my review visit,

but the doctor did not mention what I now see are low results and at least

warrant follow-up. I assume, since the results were within the " normal " range

they were ignored by the doctor.

Rather then return to my GP, I will be seeing my Urologist for my follow-up. I

have a better rapport with my Urologist as I have been a regular patient with

kidney stone treatment and ED treatment. I first called to make sure TRT was

part of the Dr's practice.

Looking back, I should have not dismissed my ED symptoms that started to concern

me three-years ago. At that time the ED mostly affected maintenance of an

erection which I dismissed as getting older or perhaps some CVD. Accompanying

this was increasing abdominal fat and fatigue, especially mid-afternoon and

latter.

I could use some advice as how to approach TRT with my Urologist and what to

look for in Dx and treatment. Your advice is appreciated.

````````````````

Some general notes...

At 50, these are my symptoms but I don't have all of the textbook symptoms:

ED and reliance on Cialis

No nocturnal erections without Cialis

Abdominal Fat and overweight [lost 15 pounds on a low-carb diet but hit a wall]

Now 185# at 5'9 "

Irritability

Lower muscle mass then most males but this way all through life

{after reading, I am wondering if T has been marginal]

Less Libido then ever before age 45, but still some

Loss of energy - pronounced afternoon - had always been my high-energy part of

the day through bedtime.

I had never been a morning person but now more difficult to begin my day.

Brain-fog

My minimal lab tests so far (fasting, 10:30AM):

CBC and metabolic panel results are normal so I'll mostly skip

Total serum T = 382 ng/dL

Free T 9direct) = 9.9 pg/mL

TSH 2.34 uIU/mL

Glucose = 97 mg/dL

Albumin = 4.8 g/dL

Chol = 247 mg/dL

HDL = 37 mg/dL

LDL (calc) = 178 mg/dL

Trig = 160 mg/dL

I am now treating the lipids with 2000 mg Niacin, diet, and 6 g fish oil per day

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This is not easy to do you need to get a mess of labs here is a link to the labs

I tell men to get.

http://forums.realthyroidhelp.com/viewtopic.php?f=5 & t=7059

Adding to the above is Total T3 & T4 on the Thyroid.

A good site on them labs is Dr. 's www.allthingsmale.com read TRT: A recipe

for success and his HCG update in them are the labs you need and way.

Also go to Dr. Gorden's site and read it and watch the videos.

http://www.thehiddendisease.com/

One way of telling how your labs look is by the LH and FSH this is the message

sent by your pituitary in your brain that tells your Testis to make more

Testosterone. If your Estradiol is in the lower end of the range say less then

30 pg/ml best for most men at 20 and your LH and FSH are low with low

Testosterone then this is called Secondary low Testosterone meaning your

pituitary in your brain is not working right a bad head injury or a tumor will

do this and one needs to get an MRI to rule out a tumor this is rare to be

cancer. If your LH and FSH are high with good Estraiol and low Testosterone

this is called Primary meaning your testis don't work good enough to make more

Testosterone and your Pituitary is sending more LH and FSH asking for more

Testosterone.

LH turns on of off fast so if it low with higher FSH it means you did the labs

on the off side of the LH still will mean your Primary.

There are other things that cause low Testosterone a fatty liver, low grade

infection, high Iron levels, Stress, over doing it in the gym this happens a lot

to younger and older men the list is long if you find out the cause and fix it

your levels can go back up. In older men high levels of Estradiol will make the

Testostereone low read this link.

http://jcem.endojournals.org/cgi/content/full/89/3/1174

I could go on for hrs about this but you can learn about this and you should at

the home page on the left we have a Links and Files Section full of info about

this.

As for ranges they are not accurate from lab to lab because most of the labs use

men in there sample that all ready have low levels of testosterone. So when one

has a range of 250 to 1100 the true bottom end of the range is 407 just take the

top of the range for a young man and div. it by 2.7. If your levels come back

between 350 to 450 your levels are that of a man 70 to 85 yrs of age. So when a

Dr. tells you your in the normal range and your at 300 I see this all the time

you normal for a man 100 yrs old. Run from this Dr. he does not know about low

Testosterone.

Co-Moderator

Phil

> From: <kevinh@...>

> Subject: New to TRT

>

> Date: Saturday, July 11, 2009, 7:39 PM

> On a hunch, I asked my GP to check T

> and Free T while performing lab work for a well-care

> visit.  I had not seen the lab results until after my

> review visit, but the doctor did not mention what I now see

> are low results and at least warrant follow-up.  I

> assume, since the results were within the " normal " range

> they were ignored by the doctor.

>

> Rather then return to my GP, I will be seeing my Urologist

> for my follow-up.  I have a better rapport with my

> Urologist as I have been a regular patient with kidney stone

> treatment and ED treatment. I first called to make sure TRT

> was part of the Dr's practice.

>

> Looking back, I should have not dismissed my ED symptoms

> that started to concern me three-years ago.  At that

> time the ED mostly affected maintenance of an erection which

> I dismissed as getting older or perhaps some CVD.

> Accompanying this was increasing abdominal fat and fatigue,

> especially mid-afternoon and latter.

>

> I could use some advice as how to approach TRT with my

> Urologist and what to look for in Dx and treatment. Your

> advice is appreciated.

>

>

>

> ````````````````

> Some general notes...

> At 50, these are my symptoms but I don't have all of the

> textbook symptoms:

> ED and reliance on Cialis

> No nocturnal erections without Cialis

> Abdominal Fat and overweight [lost 15 pounds on a low-carb

> diet but hit a wall]  Now 185# at 5'9 "

> Irritability

> Lower muscle mass then most males but this way all through

> life

> {after reading, I am wondering if T has been marginal]

> Less Libido then ever before age 45, but still some

> Loss of energy - pronounced afternoon - had always been my

> high-energy part of the day through bedtime.

> I had never been a morning person but now more difficult to

> begin my day.

> Brain-fog

>

> My minimal lab tests so far (fasting, 10:30AM):

> CBC and metabolic panel results are normal so I'll mostly

> skip

> Total serum T = 382 ng/dL

> Free T 9direct) =  9.9 pg/mL

> TSH 2.34 uIU/mL

> Glucose = 97 mg/dL

> Albumin = 4.8 g/dL

> Chol = 247 mg/dL

> HDL = 37 mg/dL

> LDL (calc) = 178 mg/dL

> Trig = 160 mg/dL

>

> I am now treating the lipids with 2000 mg Niacin, diet, and

> 6 g fish oil per day

>

>

>

>

>

>

>

>

>

> ------------------------------------

>

>

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What were the total T and Free T numbers? Ask for an E2 test also.

On Sat, 11 Jul 2009 23:39:10 -0000, you wrote:

>On a hunch, I asked my GP to check T and Free T while performing lab work for a

well-care visit. I had not seen the lab results until after my review visit,

but the doctor did not mention what I now see are low results and at least

warrant follow-up. I assume, since the results were within the " normal " range

they were ignored by the doctor.

>

>Rather then return to my GP, I will be seeing my Urologist for my follow-up. I

have a better rapport with my Urologist as I have been a regular patient with

kidney stone treatment and ED treatment. I first called to make sure TRT was

part of the Dr's practice.

>

>Looking back, I should have not dismissed my ED symptoms that started to

concern me three-years ago. At that time the ED mostly affected maintenance of

an erection which I dismissed as getting older or perhaps some CVD. Accompanying

this was increasing abdominal fat and fatigue, especially mid-afternoon and

latter.

>

>I could use some advice as how to approach TRT with my Urologist and what to

look for in Dx and treatment. Your advice is appreciated.

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On Mon, 13 Jul 2009 00:45:17 -0000, you wrote:

>

>>

>> What were the total T and Free T numbers? Ask for an E2 test also.

>>

>>Total serum T = 382 ng/dL

>

>Free T (direct) = 9.9 pg/mL

>E2 not done yet

Was this an early morning test? T levels can jump 100s of point sin

hours. One test around 400 is not a sign of low T, but being

consistently below 400 probably needs TRT. Median for most ages is

650.

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> >

> >>

> >> What were the total T and Free T numbers? Ask for an E2 test also.

> >>

> >>Total serum T = 382 ng/dL

> >

> >Free T (direct) = 9.9 pg/mL

> >E2 not done yet

>

>

> Was this an early morning test? T levels can jump 100s of points in

> hours. One test around 400 is not a sign of low T, but being

> consistently below 400 probably needs TRT. Median for most ages is

> 650.

>

The test was at 10:30 AM. I realize it was only one test so far, but symptoms

seem to suggest that available T is dropping through the day and seemingly quite

diminished before days-end.

I have an appointment to see my doctor this week and will be assertive for more

testing.

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