Is My Testosterone Count Too Low?

[kinggg]

If you're not being taken seriously about your symptoms, then move on to another doc.

You just need to identify a doc who is not blowing smoke about their knowledge and capabilities on such things. It might not be your urologist who should be managing this, you might in fact want to seek out a competent endocrinologist who you find you have a good rapport with, one who is curious, one who listens, and one who is patient in seeing this through with you.

Greatly agree with that. This same asshole of a uro I explained previously about stormed angrily into another room in the clinic when I tried to ask him a question. He yelled, “I have no time, I have no time!” As a result I complained to the dept. manager. Mind you, hes the same master of the universe uro who proclaimed to know everything about sexual med, except of course for PT-141.

Since hes more senior than the rest of the uros in the clinic I was thinking of giving him one more chance to see him again. But now that I think about it I believe its in my best health to seek another uro or endo as you’ve suggested who understands patients instead of tossing them aside. Appreciate that you opened my eyes.

But at 2.6 you're probably within a "normal" reference range there, too, but on the low end. Either the pituitary or hypothalamus may be the culprit. ...there may be a tumor present in either the pituitary or hypothalamic gland which can be identified with a radiological examination.

About 2 months ago I had a brain MRI performed which showed no cancer or pituitary issues which might give rise to ED and low libido. But the docs that actually evaluated me specialized in areas outside the medical discipline of urology, namely neurology, endo and ENT. Except for 3 small white anomalies dotted along the left side of my left brain which is normal according to these docs I’m fine.

Perhaps a uro might be best qualified to interpret the MRI results?

I tried with gels. I just couldn't get the levels I needed to alleviate symptoms unless I was rubbing gel on my shoulder in massive amounts and at short intervals. For me I just find the needle easier.

Honestly I only tried androgel for no more than 2 weeks. I stopped after reading complaints that some have prematurely shedded hair from it. But I may give it a go with injections next time if warranted from your explanation and a past uro's recommendation that such a side effect is a rarity.

Sorry to ramble on here. Again, hope something in here was of some benefit.

Oh no, NEVER apologize for providing a treasure trove of info! Believe it or not you’ve been miles more analytical and helpful than any uro I’ve ever visited in my entire life. I kid you not! If you had studied urology you’d be famous, far more than the much worshipped Dr. Mulhall of NYC who’s more fluff than substance. Confidently I always benefit from any info at any length you provide.. the more the better.

[stephen54]

This same asshole of a uro I explained previously about stormed angrily into another room in the clinic when I tried to ask him a question. He yelled, “I have no time, I have no time!” As a result I complained to the dept. manager...Since he's more senior than the rest of the uros in the clinic I was thinking of giving him one more chance to see him again. But now that I think about it I believe its in my best health to seek another uro or endo

I'm a "second chance" guy with one glaring exception: human medicine.

I'd walk away if I were you. Quickly.

Often we're not entirely sure what's happening in our interactions with healthcare providers, it can be all so shrouded in mystery. What's not so mysterious, though, are these guys who have these bloated egos on full display. At least this guy SHOWED YOU who he is. Pretty unambiguously. He doesn't have "time"? Well here's a robust "fuck you", then, buddy. I don't have time for you not having time. Imagine yourself, just for a moment, under the knife of such a guy. Not exactly comforting. He did you a favor showing who he really is.

Move on. With haste. Find a compassionate listener and someone who still deeply gives a shit about patients. They're out there. Accept nothing less.

[rdmercer1953]

mine was low 155 and mine was due to pain meds namely methadone for ten years, got on TRT and things were great and still doing bi weekly injections.

[Simbarn]

I'm a "second chance" guy with one glaring exception: human medicine.

I'd walk away if I were you. Quickly.

Often we're not entirely sure what's happening in our interactions with healthcare providers, it can be all so shrouded in mystery. What's not so mysterious, though, are these guys who have these bloated egos on full display. At least this guy SHOWED YOU who he is. Pretty unambiguously. He doesn't have "time"? Well here's a robust "fuck you", then, buddy. I don't have time for you not having time. Imagine yourself, just for a moment, under the knife of such a guy. Not exactly comforting. He did you a favor showing who he really is.

Move on. With haste. Find a compassionate listener and someone who still deeply gives a shit about patients. They're out there. Accept nothing less.

Some very good posts Stephen. Good to see someone else here who has a good understanding with regard to TRT.
It is good to remember when dealing with some of these doctors who present with an attitude is they are working for you, as you are the one paying them. Let them know that when you walk out the door.

Uro’s are generally not that good at TRT. Most are very old school and use outdated protocols and won’t consider T replacement unless you have a T level way below the lower limit of normal. To be honest, many are not great with erectile dysfunction either, my own GP said this to me.

If you are considering T injections, it is better as I mentioned before to try more frequent injections. Anything higher than weekly is something we did years ago. TRT doctors who really understand this stuff usually try to smooth out the peaks and troughs. Injecting fortnightly will still give you quite a high peak.
I inject twice weekly in the thigh with a very small 27 gauge needle. Its quick and I don’t really feel it. I am injecting about 50mgs per time so my peak of T level is much lower. This gives me 2 small elevations in the week instead of one massive one a fortnight.
You will need to learn to inject yourself. This is not difficult and saves doctor’s visits every 2 weeks.
For the guys who do not have a penis implant this is more important. Why? Because the peak you are causing from injecting 200mgs of T at a time will most likely cause estrogen issues down the track or worsen an excessive E2 issue you may already have. This can play havoc with erectile function and sexual sensitivity in the penis.
Younger men appear to feel the effects of too much estrogen more so because I think their bodies are more sensitive to hormonal fluctuations. Plus younger men’s expectations are higher, they want perfect sexual performance, whereas older men are used to not having this and can be satisfied with any improvement.
I also feel flooding T receptors with T regularly could cause some desensitisation over time. This is something bodybuilders using testosterone or the like know very well.
Injecting large amounts of T at a time will also shut the HPTA down harder as well. This means your testicles will shrink considerably as there will be no LH and FSH at all. Some men’s sexual function can be affected by this. My testicles have only shrunk a little from the therapy as I am keeping the peaks as low as possible. HCG or Ovidrel can be used to alleviate testicle atrophy as well. This needs to dosed correctly to avoid further estrogen issues. It can also help to reinstate lost semen levels during TRT and maintain fertility which can be important considerations for younger men.

Many guys say they feel great after receiving a dose of T of 200mgs or higher. This is because testosterone can give you a high. If given in a large dose, which 200mgs is, it interacts with dopamine and causes it to increase, especially in someone fresh to the preparation. This is not how good TRT should be working. Most using gels do not experience this “high” because T levels stay within normal limits ALL the time if the right amount is used.
The good effects of properly administered TRT may take time to eventuate and may not be felt immediately as a whopping dose of injectable T often is.
In the past, many years ago, when I injected a dose of 200-250mgs a fortnight of T, I would feel a rush of T in my system. My temper would be elevated, my mood also highly elevated and also a level of anxiety. This would gradually wane over a period of days. By the end of the second week I would start to feel tired. My nipples also began to get sensitive. My erectile ability was all over the place as was sensation.
This drove me crazy and the doctors were utterly useless when it came to understanding why I was having difficulties. They didn’t even really understand how exogenous T can convert into estrogen so readily if not dosed properly.
This is when I began my very long journey into learning about T replacement and its many pitfalls.
These days there are more doctors who have taken the time to learn about TRT and the better ways of administering it.
If the OP wants somewhere to start, I would recommend reading Dr. John Crislers book; “Testosterone replacement, a recipe for success”.
I was a member of his forum for 15 years. I learnt so much there.

[kinggg]

This same asshole of a uro I explained previously about stormed angrily into another room in the clinic when I tried to ask him a question. He yelled, “I have no time, I have no time!” As a result I complained to the dept. manager...Since he's more senior than the rest of the uros in the clinic I was thinking of giving him one more chance to see him again. But now that I think about it I believe its in my best health to seek another uro or endo

I'm a "second chance" guy with one glaring exception: human medicine.

I'd walk away if I were you. Quickly.

Move on. With haste. Find a compassionate listener and someone who still deeply gives a shit about patients. They're out there. Accept nothing less.

Fully agree with you.. 1000% !!!

[kinggg]

mine was low 155 and mine was due to pain meds namely methadone for ten years, got on TRT and things were great and still doing bi weekly injections.

Hi, rdmercer1953,

Did you experience any hair loss while on it? How long have you been on TRT?

[kinggg]

Uro’s are generally not that good at TRT. Most are very old school and use outdated protocols and won’t consider T replacement unless you have a T level way below the lower limit of normal. To be honest, many are not great with erectile dysfunction either, my own GP said this to me.

Hi, Simbarn. The uro in question is Dr. Aaron Grotas of Beth Israel Hospital in NYC. Please guys, AVOID THIS ASSHOLE. Go to a qualified uro. Your health always comes 1st !!!

If you are considering T injections, it is better as I mentioned before to try more frequent injections.

Will keep this in mind. So just to be clear, more frequent but smaller dosed injections, right??

I also feel flooding T receptors with T regularly could cause some desensitisation over time. This is something bodybuilders using testosterone or the like know very well.

My sensation in my penis has been affected. It feels like my penis isnt able to respond sexually as much as before. Its assumed that TRT can improve on that too which is something I need big time since lower my sexual sensations in my penis is turning me off from sex.

Do you also think nerves in the penis responsible for enhancing these sexual sensations break down over time? If so, any way to regenerate them?

In the past, many years ago, when I injected a dose of 200-250mgs a fortnight of T, I would feel a rush of T in my system. My temper would be elevated, my mood also highly elevated and also a level of anxiety. This would gradually wane over a period of days. By the end of the second week I would start to feel tired. My nipples also began to get sensitive. My erectile ability was all over the place as was sensation.

Simbarn, this is the same feeling we all had in our 20s and 30s when we didnt need TRT. But honestly, I'd do T injections just to get that feeling back cuz it goes hand in hand with the other feelings youve mentioned associated with high libido. I know youve warned against too frequent and high dosed injections but I'd feel like my old normal self if I did.

If the OP wants somewhere to start, I would recommend reading Dr. John Crislers book; “Testosterone replacement, a recipe for success”..

Wow.. I really wish serious uros with sexual med as their specialty would frequent this forum to learn the very things I'm certain aren't taught in med school. They can actually learn from patients as experience is the best teacher.

Simbarn, would you name a few uros whom you consider now their stuff in sex med? Its hard finding docs like that.

Also, did you experience any hair loss attributed to TRT injections?
.

[Simbarn]

Uro’s are generally not that good at TRT. Most are very old school and use outdated protocols and won’t consider T replacement unless you have a T level way below the lower limit of normal. To be honest, many are not great with erectile dysfunction either, my own GP said this to me.

Hi, Simbarn. The uro in question is Dr. Aaron Grotas of Beth Israel Hospital in NYC. Please guys, AVOID THIS ASSHOLE. Go to a qualified uro. Your health always comes 1st !!!

If you are considering T injections, it is better as I mentioned before to try more frequent injections.

Will keep this in mind. So just to be clear, more frequent but smaller dosed injections, right??

I also feel flooding T receptors with T regularly could cause some desensitisation over time. This is something bodybuilders using testosterone or the like know very well.

My sensation in my penis has been affected. It feels like my penis isnt able to respond sexually as much as before. Its assumed that TRT can improve on that too which is something I need big time since lower my sexual sensations in my penis is turning me off from sex.

Do you also think nerves in the penis responsible for enhancing these sexual sensations break down over time? If so, any way to regenerate them?

In the past, many years ago, when I injected a dose of 200-250mgs a fortnight of T, I would feel a rush of T in my system. My temper would be elevated, my mood also highly elevated and also a level of anxiety. This would gradually wane over a period of days. By the end of the second week I would start to feel tired. My nipples also began to get sensitive. My erectile ability was all over the place as was sensation.

Simbarn, this is the same feeling we all had in our 20s and 30s when we didnt need TRT. But honestly, I'd do T injections just to get that feeling back cuz it goes hand in hand with the other feelings youve mentioned associated with high libido. I know youve warned against too frequent and high dosed injections but I'd feel like my old normal self if I did.

If the OP wants somewhere to start, I would recommend reading Dr. John Crislers book; “Testosterone replacement, a recipe for success”..

Wow.. I really wish serious uros with sexual med as their specialty would frequent this forum to learn the very things I'm certain aren't taught in med school. They can actually learn from patients as experience is the best teacher.

Simbarn, would you name a few uros whom you consider now their stuff in sex med? Its hard finding docs like that.

Also, did you experience any hair loss attributed to TRT injections?
.

I have not bothered to see a Uro with my current ED issues and certainly not for hormone related issues. Find a doc who understands TRT and is aware of new thinking into testosterone replacement. I am in Sydney AU, so can’t give you any names of doctors, but steer clear of Uro's for anything to do with hormones. Most endo’s are very old school as well.

Perhaps contact the A4M in the US, and ask if they know of any doctors who are practicing with a similar mindset such as Dr John Crisler, or you can use the find a provider link on their site, but a recommendation would be good.
https://www.a4m.com/
Dr John passed away last year.
https://agemed.org/e-journal/feature-ar ... n-crisler/

Yes, more frequent injections with a lower dose is ALWAYS better. I do 40-50 mgs each injection twice a week. I use an insulin syringe and inject myself.

In your other post regarding sexual sensation I recently answered with some information about how I felt everyday low dosing of Tadalafil has improved sexual sensation for me.
As we age sexual sensation can change, but it should not deteriorate as much as yours has, something is wrong.

I realise you do want to feel those intense sexual feelings you had when you were younger. However, taking large doses of T is not the way to help this. Some guys do feel this for a short period if they take larger amounts of T initially. Then all the side effects kick in and it causes more problems down the track with E2 conversion. It is far better to do things slowly and gradually with more physiologic doses of T.

I have had hair loss, however, both my brothers have had hair loss as did my dad. So I think it was inevitable. I actually began to lose my hair later than all of them, which I think may have been related to my having a low T level all my life.

[kinggg]

Perhaps contact the A4M in the US, and ask if they know of any doctors who are practicing with a similar mindset such as Dr John Crisler, or you can use the find a provider link on their site, but a recommendation would be good.
https://www.a4m.com/
Dr John passed away last year.
https://agemed.org/e-journal/feature-ar ... n-crisler/

Yes, more frequent injections with a lower dose is ALWAYS better. I do 40-50 mgs each injection twice a week. I use an insulin syringe and inject myself.

Yes I will contact A4M for their recommendation of docs hopefully from my area. Thanks.

In your other post regarding sexual sensation I recently answered with some information about how I felt everyday low dosing of Tadalafil has improved sexual sensation for me.
As we age sexual sensation can change, but it should not deteriorate as much as yours has, something is wrong.

Yes I've tried cialis. But the problem is that my body has already become tolerant of it and other pde5 inhibitors including viagra. I which I could reverse this. Cialis and viagra did help when it worked. They stopped working 4 years ago.

I also mentioned this and asked about a reversal of this tolerance in my other post to you on another thread. Very much am looking forward to any news you may have about this.

[Growinjim]

Concerning the post about using frequent injections of Testosterone with an insulin syringe, I don't understand how an insulin syringe can be used. My Uro prescribed 110 mg/week of testosterone. My solution is oily and can't be drawn with an ordinary syringe. I've been provided big bore needles for Loading, then switch to a smaller bore at 1.5" for an intramuscular injection in the thigh. I must have misunderstood...?