Testosterone replacement therapy (TRT) needed? Age 23, no morning wood for years. Bloodwork Done.

[Megatron28]

It will be interesting to see what your next results are. I don't understand why the need to make you wait 3 months, but that's just me. Prolactin is one of those hormones that men don't actually need at all as we do not need to make milk with our mammary glands. I have yet to read anything stating how the reduction of this hormone has negative side effects in men in fact. I read that study from 1975, and if you're going by the chart to see if you fall in the ranges, you should note the units are different than what your results have. Sorry, I have no clue how to convert mU/L to ug/L. (I don't even know what the heck an mU is LOL - milliunits?) I don't think linking other forums is allowed, but AFAIK there isn't an "optimal" prolactin level other than low.

Please be sure to update us on when you do get your new results, I always like to learn new things and would be happy knowing that everything works out in the end.

Hypoprolactemia in Men

For what it is worth, this study concludes that it is correlated to sexual disfunction including premature ejaculation and erectile disfunction. Related to metabolic syndrome too.

Hypoprolactinemia: a new clinical syndr - PubMed Mobile

I read somewhere else that it is correlated with low sperm motility.

 

[bigben34]

Halfwit.. your inbox is full.. have a question for ya if you don't mind. don't need a source.. just advice.

 

[< JB >]

This is great advice, Im in the same situation right now myself only my numbers are a little more disturbing. My Total Test- 9.3 nmol/L and Free Test- 8.1 nmol/L. Although my extremely inadequate doctor did no other hormonal tests these testosterone levels seem very strange for a 25 year old male with otherwise no health issues im aware of. I was put on 200mg Test E once monthly ( No Aromatase inhibitor (AI) and No Human Chorionic Gonadotropin (HCG) ), Doc isn't concerned with monitoring E2 or any other hormone levels. He is literally just injecting exogenous test with no care in the world as to what it is going to do me. At first I was so excited to maybe start feeling like myself again and that everything was going to get better but now 3 weeks after the injection I am feeling so terrible. I get EXTREMELY irritated by everything and anything and when this happens I feel shaky and restless to the point I feel I need to walk it off. I have never been an angry person, Im a very humble guy who cares very much for others. Is this normal when being on TRT? or is this because my test levels are now worse than they were before I started? I have absolutely NO energy at all and feel very sluggish if that makes sense. Its hard to get going in the morning and I burn out very fast. I have NO sex drive at all and the weird thing is that for like a week after getting my first injection I felt like my sex drive was suddenly on fire or awakened. And another thing I want to mention is that I am sweating so severely its kind of freaking me out. I will just sweep the floor which takes no energy at all and sweat will literally be dripping off my face, and I'm not even exaggerating. I have never sweat like this, not even after running a mile in the hot sun. Is this another normal symptom? I am so sorry for all these questions but I am at a total loss. My doctor seems so ignorant to testosterone replacement therapy (TRT) and wont listen to any of my concerns. He refuses to prescribe any more than 200mg a month and will NOT even split the dose up to 100mg twice monthly to help with the ups and downs. I dont understand, I thought this was going to help me? I feel worse than ever and almost wish I never even knew I had test levels this low. I cant even find a new doctor who wont charge an arm and a leg to help me. ( I live in CANADA by the way, where health care is free ) No one seems willing to help me or let me know what is really going on with me. Once again sorry for the rant/questions Im just feeling helpless right now. Thanks < JB >

 

[halfwit]

Hypoprolactemia in Men

For what it is worth, this study concludes that it is correlated to sexual disfunction including premature ejaculation and erectile disfunction. Related to metabolic syndrome too.

Hypoprolactinemia: a new clinical syndr - PubMed Mobile

I read somewhere else that it is correlated with low sperm motility.

Good study, but I find the conclusion disturbing:

CONCLUSIONS: Our findings demonstrate that, in subjects consulting for sexual dysfunction, PRL in the lowest quartile levels are associated with MetS and arteriogenic ED, as well as with PE and anxiety symptoms. Further studies are advisable in order to confirm our preliminary results in different populations.

This study was done with men that already had ED/Sexual dysfunction! Now they're saying that premature ejaculation and ED are contributed to a lack of prolactin? I'm going to have to look around for this other study I had that showed there was zero difference between lowest quartile and mid quartile PRL levels. I've actually been crushing my prolactin lately because I like the sides from dopamine agonists and after having slightly elevated prolactin, I do not want to go through that again haha. You're still the man though Megatron.

Halfwit.. your inbox is full.. have a question for ya if you don't mind. don't need a source.. just advice.

Cleared out.

JB: I would recommend starting a new thread as you'll get more views and better responses regarding YOUR problem.

 

[sphinxbrah]

This is great advice, Im in the same situation right now myself only my numbers are a little more disturbing. My Total Test- 9.3 nmol/L and Free Test- 8.1 nmol/L. Although my extremely inadequate doctor did no other hormonal tests these testosterone levels seem very strange for a 25 year old male with otherwise no health issues im aware of. I was put on 200mg Test E once monthly ( No Aromatase inhibitor (AI) and No Human Chorionic Gonadotropin (HCG) ), Doc isn't concerned with monitoring E2 or any other hormone levels. He is literally just injecting exogenous test with no care in the world as to what it is going to do me. At first I was so excited to maybe start feeling like myself again and that everything was going to get better but now 3 weeks after the injection I am feeling so terrible. I get EXTREMELY irritated by everything and anything and when this happens I feel shaky and restless to the point I feel I need to walk it off. I have never been an angry person, Im a very humble guy who cares very much for others. Is this normal when being on TRT? or is this because my test levels are now worse than they were before I started? I have absolutely NO energy at all and feel very sluggish if that makes sense. Its hard to get going in the morning and I burn out very fast. I have NO sex drive at all and the weird thing is that for like a week after getting my first injection I felt like my sex drive was suddenly on fire or awakened. And another thing I want to mention is that I am sweating so severely its kind of freaking me out. I will just sweep the floor which takes no energy at all and sweat will literally be dripping off my face, and I'm not even exaggerating. I have never sweat like this, not even after running a mile in the hot sun. Is this another normal symptom? I am so sorry for all these questions but I am at a total loss. My doctor seems so ignorant to testosterone replacement therapy (TRT) and wont listen to any of my concerns. He refuses to prescribe any more than 200mg a month and will NOT even split the dose up to 100mg twice monthly to help with the ups and downs. I dont understand, I thought this was going to help me? I feel worse than ever and almost wish I never even knew I had test levels this low. I cant even find a new doctor who wont charge an arm and a leg to help me. ( I live in CANADA by the way, where health care is free ) No one seems willing to help me or let me know what is really going on with me. Once again sorry for the rant/questions Im just feeling helpless right now. Thanks < JB >

JB,

Really sorry to hear this. Although my case isn't as bad as your's seems to be - more or less I am only lacking morning wood..... worrying to be sure, but in and of itself not even close to a big deal in my life... I just want to make sure it doesn't lead to something that might one day become a very big deal e.g. if it is an early warning of hypogonadism.

I would suggest you make your own topic so that ours don't get cluttered! Moreover, splitting your posts into paragraphs would help - I had a bit of trouble following it in one big wall of text.

If you are sweating copious among simply sweeping floors perhaps it is a problem your thyroid causing all of this? Please keep in mind this is a very uneducated guess on my part and I am far from an expert on these issues. The guys on this forum know way more than me and are in better position to advise.

I sympathize with you being in Canada. It is very hard to see specialists here. You have to push extremely hard just to get a referral. When you do get in, the wheels move beyond slow and you can only see an endo once a month if you are lucky. If your endo is not competent may the Lord help you..... because getting a referral to a 2nd might well be an all but impossible task. I guess to plus side is that all of our tests are free. I have yet to (nor will I have to in the future) pay a dime for any of my blood work which is quite nice.

 

[bigben34]

Halfwit.. Still can't post PM yet.. Forgot I needed 50 posts.. I'll hold off for now and ask my question when I'm able. thanks.

 

[< JB >]

Thanks for the quick reply, and yes I will try and split up my posts from now on, I never thought of the never ending scroll of words haha. I have started my own thread, very sorry to hijack yours. Take care and I hope everything works itself out for you.

 

[halfwit]

Halfwit.. Still can't post PM yet.. Forgot I needed 50 posts.. I'll hold off for now and ask my question when I'm able. thanks.

We can always discuss whatever is on your mind in a thread if you feel comfortable doing so. I'm going to be a post-whore for the next hour or so, so I'll be looking at new threads if you feel this is an option for you.

Thanks for the quick reply, and yes I will try and split up my posts from now on, I never thought of the never ending scroll of words haha. I have started my own thread, very sorry to hijack yours. Take care and I hope everything works itself out for you.

No worries man, I replied to your thread. Hope it helps some.

 

[DrHouse]

Hello all, as this is my first post I would like to say I feel confident this is the best board out as far as advice from my readings.

I myself suffer from similar symptoms (low sex drive, etc.) and from my experience through physicians, no one will help a young man (20s). I have been referred to an Endo who refused to see me and thought I needed psychological help which I found very disrespectful. I have not looked at my lab results from my pituitary gland testing but my Free and Total T are below and low end (respectively) of the normal range. I noticed my units of measurements are different and I think that may be because i'm from the US.

I find these topics interesting to see who else around my age are experiencing similar symptoms and I thank every one for the information.

If I could add anything, it would be to consider the timing of the test. I know testosterone will continue to lower from the time you wake until you go back to sleep. I'm not sure of the rate or if its continuous but I use to work in a lab where I got my testosterone checked free. The lady who did the testing for me suggested the earlier the better. I had several tests ran an my levels fluctuated some with the time being somewhat the same.

I hope I contributed something!

 

[Megatron28]

Good study, but I find the conclusion disturbing:

This study was done with men that already had ED/Sexual dysfunction! Now they're saying that premature ejaculation and ED are contributed to a lack of prolactin? I'm going to have to look around for this other study I had that showed there was zero difference between lowest quartile and mid quartile PRL levels. I've actually been crushing my prolactin lately because I like the sides from dopamine agonists and after having slightly elevated prolactin, I do not want to go through that again haha. You're still the man though Megatron.


Cleared out.

JB: I would recommend starting a new thread as you'll get more views and better responses regarding YOUR problem.

Who can tell? For every study saying one thing there is another study saying the opposite. I am thinking though that moderation may be the best policy. Healthy men naturally have prolactin so it probably does something. So keeping it low is probably a good idea, but annihilation may be a bit extreme... But then again, who can argue with feeling good.

 

[halfwit]

Hello all, as this is my first post I would like to say I feel confident this is the best board out as far as advice from my readings.

I myself suffer from similar symptoms (low sex drive, etc.) and from my experience through physicians, no one will help a young man (20s). I have been referred to an Endo who refused to see me and thought I needed psychological help which I found very disrespectful. I have not looked at my lab results from my pituitary gland testing but my Free and Total T are below and low end (respectively) of the normal range. I noticed my units of measurements are different and I think that may be because i'm from the US.

I find these topics interesting to see who else around my age are experiencing similar symptoms and I thank every one for the information.

If I could add anything, it would be to consider the timing of the test. I know testosterone will continue to lower from the time you wake until you go back to sleep. I'm not sure of the rate or if its continuous but I use to work in a lab where I got my testosterone checked free. The lady who did the testing for me suggested the earlier the better. I had several tests ran an my levels fluctuated some with the time being somewhat the same.

I hope I contributed something!

You are absolutely correct in that testosterone levels are highest in the morning and this is when a blood test should be performed in order to get an accurate gauge on blood serum levels. We're glad to have you! Welcome to 'ology.

Who can tell? For every study saying one thing there is another study saying the opposite. I am thinking though that moderation may be the best policy. Healthy men naturally have prolactin so it probably does something. So keeping it low is probably a good idea, but annihilation may be a bit extreme... But then again, who can argue with feeling good.

Very true, it's kind of irritating that the eggheads that run these studies can never agree. I admit I'm being a little overzealous with my prolactin control, but I agree it's making me feel good - so I can't find a solid reason to make a change.

 

[1693]

Hello all, as this is my first post I would like to say I feel confident this is the best board out as far as advice from my readings.

I myself suffer from similar symptoms (low sex drive, etc.) and from my experience through physicians, no one will help a young man (20s). I have been referred to an Endo who refused to see me and thought I needed psychological help which I found very disrespectful. I have not looked at my lab results from my pituitary gland testing but my Free and Total T are below and low end (respectively) of the normal range.

There are way too many guys your age that have too low of test levels and the docs tend to ignore the possibility that they could be low...they think you just want to juice and your levels are fine. So sadly many either go untreated or go underground.

 

[DrHouse]

There are way too many guys your age that have too low of test levels and the docs tend to ignore the possibility that they could be low...they think you just want to juice and your levels are fine. So sadly many either go untreated or go underground.

Which is why I'm here. Doing my research to see what is out there to help me. I've been reading for some time now but never really felt comfortable enough to join a forum to discuss further. Thinking about going to the "dark side." Nothing wrong with it though!

It is sad that too many doctors just push people to the side. I could care less if they gave me anything, but not even finding an answer to my issue is the most disturbing to me. I had a physician tell me "if you're looking to get bigger just buy steroids."

 

[1693]

I think there are many guys on UGLs for testosterone replacement therapy (TRT) but there will never be a head count on how many.

At least in the US in most states a guy can order his own labs if he wants.

I had a physician tell me "if you're looking to get bigger just buy steroids."

You could have said " If I agree with you will you write me a script for some?"

 

[DrHouse]

I wouldn't recommend ordering your own labs unless you have good insurance or don't mind to spend some money. It was 1600 USD to get mine checked and I about had a heart attack until I realized my insurance paid for most of it (all but 16 dollars). I'm so thankful my mom is a school teacher!

And now that I look back I should have said that but that is one of those things you think of after you leave the office. He did say he would give me the cypionate injection but changed his mind once the endo would not see me.

 

[sphinxbrah]

Here are my latest lab results (my appointment with the endo to discuss them is on August 24) along with my previous ones.

As was the case before, my testosterone appears decent. I have a gut feeling it is just my e2 being slightly elevated that is causing my lack of morning wood as I have read that the low-mid 20s is the 'sweet spot' for e2 for most men and that having e2 over 30 sees morning wood become unlikely. Moreover, I know e2 can cause prolactin to rise and I have no symptoms of low test or any sort of hyogonadism starting to creep up (tons of energy, drive, motivation, clear thinking..... in all these regards I feel just as I did in high school when morning wood was there everyday without fail.... but I acknowledge it might be happening even if I cannot *feel* it).

Curious to get the thoughts of others.

May 28 2013 Test Results

- Prolactin: 9 ug/L (ref range 3 - 13)
- LH: 3 IU/L (ref range 1-9)
- FSH: 2 IU/L (ref range 1-19)
- Total testosterone 21.4 nmol/L (ref range 6.1 - 27.1)
- Free testosterone: 450 pmol/L (ref range 110 - 660)
- Bioavailable testosterone: 10.5 nmol/ L (ref range 2.8 - 15.5)
- SHBG: 35 nmol/L (ref range 13 - 89)
- Estradiol: 123 pmol/L (33.5 in American units) (ref range 40 - 160) (ref range 10.90 - 43.58 in American units)

May 1 2013 Test Results

- DHEAS: 8.8 umol/L (ref range 2.3 - 18.7)
- Prolactin: 11 ug/L (ref range 3 - 13)
- LH: 3 IU/L (ref range 1-9)
- FSH: 2 IU/L (ref range 1-19)
- TSH: 1.88 mU/L (ref range 0.3 - 5.6)
- Total testosterone 18.8 nmol/L (ref range 6.1 - 27.1)
- Free testosterone: 333 pmol/L (ref range 110 - 660)
- Bioavailable testosterone: 7.8 nmol/ L (ref range 2.8 - 15.5)
- SHBG: 44 nmol/L (ref range 13 - 89)
- Estradiol: 132 pmol/L (36 in American units) (ref range 40 - 160) (ref range 10.90 - 43.58 in American units)

January 19 2013 Test Results

- TSH: 1.38 mIU/L (ref range 0.35 - 5)
- LH: 6 IU/L (ref range 2-9)
- FSH: 2 IU/L (ref range 2-12)
- Free Testosterone: 37.4 pmol/L (ref range 31 - 94)

January 12 2013 Test Results

- TSH: 1.38 mIU/L (ref range 0.35 - 5)
- Total Testosterone: 22.3 nmol/L (ref range 7.6 - 31.4)
- Free Testosterone: 46.6 pmol/L (ref range 31 - 94)

June 2012 Test Results

- Free Testosterone: 42.8 pmol/L (ref range 31 - 94)

 

[Megatron28]

Here are my latest lab results (my appointment with the endo to discuss them is on August 24) along with my previous ones.

As was the case before, my testosterone appears decent. I have a gut feeling it is just my e2 being slightly elevated that is causing my lack of morning wood as I have read that the low-mid 20s is the 'sweet spot' for e2 for most men and that having e2 over 30 sees morning wood become unlikely. Moreover, I know e2 can cause prolactin to rise and I have no symptoms of low test or any sort of hyogonadism starting to creep up (tons of energy, drive, motivation, clear thinking..... in all these regards I feel just as I did in high school when morning wood was there everyday without fail.... but I acknowledge it might be happening even if I cannot *feel* it).

Curious to get the thoughts of others.

May 28 2013 Test Results

- Prolactin: 9 ug/L (ref range 3 - 13)
- LH: 3 IU/L (ref range 1-9)
- FSH: 2 IU/L (ref range 1-19)
- Total testosterone 21.4 nmol/L (ref range 6.1 - 27.1)
- Free testosterone: 450 pmol/L (ref range 110 - 660)
- Bioavailable testosterone: 10.5 nmol/ L (ref range 2.8 - 15.5)
- SHBG: 35 nmol/L (ref range 13 - 89)
- Estradiol: 123 pmol/L (33.5 in American units) (ref range 40 - 160) (ref range 10.90 - 43.58 in American units)

May 1 2013 Test Results

- DHEAS: 8.8 umol/L (ref range 2.3 - 18.7)
- Prolactin: 11 ug/L (ref range 3 - 13)
- LH: 3 IU/L (ref range 1-9)
- FSH: 2 IU/L (ref range 1-19)
- TSH: 1.88 mU/L (ref range 0.3 - 5.6)
- Total testosterone 18.8 nmol/L (ref range 6.1 - 27.1)
- Free testosterone: 333 pmol/L (ref range 110 - 660)
- Bioavailable testosterone: 7.8 nmol/ L (ref range 2.8 - 15.5)
- SHBG: 44 nmol/L (ref range 13 - 89)
- Estradiol: 132 pmol/L (36 in American units) (ref range 40 - 160) (ref range 10.90 - 43.58 in American units)

January 19 2013 Test Results

- TSH: 1.38 mIU/L (ref range 0.35 - 5)
- LH: 6 IU/L (ref range 2-9)
- FSH: 2 IU/L (ref range 2-12)
- Free Testosterone: 37.4 pmol/L (ref range 31 - 94)

January 12 2013 Test Results

- TSH: 1.38 mIU/L (ref range 0.35 - 5)
- Total Testosterone: 22.3 nmol/L (ref range 7.6 - 31.4)
- Free Testosterone: 46.6 pmol/L (ref range 31 - 94)

June 2012 Test Results

- Free Testosterone: 42.8 pmol/L (ref range 31 - 94)

Your estradiol looks fine to me. Did you get the regular or sensitive estradiol assay performed?

The "morning wood" mechanism is not fully understood. Some think it has to do with REM sleep. You might benefit from getting a sleep study done to see if you are reaching REM sleep. Research nocturnal penile tumescence for more on the matter.

 

[sphinxbrah]

Your estradiol looks fine to me. Did you get the regular or sensitive estradiol assay performed?

The "morning wood" mechanism is not fully understood. Some think it has to do with REM sleep. You might benefit from getting a sleep study done to see if you are reaching REM sleep. Research nocturnal penile tumescence for more on the matter.

I thought of this but I feel like I must be getting REM sleep. I always get at least 7 hours so my sleeping habits are sound. I always wake up refreshed and rested - I never have felt the need to drink coffee to give me an extra "push" in the mornings. Moreover, even when I wake up directly from a dream (apparently we dream mostly in REM?) I am 100% flaccid.

It is definitely perplexing to me. I have no idea what it could be because my blood work seems okay and I otherwise feel very young, healthy, strong, and energetic like all 23 year olds. It is just I never get morning wood. :S

Then only thing I can think of is slightly high e2. It is not overly high or outside of the reference range but it is still in the top 1/3rd of it.... which is apparently higher than where most young men should be sitting. Everyone is different so maybe this is just where I am suppose to be? But I am also open to the possibility that perhaps I am just outside of my 'sweet spot' for some reason. I read for most men around 20 is ideal and that being over 30 (which I am) can at times see morning wood go away.

My test results do no say which e2 test was performed re: regular or sensitive assay. So I am assuming regular? I do know I have the correct reference range, however, as both the male and females reference ranges are listed on my results (I posted only the male ranges with my results above).

 

[sphinxbrah]

DIM is all natural and available over the counter. I hear this can lower e2 a bit. I don't need anything overly strong I don't think e.g. Arimidex so I am thinking of taking DIM and if it solves the problem I guess I have my answer. Thoughts on this?

 

[Megatron28]

I thought of this but I feel like I must be getting REM sleep. I always get at least 7 hours so my sleeping habits are sound. I always wake up refreshed and rested - I never have felt the need to drink coffee to give me an extra "push" in the mornings. Moreover, even when I wake up directly from a dream (apparently we dream mostly in REM?) I am 100% flaccid.

It is definitely perplexing to me. I have no idea what it could be because my blood work seems okay and I otherwise feel very young, healthy, strong, and energetic like all 23 year olds. It is just I never get morning wood. :S

Then only thing I can think of is slightly high e2. It is not overly high or outside of the reference range but it is still in the top 1/3rd of it.... which is apparently higher than where most young men should be sitting. Everyone is different so maybe this is just where I am suppose to be? But I am also open to the possibility that perhaps I am just outside of my 'sweet spot' for some reason. I read for most men around 20 is ideal and that being over 30 (which I am) can at times see morning wood go away.

My test results do no say which e2 test was performed re: regular or sensitive assay. So I am assuming regular? I do know I have the correct reference range, however, as both the male and females reference ranges are listed on my results (I posted only the male ranges with my results above).

Ok... This is important. The Regular E2 Assay is typically 10-15 points higher than what the Sensitive E2 Assay would have put you at. The regular assay just doesn't do as good a job of measuring the lower E2 levels that men have in comparison to women. So this means that your E2 is likely truly between 21-26 which is perfect. Don't start supplementing shit to lower your E2 further. When E2 goes below 20 it starts to become a nasty problem.

If you really want to know for sure when you are at, you have to get the sensitive assay for E2 performed.