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  • Low T after orchidectomy

    Hi everyone I have some of the symptoms of Low T after my radical left orchidectomy last year November 21st. I have had spells of light headedness, fatigue and no motivation. Here are my latest test results I am 31 years old and we got the cancer in the early stages.
    Total T 16.5 nmol/l
    SHGB 50.0 nmol/l
    Free T 262 pmol/l
    FSH 6.1 IU/L
    LH 8.9 IU/L
    Prolactin 11 ng/ml

  • #2
    If you're having symptoms from it, be sure to talk to a doctor about it. Either a urologist or an endocrinologist should be able to help. Low T, in and of itself, isn't really a problem. But if it's affecting your life, then it's a problem. Some guys here have low T after just an orchiectomy, though most with low T got it from chemo. You wouldn't be far out of normal around here if you start testosterone replacement after orchiectomy alone. Good luck, brother!

    FWIW, I had fatigue and low motivation after orchiectomy and RPLND. I was worried that it was low T, and my T was pretty low. I don't know if it was the low T, but the motivation is back and the fatigue is gone, though the T never went back up. It's possible that my experiences so shortly after diagnosis and orchiectomy were at least partly psychological.

    -Uno
    11/16/16 Went to primary care complaining of testicular pain. Wrongly diagnosed with epididymitis. Told not to worry, it'll go away on its own.
    12/8/16 Diagnosed with TC in left testicle.
    12/9/16 Left I/O.
    1/5/17 Tumor Markers officially back to normal -- Stage 1A with 70% EC.
    1/26/17 Robotic RPLND using left MSKCC template as primary treatment.
    2/2/17 Pathology results: pN0. They say I still have a 10% relapse chance.
    5/9/17 One and a half year all clear.

    Comment


    • #3
      Originally posted by unotesticulo View Post
      . Low T, in and of itself, isn't really a problem.
      Even without symptoms, low T can cause serious problems. Low bone density, decreased muscle mass, heart problems,etc.Testosterone is vital to men, it's not just sex.

      Dave

      Jan, 1975: Right I/O, followed by RPLND
      Dec, 2009: Left I/O, followed by 3xBEP

      Comment


      • #4
        Thanks Uno and Dave for your help. I defiantly have noticed a lack of energy, motivation and concertration since my opp and by the afternoon I am done I just want to sleep.
        Here are some results from last year from before my opp.

        Total T 18.6 nmol/l
        SHGB 41.7 nmol/l
        Free T 341 pmol/l

        Comment


        • #5
          Persistently low T (hypogonadism) is associated with metabolic syndrome, cardiovascular issues. It also just sucks.

          The input from experts I have heard ( including Dr Einhorn) is low T of <300 ng/dl AND symptoms should be treated.
          Last edited by mcintoda; 01-17-18, 10:36 PM.
          Age 31 - Portland, OR
          01NOV16- Pain in right testicle, palpable mass
          13NOV16- R I/O. Markers normal
          27NOV16- Stage Ia non-seminoma, 1.3cm, 100% EC, no LVI
          06DEC16 - CT scan clear
          09DEC16 - Started 1xBEP. Neutropenic at day 15; Worst part for me was bleo (allergic).
          03JAN17- Ended 1xBEP; start surveillance
          18MAR17-2nd pathology report shows 90% EC , 10% seminoma

          Comment


          • #6
            So, to defend my prior assertion: Low T is associated with several things. This is true. But that is a correlation, not a causation. Someone who has unexplained low T is likely to have other health issues. On the other hand, if you have low T because of TC and losing a testicle, the cause of your low T is relatively clear, and it's not known that this type of low T is causative for anything. Also, there are issues correlated with testosterone replacement, so it's not clear that it's worth doing anything about it, if your low T is asymptomatic.

            My only source: This is what my urologist told me, while explaining that my low T levels without any symptoms are probably not worth treating with testosterone replacement. If you have better info, I'd love to know about it.
            11/16/16 Went to primary care complaining of testicular pain. Wrongly diagnosed with epididymitis. Told not to worry, it'll go away on its own.
            12/8/16 Diagnosed with TC in left testicle.
            12/9/16 Left I/O.
            1/5/17 Tumor Markers officially back to normal -- Stage 1A with 70% EC.
            1/26/17 Robotic RPLND using left MSKCC template as primary treatment.
            2/2/17 Pathology results: pN0. They say I still have a 10% relapse chance.
            5/9/17 One and a half year all clear.

            Comment


            • #7
              Many docs are shockingly uniformed about the need for testosterone replacement, add to that that it is a schedule III controlled substance in the US & some docs are reluctant to put guys on TRT. Here are a few links from reputable sources:

              https://www.mayoclinic.org/diseases-...s/syc-20354881

              tcrc.acor.org/test-check.html

              I'm trying to find another one, but it seems to be eluding me.

              Dave



              Jan, 1975: Right I/O, followed by RPLND
              Dec, 2009: Left I/O, followed by 3xBEP

              Comment


              • #8
                Thanks guys ! sorry for the late reply been really busy ! I am taking some time and seeing if my body will recover by itself and if I don't feel great in a few weeks time I will seek some advice from an endocrinologist.

                Comment


                • #9
                  Hey guys just an update went for my 6month check up and my right one is cancer free !

                  Here are my latest tests should I be worried?

                  19/04/18
                  T-Test 9.2 nmol/l
                  SHBG 40.6 nmol/l
                  F-Test 157 Pmol/l
                  FSH 3.7 IU/l
                  LH 3.3 IU/l

                  Comment


                  • #10
                    Do you have your lab's reference range? The "normal"range is different at each lab so without that, the numbers are kinda useless. The *most* important thing is how you are feeling.Even if you are in the low normal range, if you have symptoms, you may need help. That "normal " range covers guys from teenage to old age after all.Somewhere in the middle is probably where you should be at 31.

                    Dave
                    Jan, 1975: Right I/O, followed by RPLND
                    Dec, 2009: Left I/O, followed by 3xBEP

                    Comment


                    • #11
                      Hi Dave sorry the late reply. Here are the Lab ranges.

                      T-Test 9.2 nmol/l - 8.0-27.1 nmol/l
                      SHBG 40.6 nmol/l - 11.4-52.3 nmol/l
                      F-Test 157 Pmol/l - 180-536 Pmol/l
                      FSH 3.7 IU/l - 1.2-15.8 IU/l
                      LH 3.3 IU/l - 1.3-9.6 IU/l
                      Oestradiol (Roche) 72 Pmol/l - 0-160 Pmol/l

                      I went to my GP because I was depressed, short tempered and fatigued not matter how much sleep I got and he put me on Lexamil.
                      Which helped my mood only but I did also put on about 5kgs while being on it for the month so I have stopped it.
                      Last edited by Geoffcuz; 05-25-18, 02:54 AM.

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                      • #12
                        Well than, you are at the low end of normal, are 31 years old, and have complaints consistent with low testosterone. I would be asking about TRT. Expect to have to push for it, many docs just don't get it.

                        Dave
                        Last edited by Davepet; 05-26-18, 03:00 PM.
                        Jan, 1975: Right I/O, followed by RPLND
                        Dec, 2009: Left I/O, followed by 3xBEP

                        Comment


                        • #13
                          Just been to a new GP and he has Diagnosis on me is Depression and has put me on Wellbutrin XL starting at 150mg for the first week then increasing it to 300mg a day ?
                          What are your thoughts on this?

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