Low T after orchidectomy

[Geoffcuz]

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

[unotesticulo]

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

[Davepet]

. 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

[Geoffcuz]

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

[mcintoda]

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.

[unotesticulo]

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.

[Davepet]

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-conditions/male-hypogonadism/symptoms-causes/syc-20354881

tcrc.acor.org/test-check.html

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

Dave

[Geoffcuz]

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.

[Geoffcuz]

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

[Davepet]

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

[Geoffcuz]

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.

[Davepet]

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

[Geoffcuz]

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?

[Davepet]

If your T levels are low than I think that is BS, JMHO.

[mcintoda]

If I were you I’d try getting my hormone levels in a more typical range for your age (not just in normal range of lab). Advocate for yourself. See another doctor.