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  • Low T - Any advise

    I had my right testicle removed 3 years ago and did three cycles of Chemo. I have been cancer free since then thank god however have noticed symptoms like pretty decent fatigue, loss of libido, errection issues on occasions etc. My C Testosterone is around 320 ng/dL and free 60 pg/ml which according to some page I saw puts me in average with 75-80 year olds when I am in my late 30’s.

    Any suggestions on my next steps on what I would try? I have been doing gym few days a week but I think I need more?

  • #2
    What does your doc say? Sounds like you may need TRT, but no idea what "C testosterone" is? What is your lab saying "normal range" is? It is unusual for a guy with one to have low T, but it happens. If you need TRT, expect to have to fight for it. Docs seem reluctnt to prescribe it even for those with no nuts (go figure, but thanks to the stupid athletes using it inappropriately).

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

    Comment


    • #3
      The range was 249-836 for the one and the other was 47-244. Both are on the very low end of the range. When compared to “normal” people my numbers would be of 75-80 year old man. Honestly I do not care about numbers but more care about the symptoms.

      My oncologist said I should go back to see my urologist

      Comment


      • #4
        When you see your uro, put the emphasis on your symptoms, many docs are reluctant to prescribe trt when the numbers are in the "normal range" even though it's at the low end.
        Jan, 1975: Right I/O, followed by RPLND
        Dec, 2009: Left I/O, followed by 3xBEP

        Comment


        • #5
          Thanks Dave, do trt make a big difference?

          Comment


          • #6
            Originally posted by Ground View Post
            Thanks Dave, do trt make a big difference?
            Well I have no nuts, so yeah, made a big difference. I will never laugh at hot flash jokes again. It took my idiot doc two weeks to prescribe TRT after my second I/O so I know how uncomfortable they are. You'd have to think sitting in the middle of a bonfire is funny to laugh. It really can get that bad. Other than that, I went from not even being able to want an erection to being able to want & have orgasms. While I am nkt motivated to get things done these days, I think is more my age than T levels.
            .
            Jan, 1975: Right I/O, followed by RPLND
            Dec, 2009: Left I/O, followed by 3xBEP

            Comment


            • #7
              Yes proper administration of TRT can make a night and day difference. If you decide to go on it, just remember it takes your body some time to adjust (especially if you are still creating some naturally). Find what protocol works best for you and stay consistent. I have found when it comes to messing with hormones make 1 change at a time. The endocrine system is very complex and the most suttle changes can have some significant impacts (good or bad). Good luck to you.
              TC#1
              May 2013 - Left Orchiectomy - Stage pT1 Seminoma (2.3 cm)
              June 2013 - 1 Dose 1000mg of Carboplatin ---> Surveillance
              TC#2
              May 2015 - Right Orchiectomy - Stage pT1 Seminoma (2.2cm)
              TRT - Cypionate 100mg (Weekly)
              June 2015 - Surveillance

              Comment


              • #8
                Following along as my 19 year old son is getting ready to start replacement therapy.
                Son Grant
                dx 12/21/16 at age 17

                BEP x3
                Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
                2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
                Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

                Comment


                • #9
                  Trekga, sorry to hear your son is having to deal with all of this, especially at such a young age. My advice would be to find a good endocrinologist, one that specializes in male hormones. My experience (in the USA) is that most traditional endocrinologist mostly deal with diabetic patients and don't know much about TRT. They are usually happy to prescribe you what you need, but often I have had to research on my own about what they should be monitoring in my lab work and provide them guidance. Otherwise, they will just monitor Total Testosterone and call it good, without taking into consideration several other hormones that also need to be tracked. Everyone is different and responds differently to certain treatments. Finding the right method and dose takes some time and becomes more of an art than a science since the reference ranges of "normal" are so wide but don't always translate to how someone feels. I will say once you get it nailed down it makes a world of difference.
                  TC#1
                  May 2013 - Left Orchiectomy - Stage pT1 Seminoma (2.3 cm)
                  June 2013 - 1 Dose 1000mg of Carboplatin ---> Surveillance
                  TC#2
                  May 2015 - Right Orchiectomy - Stage pT1 Seminoma (2.2cm)
                  TRT - Cypionate 100mg (Weekly)
                  June 2015 - Surveillance

                  Comment


                  • #10
                    Unfortunately, the medial profession is woefully under-educated on trt. They don't understand what is needed to treat guys, especially the monitoring of all the various levels that affect how we feel. Even the endos seem nervous about prescribing a controlled substance I saw one for a few visits & she eventually said there was no reason my PCP couldn't handle my case. She was pretty useless anyway, so no big loss. None of them care about how you feel as long as the #'s are "in range". Why can't "in range" be calibrated for age??
                    Last edited by Davepet; 01-28-19, 11:11 PM.
                    Jan, 1975: Right I/O, followed by RPLND
                    Dec, 2009: Left I/O, followed by 3xBEP

                    Comment


                    • #11
                      Wanted to update. My son Grant just started on weekly injection- very low dose of 100. He is only had one dose. Endo seems fairly up to date, and hopefully in 6 weeks I can update further. Grant's other hormone levels indicate something is not working correctly in remaining testicle. So hopefully he will eventually stop being so fatigued, and start having a libido normal for a 19 year old! Not mention less mood swings. Almost like a teenager with menstrual cycle!
                      Son Grant
                      dx 12/21/16 at age 17

                      BEP x3
                      Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
                      2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
                      Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

                      Comment


                      • #12
                        Well hard to say how low that dose is. I inject 200mg every three weeks, so at 100mg every week, he's getting 50% more. Only time will tell if the dose is appropriate for a 19 year old, I'm 64 & pretty sure a minor boost might help, but good luck getting a doc to do that if you are within the very large "normal range". Hopefully his remaining guy can make up any deficit, but often, once TRT is started natural production shuts don, since the feedback loop that initiates production doesn't see a need. If he has other hormones out of wack, push the endo to address them, he's way to young to be dealing with this.

                        Dave
                        Last edited by Davepet; 03-30-19, 11:31 PM.
                        Jan, 1975: Right I/O, followed by RPLND
                        Dec, 2009: Left I/O, followed by 3xBEP

                        Comment

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