Post: #726

(06-15-2016 11:54 AM)PhDre Wrote:  At this moment he should first and foremost get his testicles examined.

His LH is high and his test is low, which can point to primary hypogonadism (balls simply stop functioning - unlikely at his age) or to a more serious problem with his balls.

What does this exam look like?

And what is the doctor looking for?

Post: #727

^ The exam should consist of multiple parts:

1) palpation of the testicles and evaluation of their volume. Here the doctor is looking for lumps or abnormal volume.
2) AFP and HCG blood tests (primary markers for testicular cancer)
3) testicular ultrasound
4) HCG stimulation test (to check the testicular response to a big HCG spike)

Basically you want to rule out testicular cancer, injury and primary hypogonadism.

As much as I dislike mainstream conventional medicine, telling this guy to go on test and adex at this stage is imply irresponsible.
His pituitary is sending a strong signal to his testes to make test (normal LH levels are 3-4) so he does not suffer from secondary hypogonadism or from excessive negative feedback due to elevated estrogen levels.

At this stage the guy needs to see a real doctor to rule out serious disease.
Afterwards he can think of getting his hormones back on track.

Maybe the problem is as simple as a lack of zinc and saturated fat in his diet, maybe not.

Post: #728

(06-17-2016 06:26 AM)PhDre Wrote:  ^ The exam should consist of multiple parts:

1) palpation of the testicles and evaluation of their volume. Here the doctor is looking for lumps or abnormal volume.
2) AFP and HCG blood tests (primary markers for testicular cancer)
3) testicular ultrasound
4) HCG stimulation test (to check the testicular response to a big HCG spike)

Basically you want to rule out testicular cancer, injury and primary hypogonadism.

As much as I dislike mainstream conventional medicine, telling this guy to go on test and adex at this stage is imply irresponsible.
His pituitary is sending a strong signal to his testes to make test (normal LH levels are 3-4) so he does not suffer from secondary hypogonadism or from excessive negative feedback due to elevated estrogen levels.

At this stage the guy needs to see a real doctor to rule out serious disease.
Afterwards he can think of getting his hormones back on track.

Maybe the problem is as simple as a lack of zinc and saturated fat in his diet, maybe not.

My endo just ordered a comprehensive blood test. I've got an appointment with my regular doc in a few weeks, planning on speaking with him on this topic. I've been suplmenting with zinc daily for months, 30 mg w/ copper. I've recently upped my intake of good fats (Udo's oil, 3 tablespoons per day). The endo did mention that she'd like to rule out other glandular issue before resorting to hormone treatments.

Post: #729

Chances are that he will end up on TRT in any case. Nothing else will get him to youthful levels. Just my opinion. Been doing this a while and have helped many men get back on track with the help of their PCPs.

Things like variocele and other physical things with testes will not have an effect on test production. For some reason his Leydigs aren't responding to LH. Doubt a few supps will do it. The OP needs to be in the gym, getting enough sleep, and eating righteously - in these conversations this should be a given.

I'm most males stress levels have an affect as well so check cortisol levels. I was stage 4 and it causes my TT to spike 156/25 respectively - that's why I said "most males".

YMMV

Post: #730

I should be clear, cancer and such would in effect have an effect on test prouduction. Most mean are intimately aware of anything having to do with their junk, if he has anything physically wrong with his testes 99% chance the op would suspect it.

Post: #731

(06-18-2016 02:59 PM)ThrustMaster Wrote:  Chances are that he will end up on TRT in any case.

That might be true.

However, the only thing we know for sure is that he is not secondary hypogonadal.

A HCG stim test would give certainty over primary hypogonadism as well.

And the fact remains that the guy is a walking estrogen factory. If he goes on T, he can expect to pop adex like candy or to grow tits. Where does this estradiol come from with a low total T? From intratesticular aromatase? From his liver?

I feel like he needs to address this aromatase problems first (after a testicle exam) because T administration will only exacerbate it.

I agree with you on a possible effect of stress hormones.

Post: #732

Been on TRT for one month. Damn, I feel good.

My brain fog is gone. My mind feels blazing fast. It's like I've upgraded from a hyundai to a lamborghini.

Post: #733

Got my lab tests back.
T4 - 1.1
T3 - 75L
DHEA 168
CORTISOL 0.51
Estradiol 31
LH 4.5
FSH 6.7
FREE TEST 77.8
TEST TOTAL 466
Bioavailable test. 160
Sex hormone 25
My clinic wants to put me on test. However it's about $200/month. Which seems steep. Going to doctor in 5 days seeing what they recommend for testicles testing

Post: #734

I've been looking into a 'self prescribed' TRT as I've always felt I have low test.

I can make solid gains quick in the gym and am usually in decent shape, so this would more be for the mental benefits of higher test. What Fortis wrote a few posts back about brain fog rang home - I don't feel as sharp as I should be (& know I can be), and I think my sex drive is low for my age, 28.

Obviously would want to get tested first, found this online - https://www.medichecks.com/find-a-test/t...ale_ANDP-/

Is this a good start to see where I'm at? It's only a finger-prick blood test, is that enough to get accurate readings?

Post: #735

^ You sound like me.

I do it myself.

Honestly, I'm only 27 but I could feel the cognitive, sexual and physical decline despite my best efforts to stay healthy at 25. I was the guy who was in the gym 4 times a week, slamming protein and fish oil like it was my job and reading voraciously but my edge was gone. It was a truly awful feeling. It was like watching sand slip through the cracks between your fingers despite your best efforts to hold on.

Post: #736

Has anyone been able to find a cheap/fast/reliable clinic to get all the necessary blood work done over in Asia?

Post: #737

^ I've heard it can be done in Shanghai, but I haven't bothered to go check it out.

If you can find a hospital that caters to foreigners in a tier-1 city you can go over the urology department and get things like test, e2 and the other important ones checked out. I did it once and it came out to about $150.

Post: #738

(06-30-2016 05:20 PM)lex the impaler Wrote:  My clinic wants to put me on test. However it's about $200/month. Which seems steep.

I pay about that much, and would pay double that in a heartbeat if it was needed.

I think you can get a better price.

However.

As with all controlled substances, your priority is to get a doctor, any doctor, to give you the prescription.

After that, it is much easier to change over to someone else who is more economical.

Post: #739

(07-01-2016 11:28 AM)el mavericko Wrote:  Has anyone been able to find a cheap/fast/reliable clinic to get all the necessary blood work done over in Asia?

There must be many in places like Bali and Ko Samui.

A quick search brings up : http://www.arcclinics.com/anti-aging-treatment-for-men/

Post: #740

(07-01-2016 07:55 PM)Fortis Wrote:  ^ I've heard it can be done in Shanghai, but I haven't bothered to go check it out.

If you can find a hospital that caters to foreigners in a tier-1 city you can go over the urology department and get things like test, e2 and the other important ones checked out. I did it once and it came out to about $150.

Thanks man, popped into a French hospital here in Saigon and things are looking good. They can't test Free T but only about 100 bucks for Total T, Estradiol, LH, FSH, SHBG, T3, T4, DHEA. Any other tests you guys would recommend getting done or should these cover me?

Oh and I've read that it's best to get your blood drawn early in the morning, does whether or not you're fasted effect the results?

Post: #741

First time I post here. I've read every single page here and I feel like I know what I'm about to do. Just want to get more assurances from you guys

I'm 36 and I go to the gym quite regularly ... About 4 to 5 times a week. My doc did the blood test for me a year ago and test was about 560 and estradiol was like 39 which was too high. He recommended an aromatase inhibitor (anastrozole) which brought the est. to just under 20 but this was only temporary and he said i should start taking a lot of zinc. Well i just did the same blood work a year later and the test was at 600 but the est is back to around 39. This dude claimed he doesn't see any issue with this but from the post above it seems that's a high est to test ratio ... What's the normal ratio anyway? So 39/600 is about 6.5% is a normal ratio much lower than this?

I asked the doc to put me on TRT as I want my levels up to like 800-1000 but I'm wondering if I'm being foolish and 600 is good enough for a 36 year old male. I mean I get some good gains in the gym, not jacked by any means and would like to get jacked. I'd say I want to bang every chick that passes me by -- I feel like at 800 I'd actually jump at them, plus I don't feel tired or anything. I could sleep more.... I usually get 6 hours of sleep. So I'm wondering whether the quest for 800-1000 test from 600 is really a stupid move and what I have is enough? Is the est to test ratio of 6.5% too high? And really if my main goal is to get quicker gains at the gym this is not the right way to go about it?

Thanks for the knowledge guys, really appreciate it

Post: #742

Well, at the risk of repeating my earlier post(s), I'm 50 and my DO is still aiming for 800-900 for me. My last screen was 772 - I just did another screen a few days ago and I'm waiting on the results from that. My DO will adjust injection levels to get me to that 800-900 sweet spot. I started TRT when I was at ~ 200, for reference.

So, if you were to ask me, I'd say no, 600 isn't enough...I wouldn't accept it. But T is a highly individual thing and your mileage may vary. It's more about how you feel, how you perform, and your quality of life more than just trying to hit a number.

Post: #743

A reminder for anyone in Kiev or Ukraine: it costs $35-40 USD to get the reproductive package, which includes SHBG, DHEAS, progesterone, proclatin, estradiol, free and total testosterone, FSH, LH. You can get other markers tested as well.

It helps if you speak Russian or go with a Russian speaker.

Post: #744

(07-02-2016 01:13 AM)el mavericko Wrote:  

(07-01-2016 07:55 PM)Fortis Wrote:  ^ I've heard it can be done in Shanghai, but I haven't bothered to go check it out.

If you can find a hospital that caters to foreigners in a tier-1 city you can go over the urology department and get things like test, e2 and the other important ones checked out. I did it once and it came out to about $150.

Thanks man, popped into a French hospital here in Saigon and things are looking good. They can't test Free T but only about 100 bucks for Total T, Estradiol, LH, FSH, SHBG, T3, T4, DHEA. Any other tests you guys would recommend getting done or should these cover me?

Oh and I've read that it's best to get your blood drawn early in the morning, does whether or not you're fasted effect the results?

I think ALL blood work is better in a fasted state at the beginning of the day.

Post: #745

Don't mean to blow you guys up but I honestly have no idea where to go from here and could really use some advice.

What I know - My T and Free T levels are abysmally low, confirmed through three different blood draws taken months apart. It's not a lifestyle issue as I'm young, eat clean, exercise regularly, lift heavy, get enough sleep, etc. So clearly there is some sort of underlying problem.

What I don't know - what to do with this information. Getting the blood work done and finding a way to source the necessary compounds shouldn't be too big a challenge in Asia. I could easily find everything I need, carefully follow the instructions from the D&P podcasts, and hope for the best. On the other hand I'm very young and feel like hopping on TRT without knowing the root of the problem could backfire. Problem is, how do I even find that out? I'm in Vietnam.. I don't have any insurance.. I honestly wouldn't even mind blowing through all my savings and going back to the US and finding the optimal doctor if I knew I'd get this taken care of for good but from what I've read online so far that seems like a pipe dream.

What would you do?

Post: #746

(07-07-2016 09:41 PM)el mavericko Wrote:  Don't mean to blow you guys up but I honestly have no idea where to go from here and could really use some advice.

What I know - My T and Free T levels are abysmally low, confirmed through three different blood draws taken months apart. It's not a lifestyle issue as I'm young, eat clean, exercise regularly, lift heavy, get enough sleep, etc. So clearly there is some sort of underlying problem.

What I don't know - what to do with this information. Getting the blood work done and finding a way to source the necessary compounds shouldn't be too big a challenge in Asia. I could easily find everything I need, carefully follow the instructions from the D&P podcasts, and hope for the best. On the other hand I'm very young and feel like hopping on TRT without knowing the root of the problem could backfire. Problem is, how do I even find that out? I'm in Vietnam.. I don't have any insurance.. I honestly wouldn't even mind blowing through all my savings and going back to the US and finding the optimal doctor if I knew I'd get this taken care of for good but from what I've read online so far that seems like a pipe dream.

What would you do?

Can't really help you at the moment as I'm possibly in the same boat, waiting on a blood test for confirmation and seriously considering low dose TRT if it's needed.

Out of interest though what are your stats - age, height/weight, body fat etc. and what did your test readings come out at? Did you have anything else tested?

Post: #747

I spoke with a very knowledgeable physician who is very respected in his field. We had a disagreement over optimal T levels.

My argument was that sub-500 was a low level for a male under 30. My level was in the upper 400s as a late 20s male. His argument was that the normal level is between 300-1000 and some people produce less naturally, but a number within that range is normal and not low. I disagreed. But he said these levels have been determined by "peer reviewed studies", not "blogs by health gurus".

He also made a comparison to hemoglobin levels in the blood. If you are in the defined range from the "peer reviewed medical community", you do not have a low level even if it is the low-end of this range.

I began to think about this more and concluded the 300-1000 is very misleading because it groups 20-80 year old men, fit, obese, etc. The range is not representative of a specific age.

Can someone help me understand what is the optimal level for a late 20s male. Is there some sort of medical research that has been performed to determine optimal levels by age? I haven't been able to find any.

Post: #748

(07-08-2016 09:13 PM)Armogan Wrote:  I spoke with a very knowledgeable physician who is very respected in his field. We had a disagreement over optimal T levels.

My argument was that sub-500 was a low level for a male under 30. My level was in the upper 400s as a late 20s male. His argument was that the normal level is between 300-1000 and some people produce less naturally, but a number within that range is normal and not low. I disagreed. But he said these levels have been determined by "peer reviewed studies", not "blogs by health gurus".

He also made a comparison to hemoglobin levels in the blood. If you are in the defined range from the "peer reviewed medical community", you do not have a low level even if it is the low-end of this range.

I began to think about this more and concluded the 300-1000 is very misleading because it groups 20-80 year old men, fit, obese, etc. The range is not representative of a specific age.

Can someone help me understand what is the optimal level for a late 20s male. Is there some sort of medical research that has been performed to determine optimal levels by age? I haven't been able to find any.

All you can do is work off standard deviations for age groups measured.

Post: #749

delete

Post: #750

Hi guys wanted some opinions. 32 here, 5'9; 165 about 11% body fat. I workout about 5-6 days per week. I got my free test checked and it came back 420. I feel that after 30 i've been feeling sluggish, less motivated, less ambitious, more lazy, and def less desire to game.

Was curious what the younger guys who have been on TRT think? A few concerns I have is bloating of the face, hair loss, and the potential to not be able to have kids in the future?