Low testosterone
Discussion
Yazza54 said:
I can muster the energy to do stuff I want to do to be fair.. any sort of workout with no overall goal just feels like a huge chore to me. Like I could cycle somewhere and back, but tell me to go do a few K on a treadmill or do some sets of weights and I feel weak and devoid of any "go".
But why do you have no goals? I think most people would feel the same as you if they just did treadmill or weights with no goal in mind. Every session should have a goal and should be working towards some particular mid-term goal.
Set yourself a couple of strength targets and once the improvements start coming your motivation to progress will surely fire up.
Hitting a PB is exhilarating - I could not imagine life without these little successes.
Morning all. Just to answer the points raised by a couple of posters and perhaps add some context.
The phlebotomist at the hospital kindly sorted me with a sample for Medichecks when she drew blood for the tests the GP asked for so it was venous blood rather than fingerprick-test. However, it was done mid-afternoon (scheduled around not missing too much of an afternoon's work).
One of the GPs called me back Friday PM and raised the question of the timing and has said he would like me to have another test but done first thing in the morning - this will cover creatinine & electrolytes (excl. urea), full blood count (again), FSH, liver function tests, LH, oestradiol, prolactin, testosterone and TSH. I'm going to get that test booked in at the hospital as soon as possible this week.
One of the comments he made (and it's a fair one) is that I'm seriously overweight - however despite my size I'm not diabetic (my haemoglobin A1c is *just* inside the pre-diabetic range @ 43 mmol/mol - this has been the same since June '23). All of the rest of my other blood results came back within spec except for CFP which is down from 35 mg/L in August to 9 mg/L, ideally should be under 5 and globulin which is down from 42 g/L in Aug to 39 and should ideally be under 35. My red blood cell count is a little on the low side at 4.3 10*12/L (ideally should be above 4.5). I've been ill/under the weather for the last 2 months hence going to getting all this stuff tested.
Re. the weight, I started my 40s at around 180kg (having been big my whole life up to that point), joined a gym and Slimming World and dropped 50kg in 18 months. I was at the gym 5-6 days a week with a programme put together for me by a PT. Then lockdowns came and I went from smashing it to probably borderline depression - I live alone and I found the isolation and lack of activity/variety really hard. Fair to say it took its toll. I managed to keep the weight steady but the lockdown around Christmas '21 finished me off and the bad habits returned, as did the weight. I'm back where I started, just turned 45.
I will lose it all again, however I'd been struggling to get my head in the right place to commit to it again (especially knowing how tough it was the first time around). Combined with a lack of drive and near-permanent fatigue I wanted to work out what's wrong before I try and restart everything - particularly if something was wrong and despite any good intentions I made it harder for myself due to deficiences or low levels of 'something', swimming against the tide.
That said, even if my testosterone levels were 3-4x higher they'd still be extremely low for someone mid-40s. I understand low testosterone could be due to obesity, however apparently weight gain could also be a symptom of low testosterone etc - I wonder if my levels dropped when I stopped training hard and never recovered perhaps?
Anyway, there's a load of context/background and I'll know more when I have the results of the next test which will hopefully be late this week or early next.
The phlebotomist at the hospital kindly sorted me with a sample for Medichecks when she drew blood for the tests the GP asked for so it was venous blood rather than fingerprick-test. However, it was done mid-afternoon (scheduled around not missing too much of an afternoon's work).
One of the GPs called me back Friday PM and raised the question of the timing and has said he would like me to have another test but done first thing in the morning - this will cover creatinine & electrolytes (excl. urea), full blood count (again), FSH, liver function tests, LH, oestradiol, prolactin, testosterone and TSH. I'm going to get that test booked in at the hospital as soon as possible this week.
One of the comments he made (and it's a fair one) is that I'm seriously overweight - however despite my size I'm not diabetic (my haemoglobin A1c is *just* inside the pre-diabetic range @ 43 mmol/mol - this has been the same since June '23). All of the rest of my other blood results came back within spec except for CFP which is down from 35 mg/L in August to 9 mg/L, ideally should be under 5 and globulin which is down from 42 g/L in Aug to 39 and should ideally be under 35. My red blood cell count is a little on the low side at 4.3 10*12/L (ideally should be above 4.5). I've been ill/under the weather for the last 2 months hence going to getting all this stuff tested.
Re. the weight, I started my 40s at around 180kg (having been big my whole life up to that point), joined a gym and Slimming World and dropped 50kg in 18 months. I was at the gym 5-6 days a week with a programme put together for me by a PT. Then lockdowns came and I went from smashing it to probably borderline depression - I live alone and I found the isolation and lack of activity/variety really hard. Fair to say it took its toll. I managed to keep the weight steady but the lockdown around Christmas '21 finished me off and the bad habits returned, as did the weight. I'm back where I started, just turned 45.
I will lose it all again, however I'd been struggling to get my head in the right place to commit to it again (especially knowing how tough it was the first time around). Combined with a lack of drive and near-permanent fatigue I wanted to work out what's wrong before I try and restart everything - particularly if something was wrong and despite any good intentions I made it harder for myself due to deficiences or low levels of 'something', swimming against the tide.
That said, even if my testosterone levels were 3-4x higher they'd still be extremely low for someone mid-40s. I understand low testosterone could be due to obesity, however apparently weight gain could also be a symptom of low testosterone etc - I wonder if my levels dropped when I stopped training hard and never recovered perhaps?
Anyway, there's a load of context/background and I'll know more when I have the results of the next test which will hopefully be late this week or early next.
Edited by Funk on Sunday 28th April 22:22
pidsy said:
lord trumpton said:
Legacywr said:
pidsy said:
Currently paying £97 a month with Optimale - and I must say, their customer care has dropped off a cliff over the past year.
Not great at all.
It’s not what it should be. Not great at all.
I just source mine myself and it costs about 15/month
pidsy said:
lord trumpton said:
Legacywr said:
pidsy said:
Currently paying £97 a month with Optimale - and I must say, their customer care has dropped off a cliff over the past year.
Not great at all.
It’s not what it should be. Not great at all.
lord trumpton said:
pidsy said:
lord trumpton said:
Legacywr said:
pidsy said:
Currently paying £97 a month with Optimale - and I must say, their customer care has dropped off a cliff over the past year.
Not great at all.
It’s not what it should be. Not great at all.
I just source mine myself and it costs about 15/month
Funk said:
One of the GPs called me back Friday PM and raised the question of the timing and has said he would like me to have another test but done first thing in the morning - this will cover creatinine & electrolytes (excl. urea), full blood count (again), FSH, liver function tests, LH, oestradiol, prolactin, testosterone and TSH. I'm going to get that test booked in at the hospital as soon as possible this week.
They need to include SHGB in those tests if low T is being considered.xx99xx said:
Funk said:
One of the GPs called me back Friday PM and raised the question of the timing and has said he would like me to have another test but done first thing in the morning - this will cover creatinine & electrolytes (excl. urea), full blood count (again), FSH, liver function tests, LH, oestradiol, prolactin, testosterone and TSH. I'm going to get that test booked in at the hospital as soon as possible this week.
They need to include SHGB in those tests if low T is being considered.Got a test done first thing this morning at the hospital and the results are already back; it's worse than the Medichecks one!
Testosterone: 2.75 nmol/L (out of range)
Oestradiol: 167 pmol/L (out of range)
FSH: 2.7 iu/L (in range)
LH: 3 iu/L (in range)
The only other things out of range on the tests results this morning are globulin (43 g/L) and Total Protein (83 g/L).
I don't think the NHS test covers free testosterone or free androgen index - or if it does, they've not uploaded the results to the Patients Know Best portal yet.
Testosterone: 2.75 nmol/L (out of range)
Oestradiol: 167 pmol/L (out of range)
FSH: 2.7 iu/L (in range)
LH: 3 iu/L (in range)
The only other things out of range on the tests results this morning are globulin (43 g/L) and Total Protein (83 g/L).
I don't think the NHS test covers free testosterone or free androgen index - or if it does, they've not uploaded the results to the Patients Know Best portal yet.
Funk said:
Got a test done first thing this morning at the hospital and the results are already back; it's worse than the Medichecks one!
Testosterone: 2.75 nmol/L (out of range)
Oestradiol: 167 pmol/L (out of range)
FSH: 2.7 iu/L (in range)
LH: 3 iu/L (in range)
The only other things out of range on the tests results this morning are globulin (43 g/L) and Total Protein (83 g/L).
I don't think the NHS test covers free testosterone or free androgen index - or if it does, they've not uploaded the results to the Patients Know Best portal yet.
Did they do SHBG?Testosterone: 2.75 nmol/L (out of range)
Oestradiol: 167 pmol/L (out of range)
FSH: 2.7 iu/L (in range)
LH: 3 iu/L (in range)
The only other things out of range on the tests results this morning are globulin (43 g/L) and Total Protein (83 g/L).
I don't think the NHS test covers free testosterone or free androgen index - or if it does, they've not uploaded the results to the Patients Know Best portal yet.
272BHP said:
Funk said:
Got a test done first thing this morning at the hospital and the results are already back; it's worse than the Medichecks one!
Testosterone: 2.75 nmol/L (out of range)
Oestradiol: 167 pmol/L (out of range)
FSH: 2.7 iu/L (in range)
LH: 3 iu/L (in range)
The only other things out of range on the tests results this morning are globulin (43 g/L) and Total Protein (83 g/L).
I don't think the NHS test covers free testosterone or free androgen index - or if it does, they've not uploaded the results to the Patients Know Best portal yet.
Did they do SHBG?Testosterone: 2.75 nmol/L (out of range)
Oestradiol: 167 pmol/L (out of range)
FSH: 2.7 iu/L (in range)
LH: 3 iu/L (in range)
The only other things out of range on the tests results this morning are globulin (43 g/L) and Total Protein (83 g/L).
I don't think the NHS test covers free testosterone or free androgen index - or if it does, they've not uploaded the results to the Patients Know Best portal yet.
Edited by Funk on Monday 29th April 13:43
Plug it in here if you want to know your free testosterone level.
https://www.issam.ch/freetesto.htm
Yours should be roughly - 0.0534 nmol/L = 1.95 %
If I was you I would phone one of the clinics today. You could be on gold standard treatment within a month. Your levels are too low and this is too important to delay - life is short.
Go the NHS route and you could be waiting over a year and still get sub par treatment at the end of it.
https://www.issam.ch/freetesto.htm
Yours should be roughly - 0.0534 nmol/L = 1.95 %
If I was you I would phone one of the clinics today. You could be on gold standard treatment within a month. Your levels are too low and this is too important to delay - life is short.
Go the NHS route and you could be waiting over a year and still get sub par treatment at the end of it.
I have to add.
Successful male hormone therapy is about balancing the hormones and a critical balance is the Testosterone to Oestrogen ratio. In most people a good ratio is having E2 pmol/L roughly 5 times your Total Testosterone nmol/L level.
So Total T 20 nmol/L should see E2 somewhere around 100 pmol/L
If someone is happier at the higher end of the range with a Total T of 30 then we should expect E2 to be higher at around 150. Along with mid range SHBG and Prolactin this should produce good outcomes for most patients.
Your T/E2 ratio at around 50 times is alarmingly high. I suspect your weight is a critical factor here and dramatic and sustained weight loss will undoubtedly be part of a successful intervention.
You need expert advice here. I have no confidence you will find this with the NHS. Both Dr Stevens at TMHC and Dr Savage at Leger clinic will have seen thousands of patients over the years and will know what to do in your particular case. There might well be other factors at play and they will know what to look for.
At the end of these consultations It still might be possible to get NHS treatment if you so wish and both of those doctors mentioned above will write a letter to present their findings and recommendations to your GP.
Successful male hormone therapy is about balancing the hormones and a critical balance is the Testosterone to Oestrogen ratio. In most people a good ratio is having E2 pmol/L roughly 5 times your Total Testosterone nmol/L level.
So Total T 20 nmol/L should see E2 somewhere around 100 pmol/L
If someone is happier at the higher end of the range with a Total T of 30 then we should expect E2 to be higher at around 150. Along with mid range SHBG and Prolactin this should produce good outcomes for most patients.
Your T/E2 ratio at around 50 times is alarmingly high. I suspect your weight is a critical factor here and dramatic and sustained weight loss will undoubtedly be part of a successful intervention.
You need expert advice here. I have no confidence you will find this with the NHS. Both Dr Stevens at TMHC and Dr Savage at Leger clinic will have seen thousands of patients over the years and will know what to do in your particular case. There might well be other factors at play and they will know what to look for.
At the end of these consultations It still might be possible to get NHS treatment if you so wish and both of those doctors mentioned above will write a letter to present their findings and recommendations to your GP.
Zio Di Roma said:
Legacywr said:
Sounds a lot like '60' if you don't mind me saying.
PH's could do with a helpful sexual health thread...
Really? I was hoping to be a bedroom hero well into my 70s!PH's could do with a helpful sexual health thread...
I am quite fit and go to the gym five times per week. Three days weights, one day steady state cardio and one of HIIT.
Though the excess fat I carry won’t shift unless I eat and train like I am in the olympics, I am not a beer swilling chip muncher.
So when I was younger I had lower testosterone but none of my current symptoms.
Am I just becoming old?
272BHP said:
I have to add.
Successful male hormone therapy is about balancing the hormones and a critical balance is the Testosterone to Oestrogen ratio. In most people a good ratio is having E2 pmol/L roughly 5 times your Total Testosterone nmol/L level.
So Total T 20 nmol/L should see E2 somewhere around 100 pmol/L
If someone is happier at the higher end of the range with a Total T of 30 then we should expect E2 to be higher at around 150. Along with mid range SHBG and Prolactin this should produce good outcomes for most patients.
Your T/E2 ratio at around 50 times is alarmingly high. I suspect your weight is a critical factor here and dramatic and sustained weight loss will undoubtedly be part of a successful intervention.
You need expert advice here. I have no confidence you will find this with the NHS. Both Dr Stevens at TMHC and Dr Savage at Leger clinic will have seen thousands of patients over the years and will know what to do in your particular case. There might well be other factors at play and they will know what to look for.
At the end of these consultations It still might be possible to get NHS treatment if you so wish and both of those doctors mentioned above will write a letter to present their findings and recommendations to your GP.
Thanks for this - I've been in touch with TMHC this morning and will progress things with them. I have no doubt you're also right re. the weight being a major factor; the challenge for me will how to proceed through the next year or two whilst I lose the weight. I can't carry on feeling as I have been for the last 3-6 months so I'm hoping that a mix of dedicated weight loss and TRT can be done in combo. I'll know more once I've gotten all my info over to TMHC. Thanks again for taking the time to post considered and helpful info; it's been taken onboard.Successful male hormone therapy is about balancing the hormones and a critical balance is the Testosterone to Oestrogen ratio. In most people a good ratio is having E2 pmol/L roughly 5 times your Total Testosterone nmol/L level.
So Total T 20 nmol/L should see E2 somewhere around 100 pmol/L
If someone is happier at the higher end of the range with a Total T of 30 then we should expect E2 to be higher at around 150. Along with mid range SHBG and Prolactin this should produce good outcomes for most patients.
Your T/E2 ratio at around 50 times is alarmingly high. I suspect your weight is a critical factor here and dramatic and sustained weight loss will undoubtedly be part of a successful intervention.
You need expert advice here. I have no confidence you will find this with the NHS. Both Dr Stevens at TMHC and Dr Savage at Leger clinic will have seen thousands of patients over the years and will know what to do in your particular case. There might well be other factors at play and they will know what to look for.
At the end of these consultations It still might be possible to get NHS treatment if you so wish and both of those doctors mentioned above will write a letter to present their findings and recommendations to your GP.
Funk said:
Thanks for this - I've been in touch with TMHC this morning and will progress things with them. I have no doubt you're also right re. the weight being a major factor; the challenge for me will how to proceed through the next year or two whilst I lose the weight. I can't carry on feeling as I have been for the last 3-6 months so I'm hoping that a mix of dedicated weight loss and TRT can be done in combo. I'll know more once I've gotten all my info over to TMHC. Thanks again for taking the time to post considered and helpful info; it's been taken onboard.
The very best of luck.I have every confidence your life changes dramatically from this day forward.
272BHP said:
I have to add.
Successful male hormone therapy is about balancing the hormones and a critical balance is the Testosterone to Oestrogen ratio. In most people a good ratio is having E2 pmol/L roughly 5 times your Total Testosterone nmol/L level.
So Total T 20 nmol/L should see E2 somewhere around 100 pmol/L
If someone is happier at the higher end of the range with a Total T of 30 then we should expect E2 to be higher at around 150. Along with mid range SHBG and Prolactin this should produce good outcomes for most patients.
Your T/E2 ratio at around 50 times is alarmingly high. I suspect your weight is a critical factor here and dramatic and sustained weight loss will undoubtedly be part of a successful intervention.
You need expert advice here. I have no confidence you will find this with the NHS. Both Dr Stevens at TMHC and Dr Savage at Leger clinic will have seen thousands of patients over the years and will know what to do in your particular case. There might well be other factors at play and they will know what to look for.
At the end of these consultations It still might be possible to get NHS treatment if you so wish and both of those doctors mentioned above will write a letter to present their findings and recommendations to your GP.
Great accurate post Successful male hormone therapy is about balancing the hormones and a critical balance is the Testosterone to Oestrogen ratio. In most people a good ratio is having E2 pmol/L roughly 5 times your Total Testosterone nmol/L level.
So Total T 20 nmol/L should see E2 somewhere around 100 pmol/L
If someone is happier at the higher end of the range with a Total T of 30 then we should expect E2 to be higher at around 150. Along with mid range SHBG and Prolactin this should produce good outcomes for most patients.
Your T/E2 ratio at around 50 times is alarmingly high. I suspect your weight is a critical factor here and dramatic and sustained weight loss will undoubtedly be part of a successful intervention.
You need expert advice here. I have no confidence you will find this with the NHS. Both Dr Stevens at TMHC and Dr Savage at Leger clinic will have seen thousands of patients over the years and will know what to do in your particular case. There might well be other factors at play and they will know what to look for.
At the end of these consultations It still might be possible to get NHS treatment if you so wish and both of those doctors mentioned above will write a letter to present their findings and recommendations to your GP.
GP called back, is arranging a referral to endocrine specialist - says it'll be months and if I have the option of private it'd be the time to take it. I like that TMHC will work with my GP/specialist down the line so am getting the ball rolling with them. GP is going to email me an export of my recent results in a usable format that I can share with TMHC.
Funk said:
GP called back, is arranging a referral to endocrine specialist - says it'll be months and if I have the option of private it'd be the time to take it. I like that TMHC will work with my GP/specialist down the line so am getting the ball rolling with them. GP is going to email me an export of my recent results in a usable format that I can share with TMHC.
Don’t be surprised if they want their on blood tests done. Gassing Station | Health Matters | Top of Page | What's New | My Stuff