TESTOSTERONE, DHEA & other male hormons

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newguy

QuoteI went to see Dr. Levine last Wednesday. I thought I would write and share my story about the visit. When the nurse called me back to the examine room she explained she wanted to draw blood to check my testostorone levels. She explained that recently they are seeing 9 out of 10 peyronies patients with low T levels.

Taken from Woodmans post follow a visit to Dr Levines office. This testosterone point appears to keep coming up. Any thoughts on it aside from those already discussed? Could it be that those with low T-Levels at the time of developing an injury (assuming that one has taken place) are much more likely to develop problematic or severe curvature, possibly as a result of a worse inflammatory phase? Hmmm..

Woodman

Newguy- Dr. Levines office called me back on my testosterone results this Friday. The nurse told me that it was at 325 and it was within normal limits. I ve read posts from Jackp stating you need to know other numbers. I was at work and the nurse sounded real busy too. She had to put me on hold 4 times while she was looking up the results so I didnt get a chance to get her to explain the numbers to me. I am 36 and have had Peyronies Disease for 2yrs and 2 months. Thought I would share the information. I have wondered about testosterone levels contributing to Peyronies Disease too lately.

jackp

Woodman

Call the doctors office back and insist that they fax, email or snail mail you a copy of your testosterone labs. They are legally obligated to give you this information.

If your total is 325 and the lab range is 250 - 1100 you are low. You also want to know your free available and bio available. If this doctors office is too busy to answer your questions find another doctor.

When you get the results send me an email or PM and we will discuss the results.

Jackp

newguy


Woodman

Thanks jackp. In the lab report will the free available and bio available numbers be included or do I have to ask for them seperately.

jackp

Woodman

Some urologist only do a total testosterone (T) . A good urologist does all the T blood work which include.

Testosterone, Total
Testosterone, Free
Testosterone, Bioavailable
SHBG
Albium, Serum

If you do not have all these you do not get a complete picture of your T levels.
Total T should be in the upper 75% of the lab range.
Free and bioavailable should be at least 65% of the lab range.

For testosterone replacement shots do a better job than gels. Gels will make your blood thick and cause other problems. Shots should be at least every week to 10 days.

Hope this helps.

Jackp

Woodman

jackp- Iam going to call and get the lab results. Iam also going to ask if they test just for the total T or the full work up.

When your Testosterone was low what symptoms did you experience?


Woodman

young25

Woodman,

325 sounds low. I was 433 on blood test & Rhein Urine T ( Considered by some doctors as the best way to test T) showed me Low, so I think you should dig more into this & as JackP suggested get al the tests done. Just add Estradiol to the list too.  

jackp

Woodman

Some symptoms of low T are. Low sex drive, general tiredness or lack of energy, weight control, ED, brain fog, etc.

Some of us on the forum believe that low T is one of the causes of peyronies. I can remember in my late 30's complaining to my then doctor about symptoms of low T but all he would do was a PSA. At about 50 I went to a urologist with a prostate infection, showed him the curve that had recently happend and he said I had peyronies. He did a blood test that showed my T was low.

E2 - Estradoil is a good number to know. Testosterone Replacement can put you in the high normal range. The drug some recommend to lower E2 is a female breast cancer drug, not available on medicare part D to males. Dr. Milam said that the side effects of the drug are worse than high normal E2 and recommended I not try it. Myself I can not tell the difference what ever my E2 level is.

By the way I did try DIM for E2 and am allergic to it.

Jackp

young25

Quote from: jackp on August 25, 2009, 07:08:30 AM

Dr. Milam said that the side effects of the drug are worse than high normal E2 and recommended I not try it. Myself I can not tell the difference what ever my E2 level is.


Jackp

I was not aware of this. My doctor is againt high E2, he suggests high E2 is as bad as Low T & some of his patients from their personal experience says high E2 interfers with the ability to maintain erections. Infact high E2 as well as Low E2 is not good, it should be mid range.

Woodman

Jackp- I just received my testosterone results from Dr. Levines office about two weeks ago. You guys mite find this interesting but the doctor only test for total testosterone. He doesnt check any of the other factors that you all mentioned. I guess next time I see my GP I will have to go over all the information and let him do the test. Hes a nice guy and is open to helping you with that extra step you need sometimes. Hes the person who finally help lead me to a Uro that treated Peyronies Disease patients in my area.


jackp

Woodman

All the local urologist I have been to only check total testosterone. I was talking with my primary care doctor (PCP) one day and he said that he thought he could help.

It had been three weeks since my last T shot and the blood work came back very low, 120 on a range of 250 - 850. The total free and bioavailable were also very low.

I have been going to my PCP for my TRT for almost 3 years and he has helped me much more than the local urologist. On my first visit to Dr. Milam at Vanderbilt I showed him copies of my blood work and treatment. He said that my PCP was doing it the right way.

Your total T can be just in range and the free and bioavailable low. For maximum benefit the free and bioavailable need to be about 65% of the lab range.

Jackp  

newguy

The study from a while back seemed to suggest that the lower the testosterone the worse the curvature. Someone pointed out that T levels drop with age and that most guys with peyronie's are older. That's a fair point, but I wonder if the younger guys have lower T levels too. I don't think that data is available. The study also noted much more of a link between low free testosterone levels and curvature than total testosterone and curvature, so I'm really surprised that Levine only measured total testosterone.

What is particular to free testosterone that isn't to total testosterone? Can anybody think why it might be related to increased curvature?

This study (http://www.ncbi.nlm.nih.gov/pubmed/16686726) notes that free testosterone is related to the quality and frequency of nocturnal erections, and "when ED is more severe, it is more probable that free testosterone levels are below the 'normal' limit." This recent japanese study specifically links low free testosterone with ED.  I propose that the worsening of the curvature in the men in the study below is directly linked to a lack in frequency and quality of both daytime and nocturnal erections.

For people who come here and are afraid of getting regular erections because they feel it will make their condition worse, maybe this kind of info will help them understand that regular erections are a very good thing. Successes with the VED and the increased oxygen levels in the penis when in n erect state (https://www.peyroniesforum.net/index.php/topic,961.msg22351.html#msg22351), really do press the importance of getting erections literally as regularly as humanly possible especially when in the active stage of the condition.


A reminder of the original testosterone/peyronies study:

QuoteAs testosterone (T) has been shown to influence wound healing, and serum T declines in the age group at risk for Peyronie's disease (Peyronies Disease), we explored the possibility that low serum T may be associated with Peyronies Disease. Aim. 

The purpose of this study was to evaluate the relationship between serum T concentrations and features of Peyronies Disease. Methods. 

Medical records were reviewed for 121 consecutive patients with Peyronies Disease seen over a 2-year period. All patients were assessed for sociodemographic data, medical history, comorbid medical conditions, findings on physical examination, and severity of curvature. Laboratory testing included serum concentrations of total testosterone (TT) and free testosterone (FT). Testosterone deficiency (TD) was defined as TT values less than 300 ng/dL and/or FT less than 1.5 ng/dL. Main Outcome Measures. 

Prevalence of TD in men with Peyronies Disease and correlation of TT and FT with severity of curvature and plaque size. Results. 

Mean patient age was 53.9 ± 10.6 years (range 28-77). Penile curvature was 50.2 ± 23.6 degrees (range 10-120). Mean TT was 411.6 ± 203.6 ng/dL (range 69-877), and mean FT was 1.12 ± 0.58 ng/dL (range 0.13-5.06). Low T was identified in 29.5% by TT alone and in 74.4% overall. Severity of curvature was greater for men with TD compared with men with normal T (54.3 vs. 37.1 degrees, P = 0.006). Men with low FT had greater penile curvature than men with normal FT (37.5 vs. 55.9 degrees, respectively, P = 0.003). Severity of penile curvature correlated significantly with FT (r = −0.314, P = 0.016) and estradiol/T (r = 0.476, P = 0.0001) but not TT (r = −0.199, P = 0.138). Conclusions. 

This pilot study suggests a possibly important relationship between low T and Peyronies Disease. Further prospective studies are needed to confirm this relationship

despise

I am 18 years old with peyronies. My urologist wanted me to have a testosterone test because I told him about me no longer getting day time erections. It is simply impossible for me to get horney even when I was making out strongly with my girl friend. I talked to him about it and he thought that the test was most likely uneccessary, however reading about this I am now convinced I should get the test. Before I had peyronies and I mean the day before I had it, I could get erections just thinking about any girl. What do you guys think about this? It seems quite odd that I can only get night time erections.  

newguy

despise- Is it literally impossible for you to get daytime erections even by manual stimulation? If you get get erections manually that is the main thing. It might be worth getting your T-Levels checked out, but since you're perfectly able to get night time erections, everything is in working order, so this may be an anxiety issue.

skunkworks

A bit more info would help despise. If you can manually get erections, and you have nocturnal erections, then this problem may be simply adrenaline and or worrying about being able to get an erection.
This is an emotionally destructive condition, we all have it, let's be nice to each other.

Review of current treatment options by Levine and Sherer]

newguy

Quote from: skunkworks on October 12, 2009, 04:06:56 AM
A bit more info would help despise. If you can manually get erections, and you have nocturnal erections, then this problem may be simply adrenaline and or worrying about being able to get an erection.

I agree. Please let us know the answer to

a) Are you able to achieve daytime erections manually (as in my stimulating yourself with your hands)?

b) When your erection is hard is it straight? If you don't get erections in the day, is your nighttime erection straight?

Looking through your posts I note that you have bladder and urethra pain. You say "After I ejaculate urinating stings. You mention that your penis "curls up towards the left". I'm struggling to understand muhc of this really. In relation to peyronie's it is the state of your erection that is most relevant.   You mention somewhere that it's "stuck pointing downwards", then other times to the left and to the right. If on any of these occasions are talking about a flacid or semi flacid penis, then that is where the confusion is coming from. From this moment forward please only discuss the state of your penis when fully erect because it will be easier for people to understand where you are coming from.

Many of these symptons have nothing to do with peyronie's disease. It does sound to me that there is a problem (the pain etc). I really don't know what that problem is though. Of course it's possible that you have peyronie's in addition to this other problem, but the descriptions are very hard to follow. We are here to help, and I really do want to get to the bottom of this, so can you answer a) and b). Thanks!!

despise

I apologize guys!
1) I can achieve a erection with stimulation, its just everything has changed with peyronies. It takes a rather long time to get fully erect but there is no anxiety involved.
2) My erection is curved to the left and upward but when i say upward i don't mean its curved upward its straight but pressing up against my stomach which my urologist told me is normal.

I'm not to sure if a testosterone test is necessary or not and I don't think I want to have one because I simply can't afford it. I guess my worry was that I don't get erections like I use to. I mean seriously right before peyronies I would just get a erection looking or thinking about girls. Now its all different but I know that is probably due to the peyronies. My penis now doesn't have much sensation at all, including the skin.  

nemo

I may have mis-posted this in the wrong forum, alternative treatments, so here it is again:

Had my annual meeting with my Men's Health guru doc, Romeo Mariano, in Monterey, CA yesterday. He'd been working on me for a year with diet, vitamin and supplement treatment to address adrenal fatigue, low energy, low frequency of nocturnal erections, etc.  Mixed results so far, but I am definitely healthier for it - diet is good, irritible bowel resolved, etc.  But one thing we've always discussed was my testosterone levels, which he wanted to see if we couldn't get up through a more holistic approach first.  Not a lot of success in that regard.  I'm 38 and in the last two years of measuring, my Testosterone has averaged in the 400s, while my Estradiol is averaging around 14.  Both are considered low for a man of my age.

So ... Dr. M has now put me on Testosterone.  I'll be injecting once a week, 100mg of Test Cypionate. I must admit, I'm a little scared, but it's something I've wanted to try for a couple years now, ever since I had my Uro check my Testosterone and it came back 235!  He sluffed it off, but I knew that was way too low.  Even in the 400s, I know I don't feel like I'm as healthy and energetic as I should be.  So, we'll see.  I'm a little worried about growing hair like Sasquatch and of course will be watching my prostate, but this literally (I hope) could be a turning point in life for me.  

On another front, I asked him about Low Dose Naltroxen, but we didn't have time to get into it.  I have both Peyronie's and Vitiligo, which are auto-immune, and he said we'd talk about it next time we talk by phone.  He sounds like he'd be open to trying it (he's very open minded and receptive to off-label type things when he thinks they're warranted.)

I'll keep you posted.  

Nemo  
51 yrs. old, multiple auto-immune conditions. First episode of Peyronies Disease in 2002. Recurred a couple times since. Over the years I have tried Topical Verapamil, Iontophoresis, all the supps and Cialis + Pentoxifylline. Still functional, always worried.

MikeSmith0

I don't have a link to the study, but I met with a well-known uro & men's health specialist recently who told me about this.  (he treats a lot of hormonal stuff w/ men in addition to being a urologist)  I don't think this is the case with me given my T numbers, but he said he heard anecdotes from all over the country that T supplementation reduced Peyronies Disease plaque size.  T also drops with age, which correlates with Peyronies Disease occurence.  

So, at some point recently (perhaps in response to the anecdotes), a controlled study was done where animals had their T blocked, and subsequently the thickness of the tunica thinned out to 25% of normal.  Quite dramatic...for just blocking T.

Interestingly, prior to Peyronies Disease I had serious "turtle" syndrome for about a year... but no plaque or anything.  What I mean by this is that, when sitting, my penis would literally retract into my body (and I don't have excess fat in my pubic area) - but it would still be pulled in and i'd be like "wtf is that about?"  because it was sort of odd to feel - but i did not think more of it. I also had poor erections arond the same time,  and ultimately I think I had some kind of minor minor trauma which led to Peyronies Disease...which wouldn't have happened if my erections were full & solid and the tunica was stronger.  (I think i might have slightly bent my penis upward during sex which didn't really hurt at the time much - and wouldn't have happened under normal circumstances, but due to the poor erection - it happened)

Anyway, he added that most doctors misinterpret T results...and ordered an extensive pannel of tests which included SHBG, Free T, Prolactin, and a few other sex hormones.  I'll know the results next week I think - though I had these tests done a year ago and they looked normal... but then again - he said that "normal" is not necessarily what the lab ranges say it is... so we'll see.  

Just wanted to put that out there.

George999

Mike,  I suggest you read this:  http://consumer.healthday.com/Article.asp?AID=644603

Testosterone is becoming one of those situations where the common wisdom among doctors may just be terribly wrong.

Life Extension recommends that ALL older guys have their T levels checked.  They also recommend aggressive repletion if T levels are out of the optimal range which they define as Free T = 20-24pg/mL and Estradiol = 20-30pg/mL.  They claim that proper Estradiol levels are just as important as proper T levels for men.  They have a track record of crossing conventional medical wisdom and ending up right multiple times.  I really suspect that men are dying because doctors are not properly dealing with their T issues.  - George

Lennyman

Peyronies is mostly caused when an incident or accident happens with a semi-erect penis. A semi erect or forced erection is a result of low test.  High or normal test levels produces a strong erection which is much more resistant to bending or breaking. Kabishe?   Lenny
Lenny was here  :)

MikeSmith0

Quote from: Lennyman on October 30, 2010, 07:44:38 PM
Peyronies is mostly caused when an incident or accident happens with a semi-erect penis. A semi erect or forced erection is a result of low test.  High or normal test levels produces a strong erection which is much more resistant to bending or breaking. Kabishe?   Lenny

There are (a) a lot of other causes (including many that are unknown) of Peyronies Disease unrelated to testosterone - e.g. men w/ prostate cancer and (b) more things than testosteone are responsible for erection quality.   Blanket statements are just idiotic (and the word you are looking for is capisce in Italian...or capish / kapishe in english...not "kabishe")

Lennyman

Hey Mike or should I say Mr. Smarti Pants,  I said most.  Masturbating or rough sex with a week erection I believe is the #1 cause.just my 2 cents.  Lenny
Lenny was here  :)

George999

The REAL question is WHY some men end up with Peyronie's after being injured and others don't.  THAT is the question that baffles the experts.  It is very similar to the question as to why some people get a lot of scar tissue after surgery and others don't.  The answer to that question has to be metabolic, which implies much complexity and the probability of multiple pathways.  Certainly testosterone fits into that picture.  IF low testosterone causes a weakening of the TA which this study seems to demonstrate, that *would* create a propensity toward injury.  It would not, however, necessarily demonstrate a propensity toward faulty healing which is a hallmark of Peyronie's.  Thus the ultimate conclusion becomes multiple metabolic factors initiated by injury which can be as simple as turning over in bed with an erection, weak or otherwise.

On the topic of testosterone itself, I will repeat something I have brought up around here multiple times.  Body fat turns testosterone into estradiol (estrogen).  One of the most effective ways of maintaining a healthy testosterone/estrogen balance is weight management.  And this whole issue is extremely perverse because, while weight gain CAUSES low testosterone, low testosterone also CAUSES weight gain.  This is why guys who are significantly overweight really need to understand the metabolic processes going on underneath the issue in order to effectively lose weight and get their life back.

- George

skunkworks

Quote from: George999 on October 31, 2010, 11:09:09 AM
The REAL question is WHY some men end up with Peyronie's after being injured and others don't.  THAT is the question that baffles the experts.  It is very similar to the question as to why some people get a lot of scar tissue after surgery and others don't.  The answer to that question has to be metabolic, which implies much complexity and the probability of multiple pathways.  

I wouldn't say that it has to be metabolic. Externally, some people seem to have a propensity for scarring. A simple scratch that would disappear without a trace in one person, can leave a scar in another.  It could very well be a simple genetic difference.
This is an emotionally destructive condition, we all have it, let's be nice to each other.

Review of current treatment options by Levine and Sherer]

George999

It is now known that genetics are to a large degree programmed by metabolics through epigenetic pathways.  Environmental factors also influence metabolics which in turn switch epigenetic tags on and off with significant health consequences.

Lennyman

There are severe mechanical causes- injections, surgery-these are irreversible because the tissue is punctured.  Moderate damage to the tissue- the strecher- bad move- you are trying to heal the tissue the same way you damaged it.  I recomend the ved to all trying to heal-and a multi vitamin and fish oils and the amino acids is the only one that worked on this site.  Lenny
Lenny was here  :)

restore

Anyone have any thoughts whether lower DHEA levels in middle age men may contribute to getting Peyronies?  I've read that it is s precursor to testosterone and falls off rather quickly after 40.  Also read that supports virility in men and promotes sexual health.  I'm wondering if I had continued to take DHEA supplements (as I started to when I turned 40) if I could've healed much better and bounced right back after my injury during sex. I'm now 49 and just was diagnosed.

David  

LWillisjr

I've read where there is a link between DHEA and Testsoterone. DHEA is state to be a "prohormone" to sex steroids (testosterone and estrogen). So I think they may be indirectly related. If DHEA levels drop, and conversely testosterone levels drop, then this would result in weaker erections. Still rigid enough for penetrative sex, but not like the 19 year old erectino we all remember. And with weaker erections one is more susceptible to trauma or bending during sex. And this can trigger the scar formation that can lead to Peyronies Disease.
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

George999

I was taking a bit of DHEA for a while recently.  Amazingly, it made me feel great.  I only stopped it because I had too since it was causing my BP to rise.  This *can* be one of the side effects and guys with hypertension like myself need to watch out of that.  I am hopeful that I can eventually be able to tolerate it, since it was benefiting my general health in so many ways.  I found that it gave me increased energy and just made me feel good and feel more healthy.  - George

slowandsteady

I have added 50 mg DHEA to my regimen. I had been taking only pregnenolone (50 mg/day) in an effort to increase my DHEA-S. Just the pregnenolone increased it to 160 ug/dL (I think they were about 60 before -- pretty low). In a consultation with a LEF doc, it was suggested I take DHEA in addition to pregnenolone, since they like to see the levels even higher.

I haven't noticed much from it, but I'm looking more at the blood tests than for how it makes me feel. I'll get my levels rechecked in the spring. Some men report that it makes them cranky. I don't know if there are any advantages to raising DHEA-S entirely with pregnenolone.

GS

I started taking DHEA about 15 years ago to boost my sex drive.  It worked for me, but it also made me very quick to anger.  I didn't tell anyone in the family I was taking it...first my wife commented about how quickly I was losing my temper and then my son said something to me about how quickly I was getting angry at people.

After they both made comments to me about my anger issue, I quit taking it and everything went back to normal.  A few years later, I started testosterone replacement therapy, but I have not had any anger issues since the DHEA.

So, if you are taking DHEA, anger and the "fight or flight" issue is something you need to be aware of.

GS

George999

Check this study out:  http://consumer.healthday.com/Article.asp?AID=658089

This could indicate that male hormone levels are more important to a healthy penis than previously thought AND inadequacy of certain male hormones just might be a factor in Peyronie's.  - George

mark2

Hello everyone,
 I went to a uro and he said I had peyronies and I should use topical testosterone.
Well I don't want to do that because my wife has had breast cancer.
And I don't want to have that in the house. He also said that I
can't have testosterone injections because I take Plavix.
My question is what can I do to increase my testosterone other than topical cream or injections?
Thanks
Mark

George999

Mark,

Two points:

1)  There are several drugs/supplements that have been shown effective for Peyronie's in research studies.  Testosterone is NOT one of them.  NONE of the Peyronie's specialists we know of around here uses Testosterone as a primary treatment for Peyronie's.  That would indicate to me that you need to be looking for a second opinion from someone, either a uro or a sexual medicine specialist, who is a *recognized* Peyronie's expert.  The rest of them are just taking shots in the dark.  Don't waste your time.  My suggestion, based on where you live in Pennsylvania, would be that you try to arrange an appointment with Dr Levine in Chicago.  Hopefully someone else hear on the forum can recommend other alternatives, but Dr Levine is really not that far away from where you are.

2)  When it comes to Testosterone, the patches [or injections] is [are] really the best approach.  Injections [Pills] come with multiple risks, patches are pretty foolproof.  With cream the problem is getting the dose right and making sure the cream does not get where it does not belong.  The other systemic alternative is DHEA along with other supplements that can boost Testosterone effectively as well.  Doing that requires regular blood testing to make sure you are getting it right.  I am doing that myself.  BUT ... this is *not* likely to help your Peyronie's to any significant degree.

- George

Luciano

its like smoking and lung cancer.. if you smoke you have more chances to get lung cancer than a non smoker.
But if you quit smoking, it will not heal the lung cancer, and also people who dont smoke can get lung cancer.

I think george is right. High Testosterone levels wont heal peyronies.

But there have been some studies, (cant remember where) that say that most of the men affected by peyronies have low testosterone levels.

That does NOT mean that getting your testosterone level to normal will heal your penis. (Like quitting smoking wont heal lung cancer)

It just means that if you have peyronies you probably also have low testosterone.

Anyway, If I were you i would get my blood checked, and talk to my urologist to fix the testosterone levels. talk to him, tell him you would prefer patches. or discuss an alternative .

This will help you in your everyday life, but like george I think it will NOT cure your peyronie's.

Luc


mark2

Thank you for your replies. I did have blood work done and was told 300 is normal for my age and I was about 265.
It is only a little over 10% low. I just thought something non perscription would help me. I have other symptoms.
That I have read could be caused be low testosterone. I didn't think that testosterone would cure my peyronies.
I am going to talk to my GP about it again. I guess he will tell me to look for another URO.
Thank you very much for replying to my question!!!
Mark

jackp

Mark

I have been on testosterone replacement therapy (TRT) for about 20 years. Pills, patches, gels and shots.
Pills are not recommended because of liver damage.
Patches have to be changed every day and cause skin irritation. Come off when you wash or swim. Hard to adjust dosage.
Gels are messy and you do not get a reliable dosage. You can also transfer the gel to your partner.
Shots work best for me. The key is you have to not only know your total T but your free T and bioavailable T also. Of these your free T should be at least 65-70% of your lab range. That can cause your total T to go to the maximum but it is not a problem for modern urologist or male sexual function specialist. Shots should be no longer than 10 days apart and you need blood work every 6 months.
For me my primary care doctor is better at treating my T than any urologist I have been to. Even Dr. Milam at Vanderbilt said he was doing it the right way when I showed him my blood work and injection schedule.
Don't buy into the theory that high T can cause prostate cancer. There is an article by Dr. Morgantaler of Mens Health Boston that reputes that theory. Look at it this way, young me have a high testosterone level and they do not get prostate cancer. When I told my local urologist this he had no responce!

Just my 2 cents.

Jackp
http://jackp-penileimplant.blogspot.com/  

George999

When it comes to things like Testosterone, "normal" is *not* optimal.  "Normal" levels of Total Testosterone range from 241-827ng/dL, depending on age.  Optimal levels of Total Testosterone range from 500-827ng/dL REGARDLESS of age.  More importantly, Free Testosterone should be in the upper 1/3 of the range.  So if you are at 300ng/dL, you WILL suffer from Testosterone deficiency.  But the medical establishment believes that because most men tend to have ever declining levels of Testosterone, that it is then "normal" and, on that basis, refuse to treat it.  There is now sufficient research to indicate that low levels of Testosterone cause all sorts of problems from higher risk of heart disease to higher risk of prostate cancer.  But in order to get all of this sorted out, a full hormone panel needs to be done testing for:

Total Testosterone
Free Testosterone
Estradiol
DHT
DHEA-S
PSA
LH
SHBG

Bioavailable Testosterone can also be tested, but it is a function of the relationship of Free Testosterone and SHBG.  The higher the level of SHBG, the lower the level of Bioavailable Testosterone.  Once these are all sorted out, there are various drugs and supplements that can address resulting anomalies which can be quite complex in some cases.  For example, Free Testosterone can be raised WITHOUT raising Total Testosterone and Bioavailable Testosterone can be increased without raising Free Testosterone.  But first you have to see the whole picture, not just a piece of the picture.

Each of these needs to be in the optimal range in order to experience optimal health.  Getting them in the optimal range will *not* reverse current disease conditions like Peyronies.  In fact, in some cases (such as prostate cancer, for example), it might aggravate them.  But getting levels in the optimal range *will* prevent more disease conditions from resulting.

The same story applies to other blood parameters.  For years the medical establishment accepted fasting serum glucose levels of over 100mg/dL as being "normal".  Many physicians still do accept such levels.  But the official standard now considers anything over that number to be "pre-diabetic".  The research, however, indicates that any serum glucose reading over 85mg/dL raises disease risks, including risk of Peyronie's.  I just recently dug up a lab sheet showing my serum glucose level to be 135mg/dL right around the time that I developed Peyronie's.  Bingo!  I now have that down to around 93mg/dL and am struggling to get it down further.  There is also research out there hinting that getting serum glucose levels down low enough *can* result in significant repair of chronic damage such as that which occurs with Peyronie's.

Again with Vitamin D levels, same story.  The medical establishment has long considered 20ng/mL to be "normal".  We now know that much higher levels, 50-70ng/mL, are optimal, and new research by American Heart Association is indicating that even higher numbers may be beneficial, but anything over 100ng/mL can cause problems.

And I could go on and on.  Most doctors do not keep up with the pace of research and rely on numbers from the days when there was no research to base them on, but only speculation.  - George

George999

Quote from: jackp on November 24, 2011, 09:14:20 PM
For me my primary care doctor is better at treating my T than any urologist I have been to. Even Dr. Milam at Vanderbilt said he was doing it the right way when I showed him my blood work and injection schedule.
Don't buy into the theory that high T can cause prostate cancer. There is an article by Dr. Morgantaler of Mens Health Boston that reputes that theory. Look at it this way, young me have a high testosterone level and they do not get prostate cancer. When I told my local urologist this he had no responce!

Urologists are NOT endocrinologists no matter how much they might try to represent themselves as such.  I am not surprised that a primary care doctor could have a better understanding of male hormones than a urologists.  Urologists are primarily trained to manage your plumbing, NOT your hormones or your sexual functioning.

It has long been known that sex hormones can fuel breast and prostate cancer.  From that most in the medical profession came up with the idea that these types of cancer where *caused* by sex hormones WITHOUT any direct evidence for that assertion.  At this point all of the research out there is indicating that sex hormones DO have a role in causing these diseases.  But the problem is not normal levels of sex hormones, but LOW levels ... sub-optimal levels.  So the thing to do first BEFORE embarking on a hormone repletion plan is to RULE OUT any possibility of EXISTING Prostate Cancer first.  Then get hormone levels into the optimal range.

Bottom line is that we agree on these issues.  As for injections, I was wrong on that one, injections are fine, its the pills that have the problems, thanks for correcting me on that.  - George

hunchback

Quote from: George999 on November 24, 2011, 09:26:37 PM
When it comes to things like Testosterone, "normal" is *not* optimal.  

I have a progressive NP who uses http://www.diagnostechs.com/Pages/MHPProviderOverview.aspx to test hormones. It is relatively inexpensive.

Also important is thyroid, which they don't currently test for with the spit test. This is good site for thyroid http://drrind.com/therapies/thyroid-scale and the idea for optimal levels of hormones.

Granted my NP is not an endocrinologist, and she tends to use formulary gels, however i feel better than i have in 20 years (which is anecdotal rather than scientific).

hunchback

jackp

George999

I was sitting here reading the post on Testosterone and one thing crossed my mind. The difference in attitudes about things that involve men and women.

Women talk openly about hormone therapy, mostly patches these days. Also about breast cancer, breast implants and breast reduction. Even TV shows about how women like to have sex. Seems like my wife is telling me a lot about what Dr. Oz or Dr. Phil has to say on the subject.

On the other hand. Men do not talk openly about testosterone replacement, prostate cancer, and there sexual desires. Viagra brough ED out of the closet. Peyronies is a word most men don't even know exist. If you say penile implant a lot of people look at you like some kind of pervert.

Women are hung up on the size of there breast. Men are hung up on the size of there penis. In reality the size of a woman's breast does not make her a woman no more than the size of a man's penis makes him a man.

When I was in the hospital I don't know how many times I was asked about the surgeries I have had. When I was put in a room a female nurse about 35 came in and asked me all the routine questions including surgeries. For some reason I told her I had surgery for peyronies. You could see all the question marks go off in her head.  ??? She said she had been a nurse for 10 years and never heard of it. I gave her a brief explanation. Then she asked what kind of surgery. I told her I have a penile implant. Even more question marks in her head.  ??? She again said she never heard of one. Then she asked how it worked and I gave her a brief expiation of how it worked. She seemed genuine and wanted to learn. It did not emberass her or myself to talk about it, but I kept it as clinical as possible.

Porn has men thinking bigger is better. Movies have women thinking the big breast are what men are after. In real life the only thing that counts between a man and woman is how they feel about each other. The size of there sex organs and/or breast only counts in the movies.

My thoughts. Jackp

George999

Quote from: hunchback on November 25, 2011, 09:05:47 AM
Granted my NP is not an endocrinologist, and she tends to use formulary gels, however i feel better than i have in 20 years (which is anecdotal rather than scientific).

hunchback

Actually, some NPs often know quite a bit about endocrinology and so do some other primary practitioners (MDs, DOs, NDs, etc).  Its mainly the specialists that are the problem.  What I find odd is that many specialists seem to simply reject endocrinology.  Look, for example, at who has been fighting against vitamin D supplementation.  Its generally oncologists and dermatologists who have even gone to great lengths to debunk vitamin D with ludicrous research studies that are rigged to fail.  Why?  I hate to think that they perceive widespread optimization of vitamin D levels to be a threat to their businesses, but why else?

Urologists follow a similar pattern although in their case it seems more out of ignorance than a matter of self interest.

The new issue is iodine, it will be interesting to see how that works out.

- George

George999

Quote from: jackp on November 25, 2011, 10:17:10 AM
George999

I was sitting here reading the post on Testosterone and one thing crossed my mind. The difference in attitudes about things that involve men and women.


I think that part of it is that women are not seen as being capable of being perverts while men are not seen as being capable of *not* being perverts.  That is why doctors tend to rush to give women hormones while even (especially) men doctors seem to be terrified of offering hormones to men.  The exception is endocrinologists and a significant number of primary docs.  Its like "you are already a dirty old man (the fact you are even thinking about hormones is evidence of that) and you are still not satisfied".  But the problem with this attitude, of course, is that hormonal balance is far more than just a sexual issue.  Its a very important general health issue.  - George

trevorrr

This testosterone talk is getting out of control. Matter of fact I hate the word, my entire team was on TRT its the BIGGEST greasy loop hole in sports. You simply get are team docs to give us a script and say were Low t which is bogus, next thing yeah know we are all banging are heads off the wall pumpin serious iron and ready to murder the apposing teams quarterback, it actually LED to my injury due to over anxiousness and aggressiveness sexually. Testosterone has ZERO to do with peyronies. Ive had so many long discussions with my all the medical profs about testosterone probably 10 fold the average person, I'm actually struggling to slightly lower my levels. having slightly lower testosterone is much better than having slightly above when it comes to older gentlemen, there are many many issues that come with TRT and many docs would choose to avoid it in general, It is used a scape goat for many things when it comes to senior males. My class actually just did a recent study about the topic and I am very pleased to share the results with my peyronies family here. Older men generally do nothing to create natural testosterone that's just life also they are creating less any way as they age, however they took a bunch of men who were supposedly low testosterone and had them do SIMPLY leg works out such as light weight squats or general quad and hamstring exercises using the machines every gym has. 3 days a week and they all showed improvement. Leg work outs is where major testosterone and growth hormone is released, we get alot of guys on the team who say they only want upperbody strength so they dont need to do legs and us who know the science of training simply laugh because doing leg work outs will actually help ur arms more than the arms themself!


Now the funny thing is were all on Pentox which does wonders for your legs matter of fact i believe that's what its intended for. So it can be your best friend when it comes to lower body exercises. Give it a try before you try TRT you may be very surprised.

Also as a personal update every since i  have added low dose cialis and pentox Ive been showing improvements and for some reason I also have had better erections when I dont ejaculate, Ive continued erections however I'm consciously not ejaculating and things seem so much better my uro believes that yes some with peyronies do get bad reactions with ejaculation and also the contractions and the pulling in of ligaments during ejaculation could be affecting my own specific case and he is very munch in favor of me not ejaculating for as long i can without getting carried away which i found incredibly interresting considering that ejaculation has some how worked its way into the equation

George999

trevorrr, I fail to see how the use (misuse) of steroids as a performance enhancer for sports has anything whatsoever to do with the use of testosterone in older men for health reasons.  You ONLY have bad side effects from testosterone when you increase it to unnatural levels.  There are a lot of men out there on testosterone who are experiencing major health improvements as a result of *responsible* testosterone augmentation.  None of them are experiencing "roid rage" if they are properly managing their levels with testing.  The use of steroids for sports is a racket.  It has absolutely zero bearing on the legitimate use of steroids for bona fide medical purposes.  The whole argument that older men produce less testosterone so thats the way it should be does not make a whole lot of sense either.  Older men these days tend to have their blood glucose shoot up to diabetic levels as well.  We don't say "well that is occurring with a large percentage of older men these days so we will just consider it *normal*."  We treat it.  Older men also loose all their teeth before long without intervention, we don't label that as normal either.  I would also wager that most guys around here who care enough to deal with their testosterone levels are also on a serious exercise regimen as well, but there is only so much you can accomplish with that strategy.  Those of us who are working on boosting our testosterone levels around here are doing it for health reasons, NOT as a "performance enhancer" either in terms of athletic ability OR in terms of sexual performance.  That is what lots of people don't seem to get.  In fact, your post is a virtual "poster boy" for my previously posted argument regarding all the bias in the medical profession against testosterone.  - George

George999

Old Man,  I agree COMPLETELY with what you are saying here.  Any RESPONSIBLE advocate of Testosterone therapy will include that caveat up front.  In my own case, I was advised that I should have complete screening before taking this step even though I have never had prostate cancer AND I am not using testosterone directly.  The recommendations I am seeing also advise continuing to get regular testing for prostate cancer while on any type of testosterone elevating therapy.   But certainly it is important to consider ALL of the risks when embarking on any therapeutic regimen.  - George

jackp

George / Old Man

Proper Testosterone treatment for us older gentleman has a lot of benefits. One thing it will not help is ED.

I have been on TRT for about 20 years. My regular doctor told me back in 2008, when I almost died in the hospital, that having my testosterone levels at optimum levels helped give me the strength to survive. The testosterone gave me the physical strength. My wife, faith and prayers gave me the spiritual strength.

Again when I was hit while walking by the truck 8 days ago. Having an optimal testesterone level gave me the physical strength I needed.

Yes, your treatment must be properly managed. I have my blood checked every 6 months, a PSA, DRE and ultrasound every year.

I am asked often by other men how I stay so active at 69 years old. I tell them proper testosterone treatment. The gentleman I work for is 11 years younger than I am. I have known him for over 20 years. One day he asked me how I stayed active and I told him. Now he is on optimal treatment and feels much better.

For every one NO. Done properly it will give you many benefits.

My 2 cents.

Jackp
http://jackp-penileimplant.blogspot.com/


George999

Jack, I completely agree.  The research that I have been reading indicates the low testosterone results in wasting of muscle tissue and increases fat accumulation.  Fat powerfully converts what little testosterone is left to estradiol, further lowering testosterone which results in a vicious circle leading to accelerated physical decline.  Testosterone repletion breaks this cycle and tips the scale for a lot of guys.  A lot of chronic disease results, in part, from the buildup of fats in major organs such as the liver and the heart.  It is really essential to break this cycle.  Those guys who do have a greatly increased quality of life as a result.  I would also argue that HGH *DONE PROPERLY* under the supervision of a qualified physician is a useful therapy for *some* aging guys.  The huge problem is when these things are abused as they often are.  It is extremely rare that a younger guy needs these sorts of treatments.  But there are always low life physicians out there trying to make a quick buck by enticing young guys trying to become physical super men.  And these situations usually go very wrong and ruin lives because thats what happens when you artificially boost hormone levels beyond the normal range in an attempt to achieve the impossible.  The other issue of course is that no level of therapy will work without adequate exercise and a healthy diet.  You can't be a couch potato addicted to corn syrup laced treats and expect testosterone to fix everything.  It has to be part of an overall healthy lifestyle effort.  - George