So, at my annual physical, I asked them to check my testosterone levels. The blood test showed my testosterone level at 439, which is in the "normal" range, so I was fine. But looking at different charts, The average level for my age (41) should be 650-675...

So, I was thinking about looking into testosterone therapy. Wondering if anyone has gone through it, and what their thoughts are? Should I go through my primary care doctor, or go to a specialized testosterone center?

Thanks!

Here is what is going to happen if you go to your primary doctor. They'll send you to an endocrinologist to check out if everything is okay. They'll run a bunch of tests to fix to find out what you already know. They will then tell you since you are in the normal range that they don't want to risk heart issues or liver issues. So you will be stuck feeling less than you could.

Now if your primary care doctor is any good, he'll put you on a script, monitor to get you where you should and then monitor yearly to make sure you are good. But I doubt your doctor will listen or is any good. Plus they gotta make their money.

Test clinics are expensive and you insurance probably won't cover it since you are in the normal range.

If primary is any good go to him.

FWIW - if you were a woman and complained of hormone issues, they would write you any script you want.

What Hoose said. Most insurances don't cover any treatments, and those test centers are there to sell test injections and they want you to come in every week. That adds up quick because once you're on you're not getting off.

I went to a urologist and they confirmed and then got me started on Clomid. 209 to 900 in about 5 weeks.

Where are you located?
I was around 250 and got started on injections that I do myself at home once a week. I'm around 700 give or take now and feel 10x better. It runs me about $1-2 per week.

I live in North Dallas. Did you go somewhere to get the injections?

I'm in Houston. I went to a clinic that specializes in hormone therapy, but I also had some other stuff going on post thyroid cancer.
They prescribed the testosterone and I just get it filled at my normal pharmacy.

07fta07 said:

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Where are you located?
I was around 250 and got started on injections that I do myself at home once a week. I'm around 700 give or take now and feel 10x better. It runs me about $1-2 per week.

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What's your protocol?

0.5 ml of 200 mg/ml testosterone cypionate once per week after doing 1.0 ml the first 4 weeks.

cochrum said:

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As someone who prescribes testosterone....yours is normal. My group would not prescribe anything. Need to find other reasons why you are tired. All these commercials about testosterone make men think they always need it but it's not true.

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Yeah, the Dr's office shows anywhere from 300-890 being normal.. But everything I have read (Not from the testosterone facilities) and the charts I have seen show that a 35-44 year old should be closer to 650... So it seems like while I may not be officially in the low range, I am definitely lower than the average person my age..

07fta07 said:

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0.5 ml of 200 mg/ml testosterone cypionate once per week after doing 1.0 ml the first 4 weeks.

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What's the reason to front load like that? Are you on any AI and/or HCG?

Following doctors orders, and yes I am but can't remember what off the top of my head.

aggie34 said:

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cochrum said:

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As someone who prescribes testosterone....yours is normal. My group would not prescribe anything. Need to find other reasons why you are tired. All these commercials about testosterone make men think they always need it but it's not true.

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Yeah, the Dr's office shows anywhere from 300-890 being normal.. But everything I have read (Not from the testosterone facilities) and the charts I have seen show that a 35-44 year old should be closer to 650... So it seems like while I may not be officially in the low range, I am definitely lower than the average person my age..

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Everyone has their own normal. Don't do test replacement therapy to shoot for a number. One person may feel fine at 300 while another feels low at 600. If you feel fine, leave it alone.

I'm only 31 and was around 250 and while they acknowledged that it was on the low end, they wouldn't have prescribed based on the number alone.

RedlineAg08 said:

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What Hoose said. Most insurances don't cover any treatments, and those test centers are there to sell test injections and they want you to come in every week. That adds up quick because once you're on you're not getting off.

I went to a urologist and they confirmed and then got me started on Clomid. 209 to 900 in about 5 weeks.

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From what I understand, Clomid isn't a long term solution. Also, within weeks/months of quitting, you will be back at your baseline.

Lastly, when you say "once you're on, you're not getting off" in regards to TRT, what do you mean? You have to be on it for life? I always thought that once you quit, especially if you cycled off correctly with clomid hcg etc, you would just go back down to your baseline. Are you saying this because no one on TRT with test levels in the 800-1000 range would ever want to go back down to their old 200-400 baseline?

A doctor will tell you you are normal as a 30 year old man with levels in the low 400's upper 300's...because they read that in a book and they have a chart that isn't broken down by age groups. One of a million things they simply memorized to get through medical school. In reality, that is probably more normal for a 65-70 year old man.

No secret that men's testosterone levels have declined sharply in the last 50 years. No clue what the major culprit could be but sitting slouched at a desk 9 hours a day under artificial lighting and grinding it out on our leather asses probably isn't helping as a whole.

I'd probably add the amount of processed food we consume, and our culture as culprits, as well.

I can't speak on the long-term viability of Clomid. I've been on it for about 4 months now and loving it. Actually go in for a check up next week to retest.

HGH and Clomid may get your body producing test again if you were to decide to get off of TRT, but a doctor can't guarantee that. That's all I mean. I would chance it, personally, if insurance paid for TRT, but it's still a risk.

Whatever you need to do to feel better... I workout 6 days a week and with 209 test I couldn't recover for ****, got tired by 2pm and was in bed the moment I got home from work. With 900 test I spring out of bed every morning, workout 6 days a week, recover like a champion, sleep like a baby, have plenty of energy all day long, and have put on 10 lbs of good weight. It's a miracle.

Yea the changes for me getting my thyroid meds and test levels right have made a huge difference. Was able to drop 25 pounds last year (not doing anything differently), sleep well, recover much better, and I'm not constantly tired.

RedlineAg08 said:

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I can't speak on the long-term viability of Clomid. I've been on it for about 4 months now and loving it. Actually go in for a check up next week to retest.

HGH and Clomid may get your body producing test again if you were to decide to get off of TRT, but a doctor can't guarantee that. That's all I mean. I would chance it, personally, if insurance paid for TRT, but it's still a risk.

Whatever you need to do to feel better... I workout 6 days a week and with 209 test I couldn't recover for ****, got tired by 2pm and was in bed the moment I got home from work. With 900 test I spring out of bed every morning, workout 6 days a week, recover like a champion, sleep like a baby, have plenty of energy all day long, and have put on 10 lbs of good weight. It's a miracle.

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Short answer from someone who prescribes hormones and supervises hormone replacement clinics is that no one really has a clue here. There haven't been nearly enough large-scale studies to say anything with confidence. That's getting better though.

We know low testosterone can cause loss of muscle mass, osteoporosis and erectile dysfunction. We know that raising testosterone in the normal level can fix these problems as well as improve cholesterol, reduce body fat, and improve diabetic control. The major risks are hyperviscosity from polycythemia and a possible increased risk of cardiovascular disease.

But if you don't feel right, have the money, and want to see how you feel at a slightly higher level (prob 600-900 is a good goal) then go nuts. Chances of adverse effects seem to be very low in such instances.

ramblin_ag02 said:

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Short answer from someone who prescribes hormones and supervises hormone replacement clinics is that no one really has a clue here. There haven't been nearly enough large-scale studies to say anything with confidence. That's getting better though.

We know low testosterone can cause loss of muscle mass, osteoporosis and erectile dysfunction. We know that raising testosterone in the normal level can fix these problems as well as improve cholesterol, reduce body fat, and improve diabetic control. The major risks are hyperviscosity from polycythemia and a possible increased risk of cardiovascular disease.

But if you don't feel right, have the money, and want to see how you feel at a slightly higher level (prob 600-900 is a good goal) then go nuts. Chances of adverse effects seem to be very low in such instances.

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Is the only real treatment for this to donate blood every once in a while?

Sure if you have polycythema vera which is an inborn condition. If you have polycythemia from testosterone therapy we just cut back or stop the testosterone.

ramblin_ag02 said:

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Sure if you have polycythema vera which is an inborn condition. If you have polycythemia from testosterone therapy we just cut back or stop the testosterone.

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So I am guessing supranormal (i.e. test level of 1200-1300) levels would lead to greater risk than say maintaining a more normal 700-900 level over time? May be a stupid question.

No biggie. To be honest, no one knows. Even "normal" is sort of a guess since there is so much individual variation. Some doctors don't even pretend like they are getting people to normal. They feel they are treating a disease with a drug, and would say that we don't dose other medications (like blood pressure meds or seizure meds) based on "normal". Some of these will use 1000 as an absolute minimum, and some will go as high as your body will stand (even up to 2000-3000). Most of us tend to stick in the 600-1000 range when treating low testosterone since that is typical of many unsupplemented men.

The polycythemia effect appears to be dose related, but it can happen even at the 600-1000 range.

Good info, thx ramblin

So, did y'all have symptoms of Low T and had it tested or just went to annual checkup and that's when you found out? I just switched PCP in July and went for annual in December and this was the first time T was ever included in the blood draw. My previos PCP never did it.

I had symptoms and had it specifically tested. I had suspected it for a while but had put off going to deal with it.

If you asked them to test your levels is it because you don't feel well, or you just wanted it checked? If you don't feel right but your levels are normal then you still have an issue to address, your hormones just aren't the problem. Could be diet, exercise, or even actual depression.

I'm on HRT and have been for about a year at this point. I had some pretty significant energy and mood issues, amongst other things. I'm younger than you and had significantly lower readings. I've been on injections now for a year and I'm at normal levels which has improved how I feel. That being said its not a miracle tool, I would love to feel like I was 17 again energy wise, but getting to normal levels doesn't do that, I feel how I should in my 30s, that's the goal of the therapy.

If you have legit concerns the best thing to do is to see your PRP and then you can be referred to an endocrinologist. The notes about insurance not covering it are wrong. My insurance covers most of it, but I have blood tests to back it up. Those "mens clinics" will basically sell it to you, and good luck at getting any of it reimbursed by insurance. A lot of men can get influenced by the advertising and that is creating a false run on the doctors, which shouldn't prescribe you hormones if you're normal.

That being said it sucks to have to inject yourself once a week, the pain isn't the problem, its mental. I am still feel a lot of shame. Basically my wife knows I'm on it and that's it, its so embarrassing to me, but its a legit medical issue that I'm dealing with, and this is how I have to deal with it. Ignoring it is way worse than pride though.

There are other medications other than hormone injections, like Axiron, but at my levels my endocrinologist said its best to be on the real stuff.

Not sure why you're embarrassed by it. It's a medical issue out of your control just like anything else. It doesn't bother me one bit to take care of myself. I kinda look forward to my injections because I know how much they've helped me. I wasn't embarrassed by my cancer, I wasn't embarrassed by my many surgeries, I'm not embarrassed by low test levels.

I'd be embarrassed by not doing what I could to take care of myself.

Interesting thread and a lot of good information.

Question:

Is it a good idea to get a baseline testosterone test when you're my age (30) to compare when you're older?

Obviously you're going to decrease as age wears on but I am just wondering if having a known level will help you monitor any major drops in test.

Mine is probably above normal right now (for my age - just work out a lot, not supplemented) and have zero issues and don't expect to have any... but is it smarter to just have this as a baseline?

Doesn't hurt to get tested. Ask them to check your test the next time you have blood work done at your annual exam/checkup.

That's the plan. I am curious if I have to specifically ask for those results to be included?

Same with thyroid levels... family and sister have had issues with this and would like to know T2 and T4 (? I think). I guess you can just ask for further analysis? Or do you have to have a doctors permission to get insurance to cover it?

You do have to specify. And then your PCP will say "you don't need to check that until you're 40." Seems to be the textbook answer. Just insist that you'd like to see where you're at.

Thank you!

What time of day were you tested? T drops steadily throughout the day. If you got tested at, say, 3pm and you are in the normal range, don't go to some quack and get drugs. Go to an endocrinologist and find out what's happening.