Young Male with Low Testosterone

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Within the last five years, I have noticed a gradual decline. I never really knew what it was, but I knew something was up. Recently, I went to a doctor and had a full endocrine screening. The results returned were within a 'normal' range, but upon further investigation, I noticed my testosterone levels were MUCH lower than the typical male my age. I then looked up symptoms associated with it. There are many symptoms, but I have nearly half of the ones (that I know of) listed.

Dry skin and/or cracking nails
Youthful appearance
Frequent urination (polyuria) without infection; waking at night to urinate (nocturia)
Irritability
Psychological and relationship problems
Poor sleep
Difficulty concentrating
Memory loss
Depression
Anxiety
Increased abdominal fat
Decreased sexual function
Fatigue

My doctor, however, says that since it is in a normal range, I am fine. But that isn't normal. I am well below what an average male should have. And I have the symptoms associated with it. Also, there might be family history for it since my mom says my uncle had 'male problems' when he was younger.

What should I do? This is really messing with my life. I have no motivation, no passion.

I'm a bit confused. The doctor says you're within normal levels but you know you're not? Is there a chart somewhere that shows average levels?

The levels defined as normal are extremely broad and take into account all age ranges.

IMAGE(http://3.bp.blogspot.com/_hUU8QufjO5U/TEIJyQWhbLI/AAAAAAAABF4/7DKq2k6il6g/s1600/testosteron-2.JPG)

I am in my mid-20s. I am have slightly greater than half of the average male at my age range. That actually places me in the bottom 5% of males my age. The fact that I experience so many of the symptoms associated with low testosterone makes me think that it is likely the culprit.

I know it isn't wise to self-diagnose, but I have heard that a lot of doctors can be very, for lack of a better word, antiquated in their view of normal testosterone levels. Also, who's to say that the level I received back was completely abnormal from what I should be at? Normal is relative. A person that usually has 1,200 ng/dl total testosterone on average would be considered normal at 600 ng/dl despite being completely out of whack with their natural state.

So I just wonder what I should do since the doctor isn't taking me seriously. I know how I feel and I know things aren't right.

Get a second opinion?

Interesting, here is a good article on testosterone and how to increase it.

Visit another doctor. You have to be happy with your doc and you have to be on the same boat. He is your hireling, not your boss. Basic dissatisfaction issues and docs bossing their patients around underlies many spurious and even globally destructive lawsuits.

Not sure what country you're in, but in North America, you'll have no trouble finding a doctor willing to write any script to solve all of your problems. It may take you three or four different visits, but you'll find one.

I'm not advocating looking for a doctor to turn you into a juice monkey. I'm saying that North America is a commercially driven society. It's there somewhere, if you look for it.

I have a friend who works for a drug company as a salesman. He has said, point blank, to me, "our company invented this "syndrome" because we had a drug which got a result not currently associated with any medical conditions". He had no idea that my brother had just been prescribed this drug for this very syndrome. My mother, being a former nurse had already talked my brother out of taking the drug because she recognized it as a dangerous narcotic which is addictive in any dose considered to be effective. What was happening was, the doctors were prescribing it in a dose well below what was considered effective, to avoid the addiction problems associated with it.

So, do your research, and make friends with some medical professionals.

Also worth noting:
Those are all symptoms of being out of shape, and living in Canada during winter.

'cause I'm pretty sure that I don't suffer low testosterone. I do however suffer all of those at some point due to being stuck in a dark basement eating chocolate covered almonds while I work on my computer.

Certis wrote:

Interesting, here is a good article on testosterone and how to increase it.

I was very interested in #9, but my 2 year old and 3 month old conspired against me.

SallyNasty wrote:
Certis wrote:

Interesting, here is a good article on testosterone and how to increase it.

I was very interested in #9, but my 2 year old and 3 month old conspired against me.

My two kids conspire against me as well. I tried to explain it to them rationally, but they don't seem to care. They are so selfish.

Certis wrote:

Interesting, here is a good article on testosterone and how to increase it.

Thanks for the article; however, I am already fitness-minded and do many of the things prescribed in that article already. So my habits are good.

Agent 86 wrote:

Get a second opinion?

LarryC wrote:

Visit another doctor. You have to be happy with your doc and you have to be on the same boat. He is your hireling, not your boss. Basic dissatisfaction issues and docs bossing their patients around underlies many spurious and even globally destructive lawsuits.

I think that might be the best bet, but as a person without insurance, it can be hard to find a doctor. I will try to speak with him again and make him realize he is working for me, not the other way around. Good advice!

Ghostship wrote:

Also worth noting:
Those are all symptoms of being out of shape, and living in Canada during winter.

'cause I'm pretty sure that I don't suffer low testosterone. I do however suffer all of those at some point due to being stuck in a dark basement eating chocolate covered almonds while I work on my computer.

The problem is that I am quite fit. I am an avid weightlifter with a bench press of 225, full squat of 305, deadlift of 370, and an overhead press of 160. One reason I even went to the doctor was because I felt I wasn't progressing the way I should have. It just seems like people pass me up in the gym left and right. And my gains are very inconsistent. The doctor told me I wouldn't get any medical sympathy from him about feeling weaker than I should since he said I am much stronger than the average male.

Some of the symptoms I experience are quite extreme, like the sexual dysfunction. That provided another impetus for me to reach out to a doctor. I know this isn't a medical forum, but you guys have been around the block and I consider you friends, so I was hoping for advice. I haven't actually been to a doctor since I was 8. It can be very complicated.

I thank you all for your replies. I hope to have this resolved one way or the other. I am tired of feeling the way I do.

ZaneRockfist wrote:

The doctor told me I wouldn't get any medical sympathy from him about feeling weaker than I should since he said I am much stronger than the average male.

Reading this made me want to chime in with "Go see a better doctor."

Per your statements you are obviously not stronger than the average male who engages in a similar exercise program. Find yourself a doctor with a specialty or interest in sports medicine and not some general practitioner who thinks everyone should be happy if they fall between the 60% and 80% marks on his charts.

I had to "fire" a primary care physician a few years back because he honestly thought that telling me I should accept slowing down as I age was more appropriate than providing me with a treatment plan to rehabilitate an injury. (An injury that I have long since completely recovered from and surpassed my personal bests from that time.)

What's your diet like, if you don't mind my asking?

I don't have any specific advice on the issue, but I just want to say that in general I thing self diagnosing is not a good thing to do. Most people lack the perspective to look at the facts objectively enough. This is true even of medical professionals. I know several who consistently try to self diagnose and the only difference between them and a layman is how confident they are in their diagnose, they're wrong equally often though. That said, unless you're a doctor you don't have the required experience and knowledge to make a good diagnose anyway.

Irritability, anxiety, depression, sleep problems any many of the other things you listed can be caused by a whole host of things, and aren't uncommon at all. I'm not saying don't look into it, I'm just saying don't rush to conclusions.

edit: well I saw you already comment on this but I'll leave my post here anyway because I think it bears repeating. I've seen it so many times myself.

kyrieee:

No offense to your acquaintances, but if they can't self diagnose better than a layman, then they have absolutely no business being in the medical profession.

Elycion wrote:

Per your statements you are obviously not stronger than the average male who engages in a similar exercise program. Find yourself a doctor with a specialty or interest in sports medicine and not some general practitioner who thinks everyone should be happy if they fall between the 60% and 80% marks on his charts.

I definitely feel very weak in spite of my training. And when I worked construction, I was so much weaker than all of the other males in the crew despite weightlifting. Perhaps I will see a doctor with a background in sports medicine! We shall first see how things go when I see this doctor again soon.

Slumberland wrote:

What's your diet like, if you don't mind my asking?

I recently started a carb-cycling diet to get rid of fat, specifically the burgeoning amount of fat on my stomach. Honestly, the level of fat on my abdomen has skyrocketed in the last few years. It just doesn't seem natural. Prior to my early 20s, I did not hold any fat on my abdomen. Now I hold all of it there, it seems.

kyrieee wrote:

edit: well I saw you already comment on this but I'll leave my post here anyway because I think it bears repeating. I've seen it so many times myself.

The problem is that I can look at facts and figures and I can plainly see that my testosterone levels are well below what is average (bottom 5%) for someone my age. And since many of my symptoms correspond with the symptoms present in low testosterone, it just seems logical. When everything is burning down around you, you don't look at the fire and say, "There might be another reason." The cause of the fire itself may be in dispute, but not the fire itself.

Well, I'm exaggerating to make a point, which is that you should be humble before that which you don't know. I'm not saying doctors are incapable of self diagnosing themselves, I just think they're equally, or more, prone to do it in situations where they shouldn't be. Because they know more they're more confident in their own diagnose, and quite frankly I think doctors can get a bit full of themselves and not refer to people who know more than they do even in situations where they should. That can be a problem even when diagnosing patients, especially for GPs.

This is getting off topic though so I apologize.

@Zane
I guess what I wanted to say was, definitely get a second or even third opinion, just be honest with yourself and make sure you're not just looking for an opinion that agrees with what you already think. I don't mean any offense with that, because it's not an easy thing to do. If you want to find a doctor who gives you the diagnose you want, you'll be able to, but that won't necessarily help you.

LarryC wrote:

kyrieee:

No offense to your acquaintances, but if they can't self diagnose better than a layman, then they have absolutely no business being in the medical profession.

I don't doubt they can self-diagnose better than a layman, but the question is whether they should. It's always been my understanding that it's frowned upon in the medical profession to self-diagnose.

Agent 86 wrote:

Get a second opinion?

That was the first thing I thought of as well.

MannishBoy wrote:

I KNOW when I'm low. I feel it. It's nothing major, but energy levels, body fat levels, sex drive, etc all just start to get slightly off when my numbers get low.

And yes, low normal still doesn't feel right. I really feel good when I'm slightly above normal. And I'm not talking normal for my age of 40, I'm talking normal for a younger guy.

This is really interesting because I've heard guys who juice, in the abusive sense, say how great they feel when they're in a cylcle.

Makes me want to persue the natural means mentioned in that article above.

Do you live in an area that has a University medical center? If so, it might be possible to work with one of the docs there and see if there is a pilot program or research study that can slot you in. Alternately, and I don't mean any offense with the term, but you might look into "indigent" care and see what is available at a free clinic. No, it won't be world-class or super fancy, but going _somewhere_ and getting _some kind_ of second opinion from another medical professional seems like a good idea now.

You did mention the sexual dysfunction to the doctor, didn't you?

Related but unrelated - every time I get in a cycle where I exercise hard, I start getting acne again. Hormones are so weird.

After lymphoma/chemo kind of wiped me out, I'm on testosterone replacement therapy. And in my experience, doctors are harder to get to help guys with this problem than women with low estrogen. I don't know if it's the steroid stigma or what, but it's hard to get really taken seriously. I'm sure some guys try to get the diagnosis for body building related reasons, but the stigma hurts guys that really need help, too.

I KNOW when I'm low. I feel it. It's nothing major, but energy levels, body fat levels, sex drive, etc all just start to get slightly off when my numbers get low.

And yes, low normal still doesn't feel right. I really feel good when I'm slightly above normal. And I'm not talking normal for my age of 40, I'm talking normal for a younger guy.

At least in my case there's an obvious culprit that made finally getting a prescription easier.

All I know to tell you is to get some other opinions. You might be OK with a low dose of a transdermal like Androgel just to get you back to feeling good.

All that said, you might have other things going on. It might not be low T. I agree self diagnosis isn't wise, but second opinions can't hurt.

As for holding fat on your belly, welcome to a bit of age. That's not necessarily T related. Low T can contribute, but you have to face the fact that you're getting older and what was fine when younger won't always work.

ZaneRockfist wrote:

I am in my mid-20s. I am have slightly greater than half of the average male at my age range. That actually places me in the bottom 5% of males my age.

I can't speak to testo specifically since I haven't done much endocrinology, but you need to interpret those kinds of numbers with a bit of caution. First, they can be very time- and region-specific and so may not apply to your population. Second, being in the bottom 5% of the normal range doesn't necessarily mean that anything is wrong, it just means that you're in the bottom 5% (like 1 in 20 healthy people). Say you had a testo of about 12, you'd be well into the bottom 5% (<14) but still well within the reference range (10-45). Third, even being outside the reference range is not necessarily clinically significant.

The fact that I experience so many of the symptoms associated with low testosterone makes me think that it is likely the culprit.

As mentioned earlier, most of those symptoms are equally consistent with a whole swag of other stuff. It's equally likely you have something like a Vitamin D deficiency and the lower-than-average-but-still-normal testo is a coincidental. Was anything else on the endo screen out of whack?

So I just wonder what I should do since the doctor isn't taking me seriously. I know how I feel and I know things aren't right.

See, that's an issue quite distinct from the clinical chemistry. If you feel unwell you feel unwell, and if you don't have a good relationship with your doctor it's quite reasonable to find another doctor to talk about your concerns. You could maybe discuss getting some other tests done, or even just repeating the original tests. Just avoid going doctor-shopping until you find one that fits the diagnosis that you've already decided upon - you'd eventually find one that agreed with you, but that wouldn't mean it was the right answer. It may be obvious, but I'd also suggest against framing the conversation as "I know what's wrong with me" since it drives our specialists up the wall.

All valid responses. I'm just adding my voice to those that say seek a second opinion.

Welcome to the world of sh*tty, antiquated endo guidelines. Like LarryC and others are saying, find another doc if you can.

Since I did notice you had a no-insurance comment, one way you might try to narrow down the search is to look for docs who have reviews (Yelp or otherwise) that they treat thyroid/adrenal/endo conditions based on symptoms and not just test results. That way you don't have to go to twelve doctors before finding one that will listen to you.

So I called the doctor's office and explained about the symptoms again. The doctor flat-out refused to give me treatment in spite of my symptoms because my levels were in the 'normal range.' That pissed me off so I told him I didn't want to be his patient anymore. Later on, I went to the gym and spoke to some people there. They have hooked me up with a connection to two local doctors that are very friendly towards TRT and that agree that my levels are too low for my age.

So I might soon be starting a program to get my T levels where they should be! I am very, very excited. This nightmare might finally be over.

Someone with a name like ZANE ROCKFIST should have the MOST testosterone.

Gravey wrote:

Someone with a name like ZANE ROCKFIST should have the MOST testosterone.

That's the plan. :X

Legs like Zane?
Am I dating myself?

ZaneRockfist wrote:

So I called the doctor's office and explained about the symptoms again. The doctor flat-out refused to give me treatment in spite of my symptoms because my levels were in the 'normal range.' That pissed me off so I told him I didn't want to be his patient anymore. Later on, I went to the gym and spoke to some people there. They have hooked me up with a connection to two local doctors that are very friendly towards TRT and that agree that my levels are too low for my age.

So I might soon be starting a program to get my T levels where they should be! I am very, very excited. This nightmare might finally be over.

I'm very interested in seeing how this goes. I have a lot of the same symptoms but have never considered this as a possibility. I also eat a ton of soy which is apparently not great for this.

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