15 replies to this topic

[TheFountain]

Alright I am about to get lab work to measure my testosterone levels to see if this might account for intermittent low energy. What is Ideal here? What should i be looking at, and if it turns out on the low side what should I do? And furthermore what here in this community is considered low vs what medical science considers low?

[The Immortalist]

TheFountain, on 17 August 2012 - 10:37 PM, said:

Alright I am about to get lab work to measure my testosterone levels to see if this might account for intermittent low energy. What is Ideal here? What should i be looking at, and if it turns out on the low side what should I do? And furthermore what here in this community is considered low vs what medical science considers low?

I just went to a lab recently to get my total and free testosterone levels checked. I am also getting my prolactin and estradiol levels tested. I am waiting for the results.

I would also like to know the answers to your questions.

[Matt79]

This reminded me, I wonder if my levels are too high (in terms of longevity)?



(I need to do an update this year)

[The Immortalist]

Matt79, on 31 August 2012 - 05:06 PM, said:

This reminded me, I wonder if my levels are too high (in terms of longevity)?



(I need to do an update this year)

Would most tests check the sex hormone binding globulin by default or is it something you usually have to specifically ask to get checked? Also aren't your testosterone levels way to low? Shouldn't a mans be 500 nmol/L or higher?

Edited by The Immortalist, 05 September 2012 - 11:47 PM.

[Matt79]

The Immortalist, on 05 September 2012 - 11:03 PM, said:

Would most tests check the sex hormone binding globulin by default or is it something you usually have to specifically ask to get checked?

Depends I guess. The one I previously used, allowed you to select either groups (eg a Testosterone group), or individual tests.

[nowayout]

The Immortalist, on 05 September 2012 - 11:03 PM, said:

Also aren't your testosterone levels way to low? Shouldn't a mans be 500 nmol/L or higher?

No, not in those units.  

Quote

Would most tests check the sex hormone binding globulin by default or is it something you usually have to specifically ask to get checked?

Depends on the doctor. I don't think it is usually checked by default, but that should only matter if your total testosterone is low-normal, say, below 400 ng/dl.

[misterE]

TheFountain, on 17 August 2012 - 10:37 PM, said:

{1}What is Ideal here?  {2}What should i be looking at, and if it turns out on the low side what should I do?

{1} The Ideal hormonal profile for a man would be: High SHBG and high testosterone and low estrogen. Men with metabolic-syndrome or obesity have low SHBG and low testosterone and high estradiol.

{2} I would check SHBG, total-testosterone, LH, FSH, and total-estrogens.

If your testosterone is low and your estrogen is high, I would suggest an aromatase-inhibitor (like letrozole or anastrozole); this would rapidly lower estrogen, which in turn would increase your bodies’ natural production of androgens (by upregulating LH secretion). Testosterone should be 500ng or above. Estrogens should be below 100pg. Getting lean (exercise) and eating a low-fat/high-fiber diet will rapidly reduce estrogens.

If your SHBG is low, I would suggest a low-fat/low-protein -- high-fiber/high-starch diet.

Edited by misterE, 07 September 2012 - 09:19 PM.

[TheFountain]

misterE, on 07 September 2012 - 09:18 PM, said:

TheFountain, on 17 August 2012 - 10:37 PM, said:

{1}What is Ideal here?  {2}What should i be looking at, and if it turns out on the low side what should I do?

{1} The Ideal hormonal profile for a man would be: High SHBG and high testosterone and low estrogen. Men with metabolic-syndrome or obesity have low SHBG and low testosterone and high estradiol.

{2} I would check SHBG, total-testosterone, LH, FSH, and total-estrogens.

If your testosterone is low and your estrogen is high, I would suggest an aromatase-inhibitor (like letrozole or anastrozole); this would rapidly lower estrogen, which in turn would increase your bodies’ natural production of androgens (by upregulating LH secretion). Testosterone should be 500ng or above. Estrogens should be below 100pg. Getting lean (exercise) and eating a low-fat/high-fiber diet will rapidly reduce estrogens.

If your SHBG is low, I would suggest a low-fat/low-protein -- high-fiber/high-starch diet.

What is the likelihood of being lean, having a six pack and still having high estrogen and low testosterone?

[THawk720]

Possible, but not easy. I'm assuming you're trying to use the thought process that since you have visible abs that you probably don't have low testosterone. Based on your pictures I'd say you have low to normal levels of testosterone and probably moderate  estrogen.  Let me know how it turns out

Edited by THawk720, 13 September 2012 - 01:11 AM.

[nowayout]

TheFountain, on 08 September 2012 - 06:37 PM, said:

What is the likelihood of being lean, having a six pack and still having high estrogen and low testosterone?

High and low are not defined by lab values - they are defined by clinical symptoms, and lab values can at best provide circumstantial support for a diagnosis if clinical symptoms are present.  People vary greatly in their body's response to circulating T and E.  Some men have more T receptors, for example, so their testosterone of 350 ng/dL might be as bioactive as the next guy's who has a level of 700 ng/dL, but no lab test will show you this.  Same thing with estrogen - some men need much higher levels of estrogen than other men to function properly, have good bone density, and have good libido.

It doesn't sound as if you have symptoms of anything, and from the pictures you posted some time ago you appear to be in great hormonal health, so I would suggest that you avoid lab testing.  If your labs turn out to be different from those of the average guy, they can only cause you needless worry.

A lot of unscrupulous doctors treat lab values, not symptoms.  Stay away from such doctors.

[misterE]

My overall recommendations would be… if your testosterone is low (below 400ng or so) and your estrogen is high, I would recommend an aromatase inhibitor like letrozole or anastrozole. There are many studies showing rapid and huge increases in androgens, with these drugs. For instance in one study, men had a 60% increase in testosterone and 54% decrease in estradiol within ten days of taking 1mg of anastrozole daily [1]!

The problem I see with testosterone-replacement-therapy (TRT) is that it doesn’t solve the underlying problem of why testosterone is low in the first place. The main reason testosterone is low in men in the first place is due to high levels of estradiol; which inhibits the production of testosterone. Adding more exogenous testosterone to a man with high levels of body-fat (aromatase) will actually create more estrogen, because the testosterone he is getting from the TRT will be soaked up into the body-fat and converted into estrogen. This is why common side effects of TRT are prostate problems, gynocomastia, hair-loss, cardiovascular disease etc.

The solution is to lower estrogen, which will enable your body to once again produce it’s own testosterone. The way you lower estrogen is by exercising, getting lean, eating a low-fat/high-fiber diet and taking aromatase-inhibitors.




[1] J Clin Endocrinol Metab. 2000 Jul;85(7):2370-7. Estrogen suppression in males: metabolic effects. Mauras N, O'Brien KO, Klein KO.

[nowayout]

The problem with aromatase inhibitors is that they can cause their own set of problems.  Lowering E too much, which is very easy to do given that everyone has a different ideal level of E so that labs are not very helpful, can cause a host of health problems in the long term.  Also, in studies where they have been shown to raise testosterone, they did not on average improve the symptoms of lw T the men may have had to begin with.  Somehow the aromatase inhibitor canceled out any benefit the men may have gotten from increased T.

Edited by viveutvivas, 14 September 2012 - 03:04 AM.

[THawk720]

Estrogen is a major component in libido. When it's too low you end up having no libido. Hard to fine tune these things sometimes.

[misterE]

viveutvivas, on 14 September 2012 - 03:03 AM, said:

Also, in studies where they have been shown to raise testosterone, they did not on average improve the symptoms of lw T the men may have had to begin with.  Somehow the aromatase inhibitor canceled out any benefit the men may have gotten from increased T.

I have seen studies where aromatase-inhibitors didn't affect body-composition... but in one study, researchers noticed an increase in insulin-sensitivity and a decrease in triglycerides, after giving young men letrozole [1].




[1] Diabetes Care. 2010 Aug;33(8):1831-3. Sex steroids affect triglyceride handling, glucose-dependent insulinotropic polypeptide, and insulin sensitivity: a 1-week randomized clinical trial in healthy young men. Lapauw B, Ouwens M, 't Hart LM.

[nowayout]

misterE, on 14 September 2012 - 10:04 PM, said:

viveutvivas, on 14 September 2012 - 03:03 AM, said:

Also, in studies where they have been shown to raise testosterone, they did not on average improve the symptoms of lw T the men may have had to begin with.  Somehow the aromatase inhibitor canceled out any benefit the men may have gotten from increased T.

I have seen studies where aromatase-inhibitors didn't affect body-composition... but in one study, researchers noticed an increase in insulin-sensitivity and a decrease in triglycerides, after giving young men letrozole [1].

[1] Diabetes Care. 2010 Aug;33(8):1831-3. Sex steroids affect triglyceride handling, glucose-dependent insulinotropic polypeptide, and insulin sensitivity: a 1-week randomized clinical trial in healthy young men. Lapauw B, Ouwens M, 't Hart LM.

Maybe, but very little can be inferred from a weeklong trial manipulating hormones.  Even when hypogonadal men are put on testosterone replacement, it takes 3-6 months for some of the effects to become significant.  So altering hormones for a week and then measuring some biomarkers is not a very helpful study.  Certainly it says nothing about safety - indeed letrozole is a very strong AI and very easy to overdose even at small doses, especially in men who already have compromised hormonal health, and that could have bad consequences for cardiovascular health, brain function, etc.  It can be dangerous to just take will-nilly without being followed by a doctor.

[The Immortalist]

THawk720, on 14 September 2012 - 03:33 AM, said:

Estrogen is a major component in libido. When it's too low you end up having no libido. Hard to fine tune these things sometimes.

HOw much estrogen does a man need to have a normal libido?