Dad is weak; Can T help?

I’ll ask the doc about this on my dad’s next visit. I suppose he could get a script for gel and just apply that sparingly as the pellets dissolve—just to pick up the slack temporarily.

I think the pellets are probably a good solution for my dad, since he’s not likely to apply the gel consistently and is concerned about transferring it to other people. Also, you can’t shower after applying the gel; it’ll just wash off. Often, Dad doesn’t get around to showering until late in the day. So, having to apply the gel every morning might be a problem for him.

The doctor also said that the dosage delivered by the gel is a lot more variable than the pellets, and needs to be increased roughly 50% of the time after initial dosing. In other words, it may take longer with the gel to reach proper levels.

One thing I really like about the gel, however, is that it tends to cycle ones T levels over the course of the day in a roughly natural way (higher in the morning, when applied, and slowly diminishing thereafter). He’ll be trading off this potential benefit for consistency.

I’m not sure what the protocol will be, but I’ll certainly ask. T therapy is a big part of this doctor’s practice, so I expect he’s on top of things. It won’t hurt to double check, however.

Thank you. I’ll continue to bend your ear; hopefully, not to the breaking point. :)

It was really interesting to see how this doc differed from Eugene Shippen (“The Testosterone Syndrome”). First, he didn’t seem overly concerned about estradiol. He said my dad’s breast tissue almost certainly was not caused by estrogen, since nearly all estrogen in men is produced from free T. No free T, no estrogen. So estrogen can’t be the culprit, he said. Still, I’m relieved that he will be testing estradiol both initially and on an ongoing basis.

He said he didn’t think the ratio of T/E was very important. He said the absolute numbers were more important than the ratio. Again, I’ll keep an eye on it and bring the issue up with him later if the ratio gets too low.

Since he wasn’t overly concerned about estrogen, I didn’t bother asking about aromatase inhibitors. Again, I’ll bring it up later if necessary.

The doc wasn’t really hot on HCG, either. He said there was little benefit, except for preventing testicular atrophy, which he didn’t think would be a problem in my father’s case. I would have felt better if he had asked my father if it was going to be a problem. The doctor was slightly brusque. He also said that pushing my father’s system to produce more T, when that system was already showing a lot of wear, was probably beating a dead horse. He didn’t use those words, but that was his point.

He wasn’t crazy about zinc, either. He slightly rolled his eyes when I mentioned it, saying that there was no data to support zinc being helpful for testosterone levels. I think I’ll check up on that detail.

While I have a few concerns about this doctor’s approach, I think we’re off to a good start. The best measure of the doctor’s success will be how my father responds.

To the Doctors, Modesto Man and RickM

Just got my test results back. Have not talked to my doctor, just wanted to know what you guys think of these numbers. I will soon start my own thread as to not take up space in yours.

sex horm BD GLB 35 11- 80 nmol/L

Testosterone 399 300-890 ng/dl

Free Test 71 47-244 pg/ml

% Free Test 1.8 1.6-2.9 %

What do you guys think of these numbers? Are they low enough to fight for help? Is this the reason I feel the way I do?? I don’t think I am crazy, just my doctor!! Any imput is more than welcome!! Thanks guys!!!

sorry the space inbetween my numbers and the reference numbers did not come out the way I typed it!!!!! My numbers are the first ones listed the reference numbers are next. Sorry!!

In case people aren’t following the “squats” thread, your post above appears to be a follow-up to your earlier post there.

Your numbers are certainly on the low side. According to “Testosterone for Life,” a total T reading under 400 is suspect, and a free T reading under 50 (using calculated free T method, which this appears to be) is certainly low. Your numbers qualify as suspect, but you’re in a gray area, in which some clinical judgment is required.

Based on what I’ve read, your free T measurement of 71 certainly warrants treatment if you have clinical symptoms of low T, e.g., fatigue, low energy, weak erections, low sex drive, and/or low bone density. The numbers alone don’t tell the whole story. I encourage you to push your doctor for a 6 month trial of T treatment. Let him get your levels high-normal (700-800 total, 100 free), and see how you feel. If you feel better, the diagnosis will be confirmed.

Also realize that T levels vary over the course of the day—especially for younger men (levels are much more consistent for older men). There’s always the chance that the “snapshot” of your levels at the time your blood was drawn is actually higher than your typical values over the course of the day, and especially during the evenings.

On another forum, I read a post from a 77 year old man whose free T was around the same level as yours. He was already receiving T therapy. His doctor told him the number should be closer to 100 and increased his dose. The original poster reported back that his reading was up to 99 and he was feeling much better.

Well buddy, how is he? I assume he’s started HRT. For me when I first started, it was like, hey, who switched on all the lights. This happened within 24-hours. While changes to muscle:fat ratios and some other things might take time, how he feels should be very fast. Well, that was my experience anyway.

Hey Rick,

This has been a long process, but there is finally light at the end of the tunnel. We started this process with my dad’s primary care physician at the beginning of January, and at long last he is scheduled for pellet implantation next week.

So, no, he hasn’t started yet, but we’re almost there. The urologist needed to get baseline measurements for PSA, SHBG, and estradiol. He would only schedule the implantation once the PSA came back clean. That happened yesterday. His PSA was 0.7, which is extremely low. This is a good sign as far as prostate cancer risk is concerned, but, according to the doc, is yet another indication of low T.

At any rate, my dad is continuing to decline. He had another fall this week—fortunately with no injury, but it shook him up. He’s also confused and forgetful more often now.

The doc said we can probably expect to see nervous system improvements (energy, cognition) very soon after treatment begins. He also said, as you did above, that changes in body composition and “infrastructure” come around more gradually.

My mom, who has become my dad’s nurse, is very eager to see improvements, as you might expect, but I’ve noticed she’s also thinking negatively about Dad’s prospects. I think she’s trying to protect herself from disappointment. I’m allowing myself to be a little more positive.

We are all very interested to see if there is improvement after the procedure. Sure hope something positive happens. Keep us posted.

Thanks for the good wishes, Gprent. You can be sure I’ll continue posting.

She might not be so happy when he gets randy and wants a bit of slap and tickle (LOL). There could be life in them there loins after all. Don’t be surprised at what happens.

As my mother said when I mentioned this possibility awhile ago, “I should be so lucky.” ;)

Dad got his implants today. The procedure was painless (except for the anesthetic), and he’s had not discomfort at all. There was a small incision in the side of his butt, covered with a steri-strip. No stitches were required.

Now we wait. The doc says it will take about 10 days for the pellets to start dissolving enough to raise his T levels to the target zone, which is in the 800’s.

He gets blood tests every month until the next implantation, which is scheduled for 3 months from now. Fingers are crossed.

This is so exciting I can’t wait to hear how it goes, best of luck to your family.

Wow, I didn’t realise that he’d have to wait that long with implants. With gel, it goes in to your system almost instantly and the effects, well some of them, happened overnight. As I said in an earlier post, it was like, hey, who switched on all the lights?

Please remember, though, that the implant will wear out before he gets a new one (so I’m told anyway). So, he’ll have a spell as his old self to some extent before the new implant kicks in. That was why I went for gel. If his memory is not good, gel is not a good way to go for fear of missing or doubling up. Injections are almost instantaneous, but they are spread out too and you run out of the good oil before you get the next one.

I’ll be thinking of you and your Dad, brother. Please do keep us posted. I’ll bet there are a heap of guys waiting for the results and not just the few who have posted here.

My dad says he’s been impotent for 20 years. He’s also recently developed urinary incontinence, as I mentioned above, so he sleeps with a clamp on his penis to prevent accidents.

Now for the good part. This morning he woke up with some discomfort because his clamp was pinching. Evidently, he had a semi! Never happened before, he said. Dad was positively beaming, and in about 30 seconds everyone in the house knew.

I didn’t expect results so soon. I said I hope he makes good use of his rediscovered abilities … :) .

Haha good stuff.