Dad is weak; Can T help?

That’s great mate. Good stuff!! I wait for your further regular reports — as I’ll bet do quite a few others on this forum. Thanks for posting.

We’re one week post-implantation. So far, there’s little to report. My dad says he feels little “wisps” of new sensations, but nothing to write home about. The doc said it would be 9 days to 2 weeks before we could expect anything, so I’m sitting tight and trying to stay positive.

If your dad’s doctor is anything like mine, he’ll take things VERY cautiously. That means he’ll deliberately underdose him to start with and increase his dosage very slowly over the next 12-24 months, monitoring each step with blood tests as he goes. In these days of litigation, he’ll not do anything radical and take only one step at a time, especially if he’s not too sure of what he’s doing. Hence I was surprised at your earlier post inferring a response the next day with a mild morning woody. I suspect that these will come, but probably not as soon as you’d (he’d) like. Some of my responses were very fast (e.g. thinkability), but others took quite a long time (change in muscle:fat ratios). Be patient and hang in there!

We’re now 11 days into treatment, and I figure it’s about time for Dad to start feeling different. I asked Mom first. She said she sees nothing different. He’s still very tired and even had another fall earlier this week.

Then I talked to Dad. He says he thinks he has a little more energy—especially at night. He says he still needs a nap, but feels a bit stronger. Just a bit at this point.

Of course, the concentration from the pellets is still on the upswing, and there’s no telling exactly where his levels will settle until the first blood test, which will be in about 3 weeks. I’m hoping for a stronger signal …

There are no negative symptoms to report at this time, except for the slight bruising around his incision where the pellets were implanted.

Thanks for that ModestoMan. However, like I said above, it probably will take time. Please be patient.

Dad is now a little over one month into treatment. He is not feeling any better. It fact, he has continued to decline in energy, mobility, and cognitive function. This has been discouraging.

A couple of observations about the numbers:

1. Estradiol is high. Most sources I’ve read say it should be kept below 30. His is 46.6. I suspect this as a reason he’s not feeling better.

2. SHBG is way high. This is the protein that binds to free T and deactivates it. It’s amazing how low his free T is, considering how high his total T is. Dad seems to be very good at making SHBG, which isn’t helping.

3. FSH and LH are low, as expected, since his brain is detecting the higher hormone levels and not asking for more.

4. Even though Free T is high for his age, it is still low in absolute terms.

Did they test for thyroid function T4, T3, tsh? Thyroid function declines with age. Also did they test for anemia’s?

If I’m not mistaken I think it takes a few months for test to make necessary changes. If your dad says he is feeling better then this is a positive sign.

From my experience, his only BIG problem is estradiol. He needs to get it MUCH lower — to the lower 25% of the normal population range if he can (not the range for old farts). When it’s as high as it is, he’ll feel crap. I take Arimidex for this, half a 1 mg tablet three times a week and it does the job. No time now … I’ll comment further on Tuesday.

Incidentally, did you read my post at Declining Testosterone levels ?

If he starts supplementing with Nettle Root then his problems may be solved. It frees up testosterone form SHBG, increase free T levels by around 50%. Also get him to eat honey every day as it may reduce estrogen levels (read a study on this, but can’t seem to find it).

Thanks for the replies.

Kingpole: Thyroid and anemia have been tested by an endocrinologist. No problem found with either. Unfortunately, he’s not feeling any better at all, despite the statement of the urologist prescribing the T that he should feel much more energetic within a week or two of beginning treatment.

RickM: We’re heading in the same direction. My concern is that this doctor didn’t seem all that concerned about estradiol levels at the beginning of this process. He didn’t even test them. His justification was that the only way men create E is by aromatizing T. According to his thinking, a man having low T will also have low E. In retrospect, that doesn’t compute, since vigorous aromatization will suppress T and boost E. I don’t know how he could have known that Dad’s E was low without independently testing it. Maybe SHBG levels are a hint, since SHBG binds to both T and E. I don’t know; I’ll ask him.

Man-of-10: I’ve seen a lot around the web about Nettle Root. What I’ve read is that it prevents SHBG from binding to DHT (not T itself). Not that that’s a bad thing. I just don’t know that it directly raises free T. Also, I have no idea how effective it is. Can it make big changes or only small ones? How does one compute dosage?

G’day ModestoMan,

Some comments based on MY results. I hope they help. All my results are in International Units and not American. To convert European (nmol/L) units to US (ng/dL) multiply the European by 28.57. I think you can work out pmol (10^-12), nmol (10^-9) and umol (10^-6).

I believe that the Total Testosterone normal male population range according to my pathologist is 8.3-29.0 nmol/L. My five most recent 3-monthly results recent results are 41.8, 34.6, 39.5, 39.9 and 50.1, so, I’m off the top of the scale. Your Dad is nearly on a par with me and some might argue is a tad too high. My doctor monitors my blood pressure and skin (blood pressure can go up and you can develop an oily and pimply skin if it’s too high). I’m fine on both accounts – in fact my blood pressure is excellent at 110/65.

You say, “even though Free T is high for his age, it is still low in absolute terms”. However, my Pathologist reckons the normal male Free Testosterone range is 20.0-80.0 pmol/L and I think your Dad is at about 64, which is good. Having said that, my most recent five 3-monthly results are 132.2, 100.4, 84.6, 117.5 and 160.1. He is low compared to that and, maybe, could be a bit higher.

As you say, his FSH and LH are low, as expected, since his brain is detecting the higher hormone levels and not asking for more. My results for both are always >0.5. In the normal male population, my Pathologist says they should be <14 IU/L and >11.0 IU/L, respectively.

As you say, this “is high. Most sources I’ve read say it should be kept below 30. His is 46.6. I suspect this as a reason he’s not feeling better”. I totally agree. According to my Pathologist, Oestradiol: should be <150 pmol/L. My recent results are 141, 127, 144, 110 and 91. As I said in an earlier Post, I suggest Arimidex ASAP. It certainly works for me.

As you say, “SHBG is way high… . amazing how low his free T is, considering how high his total T is. Dad seems to be very good at making SHBG, which isn’t helping”. According to my Pathologist, Sex Hormone Binding Globulin: should be 9-111 nmol/L. My doctor doesn’t always test for this, but two of my recent results are 24 and 21. I reckon the lower it is the better.

Some other tests that I get:

Progesterone: expected range is 0.9-3.9 nmol/L; my recent results are 3.2, 3.3, 3.2, 2.8 and 3.5.

Androstenedione: should be 2.4-13.0 nmol/L; my recent results are 12.6, 12.7, 13.3, 13.7 and 9.2.

Free Androgen Index (FAI): should be 20-120%; two recent results (not always given) are 174.2 and 164.8. FAI is Testosterone/Sex Hormone Binding Globulin x 100. When FAI is below 50, some texts say that symptoms of andropause appear.

I dunno if any of this helps. But there it is.

Cheers,

Rick

I talked to the doctor, and he responded as I predicted. He said that Dad’s estrogen was “a little high” but not unusually so. He said he sees those numbers all the time and expects them to come down over time on their own. He said he isn’t eager to prescribe Arimidex, on account of its side effects, which he said could be “awful.”

The doc said that if Dad’s not feeling better by 3 months after beginning treatment, testosterone isn’t his problem and it’s back to square one.

I pushed back a little regarding estrogen levels, saying that I’ve read that levels need to be much lower for men to feel their best. He said there is a wide range of opinion about proper estrogen levels, and he’s basing his decision not to treat Dad’s levels on what he sees in his practice.

The plan now is to wait and see. Meanwhile, I’ll start building a case for Arimidex.

I really think you should start hitting this from the nutrition view point. I don’t have a clue what your dad eats now, but I am willing to bet it is not that healthy.

Of course, getting a guy in his eighties to change his ways is not easy and this one would even include getting your mom to make changes, but I can tell you from personal experience, you are what you eat. Eat crap and you function like crap. Eat healthy and you turn your life around.

Dad eats too many sweets and carbs. I know he gets adequate protein, however. I’ll talk to my mom about maybe upgrading his diet with more fresh foods and fewer baked goodies.