Low Testosterone

[rick2057]

I have just been diagnosed with Low Testosterone.  I am 53, 6-2", 195 lbs, and in overall good health.  I have high b/p (controlled with meds) and high lipids (also contolled with meds).  My Testosterone levels were:

total serum testosterone  269 ng/dl
free testosterone  5.9 pg/ml
and also tested
prolactin   5.1 ng/ml
TSH  0.98 ulU/ml (?)

I kinda expected the dx, but was still taken aback and didn't ask any questions.

Doc started me on Testosterone Replacement Therepy (TRT) via injections.  Didn't ask specific type, but did overhear that it was 200 mg.

My issues/questions are - just how low is my testosterone?  what can/should I expect from TRT?  When should I notice effect?Physical changes?  

I go back for my next shot in 3 weeks.

[Dr. Kokil Mathur]

Hi
Welcome to the forum!
The normal level of testosterone in the age group 51-60 is 505 ng/dl. So in your case its almost half the normal level. Normal free tetstosterone in 18 years and older: 47-244 pg/mL. So in your case it is really low.
Some common low testosterone symptoms are decrease in sex drive, ejaculation problems, shrinking testicle, fatigue, loss of body hair, difficulty gaining or maintaining muscle, depression, and loss of strength. With therapy there will be improvement in all these parameters with time.
Hope this helps. Please let me know if there is any thing else and do keep me posted. Take care!

[rick2057]

Thanks for you response.  The only symptoms that I have been having are a significant decrease in sex drive (primary symptom), fatigue (secondary), and loss of strength (which has been minor).

I was also diagnosed with OSA approximately 1 year ago, and have been on XPAP since 11/08.  SInce my post I have read that TRT can be an issue with OSA patients.  I consider my PAP therapy fairly successful, and continuing to get better.  Should I have any concerns about TRT and OSA since the PAP therapy is working?

Since I have not experienced any of the "physical" symptoms, should I notice any physical changes after being on therapy for a while?

Since my levels are significantly lower than the normal range, I have to wonder how long they have been low.  I know there is probably no way to tell, especially since I have had none of the physical symptoms to use as a barometer for when things started to change.  I actually think that I have always had low testosterone because I have never been highly sexually motivated and I definitely am not what one would consider "blessed" in the genital area.  The contradiction is that I have a fair amount of body hair, my testicles are pretty much above average size (based on limited visual "comparisons"), and when aroused, generally no problem with ejaculation.