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hormone test results

I am a 25 year old male about 100 pounds overweight not really active and have a sedentary job. I have been having many symptoms of low testosterone including ed and gynecomastia. I recently took a hormone test and the results were:

Dhea(NL)                          458ng/DL           Ref range142-1410
Testosterone, total (DSL)   346Ng/DL          Ref range  190-1037
Estradiol (DSL)                  32 PG/ML         None given
Cortisol                             14.8 Ug/DL        None given

The doctor told me the numbers were in normal range and it is not a problem. I know that my testosterone is low for my age. I plan on losing excess weight and see what happens from there. I know losing weight will lower my estradiol and raise my testosterone, but how much of a difference will it make? I would be willing to try TRT but I am scared of infertility. Could my testosterone level be causing my ed?
12 Responses
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Avatar universal
MEDICAL PROFESSIONAL
Hi,
Weight loss to your ideal weight, or as close to it as possible, can help you get healthy and stay that way.

Given your excess weight and sedentary lifestyle, it is possible that you can develop other obesity-induced disorders, such as diabetes and hypertension, if you do not lose some weight and modify your lifestyle.

It is obvious that weight loss will bring about a significant difference to your current problem, given its physiological and psychological impacts.
Increasing your level of physical activity will promote the release of adrenaline, endorphins, and certain androgens that could help with the ED.

Trying TRT should be an option exercised after trying more conservative measures, recommended above, if they fail.

You can start with a combination of high-fiber and protein diet, eliminating fats and minimizing carbohydrates combined with daily physical cardio exercises for at least 30 min.

Do keep us posted on your doubts and progress.
Regards
Helpful - 0
Avatar universal
I am following your advice thank you, but I really want to know if I can naturally bring my testosterone levels to where they should be for a person my age.  Before I took the blood test I had lots of health anxiety as I thought I had cancer. I was not sleeping or eating enough and I was under lots of emotional stress anyway I lost over 20 pounds in about three weeks before the blood was drawn. Would that drastically effect the levels of testosterone? I read that because of my age my testosterone should be in the upper third quadrant not the lower third quadrant. I also read that probably some of the best results I could expect on Testosterone gel would not be over 500. Am I doomed or can I get my levels where they should be. I also read that men with higher testosterone levels live longer.
Helpful - 0
Avatar universal
MEDICAL PROFESSIONAL
Hi,

"Because of diurnal variation, borderline levels should be repeated on samples taken between 8:00 am and 9:00 am.

Hypogonadism can be due to primary testicular failure with elevated levels of FSH and LH. It can be secondary to decreased gonadotropin secretion resulting in inadequate Leydig cell stimulation and testosterone production. Major causes of primary hypogonadism include Kleinfelter's Syndrome, mumps orchitis, testicular trauma, alcoholism, chemotherapy and radiation exposure. The major causes of secondary hypogonadism are hypothalamic tumors, pituitary tumors and surgery, hyperprolactinemia, obesity and aging. "
"Other causes of decreased testosterone production include stress, illness, medications, malnutrition, obesity, and psychiatric conditions."
www.med.ucla.edu/modules/wfsection/article.php?articleid=198

"Physical exercise increases testosterone levels.
Multiple studies have shown that regular, high-intensity exercise keeps a man’s testosterone at optimal levels. A 1999 study examined how the effects of heavy resistance training in both young (23 to 35 years old) and older (58 to 65 years old) men affected their testosterone levels.20 Both groups saw a statistically significant increase in testosterone levels after exercise. A more recent study published in 2001 also showed that strength training in middle-aged (44 to 48 years old) men increased levels of free testosterone.21

2. Protein combats SHBG, helps maintain optimal testosterone levels.
While adequate protein consumption is vital to maintaining muscle mass in both men and women, it is also important in maintaining testosterone levels. A study published in 2000 examined the relationship between diet and SHBG, and found that “diets low in protein in elderly men [40-70 years old] may lead to elevated SHBG levels and decreased testosterone availability. The decrease in bioavailable testosterone can then result in declines in sexual function and muscle and red cell mass, and contribute to the loss of bone density.”22

3. Soy and fish oil keep estrogen and SHBG in check.

Another Japanese study examined how the essential fatty acids EPA and DHA (found in high concentrations in fish) affected SHBG levels in men 43 to 88 years of age.24 After controlling for other variables, the researchers concluded that both EPA and DHA decreased levels of SHBG in middle-aged and elderly men.

4. Indole-3-carbinol protects against high estrogen levels, prostate cancer.
An adequate intake of indole-3-carbinol (I3C), through vegetables such as broccoli, brussels sprouts, and cabbage, or via supplements, may prove to be very helpful for aging men in both keeping estrogen levels in check and decreasing their risk of prostate cancer.

5. Zinc is essential for optimal testosterone production.
One supplement that should be considered absolutely essential for maintaining a man’s testosterone levels is zinc. This busy mineral is involved in almost every aspect of male reproduction, including testosterone metabolism, sperm formation, and sperm motility.

6. Chrysin is a natural aromatase inhibitor.
A bioflavonoid called chrysin has shown potential as a natural aromatase inhibitor. Bodybuilders have used chrysin as a testosterone-boosting supplement because by inhibiting the aromatase enzyme, less testosterone is converted into estrogen. The problem with chrysin is that because of its poor absorption into the bloodstream, it has not produced the testosterone-enhancing effects users expect. Pilot studies have found that when chrysin is combined with piperine, reductions in serum estrogen (estradiol) and increases in total and free testosterone result in 30 days.

7. Nettle root liberates “bound” testosterone.
Testosterone that becomes bound to serum globulin is not available to cell receptor sites and fails to induce a libido effect. When testosterone binds to sex hormone binding globulin (SHBG), it loses its biological activity and becomes bound testosterone, as opposed to the desirable free testosterone.European researchers have identified constituents of nettle root that bind to SHBG in place of testosterone, thus reducing SHBG’s binding of free testosterone.

8. Human Studies Using Combination Nutrients
To ascertain the safety and efficacy of nutrients that are purported to modulate male hormone levels, the Life Extension Foundation sponsored clinical studies to assess the effects of specific supplements on blood levels of testosterone, estrogen, SHBG, etc.35 Based on the results of these studies, a formula called Super MiraForte was developed that combines chrysin, nettle root, muira puama, piperine, and other nutrients that showed the most potent effects in boosting free testosterone and suppressing estrogen in aging men. For those who would prefer to avoid testosterone-boosting and estrogen-suppressing drugs, four capsules a day of Super MiraForte may be considered. Before embarking on a hormone rejuvenation program, please refer to the Male Hormone Modulation protocol that can be accessed at www.lef.org/test."
www.lef.org/magazine/mag2004/feb2004_cover_test_04.htm


The information I have added is just for your knowledge. I still advise you to follow conservative measures, such as weight loss and dietary changes and supplements, as these will be healthier in the long run.

Yes, hypogonadal men do develop other organ system disorders earlier than men with normal testosterone levels. But, given your age, conservative corrective measures will help greatly, over the next several weeks.

Do keep us posted on your doubts and progress.
Regards
Helpful - 0
Avatar universal
Thank you so much I am taking this all into consideration and this is one of the most informative and complete answers I have gotten on this website. My compliments and to me it is refreshing.


Thank you again.
I will keep you posted
Helpful - 0
Avatar universal
Hi sorry I have one more quick question.  My hormone levels don't indicate hypogonadism do they?  I have none of the major causes you listed for primary hypogonadism, but for the secondary ones I am not sure. Should I get checked for other problems Hypothalmus, pituitary, or testes? Another question if the cause is secondary is the outlook better if it is not my testes? My FSH and LH were within range liver, kidney, and thyroid all okay. I plan on keeping up the healthy lifestyle for a few weeks including taking a multivitamin daily,healthier diet, cardio and weight training and retesting earlier in the morning with a more complete list of hormones. I want to do this as a more solid base for my overall goal to increase my testosterone in the future.
Helpful - 0
Avatar universal
MEDICAL PROFESSIONAL
Glad to be of help :-)
Helpful - 0
Avatar universal
MEDICAL PROFESSIONAL
Hi,

"Male hypogonadism is a condition in which the body doesn't produce enough of the sex hormone testosterone. As many as 5 million men in the United Sates may not produce enough testosterone — the hormone that plays a key role in masculine growth and development during puberty."

"n adult males, hypogonadism may alter certain masculine physical characteristics and impair normal reproductive function. Signs and symptoms may include:

    * Erectile dysfunction
    * Infertility
    * Decrease in beard and body hair growth
    * Increase in body fat
    * Decrease in size or firmness of testicles
    * Decrease in muscle mass
    * Development of breast tissue (gynecomastia)
    * Loss of bone mass (osteoporosis )

Hypogonadism can also cause mental and emotional changes. As testosterone decreases, some men may experience symptoms similar to those of menopause in women. These may include:

    * Fatigue
    * Decreased sex drive
    * Difficulty concentrating
    * Hot flashes
    * Irritability
    * Depression"

"f tests confirm you have low testosterone, further testing can determine if a testicular disorder or a pituitary abnormality is the cause. Based on specific signs and symptoms, additional studies can pinpoint the cause. These studies may include:

    * Hormone testing
    * Semen analysis
    * Pituitary imaging
    * Genetic studies
    * Testicular biopsy"
www.mayoclinic.com/health/male-hypogonadism/DS00300
I do not think you have hypogonadism at present since your testosterone levels are within the normal range. However, the secondary causes of hypogonadism include obesity. Most times, the most obvious cause is the definite cause of a disorder, so here if you are thinking of hypogonadism, the cause would be obesity, since you do not have any othe symptoms that point to a hormonal disorder.

So the focus should be on reducing stress and losing weight.
Regards
Helpful - 0
Avatar universal
Thanks I for your reply. I do have these symptoms you listed:

    * Erectile dysfunction-(maybe psychological I can masturbate, sometimes I get        morning wood and I get nocturnal erections, but I don't get spontaneous erections during the day time as much. My main problem is with my partner of 5 years it happened once and I never got over it. I get erect but as soon as I start thinking about it it happens.)
    
    * Infertility- No, got girlfriend pregnant twice within last two years last one within six months ago, but she miscarried

    * Decrease in beard and body hair growth- Definitely not very hair guy all over, but have male pattern baldness

    * Increase in body fat- always been overweight I know 100 pounds overweight sounds like alot but I do not look obese. I am 6'1" broad shouldered and size 13 shoes
    
    * Decrease in size or firmness of testicles- throughout the day at different times my testicles feel of different hardnesses.
    
     * Decrease in muscle mass- No, but I feel weaker could be due to lack of exercise I used to be more active
    
     * Development of breast tissue (gynecomastia)- Doctor said I have a unilateral enlarged breast bud, but said he would call it gynecomastia
  
     * Loss of bone mass (osteoporosis ) Not sure, but my bones make alot more popping noises lately. I haven't had any bone related injuries lately though.

    * Fatigue- Yes

    * Decreased sex drive-Hard to answer yes I think about sex and fantasize, but sometimes I don't feel good so I don't really want sex especially lately. I have sex 2-3 times a week and masturbate 2-3 times a week

    * Difficulty concentrating- Mentally no but visually when I am zoning out thinking about things it is hard to focus and my eyes go blurry a little if I look away it stops

    * Hot flashes-no, but sometimes I sweat alot

    * Irritability- Definitely

    * Depression- Runs in the family

I plan on doing
    * Hormone testing- more detailed test
    * Semen analysis- want to have child next year hope its good
    * Pituitary imaging-sometimes I have headaches and blurry vision

I am honestly scared to get a testicular biopsy and am wondering if you suggest this to rule out cancer? Or is it to see what is really going on inside of them? I thought I had breast cancer originally and am terrified of imaging, biopsies, and radiologists. I had a really bad experience where the radiologist told me he really thought I had cancer and went through the entire treatment I would have to go through if I did have it. He said it couldn't be gynecomasita because it is only on one side. I got a second opinnion from a surgeon who specializes in oncology and he told me it doesn't look like cancer and it isn't behaving like it as I had it for 7-8 months before getting it checked and it didn't grow. He made me get a hormone test and pointed me in the right direction. When he told me my results it seemed like he wanted to tell me it is low, but couldn't he suggested a few things and said don't worry. I don't think it is really fair that the age range on the reference range is so broad. If I'm 26 the testosterone levels of a 60 or 70 year old are not good enough. I hope my insurance doesn't pull the whole your within range so we won't pay for it.

Helpful - 0
Avatar universal
MEDICAL PROFESSIONAL
Hi,

  * Erectile dysfunction- The fact that you wake up with erections could mean that your hormone levels are normal enough. If you have difficulty sustaining or having an erection consciously, it could be that you are just creating undue stress for yourself, with not very good outcomes. So avoid stress.
    
    * Infertility- So no infertility. Evaluate cause of miscarriage.

    * Decrease in beard and body hair growth- Always been that way, or developed body hair loss recently?
Male-patern baldness usually indicates your male hormones are sufficient.

    * Increase in body fat- 100 pounds overweight for a large frame with your height or have you take just the average weight for your height, irrespective of frame? Even so, you may need to lose about 50 pounds.
    * Decrease in size or firmness of testicles- This could be subjective. So get a second opinion.
    
     * Decrease in muscle mass- Yes, it happens with lack of exercise
    
     * Development of breast tissue (gynecomastia)- Any enlargement of breast tissue would be called gynecomastia in the male. But, don't judge your hormone levels based on this.
  
     * Loss of bone mass (osteoporosis ) No, its not identified by popping sounds. ANd given your age, it is unlikely.

    * Fatigue- Yes

    * Decreased sex drive-This seems normal

    * Difficulty concentrating- No, its not a symptom. Happens to nearly everyone when they think too hard. So you need to learn to focus optimally. Not hormone-induced problem.

    * Hot flashes-Normal to sweat.

    * Irritability- Subjective. Could be a response to stress.

    * Depression- So you need not have it. It just causes a predisposition, but you can counter it since you know it can happen.

I plan on doing
    * Hormone testing- more detailed test
    * Semen analysis- want to have child next year hope its good
    * Pituitary imaging-sometimes I have headaches and blurry vision
The testicular biopsy is not needed. Please do not think I advised it. It is part of the workup done IF you have hypogonadism (which you don't appear to have). It was, as I said, just for your info.

You can definitely go ahead with more detailed hormone testing. Try to keep all investigations as noninvasive as possible.
Testicular biopsy has complications and can affect fertility, so do not consider it as there is no justification in doing it with your symptoms.

Just try to lose weight over a month or so and then repeat just the hormone tests.
Regards
Helpful - 0
Avatar universal
Thank you for your prompt, detailed and informative replies. I really appreciate it, I will repost in about a month give or take. I'm gonna try being healthy for a month then re-testing. Hopefully you are still around here.

Once again thank you
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Avatar universal
MEDICAL PROFESSIONAL
You are welcome.
:-)
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Avatar universal
Hey doc if your still out there just an update.

I have been on a diet to raise my testosterone and build muscle. In another month I am going to change it to drop weight. I have been lifting weights five times a week and doing cardio for at least a half hour five times a week. I have gained six pounds of muscle, however even though I have gained weight my body fat is lower a little I can see it and clothes are a little looser. I saw an endocrinologist he told me my testosterone was a little low, but retested with a more complete bloodwork panel. He said everything was fine after doing a complete physical. He also said that the one reading of my testosterone is just a snap shot and that the level varies. He asked me about my erections, but I didn't tell him the whole story. Kind of embarassing with your pants down and a nurse in the room for me to explain sometimes I have erection problems. I see him again in two weeks. The main thing is lately I feel better. Still have down days but who doesn't I guess. Still no cigarettes. Gynecomastia is bilateral now not big, there are glands behind nipples. Bothers me, but can't get surgery until I lose weight. I am really hoping that my levels went up. I worked hard last month.
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