Got Testosterone?

[WillBrink]

Okay, I skipped my injection as scheduled and got my lab work done and met my new urologist.
We had a long discussion about T levels apparently my initial visit with my prior urologist was 290. That's pretty damned low for someone 57 and so I got my initial prescription based off of that level. My second visit was unscheduled, I walked in to get my refill and was not aware I would get a blood test, I had my injection on Sunday and it was Tuesday and my T level was 1000.
So, I have a better idea how this works now. When I go for my next refill and blood work, I will just lay off a week to ten days. I'm not sure if it is in my head or not, but I felt like I was low at the point when I went in this time. Workouts were dragging, lethargic etc.
So my new Urologist is a female and she seems willing to work with me on this. I explained my reason for coming in initially and she agreed, very supportive of my weight loss and working out. She was concerned that I wanted to "Get Jacked" lifting weights and that might be my motive for getting TRT. I laughed it off and joked with her about being "Too Old for That."
Anyway, a positive experience and I got some knowledge along the way and six more months of T.

It's always nice, and rare, that such a meeting goes well. Good deal.

[WillBrink]

T/E ratio as strong predictor of CVD. This in men with pre existing CVD, but other data supports the idea that the T/E ratio being off, plays a major part in the development of the CVD to begin with:

"In male patients with manifest atherosclerotic disease, low T/E2 ratio was associated with increased systemic inflammation, increased inflammatory plaque proteins and an increased risk of future major cardiovascular events as compared to men with normal T/E2 ratio."

Testosterone to estradiol ratio reflects systemic and plaque inflammation and predicts future cardiovascular events in men with severe atherosclerosis

Cardiovascular Research, cvy188, https://doi.org/10.1093
20 July 2018

Abstract
Aims

The effects of testosterone on cardiovascular disease (CVD) as reported in literature have been ambiguous. Recently, the interplay between testosterone and estradiol as assessed by testosterone/estradiol (T/E2) ratio was suggested to be better informative on the normal physiological balance. Considering the role in CVD, we hypothesized that a low T/E2 ratio in men with CVD is associated with increased inflammation, a more unstable plaque and a worse cardiovascular outcome.

Methods and results

Testosterone and estradiol concentrations were determined in blood samples of 611 male carotid endarterectomy patients included in the Athero-Express Biobank Study. T/E2 ratio was associated with baseline characteristics, atherosclerotic plaque specimens, inflammatory biomarkers and three-year follow-up information. Patients with low T/E2 ratio had more unfavorable inflammatory profiles compared to patients with high T/E2 as observed by higher levels of C-reactive protein (CRP) (2.81 μg/mL vs. 1.22 μg/mL (p < 0.001)) and higher leukocyte counts (8.98*109/L vs. 7.75*109/L (p = 0.001)) in blood. In atherosclerotic plaques, a negative association between T/E2 ratio and number of neutrophils (B=-0.366(p = 0.012), plaque calcifications (OR: 0.816(p = 0.044)), interleukin-6 (IL-6) (B=-0.15 p = 0.009) and Il-6receptor (B=-0.13 p = 0.024) was found. Furthermore, in multivariate Cox regression analysis, low T/E2 ratio was independently associated with an increased risk for major cardiovascular events (MACE) during three-year follow-up (HR 1.67(95%CI: 1.02-2.76) p = 0.043). In men with elevated body mass index, these effects were strongest.

Conclusions

In male patients with manifest atherosclerotic disease, low T/E2 ratio was associated with increased systemic inflammation, increased inflammatory plaque proteins and an increased risk of future major cardiovascular events as compared to men with normal T/E2 ratio. These effects are strongest in men with elevated body mass index and are expected to be affected by aromatase activity in white fat tissues. Normalization of T/E2 ratio may be considered as target for the secondary prevention of CVD in men.

https://academic.oup.com/cardiovascr...cvy188/5056751

[WillBrink]

This is an important read on how testosterone is used in the treatment (yes, treatment!) of some forms of prostate cancer:

Clinical Advances in Hematology & Oncology
June 2018 - Volume 16, Issue 6
Bipolar Androgen Therapy in the Treatment of Prostate Cancer
Samuel Ray Denmeade, MD

Professor of Oncology and Urology
Johns Hopkins University School of Medicine
Baltimore, Maryland


"What is bipolar androgen therapy (BAT)?

SD BAT consists of the administration of a high dose of androgen—also called testosterone—in an effort to control prostate cancer in men whose tumors are progressing on androgen deprivation therapy (ADT). This causes the levels of testosterone in the blood to alternate between the polar extremes of very high and very low during a treatment cycle.

H&O How can the intermittent administration of high-dose testosterone produce an antitumor effect? "

Cont:

http://www.hematologyandoncology.net...ostate-cancer/

[jpmuscle]

Went to a urologist

He won’t do shit


Blah blah your labs are normal blah blah you don’t meet guidelines blah blah it’s definitely something else.

Fvck off. Waste of a copay




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[LowSpeed_HighDrag]

Went to a urologist

He won’t do shit


Blah blah your labs are normal blah blah you don’t meet guidelines blah blah it’s definitely something else.

Fvck off. Waste of a copay




Sent from my iPhone using Tapatalk

Had the same thing with my doctor. Ya, your labs are a little low, no, I wont do anything about. A little low? I workout all week, am under 15%BF, eat a ton of protein, and my labs are low? Well thats usually not a good thing....whatever.

[Averageman]

It took me three different Doctors over two years to find the right one.
It's a bitch, but keep trying, it's worth it.

Message me if I can help.

[WillBrink]

Went to a urologist

He won’t do shit


Blah blah your labs are normal blah blah you don’t meet guidelines blah blah it’s definitely something else.

Fvck off. Waste of a copay




Sent from my iPhone using Tapatalk

I can't read the actual numbers from the pic. Post numbers with lab ranges used for any comments.

[WillBrink]

Had the same thing with my doctor. Ya, your labs are a little low, no, I wont do anything about. A little low? I workout all week, am under 15%BF, eat a ton of protein, and my labs are low? Well thats usually not a good thing....whatever.

That's not a lab measurement, but an subjective statement. Always ask for a copy of your lab work.

[jpmuscle]

I can't read the actual numbers from the pic. Post numbers with lab ranges used for any comments.

I have a copy of my lab work. The above is just a pic of the flow chart the (urology) use to discern and diagnose low T.

But for reference this was mine



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[Averageman]

Normal is subjective, normal for you may not be normal for me. Mine was actually at 250 and they were fine with that because I was within the band, I had to shop a bit to find a urologist who would work with me. You are at 442 which is on the low end of the band they are using to call normal. You might be much happier at 800 which is where mine seems to stay while supplementing with TRT.
Do you know someone in your area that is currently using TRT?
I'm wondering if you have had them look at your thyroid for abnormalities?