I recently listened to the testosterone videos and was able to have a conversation with my doctor about what Ive been going through for the past year or so. Ive had 0 -Libido, ED, daily fatigue, trouble focusing, not feeling rested after 8 hours of sleep. with that discussion came the following
1- prescription for melatonin - which i declined since i don’t have trouble falling asleep. Some nights i do have trouble staying asleep, and based on the information from BBM.
2- Testosterone test taken at 8AM -Result: All within range except for bio available. although to me 337 is low, but I think 240 was mentioned somewhere as being considered low. I also had been tested my previous doctor in 2015(for reasons i cannot recall) and my level were much higher. Not sure if this even matters but it concerns me having a 60% decline in 7 years?
2022 2015
Total 337ng/dl 565
Free 50.3pg/ml
Bioavailable 97 ng/dl
SHBG 28nmol/L
Albumin 4.2 g/dl
3- We agreed that a sleep study would be a good idea , so that is scheduled.
4- Prescription for cialis for the ED. I accepted, but not sure how it will help since i don’t have any desires.
Further in the discussion the doctor stated that everything is within range and the next step would be the sleep study, and sees no need to move forward on additional Testosterone testing. This is where I’m not sure if i agree since i am on the lower end and am experience symptoms i mention. He also stated hes never treated anyone with TRT in his 12 years of practice. I wasn’t sure how t take that. Did he mean its not a common thing, who he has no experience with treating it.
I feel like I m going in the right direction based on the BBM info but i still feel i need to take the next step in Testosterone testing. Note that i say FEEL…: Are my feels wrong? or should I pursue further?
Thanks to BBM for Putting out such great contact and giving us info that allows us to have meaningful dialogue with our doctors!
Hi,
Thanks for the kind words. I agree that there is more to this evaluation that needs to be completed before further consideration of testosterone therapy. I would also not over-interpret the absolute change between those numbers; testosterone fluctuates from hour to hour throughout the day, and people can have significant swings based on a variety of factors. It is not maintained at a constant blood level over time.
I strongly agree with the plan for a sleep study as the next step. Even if your testosterone were low, fixing sleep would be a better next step than immediately starting testosterone injections, since injections are a typically a lifelong treatment vs. improving sleep (whether through habits or treatment of sleep apnea, if diagnosed) that can improve testosterone (and many, many other health issues/symptoms) on its own.
If you’re comfortable answering: what is your age? waist measurement? How much alcohol do you drink?
There are a few other labs that I figure have likely been checked, but were not mentioned here - things like Hemoglobin (and potentially iron panel), thyroid stimulating hormone, comprehensive metabolic panel (kidney/liver/electrolytes), lipid panel, and potentially others depending on your individual history and risk factors.
DR, Baraki,
Thank you for the response! Additional info below
Stopped drinking in February. I rarely drink at all now. Maybe once or twice in the last month.
Age 52
Height 6’ 1"
Weight 238lbs ( dropped from 250 due to diet change in the last 3 months triggered by LIPID results)
Waist 41’ (dropped from 43’ due to diet change in the last 3 months)
PSA 1.03
NO IRON PANEL WAS PERFORMED
Hemaglobin A1C 5.3
TSH, 3rd gen w/reflex to FT4 1.47 miU/
Metabolic Panel -all in range. A few to note below
Glucose 100
BUN 25
Creatinine 1.24
LIPID PANEL
Total cholesterol 201 mg/dl
HDL 34 mg/dl
Trig 114 mg/dl
LDL 144 mg/dl
Chol/HDL Ratio 5.9
Non HDL cholesterol 167
I appreciate the feedback.
Hi,
This is helpful. My first/top priorities in this situation would be getting the waist well below 40" (ideally 37" or less), and getting the sleep study done. Your waist measurement, fasting blood sugar, and triglyceride level all suggest a degree of insulin resistance that can be improved with fat loss, which will also improve testosterone levels.
Dr Baraki,
The sleep study is scheduled, and I’ll be working on adjusting my diet some more to reduce my waist size.
I sincerely appreciate your feedback!
Regards,
Martin
Have you been able to adjust your libido?
Have you managed to adjust the level of testesterone?
Hey there, I’m new here, too, and I totally get where you’re coming from.
Hey there, I’m new here, too, and I totally get where you’re coming from. It’s great that you were able to have a meaningful conversation with your doctor and get some tests done.
Hey there! It’s great to hear you’ve been proactive in discussing your symptoms with your doctor and seeking solutions. It’s understandable that you have concerns about your testosterone levels and the decline you’ve noticed over the years. I hope you’ll be fine! Let us know how’s it going.
Hey there! It’s great to hear you’ve been proactive in discussing your symptoms with your doctor and seeking solutions. It’s understandable that you have concerns about your testosterone levels and the decline you’ve noticed over the years. I hope you’ll be fine! Let us know how’s it going.