Anyone here suffering from low testosterone?
UPDATE 2024/04/26: Couldn't find any spot with a Endocrinologist right away so I went to a urologist.
Urologists these days, at least here in Brazil, are well versed in TRT and knows exactly what to look for.
Turns out I have some issues that could be causing my low T. My left testicle is way smaller than my right which indicates that things are not working. I also have varicocele (enlarged veins in the scrotum), which in some cases can cause low testosterone and in a lot of cases can lower your sperm count and quality.
So he ordered blood tests to check all my hormones as well as Triglycerides and other things, ultrasound of my balls and spermogram.
It'll probably take a week or two to have all these done and I'll come back here with the results.
I am also noticing some symptoms besides libido, like poor sleep (I am waking up a lot more in the night, like 4+ times) and really low muscle gain for someone who lifts for 10 years and can push some heavy weight. There are some things in me that it could be linked to this. I feel like I am just pushing through life these days, feeling a little beaten and just going through the motions. It could explain my exacerbated cynicism and lack of interest in everything.
It could be that my body has been working against me for some time.
Original thread:
I am 37yo.
One year ago I did a checkup and asked for my testosterone levels because I was feeling my libido was lower than normal.
The results came back and my numbers were 377 ng/dL, free test was 9 ng/dL and SHBG 23,6 mmol/L.
It was low, but within the normal range.
Everything else was perfectly normal.
Now almost a year later I am feeling that things are worse. I can go a week without feeling any desire. I still have morning wood, but it is not every day like it was. I have sex with my SO, but I can easily lose my erection.
I scheduled an appointment with an endocrinologist from my health inssurance, but it has a spot only in July!
So I went to a lab and did a blood test for testosterone and it is indeed worse.
It is now 255 ng/dL, free test was 6,5 ng/dL and SHBG 19 mmol/L.
I am physically active, lift weights 4 days per week, can squat relatively big numbers, am not overweight (on mornings I have a six pack) and drink alcohol only on weekends.
Is this drop normal when you reach 40s or there is probably an issue here?
I thought HRT was for when we were in our 50s.
Anybody has gone through anything similar and can share your stories?
This is an area where the power of suggestion (ie. nocebo) has a dramatic effect. There's even an extent to which this can have downstream effects on your actual hormones (feelings of pride raise testosterone, feelings of shame reduce it). Supplementing testosterone is potentially dangerous, and it doesn't seem like a direct measure of health and vitality. Your testosterone will begin to drop as you age and, unlike women and estrogen, it's a gradual and steady reduction over the course of your life after peak sexual maturity. The most important things you can focus on are getting quality and consistent sleep (!!), exercising regularly, eating whole foods, and avoiding putting yourself in a state of chronic mental stress.
There is something going on at the population level with respect to male sexual health that's concerning (ex. worldwide drops in sperm count), but I don't think the answer at the individual level is to start taking T.
Thanks.
I understand, but things being normal, HRT is a life saver for a lot of people.
I don't really want to do it, that's why I am seeing a doctor, but I have a pretty good life and it is still dropping.
I sleep early and get 7 to 8hr of sleep. My job is low stress and I work 2hr per day only. I've been lifting weights since I was 28. I am not rich, but money is not a problem. Have no kids.
I hope I can raise it naturally, but I already eat pretty well, lift weights, am fit and it is still going down and is now in the lower end.
I would wait to see what the endocrinologist recommends. I'd also recommend to more or less stick to their guidance and not to shop around too much for opinions.
You don't think you're over-training? That can reduce T levels. I don't like to take days off but I force myself, otherwise if I worked out for 7 days a week, like I have before, I get to feeling bogged down and it just feels like my T levels get lower as motive and libido get lower also.
I don't think so. I have three rest days and my workouts are shorter than before. Today was my second leg day and it was just 4 sets of light squats and kettlebell swings.
Monday is my longer workout and it's just 6 exercises.
I thought so, working out as long as you have. When I was younger I could work construction, then come home and workout an hour a day. Now my job's easier but sometimes it's a struggle alone just to complete a workout. Sucks getting older as T makes recovery and effort easier per same weighted workout. It's so tempting to want to do TRT or even steroids, hate to admit, but I'm pretty determined to be all natural.
How often do you take at a minimum 1 week off?
Never. Last time was October when I traveled to Thailand.
There was some weeks that I only lifted 2 days last month.
At 36 I have some of the symptoms you describe. I've wondered about my levels of test but also compete in a tested sport so HRT wouldn't really be an option.
What I have found is that the underlying stress makes a big impact. I track my recovery, workouts, and diet pretty closely. We've identified that about 4 weeks of training is when my performance starts to drop. I'll run a deload week that cuts volume in half. During those deload weeks my drive will spike and energy comes back. Same happens on taper weeks before meets, my energy ends up being much higher and most of the symptoms diminish.
It sounds like you are fortunate to have a low stress life and it doesn't sound like you are exerting yourself too much. But building in some easier weeks to your programming may be beneficial.
That might be part of it as well. Your body needs rest. 1 day on then off isn't enough. Good recommendation is 1-2 weeks off every 10-12 weeks
Thanks. Will rest the next week.
Just for what it's worth, it's much better to rest by doing light exercise than to stop completely. Let your body be your guide - if after 3-4 light days you're feeling good and eager to get back to it, go ahead.
(I have a background in human sports performance).
Forgive the direct questions, but on what basis are you making your recommendations? Do you have medical qualifications or are these non-expert opinions?
I should say that before taking anything stronger than painkillers, you should speak to a specialist doctor. Definitely get a second or third opinion if things feel wrong, but pills should be taken only after a doctor cleared it, not from google saying so.
That's not to say it's not useful to search around and ask for opinions, especially stuff like this where asking people in real life can be awkward (how do you even bring it up?).
I won't say exactly for privacy, but disclaimer: I am not an expert.
I would like to pleasantly disagree with this. I'm not aware of any studies proving that using exogenous testosterone directly improves health and vitality, but that's more because vitality is a super nebulous concept that's difficult to rigorously measure. That exogenous testosterone has a massive, verifiable effect on the body has been proven conclusively. To the point about how it's more important to focus on exercising, etc, the link above shows that supplementing testosterone and doing no exercise had a greater effect on lean body mass than exercising without testosterone.
I recognize that we're discussing vitality and not lean body mass, but I do think that the one is a reasonable analogue for the other if we're trying to determine whether testosterone has an effect on the body.
45 here and went through the exact same thing. However, I'm an office monkey (8-9 hrs of office work in a chair), taekwondo once a week and the rest of the time is running around looking after 3 older teens and 3 yr old.
Libido took a dive. ED started to happen occasionally and it took a lot more work. Diet didn't make much difference and I shaved off almost 30lbs, that wasn't the cause or fix.
My doctor has said it's mostly a natural process. Depending on your genetics, you could win the lottery and be Johnny Sins into your 90s, or you can luck-out and have a crash of T mid 30s which steadily gets worse, or even younger.
The libido and ED solution was as simple as Cialis dailies, lowest dose (2.5mg I believe it is) in my case. To be honest, I take the dailies 3 days apart and it's still 'enough'.
Don't self prescribe anything. Speak to a medical professional about all of this. Be patient.
Thanks. I found an urologist that works with these issues and have an appointment next week.
Apart from losing my older brother last year, my life is stress free mostly. I work only 10 to 20hrs / week. Maybe my genetics are against me on this one. Thankfully I have full thick long black hair still, so there's that good part of my genetics going on. 🤷🏾♂️
I'm 50, and since ~ August of last year my recovery from gym time, and general energy levels, have taken a nosedive, as well as my desire and ability to perform in the bedroom.
What is especially frustrating about all of this is that I need to be able to go to the gym; if I don't, I get seriously depressed. Not just blah, but affect-my-ability-to-live. I've had my doctor check my hormone levels, and both my thyroid and T are below normal, but she's been hesitant to prescribe anything. I almost regret bringing up the bedroom issues at this point; she now just wants to prescribe me Cialis and call it a day.
From my point of view, this is treating a down-the-line symptom, not the primary cause. I need to have my energy and recovery back, not just for mental health reasons, but I need to be able to work effectively to provide for myself and my family. Chiding that these are natural side effects of getting older is maddening. Ok, great. Are you going to provide the money I need to continue my life? No? Then fuck off with the patronizing warnings, I need to be able to work.
I wish I had an answer for you, but I'm posting to let you know that you aren't alone. HRT is fully understood as a sometimes-appropriate treatment for women, but it is treated with a lot less respect when it comes to men. I wish you the best of luck of navigating your own healthcare journey, and don't let doctors or others shame you for trying to fix things. You know how you feel, and how you are supposed to feel, better than anyone else. Let that be your guide.
I was diagnosed with secondary hypogonadism in my late 20s and was on TRT for awhile. My numbers looked fairly similar to your most recent labs, but I was a bit younger. I pushed for TRT because I was getting hot flashes, needed two coffees in the afternoon to stay awake and my depression was really acting up. Testosterone resolved them. My narrative is going to counter the hesitancy you're seeing from other people- I felt so much better running on higher levels of testosterone. My energy felt better than it ever was, I struggled a lot less with body fat (I had body dysmorphia so I was constantly in single digit body fat because I lifted a lot, ate healthy and was a bit obsessive about it) and most of my problems went away.
I also ended up embracing my femininity a lot more during this time frame and decided to give estrogen a try after being on TRT for like 1-1.5 years since I was gonna be on hormones the rest of my life anyways and wanted to see how it felt. Estrogen ended up feeling more right for me (finally felt like I had more control over my sex drive and I stopped caring so much about my appearance- the BDD went away) so I ended up staying on estrogen.
I think the only piece of advice I really have is to pay attention to the symptoms that are bothering you. If it's mostly just about the absolute numbers you shouldn't do anything. But if you're experiencing symptoms you should look into what can be done to alleviate the symptoms. If libido is the only thing you're feeling is decreasing, that's pretty normal with age. If it comes with ED, just get a low dose Cialis for daily consumption. If it's more than that, talk with your doctor and troubleshoot what drugs feel like the right risk and reward profile for you. Getting on hormones means you'll be on them for the rest of your life and that's not something you should take lightly.
Just updated the thread text with new info from the doctor.
yeah, unfortunately this is a thing that happens to some people. HRT will help immeasurably, but keep in mind that you'll be on it for basically forever. Two additional suggestions which will not work miracles, but may help a little bit in the meantime or if you choose to delay HRT.
You may be undertraining a little bit, just based on the workout you posted.
didn't see anything on diet in there - what does that look like? Are you getting enough healthy fat and HDL?
Yes, I take fish oil daily and eat fish at least once a week.
My workout is not that light, but since I have a home gym it is limited, but I have good numbers and train with intensity instead of volume.
Monday is:
Tuesday:
Thursday
Friday
I do weighted chin ups with 23kg hanging, squat 1rm is 120kg and weighted dips with 30kg.
Diet is real food. I don't eat garbage on weekdays, only weekend. Plenty of rice and beans (I'm Brazilian), chicken, red meat, fish, broccoli, greens, carrot, etc. Protein shake with peanut butter, banana and apple every day. Milk and oats and three eggs in the morning.
I eat at maintenance (2400 kcal). Height is 178cm and weight 74kg.
I was slow bulking with 2600 kcal gaining 1kg per month, but now reduced to 2400 to maintain for a while.
That all looks pretty good. Two additional thoughts - if you've been doing that same workout for quite some time, switch it up a bit and see how you feel. And I'd also recommend playing around with the macro ratios of your diet - spend a week or two with a higher proportion of carbohydrates to see how you feel, then do the same with fat, same with protein, etc.
And feel free to disregard if those thoughts are annoying or if you're set on HRT (which I say without judgement). I know how obnoxious it can be when people give unsolicited advice, but since this is a "what's going on" thread I figured I'd throw it out there.
Thanks! I'm not set on HRT. I want to avoid if possible because I heard it can affect sperm count and I want a child in the near future, but going from 370 to 250 in a year doing everything "right" I don't think diet and exercises (my numbers are going up on a weekly basis) are really the problem, but it is worth a try messing with ratios.
I plan to investigate all I can before jumping on HRT.
OP already has this nailed down, but for others there has actually been research showing that squats increase testosterone. Interestingly, only in men.
I haven't finished this book yet, but so far it is very interesting.
Natural Remedies for Low Testosterone: How to Enhance Male Sexual Health and Energy by Stephen Harrod Buhner
It teaches the reader the basics of the science around testosterone issues. The book also goes into the various kinds of pollutants that decrease testosterone. Lastly the book goes into dietary choices, and herbal medicines that help promote better free testosterone levels.