[Closed] Low Testosterone - Therapy ? (male menopause)

No experience of it, but I understand that exercise and weight loss are two things clinically proven to help with testosterone levels.

You've the double whammy of fatigue and demotivation - but diet and exercise are definitely your friends.

No experience of it, but I understand that exercise and weight loss are two things clinically proven to help with testosterone levels.

And thats the annoying bit, 1 having the time to exercise 2 having a hip that will let me exercise.

I cant run anymore and biking hurst after 30 miles or so, and difficult to fit in with a week at work and ferrying son around to football training sessions ! Doc wont give me a new hip as apparently it isnt severe enough yet....

You have come to the conclusion it is the testosterone level - I would suspect that the nr diabetes status may be a bigger factor ( or play a very important part).
I was diagnosed with diabetes - which I have now reversed
I have slightly raise cholesterol - which the NHS wanted to put me on statins - but finally agree to wait until I was 65.

Anxiety , night sweats , lack of drive, too much effort to do stuff, fatigue are all bang on characteristics of diabetes. ( as well as perhaps mid life issues).
Work on you weight - find exercise you can do (running / walking with hips issues isn't the answer - cycling would be ) - and then look at the testosterone - that may also be reduced because of the weight.

If i were you id look at reducing the carbs in your diet to reverse the borderline diabetes, in particular the simple, sugary carbs. You might find that'll help improve your cholesterol as well as assist in weight loss and maybe help T levels.

I don't listen to much on the internet but Dr Berg is full of useful advice https://www.youtube.com/c/DrEricBergDC

Thanks all some interesting stuff to think on.

To be fair I havent really adjusted my carb intake since reducing exercise + a son who has to eat 3000 + calories a day to keep on top of all the exercise he does, doesnt help!

@edward2000 - you're brave posting advice from a US chiropractor on here! Can't wait to see the responses.

I agree about looking to reduce carbohydrate intake to help with pre-diabetes and diabetes. If you look at Dr David Unwin's work, he has had great success in improving many of his patients diabetes, metabolic markers, weight, and medications simply by getting them on a low carb, higher fat and moderate protein diet. There's a definite link between low testosterone and insulin resistance. Resistance (strength training) has been shown to help a lot with testosterone levels, so may be a good idea to hit the weights and see if that helps.

I'm on TRT. If you're going via the NHS expect a long and tedious journey. When I was 30 mine was below the level acceptable for an OAP and would have been fine to compete as a woman in international sport. Yet the consultant told me it was "on the lower end but still normal".

Anyway after a few more visits to the GP I was at my wits end and ended up in tears. At that point a kind doctor actually listened to me, i got referred again and dug my heels in and now I'm on TRT and feeling 100% better.

Every time I go for my checkup they try and get my back off it though. It's mega frustrating.

Low testosterone is a risk factor for T2DM regardless of weight so it’s worth getting that sorted regardless. Dunno how old you are but TRT is prescribed pretty widely by endocrinologists round our way.
Regarding being started on statins “by the nhs” what you mean “by evidence based medicine”. There is little doubt that statins reduce the risk of stroke heart attack and mortality in type 2 diabetics regardless of cholesterol level, bmi, etc etc. hence being routinely recommended for all t2dm over 40. Of course the issue is that studies haven’t (as far as I’m aware) been done on the effects of reversing diabetes through diet on all this- but a lack of evidence of benefit is not the same as evidence of a lack of benefit.
Doi- male 50+ gp with strong family history of t2dm, trying to keep bmi under 30…

There is little doubt that statins reduce the risk of stroke heart attack and mortality in type 2 diabetics regardless of cholesterol level, bmi, etc etc. hence being routinely recommended for all t2dm over 40. Of course the issue is that studies haven’t (as far as I’m aware) been done on the effects of reversing diabetes through diet on all this- but a lack of evidence of benefit is not the same as evidence of a lack of benefit.
Doi- male 50+ gp with strong family history of t2dm, trying to keep bmi under 30…

Interesting - as when I got to talk to my GP about statins ( over 60, BMI of just under 30, slightly high cholesterol) and my unwillingness to go on them (mainly down to muscle cramps - my brother suffer badly from them when on stains, I suffer from them, without being on statins) she was less that kind about " the little doubt that statins reduce heart attacks and strokes in the over 60s". The stats she gave me was at 59 you have a 8% chance of a heart attack, o the days of your 60th birthday this goes up to 12%. But it is obviously just statistics. Really your actually risk will stay as it was until something major happen. She also confirmed the issue that they doesn't really know why statins work. I have no doubt that if you have high chance of coronary issues, or a very high BMI, or high "bad" cholesterol with a bad ration of good to bad, then statins may be a route to go.
But I really question that it is unequivocal fact.

But getting the pre diabetic state down from nearly diabetic, th weight down, and sorting out the hormones, are likely to have much bigger effect that statins. Statins are the NHS's elastoplast ...

There is little doubt that statins reduce the risk of stroke heart attack and mortality in type 2 diabetics regardless of cholesterol level, bmi, etc etc. hence being routinely recommended for all t2dm over 40

The irony is that taking statins has been shown to increase the risk of T2DM with virtually no mortality benefit in low risk patients (look at the NNT website if you don't believe me https://www.thennt.com/nnt/statins-persons-low-risk-cardiovascular-disease/).

So personally, in your shoes I would try everything possible if you are pre-diabetic to improve your metabolic health through other means, before going anywhere near statins.

Fenugreek, D-aspartic acid, tribulus, vitamin E and ashwaghanda root extract - that natural stack will have you chopping wood with your pecker again in no time 😉

Plus lifting heavy things, losing weight and reducing carbs - all great advice too IMO.

I had a big op on my foot last year and couldn't really stand for 6-8 weeks. I found some quite good seated dumbell/kettlebell workouts that might be manageable with a hip issue too. Get a strong chair though.

I agree about looking to reduce carbohydrate intake

+1

For me it was the inconvenient truth. I always just smashed in everything, thinking I'll just run it off. But they say you can't outrun a mars bar, or something. And when my exercise routine took a hit during lockdown I started to pile it on. Try to give up the starchy stuff, bread and sugar. I know it's not easy. Everything seems to be made of wheat and/or sugar. If you can do fasting, do it. It really works (for me). What it does I'm not sure but I try to do a three-five day water fast occasionally and it makes me feel like a new man. If a long fast is too hardcore, maybe don't eat until early evening or something. Look it up. It's all about giving your body a break to sort itself out. I'm not a doctor though.

Can you do a workout with dumbbell's perhaps? Using a bench to rest your hips. Lifting heavy weights should help your testosterone if you're convinced that's the problem. But sounds to me like the old diet and exercise need looking at primarily.

You sound very much like me, i always thought i was fit despite being a big guy, and excuse was i'd spent 20 years a rugby prop forward, so i am big lad, but i could cycle 200 miles in a day and deadlift 200kg, so i must be fit...

I had a few low testosterone tests, and i kept having fatigue issues, but again put that down to cycling to an from work over 10,000 miles for the year, the year prior, which i had to stop as i was suffering mood swings and extreme fatigue.

I had been tested for T2 and always hovered around 37-38 on hba1c (pre-diabetic is 40-48, over 48 is diabetic) the final straw seemed to be having severe COVID, in the weeks after my eyesight went blurry, dizzy when i stood up, urinating a lot and raised blood pressure.

Went for T2 tests and hba1c was 60, well into diabetic territory and they wanted to put me on Metformin drug straight away, but i asked if i could tackle it head-on myself and try diet and exercise for 3 months, if still no good, then i'd go onto drugs.

Read up a lot on it (helped by having Type 1 diabetic daughter, so knew carb content of foods), and from my diagnosis in mid December 2021 to end of Feb 2022, i dropped 2 stone, i cut carbs back to low-GI only, regularly tested by blood glucose levels to see what spiked me, cut carbs overall to less than 150g a day and increased good quality protein.

Best thing i did was buy a quality turbo trainer, now instead of riding 2 times a week outside, i follow a plan on Wahoo SYSTM, and ride 6 days a week inside and out, the turbo means i can fit in an hour around family life when i don't have time to ride outside. I also lift weights 2-3 times a week in my lunch break.

Weird thing is on first review my hba1c was back to 37, so diabetes in remission, i feel better than i have done in years, fitter and stronger, beasting workouts on turbo and blood glucose, weight and blood pressure all improved.

So moral of the story, even with the challenges of your hip, try and lose some weight and exercise where you can, as it can make a real difference.

biking hurst after 30 miles or so, 

That stands out to me, as someone with other medical/time/weight issues.

Rides don't have to be 30 miles plus, you know. I can easily cover 20-25 miles while my daughter is at gymnastics training twice a week. I can walk 2 miles while she has a music lesson tonight. I can fit in 10 miles while she's at Guides tomorrow night. I've got 4 hours to kill while she's at music centre Saturday morning.

The reason that I don't is the reason I'm overweight.

Again thanks for the info. I am approaching 48. My weight has remained static but muscle is definitely being replaced by flab !

Cholesterol was about 5.5 a year ago and now 7.2 - Genetic on one side of the family, my brother was similar levels before he went on statins. My Mum had big heart attack late 40's, and my Grandma dies early 50's of heart attack

HbA1c - 41

Bit worrying about the statins and links to diabetes.

Looks like a solution for now is getting back in to regular exercise and diet control.

Looks like a solution for now is getting back in to regular exercise and diet control.

If you crack that one I'll pay for the information! 🤦‍♂️

Looks like a solution for now is getting back in to regular exercise and diet control.

Might be worth as you're pre-diabetic range buying a blood glucose monitor and seeing what foods cause a spike with you, at first i went completely low-carb, the advice being to shed 10% of bodyweight, but after a while you can work out what carbs cause a spike and eliminate them from diet.

You need to test blood glucose, normal range being 4-7, then eat, and then test 2 hours later and you should of gone back to same figure before the food.

For me white bread, pasta, rice, and any of the refined carbs are no good, but i am fine with brown rice etc, and the best thing i have found for fuelling exercise is overnight oats, i have 50g of jumbo oats, a carb free vanilla protein powder, chia seeds and 150ml of almond milk left overnight mixed, then dollop of greek yoghurt and berries on top, been my go to and weirdly lowers my blood glucose after 2 hours.

The other thing is to make sure that when you consume carbs that you are consuming protein and healthy fats as they slow the absorption of the carbs into the bloodstream, so a large apple will raise BG, but with a handful of nuts its fine.

Best thing is, a lot of good curry sauces and the like are low carb, so eat well still big chicken curry with loads of veg in it, and often replace rice with lentils, dahl, spiced chickpeas etc, still very filling but all low GI

Weightlifting, or other strenuous sports. Eating red meat,fats and carbs, Plenty of sun and good restful sleeps.

So offroad cycling in the sun, followed by a hearty dinner of fatty steak, potatoes, bread and butter, washed down by beer, and a good nights sleep = Vitality.

Green veg, optional.

@funkydunc I can’t help you with the testosterone stuff, but I would say it’s worth persevering with exercise despite the labral tear. I have one, and it took a couple of years of stopping running and treating very gently before I found the aggravation calmed down enough for it not to be a constant source of pain. I can even walk pretty far and run a bit again now, despite not having the op. My top tips would be:
-avoid carrying heavy things, or anything much at all. Even a backpack on a walk will add enough weight to press my hip and leg bones together and cause pain.
-wear very light shoes. Somehow heavy shoes (walking boots for example) cause me all sorts of pain.
-avoid extremes of movement like you get on an aggressive road bike position or on a climbing wall. Or when jumping over a stream. No cyclocross style leg swinging onto the bike!
- do lots of glute stretches and deep tissue massage with a tennis ball, to stave off the pain that’s caused by correction/tension from favouring the hip without the tear, uneven walking etc.

If you can do that so that the pain subsides I’d be very surprised if mountain biking is uncomfortable. I know a few people who find bike riding one of the most comfortable activities with a labral tear. If it’s already sore it makes it worse, but if it’s not aggravated it seems ok. And if it’s got bad enough that it’s getting stuck or clicky, you probably just want to see another dr. There’s one local to me that is known for doing hip work on young active people - might be worth another push with the dr if you think you’re being fobbed off. Personally, I’m waiting for mine to get worse while the surgeons get more practice in! Good luck!

Testosterone? Make sure you're well stocked up with zinc, magnesium, oysters: each one reputed to have you firing off all cylinders.

Can you walk rather than run? If so a dog is the answer. I’m walking about 30 miles a week (4000Kcal or about 600/day) or more and that is a great exercise. I also keep a kettlebell by the desk for simple workouts during meetings. Nothing too strenuous as it’s just 15kg. But I think it helps.

Exercise is not really the way to weight loss, sadly. Diet is what matters. Porridge in the morning for a slow GI win helps me. But I am naturally slight despite being a carb hoover when properly training.

i agree with a lot of the testosterone inducing stuff above, but are you sleeping properly?
all the exercise in the world wont help if you dont sleep well
and dont expect hrt to make you sleep better

Tons of great info here, but only one person answered the question: Has anyone else had Testosterone replacement therapy, and did it help / side effects?

Saying "get more exercise" is all well and good, but harder than hell when you have low T.

So, has anyone else had Testosterone replacement therapy, and did it help / side effects?

Body fat = more estrogen, which = less testosterone
A friend of mine tried testosterone therapy, but it made him spend all his money on hookers, so he gave it up.
Id take it myself given the opportunity, but I feel that if I live to be 100,maybe it wouldnt be such a good idea to act like a teenager. Life might have planned something else.

TRT here. Started getting symptoms six months after having 'further repair work' following a dodgy snip. Fairly nasty operation to reduce the pain I was in (still have pain from snip - 10 years now), but it knocked my T levels down to 5 n/mol.(Normal 12-30).

As said above, long battle, loads of blood tests all coming back low. Had to move doctors practice as they weren't helpful with my snip issues, nor would my female doctor look at TRT. Went to new practice, doc saw results prescribed meds.

I noticed a massive decrease in my commute speeds and energy - very easily mapable from garmin data so I waved that at them. Tried injections and gels, ended up with gel. Injections were OK, but I was getting them every two weeks, and I'd be hobbling for five days out of 14 as it's intramuscular.

Been on gel years now. Can burn your skin a bit, so I apply to my 'sides' as it's less painful than shoulders. Just need blood tests every so often to measure my blood isn't getting too thick, and my PSA doesn't go up.

I certainly know when I forget to take it. Had many blood tests, and if I don't apply the gel in the morning before a blood test it's back at 5. If I apply the gel first then it's shot to 30. I'm no medic, but I've told the medical staff, as I'm on replacement, you'll either get overly low, or overly high levels in the morning - aren't you best testing in the afternoon. I've usually dropped to 13 ish by afternoon, so I try and split my dose these days, some at night some in the morning.

Just have to make sure no-one in the household comes into contact with your skin for a few hours - AKA your partner.

The docs won't accept that a bad snip (severed blood vessel) followed by extensive surgery caused it - funny how it suddenly appeared after these procedures.

It will take a while to be seen, and followed by regular blood tests to see if this isn't a one off, then you'll get prescribed.

PS no side effects, took a while for my red blood cell levels to be middle of the readings, as it went quite low. PSA did rise but became steady.

Only issues is the gel can sting and does dry your skin, and the injections can be painful after due to muscle damage. Also you'll have to have more blood tests at first with injections to see the re-dose rate - all a bit of a pain going back and forth to the docs as you can't do the injections yourself. I've had some supply issues as well, that I've had to try and sort out a few times. I do have enough spare to keep me going just in case.

As for exercise, I was commuting 25-50 miles a day, 5 days a week, so couldn't do more. Yes weight can affect it, and so can exercise, but I was way below the borderline.

What level are you at. You'll struggle to get treatment at 10 n/mol or above, even though 15 plus is recommended.

Once on replacement you'll be on it for life - your natural production stops. I know my baseline is 5, so they won't be taking me off it - they may reduce the dose as I'm on the maximum, but I find some of the gel get's absorbed into my clothing - I'm not going to sit there 10 minutes for it to dry.

Thanks fossy very insightful

Current reading is 10.9 - as you say so many variables.

I am taking this all as a bit of a middle aged warning sign thing, and try and improve things under my control to see if things can be improved.

Once on replacement you’ll be on it for life – your natural production stops.

I read a lot about this, and am fairly certain your natural testosterone can be restored. I dont recall the details

T can't come back if it was as low as mine, I unfortunately have blood supply damage, so enough isn't getting into my system.

Back to op, 10.9 is low, but boarder line - you will be knackered with it, but will struggle to get replacement - they weren't too keen when mine was consistently below 7. I'd suggest trying to improve exercise, diet, vitamins and get retested in a few months.

Low T here too. Diagnosed about 7 years ago when I had a spell of extreme fatigue, which built up gradually over the months and years before. Turns out I was off the bottom of the scale at 4ish nmol.

Tried gels but they didn't work for me, didn't recover my levels and found them a bit of a faff. Now have an injection every 10 weeks, and this seems to keep me fairly stable in the low 20s nmol. Going to the GPs for the injection is now just part of the normal routine.

Still find I am much more easily fatigued than I used to be, but I'm a while lot better than when I was in that low spot 7 years ago.

you’re brave posting advice from a US chiropractor on here! Can’t wait to see the responses.

Oh I didn't spot that  You can happily ignore anything he says at nothing he says can have any value.

On statins - there is no doubt at all they reduce mortality and morbidity from strokes - its grossly evident in the number of folk in hospital with strokes!  Noticeably less than when I started

Are they over prescribed in marginal cases?  Thats up for debate

Doesn't TRT reduce your body's natural production? Sounds like a Faustian pact.

There is always the option of going private. This is quite a good article citing the pros & cons of getting it on the NHS:

https://balancemyhormones.co.uk/trt-uk-nhs/

I'm Type 1 and been on statins since I was 26 - cholesterol was 4.1 and my blood pressure was described as high normal - so just above the normal range but only just. As I was diabetic, I was put on statins as they help protect other bits and lower risks of other things. Been fine for the last 21 years but it does mean when getting quotes for life insurance/assurance/whatever it is! or holiday insurance the price goes up as the statins are seen as a risk-factor - at least that is what I've been told when I've done some checks on how much life insurance/assurance or holiday insurance would cost me.