Post by andy12345 on Sept 21, 2009 20:54:46 GMT
EDIT I think I have been suffering from the decline of low normal to low T as the years went on, but of course, no tests= no proof.
Still reading more info actually, so this may be edited again...
Blood tests.
I saw the doc today about my blood tests (which on two occasions within 7 days I wrote some extra tests onto the sheet (about 10 extra tests in all.)
Well, when the doctor called me and said "andrewwwwww" I thought it sounded edgy like doc wanted to kill me or something..... Can't think why?
Walked in, shook doc's hand as usual, cos I'm like that.
Went through the usual pre-amble. "how are you" "I am ££$£" etc etc.
Doc told me that adult adhd specialist out-of-area funding needed to be done with dr. the main doc (doc is a locum) , so that means I will probably write a letter to (main) doc instead of needing to see main doc.......
I prepared almost 8 hours yesterday (procrastinating and printing/reading), omg just like the exam days and I was up at 8am after 4 hours sleep, doing more work, so that was another 6 hours (procrastinating printing reading eating.)
I wanted to get all of my blood test results but I did not ask for them to be printed because it might seem rude. After all, he is the doctor and a health professional. However, I did my usual bit with credible info etc.
Anyway, doc ended up saying I knew more about the hormones issue than they did, I was well spoken about it lol.
on two occasions (with short time to spare) I went through the old "justification" of why I did what I did blah blah without actually telling doc what I wanted......... Doc said "what do you actually want?" lol
Relative to males only......
Total Testosterone test 1 = 8.5nmol/l argh E2(estradiol) 120(ouch) Test 2 (1 week later) 9.9nmol/l argh E2 (presume 120) ouch again. E2 is a potent oppressor of testosterone.......
Remember the normal range is 12-38 and 12 would be considered to be a er healthy man of 70.........whilst a young, virile man of 20 could have 38, hence their sometimes, rather dominant behaviour.
Doc said my hormone results were all "normal" (watch out for that word.....normal) (remember the doc is a gp, don't know what the speciality expertise is), anyway I had my european urology document ready and pointed out that less than or equal to 12nmol of testosterone (english units) was now "agreed" by the main countries of europe to be the trigger point, that is, the level which supplementation is prescribed. (less than 12nmol = testosterone possibility) So, consequently I was asked did I want a urology referral etc as doc knows nothing about this and I know far more lol......... scary stuff.
As we looked at the blood test results I said "oh, by the way, I wrote some of the tests on myself"
Doc said "did you?"
I said "I want you to know that I would not do it unless I knew exactly why I wanted them and how they would benefit me".
(After all, they are the professionals, whether or not they don't "know it all" Respect! until it's time not to Respect them........)
A little bit about testosterone levels and "normal levels"....
1) Total testosterone, in England, has a working range of 12- 38 nmol/litre. Bodybuilders cycle up to about 50 I think...!!!! roarrrrrrr!!
All of the labs have various cut off's but they are generally quite close.
2) Less than 12nmol is treatable under European urology guidelines..... but English levels currently "allow" you to dip to (die more like) I think down to 8.5 nmol before treatment (backwards I tell you......)
3) About E2(estradiol, a potent testosterone nullifier) Bodybuilders regularly aim to keep E2 at 81 pmol/l or less
Well, there are forums all over the place discussing massive testosterone level cycling, so I can't comment, although perhaps a little bit higher say 35 would be safer, but HEY, they are the experts, not me.......
So if you have low test, high E2 argh what a nasty combo
IF you have high test, high E2 argh again.
High test low E2 lucky you......
So, there are now options......
Firstly though, one has to ask, why is my Testosterone low.......? I know what most of the causes can be but I can't check them... hence an endocrinologist referral which is my next step to check the HPTA, but I suppose working with the doc on the other relevant blood tests, fsh, lh, etc. before endocrinology referalls would be cost saving for the NHS so we can pay for more managers/bean counters/stat counters/clipboard maintenance engineers/ clipboard maintenance engineer support staff etc....
1) Take T supplementation,
Pro's masssive energy (well compared to before), vitality, mood, concentration, enthusiasm, in some cases less depressive symptoms and er more potency lol....
Neg's T gets converted to E2(estradiol) via aromatase. More bodyfat generally means more aromatase enzyme, which means more E2 which of course nullifies testosterone.......causing low T symptoms of .... I know that gels and such do work though and there is plenty of statistically significant info around.
From the european journal of endocrinology
Testosterone substitution with a new transdermal, hydroalcoholic gel applied to scrotal or non-scrotal skin: a multicentre trial
www.eje-online.org/cgi/content/full/153/2/317
2) Take Aromatase inhibitors.... I don't recommend "serms" (aromatase blockers). you can ask on many forums about that.
PRO's These will reduce the level of aromatase and increase testosterone and importantly free testosterone activation without any estradiol production.
Negs Need to stabilise the correct dose otherwise estradiol will be completely blanked and that is BAaaad.
Perhaps more study is needed for efficacy....
3) Do both..............
Look up the symptoms of male hypogonadism to see if you fit...........
If you have an E2 bloodtest make sure it is definitely "male sensitive or super sensitive"
At this time, I am not sure what a good E2 level is for a man who wants to be on the safe side of "superman"
Also, I don't consider that good levels of hormones will "cure" "correctly diagnosed ADHD" but you will perhaps find that some things change for the better and allow you to cope more with adhd. At the moment, I cannot really cope at all, so I hope things will change soon.....
Anyway, I am going to carry on working with the NHS, after all, it has much potential if not for those excessive quangos, bean counters and managers. I hope one day things will change.......(lol)
If you got this far, well done. Does anything in thismake sense not make sense, let me know....
doc shooed me out of the door in the end, because of time constraints lol.....so funny........
Also said "that's a bit naughty" regarding writing tests... Just be respectful until it's time to show your teeth grrrrrrrr. (hopefully never)
Anyway who wants to try to argue with their ignorance (not pointed at adduk, but those arrogant types) by saying that less than 12nmol/l is acceptable............ read this.
**********
EDIT ADDED SECTION
Someone asked me if hormones sometimes cause mood problems etc.
I can't really answer that as I am not on any meds that will change my blood levels but here's an example of an American article.
Also, I don't know exactly how adhd/depression relates to affecting levels of hormones......... all that up and down mood can't be good..........
www.seekwellness.com/andropause/low_testosterone.htm
Also, this info is from the top of the food chain of European urology.
__________________
www.uroweb.org/
ABOUT US
The European Association of Urology (EAU) represents more than 16,000 urology professionals across Europe and worldwide. Its mission is to raise the level of urological care in Europe.
Their document which answers some questions.
www.uroweb.org/fileadmin/user_upload/Guidelines/14%20Hypogonadism.pdf
However, the USA are actually ahead of the game on this, with additional research on E2 (estradiol)
_____________________________
Things will change eventually..
Still reading more info actually, so this may be edited again...
Blood tests.
I saw the doc today about my blood tests (which on two occasions within 7 days I wrote some extra tests onto the sheet (about 10 extra tests in all.)
Well, when the doctor called me and said "andrewwwwww" I thought it sounded edgy like doc wanted to kill me or something..... Can't think why?
Walked in, shook doc's hand as usual, cos I'm like that.
Went through the usual pre-amble. "how are you" "I am ££$£" etc etc.
Doc told me that adult adhd specialist out-of-area funding needed to be done with dr. the main doc (doc is a locum) , so that means I will probably write a letter to (main) doc instead of needing to see main doc.......
I prepared almost 8 hours yesterday (procrastinating and printing/reading), omg just like the exam days and I was up at 8am after 4 hours sleep, doing more work, so that was another 6 hours (procrastinating printing reading eating.)
I wanted to get all of my blood test results but I did not ask for them to be printed because it might seem rude. After all, he is the doctor and a health professional. However, I did my usual bit with credible info etc.
Anyway, doc ended up saying I knew more about the hormones issue than they did, I was well spoken about it lol.
on two occasions (with short time to spare) I went through the old "justification" of why I did what I did blah blah without actually telling doc what I wanted......... Doc said "what do you actually want?" lol
Relative to males only......
Total Testosterone test 1 = 8.5nmol/l argh E2(estradiol) 120(ouch) Test 2 (1 week later) 9.9nmol/l argh E2 (presume 120) ouch again. E2 is a potent oppressor of testosterone.......
Remember the normal range is 12-38 and 12 would be considered to be a er healthy man of 70.........whilst a young, virile man of 20 could have 38, hence their sometimes, rather dominant behaviour.
Doc said my hormone results were all "normal" (watch out for that word.....normal) (remember the doc is a gp, don't know what the speciality expertise is), anyway I had my european urology document ready and pointed out that less than or equal to 12nmol of testosterone (english units) was now "agreed" by the main countries of europe to be the trigger point, that is, the level which supplementation is prescribed. (less than 12nmol = testosterone possibility) So, consequently I was asked did I want a urology referral etc as doc knows nothing about this and I know far more lol......... scary stuff.
As we looked at the blood test results I said "oh, by the way, I wrote some of the tests on myself"
Doc said "did you?"
I said "I want you to know that I would not do it unless I knew exactly why I wanted them and how they would benefit me".
(After all, they are the professionals, whether or not they don't "know it all" Respect! until it's time not to Respect them........)
A little bit about testosterone levels and "normal levels"....
1) Total testosterone, in England, has a working range of 12- 38 nmol/litre. Bodybuilders cycle up to about 50 I think...!!!! roarrrrrrr!!
All of the labs have various cut off's but they are generally quite close.
2) Less than 12nmol is treatable under European urology guidelines..... but English levels currently "allow" you to dip to (die more like) I think down to 8.5 nmol before treatment (backwards I tell you......)
3) About E2(estradiol, a potent testosterone nullifier) Bodybuilders regularly aim to keep E2 at 81 pmol/l or less
Well, there are forums all over the place discussing massive testosterone level cycling, so I can't comment, although perhaps a little bit higher say 35 would be safer, but HEY, they are the experts, not me.......
So if you have low test, high E2 argh what a nasty combo
IF you have high test, high E2 argh again.
High test low E2 lucky you......
So, there are now options......
Firstly though, one has to ask, why is my Testosterone low.......? I know what most of the causes can be but I can't check them... hence an endocrinologist referral which is my next step to check the HPTA, but I suppose working with the doc on the other relevant blood tests, fsh, lh, etc. before endocrinology referalls would be cost saving for the NHS so we can pay for more managers/bean counters/stat counters/clipboard maintenance engineers/ clipboard maintenance engineer support staff etc....
1) Take T supplementation,
Pro's masssive energy (well compared to before), vitality, mood, concentration, enthusiasm, in some cases less depressive symptoms and er more potency lol....
Neg's T gets converted to E2(estradiol) via aromatase. More bodyfat generally means more aromatase enzyme, which means more E2 which of course nullifies testosterone.......causing low T symptoms of .... I know that gels and such do work though and there is plenty of statistically significant info around.
From the european journal of endocrinology
Testosterone substitution with a new transdermal, hydroalcoholic gel applied to scrotal or non-scrotal skin: a multicentre trial
www.eje-online.org/cgi/content/full/153/2/317
2) Take Aromatase inhibitors.... I don't recommend "serms" (aromatase blockers). you can ask on many forums about that.
PRO's These will reduce the level of aromatase and increase testosterone and importantly free testosterone activation without any estradiol production.
Negs Need to stabilise the correct dose otherwise estradiol will be completely blanked and that is BAaaad.
Perhaps more study is needed for efficacy....
3) Do both..............
Look up the symptoms of male hypogonadism to see if you fit...........
If you have an E2 bloodtest make sure it is definitely "male sensitive or super sensitive"
At this time, I am not sure what a good E2 level is for a man who wants to be on the safe side of "superman"
Also, I don't consider that good levels of hormones will "cure" "correctly diagnosed ADHD" but you will perhaps find that some things change for the better and allow you to cope more with adhd. At the moment, I cannot really cope at all, so I hope things will change soon.....
Anyway, I am going to carry on working with the NHS, after all, it has much potential if not for those excessive quangos, bean counters and managers. I hope one day things will change.......(lol)
If you got this far, well done. Does anything in this
doc shooed me out of the door in the end, because of time constraints lol.....so funny........
Also said "that's a bit naughty" regarding writing tests... Just be respectful until it's time to show your teeth grrrrrrrr. (hopefully never)
Anyway who wants to try to argue with their ignorance (not pointed at adduk, but those arrogant types) by saying that less than 12nmol/l is acceptable............ read this.
**********
EDIT ADDED SECTION
Someone asked me if hormones sometimes cause mood problems etc.
I can't really answer that as I am not on any meds that will change my blood levels but here's an example of an American article.
Also, I don't know exactly how adhd/depression relates to affecting levels of hormones......... all that up and down mood can't be good..........
www.seekwellness.com/andropause/low_testosterone.htm
Also, this info is from the top of the food chain of European urology.
__________________
www.uroweb.org/
ABOUT US
The European Association of Urology (EAU) represents more than 16,000 urology professionals across Europe and worldwide. Its mission is to raise the level of urological care in Europe.
Their document which answers some questions.
www.uroweb.org/fileadmin/user_upload/Guidelines/14%20Hypogonadism.pdf
However, the USA are actually ahead of the game on this, with additional research on E2 (estradiol)
_____________________________
Things will change eventually..