Testosterone treatment confusion.
I'm male, 73 years old. Stroke in 2012. Heart attack in 2014 quad bypass. About 8 years ago. I complained to my PCP of low energy, no libido, exhaustion. He suggested vitamins, but was reluctant to test for testosterone levels. After a year of being tired and no drive, I insisted on a test. He said my testosterone was non-existent, and put me on 200mg/M injection weekly. I was on that dose for about 7 years. I had energy, chased the wife around the house, and felt great. Insurance changes made for a doctor change. During the initial visit, he remarked that 200mg a week was unusual to start with. Of course, he didn't do a test for the T level. Things were fine for two years more. Then a blood test showed elevated PSA. He told me he was uneasy with the Testosterone therapy in case the PSA level indicated cancer. I told him that, prior to that appointment, that I had had sex with my wife. I understood that that might elevate it.
He was still concerned, as he didn't want to feed any cancer that "might" be there. I was showing no symptoms of any type. But he pulled me off the testosterone, totally. Set me up, with a specialist Urologist" for tests. Which, wound up taking 5 months to finally be seen. After about a week and a half, I thought I was going to die! Couldn't breathe, falling stumbling, couldn't hold a thought, could hardly walk 40 yards before having to stop. Finally saw the Urologist who set me up with a battery of test, Prostate/Bladder ultrasound, Hydro flow test, Manual check of the Prostate, which all was declared normal. He tested for PSA, and said it was slightly elevated, but well down from my doctor's last test 5 months before. When I next saw my PCP, I told him of the horrible feelings and problems, and asked if maybe we could try a quarter or half dose a week, so I wouldn't just die out in the yard. It was that horrible of a feeling.
He allowed 100mg injection a week, tested for T after 6 months, and announced it was normal, almost below normal.
I didn't know, until I checked when my body seemed to be crashing and I researched a little, that I might should have been tapered off to reduce the shock on my body. It's been about 5 months now, of the lower dosage, but I still stumble, can't think well under stress, very weak.
Any ideas. or thoughts? He says the T is normal, and PSA barely elevated, but I just don't feel recovered from that withdrawal it felt like. It was really horrible. I wouldn't wish it on my worst enemy.
Thanks,
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Nothing to contribute other than, for some reason, I have been unable to get my prescription for testosterone topical gel filled since March. I am chronically fatigued and experience mental fog. The gel packs are unavailable at any pharmacy anywhere, apparently.
Please know the male population's Testosterone levels have been dropping over the last several decades. A few years back the folks that determine what a reference range should be for Testosterone at various ages LOWERED the reference ranges. You may have been deemed low several years ago and the same test would declare you normal now. The range of normal Testosterone levels is very wide. You should not go strictly by the number on the lab test but also consider your symptoms.
Also, Free Testosterone levels should be confirmed. A man can have normal to somewhat high Total Testosterone and still have low Free Testosterone. It's the Free Testosterone that is available for your body to use.
I strongly recommend seeing an endocrinologist that specializes in men's hormone health. Very few if any urologists or PCPs get much training in this area.
I'm on injections of 100 mg testosterone cypionate once per week. My endocrinologist did not think my non-existent libido would reappear if he allowed me to increase the dose beyond 100 mg. My free=T had dropped to well below normal levels before I originally convinced the doctor to prescribe the T for me. Then he prescribed an aromoatase in inhibitor, exestamane, 1.2 tablet every 3.5 days. That's to fight the conversion of T to estrogen. I still have no libido whatsoever. I'm 77 years old. So, my doctor is going to a concierge service and will charge $3,400 per year to still serve his patients. I can't afford that, and we were at an impasse in terms of libido recovery anyway. Now i need to find a new endocrinologist.
So, any ideas for me?