Nope, none of the major common symptoms. Really confusing to my doctors
Do you recall what your Free T number was? Total T isn’t really what’s Important but it Is the thing most focus on, Free T is what really matters. If you have low SHBG It is possible to have low Total T number with a relatively normal Free T number.
No I don’t have that one handy (it was similarly low though) - I just had another draw for it done this morning so I should have an updated number in a couple of days
Curious to hear if you added in more strength training? (with weights instead of bodyweight only)
Yes, I strength train with weights 3x a week now - hasn’t changed my testosterone numbers at all
What lifts do you do? I do three main lifts every week, squat, dead lift, bench and my T levels raised through this process. If I do arm curls or other non-compound lifts I just get more run down and don’t get any real benefit other than bigger biceps and honestly that is irrelevant to me. Just something to consider.
Bench, squat, military press, horizontal rows
I get a treatment called Biote. It’s a “bioidentical” implant that last 6 months. It’s part of a preventative medicine program that includes regular blood panels. They look at your blood and suggest taking supplements or medications to get everything where they want it. Not just hormones.
@trpnhntr Any updates?
No real changes for me. Numbers are still concerningly low, training and fitness are still high. I’ve tried a ton of different permutations on training and rest and none of them have meaningfully moved the number. Still minimal impact on my day to day life, although every doctor I’ve spoken with assures me I’d have more energy and would be much stronger if I could get the number higher
Are you eating enough? Long-term undereating could cause a low level of testosterone. Combined with some bursts of overeating (e.g. rest day), your weight could remain stable, while you are in fact undereating most of the time.
Are you fueling your workouts enough? Before, during and after the workout?
Perhaps interesting for you is one of the recent succesful athletes podcast: https://www.youtube.com/watch?v=GaOyu4Js3Tw&list=PLrKJ0zeMQrI4ViIjWs8xnCiBCYoay5U0B&index=3 He reached extremely low levels of testosterone by underfueling.
An interesting suggestion, not something I’ve really considered in depth
My weight has been largely stable for the last two years (170 lbs at 6’4" give or take). I do fuel workouts pretty extensively but if I’m being honest I probably have some disordered eating habits (as do many cyclists imo).
I’ll check out that episode in more depth and see if there’s some changes I could experiment with. Thank you!
Based purely on numbers, 170lbs at 6ft 4 sounds right at the bottom end of the normal range to me (mental maths, not a scientific check). Have you tried pushing your bodyweight up 5-8lbs and seeing what happens?
That aside, unfortunately if this is primary hypogonadism, while I’m not saying you can’t do anything, if what you have tried hasn’t worked then you’re not going to move the dial much more, and will have to take the decision whether or not you accept low testosterone or go on TRT; there isn’t a third option. There is also increasing awareness of the potential health issues associated with long term low T, so while I totally understand the reluctance of many on here (especially the racers, as it’s a career-ender) to go down the hormone replacement route, that’s not something I’d simply dismiss on principle.
Good luck.
Cut out alcohol, all soybean products/oils and flaxseed. Flaxseed has been shown to have estrogenic properties which could lower testosterone. Make sure none of the products you use have soybean oil including chamois creme. Don’t drink out of plastic bottles that have been sitting in the sun. Eat plenty of eggs, daily. Good luck.
The eating enough part might be worth playing around with? Maybe try and eat in a daily surplus of few hundred calories (300 maybe) for like three months. Might gain a bit of weight but that could be quite a lot of muscle considering all of your training. At this point I don’t think you should be afraid of that because it’s easily lost if it doesn’t have any effect.
Long term deficits can lead to a decrease in testosterone. Even if the overall deficit is small.
Good luck man.
I think the original poster and his MD are on the right track. Basically with low T, you have an impaired ability to recover and that makes the concept of Minimium Effective Dose (of training stimulus) more important. I havehad my testosterone tested for about 15yrs now following a high altitude climbing trip where I felt really beat down even months after the trip was over.
I have found that:
Being really lean (under6%) lowers my T numbers.
Very low fat diet lowers my T numbers
Excessive stress from any source lowers my T numbers
That said, the thing that really lowers my numbers is excessive mid and high intensity training. I feel beat, I am beat and blood tests confirm I am beat!
I try to get as much training stimulus as possible while beating myself up as little as possible. Currently, I am doing a LV plan built by TR plan builder, and adding an hour at 75% on three of the off days.
I’m 58yrs but I think the concepts apply.
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So I have had experience with adrenogenital syndrome. It means more or less that my adrenal glands were not capable of synthesizing a some chemicals into testosterone (IIRC). So, I was put on hydrocortison to give it to my body directly, and now after years almost off it and balance restored (as it seems this far). I was basically stacking up on DHEA, which my body should have been converting.
I felt tired, foggy brain, could not push through either lifting running or cycling.
Point is, there are MANY of these kind of hormonal deviations and to get it tested properly, you need an endocrinologist who also looks at 24h/urine as many hormones are secreted or lost in urine.
I would rather focus on that first and reducing training load now that you still have energy. Be warned, it may be nothing serious but you can make it serious by exhausting the body.
I’ll throw my hat into the ring. I recently got my T checked due to low sex drive. I was on the low-normal side of the spectrum. (Just so we are clear, there is a normal range, and I was on the low side; it was low enough that my primary care doc said I should see an endocrinologist, but it was not below the reference range, so not a clear indication of pathology based just on the number.) I saw an endocrinologist to see if there was anything that could be done.
He ran a full blood panel on me, and it turned out that my prolactin was high. Prolactin is the hormone that women have when they’re pregnant or lactating. Now, in men, this will inhibit your testosterone production. How the heck do men get high prolactin? Benign small tumors in your pituitary gland can cause this (but there are other causes). I took an MRI to confirm that. As a result of that, I’m on cabergoline, a first generation dopamine agonist. Apparently (I’m not an MD), dopamine also regulates prolactin, and treatment with a dopamine agonist should eventually shrink the tumor. Side note, second-generation dopamine agonists are used in Parkinsons, and first-generation ones at the doses they would take have a lot of side effects. For hyperprolactinemia, you take a lot less than someone would take for Parkinsons, so no worries there.
This was a relief from the TUE side. I skimmed the USADA criteria, and to grant an exemption for testosterone, they require your testosterone to be below the reference level (i.e. low side of normal, like I had, wouldn’t qualify), and documentation of an organic cause, e.g. your testicles got injured, so we’re shooting you up with T. My endocrinologist said he would have recommended Clomid, which has fewer side effects than straight up T, but Clomid is also banned.
I’m putting this out there in case it helps someone. A regular primary care doctor may not know to check for this hormone; mine did not (this is not a knock on primary care physicians, NPs, or PAs - they have to know a bit about every area of medicine, which is a lot of stuff). If you saw an endocrinologist, I’d assume they would have checked. I don’t know how common these pituitary tumors are. Apparently, autopsy studies may say they are not uncommon. However, we don’t know how many people actually saw high prolactin levels because of it; it’s a bit like prostate cancer, where a lot of people die with asymptomatic prostate tumors.
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@trpnhntr I’ve followed this thread for a while. Sounds like you’re doing great except for a low test number. At this point are you leaning towards just not doing anything? It’s starting to sound like that could be a viable option.
The problem with exogenous testosterone (even in therapeutic doses) is that it’s like crossing the Rubicon. You’ll never get back to the person you were the day before you started taking test. So you’d have to really not like the way you are now to embark on that journey, IMO. You sound like you’re doing at least better than OK so it’d be a hard decision to make.
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Yeah, I’m basically continuing with life as normal. I am always looking for other things to try to get to a normal range, but the various doctors I’ve seen all seem to have come to the same conclusion, which is - stop training and your body will reset over the course of several months, and we expect your testosterone level to return to normal
I’ve had three different doctors do full workups at this point and no one can find any real cause other than the chronic stress associated with my training. Not to say there’s something they’ve all missed, and the fairly recent comment above about diet did ring true to me - bro science-ish but I’m certainly going to experiment with adjusting my caloric intake up a bit over the next few months and see how that goes.
I think the primary impact on my life is a generally lower energy level, but I don’t think it is hurting me off the bike (sex drive, general cognition, depression, etc. all unchanged). While my performance on the bike has been higher in past years, I’m only about 20 watts below my all time FTP high (per a recent 40 minute test I did where I averaged 367 watts - and its definitely my off-season so I’m not particularly fit right now. Further, last season (2019), nearly 12 months into this chronic low T, I got my cat 1 road upgrade, so my racing performance is still trending upwards despite this and my increasing age
All that to say - yeah, I’m definitely not going to take anything, never really considered it. I will reduce my cycling and see if it comes back naturally if it starts to impact me elsewhere. Only if it doesn’t rebound with greatly reduced training will I consider taking something.
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