{attn Eric} on male hormone testing
rabbit
You've posted some specific and helpful comments here on the subject of
hormone testing and treatments. I'd be interested in your thoughts about
the following note from my physician summarizing the results of some recent
bloodwork, with particular reference to the third paragraph:
--
"Your electrolytes (sodium, potassium, etc.) were within normal limits.
Your kidney function was normal. Your blood sugar was normal. Your urine
test was normal. Your liver function tests were normal. Your TSH (thyroid
hormone) was 1.80, with normal 0.49-4.67. Your test of thyroid hormone was
normal. Your blood count was essentially normal except for a mildly
decreased platelet count of 136, with normal between 140-440.
"Your total cholesterol is normal, at 156 mg/dl, normal is <200. Your LDL
(bad) cholesterol was 110; the desired value <130. The total cholesterol is
made up of both good (HDL) and bad (LDL) cholesterol. Your LDL or 'bad'
cholesterol was normal. Your triglyceride result was 79, a normal range is
<150. Triglycerides are another fat that we measure in the blood. Your HDL
(good) cholesterol is 30, normal is > 40. The HDL cholesterol is protective
in the development of vascular disease. Your HDL level is low. This can be
raised by regular aerobic exercises most days of the week.
"Your testosterone level was normal. Your FSH level is normal. Your FSH
result is 1.5. Your LH result is 1.2, this is slightly low with a range of
1.5 - 9.3. Your prolactin level is normal. Your prolactin result is 5.0."
__
What does the lutenizing hormone level of 1.2 (said to be slightly low)
indicate with respect to depression and/or erectile dysfunction? I'm
wondering if this might indicate hypogonadism? I do have a follow-up
appointment with my urologist next week, for his interpretation.
I'm currently on 400 mg. per day of Wellbutrin-SR, as well as Cialis for
erectile dysfunction. If there's a connection between these two issues,
since I believe the latter to be more physiological than psychological, I
wonder about hypogonadism as a possible common cause. My internist didn't
take a strong position on the question, but didn't discourage me from
seeing the urologist.
Any thoughts or suggestions that I might take to the uro appointment?
Many thanks.
Contrarian
> Eric,
>
> You've posted some specific and helpful comments here on the subject of
> hormone testing and treatments.
and on other subjects as well.
Larry Hoover
"rabbit" <rab...@mailinator.net> wrote in message
news:Xns9579EA37E5BFF...@24.168.128.78...
> What does the lutenizing hormone level of 1.2 (said to be slightly low)
> indicate with respect to depression and/or erectile dysfunction? I'm
> wondering if this might indicate hypogonadism? I do have a follow-up
> appointment with my urologist next week, for his interpretation.
LH is a pituitary hormone. Its effect is to stimulate the Leydig cells in
the testes to produce testosterone. There is a direct link between low
testosterone and erectile dysfunction, so the link to LH is indirect, but
obviously connected.
The hypothalamus releases gonadotropin-releasing hormone (GnRH) to the
pituitary in response to its assessment of e.g. circulating levels of
testosterone. This is the stimulus for LH release, the modulating factor.
What's missing from your blood work was an assessment of free and bound
testosterone.
Yes, you have evidence for hypogonadism, and it looks like its probably
secondary (i.e. hypothalamic/pituitary) hypogonadism (low LH). You do not
have sufficient information from these test results to be more specific.
There was no assessment of (GnRH), or testosterone. Sperm count is another
possible assessment.
Disturbances in hypothalamic-pituitary-gonadal hormones are more common in
mood-disordered individuals, but it is unclear what that relationship really
is. Depression could cause hormone disturbance; hormone disturbance could
cause depression; or, both could arise from a single fundamental
dysfunction.
Lar
Reeducation Camp
>From: rabbit rab...@mailinator.net
>Date: 10/5/2004 10:55 PM Eastern Standard Time
>Message-id: <Xns9579EA37E5BFF...@24.168.128.78>
>
>Eric,
>
>You've posted some specific and helpful comments here on the subject of
>hormone testing and treatments. I'd be interested in your thoughts about
>the following note from my physician summarizing the results of some recent
>bloodwork, with particular reference to the third paragraph:
>
>--
>"Your electrolytes (sodium, potassium, etc.) were within normal limits.
>Your kidney function was normal. Your blood sugar was normal. Your urine
>test was normal. Your liver function tests were normal. Your TSH (thyroid
>hormone) was 1.80, with normal 0.49-4.67. Your test of thyroid hormone was
>normal. Your blood count was essentially normal except for a mildly
>decreased platelet count of 136, with normal between 140-440.
Is that red blood cell count? RBC? Have you had your iron levels checked? Low
iron levels cause low RBC and low energy, fatigue, etc.
>"Your total cholesterol is normal, at 156 mg/dl, normal is <200. Your LDL
>(bad) cholesterol was 110; the desired value <130. The total cholesterol is
>made up of both good (HDL) and bad (LDL) cholesterol. Your LDL or 'bad'
>cholesterol was normal. Your triglyceride result was 79, a normal range is
><150. Triglycerides are another fat that we measure in the blood. Your HDL
>(good) cholesterol is 30, normal is > 40. The HDL cholesterol is protective
>in the development of vascular disease. Your HDL level is low. This can be
>raised by regular aerobic exercises most days of the week.
I am not a doctor and I have no idea about this stuff above. Sounds OK to me.
>
>"Your testosterone level was normal.
Thats what my family doctor told me the first time I had my testosterone
tested. Turned out when I got copies of my medical records from that guy a
little over a year later, my total serum testosterone was extremely low...below
normal and my free serum testosterone was just borderline above the cutoff
mark. To him, that was technically "normal" and he was safe in not wanting to
prescribe testosterone to me.
The endocrinologist I saw a year or so later who was a specialist in androgen
therapy said my initial testosterone test was "low normal" and he would have
initiated testosterone replacement. All my subsequent testosterone tests showed
below normal...both total serum and free serum T.
Your FSH level is normal. Your FSH
>result is 1.5. Your LH result is 1.2, this is slightly low with a range of
>1.5 - 9.3. Your prolactin level is normal. Your prolactin result is 5.0."
My LH was also about what yours is. 1 point something or other. The
endocrinologist I saw said that was "low normal" LH and when you have low
testosterone scores along with a low or low normal LH, usually it means your
hypogonadism is "secondary." Meaning the cause is not in your testicles, its in
your brain. Usually it means a hypothalamus or pituitary thats not working up
to full speed. The technical term for secondary hypogonadism is
"hypogonadotrophic hypogonadism."
If your LH score is high normal or high along with low testosterone, that means
your testosterone deficiency is "primary" meaning the problem is directly in
your testicles...they arent working right, due to testicle injury, surgery in
that area, old age, exposure to radiation...whatever.
Did you get your actual testosterone score? You didnt post your total serum and
free serum testosterone levels. A good total serum testosterone (AM) is
considered to be 350 ng/ml or higher. Mine was like 200 ng/nl...very low for my
age.
>What does the lutenizing hormone level of 1.2 (said to be slightly low)
>indicate with respect to depression and/or erectile dysfunction? I'm
>wondering if this might indicate hypogonadism?
it goes along with the diagnosis of clinical depression. You didnt post your
testosterone scores...are they low normal or truly just "normal?"
I do have a follow-up
>appointment with my urologist next week, for his interpretation.
>
>I'm currently on 400 mg. per day of Wellbutrin-SR, as well as Cialis for
>erectile dysfunction. If there's a connection between these two issues,
>since I believe the latter to be more physiological than psychological, I
>wonder about hypogonadism as a possible common cause. My internist didn't
>take a strong position on the question, but didn't discourage me from
>seeing the urologist.
He probably doesnt want to rx you testosterone unless you formally flunk all
the numbers on the blood tests. Testosterone is a controlled substance and
doctors are very careful about prescribing controlled substances.
Mine was the same way...he wouldnt rx me testosterone the first test I had and
told me it was "normal." It wasnt normal, my total serum T was extremely low
and my free serum T was extremely low normal. So in his mind, I was "OK." Fat
chance of that.
>
>Any thoughts or suggestions that I might take to the uro appointment?
Get your testosterone scores (both total serum T and free serum T...morning
scores) and decide for yourself if they are truly in the normal or average
range or if they are in the "low normal range." If its low normal, let a
specialist treat you and screw your internal med doctor. A specialist for this
means either an endocrinologist who area of interest is androgen replacement or
a
If on the other hand your testosterone levels are truly normal, I wouldnt fuck
with it. Id leave it alone. Taking a strong hormone like testosterone if your T
levels are OK is messing with your body in ways you dont want to do.
For example, taking testosterone oftentimes results in elevated cholesterol
levels. Also, it can change your glucose sensitivity. It can also raise your
red blood cell count to abnormally high levels and your blood can thicken and
you can have a stroke. There are serious potential side effects to taking
testosterone and I wouldnt take the stuff unless you were low or low normal on
formal T bloodwork.
Eric
"The whole world can kiss my ass"
LostBoyinNC
Larry Hoover
"Reeducation Camp " <deeps...@aol.comSpeakers> wrote in message
news:20041006174203...@mb-m15.aol.com...
>>"Your testosterone level was normal.
>
> Thats what my family doctor told me the first time I had my testosterone
> tested. Turned out when I got copies of my medical records from that guy a
> little over a year later, my total serum testosterone was extremely
> low...below
> normal and my free serum testosterone was just borderline above the cutoff
> mark. To him, that was technically "normal" and he was safe in not wanting
> to
> prescribe testosterone to me.
>
> The endocrinologist I saw a year or so later who was a specialist in
> androgen
> therapy said my initial testosterone test was "low normal" and he would
> have
> initiated testosterone replacement. All my subsequent testosterone tests
> showed
> below normal...both total serum and free serum T.
Sorry for missing the statement about testosterone being normal. I guess I
was looking for numbers, and my brain skipped that sentence. Normal is not
detailed enough an answer, as Eric makes clear. I think testosterone ranges
deemed normal are something like older thinking on thyroid TSH; the range of
normal was far too broad, and included some individuals with thyroid
problems. Same goes for the testosterone. It's arbitrary to say "normal"
about testosterone, when LH is low. You need to interpret them together.
Lar
rabbit
least, is that I ask my internist for copies of the actual lab reports
prior to seeing the urologist next week.
Seeing the urologist about this is my natural inclination because I have an
established relationship with him; and he's the one who prescribes my ED
meds (Cialis and before that Viagra). Do you think he is the best
specialist for questions about hormones, or an endocrinologist. According
to his website, my urologist received specialized training in male
infertility at Beth Israel Medical Center and is "considered an expert" in
"erectile dysfunction and minimally invasive surgeries."
This sounds like appropriate special expertise to me, but I have no
experience in seeking treatment for hormonal issues.
Reeducation Camp
>From: rabbit rab...@mailinator.net
>Date: 10/6/2004 6:55 PM Eastern Standard Time
>Message-id: <Xns957AC1F0FD1D4...@24.168.128.74>
>
>Thanks Eric and Larry. One thing that you've suggested, implicitly at
>least, is that I ask my internist for copies of the actual lab reports
>prior to seeing the urologist next week.
Yeah, get copies of the actual AM testosterone levels (total serum T and free
serum T) from your family doctor. So you can see them for yourself and bring
them with you to discuss with your urologist.
>
>Seeing the urologist about this is my natural inclination because I have an
>established relationship with him; and he's the one who prescribes my ED
>meds (Cialis and before that Viagra). Do you think he is the best
>specialist for questions about hormones, or an endocrinologist. According
>to his website, my urologist received specialized training in male
>infertility at Beth Israel Medical Center and is "considered an expert" in
>"erectile dysfunction and minimally invasive surgeries."
Yeah, he sounds like he probably would be a good guy to use for this thing.
Particularly since you have an established relationship with him and it sounds
like a good patient/doctor relationship.
Definitely get copies of those testosterone lab tests though. "Normal" could be
anything from just passing to truly "average guy" normal testosterone levels.
Only when you see the results yourself can you make a decision.
>
>This sounds like appropriate special expertise to me, but I have no
>experience in seeking treatment for hormonal issues.
Neither did I til about a year and a half ago. Its not hard to learn. The good
thing about it is that its more medical and therefore more cut and dry than
this psychiatry bullshit.
Reeducation Camp
>Date: 10/6/2004 7:23 PM Eastern Standard Time
>Message-id: <20041006192305...@mb-m15.aol.com>
Another thing. When you discuss this testosterone stuff with doctors, try to
make it clear that your main interest is not treating erectile dysfunction and
low libido. Just my personal opinion.
With some doctors (not all though) they start thinking youre a perv somewhat
persisting so much about low libido and inability to get a good erection. This
is highly variable though. In psychiatry Ive personally found it to be the
older the Pdoc, the less important sexual matters are to them. They are more
concerned about your mood and thinking abilities and sex is last on their list.
Which is actually not a bad thing really in some ways.
Many are too stupid and poorly educated to realize that low testosterone levels
not only affects men's sexual appetite but also affects negatively the male
mood. There are even studies showing that low testosterone levels leave men
more open to development of Alzheimers disease.
What Im trying to say is that low testosterone is another ball of wax and low T
levels can have profound effects on mood and anxiety, body composition, how
strong your bones are, whether or not you get osteoperosis, how aggressive you
are (or to be politically correct, how "assertive" you are).
When many doctors think testosterone they ONLY think sexuality issues. Or they
think about muscles. I swear its unbelievable how poorly educated many Medical
Doctors are about low testosterone. The bad thing is that low T levels affects
a broad spectrum of male mental and physical health issues.
Dont be overly focused on sex stuff when talking to these doctors.
rabbit
Today I stopped by my doc's office and picked up copies of the lab reports
mentioned in my initial post at http://tinyurl.com/3ootc.
I've temporarily placed the lab reports on the web, with identifying info
removed, at http://herrrabbit.tripod.com .
I'm 45, 200 lbs., 5'9", diagnosed with chronic depression, acute for about
two years (medicated with 400 mg. of Wellbutrin-SR per day); erectile
dysfunction for about two years (medicated with 50 mg. Cialis PRN), asthma
(medicated with Proventil and Advair), sinusitis (medicated with Nasonex
spray), hyperlipidemia and pre-hypertension (exercise and low salt intake
recommended in lieu of meds); history of hydrocelectomy at age 3 and
possible scarlet fever at age 5.
I have an appointment to review these labs with my urologist on Monday
afternoon, 10/11/2004. Any specific comments or general suggestions that
you can offer in preparation for that visit would be appreciated. I realize
that neither of you are physicians, but your knowledge of hormone levels
well exceeds mine and may help me to ask better questions of my doctor.
Thanks for sharing the benefit of your experiences.
rabbit
Reeducation Camp
>From: rabbit rab...@mailinator.net
>Date: 10/8/2004 8:24 PM Eastern Standard Time
>Message-id: <Xns957CCF85BC57B...@140.99.99.130>
It looks like your doctor only checked your "total testosterone" AKA total
serum testosterone. You really needs BOTH total serum and FREE serum
testosterone levels. According to my doctor and from what Ive read its actually
the free serum testosterone thats most important.
Your total serum testosterone was much higher than mine at any time Ive had it
checked. The highest my total testosterone has been was 200 ng/dl. Yours is on
the low end of normal. Really, total serum testosterone ought to be 400 ng/dl
or higher. Yours is right about there.
Here is my advice. Go to a specialist (the urologist you have a good
relationship with) and discuss this with him. Ask for a SECOND blood
draw...with both total serum testosterone AND free serum testosterone...done in
the morning of course. And discuss whether that score along with the total
serum testosterone in the above lab test are acceptable for someone your age,
with refractory depression, correct?
The rest of your bloodwork looks good, except for the cholesterol. Keep in mind
if you go on testosterone replacement, thats likely to have a worsening effect
on your cholesterol levels. You will most likely have to take a cholesterol
drug for as long as you are on the testosterone as well as do a lot of aerobic
exercise to try to improve your HDL cholesterol levels.
Testosterone replacement is sort of a double edged sword...its good for some
things and bad for others. Its good for mood and feeling of well being, libido,
heart muscle strength (testosterone is said to have a dilating effect on blood
vessels and the heart), stronger bones, less osteoporosis as you age...which
some men get.
Bad things about it include worsened cholesterol profile and possible bad
effects on blood sugar...decreased glucose tolerance. And fluid retention which
can lead to hypertension. And of course the increased red blood cell count, AKA
"polycythemia" which has to be monitored religiously cause if its not this can
possible lead to stroke. But the RBC thing can be caught easily and taken care
of quickly. My doctor demanded I have bloodwork with CBC (complete blood count)
and cholesterol screening every three months. Or I couldnt stay on the
testosterone.
Its nothing to take lightly.
Erection problems are oftentimes a part of major depression. Erection problems
can be caused by a number of things, such as high cholesterol, being
overweight, low or low normal testosterone, depression, diabetes,
hypertension...so dont be so sure to blame it on low testosterone.
All in all I have this to say. Discuss your numbers with a specialist and see
what they say about it.
Larry Hoover
The low FSH and LH, and low normal testosterone are strongly suggestive of
secondary hypogonadism. As Eric points out, free testosterone is also an
important distinction to make. Testosterone is nearly completely bound to
protein "sponges" called globulins, while it travels through the
bloodstream. A fraction of the total testosterone is "free" (i.e. not bound
to the globulin) at any point in time. Only free testosterone is
physiologically active. Total testosterone (the test you had) tells you more
about the reserves of testosterone. You also want to see whether it is found
at sufficient levels in the free form, to do its job.
Your bloodwork reveals a troubling pattern in the white cell count and
platelet levels. It looks very much like you have mononucleosis
(Epstein-Barr virus infection), or perhaps cytomegalovirus. There are
confirmatory tests for those suggested diagnoses. Did your doctor talk to
you about that possibility? 4% atypical lymphocytes should have raised some
attention. Combined with low total lymphocytes and low platelets, you might
even have a bone marrow disorder, like early leukemia. Nothing critical yet,
but I would think that follow-up bloodwork (at a minimum) is in order. Viral
infection is the most likely explanation, but I ain't a doctor.
Testosterone supplementation can also play havoc with bone marrow, so you
would best get a clear picture of what's going on. I developed polycythemia
from testosterone supps, went off them, and the counts came down. Could have
been a coincidence, though, so we're doing a rechallenge with testosterone.
If my hemoglobin gets too high again, I'll be getting a bone marrow biopsy.
Hormone therapy is powerful medicine. You shouldn't take it lightly.
Lar
Reeducation Camp
>Date: 10/8/2004 9:45 PM Eastern Standard Time
>Message-id: <kpH9d.37690$HO1.1...@news20.bellglobal.com>
>
>Testosterone supplementation can also play havoc with bone marrow, so you
>would best get a clear picture of what's going on.
Very true.
>I developed polycythemia
>from testosterone supps, went off them, and the counts came down. Could have
>been a coincidence, though, so we're doing a rechallenge with testosterone.
>If my hemoglobin gets too high again, I'll be getting a bone marrow biopsy.
Wow..you never said that you developed polycythemia from the testosterone.
Thats not good. You can stroke out very easily from polycythemia. Did it
elevate just your red blood cell count or did it also effect your white blood
cell count as well? My doctor says polycythemia from testosterone ONLY effects
RBC, but Im skeptical of what these doctors say...they cover their ass you
know.
I didnt look at his CBC counts, RBC and WBC and all. My Pdoc told me that WBC
gets elevated from severe stress. He told me that oftentimes when he puts
someone in the psych hospital, their initial CBC is higher than normal. After
their treatment is initiated and they stabilize, he told me the WBC comes back
down to normal.
>Hormone therapy is powerful medicine. You shouldn't take it lightly.
Thats an understatement. Its powerful stuff.
Larry Hoover
"Reeducation Camp " <deeps...@aol.comSpeakers> wrote in message
> >Subject: Re: {attn Eric and Larry} on male hormone testing - LAB REPORTS
>>From: "Larry Hoover" larry...@sympatico.ca
>>Date: 10/8/2004 9:45 PM Eastern Standard Time
>>Message-id: <kpH9d.37690$HO1.1...@news20.bellglobal.com>
>>
>
>
>
>>Testosterone supplementation can also play havoc with bone marrow, so you
>>would best get a clear picture of what's going on.
>
> Very true.
>
>>I developed polycythemia
>>from testosterone supps, went off them, and the counts came down. Could
>>have
>>been a coincidence, though, so we're doing a rechallenge with
>>testosterone.
>>If my hemoglobin gets too high again, I'll be getting a bone marrow
>>biopsy.
>
> Wow..you never said that you developed polycythemia from the testosterone.
It isn't clear that I got it from the testosterone. My hemoglobin/RBC have
been increasing for a number of years, just never got over the line into too
high until after I started getting shots.
> Thats not good. You can stroke out very easily from polycythemia. Did it
> elevate just your red blood cell count or did it also effect your white
> blood
> cell count as well?
Just RBC/hemoglobin.
> My doctor says polycythemia from testosterone ONLY effects
> RBC, but Im skeptical of what these doctors say...they cover their ass you
> know.
That's why it's a good idea to check things in other sources of information.
> I didnt look at his CBC counts, RBC and WBC and all. My Pdoc told me that
> WBC
> gets elevated from severe stress. He told me that oftentimes when he puts
> someone in the psych hospital, their initial CBC is higher than normal.
> After
> their treatment is initiated and they stabilize, he told me the WBC comes
> back
> down to normal.
Getting back to rabbit's findings, the atypical lymphocytes were what raised
concern. Atypicals are in the activated form. They're fighting something. It
ought to be determined what has activated them.
>>Hormone therapy is powerful medicine. You shouldn't take it lightly.
>
> Thats an understatement. Its powerful stuff.
>
> Eric
Yup.
Anti-med ho Pimp
>From: "Larry Hoover" larry...@sympatico.ca
>Message-id: <MNZ9d.40433$HO1.2...@news20.bellglobal.com>
>
>
>"Reeducation Camp " <deeps...@aol.comSpeakers> wrote in message
>news:20041008222106...@mb-m26.aol.com...
>> >Subject: Re: {attn Eric and Larry} on male hormone testing - LAB REPORTS
>>>From: "Larry Hoover" larry...@sympatico.ca
>>>Date: 10/8/2004 9:45 PM Eastern Standard Time
>>>Message-id: <kpH9d.37690$HO1.1...@news20.bellglobal.com>
>>>
>>
>>
>>
>>>Testosterone supplementation can also play havoc with bone marrow, so you
>>>would best get a clear picture of what's going on.
>>
>> Very true.
>>
>>>I developed polycythemia
>>>from testosterone supps, went off them, and the counts came down. Could
>>>have
>>>been a coincidence, though, so we're doing a rechallenge with
>>>testosterone.
>>>If my hemoglobin gets too high again, I'll be getting a bone marrow
>>>biopsy.
>>
>> Wow..you never said that you developed polycythemia from the testosterone.
>
>It isn't clear that I got it from the testosterone. My hemoglobin/RBC have
>been increasing for a number of years, just never got over the line into too
>high until after I started getting shots.
You sure about that? I read polycythemia is a very rare medical problem. Dont
you think that since it flared up after you had been getting testosterone
injections that was the culprit? And you said it went down after you stopped
the testosterone?
There you go...the cause.
BTW...with all those supplements you take you dont think youre getting an
overdose of iron do you? If so, could that be contributing any to an increased
RBC, especially with administration of testosterone? Im just asking this
because many multivitamins contain iron and I dont know if you take
multivitamins or what.
>
>> Thats not good. You can stroke out very easily from polycythemia. Did it
>> elevate just your red blood cell count or did it also effect your white
>> blood
>> cell count as well?
>
>Just RBC/hemoglobin.
>
Thats good to know. I was concerned it could also elevate my WBC and Im NOT
messing with those white blood cells! Told my doctor that too and he agreed
with me.
Eric
"It's a ho wide world. Dem ho's, dey be everywhere."
LostBoyinNC
Larry Hoover
"Anti-med ho Pimp" <deeps...@aol.comhohoho> wrote in message
news:20041009191440...@mb-m18.aol.com...
>>> Wow..you never said that you developed polycythemia from the
>>> testosterone.
>>
>>It isn't clear that I got it from the testosterone. My hemoglobin/RBC have
>>been increasing for a number of years, just never got over the line into
>>too
>>high until after I started getting shots.
>
> You sure about that? I read polycythemia is a very rare medical problem.
> Dont
> you think that since it flared up after you had been getting testosterone
> injections that was the culprit? And you said it went down after you
> stopped
> the testosterone?
>
> There you go...the cause.
The high RBC/hemoglobin could be due to stress. I experienced a significant
number of stressful incidents this spring, sufficient to have me seek
medical care for depression (yes, I asked to be put on an antidepressant,
Zoloft, in this case).
Although my counts declined after going off the testosterone, it still could
have been due to stress reduction as well. My hematologist supports a
rechallenge with testosterone. If the high counts reccur, then it is far
more likely to be due to testosterone. In any case, a bone marrow biopsy
will be necessary, if the counts increase again.
Only after these high values showed up this spring were my prior records
reviewed, with the idea of seeing if there had been a pattern over the prior
years' of medical tests. In fact, there was a slowing escalating trend
towards higher RBC/hemoglobin.
>
> BTW...with all those supplements you take you dont think youre getting an
> overdose of iron do you?
No, not from the supps. I don't supplement iron. I do eat a lot of meat,
however. I am a committed carnivore.
> If so, could that be contributing any to an increased
> RBC, especially with administration of testosterone?
I haven't seen diet linked to polycythemia.
> Im just asking this
> because many multivitamins contain iron and I dont know if you take
> multivitamins or what.
I do use a multi, but it's more for the B-complex. The minerals are kind of
tag along. I take extra minerals anyway, but not iron.
>>
>>> Thats not good. You can stroke out very easily from polycythemia. Did it
>>> elevate just your red blood cell count or did it also effect your white
>>> blood
>>> cell count as well?
>>
>>Just RBC/hemoglobin.
>>
>
> Thats good to know. I was concerned it could also elevate my WBC and Im
> NOT
> messing with those white blood cells! Told my doctor that too and he
> agreed
> with me.
>
> Eric
>
> "It's a ho wide world. Dem ho's, dey be everywhere."
>
> LostBoyinNC
I use some herbs that restrain the immune system, as immune activation is
associated with a number of the symptoms found in chronic depression. My WBC
etc. counts are always excellent (superb cholesterol numbers, for example
(hint: fish oil)), but only the RBC/hemoglobin has ever crossed the line.
Lar
Larry Hoover
"Larry Hoover" <larry...@sympatico.ca> wrote in message
news:V9%9d.42577$jj2.1...@news20.bellglobal.com...
>
> Only after these high values showed up this spring were my prior records
> reviewed, with the idea of seeing if there had been a pattern over the
> prior years' of medical tests. In fact, there was a slowing escalating
> trend towards higher RBC/hemoglobin.
....slowLY escalating trend....
Anti-med ho Pimp
>From: "Larry Hoover" larry...@sympatico.ca
>Message-id: <V9%9d.42577$jj2.1...@news20.bellglobal.com>
>
>
>"Anti-med ho Pimp" <deeps...@aol.comhohoho> wrote in message
>news:20041009191440...@mb-m18.aol.com...
>
>
>>>> Wow..you never said that you developed polycythemia from the
>>>> testosterone.
>>>
>>>It isn't clear that I got it from the testosterone. My hemoglobin/RBC have
>>>been increasing for a number of years, just never got over the line into
>>>too
>>>high until after I started getting shots.
>>
>> You sure about that? I read polycythemia is a very rare medical problem.
>> Dont
>> you think that since it flared up after you had been getting testosterone
>> injections that was the culprit? And you said it went down after you
>> stopped
>> the testosterone?
>>
>> There you go...the cause.
>
>The high RBC/hemoglobin could be due to stress. I experienced a significant
>number of stressful incidents this spring, sufficient to have me seek
>medical care for depression (yes, I asked to be put on an antidepressant,
>Zoloft, in this case).
Youre taking zoloft for depression? Just curious but have you taken lamictal?
Its good for depression (for some folks) but has a low chance of setting off a
manic or hypomanic episode.
RBC can increase due to stress? I didnt know that and Im going to ask my
psychiatrist about that next time I see him. Im not contesting you, Im just
genuinely curious. He told me that WBC can increase to severe stress...I
already told you the story he told me about many of his inpatients....their WBC
sometimes is high upon admission and goes down by the time they are stable and
discharged.
Good reason to try to keep stress levels down.
>
>Although my counts declined after going off the testosterone, it still could
>have been due to stress reduction as well. My hematologist supports a
>rechallenge with testosterone. If the high counts reccur, then it is far
>more likely to be due to testosterone. In any case, a bone marrow biopsy
>will be necessary, if the counts increase again.
Hmmmmmmm I hope so man, but realistically...dont you think it was probably the
testosterone? Would using a non injectable form of testosterone like a gel or
patch form decrease the possibility of getting polycythemia again? I have read
that using the gel and patch forms of T decrease the chance of polycythemia. I
dont know if thats really true or just drug company marketing bull, but if it
is true it would definitely be worth considering Androgel or something like it
next time you try testosterone. What do you think about using gels and patches
versus the old injectable testosterone?
>
>Only after these high values showed up this spring were my prior records
>reviewed, with the idea of seeing if there had been a pattern over the prior
>years' of medical tests. In fact, there was a slowing escalating trend
>towards higher RBC/hemoglobin.
>
>>
>> BTW...with all those supplements you take you dont think youre getting an
>> overdose of iron do you?
>
>No, not from the supps. I don't supplement iron. I do eat a lot of meat,
>however. I am a committed carnivore.
>
>> If so, could that be contributing any to an increased
>> RBC, especially with administration of testosterone?
>
>I haven't seen diet linked to polycythemia.
>
>> Im just asking this
>> because many multivitamins contain iron and I dont know if you take
>> multivitamins or what.
>
>I do use a multi, but it's more for the B-complex. The minerals are kind of
>tag along. I take extra minerals anyway, but not iron.
Does that multivitamin have iron in it? If so I would ditch it and use a
multivitamin that didnt have iron in it...that would have to be bad for the
RBC.
>
>I use some herbs that restrain the immune system, as immune activation is
>associated with a number of the symptoms found in chronic depression. My WBC
>etc. counts are always excellent (superb cholesterol numbers, for example
>(hint: fish oil)), but only the RBC/hemoglobin has ever crossed the line.
My blood pressure is shot thanks to MAOIs, I have high cholesterol now thanks
to three years of physical inactivity since my MAOI disasters. Ive noticed
since Ive been on baclofen for this mild dystonia dx that my blood pressure is
better.
A lot of people are getting good results with high dose lamictal...it didnt
work for me but it might work for you.
Anti-med ho Pimp
>From: "Larry Hoover" larry...@sympatico.ca
>Message-id: <Hb%9d.42607$jj2.1...@news20.bellglobal.com>
I read polycythemia is a very rare medical condition. If you have it not from
testosterone, youve got a rare disease there. I suspect it was from the
testosterone.
Ask about using gels or patches next time you take testosterone to prevent more
polycythemia.
Larry Hoover
"Anti-med ho Pimp" <deeps...@aol.comhohoho> wrote in message
> I read polycythemia is a very rare medical condition. If you have it not
> from
> testosterone, youve got a rare disease there. I suspect it was from the
> testosterone.
Ya, but my levels were in the 160s (170 being the high-normal cutoff) before
I started. I was already borderline. Rare disease or not, although I do not
relish the idea of a bone marrow biopsy, it is likely going to go that
route.
>
> Ask about using gels or patches next time you take testosterone to prevent
> more
> polycythemia.
As I understand it, there is no protective effect of using transdermal
testosterone. I haven't looked at the whole thing in months....do you have a
link handy?
Lar
Larry Hoover
"Anti-med ho Pimp" <deeps...@aol.comhohoho> wrote in message
>>The high RBC/hemoglobin could be due to stress. I experienced a
>>significant
>>number of stressful incidents this spring, sufficient to have me seek
>>medical care for depression (yes, I asked to be put on an antidepressant,
>>Zoloft, in this case).
>
>
> Youre taking zoloft for depression?
Used to be. I only got up to 75 mg (doctor wanted to go to 200), and I never
got so I could tolerate the side effects. I just finished withdrawal this
week. I'm starting on selegiline now.
> Just curious but have you taken lamictal?
Nope. It's still an option. I had a horrible response to lithium (made me
intensely suicidal, worse than I have ever been before or since), so maybe
we've steered clear of the mood stabilizers without good reason. Or maybe
with good reason. Hard to say.
> Its good for depression (for some folks) but has a low chance of setting
> off a
> manic or hypomanic episode.
High side-effect profile was a real concern. I am Mr. Side-Effect. I get all
the usual ones, and a good number of the rare ones.
> RBC can increase due to stress? I didnt know that and Im going to ask my
> psychiatrist about that next time I see him.
Yes, stress alone can do that. Chronic stress is what I'm talking about.
It's one of the reasons stress is associated with heart attack.
> Im not contesting you, Im just
> genuinely curious. He told me that WBC can increase to severe stress...I
> already told you the story he told me about many of his
> inpatients....their WBC
> sometimes is high upon admission and goes down by the time they are stable
> and
> discharged.
I think there's a similar mechanism behind both, as both types of cells are
made in the same tissues.
> Good reason to try to keep stress levels down.
As if you needed another one, apart from experiencing the stress itself, eh?
Being disabled by illness is a full time job already, but when shit happens,
it can be more than you can handle.
>>
>>Although my counts declined after going off the testosterone, it still
>>could
>>have been due to stress reduction as well. My hematologist supports a
>>rechallenge with testosterone. If the high counts reccur, then it is far
>>more likely to be due to testosterone. In any case, a bone marrow biopsy
>>will be necessary, if the counts increase again.
>
> Hmmmmmmm I hope so man, but realistically...dont you think it was probably
> the
> testosterone? Would using a non injectable form of testosterone like a gel
> or
> patch form decrease the possibility of getting polycythemia again? I have
> read
> that using the gel and patch forms of T decrease the chance of
> polycythemia. I
> dont know if thats really true or just drug company marketing bull, but if
> it
> is true it would definitely be worth considering Androgel or something
> like it
> next time you try testosterone. What do you think about using gels and
> patches
> versus the old injectable testosterone?
I'm certainly going to discuss all that with my doctors, at length,
regardless of the outcome of this rechallenge with testoserone. I'm using
the cypionate. At present, I'm tied to my family doctor as he won't teach
me/permit me to self-inject. So, every two weeks, I have to go to the doc's
office. The gel is far more adaptable, both by dose and by ease of use, but
its cost was prohibitive (not covered by disability drug allowances).
Further budget issues arose when I broke my arm, because it bumped me off
disability onto worker's comp, and wc doesn't pay for any meds except those
related to the injury. Being unable to work, and having my expenses increase
simultaneously, were very stressful to me (not even mentioning the acute
pain that I still suffer from the injury itself). I also had a bunch of
other stressors going on....
>>I use some herbs that restrain the immune system, as immune activation is
>>associated with a number of the symptoms found in chronic depression. My
>>WBC
>>etc. counts are always excellent (superb cholesterol numbers, for example
>>(hint: fish oil)), but only the RBC/hemoglobin has ever crossed the line.
>
> My blood pressure is shot thanks to MAOIs, I have high cholesterol now
> thanks
> to three years of physical inactivity since my MAOI disasters. Ive noticed
> since Ive been on baclofen for this mild dystonia dx that my blood
> pressure is
> better.
I'm serious about the fish oil, Eric. I have the medical records to prove
it. After getting on a regular intake of fish oil (and fish itself, such as
salmon), my blood pressure dropped by 20 points systolic and 15 points
diastolic. Ever since I was a teenager, my resting BP was 135-140 over
85-90. That was the same for twenty years. Now it is 115-118 over about 72.
My cholesterol LDL:HDL ratio inverted, favouring HDL, totalling removing me
from cholesterol risk. I've always had relatively high cholesterol, but I
now have so much HDL that I'm quite safe. Fish oil is also protective
against Alzheimer's, and other dementias. It can reverse atherosclerosis. It
is also an antidepressant, but shit, do it for your heart.
> A lot of people are getting good results with high dose lamictal...it
> didnt
> work for me but it might work for you.
>
> Eric
Selegeline is doing a remarkable job. I'm using 5 mg, and if it's going to
work, it works right away. It is also far more effective with supplemental
DLPA (d-,l-phenylalanine). The d-phenylalanine, in particular, promotes
formation of phenylethylamine, and the selegiline blocks its degradation.
Selegiline is also an MAO-B inhibitor, but at low doses, you don't need to
concern yourself with tyramine issues. At higher doses (greater than 10 mg),
MAO-A is also inhibited, so food issues can become very important.
I strongly suggest you give it a try, Eric. Recent work on
selegiline/phenylalanine is published with no abstracts available, and I
haven't done a web search to see if I can find those articles.....but here's
one that covers the concept.
Lar
Int J Neuropsychopharmacol. 1999 Sep;2(3):229-240.
Does phenylethylamine act as an endogenous amphetamine in some patients?
Janssen PA, Leysen JE, Megens AA, Awouters FH.
Centre for Molecular Design, Janssen Research Foundation, B-2340 Beerse,
Belgium.
In brain capillary endothelium and catecholaminergic terminals a single
decarboxylation step effected by aromatic amino-acid decarboxylase converts
phenylalanine to phenylethylamine, at a rate comparable to that of the
central synthesis of dopamine. Phenylethylamine, however, is not stored in
intra-neuronal vesicles and is rapidly degraded by monoamine oxidase-B.
Despite its short half-life, phenylethylamine attracts attention as an
endogenous amphetamine since it can potentiate catecholaminergic
neurotransmission and induce striatal hyperreactivity. Subnormal
phenylethylamine levels have been linked to disorders such as attention
deficit and depression; the use of selegiline (Deprenyl) in Parkinson's
disease may conceivably favour recovery from deficient dopaminergic
neurotransmission by a monoamine oxidase-B inhibitory action that increases
central phenylethylamine. Excess phenylethylamine has been invoked
particularly in paranoid schizophrenia, in which it is thought to act as an
endogenous amphetamine and, therefore, would be antagonized by neuroleptics.
The importance of phenylethylamine in mental disorders is far from fully
elucidated but the evolution of phenylethylamine concentrations in relation
to symptoms remains a worthwhile investigation for individual psychotic
patients.
Larry Hoover
"Anti-med ho Pimp" <deeps...@aol.comhohoho> wrote in message
> Does that multivitamin have iron in it? If so I would ditch it and use a
> multivitamin that didnt have iron in it...that would have to be bad for
> the
> RBC.
Forgot one detail. The obvious thing to check before polycythemia is
considered is the iron-storage disorder hemochromatosis. Frankly, it would
have explained a lot, if I had it, but there's a simple blood test to
confirm or exclude that diagnosis.
For everyone else, those without hemochromatosis, iron intake is not linked
to hematrocrit level, except when iron is deficient (iron-deficiency
anemia). Your body will not overproduce red blood cells if it gets more iron
than it needs.
Lar
Anti-med ho Pimp
>From: "Larry Hoover" larry...@sympatico.ca
>Message-id: <g99ad.3090$3C6....@news20.bellglobal.com>
>
>
>"Anti-med ho Pimp" <deeps...@aol.comhohoho> wrote in message
>news:20041010001754...@mb-m02.aol.com...
>
>>>The high RBC/hemoglobin could be due to stress. I experienced a
>>>significant
>>>number of stressful incidents this spring, sufficient to have me seek
>>>medical care for depression (yes, I asked to be put on an antidepressant,
>>>Zoloft, in this case).
>>
>>
>> Youre taking zoloft for depression?
>
>Used to be. I only got up to 75 mg (doctor wanted to go to 200), and I never
>got so I could tolerate the side effects. I just finished withdrawal this
>week. I'm starting on selegiline now.
>
>> Just curious but have you taken lamictal?
>
>Nope. It's still an option. I had a horrible response to lithium (made me
>intensely suicidal, worse than I have ever been before or since), so maybe
>we've steered clear of the mood stabilizers without good reason. Or maybe
>with good reason. Hard to say.
Lamictal is totally different than lithium. I took lithium once years ago
combined with Effexor. Lithium is one of the worst drugs Ive ever tried it made
me super depressed, my family noticed it and didnt like me on it. Lithium even
made me more irritable!
I tried lamictal last summer and because of dystonia problems, had trouble
tolerating it. I could tolerate it if I took amantadine or some parkinsons type
drug with it, but I am not going to do that. Anyway, I noticed a slight mood
lift on it, not nearly as much as on an antidepressant. Not enough for me to
get by. But for many, I think that mood elevation would be plenty.
It also caused weight gain. The rash thing is overrated IMO as long as you
start low and go slow. Like start at 25 mg and gradually build up to 200 mg
over several months under your doctor's supervision.
>
>> Its good for depression (for some folks) but has a low chance of setting
>> off a
>> manic or hypomanic episode.
>
>High side-effect profile was a real concern. I am Mr. Side-Effect. I get all
>the usual ones, and a good number of the rare ones.
Eh...it only caused weight gain. I didnt get ANY rash on it. I bet you wouldnt
get any major side effects on the stuff, youd probably like it as long as you
can tolerate drugs OK.
>
>> RBC can increase due to stress? I didnt know that and Im going to ask my
>> psychiatrist about that next time I see him.
>
>Yes, stress alone can do that. Chronic stress is what I'm talking about.
>It's one of the reasons stress is associated with heart attack.
Im going to ask my psychiatrist about that RBC/stress connection, Im curious.
I think the gels have a lower chance of causing polycythemia dude. I just
rechecked and my source says transdermal has lower chance of causing
polycythemia.
>I'm serious about the fish oil, Eric. I have the medical records to prove
>it. After getting on a regular intake of fish oil (and fish itself, such as
>salmon), my blood pressure dropped by 20 points systolic and 15 points
>diastolic. Ever since I was a teenager, my resting BP was 135-140 over
>85-90. That was the same for twenty years. Now it is 115-118 over about 72.
>My cholesterol LDL:HDL ratio inverted, favouring HDL, totalling removing me
>from cholesterol risk. I've always had relatively high cholesterol, but I
>now have so much HDL that I'm quite safe. Fish oil is also protective
>against Alzheimer's, and other dementias. It can reverse atherosclerosis.
I believe you as fish oil is a blood thinner and is likely to produce a
reduction in blood pressure. So is vitamin E. Ive tried fish oil but had
trouble tolerating it due to what else, dystonia. I just have major trouble
tolerating most drugs nowadays. And even OTC supplements. One supplement I can
sort of tolerate though is vitamin E, I dont know why. And I notice my blood
pressure goes down on the stuff.
>
>> A lot of people are getting good results with high dose lamictal...it
>> didnt
>> work for me but it might work for you.
>>
>> Eric
>
>Selegeline is doing a remarkable job. I'm using 5 mg, and if it's going to
>work, it works right away. It is also far more effective with supplemental
>DLPA (d-,l-phenylalanine). The d-phenylalanine, in particular, promotes
>formation of phenylethylamine, and the selegiline blocks its degradation.
>Selegiline is also an MAO-B inhibitor, but at low doses, you don't need to
>concern yourself with tyramine issues. At higher doses (greater than 10 mg),
>MAO-A is also inhibited, so food issues can become very important.
>
>I strongly suggest you give it a try, Eric.
Ive already tried selegiline dude. I tried it briefly this past winter at the
same dose youre on, 5 mg. It felt like speed to me, but without elevating my
blood pressure. Unfortunately, thinking I didnt need to follow an MAOI diet on
it AT ALL, the next day I went and ate a small pepperoni pizza with extra
cheese and drank a lot of iced tea. I experienced a small MAOI hypertensive
crisis that took a day to come down off of. I dumped the selegiline after that.
MAOIs and I just dont seem to get along. If this selegiline MAOI patch really
turns out to not require a diet AT ALL other than drug restrictions, I will
probably try it. But my poor blood pressure and brain blood vessels cant
tolerate anymore MAOI fuckups.
rabbit
news:20041008205319...@mb-m29.aol.com:
**
> All in all I have this to say. Discuss your numbers with a specialist
> and see what they say about it.
Eric and Larry,
I saw my urologist today and he said he thought my labs were within
normal limits (http://herrrabbit.tripod.com). He said that measuring free
testosterone isn't necessary since my full testosterone level of 390 is
better than average in his experience; and the low LH level is not
significant for the same reason. This is essentially what my GP told me.
My urologist said today that even if I did have low T numbers, he
wouldn't recommend testosterone replacement for me because six months ago
I had an elevated PSA which subsequently declined to 3.3 and horomone
replacement would elevate my risk for cancer.
He also said that he didn't view the 4% atypical lymphocytes as
indicative of anything significant. Ten per-cent or higher seemed to be
the threshold at which he would become concerned, if I understood
correctly. In any case, he advised me not to worry about 4% (with which
my GP also agreed). Ditto for the "platelet clumping," which he said was
likely an artifact of the manner in which blood is collected in the tube.
He said he gave me "an A+ for asking all the right questions," when I
came into his office with the following outline, but the answers were all
negative - a relief in one sense, but frustrating in that it left me at
the same dead end with respect to resolving the depression and ED through
any means other than antidepressants and talk therapy (which I'm doing).
==
Current Concerns:
1. Could hypogonadism be a factor in my depression, erectile
dysfunction, and other physical issues?
a. I recently had hormone blood levels measured as a result of
symptoms including depression (treated with 400 mg. of Wellbutrin per
day) and erectile dysfunction (treated with 50 mg. of Cialis PRN
prescribed by you). Blood levels showed a lutenizing hormone (LH) level
of 1.2, which my primary physician, My GP described as "slightly low with
a range of 1.5 to 9.3." I would like your opinion on this, together with
recommendations for any further testing or treatment approach which may
be indicated.
b. Is testicular asymmetry significant? What, if anything in relation
to hormone levels, might it suggest?
c. Might the hydrocelectomy that I had in childhood contribute to an
adult hormonal imbalance?
d. It's my understanding that LH is a pituitary hormone that
stimulates cells in the testes to produce testosterone. There is a link
between low testosterone and depression as well as ED, so the link to LH
is indirect, but seemingly present. It's also my understanding that an
imbalance of male hormones can contribute to a spectrum of mental and
physical health issues, including not only chronic depression and ED, but
conditions like osteoporosis and possibly even Alzheimer's disease later
in life. I am looking to you for help in clarifying and interpreting this
information in hopes of improving my life and health in these areas, or
for any other suggestions that you may offer for further testing and
treatment to help resolve these symptoms.
e. While I have read that obesity can be one symptom of hypogonadism,
I have lost about 30 lbs. since 8/13/2004 through exercise, controlled
diet, and encouragement from my GP. I hope to lose 30 lbs. more, in part
to control borderline hypertension and avert a need for meds.
f. Do you think that a second blood draw might be helpful, this time
to measure free serum testosterone levels, to determine whether the
scores along with the total serum testosterone in the recent lab tests
(which on its face, at 390, appears within normal limits) are optimal for
someone my age who has refractory depression and ED?
2. Are there any other concerns that you see raised by the results of
this blood-work?
a. Is there cause for concern in the notation on the labs of the
"presence of some platelet clumping"? Is this a significant concern and
if so, could it be caused by ED meds like Viagra and/or Cialis?
b. Might 4% atypical lymphocytes indicate something resembling
mononucleosis, EBV, or some other disorder, either dormant or active? (I
did not have a chance to see the labs until after my most recent visit
with my GP.)
3. PSA and general follow-up, and any other tests you may recommend.
a. Prior PSA results: 8/4/2003 = 2.51, 4/28/2004 = 4.51 (biopsy
considered and ruled out after subsequent retest), 5/12/2004 = 3.3.
==
Thanks for your help.
Anti-med ho Pimp
>Date: 10/11/2004 8:54 PM Eastern Standard Time
>Message-id: <Xns957FD49A09422...@140.99.99.130>
Thats what I thought when I first saw the score. I wish my total serum T was
390. Mine is like 200 ng/dl. And Im younger than you. Also, they wont give it
to you cause your PSA scores came back a little elevated as you mentioned and
no doctor is going to put themselves on the line liability wise when it comes
to cancer risk when your testosterone scores are OK.
Id forget about it.
Unfortunately, erectile dysfunction oftentimes is a part of major depression.
The cause isnt just low testosterone. You might have to learn to live with it
and take a lot of Cialis. Wellbutrin is a good drug for the sex department BTW.
Youre best odds IMO are to try to treat your depression to the best it can be
treated and try to keep your weight down and keep your cardio health as good as
you can. Beyond that, all you can probably do is take cialis.
One possibility is to switch to a regular antidepressant (SSRI or Effexor,
etc.) and try adding a dopamine agonist under your psychiatrist's supervision.
Maybe dostinex or amantadine or something. Dopamine agonists can sharply
increase libido and might possibly improve your erections. Not guaranteed at
all, but something to discuss with your doctor.
Honestly, you seem more concerned about your erections than your depression.
Testosterone replacement aint for every guy.
rabbit
news:20041011210756...@mb-m02.aol.com:
* * *
> Honestly, you seem more concerned about your erections than your
> depression.
* * *
Eric,
I'm married 16 years and sex with my wife is one of the few things in
life that gives me joy, when it goes well. Of course I know there's more
than one way to skin a cat, but intercourse is satisfying to us both,
when things go well. We communicate well in many if not most areas, but
there have been times that she has questioned my faithfulness to her
(which has always been consistent throughout our relationship), or my
physical attraction to her, when I can't finish what is started in bed.
This is both painful and extremely frustrating to me (leading to a self-
perpetuating depressive cycle which I understand in my head, but can't
seem to get past), so I talked to my urologist a year and a half ago,
which was when he first prescribed Cialis. That works okay, but if
there's an problem that underlies both the depression and the ED, I'd
like to discover what it is so it can be treated.
Depression has been with me, from young adolescence when I ran away from
home multiple times, spent a period in secure detention for delinquent
behavior, was sexually abused on a number of occasions by non-relatives,
and was physically and emotionally abused at home, through college and
graduate school, a very brief first marriage, up to the present day. For
most of my life I wasn't on antidepressants, though I did have extensive
counseling as a teenager and in college. Despite the history, I've held
together a steady work history as an adult and have raised some good kids
along with my wife. Still, aside and apart from the ED which is of
relatively recent onset, my thoughts have been consumed at times with
death and of loved ones who have died; ruminating on my own death, and
occasionally thinking of hastening it. I'm not currently suicidal, though
I did attempt it as a teenager.
I've been on Wellbutrin for a year and a half now (currently 400 mg.) --
which is about the same time that I reached out for help to a urologist
as well. I'm currently engaged in talk therapy. Both are helpful with
respect to subjective mood and understanding, I think. The therapist
asked early on if I'd be interested in seeing the psychiatrist that he
works with rather than continuing prescriptions from my GP. I initially
replied that I was okay with the GP, but I'm starting to wonder about
that. I tend to be skeptical of psychiatrists, but I'm thinking that
perhaps his expertise with psychotropics might better equip him to fine-
tuning than a GP. I'm scheduled to see my therapist tomorrow and will
bring up the idea of seeing "his" doctor, though I'm still not thrilled
about the idea.
I posted my inquiry here about male hormones because I've read your
postings on the topic, Eric (hence my focus on that topic). My GP
initially raised the issue of hormone testing and possible testosterone
replacement as a possible treatment for depression, if my horomone levels
so indicated -- to which my initial and immediate reply was to express
fear of possible side-effects including cancer. As I thought more about
it, the possibility seemed to hold out some hope of resolving the two
separate but connected issues of emotional and physical depression, but
after today's uro exam it seems that I'm back to square one.
Pablo
> >Subject: Re: {attn Eric and Larry} on male hormone testing - LAB REPORTS
> >From: rabbit rab...@mailinator.net
> >Date: 10/11/2004 8:54 PM Eastern Standard Time
<snip>
> Honestly, you seem more concerned about your erections than your
depression.
Give the guy a break. After all, his nym is rabbit. ;-)
Pablo
Anti-med ho Pimp
>Date: 10/11/2004 10:50 PM Eastern Standard Time
>Message-id: <20041011225012...@mb-m01.aol.com>
>
>>Subject: Re: {attn Eric and Larry} on male hormone testing - LAB REPORTS
>>From: rabbit rab...@mailinator.net
>>Message-id: <Xns957FE172ADF97...@24.168.128.86>
>>
>>deeps...@aol.comhohoho (Anti-med ho Pimp) wrote in
>>news:20041011210756...@mb-m02.aol.com:
>>
>>* * *
>>> depression.
>>
>>Eric,
>>
>>I'm married 16 years and sex with my wife is one of the few things in
>>life that gives me joy, when it goes well. Of course I know there's more
>>than one way to skin a cat, but intercourse is satisfying to us both,
>>when things go well. We communicate well in many if not most areas, but
>>there have been times that she has questioned my faithfulness to her
>>(which has always been consistent throughout our relationship), or my
>>physical attraction to her, when I can't finish what is started in bed.
>>This is both painful and extremely frustrating to me (leading to a self-
>>perpetuating depressive cycle which I understand in my head, but can't
>>seem to get past), so I talked to my urologist a year and a half ago,
>>which was when he first prescribed Cialis. That works okay, but if
>>there's an problem that underlies both the depression and the ED, I'd
>>like to discover what it is so it can be treated.
>
>kind
>of relationship, I sympathize with you. To be honest, I suspected ED problems
>might be compromising your marriage. Which is totally understandable. When
>sex
>goes, so oftentimes does the marriage. Unfortunately. Thats my impression at
>least from observing those who are married.
>
>>
>>Depression has been with me, from young adolescence when I ran away from
>>home multiple times, spent a period in secure detention for delinquent
>>behavior, was sexually abused on a number of occasions by non-relatives,
>>and was physically and emotionally abused at home, through college and
>>graduate school, a very brief first marriage, up to the present day. For
>>most of my life I wasn't on antidepressants, though I did have extensive
>>counseling as a teenager and in college. Despite the history, I've held
>>together a steady work history as an adult and have raised some good kids
>>along with my wife. Still, aside and apart from the ED which is of
>>relatively recent onset, my thoughts have been consumed at times with
>>death and of loved ones who have died; ruminating on my own death, and
>>occasionally thinking of hastening it. I'm not currently suicidal, though
>>I did attempt it as a teenager.
>
>and
>then you lose your rights. The courts get involved. Your doctor will insist
>you
>see a psychiatrist and psychiatrists have legal power over you if and when
>you
>attempt suicide. They dont have any legal power over you when you have not
>attempted suicide.
>
>Also, a suicide attempt means an automatic trip to the psych hospital, a
>degrading and humiliating experience. Trust me, you do not want to go there
>even for a short period.
>
>>
>>I've been on Wellbutrin for a year and a half now (currently 400 mg.) --
>>which is about the same time that I reached out for help to a urologist
>>as well. I'm currently engaged in talk therapy. Both are helpful with
>>respect to subjective mood and understanding, I think. The therapist
>>asked early on if I'd be interested in seeing the psychiatrist that he
>>works with rather than continuing prescriptions from my GP. I initially
>>replied that I was okay with the GP, but I'm starting to wonder about
>>that. I tend to be skeptical of psychiatrists, but I'm thinking that
>>perhaps his expertise with psychotropics might better equip him to fine-
>>tuning than a GP. I'm scheduled to see my therapist tomorrow and will
>>bring up the idea of seeing "his" doctor, though I'm still not thrilled
>>about the idea.
>
>psychopharmacology trends will be more willing to experiment and push things.
>Get one who listens and DONT get one with a bad temper or is a know it all!
>
>If testosterone is not on the table for you anymore and it sounds like its
>not,
>perhaps you should consider dopamine agonists added to an antidepressant.
>Providing you dont have any tendencies towards psychosis, paranoia or major
>anxiety problems, many depressives get "extra help" from various dopamine
>agonists (meds used for parkinsons and other movement disorders). These drugs
>are PURE dopamine and as such, sometimes sharply increase libido and improve
>erections in men. Amantadine improves both my sex drive and erection quality
>for example. The MAOI Parnate, another strongly dopaminergic drug, also
>strongly increased my libido and erection quality...actually more than
>testosterone did!
>
>However, I wouldnt recommend you try an MAOI...they are nothing but trouble
>and
>very tricky to take. The dopamine agonists are another story though...they
>are
>safe as long as you are under supervision and your doctor thinks its an OK
>idea.
>
>dopamine agonists you can try for improved libido and ED quality include:
>
>1) dostinex
>2) amantadine...you can get this diagnosed in liquid form in lower doses than
>pill or capsule form. For example...200 or even 100 mg a day in capsule form
>might be too much dopamine for you, but you can get it dosed in liquid form
>at
>50 mg or even less.
>3) Mirapex...tends to make people real drowsy though
>
>Antidepressants that dont impair sexual function include:
>
>Wellbutrin, Remeron, generic serzone.
>
>A combo that might work might be generic serzone combined with a dopamine
>agonist. Serzone is sex friendly and causes no weight gain. You could easily
>add a dopamine agonist to it to see if it improves libido.
>
>Hint: dopaminergic drugs tend to elevate testosterone levels indirectly. When
>I
>take amantadine, my beard grows faster and thicker.
>
>>
>>I posted my inquiry here about male hormones because I've read your
>>postings on the topic, Eric (hence my focus on that topic). My GP
>>initially raised the issue of hormone testing and possible testosterone
>>replacement as a possible treatment for depression, if my horomone levels
>>so indicated -- to which my initial and immediate reply was to express
>>fear of possible side-effects including cancer. As I thought more about
>>it, the possibility seemed to hold out some hope of resolving the two
>>separate but connected issues of emotional and physical depression, but
>>after today's uro exam it seems that I'm back to square one.
>
>everybody. In some ways I envy you as your T levels are still in an
>acceptable
>range. Mine are shot and Im only 35.
>
>I dont think a hydrocelectomy at age 3 would affect your present testosterone
>levels, though Id encourage you to discuss that with an actual MD for a more
>definitive answer.
>
>Good luck and ask your doctor about trying a dopamine agonist possibly at
>some
>point. It may or may not improve libido and/or ED. Dopamine drugs tend to be
>the "sex drugs." Ever seen a woman on cocaine? LOL
>
>Eric
>
>"It's a ho wide world. Dem ho's, dey be everywhere."
>
>LostBoyinNC
>
I should have mentioned to make sure to ask your doctor if taking a dopamine
agonist would aggravate your PSA scores or aggravate your prostate. If so, you
probably wouldnt want to try one. Amantadine has mild anti-cholinergic effects
and that could possibly be bad for an enlarged prostate.
good luck,
Larry Hoover
> Eric and Larry,
>
> I saw my urologist today and he said he thought my labs were within
> normal limits (http://herrrabbit.tripod.com). He said that measuring free
> testosterone isn't necessary since my full testosterone level of 390 is
> better than average in his experience; and the low LH level is not
> significant for the same reason. This is essentially what my GP told me.
The normal range includes values much higher than yours. It's impossible to
know, but yours might have fallen significantly, even though they're still
at 390. There's another issue that arises as we age. The proteins in the
blood that bind testosterone become more powerfully binding, as we age.
That's one of the reasons the free to total testosterone ratio is done.
> My urologist said today that even if I did have low T numbers, he
> wouldn't recommend testosterone replacement for me because six months ago
> I had an elevated PSA which subsequently declined to 3.3 and horomone
> replacement would elevate my risk for cancer.
Ya, that's an important thing to consider. I'm not trying to argue a
particular point, but some doctors do not believe in the association between
testosterone and PSA, as a blanket generalization. There are testosterone
sensitive prostate tumours, but not all of them are.
> He also said that he didn't view the 4% atypical lymphocytes as
> indicative of anything significant. Ten per-cent or higher seemed to be
> the threshold at which he would become concerned, if I understood
> correctly. In any case, he advised me not to worry about 4% (with which
> my GP also agreed). Ditto for the "platelet clumping," which he said was
> likely an artifact of the manner in which blood is collected in the tube.
Good. I'm glad you've been reassured. Yes, the platelet clumping is
generally associated with sloppy lab work.
> He said he gave me "an A+ for asking all the right questions," when I
> came into his office with the following outline, but the answers were all
> negative - a relief in one sense, but frustrating in that it left me at
> the same dead end with respect to resolving the depression and ED through
> any means other than antidepressants and talk therapy (which I'm doing).
Your doctor knows that you're not blindly counting on him to make decisions.
That's good.
> ==
>
> Current Concerns:
This is what you typed out and took to the urologist? Good plan. I started
to answer these without realizing that. I'll finish my comments, anyway.
> 1. Could hypogonadism be a factor in my depression, erectile
> dysfunction, and other physical issues?
Yes. There are hormone resistance syndromes, which some doctors do not
readily accept as even being possible. There are thyroid conditions
presenting as hypothyroid, but with normal levels of TSH (the hormone which
activates the thyroid). Insulin resistance, at least, is more commonly
accepted. I would not rule out testosterone resistance. Nor would I rule out
testoterone deficiency without doing a free testosterone ratio. That's just
my way of thinking.
> a. I recently had hormone blood levels measured as a result of
> symptoms including depression (treated with 400 mg. of Wellbutrin per
> day) and erectile dysfunction (treated with 50 mg. of Cialis PRN
> prescribed by you). Blood levels showed a lutenizing hormone (LH) level
> of 1.2, which my primary physician, My GP described as "slightly low with
> a range of 1.5 to 9.3." I would like your opinion on this, together with
> recommendations for any further testing or treatment approach which may
> be indicated.
I'm personally not comfortable with the low LH. Pituitary dysfunction can be
generalized (you didn't have a full pituitary panel), and depression can
indeed be caused by lesions or defects in the pituitary.
> b. Is testicular asymmetry significant? What, if anything in relation
> to hormone levels, might it suggest?
One working testis is all that is needed. Asymmetry is irrelevant.
> c. Might the hydrocelectomy that I had in childhood contribute to an
> adult hormonal imbalance?
No. You'd have had problems at puberty, if that had been the case.
> d. It's my understanding that LH is a pituitary hormone that
> stimulates cells in the testes to produce testosterone. There is a link
> between low testosterone and depression as well as ED, so the link to LH
> is indirect, but seemingly present. It's also my understanding that an
> imbalance of male hormones can contribute to a spectrum of mental and
> physical health issues, including not only chronic depression and ED, but
> conditions like osteoporosis and possibly even Alzheimer's disease later
> in life. I am looking to you for help in clarifying and interpreting this
> information in hopes of improving my life and health in these areas, or
> for any other suggestions that you may offer for further testing and
> treatment to help resolve these symptoms.
> e. While I have read that obesity can be one symptom of hypogonadism,
> I have lost about 30 lbs. since 8/13/2004 through exercise, controlled
> diet, and encouragement from my GP.
Thirty pounds in 8 weeks? That's twice the recommended rate, pretty much.
Fat cells, the ones called adipocytes, are very recently being recognized as
being significant contributors to endocrine hormone levels. They're very
likely to be reclassified as endocrine glands, though a diffuse population
(i.e. not localized to one site, as are e.g. the adrenals). Was your ED
prominent before the weight loss?
> I hope to lose 30 lbs. more, in part
> to control borderline hypertension and avert a need for meds.
That's a wise thing to do. Also, fish oil has been shown to encourage proper
insulin utilization, and to improve the blood pressure and cholesterol
scores.
> f. Do you think that a second blood draw might be helpful, this time
> to measure free serum testosterone levels, to determine whether the
> scores along with the total serum testosterone in the recent lab tests
> (which on its face, at 390, appears within normal limits) are optimal for
> someone my age who has refractory depression and ED?
I guess he said no, eh?
> 2. Are there any other concerns that you see raised by the results of
> this blood-work?
> a. Is there cause for concern in the notation on the labs of the
> "presence of some platelet clumping"? Is this a significant concern and
> if so, could it be caused by ED meds like Viagra and/or Cialis?
> b. Might 4% atypical lymphocytes indicate something resembling
> mononucleosis, EBV, or some other disorder, either dormant or active? (I
> did not have a chance to see the labs until after my most recent visit
> with my GP.)
I'm reassured by his response.
> 3. PSA and general follow-up, and any other tests you may recommend.
> a. Prior PSA results: 8/4/2003 = 2.51, 4/28/2004 = 4.51 (biopsy
> considered and ruled out after subsequent retest), 5/12/2004 = 3.3.
>
> ==
>
> Thanks for your help.
That's a pretty significant decrease. Did you have prostatic or urinary
irritation?
Lar
Anti-med ho Pimp
>> I have lost about 30 lbs. since 8/13/2004 through exercise, controlled
>> diet, and encouragement from my GP.
>
rabbit, Im no doctor but I think its highly unlikely you could lose that much
weight that fast if you had hypogonadism. Hypogonadism makes it VERY difficult
to lose fat.
rabbit
> rabbit, Im no doctor but I think its highly unlikely you could lose
> that much weight that fast if you had hypogonadism. Hypogonadism makes
> it VERY difficult to lose fat.
That's encouraging in a sense. Not only did I lose that much in two months
(period commencing 8/13), but I lost the first 16 lbs. during a month that
I was on a Zoloft trial - despite that drug's reputation for weight gain.
I've made up my mind to consult a pdoc; something that I'd hoped to avoid.
Thanks for the suggestions and information.
Anti-med ho Pimp
>From: rabbit rab...@mailinator.net
>Message-id: <Xns9581BF353EF19...@24.168.128.78>
Yes, I really doubt you could lose that much weight that fast if you were truly
hypogonadal.