VARICOCELE...can it effect testosterone?

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  1. Quote Originally Posted by Megazoid
    I am going to be setting up a website highlighting the dangers and being a one-stop-source for varicocele sufferers. Hopefully we can get the message across with time.

    JazSz, it sound's like the varicocele might have been the cause of your low t. However you are an older dude too so it might be a combination of factors. Did you suffer any atrophy at all or were your nut's normal size before you started TRT? How long did you go "suffering" (with the ED/Libido and general Low t) before you went onto TRT?

    In a realistic world i would have got the varicoceles fixed and see how you got on. Even now it might be worth fixing them then trying HCG if your LH/FSH aren't elevated due to testicular failure.

    Why do you say you function "semi-ok" JazSz? I thought you were feeling really good on your TRT plan and were getting erections when you wanted them (is the libido still there?).

    Hyde, would you be up for helping me with the site (moderating the forum, helping out, etc)?
    Yes, most likely the varicocele is a reason for my low T.
    I think my nuts were about the same size as usual, up until I started on Androgel, now small and soft.
    I think my nuts were about right throughout my life.
    One possible exception from normal was, and still is, that my right nut travels up the sack, right before orgasm.
    It is uncomfortable enough that when it happens I have to stop and push it back, so it drops back into sack.
    I had erection problems for about 3 years.
    Now on Androgel it mostly works, underline mostly, not always, and that is with Cialis.
    I never had libido problem, looking at pretty girl works me up, mentally.
    It is quite confusing now, to get erection I need mechanical friction and there is time delay, even when everything works.
    My wife is accustomed to the routine by now, still I have to concentrate a lot on the business at hand,
    any distraction and erection may be gone.
    I guess if I tried with somebody else it may not work unless she was really patient.
    Few minutes ago I made appointment to see my new doctor (osteopath), next Tuesday.
    That will be my second visit with him. His nurse, my dancing friend, said that he want to learn TRT.
    So there is my big chance. I am hoping for change for better when I start HCG.
    My ejaculate is almost non-existing,
    I should probably do the other hormone, FSH, forgot its name, do not know brand names, dose, frequency, details. Somebody fill me in, please.
    I will also ask him for script for Armour Thyroid and Cortef.
    Actually I already ordered Armour over internet an already have Isocort,
    but with the script my prescription plan will get a chance at footing my bills.
    ---------------------------------------------------------
    Wish there was some detailed discussion on GH here.
    Last time I checked my (IGF-1)=120 (75-212) (Sep2/05)
    ------
    01-22-2007, 05:07 PM , Dr John said
    1.35 Mg of GH per day & Igf-1 levels still sub optimal

    Any doctor with much experience will tell you not to chase IGF-1 levels.
    Once you have passed 2IU, what's the use?
    You have to treat the patient, not a laboratory printout.
    We normally produce about 0.5IU of GH per day.
    ---------
    That may be a good starter.


  2. HCG is known to improve ejaculate volume but it will result in that thin, watery like ejaculate which isn't too great.

    I am only 23 year's old and also have to really work to get erections. I am not sure if thryoid/adrenals have a role to play int his too though. My thyroid is in the shape with no problems (if anything, i am a little underweight).

    What were your latest labs like JazSz?
    •   
       


  3. Quote Originally Posted by Megazoid
    HCG is known to improve ejaculate volume but it will result in that thin, watery like ejaculate which isn't too great.

    I am only 23 year's old and also have to really work to get erections. I am not sure if thryoid/adrenals have a role to play int his too though. My thyroid is in the shape with no problems (if anything, i am a little underweight).

    What were your latest labs like JazSz?
    HCG basicaly replaces missing LH.
    I was taking about Follicle stimulating hormone (FSH).
    Supposedly it works better than HCG, and increases ejaculate volume, something I could use.
    In wikipedia I was able to find:
    Follicle-stimulating hormone - Wikipedia, the free encyclopedia
    "FSH is available mixed with LH in the form of Pergonal, and other more purified forms of urinary gonadotropins as well as in a pure forms as recombinant FSH (Gonal F, Follistim). "
    ------
    If there was discussion on this, FSH, topic, please point me to it.
    I would like to know dose, frequency, product names any other particulars.
    ============================== =============

    I did my last test in Oct/06, at LabCorp, it was a short test.
    As you see I got that useless FreeT, and they skipped SHBG, just so I was not able to do my own calculations. I was on 10grams of Androgel. I have since reduced to 7.5mg, I think it works better. I also take one extra, for the total of two pills of
    LEF version of DIM+I3C. They have two of them, I use this one:
    Dual-Action Cruciferous Vegetable Extract With Resveratrol & Cat's Claw, 60 Vegetarian Capsules
    .
    Total Estrogens------------------------------ ---260 pg/mL (40-115) LEs Optimal Range: 4077 pg/mL
    estrone, serum------------------------------- ----78 pg/mL (12-72)
    Estradiol, sensitive--------------------------- ----27 pg/mL (3-70) LEs Optimal Range: 1030 pg/mL
    Progesterone---------------------------------- ----1.4 ng/dL (0.3-1.2)
    Pregnenolone---------------------------------- ----23 ng/dL (10200) LEs Optimal Range: 100170 ng/dL
    Total Testosterone-------------------------- ---932 ng/dL (241-827) LEs Optimal Range 500827 ng/dL
    Free Testosterone--------------------------- --36.5 pg/mL (6.6-18.1) LEs Optimal Range: 1826.5 pg/mL
    DHT (dihydrotestosterone)--------------- ---226 ng/dL (30-85) LEs Optimal Range: 3050 ng/dL
    prolactin, serum----------------------------- ----4.2 ng/dL (2.1-17.7) LEs Optimal Range: 2.15 ng/mL
    sex hormonebinding globulin (SHBG), serum nmol/L 1371 LEs Optimal Range: Lower part of normal range is desirable
    (TSH)-------------------------- --1.89 uIU/mL (0.350-5.5) LEs Optimal Range: 0.35 to 2.1 mIU/mL TSH good if below 1.5(Gary Field) 1.425
    Free (T3)----------------- --2.9 pg/mL (2.3-4.2) (3.67-4.2)per Crisgj2 =4.3-(4.2-2.3)/3=3.67 3.825 <--FT3 start of upper 25%
    Total T3---------- ---104 ng/dL (85-205) MESO-Rx - View Single Post - For those of you on thyroid medication 3.667 <--FT3 start of upper 33%
    Free T4(direct)--------------- --1.37 ng/dL (0.61-1.76) Top of the FT4 and upper third for FT3 is what I look for 3.350 <--FT3 start of upper 50%
    DHEA Sulfate------------------------------------- ---369 ng/dL (42-290) LEs Optimal Range: 500-640 ug/dL
    Cortisol (7:20)AM --24.2 g/dL (4.3-22.4)
    Cortisol (3:20)PM ----6.9 g/dL (3.1-16.7)
    Hematocrit---------------------------------------- --45.6 % (36-50)

  4. Ok, Im getting my varicocele surgery next Thursday. They are going to be doing the one in which they go through the groin. I will keep everyone posted of the outcome. Megazoid, I think the website is a great idea and I would love to help with it. People need to get the truth about these things and not put off the repair because they do effect Testosterone levels.

  5. I wish you the best luck with your surgery Hyde and hope get a fast and effective recovery. Because your T is low this will effect your "recovery" time and i would strongly advise topping yourself on some TRT to get into a good 500/700 range so you recover faster. This operation will involve cutting muscle and this will generate at roughly 70% rate in normal t level men. While this will supress your HPTA further, in the long run i feel running TRT + HCG might be the answer after your surgery, this way you can reap the benfits of TRT while helping your balls to heal and grow back. The atrophy IS for the most part

    Your HPTA is not firing out enough signals and you're balls won't be responding well so you should probably do TRT for a few months alongside HCG to get them back working again. After this you can try coming off everything using a post cycle therapy style cycle and restarting properly.
    •   
       


  6. Thanks for the reply Dr John.

    The main reason i have had to resort to self-treatment is because doctors are failing to help me in my country and i have spent thosands trying to get proper treatment. I have spent the past 6 months researching the subject of varicoceles and the effects on steriod secreation and testicular dysfunction caused by the varicocele. I am trying to raise awareness of the information i have gained regarding this subject and help others.

    However you are right, i am not in a position to give out information regarding TRT so i will stay out of this one.

  7. Dr John, i have a few questions for you which i hope you don't mind me asking.

    1) Have you ever been presented with a patient that has varicocele induced testicular atrophy and normal LH/FSH levels but low T?

    2) Have you ever used HCG on a varicocele sufferer and had good results with regards to improvements in testicular health and size (getting back "normal" testicular size for example)?

    3) Have you ever been able to recover a varicocele suffer into gaining high T levels without TRT, using HCG + PCT style recovery (clomid/nolva)?

    Special thanks for your help and input on this matter.

  8. Quote Originally Posted by Dr. John
    As I do sometimes, I'll just insert my responses IN CAPS. Please ignore usual Internet etiquette, as this is not meant as shouting.
    We need more doctors out there like yourself. The Urologists that I've seen told me Varicoceles wont effect T Even though the testicle on the side with the varicocele is Atrophied.

  9. Quote Originally Posted by Dr. John
    Can somoene do a seach and look for a proven connection?

    I just know I have seen the association enough times to ignore it. You know, when I hear the same story over and over, I have to take it seriously.

    But even if an association is not proven, the result is the same: repair the variocele, see what happens, and administer TRT if necessary.
    I would say it does effect testosterone level, even the studies against, still say it does raise testosterone after surgery although insignificantly.

    For
    Entrez PubMed
    Entrez PubMed


    Against
    Entrez PubMed
    Entrez PubMed

  10. Quote Originally Posted by ItsHectic
    I would say it does effect testosterone level, even the studies against, still say it does raise testosterone after surgery although insignificantly.

    For
    Entrez PubMed
    Entrez PubMed
    Against
    Entrez PubMed
    Entrez PubMed
    43% raise seems like a pretty significant amount to me.

  11. Defenetly, but its weird how 2 studies have diffrent views on what should be simple.

  12. Quote Originally Posted by ItsHectic View Post
    Defenetly, but its weird how 2 studies have diffrent views on what should be simple.
    I bet the second studies were done using men with minor Varicoceles. I have a level 3 one (the biggest possible)

  13. I think in most cases varicoceles cause multi-factorial issues which in turn cause testicular dysfunction. Testosterone and DHT have a role in determining blood flow through the penis and testes, affecting nitric oxide production. Which links back to what Hyde said, so this in turn could explain why my nut's are for lack of a better word, going nut's. Low T in itself effects blood flow around the body and in turn could be the the cause of the atrophy. Low estridol can effect sperm production and 'technically' cause atrophy due to this. I believe high E2 can cause epididyml abnormalities and blockages when E2 is high.

    Androgel (50mg) reduces my LH to 2.2 but brings my total t up to 25/6nmol. Within a few hour's my penis and testicles feel allot more healthy and fuller (for lack of a better word). Which again might back up this theory.

    Some men can go through life having bi-lateral varicoceles and never have atrophy or low testosterone until allot later in life (JazSz being a good example). However the sluggish blood flow caused by the varicocele can cause over-heating and tissue damage to the testicle in the long-term.

    It's important to remember that varicoceles cause, in most cases, permanent damage to the testicle, tissues and cells (leydig included - though they are alot 'tougher' than sperm production tubules). I believe when the testicles atrophy a degree of compression and a tighter area of leydig cells occur which in turn can cause some degree of dysfunction and reduced binding of the LH signals. I guess a kind of 'domino' effect occurs with varicoceles.

    While there is no "average" testosterone level and everyone is different it's assumed that an inter-testicular testosterone level of 23+nmol is required for proper sperm production and transportation, so i guess when your T goes low this might explain the atrophy too. Low E2 can contribute to sperm production problems (which i have myself).

    Dr John, the best research paper i have found is here:

    Elevation of serum testosterone and free testosterone after embolization of the internal spermatic vein for the treatment of varicocele in infertile men -- Gat et al. 19 (10): 2303 -- Human Reproduction

    I have to agree fully with you on this one, get the surgery, see how thing's go but don't expect miracles (i need to honest here, having spoken with alot of varicocele sufferers). I am pretty confident i haven't seen any improvements what so ever with the exception of reduced pain and no more swelling in the scrotum. However using TRT + HCG i am hoping i can restore thing's as i don't have full primary testicular failure. My LH/FSH are both in the normal if not 'perfect' range. Elevated LH would mean leydig cell dysfunction/atrophy.

    If you come across any old patient records on the subject Dr John, i would love to hear more about your own personal experiences treating varicocele patients and how they respond to HCG. My other testicle was already atrophied due to being undescended as a child and ironically also suffered from a varicocele in my early teenage years.

  14. A long thread.

    When a varicocele or other injury reduces the ability of the teste(s) to produce T, if the upper end of the HPTA is working right, then the levels of LH will be high. So in that case, taking HCG will probably not be of value as the LH levels are probably above normal range already. If this is the case and the varicocele is restored and the teste recovers circulation and is has not suffered permanent damage, then there should be enough LH on hand. But perhaps a short shock treatment of HCG might have some value (but I am not saying that that is the case).

    When would HCG be of benefit with a repaired varicocele? If the top end of the HTPA is not making LH, then for HCG to be of benefit more than the testes and T, it would have to increase T levels that that might wake up the top end of the HTPA. If the HTPA is not doing the right thing, then it might be from too much E. That is where a SERM might get things going.

    I have seen a few guys with this problem on another board who are now happy to be on TRT.

  15. Thanks for your reply KSMan, i think i sent you a message a little while back on t-nation?

    I believe it's more based on "dysfunction" rather than full blown damage. It's difficult to really understand what happens with varicoceles and how they effect the testicle, i believe a lack of nutrients alongside sluggish blood flow are the prime causes.

    My actual problems comes from having low E2/DHT. When i apply androgel (even 50mg) i go up to 25/6nmol and my ball's feel alot better. Erections aren't perfect but a good bit better than before.

    KSMan, do you know of any varicocele sufferers that are using HCG alongside TRT? I want to use Testim (50mg - or more) daily alongside HCG at least 3 times a week.

  16. Megazoid, Im not sure that testosterone plays a huge part in Nitric Oxide. I have been doing more research and from what I read, most men recover from Varicoceles after the surgery. Im getting the operation in the morning. Wish me luck.

  17. You'll be cool Hyde, it's pretty straightforward and you'll be back on the forum tomorrow night i am sure (if limping a little).

    Best of luck with the operation tomorrow! Let me know how it goes.

  18. Quote Originally Posted by Megazoid View Post
    Thanks for your reply KSMan, i think i sent you a message a little while back on t-nation?

    I believe it's more based on "dysfunction" rather than full blown damage. It's difficult to really understand what happens with varicoceles and how they effect the testicle, i believe a lack of nutrients alongside sluggish blood flow are the prime causes.

    My actual problems comes from having low E2/DHT. When i apply androgel (even 50mg) i go up to 25/6nmol and my ball's feel alot better. Erections aren't perfect but a good bit better than before.

    KSMan, do you know of any varicocele sufferers that are using HCG alongside TRT? I want to use Testim (50mg - or more) daily alongside HCG at least 3 times a week.
    That is me on t-nation.

    If you do TRT, you will be fully LH repressed if it is effective [which for some can be problematic for some on transdermals]. Then you can/must use HCG to keep your testes from shutting down. But if not on TRT, as I stated before, the LH levels might be above normal range already as the HPTA tried to get higher T+E levels.

    So there were two answers there. If not on TRT, adding HCG might take levels higher than needed, but the HPTA would probably simply reduce LH to get you back to where you were in terms of T+E status.

    If you need a boost in your T levels and there is little prospect of you recovering to higher T levels on your own, then TRT+HCG seems to make a lot of sense. E will also recover and you might need AI to maintain libido and mood later. If costs are an issue, injections are certainly the least cost if you can self-inject.

    If surgery and recovery make the teste(s) ready to go from a blood flow point if view, the(y) might be profit from HCG and/or SERM as would be used in PCT to kick things into gear, get the testes developed and responsive and get the HP part of the HPTA going again. When we see guys that have botched cycles and PCT who can't get their HPTA to self-recover over time, then it seems that this system can be stuck or trapped. Use if PCT methods to get things running again can work, and in some cases of varicoceles, if blood flow is normalized, then HCG could take care of physical recovery of the testes and create some T to help wake things up. A SERM would encourage resumption of LH. But for some varicoceles after surgery with good blood flow circulation, LH may be ready and willing and HCG might help, but may not be necessary.

    I think that for the HPTA to be stuck, bilateral varicoceles might be needed. If one is bad, the HPTA may be working ok and a PCT approach does not seem to have any obvious benefit. The amount of time that a teste was shutdown or starved also speaks to the issue of permanent damage vs recovery. If TRT is required after all is said and done, so be it. We have seen guys [not gear users] in their 20's with very low T. These things happen.

  19. Very special thanks for the feedback guy's. Dr John, your advice is also appreciated, as is yours KSman. The sad but true fact is i am getting zero support from doctors across here and have to self-medicate which is terrible. I have found a good blood testing lab though and know enough to self-medicate myself (sometimes i think just going by "how you feel" is worthwhile - libido, morning wood, mood, etc) and doing lab's every few months to monitor progress.

    Throughout all of this my LH/FSH are totally normal, even when the varicocele induced atrophy. LH has remained at 3.9 and down-regulates to 2.1 when doing androgel at 50mg daily (1 packet). My total T goes to 25nmol and E2 remains low (which i think is maybe my problem - too low E2?). I am getting fresh blood work soon to get a baseline with no TRT and then another a month or two latter with testim at 50mg daily.

    Usually guy's with varicoceles (or some form of testicular failure) have elevated LH which is strange as mine is normal. My only theory is that both ball's are still somewhat responding even though they are both atrophied, i was however told they were in the "normal size limits" by a urologist. But they aren't normal size for me (they were normal, adult size before). Not to mention the fact i have ED, low libido and i am suffering all the side effects of low t.

    Basically if i do HCG alone i am shooting myself in the foot but it might be worthwhile in restoring testicular size/function. I don't want to cause complete HPTA shutdown (LH = Zero) by doing HCG if it dosen't get me high enough or improve testicular health (size/function). Blood work is very expensive too and i can't afford to keep getting constant tests. A few week's back i was thinking about doing 250iu HCG daily for 3/6 weeks then running Nolvadex for 4 week's afterwards but because my HPTA seem's somewhat normal this wouldn't make sense and maybe PCT isn't the answer if my piturity is working fine. I really feel Dr John is right about this, the less stuff you take the better (plus nolvadex has IGF-1 effects which i don't want).

    I was hoping to see improvements after the surgery but haven't yet (though it's still only been about 2/3 months). No size increases and no T improvements (my original level was around 25/30nmol). I am visiting the urologist again for another ultrasound and to check if thing's are working or not. While the varicocele has cleared i am still getting some pain and feel the blood is still polling around in the whole area.

    In general i feel allot better on androgel but i don't like the tight scrotum effect i am getting and the reduced ejaculate volume. Is it possible for a guy to use 50mg androgel daily (or testim) and NOT get complete shutdown?

    It's almost ironic Dr John because say that HCG will down regulate the leydig cells but at the same time you think TRT + HCG is a good choice I agree with this however, but i really want to try everything before giving into TRT (not saying it's a bad thing - just very expensive for me right now) assuming i have no E2 problems (i am very lean, very little body fat, good build, etc) would you recommend running your own protocol of Testim + HCG? And how much HCG a week? I was considering using Testim (50mg daily - maybe moving up to 75mg if needed) as this should get me into the 500/650 range even with HPTA shutdown and then maybe using HCG at 500iu 3 times a week (mon-wed-fri). In fact maybe lowering this to 250iu HCG would work better 3/4 times a week (mon-wed-fri-sun)?

    While you can only offer your opinion (as i am not your patient - but would like to be if my doctor would work with you and not be a **** about this!) it would be appreciated as always.

  20. Quote Originally Posted by Megazoid View Post

    It's almost ironic Dr John because say that HCG will down regulate the leydig cells but at the same time you think TRT + HCG is a good choice
    The point is that too much HCG will DR the receptors. 250iu EOD or less will not do that.

  21. Hi everyone. Just got done with my surgery and yes im limping around a low, it hurts like hell to stand all the way up. On a positive note, the surgery went well and they gave me about 30 percocets for pain

  22. Very pleased to hear it went well Hyde. What technique did they use and how is the scar?

    Did they tie off the veins at kidney/abdominal level or scrotal level?

    After you have healed, what will your plan of action be?

  23. Quote Originally Posted by Megazoid View Post
    Very pleased to hear it went well Hyde. What technique did they use and how is the scar?

    Did they tie off the veins at kidney/abdominal level or scrotal level?

    After you have healed, what will your plan of action be?
    They cut me at the groin level, and its hurts like crazy. I can already feel some libido returning (believe it or not)
    and its only been one day!

  24. Good to hear Hyde, you might be on the road to recovery. When are you going to get blood work done?

  25. I am seeing the urologist this Tuesday, i really do need luck when dealing with this guy. He can be a nightmare at times and doesn't always want to listen.

    My right testicle has always been smaller and dysfunctional since having it injured as a teenager. I think it had a varicocele that magically (?) went away on it's own after a year or two. The spermatic cord has a noticable blockage though (not a varicocele) which i want fixed to see if it will restore more testicular function than present and more importantly reduce the pain. The urologist mentioned it was like a vascotemy had happened.

    Regarding left side varicocele i want to get this confirmed that the operation has worked 100%. My nut's are still going nut's and i am not sure if hormones are to blame or bad blood flow. Maybe even more factors? What i am confused with even more is the fact that my LH/FSH are normal and not registering anything "abnormal". I am going to get more test's ran.

    At present i am on TRT and feeling a "bit" better using one tube of testim a day. Only been 3 day's since starting Testim. It stinks though so i am going to change back to TestoGel (100mg daily) alongside HCG once everything is fixed and confirmed in the testicular department. I have a girlfriend now that i really love and i have had to refrain from sex because of these problems and because wood isn't too good (nor libido) so i am holding back.

    God i hate varicoceles...
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