Sudden testicle shrinkage. No libido, fatigue. Varicocele?

[fweed]

Cold shower will contract the veins and perhaps improve blood flow temporarily. Keep doing it. Have you been under any great stress lately, or in november?

 

[fweed]

One other thing, abc111. Do you have morning erections, and are you still having sexual dreams?

 

[v4lu3s]

If it is varicocele related it is due to an injury rather than the normal process of varicocele which takes typically 20 ish years to really make changes, and typically at that point you have clinically low testosterone. I think focusing on the varicocele aspect as a cause is probably not helping, and it should be looked at as a symptom of something else. Sudden shrinkage also won't be cause by a "normal" varicocele, but trauma is a more likely suspect.
What was the result of the MRI on the pituitary?

 

[fweed]

If it is varicocele related it is due to an injury rather than the normal process of varicocele which takes typically 20 ish years to really make changes, and typically at that point you have clinically low testosterone. I think focusing on the varicocele aspect as a cause is probably not helping, and it should be looked at as a symptom of something else. Sudden shrinkage also won't be cause by a "normal" varicocele, but trauma is a more likely suspect.
What was the result of the MRI on the pituitary?

Hi v4lu3s, thanks for your insight. As far as I know, I didn't have a varicocele beforehand, no symptoms and the testicle never felt unusual. One week after the shrinkage, I noticed a raised vein on the surface of the left testicle. At the time I thought it a positive sign, of blood flow. That was before I knew of varicoceles.

Most recently, I went to a urologist a couple of weeks ago. He did a manual check, along with valsalva maneuver, and detected what he described as "a very small hernia", and that the cord felt like "it might have been torsioned before, but appears fine now".

He gave the hernia and 'small' or partial torsion as the possible reasons for the intense pain this February (one year after the original shrinkage). Said the testicle seems fine now - according to him.

He then declared the hormone blood panel was 'normal and within ranges', asked if I still had no desire, when I replied no, he said it must be psychological and has referred me to a psychologist.
I've read in medical papers that a lack of morning/night/spontaneous erections is not psychogenic, and is something physical. I don't know why he ignores it.

The MRI in the beginning of January showed no abnormalities
of the pituitary. It only said there is a large vein draining into the saggital sinus, with no signs of bleeding. That it was probably congenital.

I have thought that perhaps I need an MRI of my pelvis, or at least a radiographic blood flow scan.

When the shrinkage happened, there was no pain. Discomfort did
follow, the testicle being pulled higher up, feeling a bit tight where the cord meets the canal.

Maybe it was an intermittent and silent torsion, restricting blood flow and causing rapid atrophy. If so, I don't know if it was ever resolved. I also have worries whether part of the testicle died.

I'd welcome any ideas you might have.

 

[v4lu3s]

I wish I could offer more, but I think the possibility of hernia or related damage might be more a cause, though I am not knowledgeable enough to match that up with the hormone balance required to maintain libido. I suspect that stress over this situation does not help it at all. I had a grade 3 and grade 2 varicocele and was told it was just a little hernia, no big deal. Of course that was 25 years ago...the left side was so large that it could be seen from 10 feet away as a mass of veins that looked like worms. Even then the testicle on that side never shrank until after the surgery and commencement of TRT and even then it is still in normal size range. Never had bleeding at all, that alone is a pretty good indicator that something else physically happened internally, and the fact they cannot figure out why or where it is coming from is a big issue.

 

[fweed]

That my emotions pretty much flatlined and I felt no pleasure impulses for over a year is another thing they haven't exp!ained. I read about another guy, megazoid, who had read of a link between the testicle blood flow and the vein to the kidneys and adrenals.
I have a pain in my left groin most of the time, it's become normal for me.
Was your surgery successful? If so, why were you put on TRT?
Have you read about HCG, it is supposed to keep the testicles normal sized during testosterone therapy.

My testicles are 'within normal ranges', but the left one shrank by 50%. For me that isn't normal. The left was always much larger than the right, so when it shrank they become the same size. That means that no doctor believes me that they shrank. I have no way to prove it as I never had an ecography or testicle measurement before the problem happened.
Thanks for your info though, it has given me something to think about.

Honestly, the doctors aren't interested, and just push me off as soon as they can. Urologist say it is hormonal, endocrinologist says it must be physical, then urologist says it is psychological. Meanwhile, I've lost a year and a half of my life and nothing has been diagnosed or treated.

 

[v4lu3s]

Varicocele from congenital conditions tends to cause long term testicular damage. Things are pretty normal until your mid 30s when testosterone levels start dropping faster than normal. At age 32 total test was mid 400s. Low but not unusual, and I had no other symptoms. 5 years later I was at 300. Much steeper drop off. I was also having alot of low testosterone symptoms at the time. I ran a clomid test and got levels up to 500 but that was also with high FSH LH due to the stimulation from the clomid. Finally was diagnosed with the varicocele and post surgery my total test remained unchanged though estrogen levels dropped from 100 to 25. The long term damage was done, and i already had a kid so I started TRT. The temperature/bloodflow damage from a varicocele take a long time to do their harm. If you catch it early you are more likely to bounce back, but I knew mine has been around since at least 16. It took about 6 months for the mass of veins to go away, and the random pain to stop (this was once or twice a month for a few minutes to a few hours before going away on its own), once it was gone it was gone for good though.

When the symptoms first appeared do you recall any injury occurring near then? anything that at the time might have seemed like nothing?

 

[fweed]

I don't remember any injury around that time. In years previous I'd had a couple of knocks to the testicles that hurt, but no bruising or pain lasting more than a few hours.
I had been wearing jeans that were a bit tight around the crotch. Due to circumstances I only had that paid to wear, and cash was low. I had been looking for replacements but the fashion in the country I had just moved to was everyone wearing tight trousers, which I'm not a fan of. Looking back, if that was the cause, then I'd rather have spent a thousand flying to another country to buy a pair than suffer this.
I didn't have pain though. I've read that tight trousers can cause atrophy. Doesn't explain why it was so sudden though.
Really overnight, fine one day, felt tired, slept, next morning still exhausted and libido completely gone. Three days later I noticed my testicles had shrunk to half their size.

 

[fweed]

Like I mentioned, have you thought about using HCG? It sounds like it might help in your case.
It can kick start testicles, and in some cases regrow them somewhat.
You'd have to talk with someone who knows more about it.
I don't know if it has the same limitations as clomid, or if it's be suitable. Worth researching though.

 

[v4lu3s]

HCG cannot regrow cells that have died over many years. It would for sure raise test levels, but it costs a LOT more than plain old test cypionate.

did your blood labs include any efforts to check for any diseases processes causes by virus or bacteria or even cancer?

 

[fweed]

I don't know. The doctors weren't forthcoming. Urine tests were fine apart from the day of the blood last summer. One recent one looked like names related to cancer tests, but that was a guess on my part, only saw it briefly.
Had lower leukocytes for one test a couple of months ago.
In feb I had raised thyroid hormone, suggesting a problem there, but the test in march returned normal.

I don't know if levels are supposed to fluctuate so much. Test has been up and down in each one, thyroid too changed each time, plus some others.

Someone told me to consider having my prostate checked.
Ecography of scrotum, kidneys and bladder last year showed no signs of tumours.

I've heard that sometimes the cells aren't dead, but in a hibernating state. Again, I don't have information to add any depth to that.
Someone else said to check for viruses.

Read a few reports about epididymitus and prostitis causing some problems.

 

[v4lu3s]

Lyme disease, STDs and some other stuff can cause testicular shrinkage.

Testosterone levels fluctuate during the day being highest first thing in the morning (when you wake). Thyroid hormones, cortisol, estrogen (especially e2) and prolactin all can alter test levels.

 

[fweed]

The suddeness is the strangest part. The only reference I can find is someone with a partial torsion which was then corrected. It regained its size after surgical correction the same day.

If I can find a doctor who is at all curious about finding out why they shrank and how to fix the problem, I can ask for a virus/bacteria check.
For trauma, I would need an MRI of the pelvis.

 

[damage007]

Lyme disease, STDs and some other stuff can cause testicular shrinkage.

Testosterone levels fluctuate during the day being highest first thing in the morning (when you wake). Thyroid hormones, cortisol, estrogen (especially e2) and prolactin all can alter test levels.

Good point. Also would add that, whether being on TRT or not, vitamin deficiency can affect the ratio of Testosterone:Estrogen and the amount of testosterone being taken up into the cell.

 

[fweed]

I read a lot and started eating a wide assortment of testosterone boosting foods a week after it originally happened. I don't know if it had an effect, but there was no improvement in my condition. In my case, I am pretty sure something physical went wrong. The doctors just can't be bothered or aren't capable of identifying it. So I'm left in this state.

 

[abc111]

Hi fweed, sorry for not checking in lately. To answer your question about stress. I started a new job in October so I was under a bit of stress, however I've always been the type of person to stress about work/school so it wasn't anything new really. The real stress began when my testicles began to hurt and then shrink.
And yes I still get morning erections but they do not last as long and I have hardly and sexual dreams/desires

The suddenness is also the most confusing part to me as well.

I saw my doctor again last week and he says it's all in my head/stress related. Told me to relax and come back in couple months if pain continues only then will do blood work for hormones

This has become very depressing for me. I can hardly get an erection during the day and when I'm with my girlfriend which is extremely frustrating. I just don't feel that sexual energy anymore

 

[abc111]

A list of things that I could speculate about what caused this:

-I took the acne medication accutane, however while i was on it i was fine and several months later I was still fine so I doubt its that.
-I sleep on my stomach so sometimes my morning erection would go to the side, a few days before the pain in the testicles began, I had a morning erection and rolled over to my stomach and somehow managed to push my penis completely pointing down, I felt a sharp pain and quickly got up, but I didnt notice any bruising or swelling so I assumed I was fine
-partial torsion/sports hernia? I always lived active life style(competitive runner) so when i started my new job (office job) I am sitting many hours. then after sitting about hours a day sometimes I would do workout tight after work. maybe I pulled something in my pelvis or got hernia?
-when pain in testicles began i took antibiotic cipro, I heard it is very strong antibiotic, however it didnt really help as my test came back negative for infection and maybe it made my condition worse?

Just speculating posssible causes wishing I could get this figured out but as you said seems to be a mystery to doctors. The best would be to find a doctor who would be interested in researching and thinking outside the box especially that there are other males who have had this problem... if you google it you could probably find their threads. I can try posting I dont know if it will let me though.

 

[abc111]

Also fweed, please keep me posted if you find any insight on your condition or if you find any remedies that help. I've started taking maca & korean gensang supplement. doubtful but maybe will help a little?

Im considering taking cialis as well to help with erections as girlfriend is becoming very frustrated with me.
My doctor told me I'm to young though

 

[abc111]

Ok so i cant post links to others with similar issue but Im sure you could find them by googling your symptoms

 

[abc111]

Question for you fweed, do you sleep on your stomach? Have you ever had your erection go sideways or down?

 

[fweed]

Hi abc, I don't sleep on my stomach. At the time I would sleep mostly on my back or my side. Erections always straight, nothing unusual.
I don't know if accutane can do anything. What was the time scale - how long did you use it for, how many months after use did the problem happen? If it affects your hormones it could be a background factor that caused an imbalance, but from the suddeness it sounds like something physical happened.

Take cialis as a short term thing to boost your spirits and confidence. I wouldn't recommend using it all the time or long term.

I haven't found anything in particular that helps me. I've read a lot about supplements and foods. I think without fixing the physical cause, nothing will help me much.

Better not to listen to a doctor who says it is all in your head. They say that to me too, it really means they don't have a clue and want to pass off the problem to someone else. Like one urologist said to me "I've been very stressed and my testicles didn't shrink".

Maybe consider hernia, partial torsion or intermittent torsion. Sometimes they can't be noticed on an ecography. If you have insurance, try to push for an MRI of your pelvis. Or ask at the very least, ask a specialist to check your pulse in all the regions around your pelvis to see if there are differences in blood flow. Maybe also try for a blood flow radiograph where they give you a dye and see your flow in real time.

Don't let the put you off. Keep trying for a different one.

You could try sending a link to me in pm.

 

[fweed]

Also, if there is pain, that means something is off that needs fixing. Unfortunately, doctors seem to just follow an instruction sheet most of the time. Find one that has an interest in your problem and wants to help. Or, just insist on whichever tests you think are appropriate. Don't take no for an answer and sort this out.
One more thing, keep maintaining regular erections, at least a couple of times a day for ten minutes or so. Need to keep the blood flowing and keep that area healthy.

Maybe we both have the same problem and if we figure it out we'll both be sorted.

 

[Spurfy]

Hi,

I've read through a lot of posts on here and other boards - looking for information.

In January this year (2015), I experienced a sudden loss of libido and extreme fatigue.
This happened within 24 hours (overnight). From being totally fine, healthy and full of lust for life, to nothing.
After a couple of days, I noticed my testicles had shrunk to 50% volume/total size.
I panicked, thought I had had testicular torsion, went to the hospital. No torsion, 'seemed healthy'.
Referred me to a urologist.

Since then, almost 9 months have passed. I've seen 6 urologists, an endocrinologist and several general doctors.
I have had:
- numerous manual examinations (including the valsalva maneuver)
- a scrotal ecography
- abdomenal ecography (kidneys and bladder),
- two blood tests for hormone levels

None have encountered this before - nor have any given a diagnosis or any kind of treatment whatsoever.

The scrotal ecography revealed a 'small' varicocele (4mm), a couple of 'small' hydroceles - all on the left testicle.
The abdomenal ecography was in around June, following 24 hours of 'a large quantity of blood in the urine'.
That showed nothing whatsoever in the bladder or kidneys.

No cause has been presented for the blood in the urine either.

I'm 35, physically fit, do not drink alcohol or caffeinated drinks, do not smoke or anything else. I have no other medical problems
and take no medication whatsoever.
My diet is balanced - and one week after the testicle shrinkage - I improved my diet further to include testosterone boosting
foods (more red meat, dairy, brasil nuts, walnuts, dark green vegetables, mushrooms and so on). None of these are eaten
in excess. It hasn't cured me - nor had any great effect that I can notice.

I can post my full bloodwork in a later reply, if anyone is interested.
Testosterone a month afterwards (in February) was around 670 ng/ml.
In the beginning of September, it was 890 ng/ml. The diet may have helped that, but when I questioned one doctor in particular
in July - he said my testosterone (given my fitness and age and so on) should be around 1,000.

The blood tests supposedly all fall within normal ranges - which really isn't helpful - as the doctors just tell me it is in my head
which is compounding my hopelessness.

The doctors have brushed me off, giving me a followup appointment 2 months down the line each time, last one was set for
3 months from that one (mid December). The endocrinologist was one of the worst - refuting that I had any real cause,
either physical or hormonal - saying "it is probably psychological".

I've had more pain above my left testicle since the beginning of July - which I suppose is from the varicocele.

From my guess, something burst or failed in the end of the January, very suddenly, my ball shrank and messed up my hormonal
system (adrenals/thyroid) in some way that is irreversible unless treated in the proper sequence.

My symptoms include: no morning erections, no spontaneous erections, not much sensation down there,
no sexual fantasies or even sexual dreams, no libido.
Along with that, a pain in the groin above my left testicle which lasts for almost all the day.

Some other things I have noticed which may be related. I have no real urge anymore to use the toilet, for liquids or solids. Nor do I have
any 'relief' or pleasurable feeling from doing so. I just feel 'full' or 'empty' afterwards. That's it. No great hunger or thirst either. I just
eat when I think I should have food.
The rest of my experiences and emotions feel almost completely flatline too - like I don't experience any pleasure from anything.
This could be my adrenals or thyroid or a combination.

At times, I can manually stimulate and a weak erection comes (not always) - it never reaches the full size.
If I stop manual stimulation, the erection almost immediately deflates - it doesn't last by itself.

Directly before this happened - I had morning erection almost every day, that would last 20-30 minutes by mild thoughts alone -
spontaneous erections throughout the day.

My arms and wrists seem smaller than before, I don't seem to be holding muscle as I was immediately before.

Over the months, I have been fighting off a depression that this thing is causing.
I really need some information and help on what to do next.

From what I have read, a good varicocele surgery - and one of the PCT restart therapies might fix me.

Most of the doctors have more or less laughed in my face, told me to relax and that it isn't serious.
Frankly it has ruined my life, I don't see any future continuing like this. I don't see how that can't be serious.

Thanks for reading, I'd appreciate any help.

Did you get E2 and PRL tested? If so, what were the results?

 

[fweed]

Prolactin was very high for 3 weeks before (January 2015) and one week after the incident, but untested until 2 months later - due to the speed of the hospital system.
I realised this some months after. Nipple and chest area was extremely sensitive for weeks surrounding the incident. It dropped by half or more one week after the incident. 5 months after (July 2015), nipple sensitivity returned to normal. 2 months after it was slightly high:
Prolactin, ng/ml, range (4.04-15.2) - April 2015 - 17.6, September 2015 - 17.38, January 2016 - 18.34, February 2016 - 18.08.

Estrodial, pg/ml, range (11-55): September 2015 - 29.66, February 2016 - 31.24.

MRI scan of brain/pituitary didn't show a microadenoma.

 

[Spurfy]

Prolactin was very high for 3 weeks before (January 2015) and one week after the incident, but untested until 2 months later - due to the speed of the hospital system.
I realised this some months after. Nipple and chest area was extremely sensitive for weeks surrounding the incident. It dropped by half or more one week after the incident. 5 months after (July 2015), nipple sensitivity returned to normal. 2 months after it was slightly high:
Prolactin, ng/ml, range (4.04-15.2) - April 2015 - 17.6, September 2015 - 17.38, January 2016 - 18.34, February 2016 - 18.08.

Estrodial, pg/ml, range (11-55): September 2015 - 29.66, February 2016 - 31.24.

MRI scan of brain/pituitary didn't show a microadenoma.

So, as far as you're aware, your PRL is still significantly elevated? What medications, if any, do you take? Anti-depressants? Sleep aids? OTC allergy medicine? Anything and everything, tell me about it.

Have you ever in your life taken finasteride? Did you ever have DHT levels checked? SHBG?

 

[fweed]

I take no medications of any kind. In the past few years I've taken more or less nothing. A few months ago I took some ibuprofen for a few days. Never taken finasteride, or any other hormone affecting medication. No steroids. 5 years ago a few days of antibiotics.

They never checked DHT, though I requested it they said it wasn't relevant. SHBG once.
SHBG, ug/ml, range (not stated): January 2016 - 5.6 (within normals).

They never talked about optimal levels.

Some more prolactin tests were done, one was taken an hour after the first in February 2016 to try to eliminate it, first was 18, second was 12.
Then in march 2016 a reading was taken in the afternoon instead of morning, it came back as 10.04.
I don't know if morning levels have remained the same.
Another afternoon test in April 2016 came back as 6.82.

It could be the levels have decreased. If so, they stayed at 17/18 for a year.

I am not sure that prolactin is an answer, or a secondary sign.
I wondered if I had always had high prolactin, and similarly high testosterone as a counter.

 

[Spurfy]

I take no medications of any kind. In the past few years I've taken more or less nothing. A few months ago I took some ibuprofen for a few days. Never taken finasteride, or any other hormone affecting medication. No steroids. 5 years ago a few days of antibiotics.

They never checked DHT, though I requested it they said it wasn't relevant. SHBG once.
SHBG, ug/ml, range (not stated): January 2016 - 5.6 (within normals).

They never talked about optimal levels.

Some more prolactin tests were done, one was taken an hour after the first in February 2016 to try to eliminate it, first was 18, second was 12.
Then in march 2016 a reading was taken in the afternoon instead of morning, it came back as 10.04.
I don't know if morning levels have remained the same.
Another afternoon test in April 2016 came back as 6.82.

It could be the levels have decreased. If so, they stayed at 17/18 for a year.

I am not sure that prolactin is an answer, or a secondary sign.
I wondered if I had always had high prolactin, and similarly high testosterone as a counter.

A few more questions:

1. How is your sleep quality? Do you wake up feeling refreshed? Tired? Stiff? Sore?

2. Have you ever had a head injury?

3. How does your body feel most of the time? Worn? Tired? Stiff? Sore? Loose? Warm? Cold?

4. Have you had full blood work done? CBC, CMP, lipids? Ever had A1C, CRP checked?

 

[fweed]

Sleep hasn't been as good for the last few months. Waking up too soon. Been somewhat better in the last couple of weeks.
No serious head injuries, just bumping my head. Last memorable knock was 14 years ago, just hurt and put me in a bad mood for a few hours.

MRI of head said all normal apart from a larger than normal vein draining into my saggital sinus, which they presumed to be
probably congenital.
I read that such a thing can increase stroke risk.

I feel tired much more than before it happened. I felt absolutely exhausted for the first day and two weeks after, then my energy went up again, but never to previous levels. I am often yawning at 6pm.
I have lost strength and torso/arm muscle mass. Most noticeably since last august perhaps. My wrists felt thinner. My arms are much thinner and far less vascular.

I don't know what CBC, CMP, A1C, CRP are. Lipids, I don't know.
I have had haemoglobin, leukocytes and so on as part of blood tests.

 

[Spurfy]

My guess is adult onset growth hormone deficiency, due to hypothalamic and/or pituitary dysfunction secondary to traumatic psychological stress. You're not going to find any published studies on this, this is cutting edge, and currently my primary area of research. (Lucky you!)

A person in your situation, if I am indeed correct, would do well to run rhGH 1-2 iu every night before bed for at least 12 weeks and see if recovery progresses.

 

[fweed]

I was under a great deal of stress at the time, emotional, work, lack of sleep too. Very interesting. I have some physical symptoms, which doctors discounted as 'not usually' causing this. Small varicocele and two spermatoceles on left side, and the latest urologist found a 'very small' inguinal hernia.
Which kind of specialist would you recommend me to bring your advice to? I have seen endocrinologists (3) and urologists (10) so far. Can I provide you with any more information?

 

[Spurfy]

I was under a great deal of stress at the time, emotional, work, lack of sleep too. Very interesting. I have some physical symptoms, which doctors discounted as 'not usually' causing this. Small varicocele and two spermatoceles on left side, and the latest urologist found a 'very small' inguinal hernia.
Which kind of specialist would you recommend me to bring your advice to? I have seen endocrinologists (3) and urologists (10) so far. Can I provide you with any more information?

Endrocrinologist, for any or all of the following: 24 hour GH secretion, serum IGF-1, insulin tolerance test, GHRH + arginine test, glucagon stimulation test. Bearing in mind that a "normal" test is still not conclusive, just as guys with a total testosterone of 351 certainly don't feel as well as guys with a total testosterone of 850. In your case, where you have nearly all of the psychological symptoms and many of the physical symptoms of GHD, I would recommend to a person in your situation that rhGH therapy should be commenced upon any test result below low-normal. GH will help tremendously with the repair of your brain, if GH deficiency is indeed the cause of your condition. There's a reason that all current treatments are pretty much worthless for PTSD -- none of them actually repair the damaged brain regions and structures, and the only structures (hypothalamus and pituitary) that are capable of repairing the overall brain damage are the ones that are the most seriously damaged. GH fixes this.

I'll be honest with you, most endocrinologists are going to be skeptical regarding this cause of adult-onset GHD. My best advice would be to try and remember any head injury you've had as being significantly more serious than it may actually have been, and that most/all symptoms appeared shortly after this. Severe traumatic brain injury is known to be a causative factor in adult-onset GHD.

It's unfortunate that very few but the top brain researchers in the world understand that the biomolecular brain response mechanisms to physical trauma and psychological trauma are essentially identical -- glutamate excitotoxicity, ROS generation, gliosis, apoptosis, neuroinflammation, neuronal destruction, etc, the only difference is that the physical damage from psychological trauma tends to be very selective and limited only to specific regions of the brain -- hypothalamus, pituitary, and the higher functioning cortical and limbic regions. Nevertheless the functional impairments that are seen in the brain after psychological trauma are generally fairly consistent -- albeit generally less severe -- with those seen after serious physical trauma to cortical and/or limbic regions.

If you run into dead ends, my advice to a person in your situation would be to just start rhGH therapy on your own. At 1-2 iu/day, there should be essentially zero side effects, and you would know pretty quickly (within 30 days) if it was working. Since this is merely a replacement dose, if you do find significant relief, I would consider that clear and convincing evidence that GH deficiency is the problem. Don't be afraid to go your own way if you have to, this is your life!

 

[cheftepesh1]

I would see an endocrinologist for this. A specialist won't wait for the tests you need.

 

[fweed]

Seen three endocrinologists so far, none were particularly interested in finding out what was wrong. They just said the results were mostly "within normal ranges" - and when they weren't, they said it wasn't high enough to be significant. I need to find an endocrinologist and a urologist who want to find out what is wrong and fix it.
I've made a note of all your information slurry, thanks for that.
Is there a permanent fix if GH deficiency is what is wrong?

 

[GreekTheBrick]

Ran into this very old thread

http://anabolicminds.com/forum/male-anti-aging/76060-dealing-chronic-high.html

At the end of post #9

"And, by the way, at just under age 50 his hypogonadism, a very abrupt almost overnight hyogonadism, was caused by his hypercortisolism Cushing's condition.

Literally wiped out his testicular ability to poduce meaningful amounts of Testosterone As i recall his early Total T tests when he suddenly went ED and loss of libido were averaging 140 - 150 in a reference range of 220 - 1000."

If it is irrelevant, excuse me. Just trying to help

 

[fweed]

Thanks Greek. Could be related - I really could have done with a full blood test immediately when it happened,
My testosterone has remained just above average, according to results. I asked one urologist what my level should be - he said about 1,000.

 

[damage007]

Cortisol but also ACTH is big in Pituitary function in Men.

The relationship of serum and salivary cortisol levels to male sexual dysfunction as measured by the International Index of Erectile Function

Adult hypopituitarism: Are we missing or is it clinical lethargy?

The neurophysiology of the sexual cycle.

 

[Spurfy]

High cortisol would not cause fatigue, it would cause the opposite, along with weight gain, increased appetite, and anxiety. Low cortisol would cause fatigue, widespread muscle pain, inflammation, loss of appetite, and weight loss.

And to the OP: The urology who told you that your testosterone level should be 1000 ng/dl was basically just making up a number. Moreover, serum testosterone levels are a generally a poor predictor of outcome, since there are so many other factors at play. To give you an example, clomid can raise testosterone to near superphysiologic levels, and yet most men on clomid therapy do not report "feeling" the high levels of testosterone. Endocrinology is 50% science and 50% voodoo. I would bet a paycheck that a disruption in GH/IGF-1 signalling at the pituitary is the core of your problem.

 

[fweed]

Spurfy, may I ask which country you are in - and could you recommend someone I could see about this? I am talking with a doctor where I am in Spain about your theory but it is not their speciality, though they are interested in helping solve it.

Also, I don't know if I mentioned before, but the night before it happened, I masturbated in the shower. After ejaculation I felt a strange, sudden, draining sensation in my head. I didn't think it
was physical at the time, but just a feeling.

 

[Spurfy]

Spurfy, may I ask which country you are in - and could you recommend someone I could see about this? I am talking with a doctor where I am in Spain about your theory but it is not their speciality, though they are interested in helping solve it.

I'm in the U.S.

Unfortunately, I cannot recommend any physicians here. Most of what I posted is at least 10 years ahead of mainstream medicine and mainstream medicine is notoriously slow to embrace new treatments modalities, regardless of how effective, when these modalities require that mainstream medicine admit that it really knows very little about anything other than cutting people open. Case in point: Ketamine is the most powerful treatment for depression that has ever been discovered, is exceptionally safe, well-tested, and cheap, and yet most in the psychiatric community are still saying, "We just don't know enough about it... more studies are needed... too risky." Researchers embrace new modalities, doctors deride them.

Doctors and pharmacology don't mix, especially when doctors aren't taught to ask questions, to think outside the box, to come up with radical solutions. Doctors are taught to apply a patient's symptoms to a flowchart and go from there. When this fails, they either give up or just start throwing various random medications at the patient.

I wish you the best of luck, and I hope your doctor will be open-minded enough to try some "radical" treatments, but I've said from the beginning that you need to prepare yourself for the fact that you may have to venture out on your own in terms of your treatment options.

 

[fweed]

I've seen what you have spoken about, the flow chart mentality, in almost all the doctors I have visited.
Some are more curious than others, or have a little more open mind. Most ignore outright that there is anything wrong, despite physical symptoms.
I hope you can stay in touch with me, in case as you say I need guidance to do it alone.

I'm happy to help your research if I can.

 

[fweed]

Update with a blood test from the beginning of August 2016.
DHEA sulfate, ųg/dl range(88.9-427) - 393.3
FSH, mUI/ml range(1.5-18) - 3.2
LH, mUI/ml range (1.4-11.1) - 6.4
Prolactin, ng/ml range(4.04-15.2) - 21.05 *(highest yet)
Testosterone-Free, pg/ml range(8.9-42.5) - 23.2
T4-Free, ng/dl range(0.85-2.00) - 1.56
TSH, ųUI/ml range(0.27-4.2) - 4.86 *(high again)

 

[Razvant]

Your tsh is too damn high,prolactin too
I am in almoust the same condition as you
I had a bacterial prostatitis last year and lost my erections my energy..everything...then when my testes shrunk at some point i started to panic ,did my bloodwork and discover that i had low test 300ngdl,everything was normal lh fsh tsh prolactin ,only estradiol was 31miul witch is too high for a 300 test
I went to see an urologist for prostatitis and discover that a have varicocele grade 2.My doctor sad that prostatitis and varicocele is the cause for my low t.
I treated prostatitis my t went up to 540(got a little better)
I went yesterday to my endo for some blood work and she also said that the varicocele messed up with my testesterone and estradiol too..still waiting for results .
In january i will get my varicocele fix with laparoscopic procedure
Many many research show that varicocele will lower your t levels and shrunk your testicles, and after surgery testosterone will rise up to 200ngdl depending to person..
If i were you i will found an uro to fix that right away
In the meantime you can try some clomid to raise test level by stimulating the secretion of lh ,i tooked half pill and felt like superman but the only bad thing was that it raised estradiol too so i need to add some arimidex to control e2.

 

[Razvant]

The connection with testosterone levels is quite simple, blood flow. Any body part needs adequate oxygenated blood flow to its job. Testosterone is produced when LH travels from the pituitary gland to the testes via the blood. Then the T that is produced in the testes must now travel out via blood vessels to the rest of the body. Hindering blood flow in either direction is obviously going to make it very difficult for them to do their job.

 

[fweed]

The connection with testosterone levels is quite simple, blood flow. Any body part needs adequate oxygenated blood flow to its job. Testosterone is produced when LH travels from the pituitary gland to the testes via the blood. Then the T that is produced in the testes must now travel out via blood vessels to the rest of the body. Hindering blood flow in either direction is obviously going to make it very difficult for them to do their job.

Thanks for the replies. I've read about the connection with varicoceles, and I agree with you about the effects, but the 8 or so urologists I've spoken to have mostly ignored that. They also tend to contradict one another too. I need to find a good one with appropriate experience.

Prostate infection, no one has examined my prostate yet.
My problem was very sudden, as in within hours, woke the next morning thoroughly exhausted and without any libido whatsoever.
Have you had sexual dreams? I don't have them. Used to have one once every few days or a week.
My testosterone has been around 560-780 in the tests.
Estradiol was about 36 that I remember.
I don't know what is balanced.

Do you know how I can find out what my levels should be?

 

[Razvant]

Belive me untill last year i was a horny mdfk, sex 5 times a day untill i woke up like i had a flue ,feeling very tired ,i lost some muscle too because my low t,i can stil perform sex 2 times a day but after i am getting tired and the desire for more sex is gone
Untill last year i dream almoust every night that i m having sex but now maybe one dream a mounth...no spontanious erections only manual stimulation and moorning wood thats all..

 

[Razvant]

From: Dr.Maraino via thinksteroids.com

Estradiol is made from Testosterone.
The brain preferentially measures Estradiol and other estrogens to testosterone when determining LH and FSH production.
Estrogens are necessary to have testosterone receptors. Without estrogen, one's cells may be deaf to testosterone.
Testosterone production is needed to overcome Estrogen's unwanted effects - gynecomastia, etc. Though Thyroid hormone production is also a factor.
Both Estrogens (as measured by Estradiol), and Testosterone are important for libido.
LH (and HCG), not only increases Testosterone but it increases Estradiol production. One way of looking at this is that Estradiol production is the actual reason for LH production, with Testosterone being an intermediate.

The observation is that in well functioning, physiologic level signaling male adults, a common T to E2 ratio is somewhere around 20:1 to 30:1 - when using ng/dL testosterone and pg/ml for estradiol and comparing the raw numbers. Thus an estradiol level of 20 predicts a total testosterone of around 400-600.

This ratio then allows one to determine if estradiol production is too high or low, in which case, problems in functioning may occur.

If Estradiol production is too high, then adding an aromatase inhibitor is an option. Blocking the stronger estrogens with Tamoxifen is also an option. If Estradiol is too low, then HCG is an option. And so forth.

Adding external testosterone throws a wrench in physiology because it also lowers thyroid hormone production by shutting down testicular function. This then allows Estradiol to further lower thyroid hormone by increasing thyroid binding globulin production. This can destabilize mood, among other things, in susceptible men. Testosterone in this case doesn't necessarily counteract the negatives of estrogens.

How estrogen affects the nervous system is another complication. If estradiol increases serotonin excessively (which lowers dopamine), then libido is reduced. This is an effect not counteracted by testosterone.

The ratio is not hard coded. There is room for flexibility. For example, if other components contributing to libido are in play, then the ratio can be higher. But it does give one a starting point for determining what is happening and what is usually expected.

Supraphysiologic levels of testosteron do not necessarily insure a person has libido or other positive functions of testosterone unless the other systems are also tuned for it. It would be great if it was this simple. But for some men, the peak of testosterone may instead be inhibiting. Testosterone is a very calming signal, helping reduce norepinephrine signaling. The high and excitement from sex, however, is given by norepinephrine. Too high a testosterone with too low an estradiol level would also blunt the libido component from estradiol. Thus, excessive testosterone can be dulling instead to libido. As the levels go down, then one may see libido improve as testosterone comes more into balance with the other signals.


After reading numerous explanations of T/E ratio this one was the most understandable to me.

 

[Razvant]

So..you ve been to 8 uro s and none of them examine your prostate?wtf?this is the first thing an uro should do...for me it starts like a flu ,do you had any fever or feeling sick?how was your urine flow?any pain on genital area?
Is your sperm volume low?

 

[fweed]

To answer to your last post, I had no flu symptoms, no fever ir anything. Just incredible fatigue, like I hadn't slept in days.
No pain, urine flow was normal until about 4-5 months later when I my urine had a large amount of blood in it for 24 hours. Had a sperm test done only this June, the sperm count seems normal, but only 30% of sperms are living, when it should be 60%+ for a healthy sample.

I have had morning wood a handful of times in the last year and 10 months since it happened. Never fully erect, and not at all long lasting, fading after seconds most times. This year it has happened once every 2+ months perhaps.
Manual stimulation doesn't work very well, but comes with patience.
Erections fade fast and aren't full strength.
I have almost zero sexual thoughts, like that section of my brain has been turned off or down to 1% functionality. If I ejaculate it takes a couple of weeks to feel the same state again.

Like I am 90 years old.

 

[Razvant]

Any burning pain during urination?or back lower pain?i m asking you because i m trying to eliminate them 1 by 1

 

[Razvant]

If your sperm is affected is either from a prostate or bladder infection or varicocele...mine is affected too ,another reason for fixing my varicocele