Some time ago I began to be increasingly concerned about a group of symptoms, and my suspicions of low testosterone were confirmed by a blood test.

Since then, I've tried various ways to modify my exercise and diet to minimise the low-T problem. For example, in the gym, I have done mostly large compound exercises in an upper/low split. I do cardio on most of my days off, but I am careful to get sufficient rest and recovery. I have kept my diet very clean, continued to organise meals that keep blood glucose under control, and made sure I don't fall short on monounsaturated fat, vitamins, zinc, etc.

My maintenance calories are now somewhat lower than they used to be (at comparable weight), even though I am now more physically active. While eating to maintain total body weight, I am gaining fat (especially abdominal fat and a couple of other specific areas) fairly quickly and losing muscle mass. The dilemma, then, is this: should I continue to eat to maintain total body weight, and find ways to tolerate or compensate for further muscle loss and fat gain over time; or should I reduce calories to arrest (or maybe even reverse) further fat gain, even though this might accelerate the existing muscle loss trend and might leave me with reduced energy and hence reduced capacity to exercise?

As I still suffer from acne (at age 42) I am guessing that the low androgen levels are accompanied by high estrogen levels - and if so, then perhaps excessive aromatisation is contributing to the problem in the first place. This is all pure speculation; but since adipose tissue is a major cite of conversion of androgens to estrogen, it might suggest that my priority is to reduce body fat even at the expense of temporarily worsening my muscle loss.

Unfortunately, these matters are strictly out of bounds regards my doctor. When I briefly mentioned my concerns about continued muscle loss and accompanying fat gain, she told me that she was unable to advise me on this as a preference for better body composition is a purely psychological, rather than medical, matter.

Other symptoms I'm having now are increased blood pressure, near-total absense of sexual desire, memory problems, hot sweats at night, and reduction in intensity of emotions in general. Of these, the memory problems are now sometimes interefering with my work. Even the lack of sexual feelings is (in a comical - but still important - way) reducing the artistic quality of my work (as I am an Adult photographer and now have very little feeing about my subjects). The hot sweats actually keep my wife awake more often then me, because of the unnaturalness of my hot sweaty skin at these times! The reduction in emotion (which I guess is a form of very slight depression, in a technical sense) is, for the time being, sometimes a slight advantage as I was always very volatile and my dramatic temper and rages are less often provoked now. But if the trend continues, I think there is a risk to my enthusiasm and optimism.

If you legitimately have low testosterone, and are having symptoms that are disrupting your quality of life, then you should be able to locate a doctor that will supply you with replacement hormone. That would be my first option if I were you.

You could also try some test boosters (aromatase inhibitors) like Novedex XT or 6-oxo in the short term.....

Since you've been tested and know your T levels are low, did you discuss HRT?

Several of us have discussed it before on here. I'm personally on it, and my theory is mine low T level was chemo related. I'm using the 5g dose of androgel and it's helped me with a lot of the problems you've referenced.

Unfortunately, these matters are strictly out of bounds regards my doctor. When I briefly mentioned my concerns about continued muscle loss and accompanying fat gain, she told me that she was unable to advise me on this as a preference for better body composition is a purely psychological, rather than medical, matter.

If you've tested low, and she still thinks this...time for another opinion. Maybe an endocrinologist. Sounds like she just thinks its all in your head. It isn't if you've got a proven low test. These symtoms are real and can most likely be helped. Mine were, and I wasn't even that low comparitively to what I've seen from others (low normal to high low range in my case).

I'm wondering why there seems to be such a push back from so many doctors about this in men, when they will jump at the chance to put women on estrogen replacement therapies? To my knowledge, there aren't a lot of the downside risks with testosterone that there are with estrogen, so it seems like the situation would be reversed if anything.

Philph, I've talked to you about this before. I wish you could find a doctor that would allow you to try HRT for about 6 months. I know my T-injections have helped me with all the symptoms you described (I had them all too). I've been on HRT for 1.5 years and my quality of life has improved as have my training results. Good luck, man.

Thanks for your replies. Note - this will be a long-winded post. Most of it will sound like I'm whining (which I am, kind of!) and repeating a couple of things that I described in the past. But there's a good news at the end of this for those who want to skip to that :)

From what I understand from talking with various people, the problem seems to be more of an NHS-related one rather than specific to my doctor. When I was discussing the test results with my doctor, she said that HRT is suspected to increase the risk of heart disease in some patients, so is not appropriate.

I raised the subject of lean mass loss and fat gain with her, and she countered this by saying that so long as the weight of muscle I lost was greater than the weight of fat gained, I was actually better off because that would then take my BMI below the threshhold of overweight. And regards my change in body fat distribution (i.e. an increase in abdominal fat and possibly visceral fat accompanied by simultaneous loss of limb fat) this was fine, as she thought it was (you guessed it) caused by me doing lots of arm exercises! :lol: It was at that point that I expressed my concern that becoming a fatter, weaker and probably less physically active version of myself would reverse the progress I had made in controlling my diabetes, which I told her I thought had been achieved largely by adopting an active lifestyle and an improved body composition. It was my desire for the opposite trend this that she told me was a psychological problem, and to demosntrate my irrationality she told me that it has been proven in studies that skinny people are more "influential" than non-skinny people, so my preferrence is an illogical one!

She said she would be happy to prescribe Viagra for me, though.

All of this was after she had obtained further guidance from her colleagues.

Some very good news, though: since starting this thread the other day, I have finally found a way of obtaining a private appointment with a genuine endocrinologist, basically circumventing my doctor and the NHS. My first consultation is this coming Friday, and I am very excited about this to say the least. I'm confident that if I can persuade them to allow me to try HRT, it will be an opportunity for a new lease of life.

i hope the new doctor allows you to try HRT. I know you are dealing with other health issues which must be addressed but with proper monitoring, I would think that they could keep you healthy and that you could enjoy the benefits that HRT is providing for so many men. Let us know how it goes.:tu:

Let us know how it goes.:tu:

Thanks, I sure will :)

I had my consultation with the endocrinologist this morning. He thinks it is very unlikely that there's anything pathological happening.

The changes in body fat distribution (simultaneous fat increase in some sites and decrease in others) is very possibly the effects of my choices of exercise (i.e., pretty much what my GP earlier suggested, spot reduction in some parts of body combined with simultaneous "spot fattening" in other parts).

I queried him on this point, and it seems that despite our widespread belief that spot reduction is generally a myth, it is something that is accepted and expected by medical practicioners.

Regarding the low testosterone reading, this could very well be a "red herring". Just to be sure there's nothing wrong, we're going to have further tests to look at things like sex hormone binding globulin, etc.

It also seems that the other things I've complained of, such as memory deficits, hot sweats, absense of libido, and reduction in mood intensity are not cause for alarm in themselves. I will admit that my personal bias could make me lump these things together, and it is conceivable that they do not have a common cause after all.

Meanwhile, at the gym today my trainer made the good point that, notwithstanding my fears, my strength is increasing at every workout, and that I've made above-average progress since I began. So who knows. Maybe my mind is playing tricks on me and I'm seeing "canals on Mars". :confused:

I queried him on this point, and it seems that despite our widespread belief that spot reduction is generally a myth, it is something that is accepted and expected by medical practicioners.




I just read this thread. I hate stupid, ignorant, doctors --- as most of them are.....

hmmm..my doctor isn't ignorant or stupid..he's just not on the same page as me :bang:

well, you didn't post nay lab results, but clearly the NHS isn't going to run all the necessary tests. My sister-in-law has been going round in circles for years with one nonsense test after another trying to find out what is wrong with her. Hypothyroidism runs in her family and my wife was diagnosed last year with Hashimoto's (sp?) and still they have not even run a simple, but complete thyroid panel on her sister. The problem is 'we' get busy, private is expensive and we wonder if it will really help, or we will just go round in circles while spending a lot of money.

Anyway, I would take a look at this site:

http://forum.mesomorphosis.com/mens-health-forum/

It's the best HRT forum I know of, although it may not be what it used to be.

The sticky by SWALE should be your starting point. There are people from the UK who post there that might be able to help with regards to doctors.

You will see on the HRT forum that some people have had some success restarting their natural testosterone production using Nolvadex and/or Clomid. The sooner you get your T-levels to mid-normal the better your chances of not having life-long problems. This is especially important if they are not super low right now.

Long-term low T levels (even low-normal) are a serious health hazard - whether or not they are the cause of your symptoms. I would take this very, very seriously and NOT blow it off, unless your T-levels are really more low-mid normal than low-normal (you really want them above 400 ng/dL in US units for long-term health).

I just read this thread. I hate stupid, ignorant, doctors --- as most of them are.....

Well, I have been remonstrated for the above post in a private PM... and yeah, I guess, justifiably so....

SO I said I would come here and post an apology but I won't delete the post.

This is in part what I replied ot the PM:

Well... I didn't say "all", I said "most" ... and though yeah it may be over-the-top, I have watched friends of mine get incredibly bad medical advice about rather serious things lately... and I have been reading quite few posts lately on here at JSF of posters getting truly ignorant information from doctors.

I just was feeling a little annoyed and irritated by how the medical profession conducts itself (and I am not saying that the legal profession does any better --- it doesn't.)

My doctors are great -- but I have access to some of the very best in the world -- fortunately for me -- it just pains me that so many people are seriously damaged or lose their lives by such ignorance.

[I find] some doctors' intellectual dishonesty (in that they know they don't really know what they're talking about but they say what they do anyway just to triumph over their patient to show they "know better", which I find just reprehensible and unprofessional conduct.)

But I will go and post an apology ... but I won't delete the post... :nope:

Maybe JSF is not the place to express irritation... but hey, I am human, I can slip up once in a while too..... :D

What's the most sad truth when it comes to your health?

The #1 killer in our society is not cancer or heart disease. The #1 killer is the health care system itself (something doctors call iatrogenic death). This includes death from:

* Medications
* Surgical errors
* Hospital-acquired infections
* Diagnostic machines
* Hospital-acquired malnutrition

So how can you protect yourself, particularly when it comes to your prescription drugs?


Anyone remember that "wonder drug" called Vioxx? I think they took it off the market in 2004 when studies showed that it doubled your risk of a heart attack. These studies were not "new" news. Memos from Merck prove that they knew of Vioxx’ connection to heart attack and stroke but covered it up before they even submitted the data for approval. And the irony of it all is that merck actually wants to bring Vioxx back to the market, this time as a cancer-inhibiting drug!

I guess we are allowed to forget about the estimated 139,000 Americans that died from Vioxx during its first incarnation.

I don't want to go further or inject anymore venom. The solution isn't anger at the medical system. The solution is and always has been to be your own doctor. Sure, the medical establishment is alot more unwieldy, complex, and confusing than it used to be. But if you don't do your homework, you pay the price. Financially and mortally.

I queried him on this point, and it seems that despite our widespread belief that spot reduction is generally a myth, it is something that is accepted and expected by medical practicioners.


Spot reduction can occur if your hormonal profile changes. This is one of the concepts of biosignature modulation. If you're testosterone-laden, you're going to store fat primarily in your gut.

If you're not going to be on HRT, I think it will be hard to see any spot reduction since fat loss will just make you smaller all-over.

Have you had your estradiol levels checked? you might be converting too much T into E in your adipose tissue..


Also, have you tried tweaking your diet.. more oysters and broccoli (zinc and indol-3-carbinol)?

Many thanks to everybody for your further replies.

NEdge - thanks for that link, which I've bookmarked. It looks like some useful perpectives there.

Justitia - I often feel the same way. I know my doctor is highly qualified and I respect her many gerat qualities which have no doubt helped find a solution for many a medical problem with her patients. I think what frustrates me is the system itself that we have in the UK - in certain fields, there seems to be so much conservatism and lack of penetration. The doctors have to follow guidelines, so I don't put my experiences down to my doctor's individual ignorance.

Bitenose - although estradiol was not tested, I suspect it isn't a major factor in my problem. Of the things that have been tested (or re-tested), other than the low total T, SHBG was normal (a little below the average for my age), T3 was a bit low with TSH correspondingly a little high. A little while ago, I did some experimentation with diet, and indeed oysters was one of the things I tried. It's hard to assess the results, but I seemed to enjoy some subjective improvements.

I have also carried out other experimentations. Without going into too much detail, I would say that many of my symptoms are now reduced or abolished, and that this likely corresponds with a change in hormonal profile.