Re: my tests muck up tpday

May 16, 2006

Hi

Sorry to hear of your difficulties. However this is why we say to be at a

teaching

hospital that states it deals with Pituitary and other important glands other

than

Diabetes and the pancreas.

For example Prolactin and other pituitary hormones are rarely requested by GPs

only when a consultant has already tested these hormones and suggested repeat

testing.

I perhaps should apologise that I am not familiar with your case and so forgive

me if

you have spend a long time recently saying all of this. As self-help may I

suggest

we explore which is your nearest Teaching Hospital? I see you have a UK email

address. Could you say where about in the UK you are based? I am Dorset based. I

am also a Dorset representative for the Pituitary Foundation and can get you

some

teelphone help and a buddy to speak with as well as helping with getting you to

a

suitable consultant on the NHS.

My Dorset (text based) website is:

http://www.communigate.co.uk/dorset/dorsetpituitaryfoundation/index.phtml

The National Pituitary Foundation website is at:

www.pituitary.org.uk

We have guys here from many different areas of the UK with direct experience of

hospitals and consultants as well as the National Organisation where there is a

National Coordinator and representatives for the counties of England & Wales as

well as in Scotland.

Perhaps you would you briefly say what your symptoms are and if this is your

first

referal or are you already diagnosed chronically ill and needing a referal now

for

some new reason.

I feel I should stress that you would NOT EXPECT a GP especially on the NHS

where funding is now from your sources to arrange these tests as first time. It

is not

the job of a GP to do this testing and diagnose a specialist almost rare illness

but

that of a hospital consultant and their team. At no stage during the last 20

years has

a GP when agreeing I needed to be referred to a consultant / hospital previously

taken such blood tests. I could understand Testosterone but the GP should be at

primary level and testing liver and kidney function and full blood and ruling

out more

simple illnesses and Diabetes etc. There should be a list of your symptoms that

after the GP has taken routine bloods and blood pressure etc diet cannot explain

and so feels a consultant is needed to investigate. In referring you to an

endocrinologist that means the Gp and you feel the symptoms are explained more

on that basis but it may well be that you see a physician first so as to rule

out other

medical causes. Many on this group even when they have been diagnosed with a

pituitary or similar endocrine illness find they have something else wrong as

well eg

Syndrome X / Metabolic Disorder.

Hope this helps and I look forward to your emails.

Kind regards from Dorset where it looks as if it is going to rain!

On 16 May 2006 at 9:39, paul wey wrote:

> well what a crap morning i have had

>

> took down those tests i have been told about on here

>

> LH

> TESTOSTERONE

> ESTRADIOL

> PROLACTIN

> SHBG

>

> went to our clinic and gave the nurse the paper the doc had given me

> last week,i asked if the aboeve tests that were not already on that

> list to be done.

>

> testosterrone of course was on there,others were not,she had to refuse

> as not on the list.

>

> i got upset and stormed off saying i was going to walk into the path

> of a oncoming lorry as i am so pissed off with it all.

>

> went across road to my doctors surgery,my doc is not in,so nurse there

> looked at the piece of paper i had written the above checks.

>

> she laughed and saif estradoil was a female hormone and could see no

> reason why that was on there,i told them i had spoken to people in the

> know on a support group,and of course that was met with another

> smile!!!

>

> she went to each doctor and all refused to add on the extra

> tsts,saying none were required and that why test a female hormone on a

> male its totally irrelevant.

>

> i then wnet in a panic attack crying and shouting and mumbling to my

> self ,and then into meltdown and said i was not leaving the surgery

> till the checks were all done and iwas sitting outside the

> door,[unless you have seen an aspergerrs/add meltdown its hard to

> visualise]

>

> anyway nurse wnet back to one of the doctors and female nice doctor

> called me in.

>

> she said she was acutally had specialist knowledge in male hormones

> etc,and again said the female ones dont need to be looked at,i was

> still crying and panicking she calmed me down a bit and said

>

> SHBG thsats a good one to check,so i will get that one done,but the

> others not,but maydo depending on results of the shbg and testosterone

> and also ask my doctior to refer me to a specialist at hospital.

>

> anyway i sat waiting for the tests but i was still panciking/tense and

> crying

>

> i have always had problems with them getting blood from me and today

> was no expcetion

>

> both arms and one hand tried to get enough blood but she gave up .

>

> so i know have go to hospital and try there when i get time that

> is,and have to starve mysefl for 12 hours so it wont be today,maybe

> wednesday or thursday and hope they manage to get blood

>

> one time even in hosptial it took two nurse and two doctros trying

> various thingss before blood came out and even then it was a bout 75

> per cent slower than expected and the procedure i had took much longer

> !!!

>

> typical me that is

>

> anyway i did ask why is my blood like this,it happend so often since i

> was little and once turned a lovely shade of green puking up on doctor

> when about 10 i think.

>

> one reason is if one is tense/anxious etc,so i told this nurse

> differant from the one who had seen me when i arrived i have had a

> panic attack/meltdown etc and am usually nervous most times so that

> might expalin all the problems they have.

>

> anyway rather upset at momnet but will ty and relax before i try again

> at hospital

>

> regards paul

>

May 16, 2006

hi peter i am in baldock north hertfordshire

regards paul

Re: my tests muck up tpday

May 16, 2006

This kind of heavy handed ignorance makes me VERY angry!

I wish I had of been there with you as I would used that anger

in the most articulate manner and gave them a lesson in

endocrinology and the absolute necessity of testing estradiol in men.

If you get a copy of Eugene Shippen's book The Testosterone Syndrome

and take that to the female doctor and tell her to read the chapter

on estrogen, you might be able to educate her on this matter.

As an alternative perhaps one of the guys here can provide you with

details that you can print off regarding the importance of testing

estradiol.

I hope you can get treated for your low testosterone, irrespective

of your other medical situations, you might find that your emotions

are on more of an even keel if you are treated with TRT.

I wish you the best.

>

> well what a crap morning i have had

>

> took down those tests i have been told about on here

>

> LH

> TESTOSTERONE

> ESTRADIOL

> PROLACTIN

> SHBG

>

> went to our clinic and gave the nurse the paper the doc had given

me last week,i asked if the aboeve tests that were not already on

that list to be done.

>

> testosterrone of course was on there,others were not,she had to

refuse as not on the list.

>

> i got upset and stormed off saying i was going to walk into the

path of a oncoming lorry as i am so pissed off with it all.

>

> went across road to my doctors surgery,my doc is not in,so nurse

there looked at the piece of paper i had written the above checks.

>

> she laughed and saif estradoil was a female hormone and could see

no reason why that was on there,i told them i had spoken to people

in the know on a support group,and of course that was met with

another smile!!!

>

> she went to each doctor and all refused to add on the extra

tsts,saying none were required and that why test a female hormone on

a male its totally irrelevant.

>

> i then wnet in a panic attack crying and shouting and mumbling to

my self ,and then into meltdown and said i was not leaving the

surgery till the checks were all done and iwas sitting outside the

door,[unless you have seen an aspergerrs/add meltdown its hard to

visualise]

>

> anyway nurse wnet back to one of the doctors and female nice

doctor called me in.

>

> she said she was acutally had specialist knowledge in male

hormones etc,and again said the female ones dont need to be looked

at,i was still crying and panicking she calmed me down a bit and

said

>

> SHBG thsats a good one to check,so i will get that one done,but

the others not,but maydo depending on results of the shbg and

testosterone and also ask my doctior to refer me to a specialist at

hospital.

>

> anyway i sat waiting for the tests but i was still panciking/tense

and crying

>

> i have always had problems with them getting blood from me and

today was no expcetion

>

> both arms and one hand tried to get enough blood but she gave up .

>

> so i know have go to hospital and try there when i get time that

is,and have to starve mysefl for 12 hours so it wont be today,maybe

wednesday or thursday and hope they manage to get blood

>

> one time even in hosptial it took two nurse and two doctros trying

various thingss before blood came out and even then it was a bout 75

per cent slower than expected and the procedure i had took much

longer !!!

>

> typical me that is

>

> anyway i did ask why is my blood like this,it happend so often

since i was little and once turned a lovely shade of green puking up

on doctor when about 10 i think.

>

> one reason is if one is tense/anxious etc,so i told this nurse

differant from the one who had seen me when i arrived i have had a

panic attack/meltdown etc and am usually nervous most times so that

might expalin all the problems they have.

>

> anyway rather upset at momnet but will ty and relax before i try

again at hospital

>

> regards paul

>

May 16, 2006

Hi

Right, Baldock. One of those towns I have passed through more than once when

crossing the country such as from M11 to M1. I quickly looked on the map as you

have various possibilities. you are also near enough to London to be considered

for

NHS treatment at a London teaching hospital if you and your GP felt this would

be

advisable. If you wish I can ask the National coordinator at Pituitary

Foundation for

advice as to nearby hospitals specialising in Pituitary and related illness? We

have

contacts who are patients at most of the major hospitals and so can always

verify

situations.

Within London Barts and Royal London have 2 Endocrinology Departments and

several professors of endocrinology. St s Hospital (Paddington) also has a

good endocrinology department.

What I would like to know is a more detailed background to your medical history

so

we can see if you need add-on services such as genetics etc etc.

Can you repeat what your medical history is including age range and main

symptoms? What tests have you already had and what does your GP say so far?

Best wishes,

On 16 May 2006 at 14:58, paul wey wrote:

> hi peter i am in baldock north hertfordshire

>

> regards paul

>

> Re: my

> tests muck up tpday

>

May 16, 2006

Gee ,

Sorry to see you have so much of a problem with this testing. And yes you

need to be calm when doing a blood test. It's good you did not do it feeling

that upset. In the UK things are different then here in the States. Is this

your first test or a follow up test. I have felt like your feeling and 20 yrs.

ago started doing this to calm down and it works read the link and try this it

takes time to get good at it but even trying it helps you feel better.

I do this 2 times a day first thing in the morning and about 8 pm at nigh.

http://www.ucop.edu/humres/eap/relaxationrespone.html

You can't get the test we can get so you need to work on your Dr. showing him

studies and info on this from the net.

http://www.smart-drugs.com/ias-estrogen.htm

http://www.medibolics.com/ArimidexBoostsTestosterone.htm

Phil

paul wey <promachief@...> wrote:

well what a crap morning i have had

took down those tests i have been told about on here

LH

TESTOSTERONE

ESTRADIOL

PROLACTIN

SHBG

went to our clinic and gave the nurse the paper the doc had given me last week,i

asked if the aboeve tests that were not already on that list to be done.

testosterrone of course was on there,others were not,she had to refuse as not on

the list.

i got upset and stormed off saying i was going to walk into the path of a

oncoming lorry as i am so pissed off with it all.

went across road to my doctors surgery,my doc is not in,so nurse there looked at

the piece of paper i had written the above checks.

she laughed and saif estradoil was a female hormone and could see no reason why

that was on there,i told them i had spoken to people in the know on a support

group,and of course that was met with another smile!!!

she went to each doctor and all refused to add on the extra tsts,saying none

were required and that why test a female hormone on a male its totally

irrelevant.

i then wnet in a panic attack crying and shouting and mumbling to my self ,and

then into meltdown and said i was not leaving the surgery till the checks were

all done and iwas sitting outside the door,[unless you have seen an

aspergerrs/add meltdown its hard to visualise]

anyway nurse wnet back to one of the doctors and female nice doctor called me

in.

she said she was acutally had specialist knowledge in male hormones etc,and

again said the female ones dont need to be looked at,i was still crying and

panicking she calmed me down a bit and said

SHBG thsats a good one to check,so i will get that one done,but the others

not,but maydo depending on results of the shbg and testosterone and also ask my

doctior to refer me to a specialist at hospital.

anyway i sat waiting for the tests but i was still panciking/tense and crying

i have always had problems with them getting blood from me and today was no

expcetion

both arms and one hand tried to get enough blood but she gave up .

so i know have go to hospital and try there when i get time that is,and have to

starve mysefl for 12 hours so it wont be today,maybe wednesday or thursday and

hope they manage to get blood

one time even in hosptial it took two nurse and two doctros trying various

thingss before blood came out and even then it was a bout 75 per cent slower

than expected and the procedure i had took much longer !!!

typical me that is

anyway i did ask why is my blood like this,it happend so often since i was

little and once turned a lovely shade of green puking up on doctor when about 10

i think.

one reason is if one is tense/anxious etc,so i told this nurse differant from

the one who had seen me when i arrived i have had a panic attack/meltdown etc

and am usually nervous most times so that might expalin all the problems they

have.

anyway rather upset at momnet but will ty and relax before i try again at

hospital

regards paul

May 16, 2006

i had tests done two years ago previously and that was 10.5 nmo/l

that was takne earrly morning so again that was at i guess peak time,so in

reality i may be under.

i decided to get tests done again and on advice from here of course asked for

the extra tests,anyway as said in end no blood of any worth was drawn so,i will

go to hospital on thursday and get tested there,again providing the staff can

get blood out of me.

regards paul

Re: my tests muck up tpday

Gee ,

May 16, 2006

Hi

Thanks for this information. Now I can remember reading some parts recently.

OK, as Chis has said and repeated recently even higher than 10.5nmol/L one

should be investigated and treated. When I attended Barts and the Royal London

ca

1993 and my level repeatedly returned ca 8nmol/L (previously it had been below

5nmol/L0 the medics there said " We take 10nmol/L as some arbitrary lower limit

but

we are treating patients even now who have a totally testosterone level higher

than

10nmol/L.

So you have confirmed Total Testosterone level of 10.5nmol/L

Although I would hope you have been treated what is also important is that you

are

not treated before having other blood tests as the pituitary hormones and

Hypothalmus ones are investigated and a diagnosis taken at that time - prior to

treatment if possible.

Others will have told you it is important to find out why you have low

testosterone

and if this is primary or secondary. However so as to ensure the best way

forward

this is for a specialist teaching hospital and not really for GPs. This is

especially so

with NHS. In the USA and some other countries it is possible for medicines to be

issued by GPs but here in the UK some medicines CANNOT be prescribed by GPs

unless a hospital consultant has first decided. Originally this was true for

Testosterone although I think that has been eased. Besides blood tests you might

need scans as well.

Now I am stressing my previous question: What are your symptoms? Are you able

to work? Why did you go to a doctor in the first place? What symptoms do you

have

at the moment?

One way in the UK with the NHS that works well if you wish is for you to have

just 1

private consultation with a specialist who is also NHS. This means you can see a

consultant within a week and at least have an examination and for your GP to be

informed by a consultant that you might need specialist investigations. That

might

costs ca £100 but gives you an expert letter for you to quote to GP etc.

However,

you say your GP IS going to refer you to an endocrinologist, yes? So again we

are

back to ensuring the GP refers you to a good endocrinologist and not a

Diabetologist etc.

May I also ask:

Age range

Weight and height

Have you have usual blood tests such as glucose, lipids, cholesterol, liver and

kidney function?

Kind regards,

On 16 May 2006 at 17:45, paul wey wrote:

> i had tests done two years ago previously and that was 10.5 nmo/l

>

> that was takne earrly morning so again that was at i guess peak

> time,so in reality i may be under.

>

> i decided to get tests done again and on advice from here of course

> asked for the extra tests,anyway as said in end no blood of any worth

> was drawn so,i will go to hospital on thursday and get tested

> there,again providing the staff can get blood out of me.

>

> regards paul

>

> Re: my tests muck up tpday

>

> Gee ,

>

May 16, 2006

Wow , sorry to hear about your lousy day.

First off I have a history of panic attacks too so I know what

you're going through. You really should be taking something for

them as my life literally changed when I started taking Zoloft for

my panic attacks. I haven't had one since and when I do get those

weird feelings they only last for a few mins and then are gone. I

really recommend you try to get some treatment for your anxiety as

there is no need for you to have to live with it.

Secondly, I don't recall if these are your first tests but it is not

uncommon for the first tests to only include Total Testosterone,

that's all they tested on my first test. After that they ordered

the full battery. Here's the deal. If your Total T is good then

it's highly unlikely that your Free T or Bio-T will be low (although

it is not impossible.) Usually only after a low Total T is shown

with a test will doctors order the LH, Prolactin, SHBG, Free T/Bio

T, etc. And Estradiol isn't hardly ever tested for unless you have

signs of high E2 (i.e. gynocomastia, sensitive nipples, or if

successful TRT isn't working on symptoms.)

So it's not surprising for your doctors not to run those tests at

this time so don't get stressed about it. If this is your first

round of screening tests then they're ordering the right tests for

the first time. I'd prefer that they do a Bio-T or Free-T test as

well but like I said it's not critical and SHBG would give a decent

look at what free-T and Bio-T are likely to be. Those other tests

(LH, FSH, Prolactin) are good for helping to determine what the

cause of hypogonadism is not necessarily that it exists. A total T

test should be fine for this initial test.

Finally, I want to reiterate that you get some treatment for your

anxiety and panic attacks. It could be that if you have

hypogonadism then this disorder is contributing, possibly

significantly, to your anxiety and panic disorder. But with that

said you should be in treatment for anxiety immediately as even if

you do have hypogonadism it can take many, many months to get it

under control and eventually change your anxiety profile. And even

then there's no guarantee that it treating low T will actually cure

the anxiety disorder. So what I'm saying is get treatment now,

there's no need to live with that crap. I did for years and it's

simply not worth it. In time it might be that you can eliminate

anxiety medications but only after time has healed the underlying

heath condition be it hypogonadism or anything else.

ASaxon

>

> well what a crap morning i have had

>

> took down those tests i have been told about on here

>

> LH

> TESTOSTERONE

> ESTRADIOL

> PROLACTIN

> SHBG

>

> went to our clinic and gave the nurse the paper the doc had given

me last week,i asked if the aboeve tests that were not already on

that list to be done.

>

> testosterrone of course was on there,others were not,she had to

refuse as not on the list.

>

> i got upset and stormed off saying i was going to walk into the

path of a oncoming lorry as i am so pissed off with it all.

>

> went across road to my doctors surgery,my doc is not in,so nurse

there looked at the piece of paper i had written the above checks.

>

> she laughed and saif estradoil was a female hormone and could see

no reason why that was on there,i told them i had spoken to people

in the know on a support group,and of course that was met with

another smile!!!

>

> she went to each doctor and all refused to add on the extra

tsts,saying none were required and that why test a female hormone on

a male its totally irrelevant.

>

> i then wnet in a panic attack crying and shouting and mumbling to

my self ,and then into meltdown and said i was not leaving the

surgery till the checks were all done and iwas sitting outside the

door,[unless you have seen an aspergerrs/add meltdown its hard to

visualise]

>

> anyway nurse wnet back to one of the doctors and female nice

doctor called me in.

>

> she said she was acutally had specialist knowledge in male

hormones etc,and again said the female ones dont need to be looked

at,i was still crying and panicking she calmed me down a bit and

said

>

> SHBG thsats a good one to check,so i will get that one done,but

the others not,but maydo depending on results of the shbg and

testosterone and also ask my doctior to refer me to a specialist at

hospital.

>

> anyway i sat waiting for the tests but i was still panciking/tense

and crying

>

> i have always had problems with them getting blood from me and

today was no expcetion

>

> both arms and one hand tried to get enough blood but she gave up .

>

> so i know have go to hospital and try there when i get time that

is,and have to starve mysefl for 12 hours so it wont be today,maybe

wednesday or thursday and hope they manage to get blood

>

> one time even in hosptial it took two nurse and two doctros trying

various thingss before blood came out and even then it was a bout 75

per cent slower than expected and the procedure i had took much

longer !!!

>

> typical me that is

>

> anyway i did ask why is my blood like this,it happend so often

since i was little and once turned a lovely shade of green puking up

on doctor when about 10 i think.

>

> one reason is if one is tense/anxious etc,so i told this nurse

differant from the one who had seen me when i arrived i have had a

panic attack/meltdown etc and am usually nervous most times so that

might expalin all the problems they have.

>

> anyway rather upset at momnet but will ty and relax before i try

again at hospital

>

> regards paul

>

May 16, 2006

Another thing, if you are anxious your blood pressure is probably

high, which is probably possibly caused by blood vessel constriction

(a common reaction when under stressful conditions). This may be

partially why they are having a hard time finding a blood vessel.

Perhaps if you were more relaxed they'd have an easier time at it.

If you are deathly afraid of needles then that probably doesn't help

either.

ASaxon

>

> i had tests done two years ago previously and that was 10.5 nmo/l

>

> that was takne earrly morning so again that was at i guess peak

time,so in reality i may be under.

>

> i decided to get tests done again and on advice from here of

course asked for the extra tests,anyway as said in end no blood of

any worth was drawn so,i will go to hospital on thursday and get

tested there,again providing the staff can get blood out of me.

>

> regards paul

>

> Re: my tests muck up tpday

>

> Gee ,

>

May 16, 2006

my first testosterone test was 2 years ago taken 9 am and was 10.5 nmo/l and was

told this was low side of normal and perefectly fine.

since i was a toddler i was not like my siblings or peers i nver like climbing

trees or doing anything that exhausting most of the time,though at times i was

hpyeractive and still can be today but more like manically doing mental

cartwheels being overloaded by loads of thoughts and not being able to

concetrate .

at 6 i had a reptuation at school already being disruptive/argumentative but not

nasty i could do and say bad things,but i never did them out of spite.

was throwing chairs at teachers at 7/7/9 etc and had quite a reputation.

anyway at 11 things changed as time for big school

in showers at my early abysmal sporting attempts i and others could see

something was wrong,ie no visible testicles.

a long story but cut very short

boys told girls i got then bullied by both,physically and mentally, and i never

really could tell anyone as i thought i was not a full male.

again all my co ordination/temper problems and inablity to concetrate,lack of co

ordination so bad at 11 my form tutor told my parents " i wont let pull hold

knives/scissors etc he is a danger to himsel and others,especially if he has a

rage as well "

always told i was lethargic,alwayts told lazy,clever but not learning

22 i broke down while working as a chef,still plagued by all the problems i had

at school.

18-22 i was actually perfect weight and size yet lethargy and all other problems

still same.

diagnosed when i told people about how i felt ,with both testicles confirmed

undescended,NHS in uk said as it eas not an important op i prob would have to

wait 3 years,not important!!!!

i was by know working in warehosing and private medical cover meant i had

orchidepxy in 3 weeks ,one check up 6 months later but no after care,no thought

to my mental health problems caused by the lack of testicles[so i had thought as

a confused teenager]

several years of working losing jobs for temper/illness and always making way

too many errors.

flash to 2002

lost job yet again this time temper again

had always felt differant,trying to do just 35 hours weeks was impossible and as

well as sick days i used most holidays up once a week as trying to work 5 days

was near impossible how i felt and indeed feel,doing 5 hours at college now,i

have had to cut down to 3 as i cant cope.

so again temper/low energy[not laziness i can assure you,thats whats so

upsetting]

diagnosed aspergers syndrome in 2003,then dyspraxia/mild dyslexia in 2004 and

now in middle of my ADD diagnosis,and many of the those prroblems are both

prresent in those conditions but also low testosterone,i believe 10.5 nmo/l is

too low for my needs especially when adding hthe lethargy problems already

associated with my other problems,and the executive functioning and attention

problmes,my tics i have also use a lot of energy up,,my metdowns and panic

attacks allso drain me of precious energy.

never have slept well

in block of 2 hours or so on a good night 2 hours sleep,2 awake or

similar,dozing durign day,if i go out i like to find a place to sit and doze

rather than do anytihng energetic.

of course over years lack of energy leads to getting larger,also eating

,depression and so on so its a vicious circle.

i have no ambition [apart from finding out how i can overcome my problems and

failing]

very low self esteem,i want perfection from me and others ,and not getting

either as is most of time then i get more anxious/stressed.

so no work,on disabled living allowance and incapacity beneifts,college 3 hours

in english and maths i have stopped ,all at a level i should of been able to do

at school,and all now getting to a level where i just cant do much more.

i will get the testosterone checked in the hospital,again only the testosteerone

and sbhg or whatever its called but my guess is it wont be much higher than 10.5

again

i will come back on here when i get the figures and see what you think then.

so even if with help on the testosterone i may still feel more letharigc than

many,and will still have my executive functioning/organisational/short term

visual/audio and also long term memory problems,at least i will hoepfully be

just a bit more alert, i am not expecting miracles just a little bbost to get me

going a bit.

i fall asleep with gf when we are together,and sometimes in the street,my sexual

intercourse abiltites are nil,but as said before i can give her so many orgasms

in other ways she does not lose out thats for sure.

but i cant do anytyhing more becauae i dont have the energy orr the abilities

as for referal NO my gp is not ,well not based on figures 2 years ago,hoefully

if still about same or worse then maybe i can persuade him,the doc i saw today

said to ask him,well i did last week and no go so far,hoepfully the results of

these tests when i get them done will spur him on to refer me.

all those other blood tests on bottom of this mail are yes part of the tests i

will be getting,last itme my blood sugar was also too high but again thats all

he said.

so 2 years since last blood tests,so i will get them done and see what they are

this time i will get gp to put it all down on papeer for me and try and expalin

to me,as normally he just reels off figures and expects me to know what he is on

about,and even with them on paper i still get very lost,as memory problems are a

real pain,people get pissed off i keep asking same questions all the itime,they

say " i told you that loads of times " and expect me to remember,well i dont and

its damend annoying to say the least

thanks for yourr pateince

ps age 40 and now 21 stone i bleeive,at 18-22 11.5 stone [ideal weight] 22-38

15-18 stone or so,but now as aid about 21 stone.

but i know many large people with so much more energy than me ,holding down jobs

,relatiosnships and even sporting abilties etc

regards paul

Re: my tests muck up tpday

>

May 16, 2006

its not so much being afraid of needles but in fsct being touched

to have my tight foreskin looked at last year by surgeon i had to be given a

full anaesthetic and 2 nights in hospital,that was just to be examained as when

being examined awake i was kicking/shouting and screaming

i have lots of sensory issues again due to my aspergers/dyspraxia etc.

that also goes for stress meds,anti depressants and sleeping tabs i have tried

in past,some dont do anytihng,some make me worse and some have had bad side

affects

i am not kiding its bloody diffiucult,agin sensory issues dont help when trying

sexual stuff with gf either!!

and yes dont know what it is at moment was takne yesterday but doc did not tell

me what it was,but yes its usually ihgh nowadatys,i spend 99 per cent of any day

stressed and thats witohut working,you can imagine what i was like when working

and travelling every day.

i am very difficult some day i think the doctors will just give up on me,i am

too hard to deal with

regards paul

Re: my tests muck up tpday

Another thing, if you are anxious your blood pressure is probably

high, which is probably possibly caused by blood vessel constriction

(a common reaction when under stressful conditions). This may be

partially why they are having a hard time finding a blood vessel.

Perhaps if you were more relaxed they'd have an easier time at it.

If you are deathly afraid of needles then that probably doesn't help

either.

ASaxon

May 16, 2006

if you had two undecended testies and you had them fixed post

puberty I think it is pretty darn obvious why you are likely to have

a low testosterone level. I would also guarentee that your

testicles would appear much smaller if tested with an orchidometer.

You need to cut through the veil of bullshit.

Go to your gp and demand a referral to an endocrinologist and don't

take no for an answer. If they ultimately refuse you need help in

registering with another practice and a gp who will act on your

behalf.

The gps simply do not know what they are doing and likely never will.

If you get to see a reasonable endocrinologist and tell them that

you had two undecended testies, brought down post puberty you have a

far better chance of getting somewhere with this.

If you don't get to see a reasonable endocrinologist for this I just

see you going around in circles.

>

> my first testosterone test was 2 years ago taken 9 am and was 10.5

nmo/l and was told this was low side of normal and perefectly fine.

>

> since i was a toddler i was not like my siblings or peers i nver

like climbing trees or doing anything that exhausting most of the

time,though at times i was hpyeractive and still can be today but

more like manically doing mental cartwheels being overloaded by

loads of thoughts and not being able to concetrate .

>

> at 6 i had a reptuation at school already being

disruptive/argumentative but not nasty i could do and say bad

things,but i never did them out of spite.

>

> was throwing chairs at teachers at 7/7/9 etc and had quite a

reputation.

>

> anyway at 11 things changed as time for big school

> in showers at my early abysmal sporting attempts i and others

could see something was wrong,ie no visible testicles.

>

> a long story but cut very short

>

> boys told girls i got then bullied by both,physically and

mentally, and i never really could tell anyone as i thought i was

not a full male.

>

> again all my co ordination/temper problems and inablity to

concetrate,lack of co ordination so bad at 11 my form tutor told my

parents " i wont let pull hold knives/scissors etc he is a danger to

himsel and others,especially if he has a rage as well "

>

> always told i was lethargic,alwayts told lazy,clever but not

learning

>

> 22 i broke down while working as a chef,still plagued by all the

problems i had at school.

>

> 18-22 i was actually perfect weight and size yet lethargy and all

other problems still same.

>

> diagnosed when i told people about how i felt ,with both testicles

confirmed undescended,NHS in uk said as it eas not an important op i

prob would have to wait 3 years,not important!!!!

>

> i was by know working in warehosing and private medical cover

meant i had orchidepxy in 3 weeks ,one check up 6 months later but

no after care,no thought to my mental health problems caused by the

lack of testicles[so i had thought as a confused teenager]

>

> several years of working losing jobs for temper/illness and always

making way too many errors.

>

> flash to 2002

>

> lost job yet again this time temper again

>

> had always felt differant,trying to do just 35 hours weeks was

impossible and as well as sick days i used most holidays up once a

week as trying to work 5 days was near impossible how i felt and

indeed feel,doing 5 hours at college now,i have had to cut down to 3

as i cant cope.

>

> so again temper/low energy[not laziness i can assure you,thats

whats so upsetting]

>

> diagnosed aspergers syndrome in 2003,then dyspraxia/mild dyslexia

in 2004 and now in middle of my ADD diagnosis,and many of the those

prroblems are both prresent in those conditions but also low

testosterone,i believe 10.5 nmo/l is too low for my needs especially

when adding hthe lethargy problems already associated with my other

problems,and the executive functioning and attention problmes,my

tics i have also use a lot of energy up,,my metdowns and panic

attacks allso drain me of precious energy.

>

> never have slept well

>

> in block of 2 hours or so on a good night 2 hours sleep,2 awake or

similar,dozing durign day,if i go out i like to find a place to sit

and doze rather than do anytihng energetic.

>

> of course over years lack of energy leads to getting larger,also

eating ,depression and so on so its a vicious circle.

>

> i have no ambition [apart from finding out how i can overcome my

problems and failing]

>

> very low self esteem,i want perfection from me and others ,and not

getting either as is most of time then i get more anxious/stressed.

>

> so no work,on disabled living allowance and incapacity

beneifts,college 3 hours in english and maths i have stopped ,all at

a level i should of been able to do at school,and all now getting to

a level where i just cant do much more.

>

> i will get the testosterone checked in the hospital,again only the

testosteerone and sbhg or whatever its called but my guess is it

wont be much higher than 10.5 again

>

> i will come back on here when i get the figures and see what you

think then.

>

> so even if with help on the testosterone i may still feel more

letharigc than many,and will still have my executive

functioning/organisational/short term visual/audio and also long

term memory problems,at least i will hoepfully be just a bit more

alert, i am not expecting miracles just a little bbost to get me

going a bit.

>

> i fall asleep with gf when we are together,and sometimes in the

street,my sexual intercourse abiltites are nil,but as said before i

can give her so many orgasms in other ways she does not lose out

thats for sure.

>

> but i cant do anytyhing more becauae i dont have the energy orr

the abilities

>

> as for referal NO my gp is not ,well not based on figures 2 years

ago,hoefully if still about same or worse then maybe i can persuade

him,the doc i saw today said to ask him,well i did last week and no

go so far,hoepfully the results of these tests when i get them done

will spur him on to refer me.

>

> all those other blood tests on bottom of this mail are yes part of

the tests i will be getting,last itme my blood sugar was also too

high but again thats all he said.

>

> so 2 years since last blood tests,so i will get them done and see

what they are this time i will get gp to put it all down on papeer

for me and try and expalin to me,as normally he just reels off

figures and expects me to know what he is on about,and even with

them on paper i still get very lost,as memory problems are a real

pain,people get pissed off i keep asking same questions all the

itime,they say " i told you that loads of times " and expect me to

remember,well i dont and its damend annoying to say the least

>

> thanks for yourr pateince

>

> ps age 40 and now 21 stone i bleeive,at 18-22 11.5 stone [ideal

weight] 22-38 15-18 stone or so,but now as aid about 21 stone.

>

> but i know many large people with so much more energy than

me ,holding down jobs ,relatiosnships and even sporting abilties etc

>

> regards paul

>

> Re: my tests muck up tpday

> >

>

May 16, 2006

Hi

Now 3AM and so a new day dawning and I hope for you too!

Now as the emails arrived I read Chis' email first and so was eager to get to

your

email to see what you had read.

Wow - Yes, now we understand better.

Where to start: I don't think your main problem is testosterone deficiency but

the

testosterone deficiency is present and your medical history shows that someone

has

been mis-treating you.

I agree with Chis but I want to try and get you to analyse the situation more so

you

might get more help more quickly.

As to some of your symptoms there is a lot of work showing you can be helped -

medically - with disruptive behaviour as child or adult. I will get you the

contact

details but if you wish to search look for Oxford university clinical Physiology

and

Dyspraxia as an example. Clinical trials have confirmed " brain foods " such as

Omega 3, 6 and 9 at the right concentrations and frequency can help within 3 - 6

months. Last year a UK TV Documentary gave a full life story and clinical

history of

a guy who was so ill and depressed he was suicidal and all the worse of symptoms

that he consented to his consultant to stop his medication and use just Omega

3,6,9

mix. A very high dose. He was given an MRi prior to starting treatment and at a

stage where he was responding to treatment. To the consultant's surprise this

patient's brain size had increased! Where he was almost certainly going to

succeed

at taking his own life just with these oils his life changed. Now this is rare

but

children given these special mixes have been shown in double blind trials to

respond. Oxford will arrange a full test and will frequently arrange payment for

treatment or find help if it is not available from your local authorities.

Now to the undecended testicles. This is a condition which is not rare and which

needs to be treated. When one is treated one would expect a caring and

proficient

hospital to test the patient for any other abnormalities. As said - Go

immediately to your GP. Try not to get emotional as this will not help. Write on

a

card so you do not have to remember in front of your GP and whilst perhaps upset

what you want to ask. Say I am 40 and realize I have problems and know my Total

Testosterone at 10.5nmol/L is low and too low for my age. I wish to see a

specialist

who is experienced in this field not just any endocrinologist and I would like

to

attend a teaching hospital where they have experience of treating males with

undecended testicles and hypogonadism.

THEN

" BTW: whilst I am here I would like some routine blood tests as I have

continued to

feel fatigued and know my blood glucose levels were raised in the past " Am I

Diabetic or do I have glucose intolerance as just one example? Would you arrange

a fasting blood glucose test plus fasting lipids and routine liver / kidney

function plus

full blood count prior to my going to the endocrinologist?

As soon as I read some of your symptoms I thought of Diabetes and if you look

back to my earlier email Syndrome X / Metabolic Disorder. You weight, and

symptoms imply further testing and should include:

Blood pressure and pulse

Fasting blood glucose

Serum Insulin

measurement of waist

BMI

Your GP should eagerly do this when you visit. If they have signed the NHS

contract then they get paid by doing these tests for Diabetes etc!

[[[[[ If for any reason your GP fails to order the tests - Go straight to your

local

pharmacy such as Boots or Lloyds and ask them for Fasting blood glucose and

lipids. This might be free of £5 per test. Do not accept treatment such as

Statins as

you need to see a hospital consultant for your other conditions but get a report

so

you can submit it to your new GP and hospital consultant!

Then measure you waist and get your height recorded - Somewhere like Boots

might also do this for you.The BMI is important and Boots will frequently take

your

blood pressure or know where this can be done if your GP needs to be changed.

This information in itself would should possible risk of CVD.

Well that's it for now. Keep in touch and keep smiling even though it feels

impossible.

I will not speak here of the hypersensitivity but this can be neurological and

can be

caused by untreated illness such as Diabetes if nerve damage or neuropathy has

occurred.

Take care

On 16 May 2006 at 22:47, paul wey wrote:

> my first testosterone test was 2 years ago taken 9 am and was 10.5

> nmo/l and was told this was low side of normal and perefectly fine.

>

> since i was a toddler i was not like my siblings or peers i nver like

> climbing trees or doing anything that exhausting most of the

> time,though at times i was hpyeractive and still can be today but more

> like manically doing mental cartwheels being overloaded by loads of

> thoughts and not being able to concetrate .

>

> at 6 i had a reptuation at school already being

> disruptive/argumentative but not nasty i could do and say bad

> things,but i never did them out of spite.

>

> was throwing chairs at teachers at 7/7/9 etc and had quite a

> reputation.

>

> anyway at 11 things changed as time for big school

> in showers at my early abysmal sporting attempts i and others could

> see something was wrong,ie no visible testicles.

>

> a long story but cut very short

>

> boys told girls i got then bullied by both,physically and mentally,

> and i never really could tell anyone as i thought i was not a full

> male.

>

> again all my co ordination/temper problems and inablity to

> concetrate,lack of co ordination so bad at 11 my form tutor told my

> parents " i wont let pull hold knives/scissors etc he is a danger to

> himsel and others,especially if he has a rage as well "

>

> always told i was lethargic,alwayts told lazy,clever but not learning

>

> 22 i broke down while working as a chef,still plagued by all the

> problems i had at school.

>

> 18-22 i was actually perfect weight and size yet lethargy and all

> other problems still same.

>

> diagnosed when i told people about how i felt ,with both testicles

> confirmed undescended,NHS in uk said as it eas not an important op i

> prob would have to wait 3 years,not important!!!!

>

> i was by know working in warehosing and private medical cover meant i

> had orchidepxy in 3 weeks ,one check up 6 months later but no after

> care,no thought to my mental health problems caused by the lack of

> testicles[so i had thought as a confused teenager]

>

> several years of working losing jobs for temper/illness and always

> making way too many errors.

>

> flash to 2002

>

> lost job yet again this time temper again

>

> had always felt differant,trying to do just 35 hours weeks was

> impossible and as well as sick days i used most holidays up once a

> week as trying to work 5 days was near impossible how i felt and

> indeed feel,doing 5 hours at college now,i have had to cut down to 3

> as i cant cope.

>

> so again temper/low energy[not laziness i can assure you,thats whats

> so upsetting]

>

> diagnosed aspergers syndrome in 2003,then dyspraxia/mild dyslexia in

> 2004 and now in middle of my ADD diagnosis,and many of the those

> prroblems are both prresent in those conditions but also low

> testosterone,i believe 10.5 nmo/l is too low for my needs especially

> when adding hthe lethargy problems already associated with my other

> problems,and the executive functioning and attention problmes,my tics

> i have also use a lot of energy up,,my metdowns and panic attacks

> allso drain me of precious energy.

>

> never have slept well

>

> in block of 2 hours or so on a good night 2 hours sleep,2 awake or

> similar,dozing durign day,if i go out i like to find a place to sit

> and doze rather than do anytihng energetic.

>

> of course over years lack of energy leads to getting larger,also

> eating ,depression and so on so its a vicious circle.

>

> i have no ambition [apart from finding out how i can overcome my

> problems and failing]

>

> very low self esteem,i want perfection from me and others ,and not

> getting either as is most of time then i get more anxious/stressed.

>

> so no work,on disabled living allowance and incapacity

> beneifts,college 3 hours in english and maths i have stopped ,all at a

> level i should of been able to do at school,and all now getting to a

> level where i just cant do much more.

>

> i will get the testosterone checked in the hospital,again only the

> testosteerone and sbhg or whatever its called but my guess is it wont

> be much higher than 10.5 again

>

> i will come back on here when i get the figures and see what you think

> then.

>

> so even if with help on the testosterone i may still feel more

> letharigc than many,and will still have my executive

> functioning/organisational/short term visual/audio and also long term

> memory problems,at least i will hoepfully be just a bit more alert, i

> am not expecting miracles just a little bbost to get me going a bit.

>

> i fall asleep with gf when we are together,and sometimes in the

> street,my sexual intercourse abiltites are nil,but as said before i

> can give her so many orgasms in other ways she does not lose out thats

> for sure.

>

> but i cant do anytyhing more becauae i dont have the energy orr the

> abilities

>

> as for referal NO my gp is not ,well not based on figures 2 years

> ago,hoefully if still about same or worse then maybe i can persuade

> him,the doc i saw today said to ask him,well i did last week and no go

> so far,hoepfully the results of these tests when i get them done will

> spur him on to refer me.

>

> all those other blood tests on bottom of this mail are yes part of the

> tests i will be getting,last itme my blood sugar was also too high but

> again thats all he said.

>

> so 2 years since last blood tests,so i will get them done and see what

> they are this time i will get gp to put it all down on papeer for me

> and try and expalin to me,as normally he just reels off figures and

> expects me to know what he is on about,and even with them on paper i

> still get very lost,as memory problems are a real pain,people get

> pissed off i keep asking same questions all the itime,they say " i told

> you that loads of times " and expect me to remember,well i dont and its

> damend annoying to say the least

>

> thanks for yourr pateince

>

> ps age 40 and now 21 stone i bleeive,at 18-22 11.5 stone [ideal

> weight] 22-38 15-18 stone or so,but now as aid about 21 stone.

>

> but i know many large people with so much more energy than me ,holding

> down jobs ,relatiosnships and even sporting abilties etc

>

> regards paul

>

> Re: my tests muck up tpday >

>

June 27, 2006

On Tue, 16 May 2006 09:39:57 +0000 (GMT), you wrote:

>she went to each doctor and all refused to add on the extra tsts,saying none

were required and that why test a female hormone on a male its totally

irrelevant.

>

>i then wnet in a panic attack crying and shouting and mumbling to my self ,and

then into meltdown and said i was not leaving the surgery till the checks were

all done and iwas sitting outside the door,[unless you have seen an

aspergerrs/add meltdown its hard to visualise]

>

>anyway nurse wnet back to one of the doctors and female nice doctor called me

in.

>

>she said she was acutally had specialist knowledge in male hormones etc,and

again said the female ones dont need to be looked at,i was still crying and

panicking she calmed me down a bit and said

Gawd but I had ignorant " specialists " and doctors.

But you have to deal with them. They hold the control of your

treatment, unfortunate as that may be.

So steel yourself, calm your self and go to them with calmness and

open mind and present them with these things in their language.

(also make sure you are talking to them about estradiol not estrogen)

Inform them that you understand T converts to estradiol through

aromotization. And that T levels can actually decrease in people not

getting treatment because of high aromotase levels - particularly if

the person is at all over weight. (Aromotase is created and " lives "

in fat.

I've given you some related studies. there is one I cannot lay my

hands on today that is actually the best of the bunch. It is a case

study that showed in some older men T levels could be raised by 200 to

300 points simply by controlling estradiol and aromitization -

without any T supplementing. Maybe someone has a copy at hand? Could

you post the link? But these are some I have found that might nudge

them a bit:

(Also know that estradiol levels much beyond 50 pg/ml lead to ED,

emotionalism, gynomastia, severley dimished sex drive, etc. It

wouldn't hurt to tell them this as well. But studies on high E2 levels

are hard to find.)

The Journal of Clinical Endocrinology & Metabolism Vol. 89, No. 3

1174-1180

Effects of Aromatase Inhibition in Elderly Men with Low or

Borderline-Low Serum Testosterone Levels

Z. Leder, L. Rohrer, D. Rubin, Gallo

and Longcope

Endocrine Unit (B.Z.L., J.L.R.), Department of Medicine, Massachusetts

General Hospital, Boston, Massachusetts 02114; Departments of Medicine

and Obstetrics and Gynecology (C.L.), University of Massachusetts

Medical School, Worcester, Massachusetts 01655; and AstraZeneca

Pharmaceuticals (S.D.R., J.G.), Wilmington, Delaware 19850

Address all correspondence and requests for reprints to: Z.

Leder, Endocrine Unit, Massachusetts General Hospital, Bulfinch 327,

Fruit Street, Boston, Massachusetts 02114.

As men age, serum testosterone levels decrease, a factor that may

contribute to some aspects of age-related physiological deterioration.

Although androgen replacement has been shown to have beneficial

effects in frankly hypogonadal men, its use in elderly men with

borderline hypogonadism is controversial. Furthermore, current

testosterone replacement methods have important limitations.

We investigated the ability of the orally administered aromatase

inhibitor, anastrozole, to increase endogenous testosterone production

in 37 elderly men (aged 62–74 yr) with screening serum testosterone

levels less than 350 ng/dl. Subjects were randomized in a double-blind

fashion to the following 12-wk oral regimens: group 1: anastrozole 1

mg daily (n = 12); group 2: anastrozole 1 mg twice weekly (n = 11);

and group 3: placebo daily (n = 14). Hormone levels, quality of life

(MOS Short-Form Health Survey), sexual function (International Index

of Erectile Function), benign prostate hyperplasia severity (American

Urological Association Symptom Index Score), prostate-specific

antigen, and measures of safety were compared among groups.

Mean ± SD bioavailable testosterone increased from 99 ± 31 to 207 ± 65

ng/dl in group 1 and from 115 ± 37 to 178 ± 55 ng/dl in group 2 (P <

0.001 vs. placebo for both groups and P = 0.054 group 1 vs. group 2).

Total testosterone levels increased from 343 ± 61 to 572 ± 139 ng/dl

in group 1 and from 397 ± 106 to 520 ± 91 ng/dl in group 2 (P < 0.001

vs. placebo for both groups and P = 0.012 group 1 vs. group 2). Serum

estradiol levels decreased from 26 ± 8 to 17 ± 6 pg/ml in group 1 and

from 27 ± 8 to 17 ± 5 pg/ml in group 2 (P < 0.001 vs. placebo for both

groups and P = NS group 1 vs. group 2). Serum LH levels increased from

5.1 ± 4.8 to 7.9 ± 6.5 U/liter and from 4.1 ± 1.6 to 7.2 ± 2.8 U/liter

in groups 1 and 2, respectively (P = 0.007 group 1 vs. placebo, P =

0.003 group 2 vs. placebo, and P = NS group 1 vs. group 2). Scores for

hematocrit, MOS Short-Form Health Survey, International Index of

Erectile Function, and American Urological Association Symptom Index

Score did not change. Serum prostate-specific antigen levels increased

in group 2 only (1.7 ± 1.0 to 2.2 ± 1.5 ng/ml, P = 0.031, compared

with placebo).

These data demonstrate that aromatase inhibition increases serum

bioavailable and total testosterone levels to the youthful normal

range in older men with mild hypogonadism. Serum estradiol levels

decrease modestly but remain within the normal male range. The

physiological consequences of these changes remain to be determined.

This work was supported by National Institutes of Health Grant

K23-RR16310 (to B.Z.L.), the Massachusetts General Hospital Clinical

Research Center grant (RR-1066), and AstraZeneca Pharmaceuticals.

Current address for S.D.R.: Glaxo Kline Pharmaceuticals,

Collegeville, Pennsylvania.

Current address for J.G.: Eximias Pharmaceuticals, Berwyn,

Pennsylvania.

Abbreviations: DHT, Dihydrotestosterone; PSA, prostate-specific

antigen.

1: J Urol. 2002 Feb;167(2 Pt 1):624-9. Related Articles, Links

Comment in: * J Urol. 2002 Oct;168(4 Pt 1):1509.

Aromatase inhibitors for male infertility.

Raman JD, Schlegel PN.

Department of Urology, Buchanan Brady Urology Foundation,

Center for Male Reproductive Medicine and Microsurgery, New York

Presbyterian Hospital, Weill Medical College of Cornell University,

New York, New York, USA.

PURPOSE: Testosterone-to-estradiol ratio levels in infertile men

improve during treatment with the aromatase inhibitor, testolactone,

and resulting changes in semen parameters. We evaluated the effect of

anastrozole, a more selective aromatase inhibitor, on the hormonal and

semen profiles of infertile men with abnormal baseline

testosterone-to-estradiol ratios. MATERIALS AND METHODS: A total of

140 subfertile men with abnormal testosterone-to-estradiol ratios were

treated with 100 to 200 mg. testolactone daily or 1 mg. anastrozole

daily. Changes in testosterone, estradiol, testosterone-to-estradiol

ratios and semen parameters were evaluated during therapy. The effect

of obesity, diagnosis of the Klinefelter syndrome, and presence of

varicocele and/or history of varicocele repair on treatment results

was studied. RESULTS: Men treated with testolactone had an increase in

testosterone-to-estradiol ratios during therapy (mean plus or minus

standard error of the mean 5.3 +/- 0.2 versus 12.4 +/- 1.1, p <0.001).

This change was confirmed in subgroups of men with the Klinefelter

syndrome, a history of varicocele repair and those with varicocele. A

total of 12 oligospermic men had semen analysis before and during

testolactone treatment with an increase in sperm concentration (5.5

versus 11.2 million sperm per ml., p <0.01), motility (14.7% versus

21.0%, p <0.05), morphology (6.5% versus 12.8%, p = 0.05), and

motility index (606.3 versus 1685.2 million motile sperm per

ejaculate, respectively, p <0.05) appreciated. During anastrozole

treatment, similar changes in the testosterone-to-estradiol ratios

were seen (7.2 +/- 0.3 versus 18.1 +/- 1.0, respectively, p <0.001).

This improvement of hormonal parameters was noted for all subgroups

except those patients with the Klinefelter syndrome. A total of 25

oligospermic men with semen analysis before and during anastrozole

treatment had an increase in semen volume (2.9 versus 3.5 ml., p

<0.05), sperm concentration (5.5 versus 15.6 million sperm per ml., p

<0.001) and motility index (832.8 versus 2930.8 million motile sperm

per ejaculate, respectively, p <0.005). These changes were similar to

those observed in men treated with testolactone. No significant

difference in serum testosterone levels during treatment with

testolactone and anastrozole was observed. However, the anastrozole

treatment group did have a statistically better improvement of serum

estradiol concentration and testosterone-to-estradiol ratios (p

<0.001). CONCLUSIONS: Men who are infertile with a low serum

testosterone-to-estradiol ratio can be treated with an aromatase

inhibitor. With treatment, an increase in testosterone-to-estradiol

ratio occurred in association with increased semen parameters.

Anastrozole and testolactone have similar effects on hormonal profiles

and semen analysis. Anastrazole appears to be at least as effective as

testolactone for treating men with abnormal testosterone-to-estradiol

ratios, except for the subset with the Klinefelter syndrome, who

appeared to be more effectively treated with testolactone.

PMID: 11792932 [PubMed - indexed for MEDLINE]

The Journal of Clinical Endocrinology & Metabolism Vol. 85, No. 9

3027-3035

From the Clinical Research Centers

Aromatase Inhibition in the Human Male Reveals a Hypothalamic Site of

Estrogen Feedback1

Frances J. , B. Seminara, Suzzunne DeCruz, A.

Boepple and F. Crowley, Jr.

Reproductive Endocrine Unit of the Department of Medicine and National

Center for Infertility Research, Massachusetts General Hospital,

Boston, Massachusetts 02114

Address correspondence and requests for reprints to: Frances ,

MB, MRCPI, Reproductive Endocrine Unit and National Center for

Infertility Research, Massachusetts General Hospital, Fruit Street,

Boston, Massachusetts 02114. E-mail: hayes.frances@....

Abstract

The preponderance of evidence states that, in adult men, estradiol

(E2) inhibits LH secretion by decreasing pulse amplitude and

responsiveness to GnRH consistent with a pituitary site of action.

However, this conclusion is based on studies that employed

pharmacologic doses of sex steroids, used nonselective aromatase

inhibitors, and/or were performed in normal (NL) men, a model in which

endogenous counterregulatory adaptations to physiologic perturbations

confound interpretation of the results. In addition, studies in which

estrogen antagonists were administered to NL men demonstrated an

increase in LH pulse frequency, suggesting a potential additional

hypothalamic site of E2 feedback.

To reconcile these conflicting data, we used a selective aromatase

inhibitor, anastrozole, to examine the impact of E2 suppression on the

hypothalamic-pituitary axis in the male. Parallel studies of NL men

and men with idiopathic hypogonadotropic hypogonadism (IHH), whose

pituitary-gonadal axis had been normalized with long-term GnRH

therapy, were performed to permit precise localization of the site of

E2 feedback. In this so-called tandem model, a hypothalamic site of

action of sex steroids can thus be inferred whenever there is a

difference in the gonadotropin responses of NL and IHH men to

alterations in their sex steroid milieu. A selective GnRH antagonist

was also used to provide a semiquantitative estimate of endogenous

GnRH secretion before and after E2 suppression.

Fourteen NL men and seven IHH men were studied. In Exp 1, nine NL and

seven IHH men received anastrozole (10 mg/day po x 7 days). Blood

samples were drawn daily between 0800 and 1000 h in the NL men and

immediately before a GnRH bolus dose in the IHH men. In Exp 2, blood

was drawn (every 10 min x 12 h) from nine NL men at baseline and on

day 7 of anastrozole. In a subset of five NL men, 5 µg/kg of the

Nal-Glu GnRH antagonist was administered on completion of frequent

blood sampling, then sampling continued every 20 min for a further 8

h.

Anastrozole suppressed E2 equivalently in the NL (136 ± 10 to 52 ± 2

pmol/L, P < 0.005) and IHH men (118 ± 23 to 60 ± 5 pmol/L, P < 0.005).

Testosterone levels rose significantly (P < 0.005), with a mean

increase of 53 ± 6% in NL vs. 56 ± 7% in IHH men. Despite these

similar changes in sex steroids, the increase in gonadotropins was

greater in NL than in IHH men (100 ± 9 vs. 58 ± 6% for LH, P = 0.07;

and 85 ± 6 vs. 41 ± 4% for FSH, P < 0.002). Frequent sampling studies

in the NL men demonstrated that this rise in mean LH levels, after

aromatase blockade, reflected an increase in both LH pulse frequency

(10.2 ± 0.9 to 14.0 ± 1.0 pulses/24 h, P < 0.05) and pulse amplitude

(5.7 ± 0.7 to 8.4 ± 0.7 IU/L, P < 0.001). Percent LH inhibition after

acute GnRH receptor blockade was similar at baseline and after E2

suppression (69.2 ± 2.4 vs. 70 ± 1.9%), suggesting that there was no

change in the quantity of endogenous GnRH secreted.

From these data, we conclude that in the human male, estrogen has dual

sites of negative feedback, acting at the hypothalamus to decrease

GnRH pulse frequency and at the pituitary to decrease responsiveness

to GnRH.

Published online ahead of print October 13, 2004, 10.1210/jc.2004-0834

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Male Endocrinology

The Journal of Clinical Endocrinology & Metabolism Vol. 90, No. 1

211-218

Short-Term Aromatase-Enzyme Blockade Unmasks Impaired Feedback

Adaptations in Luteinizing Hormone and Testosterone Secretion in Older

Men

Johannes D. Veldhuis and Ali Iranmanesh

Division of Endocrinology and Metabolism, Department of Internal

Medicine, Mayo Medical and Graduate Schools of Medicine, General

Clinical Research Center, Mayo Clinic, Rochester, Minnesota 55905; and

Endocrine Section, Medical Service, Salem Veterans Affairs Medical

Center, Salem, Virginia 24153

Address all correspondence and requests for reprints to: Johannes D.

Veldhuis, Division of Endocrinology and Metabolism, Department of

Internal Medicine, Mayo Medical and Graduate Schools of Medicine,

General Clinical Research Center, Mayo Clinic, Rochester, Minnesota

55905. E-mail: veldhuis.johannes@....

The mechanisms subserving hypoandrogenemia and relative

hypogonadotropism in older men are not known. The present study tests

the clinical hypothesis that aging impairs hypothalamopituitary

adaptations to feedback withdrawal induced by antagonism of estrogen

biosynthesis. To this end, we appraised gonadal axis responses to

estrogen depletion induced by anastrozole (a potent and selective

aromatase inhibitor) in nine older and 11 young men vs. placebo in 17

other older and eight young men. The study design comprised a

prospectively randomized, double-blind, parallel-cohort intervention.

To monitor LH release, blood was sampled every 10 min for 24 h; LH

concentrations were assayed by two-site monoclonal immunoradiometric

assay; pulsatile LH release quantitated by a model-free discrete

peak-detection technique (Cluster); feedback-dependent orderliness of

LH secretion via the approximate entropy statistic; and 24-h

rhythmicity of LH concentrations by cosine analysis. At baseline,

older men had comparable estradiol and testosterone but lower LH

concentrations than young controls. Exposure to anastrozole reduced

(24-h pooled) serum estradiol concentrations by 50% (P < 0.001) and

elevated mean LH concentrations by 2.1-fold (P < 0.001) in both the

young and older cohorts. However, older men failed to achieve young

adult augmentation of the following: 1) total testosterone

concentrations (P < 0.01) or molar testosterone to SHBG ratios (P <

0.01); 2) incremental LH pulse amplitude (P < 0.001) and LH peak area

(P < 0.01); 3) mean LH pulse frequency (P = 0.0044); and 4)

quantifiable irregularity (approximate entropy) of LH release patterns

(P < 0.001). FSH concentrations became comparable in the two age

cohorts.

In summary, administration of a potent and selective aromatase

antagonist reduces estradiol and elevates mean LH concentrations

equivalently in young and older men. The low estrogen-feedback state

in elderly men unmasks diminished incremental LH pulse amplitude and

area; absence of further acceleration of LH pulse frequency; impaired

regulation of the orderliness of LH release; and reduced testosterone

to SHBG ratios. Thus, aging alters expected

hypothalamopituitary-gonadal adaptations to short-term partial

estrogen depletion in healthy men.

________________

I am human; nothing in humanity is alien to me.

Terence

June 27, 2006

Hey bro, good information and don't let all the b-s get to you again. I know the

feeling of just wanting to run a mock, in which you did lol. I think I will have

to beg for my new ( hot russian with nice legs but Im sure a scary ) Endo

doc to put me on HCG and see if my well being can very much improve.

I posted some new tests I took earlier this month, and it concluded my E2 is up

there around the normal-high range. That sucks and now I know why the older

males in here continue to emphasize E2, but still have no idea how high E2 makes

me feel. Yet, another medication I must take now. Groovy......

Just be calm and just be patient and use the force of passive but affirm when

dealing with doctors, etc that simply dont care what we have been thru and still

do thru just to try and get healthy.

retrogrouch@... wrote: On Tue, 16 May 2006

09:39:57 +0000 (GMT), you wrote:

>she went to each doctor and all refused to add on the extra tsts,saying none

were required and that why test a female hormone on a male its totally

irrelevant.

>

>i then wnet in a panic attack crying and shouting and mumbling to my self ,and

then into meltdown and said i was not leaving the surgery till the checks were

all done and iwas sitting outside the door,[unless you have seen an

aspergerrs/add meltdown its hard to visualise]

>

>anyway nurse wnet back to one of the doctors and female nice doctor called me

in.

>

>she said she was acutally had specialist knowledge in male hormones etc,and

again said the female ones dont need to be looked at,i was still crying and

panicking she calmed me down a bit and said

Gawd but I had ignorant " specialists " and doctors.

But you have to deal with them. They hold the control of your

treatment, unfortunate as that may be.

So steel yourself, calm your self and go to them with calmness and

open mind and present them with these things in their language.

(also make sure you are talking to them about estradiol not estrogen)

Inform them that you understand T converts to estradiol through

aromotization. And that T levels can actually decrease in people not

getting treatment because of high aromotase levels - particularly if

the person is at all over weight. (Aromotase is created and " lives "

in fat.

I've given you some related studies. there is one I cannot lay my

hands on today that is actually the best of the bunch. It is a case

study that showed in some older men T levels could be raised by 200 to

300 points simply by controlling estradiol and aromitization -

without any T supplementing. Maybe someone has a copy at hand? Could

you post the link? But these are some I have found that might nudge

them a bit:

(Also know that estradiol levels much beyond 50 pg/ml lead to ED,

emotionalism, gynomastia, severley dimished drive, etc. It

wouldn't hurt to tell them this as well. But studies on high E2 levels

are hard to find.)

The Journal of Clinical Endocrinology & Metabolism Vol. 89, No. 3

1174-1180

Copyright ï¿½ 2004 by The Endocrine Society