Guest guest Posted September 12, 2006 Report Share Posted September 12, 2006 i thought the SBHG was needed to confirm hypogonadism secondary is this not the case,i had been told its one i need to get done? and again i cant see how you can tell if someone is hypogonadsm secondary or partial andrrogen deficiency?? its all extremly confuisng i go to my doctor in a few hours time and i still dont really know what to ask for,i have all those blood tests said about other day,though i personally doubt if my local doctro will get all those done,will just getting the shbg and free testosteron be enough what is in real figures is diagnostic criteriav for hypogonadsm secondarry,i need yto convince her to diagnose me and not endo as i dont intend ever to see that guy again ,all i want is my doc to see the figures after getting blood tests and say yes paul i agree not parital adnrogen deficiency but hypogonadsm secondary. i have also emailed a private company to see how much all these blood test and diagnosis may cost me in uk to gwet done,i doubt i could afford it b ut may have no other options if to get diagnosied regards paul Low SHBG and Estradiol by Dr. nco. The most common cause of low SHBG is excessive insulin - i.e. insulin resistance. Insulin resistance in turn leads to a cascade of events which results other hormone imbalances such as low testosterone production, suboptimal thyroid hormone activity, adrenal fatigue, etc. Factors which together in a balance determine SHBG are: 1. Anabolic hormones generally reduce SHBG. These include testosterone, DHEA, insulin, DHT, and growth hormone. 2. Thyroid hormone, Estrogens, and Progesterone (by increasing estrogen receptors/sensitivi ty), increase SHBG. In the absence of insulin resistance, the most common other cause of low SHBG is a very high level of other anabolic hormones - most frequency high testosterone from TRT. Those who use anabolic steroids at high doses often drive their SHBG to near zero. When total testosterone is between 650 to 1000 ng/dl, and a person still has zero sex drive, I would look for other causes for sexual dysfunction - e.g. other hormone, neurotransmitter, or immune system problems. Raising SHBG does not necessarily increase the risk for Alzheimer's disease. It is important to keep in mind the factors which lead to the risk of Alzheimer's disease. Insulin resistance (i.e. excessive insulin levels) causes low SHBG. It also greatly increases the risk of Alzheimer's disease because it results in a higher level of inflammatory cytokine production (Cytokines are the chemical messengers of the immune system). It is the inflammation which is one of the underlying factors which leads to Alzheimer's disease. SHBG level is most often a signal of the overall status of multiple hormone levels. The balance may give an indication of whether one is in an pro-inflammatory state or anti-inflammatory state - with inflammation leading to disease such as Alzheimer's disease, heart disease, strokes, cancer, etc. Some hormones such as some estrogens and insulin can lead to inflammation leading to illness. And other hormones such as the androgens (except DHT), growth hormone, and thyroid hormone, can lead to an antiinflammatory state, reducing the risk for illness. The balance determines the person's risk for illness. What estradiol level is best for any individual often needs to be determined by trial and error. It is unique for each individual. Most do best around 30 pg/ml. But some do best at lower and higher levels. For example, I have a 65 y.o. patient with a total testosterone of 840 ng/dl and an estradiol of 47 pg/ml. He's having the time of his life - able to make love numerous times each night - after more than a decade of having no sex. The estradiol level works for him without side effects. Some may do better with much loser levels of estradiol - the response is highly individualistic. Even with low SHBG - which is difficult to correct since it depends on the balance of so many hormones - when the other hormones and neurotransmitters are optimized, sex drive and the ability to have an erection can often return. When total testosterone is supraphysiologic - i.e. over 1000 ng/dl - problems with libido and erections may occur. Testosterone increases dopamine in the brain in order to increase sex drive, reduce depression, give pleasure to activities. The problem is that dopamine is a very fragile neurotransmitter/ hormone in its effects. Too high a dopamine level can cause tolerance to dopamine. This is similar to how one can develop tolerance to drugs such as cocaine and amphetamines which increase dopamine levels in the brain to cause their high. This can lead to the loss of libido when high testosterone levels are maintained for long periods of time. Conversely, when one is deprived of testosterone (and hence dopamine) for long periods of time due to hypogonadism, one can get a high during the first few weeks of testosterone treatment since the brain becomes supersensitive to dopamine when it has been deprived of it (e.g. making more dopamine receptors to pick up the weaker dopamine signals). Unfortunately, as the brain then gets use to the higher dopamine levels, it will develop some tolerance, and libido will drop off - though we often wish that hopefully a good amount remains. ____________ ______ Any statement I make on this site is for educational purposes only and is subject to change. It does not constitute medical advice, does not substitute for proper medical evaluation from physician, does not create a doctor/patient relationship or liability. If you would like medical advice, you will have to make an appointment. Thank you. Phil Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2006 Report Share Posted September 12, 2006 that was posted at Meso to a guy that has problems with ED it was not about being Secondary or Primary. If you need to know about this read this link. http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf To tell if one is Primary or Secondary you do a test on Total and Free T with the LH and FSH. If total and free T are low and LH and FSH are high the man is Primary his testis are not working good. If one tests low and LH and FSH are low he is secondary not getting the LH and FSH messages from the Pituitary Gland. If one is near the mid range then a Clomid or HCG stim test is needed to tell. Phil paul wey <promachief@...> wrote: i thought the SBHG was needed to confirm hypogonadism secondary is this not the case,i had been told its one i need to get done? and again i cant see how you can tell if someone is hypogonadsm secondary or partial andrrogen deficiency?? its all extremly confuisng i go to my doctor in a few hours time and i still dont really know what to ask for,i have all those blood tests said about other day,though i personally doubt if my local doctro will get all those done,will just getting the shbg and free testosteron be enough what is in real figures is diagnostic criteriav for hypogonadsm secondarry,i need yto convince her to diagnose me and not endo as i dont intend ever to see that guy again ,all i want is my doc to see the figures after getting blood tests and say yes paul i agree not parital adnrogen deficiency but hypogonadsm secondary. i have also emailed a private company to see how much all these blood test and diagnosis may cost me in uk to gwet done,i doubt i could afford it b ut may have no other options if to get diagnosied regards paul Low SHBG and Estradiol by Dr. nco. The most common cause of low SHBG is excessive insulin - i.e. insulin resistance. Insulin resistance in turn leads to a cascade of events which results other hormone imbalances such as low testosterone production, suboptimal thyroid hormone activity, adrenal fatigue, etc. Factors which together in a balance determine SHBG are: 1. Anabolic hormones generally reduce SHBG. These include testosterone, DHEA, insulin, DHT, and growth hormone. 2. Thyroid hormone, Estrogens, and Progesterone (by increasing estrogen receptors/sensitivi ty), increase SHBG. In the absence of insulin resistance, the most common other cause of low SHBG is a very high level of other anabolic hormones - most frequency high testosterone from TRT. Those who use anabolic steroids at high doses often drive their SHBG to near zero. When total testosterone is between 650 to 1000 ng/dl, and a person still has zero sex drive, I would look for other causes for sexual dysfunction - e.g. other hormone, neurotransmitter, or immune system problems. Raising SHBG does not necessarily increase the risk for Alzheimer's disease. It is important to keep in mind the factors which lead to the risk of Alzheimer's disease. Insulin resistance (i.e. excessive insulin levels) causes low SHBG. It also greatly increases the risk of Alzheimer's disease because it results in a higher level of inflammatory cytokine production (Cytokines are the chemical messengers of the immune system). It is the inflammation which is one of the underlying factors which leads to Alzheimer's disease. SHBG level is most often a signal of the overall status of multiple hormone levels. The balance may give an indication of whether one is in an pro-inflammatory state or anti-inflammatory state - with inflammation leading to disease such as Alzheimer's disease, heart disease, strokes, cancer, etc. Some hormones such as some estrogens and insulin can lead to inflammation leading to illness. And other hormones such as the androgens (except DHT), growth hormone, and thyroid hormone, can lead to an antiinflammatory state, reducing the risk for illness. The balance determines the person's risk for illness. What estradiol level is best for any individual often needs to be determined by trial and error. It is unique for each individual. Most do best around 30 pg/ml. But some do best at lower and higher levels. For example, I have a 65 y.o. patient with a total testosterone of 840 ng/dl and an estradiol of 47 pg/ml. He's having the time of his life - able to make love numerous times each night - after more than a decade of having no sex. The estradiol level works for him without side effects. Some may do better with much loser levels of estradiol - the response is highly individualistic. Even with low SHBG - which is difficult to correct since it depends on the balance of so many hormones - when the other hormones and neurotransmitters are optimized, sex drive and the ability to have an erection can often return. When total testosterone is supraphysiologic - i.e. over 1000 ng/dl - problems with libido and erections may occur. Testosterone increases dopamine in the brain in order to increase sex drive, reduce depression, give pleasure to activities. The problem is that dopamine is a very fragile neurotransmitter/ hormone in its effects. Too high a dopamine level can cause tolerance to dopamine. This is similar to how one can develop tolerance to drugs such as cocaine and amphetamines which increase dopamine levels in the brain to cause their high. This can lead to the loss of libido when high testosterone levels are maintained for long periods of time. Conversely, when one is deprived of testosterone (and hence dopamine) for long periods of time due to hypogonadism, one can get a high during the first few weeks of testosterone treatment since the brain becomes supersensitive to dopamine when it has been deprived of it (e.g. making more dopamine receptors to pick up the weaker dopamine signals). Unfortunately, as the brain then gets use to the higher dopamine levels, it will develop some tolerance, and libido will drop off - though we often wish that hopefully a good amount remains. ____________ ______ Any statement I make on this site is for educational purposes only and is subject to change. It does not constitute medical advice, does not substitute for proper medical evaluation from physician, does not create a doctor/patient relationship or liability. If you would like medical advice, you will have to make an appointment. Thank you. Phil Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2006 Report Share Posted September 12, 2006 Hi We said you needed to get SHBG done at the same time so as to try and diagnose what is wrong and to see what is OK. Nothing to do about Primary or Secondary as SHBG means Sex Hormone Binding Globulin and helps to understand how the Testosterone is binding to proteins and how available the T will be. Hope that helps? On 12 Sep 2006 at 21:36, paul wey wrote: > i thought the SBHG was needed to confirm hypogonadism secondary is this not the case,i had been told its one i need to get done? > > and again i cant see how you can tell if someone is hypogonadsm secondary or partial andrrogen deficiency?? > > its all extremly confuisng i go to my doctor in a few hours time and i still dont really know what to ask for,i have all those blood tests said about other day,though i personally doubt if my local doctro will get all those done,will just getting the shbg and free testosteron be enough > > what is in real figures is diagnostic criteriav for hypogonadsm secondarry,i need yto convince her to diagnose me and not endo as i dont intend ever to see that guy again ,all i want is my doc to see the figures after getting blood tests and say yes paul i agree not parital adnrogen deficiency but hypogonadsm secondary. > > i have also emailed a private company to see how much all these blood test and diagnosis may cost me in uk to gwet done,i doubt i could afford it b ut may have no other options if to get diagnosied > > > regards paul > > > Low SHBG and Estradiol by Dr. nco. > > The most common cause of low SHBG is excessive insulin - i.e. insulin > resistance. Insulin resistance in turn leads to a cascade of events > which results other hormone imbalances such as low testosterone > production, suboptimal thyroid hormone activity, adrenal fatigue, etc. > > Factors which together in a balance determine SHBG are: > 1. Anabolic hormones generally reduce SHBG. These include > testosterone, DHEA, insulin, DHT, and growth hormone. > 2. Thyroid hormone, Estrogens, and Progesterone (by increasing > estrogen receptors/sensitivi ty), increase SHBG. > > In the absence of insulin resistance, the most common other cause of > low SHBG is a very high level of other anabolic hormones - most > frequency high testosterone from TRT. Those who use anabolic steroids > at high doses often drive their SHBG to near zero. > > When total testosterone is between 650 to 1000 ng/dl, and a person > still has zero sex drive, I would look for other causes for sexual > dysfunction - e.g. other hormone, neurotransmitter, or immune system > problems. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2006 Report Share Posted September 12, 2006 Hi If you are able to afford the blood tests privately then just get those that are mentioned in our Library here and get a set which you can then send to any medic for diagnostics and prescribing, including your own GP. There is nothing to stop you have a private GP as well as an NHS GP. So you could visit one of those recommended on Nick's site for London or age and that information can go to your NHS GP for prescribing NHS prescriptions and related hospital referrals. You just need to say the Private GP is a 2nd Opinion. With the blood test work completed you can refer to this for the hospital to repeat and discuss in the future as well. Quite a large number of patients find themselves doing things this way for many different reasons. On 12 Sep 2006 at 21:36, paul wey wrote: > i thought the SBHG was needed to confirm hypogonadism secondary is this not the case,i had been told its one i need to get done? > > and again i cant see how you can tell if someone is hypogonadsm secondary or partial andrrogen deficiency?? > > its all extremly confuisng i go to my doctor in a few hours time and i still dont really know what to ask for,i have all those blood tests said about other day,though i personally doubt if my local doctro will get all those done,will just getting the shbg and free testosteron be enough > > what is in real figures is diagnostic criteriav for hypogonadsm secondarry,i need yto convince her to diagnose me and not endo as i dont intend ever to see that guy again ,all i want is my doc to see the figures after getting blood tests and say yes paul i agree not parital adnrogen deficiency but hypogonadsm secondary. > > i have also emailed a private company to see how much all these blood test and diagnosis may cost me in uk to gwet done,i doubt i could afford it b ut may have no other options if to get diagnosied > > > regards paul > > > Low SHBG and Estradiol by Dr. nco. > > The most common cause of low SHBG is excessive insulin - i.e. insulin > resistance. Insulin resistance in turn leads to a cascade of events > which results other hormone imbalances such as low testosterone > production, suboptimal thyroid hormone activity, adrenal fatigue, etc. > > Factors which together in a balance determine SHBG are: > 1. Anabolic hormones generally reduce SHBG. These include > testosterone, DHEA, insulin, DHT, and growth hormone. > 2. Thyroid hormone, Estrogens, and Progesterone (by increasing > estrogen receptors/sensitivi ty), increase SHBG. > > In the absence of insulin resistance, the most common other cause of > low SHBG is a very high level of other anabolic hormones - most > frequency high testosterone from TRT. Those who use anabolic steroids > at high doses often drive their SHBG to near zero. > > When total testosterone is between 650 to 1000 ng/dl, and a person > still has zero sex drive, I would look for other causes for sexual > dysfunction - e.g. other hormone, neurotransmitter, or immune system > problems. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2006 Report Share Posted September 12, 2006 -Hey Thanks phil this is a good read and I am gaining some info as to what to ask the doc next week. I guess I wanted to know what kind test to take inorder to find out why I am so low on testosterone even though looks slightly okay on the free testosterone for now again my lh and FSH are going down the hill so what could that mean anyone relates. Thanks Jack. In , philip georgian <pmgamer18@...> wrote: > > that was posted at Meso to a guy that has problems with ED it was not about being Secondary or Primary. If you need to know about this read this link. > http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf > To tell if one is Primary or Secondary you do a test on Total and Free T with the LH and FSH. If total and free T are low and LH and FSH are high the man is Primary his testis are not working good. If one tests low and LH and FSH are low he is secondary not getting the LH and FSH messages from the Pituitary Gland. If one is near the mid range then a Clomid or HCG stim test is needed to tell. > Phil > > paul wey <promachief@...> wrote: > i thought the SBHG was needed to confirm hypogonadism secondary is this not the case,i had been told its one i need to get done? > > and again i cant see how you can tell if someone is hypogonadsm secondary or partial andrrogen deficiency?? > > its all extremly confuisng i go to my doctor in a few hours time and i still dont really know what to ask for,i have all those blood tests said about other day,though i personally doubt if my local doctro will get all those done,will just getting the shbg and free testosteron be enough > > what is in real figures is diagnostic criteriav for hypogonadsm secondarry,i need yto convince her to diagnose me and not endo as i dont intend ever to see that guy again ,all i want is my doc to see the figures after getting blood tests and say yes paul i agree not parital adnrogen deficiency but hypogonadsm secondary. > > i have also emailed a private company to see how much all these blood test and diagnosis may cost me in uk to gwet done,i doubt i could afford it b ut may have no other options if to get diagnosied > > > regards paul > > > Low SHBG and Estradiol by Dr. nco. > > The most common cause of low SHBG is excessive insulin - i.e. insulin > resistance. Insulin resistance in turn leads to a cascade of events > which results other hormone imbalances such as low testosterone > production, suboptimal thyroid hormone activity, adrenal fatigue, etc. > > Factors which together in a balance determine SHBG are: > 1. Anabolic hormones generally reduce SHBG. These include > testosterone, DHEA, insulin, DHT, and growth hormone. > 2. Thyroid hormone, Estrogens, and Progesterone (by increasing > estrogen receptors/sensitivi ty), increase SHBG. > > In the absence of insulin resistance, the most common other cause of > low SHBG is a very high level of other anabolic hormones - most > frequency high testosterone from TRT. Those who use anabolic steroids > at high doses often drive their SHBG to near zero. > > When total testosterone is between 650 to 1000 ng/dl, and a person > still has zero sex drive, I would look for other causes for sexual > dysfunction - e.g. other hormone, neurotransmitter, or immune system > problems. > > Raising SHBG does not necessarily increase the risk for Alzheimer's > disease. It is important to keep in mind the factors which lead to > the risk of Alzheimer's disease. > > Insulin resistance (i.e. excessive insulin levels) causes low SHBG. > It also greatly increases the risk of Alzheimer's disease because it > results in a higher level of inflammatory cytokine production > (Cytokines are the chemical messengers of the immune system). It is > the inflammation which is one of the underlying factors which leads > to Alzheimer's disease. > > SHBG level is most often a signal of the overall status of multiple > hormone levels. The balance may give an indication of whether one is > in an pro-inflammatory state or anti-inflammatory state - with > inflammation leading to disease such as Alzheimer's disease, heart > disease, strokes, cancer, etc. Some hormones such as some estrogens > and insulin can lead to inflammation leading to illness. And other > hormones such as the androgens (except DHT), growth hormone, and > thyroid hormone, can lead to an antiinflammatory state, reducing the > risk for illness. The balance determines the person's risk for > illness. > > What estradiol level is best for any individual often needs to be > determined by trial and error. It is unique for each individual. Most > do best around 30 pg/ml. But some do best at lower and higher levels. > For example, I have a 65 y.o. patient with a total testosterone of > 840 ng/dl and an estradiol of 47 pg/ml. He's having the time of his > life - able to make love numerous times each night - after more than > a decade of having no sex. The estradiol level works for him without > side effects. Some may do better with much loser levels of estradiol - > the response is highly individualistic. > > Even with low SHBG - which is difficult to correct since it depends > on the balance of so many hormones - when the other hormones and > neurotransmitters are optimized, sex drive and the ability to have an > erection can often return. > > When total testosterone is supraphysiologic - i.e. over 1000 ng/dl - > problems with libido and erections may occur. Testosterone increases > dopamine in the brain in order to increase sex drive, reduce > depression, give pleasure to activities. The problem is that dopamine > is a very fragile neurotransmitter/ hormone in its effects. Too high a > dopamine level can cause tolerance to dopamine. This is similar to > how one can develop tolerance to drugs such as cocaine and > amphetamines which increase dopamine levels in the brain to cause > their high. This can lead to the loss of libido when high > testosterone levels are maintained for long periods of time. > > Conversely, when one is deprived of testosterone (and hence dopamine) > for long periods of time due to hypogonadism, one can get a high > during the first few weeks of testosterone treatment since the brain > becomes supersensitive to dopamine when it has been deprived of it > (e.g. making more dopamine receptors to pick up the weaker dopamine > signals). Unfortunately, as the brain then gets use to the higher > dopamine levels, it will develop some tolerance, and libido will drop > off - though we often wish that hopefully a good amount remains. > ____________ ______ > Any statement I make on this site is for educational purposes only > and is subject to change. It does not constitute medical advice, does > not substitute for proper medical evaluation from physician, does not > create a doctor/patient relationship or liability. If you would like > medical advice, you will have to make an appointment. Thank you. > Phil > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2006 Report Share Posted September 13, 2006 hi yes i thought that was so on hypogonadism two ,i could not understand then about all the otherr blood tests ,if lh/fsh and total testorone are low then to me thats hypogonadism secondary,or am i wrong all i want is recognition of that ,if i dont need the otherr blood tests then i wont asl for them i will tell gp today,endo made and error and i am secondary hypogonadism and want my doctor to just rubber stamp the diagnosis i wil then ask for those lh/fsh and total t tests again with sbhg and free testosterone and whatever of those other tests she allows me to have so yto get back to myu docotor lh 2 iu/l range 1-9 fsh 2 iu/l range 1-19 ttotal t 7.6 nmo/l range 6-27 am i correct in telling my docotor thst there is no sdoubt destpie the crrap the endo said that this is hypogonadism secondary? the biggest problems seems to be deciding on wehat is low, all those officially fall in normal range but low end and that may mean still my doc will say that too. i dont want to get carried away with loads of bllod test that are not indicative of hypogonadism two,yes i accept some may be needed in future but for now the only thing i am establishing is am i or am i not based on the figures i have hypogonadsm secondary,some times i am sure i am and then i see something else that confuses me i know you are all trying to help but its very confusing and made harder by our health system in UK as said i dont have an endo i trust,i certainly wont go back to the last one and he is only one in local hopsital so not much choice. and any new person would take 4 months or so to even see so are the figures i give officially ok to diagnose hypogonadism secondary[not just persnal beliefs] but actuall oficially ,as all i ever see is referance to low figures above being hypogonadism secondary but no actual classification of what is officially low or not. my figures i guess are low side of normal ansd thats the problem,as its not being recognised officialy anyway i will hopefully get my doc to say she agrees that iam hypgogonadism seciondary then at least i will have that diagnoses. regards paul Low SHBG and Estradiol by Dr. nco. The most common cause of low SHBG is excessive insulin - i.e. insulin resistance. Insulin resistance in turn leads to a cascade of events which results other hormone imbalances such as low testosterone production, suboptimal thyroid hormone activity, adrenal fatigue, etc. Factors which together in a balance determine SHBG are: 1. Anabolic hormones generally reduce SHBG. These include testosterone, DHEA, insulin, DHT, and growth hormone. 2. Thyroid hormone, Estrogens, and Progesterone (by increasing estrogen receptors/sensitivi ty), increase SHBG. In the absence of insulin resistance, the most common other cause of low SHBG is a very high level of other anabolic hormones - most frequency high testosterone from TRT. Those who use anabolic steroids at high doses often drive their SHBG to near zero. When total testosterone is between 650 to 1000 ng/dl, and a person still has zero sex drive, I would look for other causes for sexual dysfunction - e.g. other hormone, neurotransmitter, or immune system problems. Raising SHBG does not necessarily increase the risk for Alzheimer's disease. It is important to keep in mind the factors which lead to the risk of Alzheimer's disease. Insulin resistance (i.e. excessive insulin levels) causes low SHBG. It also greatly increases the risk of Alzheimer's disease because it results in a higher level of inflammatory cytokine production (Cytokines are the chemical messengers of the immune system). It is the inflammation which is one of the underlying factors which leads to Alzheimer's disease. SHBG level is most often a signal of the overall status of multiple hormone levels. The balance may give an indication of whether one is in an pro-inflammatory state or anti-inflammatory state - with inflammation leading to disease such as Alzheimer's disease, heart disease, strokes, cancer, etc. Some hormones such as some estrogens and insulin can lead to inflammation leading to illness. And other hormones such as the androgens (except DHT), growth hormone, and thyroid hormone, can lead to an antiinflammatory state, reducing the risk for illness. The balance determines the person's risk for illness. What estradiol level is best for any individual often needs to be determined by trial and error. It is unique for each individual. Most do best around 30 pg/ml. But some do best at lower and higher levels. For example, I have a 65 y.o. patient with a total testosterone of 840 ng/dl and an estradiol of 47 pg/ml. He's having the time of his life - able to make love numerous times each night - after more than a decade of having no sex. The estradiol level works for him without side effects. Some may do better with much loser levels of estradiol - the response is highly individualistic. Even with low SHBG - which is difficult to correct since it depends on the balance of so many hormones - when the other hormones and neurotransmitters are optimized, sex drive and the ability to have an erection can often return. When total testosterone is supraphysiologic - i.e. over 1000 ng/dl - problems with libido and erections may occur. Testosterone increases dopamine in the brain in order to increase sex drive, reduce depression, give pleasure to activities. The problem is that dopamine is a very fragile neurotransmitter/ hormone in its effects. Too high a dopamine level can cause tolerance to dopamine. This is similar to how one can develop tolerance to drugs such as cocaine and amphetamines which increase dopamine levels in the brain to cause their high. This can lead to the loss of libido when high testosterone levels are maintained for long periods of time. Conversely, when one is deprived of testosterone (and hence dopamine) for long periods of time due to hypogonadism, one can get a high during the first few weeks of testosterone treatment since the brain becomes supersensitive to dopamine when it has been deprived of it (e.g. making more dopamine receptors to pick up the weaker dopamine signals). Unfortunately, as the brain then gets use to the higher dopamine levels, it will develop some tolerance, and libido will drop off - though we often wish that hopefully a good amount remains. ____________ ______ Any statement I make on this site is for educational purposes only and is subject to change. It does not constitute medical advice, does not substitute for proper medical evaluation from physician, does not create a doctor/patient relationship or liability. If you would like medical advice, you will have to make an appointment. Thank you. Phil Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2006 Report Share Posted September 13, 2006 On Wed, 13 Sep 2006 06:12:44 +0000 (GMT), you wrote: >hi yes i thought that was so on hypogonadism two ,i could not understand then about all the otherr blood tests ,if lh/fsh and total testorone are low then to me thats hypogonadism secondary,or am i wrong > >all i want is recognition of that ,if i dont need the otherr blood tests then i wont asl for them i will tell gp today,endo made and error and i am secondary hypogonadism and want my doctor to just rubber stamp the diagnosis i wil then ask for those lh/fsh and total t tests again with sbhg and free testosterone and whatever of those other tests she allows me to have > >so yto get back to myu docotor > >lh 2 iu/l range 1-9 >fsh 2 iu/l range 1-19 >ttotal t 7.6 nmo/l range 6-27 > > >am i correct in telling my docotor thst there is no sdoubt destpie the crrap the endo said that this is hypogonadism secondary? > >the biggest problems seems to be deciding on wehat is low, all those officially fall in normal range but low end and that may mean still my doc will say that too. > >i dont want to get carried away with loads of bllod test that are not indicative of hypogonadism two,yes i accept some may be needed in future but for now the only thing i am establishing is am i or am i not based on the figures i have hypogonadsm secondary,some times i am sure i am and then i see something else that confuses me > >i know you are all trying to help but its very confusing and made harder by our health system in UK > > >as said i dont have an endo i trust,i certainly wont go back to the last one and he is only one in local hopsital so not much choice. > >and any new person would take 4 months or so to even see > >so are the figures i give officially ok to diagnose hypogonadism secondary[not just persnal beliefs] but actuall oficially ,as all i ever see is referance to low figures above being hypogonadism secondary but no actual classification of what is officially low or not. > >my figures i guess are low side of normal ansd thats the problem,as its not being recognised officialy > > >anyway i will hopefully get my doc to say she agrees that iam hypgogonadism seciondary then at least i will have that diagnoses. > >regards paul In my opinion before you go on Testosterone replacement you should have an E2 test. And a prolactin test. Read the AAACE guidelines to understand why. Take the guidelines to your doctor for a complete list of all tests. http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf It would seem you are most likely secondary - but high E2 or high prolactin could lay at the root and these two causes can sometimes be resolved without Testosterone therapy. Also secondary cases usually require an MRI to make sure the cause is not pituitary lesions or tumors. Once those tests are done it and those causes ruled out it makes sense to start T. Once you start they need to follow your E2 levels for a time. You should aim to keep them in the 20 to 30 range in my opinion. Much higher or lower negates the testosterone benefits and causes problems. Also before they start they are supposed to do a prostate exam. Most of this is spelled out in the guidelines. Good luck! keep asking questions here and posting results. ________________ I am human; nothing in humanity is alien to me. Terence Quote Link to comment Share on other sites More sharing options...
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