Opinions requested, not medical advice.

[reflection]

(sorry, I wanted to make that clear to the mods, I am not asking for medical advice. I am asking men what they would personally do in my situation.)

This is as much background as I can think of off the top of my head:

I am a 43 year old male. Married, two children, one teenage child, another close behind. Professional job, work at a desk all day. 5'-11", about 200. I ride my bicycle perhaps 3 nights a week after work for 5 miles or so, shoot very light hoops 1-2 nights a week for no more than 20 minutes, just enough to get a little sweat going.

The last month or so I have had a fatigue just sweep over me, so bad that it feels as if I am moving through a fog all the time. Very hard to concentrate. Sometimes it is all I can do to hold a conversation with a co-worker. However, like a lot of men, I am very good at putting on a front, so I just plow through it. My libido is still good, but it used to be great.

But it was getting so bad I started wondering if there was something physically wrong with me. Went to the doctor, had bloodwork done. Everything was spot on, except testosterone. Reference range for a man my age is 280-1070, I'm at 125. Doctor has suggested T-gel.

This stuff is scary. I realize they have to put all the side effects on the bottle, but some of the stuff is very daunting. Testicular shrinkage(!), male pattern baldness (I have a full head of hair), increased risk of prostate cancer. My wife actually does very involved research with testosterone for her job, and she says if I used the gel long enough to get up to normal range, then cycle off for awhile, and come back as needed, that my statistical chance of experiencing these effects is minimal.

So to the men in the group, I am wondering if any of you have experienced this, and if so, what *you* did, not what I should necessarily do. And if you haven't experienced it, what you would do if you were in a similar situation.

I hope I phrased this well enough to avoid a lock. I don't want medical advice. I want to know what other men think, that's all.

[ZombieHorde]

1. Tough one. I can see why would want opinions.

Being fatigued all the time can be depressing, which has its own nasty side effects. However, having your balls shrink, your hair fall out, and getting cancer is pretty lame. I would likely take the drug because I have been depressed before, and I don't ever want to go through that again.

[noamnety]

2. Female here - but I had a similar issue with cholesterol.

I had a test where the numbers were high enough that the doctor wanted to put me on meds for it. But when I read about the side effects, I was not happy at all.

I did a lot of research online about how to lower it naturally, and about how long it takes to correct it. I asked for 3 months to try a lifestyle change, then got retested. My numbers went from high risk to optimal in 90 days.

I know there are ways to boost testosterone naturally, I might try with a site like this: http://fitandstrongdads.com/14-tips-to-naturally-increase-your-testosterone-levels/ and do more research from there. I think I read more about the carbs and testosterone connection in the 4 Hour Body, but I didn't retain that since it didn't apply to me.

So yeah, for me, any time I think I might be able to fix something nonurgent (not talking cancery stuff here) with a natural approach to avoid drugs with side effects, I would try that - but retest to verify my new approach is actually accomplishing something.

[reflection]

3. Thanks to both of you for your thoughts.

I posted this in GD also, and the responses are pouring in. I've got a lot of reading and thinking to do. This is not a decision I will make lightly. For one thing, T levels are supposed to drop somewhat. And of course, the side effects are nasty.

I appreciate your time.

[Major Nikon]

4. Here's my $0.02 worth

Right now the medical evidence for the efficacy of testosterone hormone replacement therapy is still very much in question. It's also possible you may not have low-T at all. One test for blood testosterone is not sufficient to make a diagnosis of low testosterone because levels vary greatly from one day to the next. This means that A) you may not have low-T at all, and B) even if you do the therapy may not work.

As far as the therapy goes, I'm not convinced all the listed side effects are really all that prevalent. Guys with male pattern baldness and prostate cancer are no more likely to have higher testosterone levels than anyone else. This does not necessarily mean that guys undergoing hormone replacement therapy fit that same situation, but it does mean that the connection between testosterone levels and those things is not as cut and dried as you might think.

If your libido is good, I would be suspect that testosterone is the cause of your fatigue problems given your description. As scary as it sounds, the first thing I would do if I were in reasonably good shape and was having those symptoms is have my heart checked out thoroughly. Did your doctor perform an EKG on you? If not, ask for one (if you came to your doctor with those symptoms and they didn't perform one on you it might be time to find a new doctor). If your insurance covers it, you may also consider going to a cardiologist and having a stress test performed. It takes just one office visit and gives you a wealth of information about your heart. Is your blood pressure normal? Do you have a history of heart palpitations? Diabetes or irregular blood sugar? Rule out the big stuff first, then move down to things like low-T.

[Warren DeMontague]

5. Yeah, I'd second what M. Nikon has said.

You're not 100% sure it's the testosterone that's the problem. While you've had blood work done, there could still be other factors making you fatigued. When you bike, are you out in the woods? For all you know it might be something like Lyme disease.

I'd look deeper into it before being sure it's the testosterone that's the issue. Good luck.

[TM99]

6. I will relate my experience.

I would say, that yes, the cause of that fatigue is the extremely low testosterone. I have had numbers that low, and what you describe mirrors my experiences.

Testosterone alone may be the culprit, however, have they tested all of the sex hormones including the Pituitary gland? I have battled a Pituitary tumor and subsequent diseased gland for almost a decade. Please make sure the cause of the low T is not related to a wider endocrine disorder.

I, personally, switched from the gel to injections. The gel had to be used daily, is messy, and started to cause some local irritation for me. The injections have been easier for me. I dose once every two weeks. I started with a higher dosage and within a few months I was having some side effects. The worse is the edema and if you have BPH, it will make that worse as well.

We tested the female hormones and I was producing too much estrogen and prolactin, which is not uncommon on T dosing. I now take a very low dosage of Arimidex and Gabergoline. My numbers are now more balanced and my T is back up to about 450 as of my last round of blood work. The lowered dosage on the injectable ensures very little edema. After a six months of antibiotics, I have the BPH under control as well. On a lower dosage, it will take a bit longer to get my numbers up, however, I suffer only minimal side-effects this way. My Endo and I are shooting for around 750 as the magical number to reach, then we will begin cycling and doing even lower dosages further between shots.

I have suffered no other major side effects. While my libido was OK when that low, it is much more robust now. I also have more energy, sleep better, less irritability, no depression (a very common low testosterone symptom!), and I am slowly starting to work out a bit more. I have other endocrine problems and have a cocktail of replacement protocols and other medications that I must manage, so your situation if it is just low T may be a bit different.

Good luck to you!

On quick edit - I read the other replies, and a stress test is a good idea. Low T can also negatively impact the heart, and if you have had this for awhile, well, it is best to be safe. Also, they did a full cardio (EKG, Echo, & Stress Test) plus PSA and manual exam before I began injecting, so requesting that should be an easy insurance approval, as it seems to be fairly standard when starting male hormone replacement.

[Downwinder]

7. Get it checked out throughly.

An early symptom of my MS was fatigue. I would go to sleep on the stairs, I could not make it to the top.

[HuskiesHowls]

8. You don't mention if there are other medical conditions you have.

If you're taking other meds, you should be getting that checked, too. Any other current conditions that could cause this? For myself, I know that in the last 5-10 years, hot weather has been a reason for me to get drowsy (I'm 63). I find myself getting sleepy at work, and a 1-2 hour nap each day on the weekend (after a good night's sleep) is not uncommon when its hot and humid.

There may well be something else going on, and along with the other recommendations for checking your heart, a general checkup may find something. Yeah, guys don't like to go for checkups regularly, and doctors are generally anathema except when we're on our deathbed, but regular maintenance helps everything last longer.

[MicaelS]

9. I am 56, have low T and enlarged prostate.

I have definitely noticed a difference in just the last several years with low T. I don't have near the energy or drive I used to. I get tired easier. My libido waxes and wanes, and there seems there is no rhythm to it.

I don't drink, use tobacco or street drugs.

My doctor told me I need to lose weight, as I'm obese and fat is a repository for estrogen, and that exacerbates the Low T problem.

I have tried Testim Gel, didn't really like it because it was VERY messy, and switched to Axiron underarm gel, and it seemed to work better, and was not as messy. Unfortunately my new insurance doesn't cover Axiron, so it's back to Testim Gel for now. But I think I'm going to try the Androderm patch next time I see the doctor. Insurance can be a real PITA.