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Family Medicine
Family Medicine, Doctor (MD)
Category: Health
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Experience:  Board certified Family Medicine
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i am a 40 year old man, my testosterone level is LOW 34, my

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i am a 40 year old man, my testosterone level is LOW 34, my doctor had me on testosterone shots and it only went up to 124 after 6months, then i had my PSA levels checked and it was 15, took me off of testostone and gave me an antibioic and it went down to a 6, went back on my testosterone and it jumped back up, went in for a biopsy and my prostated is the size of a 20year old boy not enlarge and no tumors... the doctors than sent it off for a second opinion and they said i needed to repeat the biopsy 6weeks later, had it done again and they still cant really give me an answer they are calling it a type A cancer, cant rule out cancer and cant treat for cancer, they say i am a mystery... what do i do? and they cant understand my hormone inbalance. i eat 6 meals a day 85% organic, exercise 4 days a wk, and still have problems keeping muscle mass. i am puzzled!!! any suggestions?
Submitted: 5 years ago.
Category: Health
Expert:  Family Medicine replied 5 years ago.

Thank you for usin JustAnswer . It is privilege to help you.

 

Since how you have ben feling symptoms of testosterone deficincey?

Did you have morning testosterone levels checked or random?

Did they check total testosterone only or free testosterone was also checked?

were you or on any meds like steroids, ketoconazole, norcotics etc?

Were you ruled out of HIV infection?

How is your kidney function?

Do you have any metabolic problem like diabetes?

Did they ever discussed with you about doing MRI of the brain( sellar region)?

What is your weight and height?

 

Please provide more detail. I will appreciate it.

 

Regards

Customer: replied 5 years ago.
somedays are good and energy and somedays i am tired and dont feel as strong.
had morning checked and miday
checked total and free
been on no meds
kidney fuction is fine
not diabete
have not talked about doing MRI
5'6 137lbs
yes i am HIV but my levels are non detective. its been a year since i found out, but was tested every six months before that for years. i know how i got it and when.
the thing is, that my testosterone levels have been very low even before i was HIV, and that was one of the first things they tested me for over and over again, when i first found out about my low testosterone levels, at that time was not HIV. i do understand now that can be a cause, but i am puzzled about the biopsy and having it done twice and still no real answer. my doctor thinks i need the testosterone but i am caught between a rock and a hard place, like i said its a mystery they say. my second opinion on the 2biopsy was looked at from a gentleman from John Hopkins, and they are ruling as a type A cell, saying its could be possibility. 2 BIOPSY'S and not really an answer, A HIGH PSA and no tumors and a prostate the size of a 20 year old boy. i understand the HIV, and the effects, but have for years had low testosterone way before being infected with HIV. now i realize i have that against me too. i really appreciate your help and your advice...
Expert:  Family Medicine replied 5 years ago.

Thank you so much for providing precise information and also for waiting. I appreciate it.

 

Testosterone deficiency is not uncommon problem in males around 40 or even in 30s specially if they have truncal obesity and are obese. But your BMI with given weight of 137 and height of 5-6" is 22.1 whihc falls perfectly in healthy recommended range.this low BMI might be result of muscle wasting due to testosterone deficincy as well.

 

HIV alone can be blamed responsible for low tesosterone levels if other causes are ruled out. About 50% of patients with AIDS and 25% with HIV positive status are known to have testosterone deficiency.

 

As a matter of fact, if your PSA level is above 1.4 ng/dl then testosterone therapy is contra indicated .

But you are young and this much low testosterone of 36 ng/dl mandates testosterone supplementation once prostate problem is ruled out.Prostate biopsy may or may not show any abnormal cells so it is not 100 % reliable but your urologist must be able to tell you about the options.

 

It is good that your testosterone levels were done and repeated as morning blood test samples and also free serum level was checked too so the labortary values seems to be reliable as true values.

 

I will suggest you to talk to your urologist about option of ruling out some pathology in sellar region of brain as gonadotrophic relasing hormone is relased from there and ultimately stimulates target cells in testicles to produce testosterone.

 

Below I have attached a link that is really useful when it comes to recommended guidelines regarding testosterone levels and management options. Hope it will be of information to you.

 

http://www.guideline.gov/summary/summary.aspx?doc_id=9420

 

http://www.aidsmap.com/cms1032637.asp

 

I will advise you might think of having second opinion from another urologist regarding your PSA problem.As your PSA was decreased dramatically once you were treated with antibiotics, it will attribute this to infection of the prostate.

 

Best wishes for your health and safety.

 

 

 

Family Medicine, Doctor (MD)
Category: Health
Satisfied Customers: 710
Experience: Board certified Family Medicine
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