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My 70 year old husband has been receiving testosterone

injections for about two years...
My 70 year old husband has been receiving testosterone injections for about two years to improve muscle strength as he has a degenerative muscular dystrophy condition. These have been prescribed by an alternative medicine doctor. His most recent testosterone level was 1500, which is quite high. He's not concerned and his urologist is okay with this, too. I think he is irritable and quick tempered since this therapy has begun and I am concerned. Advice?
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Answered in 11 minutes by:
12/11/2017
Doctor John MD
Doctor John MD, Board Certified MD
Category: Medical
Satisfied Customers: 885
Experience: Medical Physician
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how often is he getting the testosterone injections?
how much is he getting?
is he taking any other medications with the testosterone?

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Customer reply replied 8 months ago
He gets 0.5 ml injected IM once a week, (testosterone 200mg/ml, 1 ml). He takes a number of medications for blood pressure control and for his syndrome, Charcot-Marie-Tooth. Do you need a list of all of his medications?
Customer reply replied 8 months ago
Please let me know if you need a list of all of his medications.

ok, is he on any medications for his prostate?

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prostate medications can also sometimes increase testosterone levels.

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And did they do his blood work the day of his injection or right before his testosterone injection?

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Customer reply replied 8 months ago
As for the time of his blood test, I'll have to check. He takes Letrozole 2.5mg Tablets, 1/4 tablet once a week which I think is for prostate. And Trospium Cl 20mg Tablets, one twice a day for overactive bladder, Finasteride 1mg Tablets once a day for male pattern baldness, Tamsulosin 0.4mg Capsules once a day at bedtime for enlarged prostate, Tamsulosin 0.4mg Capsules once a day for enlarged prostate and erectile disfunction, Vesicare 5mg Tablets once a day for overactive bladder BUT I don't think he's taken that one recently.

timing of when they draw the blood to check testosterone levels is important. if they draw it after giving him the shot, then his testosterone level will be high, but will drop over the week to a normal range.

if its running 1500 mid week or right before the injection and he is having mood issues, that could be an indication for trying him on a lower dose or spacing out the interval to every ten days between injections.

The letrozole should also decrease the conversion of testosterone to estradiol (a form of estrogen). Higher estrogen levels in men can also cause issues with moodiness and temper.

Most alternative medicine docs will also follow estrogen levels as well, but would mention it to his doc next time in case they have not done those labs in a while.

does that help answer your question?

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Customer reply replied 8 months ago
I don't think that they would have been careless enough to draw the blood close to the time of the injection but, as I said, I'm not certain about the timing. Checking the estrogen level is an interesting idea and I'll ask him about that. Would you ever think that testosterone injections would help in preventing the muscle wasting that CMT causes?

testosterone can help, but also needs good nutrition as well.
and how much is he able to exercise?

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Customer reply replied 8 months ago
what are the cardiovascular risks of higher than average testosterone levels? He had a TIA two years ago and also takes medication to control hypertension.

the research is very mixed. we originally thought testosterone was bad for the heart, but new research is suggesting that low testosterone may be worse for the heart, so we are waiting on further studies.

My take is that testosterone is fine if levels are watched and estrogen levels dont go too low since estrogen is cardio-protective.

does that help answer your question?

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Customer reply replied 8 months ago
Exercise for CMT is a problematic issue. Too much, causes excessive fatigue, which is a component of the syndrome. Mobility and balance are two big problems and as he ages, it becomes even more difficult to walk without fatigue. There are other forms of exercise, but some researchers say exercise isn't helpful or even advised. He's still ambulatory with leg braces but he tires easily. He began testosterone because some one of his health professionals suggested it could help with muscle building.

if not exercising, it will slow/stop muscle wasting, but in order to see muscle growth, would need some type of muscle stimulation from exercise. Might want to ask the doctor he sees for CMT about if a muscle stim machine like Compex would be appropriate as well. we use them for recovery aid in athletes, but would have to look for research on using in in CMT.

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Customer reply replied 8 months ago
Thanks. Is that like a TENZ unit? He's used that in the past but not consistently. Are you saying, then, that testosterone can help with muscle building but only in response to some sort of muscle stimulation like exercise or an outside stimulation?

yes, similar to TENs unit, but has different settings to stimulate muscles.

and yes, typically testosterone helps improve muscle building response to resistance exercise.

May want to see if his doctor recommends visit with PT to help design an exercise program that would not flare up his CMT.

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Customer reply replied 8 months ago
Thanks. I'm reassured. I read information that led me to believe that high testosterone might lead to cardiovascular complications.

You’re welcome and glad to be able to help you today!

I would like to thank you for your question and I hope you found my answer informative and helpful.

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- Dr John.

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