I need some search engine help

[Slightly Enhanced]

Okay friends, I need some search engine help. I am not having much luck finding the data.

I need to determine the average decrease in testosterone from morning to afternoon.

I went to the doctor today expecting them to start testosterone replacement…..instead they didn’t. My last test reading was 529 ng/dl (this was taken in the morning fasting) The past three readings were taken in the afternoon with a level of about 239 ng/dl.

I am trying to build a case that an afternoon reading below 300 warrants therapy regardless of the morning reading.

Any help would be greatly appreciated

[mick-G]

Re: I need some search engine help

It will take me awhile to look into it SE. So all i know from experience is that the endos i went to several yrs ago all did the testing in the am b4 you eat anything. If iam not mistake 239 is alittle below the low end of the normal range. This kinda thing always is determined by the dr. and you may have to go to several b4 you find one that is proactive on doing trt. You can do trt yourself tho. Just get a hg cypionate and take 200mg eow or once every 3rd wk. I heard some ppl do about 120mg ew to keep blood levels stable.

[T-Man007]

Re: I need some search engine help

From: http://www.webmd.com/content/pages/16/99337.htm

Before you go and get your testosterone levels tested, be sure you know the facts:

Laboratories vary in how they perform testosterone tests. To be sure
of the result, have all your testosterone tests done at the same
location at roughly the same time of day. (Hormones fluctuate
throughout the day, so testing at about the same time is best.)
Testosterone levels are most often measured with blood tests, but some
centers utilize saliva tests as well.

According to Henry Ritter, MD, a urologist from Atherton, Calif., the
most useful number to know is the "free testosterone" (or bioavailable
testosterone). The "total testosterone" reflects free and bound
testosterone. Bound testosterone is not available to boost libido
because it is linked to proteins, such as albumin and sex hormone
binding globulin, according to John E. Gould, MD, PhD, associate
clinical professor of urology at the University of California at
Davis. Gould also recommends getting the free testosterone number.

Different labs measure free testosterone differently. But ranges they
consider "normal" generally fall between 260 nanograms/deciliter to
1,000 ng/dL (or 2.6 nanograms/milliliter to 10 ng/mL). Since
physicians and laboratories have only recently begun to recognize the
importance of testing free testosterone, you may have to lobby to get
the test. If you are unable to get that reading and are forced to
stick with total testosterone, learn the range of normal for your lab.
Normal ranges for men usually are between 250 ng/dL to 1,200 ng/dL of
blood (2.5 ng/mL to 12 ng/mL).

Keep in mind that these ranges are created by testing many men without
much attention to their relative level of sexual function. Men whose
testosterone level is in the lowest 20% of the normal ranges above may
not feel much sex drive at all. In my clinical experience as a sex
therapist, men with total testosterone readings in the low 400s tend
not to have much sexual drive even if they are in fulfilling
relationships. Ritter says that even some men in the 600s do not feel
that much drive when other things are equal, and he prefers to see
numbers in the 700s. Throwing things into further confusion, says
Gould, is the fact that sometimes free testosterone will be low when
the total testosterone is high and vice versa.

One of the problems with all this measuring, Ritter says, is that very
few men have baseline measurements of their testosterone (free or
total) during the time their sex drive was normal. So there is no way
to know whether they have experienced a relative decrease. Also, there
are probably men who would test low but who would not complain at all
about the strength of their sexual drive. Clearly, determining the
best testosterone level for you is not an exact science since a key
component involves personal expectations about sexuality, a very
complex matter.

According to Gould and Ritter, testosterone does not affect sexual
function, only sexual drive. (And it is certainly not the only
component of sexual drive.) So look for other explanations and
solutions if erection difficulties or problems with the timing of
orgasm occur.

If you do find a low level of free testosterone in two separate
readings from the same laboratory, Ritter and Gould recommend getting
several other lab tests to determine if you're a good candidate for
testosterone supplements:

baseline liver function, or LFT
complete blood count, or CBC
prostate-specific antigen, or PSA
prolactin level
luteinizing hormone level, or LH
digital rectal exam
follicle stimulating hormone test, or FSH (optional)
Taking testosterone is dangerous only if you have certain medical
conditions. For starters, it's important to check your liver function
before, and at regular intervals during, a
testosterone-supplementation program. If there is a negative impact to
the liver, it can be reversed by discontinuing the testosterone, says
Gould.

According to Ritter, prostate cancer either in your own history or
your immediate family history rules out taking testosterone. An
enlarged prostate that isn't cancerous, however, is not a deal-breaker
-- a PSA test will let you know where you stand. The other tests help
rule out other hormone problems: An abnormal LH test or prolactin
level, says Gould, will alert your physician to check your pituitary
for a malfunction or tumor. FSH testing can help determine if your
sperm production is low.

Other potential risks: So far, no study provides solid evidence that
taking testosterone will cause hypertension or a substantial increase
in cholesterol levels. It may cause a slight rise in blood pressure or
"bad" cholesterol (low-density lipoprotein), but generally not to
levels that are significant or irreversible.

Currently, testosterone can be administered by injection, pill, or
skin patch. Most physicians favor either the injection or patch
because the pill has more potential for negative medical consequences.
Ritter states that about 10% of men who use pills develop a condition
known as chemical hepatitis and must discontinue. Gould says that
pills are generally "just hard on the liver."

With injections there are infrequent liver problems and they are
generally reversible. The two negatives: the annoyance of getting a
shot every two weeks to three weeks, and the "spike effect," which
gives a man a sudden boost of testosterone that usually wears off by
the time of the next injection.

The skin patch also causes liver problems only infrequently and has
the added advantage of eliminating the spike effect because the same
amount of testosterone is absorbed through the skin each day as a new
patch is applied. The patch approach is slightly more expensive than
injections, but involves no needles.

Men over 50 would be wise to have an annual prostate check anyway,
even if they do not decide to supplement testosterone.

If a man's relationship is fulfilling, but his sexual desire is low,
testosterone supplementation is a consideration. It won't, however,
turn a nonsexual relationship into a sexual one if there are issues in
the relationship that should be addressed.

Subject: Re: testosterone
From: zingerjones-ga on 19 Dec 2005 13:17 PST
*taken from various pages from www.webmd.com resulting from search on
testosterone test and LH test.*



Testosterone Levels
===================
The release of testosterone is controlled by a hormone called
luteinizing hormone, or LH, which is produced by the pituitary gland.
When the testosterone level is low, the pituitary gland releases LH,
which increases the amount of testosterone produced by the testicles.

One can either test for LH or total testorterone. Conditions might
indicate a test for free testosterone (see below).

One important consideration is since testosterone production varies
throughout the day, it is sometimes recommended that blood samples are
taken in the morning when the testosterone levels are said to be
highest.

Before puberty, the testosterone level in boys is low. An increase in
testosterone during puberty causes sex organs to mature, sperm to be
produced, sexual features to develop (including facial and body hair),
enlarged muscles, and a deep voice. The level of testosterone
continues to rise during adulthood until it peaks around age 40, then
gradually decreases.

Most of the testosterone in the blood is attached to a protein called
sex hormone binding globulin (SHBG). A small amount is attached to
albumin. The unattached, or "free," testosterone may be measured when
conditions that can increase SHBG (such as obesity or hyperthyroidism)
are present. Free testosterone can also be calculated from SHBG and
albumin levels. Usually this is done only at large medical centers.

Low values
----------
In men or boys who have gone through puberty, a low level of
testosterone may indicate decreased testicular function. It may also
indicate improper development of, injury to, or a lack of testicles.
It can also result from treatment with the female hormone estrogen, an
underactive pituitary gland, or many long-term (chronic) illnesses.

A low testosterone level in men can also be caused by certain
inherited diseases (such as Klinefelter's syndrome or Down syndrome),
liver disease (cirrhosis), or treatment for cancer of the prostate
gland.

Chronic alcohol use can cause a low testosterone level.

What Affects the Test
---------------------
Factors that can interfere with your test and the accuracy of the results include:

Medications such as estrogen (including birth control pills),
testosterone, corticosteroids, digoxin (Lanoxin), spironolactone
(Aldactone), or barbiturates.
Hyperthyroidism, which can increase sex hormone binding globulin (SHBG) levels.
Hypothyroidism can decrease SHBG levels.
Taking a luteinizing hormone-releasing hormone (LH-RH) agonist to
treat prostate cancer.
Medications that increase prolactin levels, such as certain seizure medications.

What To Think About
-------------------
Most of the testosterone in the blood is attached to a protein called
sex hormone binding globulin (SHBG). The unattached, or "free,"
testosterone may be measured when conditions that can increase SHBG
(such as obesity or hyperthyroidism) are present. Usually this is done
only at large medical centers.

The levels of other hormones made by the pituitary gland, such as
follicle-stimulating hormone (FSH) and luteinizing hormone (LH), may
be measured to help determine whether a low testosterone level is
caused by problems with the testicles or pituitary gland. For more
information, see the medical tests Luteinizing Hormone and
Follicle-Stimulating Hormone (on www.webmd.com). An abnormally high
level of LH and a low level of testosterone often indicates that the
testicles are not functioning properly. A low LH level and an
abnormally low or high testosterone level may indicate a problem with
the pituitary gland.

LH Levels
---------
Lower-than-normal values
Low LH levels may help explain why a woman is not ovulating or why a
man is not producing a male hormone (testosterone). This results in an
inability to become pregnant (infertility). However, low LH levels in
women may be normal and may require additional testing to determine
whether a problem exists.
Low LH levels can also indicate conditions such as anorexia nervosa,
pituitary gland failure, or damage to a part of the brain called the
hypothalamus.
Low LH levels can result from stress or low body weight.

What Affects the Test
---------------------
Certain hormone medications, including those containing estrogen or
progesterone (such as birth control pills), normally lower luteinizing
hormone (LH) levels.

LH levels may be increased in people who are obese or who have
hyperthyroidism or liver disease.

Some medications, such as clomiphene, spironolactone, naloxone, and
those given for seizures (anticonvulsants), can increase LH levels.
However, digoxin and phenothiazine can decrease LH levels.

Diagnostic imaging procedures (such as a thyroid scan or bone scan)
that use a radioactive substance (tracer) and were performed within 7
days prior to LH testing can interfere with LH results.

Rough handling, contamination, or inadequate refrigeration of the
blood sample can cause inaccurate test results.

24-hour urine LH levels may be affected by the total amount of urine collected.

[Slightly Enhanced]

Re: I need some search engine help

I have been going back and forth since July on this. I really thought that the doctor was going to prescribe the TRT today. But since I am so close I don’t want to self treat just yet.

If you find anything that discusses the average drop from morning to night please let me know. Right now mine is dropping by about 55% from morning to night

[TestRip7]

Re: I need some search engine help

Good read T-man. SE I'll look into this also and see if I can find anything.

[TestRip7]

Re: I need some search engine help

From that article, it looks like they were saying that the only accurate way to detect low or high testosterone levels was through a blood test. Is a urinalysis not an accurate way to detect low test levels???

[Fit2bLarge]

Re: I need some search engine help

with those numbers, 500 in the AM and 250+ in the PM, you wont qualify for replacement therapy. The CAP *College of American Pathologist* has the reference range for testosterone total and free between those range. this depends on the instrumentation used to analyze, but most are within those ranges. Once you get into double digit numbers, thats when replace therapy come into play. unless you go to a HRT clinic, they'll qualify you no matter what.

good luck SE

[Slightly Enhanced]

Re: I need some search engine help

Agreed that they are in the normal range, however my doctor (pcp) originally believed that they are too low for my age. The specialist is the one that just sent me packing....I go back to the pcp this thursday

Thanks for all the help