Abnormally Low T Levels

[DrKurrPhDMBA]

I have read through many of the postings regarding low testosterone levels making note of what is considered to be normal levels.  I am 44 and have noticed those commercials about men losing testosterone as they age, that makes sense, but what caught my attention was the part about lacking energy.  I started seeing a pain management Dr. last year in May for chronic pain in my back and neck.  I have had 3 shoulder surgeries, 2 on right, 1 on left.  those were in '01', '02, and '03.  I had my knee done in '10.  I found this Dr. in May after the other pain Dr. told me that I would have to be mentally strong and "learn to cope with it", that obviously was not something I liked to hear and regardless of whatever his motive was, I promptly sought out another Dr. (The other one did not even recall the last time I saw him, it was only a week and a half since he did a back injection, what a JA).

It may or may not have been related but he put me on gabapentine and after a few days I woke up with my right knee (not the one that was scoped) swollen and it hurt to even sit.  I tried my best to not go to the ER, but it got way too bad and by 5PM I went in, but only after seeing my other Dr's nurse to get a rx and she said I looked absolutely terrible.  Anyhow the ER Dr. asked if I bumped it or fell, I said no, I woke up that way, he said bursitis and gave me a shot and a rx for Vicodin, which did absolutely nothing. It took me 2 days to get in to see the Ortho Dr. and the Ortho surgeon aspirated my knee and he said he had never seen anything like it before in his life.  Barely any fluid came out and what did was extremely thick.  He gave me a rx for oxy ir and said he wanted the lab results back before getting an mri.  There was no infection or anything, but the mri showed a lesion on the bone, more precisely it was on the backside of the patella, but he said not to worry.  A few days later was when I met with the new pain Dr. and he put me on oxycodone and setup an appointment for injections.  I have disc degeneration throughout the lumbar and this was found by having 7 mri's between July and October and 1 CT scan in November for neck.  He added to the oxy a pain med called Nucynta and that happened in September.  And in January he added morphine to this.  I also take Depakote, lyrica, Blood pressure meds, ritalin, and mirtazapine and there has not been any issues with these meds, but in mid December to early January I noticed I was getting more fatigued, but also have noticed increased frequency of having my arms, hands, legs, and feet falling asleep, this happens while sitting, standing, or laying down.  I also have been getting hot and cold, blurred vision, tongue tied, and at times have to stop in the middle of the conversation and ask what I was talking about.  I saw my family Dr. in early January and mentioned this to her, in addition to whether or not this could be MS because someone suggested this plus there are a few cases in my cousins.  

She had lab tests done and the T level was 59, but I did not find that out until I met with a urologist that she referred me to.  He asked why I was there because he was a surgeon and managing the t levels was something she could do.  She also referred me to a neurologist and I saw him a few days ago and he asked if I had balance issues.  I said no and he had me walk heel to toe and I could not do it, I would have not passed a drunk driving test, lol.  He ordered a brain scan with contrast and that was done today, but I am wondering if there is any connection to these abnormally low levels and the meds, or if there is something that is more complex than just meds.  I still question the discounting of the scan that found the lesion because it did not confirm or negate the possibility is was malignant.  I questioned the Dr. about the way he worded this in the report and I also said that I would never be able to use that wording in my research because it does nothing to support either side.  The response was that the wording was for the purpose of keeping lawyers at bay.  

I will be picking up the patches that the Dr. ordered, but I would like to know what some of you all have experienced.  How long to get the levels up? What to expect? Are shots better?  I asked the nurse about what could be causing this and she said she did not know.  The urologist suggested that I also see an endocrinologist also, but I have not been referred.  He did indicate that based on the lab test, history, and some other factors that I will have a massive heart attack within 4-5 years and he said this was almost for sure because of the statistical data he has been compiling as well as what he presents to other Drs.  

Sorry for the long question, but to sum it up I am wondering if:

1. Pain meds are the culprit
2. BP meds?
3. Pituitary issues?
4. Any relationship to any brain tumors?
5. Shots or patches?

Thank you for any advice or answers.
DKurrPhD  

[DrKurrPhDMBA]

Thanks for getting back to me.  I was prescribed patches but the insurance company denied the claim even with a prior authorization, but I think the nurse said it was for ED, at least the insurance company said that she said that.  I looked at the formulary and the insurance company covers it if it is lower than 300 ng/dl and mine is 59.7 ng/dl so that is obviously nearly 6 times lower, so we are appealing.  The other thing is I had a bone density scan and it indicated osteopenia and probability of fractures are moderate to high and the therapy recommendation was one that stated mild to aggresive would be hormone replacement therapy, how much more do they need.  My RBC, WBC, and MID cell counts are also all abnormal the fatigue is terrible, tremors, pain and PARASTHESIA IN LEFT LEG & ARMS.

I don't know what to think and I had a brain scan done on Saturday that came back unremarkable but I am not sure if this discounts MS or not.  They did find a bone lesion last year on my patella, but did not say it was or was not an issue, I asked the Doctor about the wording because I said I would not be able to get away with wording like that in my research and the response was that it is done that way for the lawyers, yikes!!  I guess I have to sit and wait.

Thanks again
Dennis

[TESTPRO]

T level was a 59? 59 out of 900?

Some countries have different scales for normal range. American is 200-900. Here in Canada it is 28-38. If you have a 59 on Can scale then you are extremly high in test production. If on the American scale you are VERY VERY low. Almost making zero test.

As I said in many posts. You need to be at the high end of any scale for health and sex. 200-300 range is normal if you are a retired person. Not someone who should be in their prime.

I think shots work better. Creams and patches can make you infertile which is not good for sex drive. But with shots you also need HCG to keep your body making some natural test and keep them from shrinking up and shutting down fully.

As for pain meds. Yes they effect everything in negative manner. But once you get test levels to good range you may need less of them. Especialy if you start working out and eating proper.

[DrKurrPhDMBA]

I forgot to add that there is also ED issues involved with this as well
DKurrPhD