(09-19-2017, 11:07 AM)Spy Car Wrote: (09-18-2017, 08:18 PM)AlanE Wrote: (09-18-2017, 03:50 PM)Spy Car Wrote: "Normal" isn't optimal and at 330 a 33-year-old is neither "normal" or optimal.
No one can back that statement up with any facts.
They can't?
It would be very simple to find the "normal" range of a 33 year old male, and it isn't 330. Such a score is abnormal.
There are different ways of defining what is "normal". One commonly used definition of normal, when it comes to hormone levels, is where 95% of the general population falls. But that's just one way. Most laboratory normal ranges would in fact place 330 as normal for a 33 yo.
It's very tricky when you start talking about "low normal" vs "normal normal" for a hormone like testosterone. For testosterone to have an effect in the body, it must detach from blood protein, be transported into the tissue where it will act (eg, muscle), be transported into a cell, bind to a receptor, recruit molecular cofactors, sit on DNA, allowing for other molecules to alter the DNA, resulting in a change in mRNA production, which in turn has to be translated to protein, which then has to avoid degradation in order to have an action.
That is an
over-simplified overview of hormone action. The point is that every one of those steps has an efficiency which differs from one person to another, so the the amount of hormone in the blood is a very poor gauge of how much effect you are getting out of that hormone. One 33 yo man could have a T level of 330 while another 33 yo man could have a T level of 660, and if the first man's body is twice as responsive to testosterone as the second man's, then functionally they have the same T effect.
Sometimes it's obvious. A 33 yo man with a history of chemo treatment at a young age, small testes, a T level of 330, and a high LH
definitely has low T. A 50 yo man with liver disease could have a T level of 500, a very high SHBG, a high LH, and also have low T (despite the T level of 500). Other times it's
very tricky. What we lack is a good, reliable bioassay of testosterone action, something analogous to the role that TSH plays in gauging thyroid hormone action.
The other thing that makes this difficult is that the T blood test is not a very good one. Results from the same person vary greatly depending on what lab you use, the time of day, which day you choose, which week you choose, whether you eat carbs before the blood draw, etc. This is why most experts currently recommend at three early AM blood draws, preferably fasting, each draw at least a week apart from one another, prior to consideration of testosterone therapy. Even then, a lot of men who are low on three draws will test normal 6 months later without any intervention.
Lastly, a lot of the putative benefits of testosterone therapy are unproven. In many studies, testosterone and placebo have similar benefits on measures such as mood, energy, and even erections in older men. I'm not saying that T treatment is bunk. A lot of people benefit from it. But a lot of people are treated with T without good reason.
It sounds like the OP is working with a specialist who is doing the appropriate evaluation. Best wishes.
