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Testerone, How Low Is Low?
Jul 31, 2004

Hi Bob, Ever feel like your living back with the dinosaurs? I'm 41, been HIV Poz for 18 yrs & I just found your site. Fortunately, it's been a matter of living life on life's terms and getting through it all fairly well. I wanted to know what is consider "low" for testerone levels? I recently tested around 323, three months before that 240. I've been living with HIV long enough to go from the early meds of AZT to today's most modern marvels and I've always done well on the meds. My viral load is undectable and my Tcell count averages 550 - 750 (and has jumped to 1100 on occassion). Up to two years ago, I consistantly tested around 500-600 for testerone. However, over the past year and a half the levels have dropped (200 - 330) and I (like others) have hit the fatigue realm. I get the insomnia, lack of energy, the gut has grown as the gym has gone by the wayside. I get to the tread mill and get off tired. I don't hit a brick wall, I am the brick wall. My doc has started me on testerone therapy and, because of insurance requirements, I had the choice of either the patch or a shot. I'm not keen into shots. I hear they sting, but that doesn't bother me as much as the needle does. So, I opted for the patch. Is my testerone level (323) considered low? Is the patch as effective as other options (considering insurance requirements)? Any thoughts would be greatly appreciated. Thanks for your help and I've added the site to my favorites.

Response from Dr. Frascino


Living with dinosaurs??? Well no, except that time I walked into a "Mirth and Girth Chubby Chaser" party at a clothing-optional resort at Russian River.

OK, on to your question: How low is low when it comes to testosterone? The answer depends on multiple factors:

1. The normal range for your particular laboratory. Different labs use different testing methods and different cutoffs for their normal range. The "normal range" is also quite broad, often in the 200-800 range.

2. Your age. Testosterone levels decline with age. So Justin Timberlake and Bob Dole would be expected to have different "normal" testosterone levels. Your lab or the Internet should provide you with "age matched" normal ranges.

3. Not all testosterone is active. Some is bound to protein and unavailable to produce it marvelous and "uplifting" effects. The active component is called "free testosterone." Perhaps you should check your "free testosterone" level to see how well the patch is working (or not working). You might need two patches. Alternatively, your doctor could write to the insurance company, advise them that the patch is not working, and request approval for the gel formulation. That way the dose can be adjusted as needed, and you don't have to look like a commercial for big circular Band-Aids when you hit the showers at the gym.

Next, the gym is indeed important. Exercise increases testosterone levels (while it decreases that gut). Exercise induced endorphins make us feel energized. And best of all, working-out makes us look better naked.

So rather than hitting a brick wall or being the brick wall, it's much better just to be built like a brick shithouse.

Finally, what's up with the insomnia? Insomnia is not usually associated with hypogonadism (low testosterone). It can be associated with depression or stress. Perhaps your doc could give you a mild sleeping aid to help you get your energizing beauty sleep.

I'm glad we've become one of your favorites. Now ditch the dinos and get energized, OK?

Dr. Bob

Ongoing low grade fever

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