Testosterone level

Question

I am 60 years HIV+, CD4:512, CD4%:27.7, Viral Load: undetectable. On antiviral for 2 years, Atripla. My total testosterone is: 417, Dr. states 250-1100 as standard range, units: ng/dl. My free testosterone is 75.1, 35.0-155.0 standard, units pg/ml. Is there an "average" level, am I close. I feel fatuged, low sex drive/interest. Also, my thyroid isn't producing as it should (low) and am on levothyroxine 0.15mg. I'm not depressed, bored, just lacking the ole get up and go. I exercise on a Nordic Trak ski machine a couple of times a week, 2 miles on meter sometimes it is quite the chore to make myself do it lately. What are the standard levels for someone my age and status, or is there?

Answer

I am sorry to hear you are feeling tired.

"Normal ranges" are subjective in many cases. Some but not all doctors diagnose men with testosterone deficiency who have total testosterone bellow 500 ng/dl and all symptoms of hypononadism: lack of sex drive, fatigue, low mood, and others. Some do not believe that total testosterone below 500 ng/dl should be used as diagnosis even if all symptoms are present.

Testosterone is a long term commitment. Once you start therapy, your body shuts down its own production completely.

Before embarking on testosterone replacement, I would do something else. What people do not know is that normalizing thyroid hormones tends to also normalize testosterone and sex drive. I am not sure if the 0.15 mg of levothyroxine is optimum for you since you did not provide your T3 and T4 levels. Talk to your doctor about ensuring that this treatment is optimized since many people need a dose adjustment after a few weeks or months on treatment. After thyroid hormones are OK, your doctor would restest testosterone and reasses your symptoms to see if you need it.

If you do start testosterone therapy, remember that prostatic health/size, red blood cells/hematocrit, blood pressure, and estradiol need to be monitored during the first months of testosterone replacement to ensure proper side effect management, if any.

I would suggest you read more in my blog:
Nelson's Tetosterone Blog (Click here)

You can also join my testosterone Facebook group. There are 600 men, including at least 5 doctors in that group answering questions with me.

Nelson's FB TRT Group

I hope you get your hormones and quality of life normalized soon.

Good luck and please let us know what happens. Seldom I hear back from people who I help. Sharing experiences can be a learning tool not only for other readers but also for me!

In health,

Nelson