Reference ranges and determinants of testosterone (etc) - based cohort of older men.

Reference ranges and determinants of testosterone, dihydrotestosterone and estradiol levels measured using liquid chromatography-tandem mass spectrometry in a population-based cohort of older men.

Reference ranges and determinants of testosterone, dihydrotestosterone and estradiol levels measured using liquid chromatography-tandem mass spectrometry in a population-based cohort of older men.

Bu B Yeap ^{1 2} Helman Alfonso ³ Paul Chubb ⁴ David J Handelsman ⁵ Graeme J Hankey ¹ Paul E Norman ⁶ Leon Flicker ^{1 3}

1. School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
2. Department of Endocrinology and Diabetes, Fremantle Hospital, Fremantle, WA, Australia
3. WA Centre for Health and Ageing, University of Western Australia, Perth, WA, Australia
4. PathWest Laboratory Medicine, Fremantle and Royal Perth Hospitals, Perth, WA, Australia
5. ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia
6. School of Surgery, University of Western Australia, Perth, WA, Australia

Context
In men, testosterone (T) levels decline with increasing age, while the prevalence of ill-health increases. Controversy exists over the appropriate threshold for classifying T as low rather than normal in older men. The relevance of assessing dihydrotestosterone (DHT) and estradiol (E2) to define hormonal status in this context remains unclear.

Objective
We assessed distributions and associations of T, DHT and E2 in men aged ≥70 years, and established reference ranges for these in healthy older men.

Participants
Community-dwelling men aged 70-89 years resident in Perth, Western Australia.

Main outcome measures
Demographic, medical and physical characteristics of the cohort were collated. Plasma T, DHT and E2 were assayed using liquid chromatography-tandem mass spectrometry in early morning samples from 3,690 men.

Results
In the cohort as a whole, mean±SD for T was 13.1±4.9 nmol/L, DHT 1.4±0.7 nmol/L and E2 73.4±29.1 pmol/L. Increasing age, higher body mass index, waist:hip ratio, dyslipidemia, diabetes and higher luteinising hormone (LH) were independently associated with T and DHT in the lowest quartile. Increasing age, diabetes and higher LH were associated with lower E2.

In a reference group of 394 men aged 74.2±3.8 years reporting excellent or very good health with no history of smoking, diabetes, cardiovascular disease (CVD), cancer, depression or dementia, the 2.5^th percentile for T was 6.4 nmol/L, DHT 0.49 nmol/L and E2 28 pmol/L.

Applying these cut-offs to all 3,690 men, those with low T or low DHT had increased odds ratio (OR) for frailty, diabetes and CVD. Men with both low T and low DHT had higher OR for these outcomes.

Conclusions
The 2.5^th percentile in a reference group of healthy older men provides age-appropriate thresholds for defining low T, DHT and E2. Additional studies are needed to test their potential applicability and clinical utility in older men.

Testosterone not to blame for prostate cancer

Testosterone not to blame for prostate cancer

Apr 26, 2012, by Dr. Gary Bellman

For many years we were concerned about giving men testosterone. The basis of this concern was that testosterone contributed to the development of prostate cancer.


One piece of ‘evidence’ that testosterone causes prostate cancer was from the fact that eunuchs never developed prostate cancer. Eunuchs are boys who were castrated before the age of puberty. It was felt these men would be more strutted advisers to the powers in charge in some cultures, as well as more trusted to be alone with women. The fact that these men never developed prostate cancer was felt to be on the basis that they had their testicles removed and lost the body’s main source of testosterone.
The other piece of evidence was from the experience with a medication called Lupron. This medication has been used to treat metastatic or advanced spread of prostate cancer. The drug causes testosterone levels to go down significantly by shutting off the messages from the brain to the testicles to tell the testicles to produce testosterone. This drug caused, in many cases, for the prostate cancer deposits to shrink down.

These two pieces of evidence are not the whole story and in fact testosterone does not cause prostate cancer. A basic amount of testosterone is necessary for prostate cancer to develop. A Dr. Morgentaler, a urologist, popularized a theory called the saturation theory where the receptors for testosterone get bound up at a low level of testosterone and more testosterone does not cause any more effect on the receptors and does not contribute to a greater risk of prostate cancer.

In the 20 years of being a urologist specializing in prostate cancer, I have never seen a bodybuilder with prostate cancer. Therefore, I believe that while all men above the age of 40 should get an annual PSA (prostatic specific antigen), a blood test to check for prostate cancer and a prostate exam, the administration of testosterone does not increase the risk of developing prostate cancer.

A man’s testosterone is the highest after puberty until the early 20s. This very important hormone leads to muscle strength, boundless energy, sense of well being, high libido and good erections. It is the hormone that makes a man feel like a man. Unfortunately, for some reason, this important hormone declines as men age. For some, it starts in one’s 30s or 40s, for others, not until later. This decline causes a whole host of problems ranging from poor energy to depression, weight gain, poor libido, erectile dysfunction, osteoporosis, lipid problems, sleep problems as well as other issues. It is unclear why this occurs. Either the messages from the brain (pituitary) that go to the testicles to produce testosterone are insufficient or the testicles themselves can no longer keep up with the production. Regardless of the specific cause, the end result is that many men suffer from hypogonadism, a condition where their body has insufficient male hormone.

The remedy is testosterone replacement, where testosterone is added to erase the negative effects mentioned above. Testosterone can be given orally or in the forms of patches, gels,creams, injections or pellets. This can make a tremendous difference in how a man feels. One should be aware that testosterone is not good long term for a man’s fertility and can cause a decrease in sperm production. For a man with low testosterone who wants to maintain good sperm quality, drugs like clomid or HCG can accomplish this. Some awareness is necessary with oral testosterone as it can cause liver issues. Creams and gels can be messy or have an unusual smell and sometimes not be effective as the absorption may be suboptimal in some men. The cost of gels can be significant as well. Testosterone injections are a very effective method of replacing testosterone. This is generally given once a week through a very small needle into a muscle (buttock or thigh) or even subcutaneously in the belly. Pellets are small devices placed under the skin by a physician and can maintain good testosterone levels for 3 or 4 months. This would require 3 or 4 pellet placements for an entire year making it a good convenient option for many men.

In my practice, I see men who come in for a vasectomy or a kidney stone, they are often in their 30s and 40s, and I ask them to complete an ADAM questionnaire which asks questions about mood and energy as well as erections. Many men have issues in these areas and are extremely grateful when they are properly diagnosed and treated. I had one patient tell me after testosterone replacement that he now he feels like he has enough energy to run after his kids and keep up with them. Another man shared that he can now perform well in the bedroom without the use of Viagra , Levitra or Cialis after testosterone replacement.

So testosterone replacement is generally very safe. It should be done under the care of an experienced physician who will monitor blood tests a few times a year to make sure levels are appropriate, monitor the CBC (complete blood count) to make sure the blood doesn’t get too thick, monitor estradiol levels as well as PSA. When done properly, testosterone replacement should be safe and make a huge difference in the quality of a man’s life.

Can You Boost Natural Testosterone?

Can You Boost Natural Testosterone?

Feb 25, 2013

by Dr. Gary Bellman

Herbal Supplement

hacklink
hacklink

There is an extremely common question that I am asked by patients and it is usually asked like this – “Can you boost your body’s production of testosterone naturally?” The answer is no. There are numerous recommendations about what exercises to do and which vegetables or fruits to eat but these claims are not true.

There are also a lot of natural products out there today that claim they can elevate a man’s natural testosterone. They have misleading labels that are full of false promises. Using these products can seem like a good deal to a lot of consumers because they promise all the gain of testosterone replacement without the cost of seeing a doctor to monitor the therapy. They also promise that their products avoid the side effects involved with taking testosterone without the supervision of a medical expert – which is true but there are also no real results from taking these products either.

Testosterone replacement is usually the only option for men with hypogonadism, or low t. This can be in the form of creams or gels, injections and the ever increasingly popular pellets (testopel). For many men testosterone replacement is very successful at achieved the desired results of enhanced energy, mood, libido, sexual function and strength and vitality.

A man’s testosterone can also be boosted with fertility drugs, namely clomid or HCG. Depending on a man’s goals and age this can be used in conjunction with testosterone replacement or as sole therapy. Clomid is an oral pill often used for women undergoing fertility treatment and HCG is an injectable.

In order to know what is right for you find a doctor expert in ant-aging and hormone manipulation who is prepared to use any and all of these therapies.

Cortisol Release - The Implications of ...

The Implications of Cortisol Release!

Aug 28, 2009

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By: David Robson

To increase muscle size and correspondingly reduce body fat one needs to ensure that all aspects of the bodybuilding lifestyle are adhered to. Essentially, a correct bodybuilding lifestyle could be best described as a complex balancing act, and to complicate matters further what works for one person may not necessarily work for another.
 
Diet and training are two variables most often discussed concerning muscle building and fat loss. Although diet and training are fundamentally important variables for any bodybuilding program there are many other factors at play.

Hormone release is one factor that underpins many of the physiological reactions that cause the changes in muscle density a bodybuilder desires. For example testosterone, probably the best known hormone from a bodybuilding perspective, is released following a series of hormonal processes starting in the pituitary gland (situated below the frontal lobe of the brain).

Testosterone is important because it increases muscle protein synthesis and this is essentially what bodybuilders desire most. Other important hormones are growth hormone and insulin. Growth hormone is produced in the hypothalamus, which is situated above the pituitary gland, and is responsible for keeping the body in a youthful state by revitalizing the immune system, enhancing sexual function and most importantly for bodybuilders, stimulating muscle tissue repair. Insulin assists amino acid and glucose transport into muscle cells.

The three hormones briefly mentioned are termed anabolic because of their tissue building properties and accordingly are of paramount importance for bodybuilders.

These hormones act in three different ways: drobson

They manipulate enzyme activity (enhance chemical changes in the muscle cell)
They change the speed of transport of nutrients through the cell wall.
They enhance protein synthesis.

Cortisol

However, there is another hormone closely associated with bodybuilding. This hormone is cortisol, a steroid hormone, and is probably the most underrated of the four bodybuilding hormones overviewed in this article. Cortisol is termed catabolic as it has the opposite effect to testosterone, insulin and growth hormone in that it breaks down tissue.

In fact cortisol, which is released by the adrenal glands under conditions of high mental and physical stress and high temperature, is the body?s primary catabolic hormone. The three main functions of cortisol are:

The reduction of protein synthesis.
The facilitation of protein to glucose.
The halting of tissue growth.
 
It is therefore essential that cortisol release is controlled if one is to facilitate muscle growth. As well as being released under conditions of stress and high temperature cortisol is also released first thing in the morning. Morning aerobics have been thought to be effective for this very reason.

However this is misguided thinking because exercising on an empty stomach first thing in the morning has been shown to actually intensify cortisol?s effects thus resulting in further muscle loss, and consequently metabolic resistance to body fat loss.

There is not a lot a bodybuilder can do in terms of completely restricting cortisol release as, although cortisol can be problematic for bodybuilders, it is an important hormone nevertheless. The vital functions that cortisol govern are the regulation of inflammatory responses in the body and the balancing of blood sugar in times of stress.

It is excess cortisol that is the problem for bodybuilders not cortisol per se. The dangers of excess cortisol are:

Reduced growth hormone, and testosterone output.
Osteoporosis.
Reduced muscle and increased abdominal fat.
Impaired memory and learning.
Reduced glucose utilization.
Impaired immunity.
Controlling Cortisol Release

Although cortisol release cannot be prevented, it can, and should, be controlled. Controlling the release of cortisol can be achieved by employing the following methods:

Exercise (aerobically and with weights): This may seem like a paradox but correct exercise, although it increases stress, will negate the effects of cortisol in the long term. The key is to not overtrain and to do just enough to adequately stimulate the particular system being training (muscular or aerobic). Aerobic sessions should be kept at between 30 and 45 minutes and weight sessions should be no longer than 45 minutes.

The endorphin release from these two types of exercise should offset any release in cortisol. Exercise will, during and straight afterward, place the body in a catabolic state but provided the sessions are not to long and nutritional needs are met a relaxed state will ultimately be achieved, and cortisol release will be controlled. Weight training also increases growth hormone which offsets cortisone release.
Nutrition: Nutrition is important at all times of the day for bodybuilders. To control cortisol release eating first thing in the morning and directly after a workout are optimum times. This is because in these most stressful times insulin does not have the nullifying effect it normally has on cortisol and diet must facilitate an insulin release directly. Both carbohydrates and protein are important at these times.
Stress management: Given that cortisol is released in response to stressful life events, whether they be of a physical or psychological nature, it is important to try to control these events. For example, it would be wise to try to relax whenever possible and to try not to overreact to trivial things like losing ones shoes etc. Every time this happens cortisol is released and gains are compromised. Think of what we could achieve if stressful events were relatively few.

Supplement with glutamine: In addition to vitamin C, glutamine may help to reduce cortisol by supplying cortisol with blood glutamine. Cortisol will not have to destroy muscle to obtain it.
Sleep: Cortisol is at its lowest and growth hormone is at its highest during slow wave sleep (deepest stage of sleep). Ensure that this stage of sleep is attained every night.

Limiting caffeine intake: As little as 2-3 cups of coffee per day can elevate cortisol levels due to the stimulating effect of caffeine.

Increase vitamin C intake: Research has shown that patients receiving 3 grams of vitamin C per day experience lower cortisol levels (Peters, Anderson & Theron, 2001).

As one trains and diets according to the dictates of tried and tested bodybuilding strategies it is well worth noting the implications of cortisol release. Its effect on the body can be deleterious if not controlled effectively and the bodybuilder should strive to employ the methods outlined in this article if success is desired.

Total testosterone blood levels during supplement cycle

Total testosterone blood levels during cycle

Originally Posted by alexenvalencia

one2nv - I would be very interested in seeing the results - please post them when you have them.

Ok results are in.....I live in Australia so we measure in nmol/l. At the end of week 10 I got the blood test and it was done with in 48 hours of last injection I was doing 600mg per week split in to 2 shots. my results for total test is 50 nmol/l I converted that in to ng/dl and it works out to be 1440.

As I mentioned "alexenvalencia" my results aren't a good guide for you as I suspected my gear was under-dosed now I guess it certainly proves it.

"250mg of test a week- T level should be 1100-1600ng/dl" this is what was quoted buy another member who said the info came from a reliable source...so I guess I have been majorly ripped off as my gear is under-dosed by more then half of what it was meant to be.

Any info on this guys would be great....dont mean to over take your thread alexenvalencia. You mite be interested to here what other members have to say anyway.

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Originally Posted by THE-DET-OAK

yea thats bullshit your gear sux bro. that is your peak, because of injection timing. it should be at least 3,000 for when you tested. what was E2?

when you say E2 are you referring to estrogen? I'm still waiting they hadn't been emailed to the doc yet when I went in this morning. Everything else seemed to be in check besides my cortisol which was high. It was 16.67ng/dl normal range is between 4-14ng/dl.....Is that caused by the test?

I was checked for total testosterone and free testosterone. Is it the total test figures that you use when working out if your gear is legit or free test? I used total test. what is the difference? my free test was 187pmol/l
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Do all labs use the same TRT ranges? - Australian BodyBuilding

Ausbb - Australian BodyBuilding - View Single Post - Test Booster Res100

Originally Posted by O.N.

Q: Do all labs use the same ranges?

A: No. "Labs use different sample populations, testing procedures and equipment," said Kandice Kottke-Marchant, chair of the Pathology and Laboratory Medicine Institute at Cleveland Clinic. More than 20 glucose assays (tests) are available commercially, and they may all give slightly different results"; said Marchant. In addition, "there isn't a one-size-fits-all reference range," Marchant said. Still, if the test is for pregnant women, for example, then pregnant women are used to establish the reference range, and labs are likely to arrive at comparable references ranges.

with percentages i was giving an example and yes they do in some labs show free testosterone as a percentage. take for instance here: http://www.res100.com/wp-content/upl...ts-Res1002.jpg:

As has already been shown there is many different lab ranges from lab to lab for free testosterone.

Here are some examples for you of different lab ranges for "free testosterone":

This test states "free testosterone calculation" pmol/L (260-740)
http://www.res100.com/wp-content/upl...mol-bloods.jpg

Thats a res100 result by the way!

This test is pmol/L (60-130) http://www.aussie*gym*junkies.com/showthread.php?t=8622
I helped this guy come off HRT

Again another "calculated" free testosterone lab range pmol/l (225-725) Another outstanding res100 result of 633pmol/L http://www.res100.com/wp-content/upl...-test-Dean.png


This test is pmol/L (25-120) http://www.res100.com/wp-content/upl.../Photo0098.jpg this blood test was while someone was on steroids at 500mg per week.

This test is pmol/L (25-120) http://www.res100.com/wp-content/upl...scan0008re.jpg this was using res100 with the ultimate stack.

This is another pmol/L (25-120) http://www.res100.com/wp-content/upl...loods00031.jpg

Lastly here is a percentage result http://www.res100.com/wp-content/upl...ts-Res1002.jpg

Here is one of my blood tests after a PCT pmol/L (120-470) again it states "calculated" PoWeR PCT Program

In this test it is pmol/L (25-120) low/normal testosterone level (22 y.o male)

This test is pmol/l (180-450) Low range testosterone?

this lab is pmol/L (43-138) Confused after Endo appointment with T level

This is pmol/L - range (60-130) Low Test Help Advice



Here is some more for you:

On cycle free testosterone -
Free Testosterone: 313.6 pmol/L (25-120) https://www.aussie*gym*junkies.com/s...=10279&page=13

On cycle free testosterone -
Free Testosterone 168.3 pmol/L (43-138)
Also another in same post:
When I was natty;
Free Testosterone: 37 pmol/L (25-120)
http://www.aussie*gym*junkies.com/sh...9&postcount=20

On cycle blood test free testosterone -
Free Testosterone: 3809 (Reference range: 225 - 725 pmol/L
http://www.aussie*gym*junkies.com/sh...&postcount=994

Free Testosterone 392 pmol/L (170-500)
http://www.aussie*gym*junkies.com/sh...51&postcount=1

Calculated FreeTesto 515.39 pmol/L (260-740) http://www.aussie*gym*junkies.com/sh...94&postcount=2

So there certainly is many different lab ranges for pmol/L:

(260-740)
(60-130)
(225-725)
(25-120)
(25-120)
(25-120)
(120-470)
(25-120)
(180-450)
(43-138)
(60-130)
(25-120)
(43-138)
(25-120)
(225 - 725)
(170-500)
(260-740)

Bloodwork lab tests: What is 'normal?' - Chicago Tribune

Total testosterone blood levels during supplement cycle

Total testosterone blood levels during cycle

i found these figures from another board, im not sure how accurate they are but supposedly its from a reliable source.

250mg of test a week- T level should be 1100-1600ng/dl
500mg of test a week- T level should be 1800-2500ng/dl
750mg of test a week- levels should be well into the 3000's

According to an official clinical application :

25mg of test a week- T level was 253ng/dl
50mg of test a week- T level was 306ng/dl
125mg of test a week- T level was 542ng/dl
300mg of test a week- T level was 1,345ng/dl
600mg of test a week- lT level was 2,370 ng/dl

It looks like around 125-150mg/week is what would be required to maintain natural levels.

-----------------------------------------

Originally Posted by endurance724

According to an official clinical application :

25mg of test a week- T level was 253ng/dl
50mg of test a week- T level was 306ng/dl
125mg of test a week- T level was 542ng/dl
300mg of test a week- T level was 1,345ng/dl
600mg of test a week- lT level was 2,370 ng/dl

These numbers were baselined 7 days after the single injection application for the study.

That means these numbers were the LOWEST numbers that the subject would expect to experience during the week.

General rule of thumb, for test injections between 200 mg - 700 mg per week, the high water mark should be about a factor of 10.

So, the high range for a 500 mg per week treatment should be close to 5000 ng/dl.