
Suggest Treatment To Lower Testosterone Level In Blood While On Celebrex And Toradol

Celebrex or Mobic for anti-inflammatory and six weeks ago added Toradol . He also takes 15 to 20 mg Valium at night.
He drinks alcohol socially and will have of their lunch at work. He is 24 1/2 years old, highly motivated . He is 6 foot two and his weight has gone from 230 two years ago to 260 pounds.
He has trouble losing weight, due to inability to work out ...
He graduated college a year ago and began his first job. He is very driven and successful and under stress. He has had some difficulty with sleep . He also has had steroid injections in his spine over the years. The last injections were one year ago . At that time he became rather cushingoid and so has avoided any more injections. XXXXXXX and me are all of these things cause his low testosterone? Can he raised his testosterone significantly If he is able to lose weight? He is considering testosterone treatment. Thank you
Please do a repeat fasting testosterone level .Not to start replacement now
Detailed Answer:
Good day,
Noted your concern. I am an endocrinologist and would be glad to answer your question. Testosterone is a pulsatile hormone secreted by testes under the influence of a pituitary hormone called as LH. Levels of testosterone is variable throughout the day. The levels are best in the mornings. May i request for a repeat fasting blood sample of testosterone ( between 6 to 10 am). If that is low, then he should have test like fasting LH, FSH, TSH, Free T4, Prolactin, SHBG, Albumin and calculated free testosterone. This is essential to find the cause of low teststerone. Many a times a repeat sample can be perfectly normal. In obese people, total testosterone is often low.
Without finding out the cause of testosterone, please do not start treatment with Testosterone replacement.
Yes, by losing weight, testosterone values can be improved. The steroid injections which he had also can cause low testosterone levels. At this stage, my request would be to get an early endocrine referral. Examining the patient , in particular the testes size is very important. As you correctly mentioned, if the testosterone is low, we should also get a bone density scan ( DXA scan).
Glad to answer more.
Regards
Binu

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