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What Are The Causes Of Low Testosterone And How Is It Treated?

Posted on Thu, 13 Jan 2022

Question: I am 68 year old male with a 10 year or more history of low T. About 5 years ago, I did a work up with an endrocrine specialist that did tons of blood work after finding a small pituitary tumor. The decision was no treatment required but keep watch. I had my last MRI about 3 years ago no change. I was using Anedrol underarm and keeping my T at about 300 up from like 125...but had to come off the gel because of insurance to a shot every two weeks of 0.5 ml. My T was about 280 a year ago on shots..concern was Hemocrit about 51.
Now insurance approves gel with a couple of low levels...so I waited till the end of each two week period before my next shot and did a blood draw...results were 154 and this week 45. My Hemocrit level 46 and Hemoglobin 16.2. Should I have another MRI or just getting older and need more T??? What would you believe given my inputs?

My sugar a little high at 107...otherwise all blood work okay

Thanks

Answered by Dr. Mirjeta Guni (4 hours later)

Brief Answer:
About low testosterone causes and treatment;

Detailed Answer:

Hello,

First i would ask for some more information regarding to pituitary adenoma; was it micro or macro adenoma (was it under or above 1 cm)?
Did it produce any hormone or was non functioning?
Secondly, what is the dose of testosterone injection you applied during the last month?
Do you have symptoms of low testosterone lately?

Will be a pleasure to help you further.
Kind regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Mirjeta Guni (2 hours later)

1/2 cm or less.

Non functioning

Not sure if macro or micro, must be micro

100 mg 2 times per month

I have virtually zero sex desire and tired in mid afternoon.

I exercise and 6’1 205 lbs

Thanks

Answered by Dr. Mirjeta Guni (15 hours later)

Brief Answer:
about pituitary adenoma and low testosterone :

Detailed Answer:

Hi,

If you need another MRI it will depend on the symptoms and clinical examination (headache, visual problems, breast enlargement etc.)
If there are signs or symptoms suggesting enlargement of the adenoma, the MRI should be repeated. If it has been over 1 cm, MRI should be done despite the clinical symptoms.
Regarding to low testosterone, you should know that testosterone injections do not have a flat curve of action. There are up and down levels that will be improved while returning to gel form.

Hope the information will help.
Best wishes,
Dr.Mirjeta

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Raju A.T