Remembering Kevin Moore

Low Testosterone Levels Possibly Contributing To My Infertility, Fat Loss Struggles

It’s certainly getting a lot more interesting in the ongoing saga of trying to figure out this human body I was born with. And while I knew there were certain parts of it that were messed up for various reasons, it seems I didn’t know just how out of whack it actually was for probably my entire life. You’ll recall a few weeks back I shared my thyroid panel results after 8 years of low-carbing and the numbers didn’t really scream that there was a big issue there. So the physician I’ve been working with has done an amazing job trying to zero in on exactly what is happening with me and it looks like he may have finally stumbled upon the root cause of my infertility and recent fat loss struggles.

This outstanding doctor (who will remain anonymous for now since this is an ongoing issue that hasn’t yet been resolved) decided to run an “Expanded Male Hormone Panel” saliva test identifying the various levels of the sex hormones in the Androgen Pathway. While I’ve had a couple of blood tests conducted on these things over the past few years when Christine and I went through our failed IVF cycle in 2008 and then again for the embryo adoption process that resulted in losing our pregnancy with twin babies in 2011, I’ve never done a saliva test measuring these same hormone levels. Both tests are critical in identifying what exactly is happening with the hormones going in and coming out.

As I understand it, the blood test determines the uptake of the various hormone levels and the saliva test shows the other end of the hormones. Both are vitally important to know if these hormones are playing the role they are supposed to in the body. After filling up a vile full of spit that took about a half hour to fill and sending it off to a Tukwila, WA-based lab called Diagnos-Techs, Inc. a couple of weeks ago, the results are in…and there’s DEFINITELY something screwy going on here.

See the results for yourself:

Click on the image above to enlarge

As you can see, my numbers are a bit “off” to say the least. And it centers around testosterone levels clocking in at an abysmal 47 in this saliva test. Combine that with the 572 ng/dL testosterone results I got in my September blood test (with a range of 348-1197), there’s something wrong with the way my body is utilizing and processing testosterone. When I asked my doctor whether there’s anything I’ve done to cause this, he revealed that it’s very likely I’ve had this issue my entire life and simply inherited it from the genes my parents passed on to me. Gee thanks Mom and Dad!

Of course, when one hormone like testosterone is off kilter, that throws other ones out of balance too. The luteinizing hormone (LH) measured in this saliva test was 39 uIU/mL (normal range is 10-25) which is much higher than the LH blood test that clocked in at 7.7 mIU/mL (normal range 1.7-8.6). Of course, it’s not all bad either. DHT, estradiol, and estrone were all outstanding according to the physician I’m working with. But those good numbers are probably all a result of my low testosterone levels which is not-so-good. It’s tricky trying to figure out how to adequately improve testosterone without messing up these others. Did I mention these hormones are all wickedly interrelated?

You might be asking “Why is raising testosterone levels so important?” That’s an excellent question and it’s one my fellow health pioneer and Paleo blogger/podcaster extraordinaire Robb Wolf addressed in an epic blog post he wrote last month entitled “Paleo and Testosterone.” Take time to read and absorb all the information there when you have a chance. It’s a lot more technical (translated: “nerdy”) than what I’m sharing here today, but incredibly invaluable. In fact, it was that post that got me to seriously start taking a look at whether this was MY problem. It turns out this could be EXACTLY what I’ve been dealing with regarding low sperm count and motility and my struggles to lose body fat around the middle of my body in recent years when my legs and upper body look completely normal. I’m trying not to get too excited about this just yet, but the sense of at least knowing what is going on and attempting to do something about it has me more ecstatic than I’ve been since losing 180 pounds on low-carb in 2004.

What is my next step in this journey? My doctor is putting me on a customized testosterone cream that I will be applying daily to my inner thigh in an effort to increase testosterone production in my body. This will have an impact on the other aforementioned hormones, so the dose will be low until we know how it is impacting me. To keep DHT levels in check, he recommended I start taking saw palmetto extract along with the testosterone cream. I cannot wait to see the positive changes this treatment is expected to produce in just a matter of weeks if it does what we think it will.

What is supposed to happen if my testosterone increases as expected until the best-case-scenario circumstances? Increased libido, lower body fat, greater muscle growth, better energy levels, and a whole host of other “manly” reactions. Of course, he did warn that if testosterone levels go up too much, it could manifest itself in changes in my mood that would make me more irritable and grouchy. When I told my wife Christine this, she said, “Yeah, so what else is new?” Ahhhh, gotta love my honey keepin’ it real!

Since I’ve been engaging in a solidly healthy low-carb Paleo plan for a while now along with regular resistance training with a personal trainer at my local gym in 2011, I cannot help but think that this testosterone cream is going to be a critical piece of the puzzle that will get me leaner and stronger than I am currently. As hard as I’ve been working at the gym in 2011, I should be a whole lot more muscular than I am and shedding body fat instead of storing it. Don’t get me wrong, I am stronger with more upper-body muscle growth in my arms, shoulders and chest…but how much more muscle will I be able to have in 2012 if this new testosterone protocol works like we think it will?

The next step is getting the testosterone cream ordered and started within the next couple of weeks. I’m turning 40 on December 27, 2011, so this should be an interesting turn of events that could play a huge role in the future of my body and health. Again, I’m trying to temper my excitement about this, but I nearly cried when I heard that this might be the missing link for me. Of course, if I get my testosterone levels raised, that crying crap will be history. HA! Just kidding.

As always, I’ll keep you informed about what is happening with the testosterone cream treatment in the coming months and whether it is working or not. It’s possible that I will need to use this testosterone cream for the rest of my life to get my levels where they need to be. We’ll know more about that soon. I assume we’ll see some incredible benefits from this that will manifest itself rather quickly. We shall see. I welcome your feedback and experience on this issue in the comments section below.

12-12-11 UPDATE: This was fortuitous timing in light of this blog post about my low testosterone: “Low Testosterone May Affect Insulin Sensitivity” details research showing a distinct connection between men with low testosterone and metabolic issues including decreased insulin sensitivity, Type 2 diabetes, lack of muscle mass growth, and an increase in fat mass. Therapies designed to increase testosterone (like the cream I will soon be taking) will likely reverse most of these issues as “an important avenue” towards healing the damage that has been done. Now I’m REALLY starting to get excited.

  • Phil Bennett

    Good luck Jimmy.  You deserve a break.

    • Anonymous

      THANKS buddy! Wouldn’t it be awesome if THIS was it after all these years?

  • Howard Lee Harkness

    Be careful about assuming that you have “finally found the problem.” At this point, I have been through “finally finding the problem” for about 10 different problems. It’s definitely possible to have more than one problem.

    Which reminds me, I need to do the next instalment of my low-carb journey series on my blog.

    BTW, thanks for turning my attention to Dr. Wahl’s video. Did you make any changes as a result of her advice, and if so, did you notice any differences?

    • Anonymous

      Never said I found the problem. But I do think this is one step closer to finding the problem, Howard. I too have had the same struggle going through this, that and everything in between. But this is the most promising of everything I’ve endured so far.

      Looking forward to talking to Dr. Wahl on my podcast soon…I’m already doing many of the things she suggests.

  • Anonymous

    And I would venture to guess that there are a LOT of people walking around out in the real world with off-kilter hormones that are making it more difficult for them to attain optimal weight, health and fitness goals. But lack of willpower to change or some behavioral issue is usually blamed instead.

  • Anonymous

    I’ll be testing regularly myself now that I’m hitting the big 4-0 this month.

  • Howard Lee Harkness

    By the way, the “finally found the problem” idea has been the fodder for countless diet-guru-wannabees with MDs who find something that appears to work, and immediately assume they have all the answers. (*cough* Ornish *cough* McDougall *cough* *cough*). I’ve gotten to the point that I am very skeptical  regarding monomaniacal diet-guru-wannabees (especially MDs), even if I find myself substantially in agreement with them. For instance, Dr. Su is monomaniacal about carbohydrate restriction. Dr. Davis is monomaniacal about wheat. I think they both have some valid and important information to give, but I doubt either of them has the whole picture, which is probably too complex for one person to get anyway.

    • Anonymous

      Indeed. I’m cautiously optimistic about this protocol I’m about to embark on. If it works, great. If not, then it certainly puts me one step closer. THANKS for your insightful comments, Howard.

  • God speed your testosterone. I hope this IS the answer for you. We will know as soon as Christine is pregnant and your blog is called “Livin La Vida Roid Rage”.

    • Anonymous

      Hahaha! Too funny.

  • Jimmy,
    I have a good feeling here, I think within a year you’re going to see some amazing changes. This seems like the final piece to a complex puzzle that you’ve been working on for years, and now you have the big picture of how it all goes together. Low T can definitely be a big problem with regard to body composition, and dialing that in will probably have some big results.It’s amazing to me that you have the courage and openness to share such intimate details of your life and health with so many people. I feel like we all kind of have a stake in your journey now. Best of luck, and I hope you see some positive changes in the coming new year.

    • Anonymous

      And if sharing my journey helps encourage just one person, it’s worth it all.

  • Anonymous

    Never stop learning Susanah!

  • Anonymous

    I appreciate your support Dianne. 🙂

  • Eileen C

    Tried to post this on your thyroid blog post, but it wouldn’t stick.

    Jimmy, what is the lab-given range for Rt3? Also, I strongly suggest you
    go here: http://www.stopthethyroidmadness.com/rt3-ratio/ and look at
    your RT3 ratio. If it’s below 20, you have a definite thyroid problem.
    Also, if your Free T3 isn’t near the top of the lab range, and your Free
    T4 just above the midpoint, you are also hypothyroid. Don’t let your
    doctor tell you otherwise. Most doctors don’t know jack about
    hypothyroidism.  It was your podcast that introduced me to Janie
    Bowthorpe’s Stop the Thyroid Madness. I have suffered from hypo symptoms
    for 20+ years and doctors kept telling me I was normal. Then, thanks to
    your podcast with Janie, I realized it WAS a thyroid problem. Now I
    know what to do, and how to do it, and am teaching my doctor as we go
    along. I urge you to leave no stone unturned on this. It can make a huge
    difference.  BTW, despite years of eating lowcarb/paleo, my weight
    wouldn’t budge — until I got thyroid treatment.

    • Anonymous

      No saying the thyroid isn’t an issue…but perhaps getting the testosterone fixed will fix the thyroid concerns as well. I’m well aware of Janie’s work and it’s definitely a big piece to this ever-complex puzzle. THANKS for your input, Eileen!

      • montmorency

        All due respect Jimmy, but it could equally work the other way round and fixing the thyroid might fix the testosterone.

        Is testosterone likely to drive the thyroid, or is the thyroid likely to drive testosterone?  I know which I think is more likely.

        • Anonymous

          This is true, Mont. At this point, we don’t know until we try something. The doctor I’m consulting who I greatly respect wants to go this route. We’ll see how it goes.

  • Anonymous

    I can’t imagine where I’d be with this had I not gone low-carb in 2004.

  • Can’t wait to hear how this goes for you, Jimmy! Please do keep us posted. 

    • Anonymous

      Oh, you know I will. 😉

  • Linda

    What’s the difference between testosterone cream and a testosterone injection?  Do you know why you’re getting the cream and not the injection?

    • Anonymous

      My doc recommended the cream since it absorbs quite well. We’ll see! He said its better than the patch and the injection isn’t necessary.

  • Zorik

    Good luck Jimmy!  I am 30 year old male and I too have very low testosterone levels. Total testosterone of 288! I tested it with my naturepath just out of curiosity because of my lower energy, horrible sleeping and stubborn stomach fat that I been dealing with for years. I am thinking of seeing an endocrinologist to take further comprehensive tests like you did. Keep us updated:)

    • Anonymous

      Let me know how you do Zorik!

  • Meghan

    I love your honesty and the sincerity which shines through in your writing! Good luck!!

    • Anonymous

      Thank you Meghan. I so hope MY story can help others with their health journey.

  • Lynn

    Jimmy. I pray this will help you and your wife to conceive and  this will improve your health. If you know ahead of time that Testosterone may cause grouchiness, you can head it off at the pass and stop yourself… We women have to when PMS rears its ugly head. I am so glad to be done with that. My testosterone level is low also. I used cream for a little while. It nauseated me with in seconds, so it does absorb fast.

    • Anonymous

      I can’t wait to get started on it. 🙂

  • Cushie Diva

    Have you had your cortisol levels tested Jimmy? Hypercortisolemia can cause low testosterone, insulin resistance, diabetes, high cholesterol, effects fertility, fluctuations in thyroid levels, and it can also derail your low carb diet.

    • Anonymous
      • Cushie Diva

        That night time cortisol range was listed as 1-3 nm, So a 5nm cortisol level at night is a bit suspicious , especially considering that it’s higher than your afternoon levels……..
        Was that a salivary cortisol or a serum cortisol?

        • Anonymous

          Yes, I realize the night reading is high…saliva test.

          • Cushie Diva

            If the testosterone cream doesn’t work, I’d ask for another salivary cortisol test and a 24 hour urinary free cortisol. Your history warrants a second look. God bless

            • Anonymous

              I’m hoping they’re all interrelated and that getting testosterone where it needs to be will normalize most of these other hormones. THANKS again for your input!

  • Jimmy do you think it’s possible that to fuel a small amount of day to day life, the personal training and volleyball, that glucose is needed.  To get glucose, cortisol is released to begin gluconeogenesis.  Then the increased need for cortisol uses up steroid hormone precursors such as pregnenolone/progesterone, leaving less for production of testosterone.  When combined with modern stressors this could get ugly.

    • Anonymous

      Interesting “premise” (all pun intended, Steven) with what you’re saying. The short answer is I don’t know. But I’m sure doing my darndest to figure out the answer. 🙂 THANKS for your input!

  • If I where you, I would have a little chat with Robb Wolf and Chris Kresser (you know where to find them;-) ). I know they both dived deeper into this subject. Be careful with hormone creams and hormone replacement therapies, it could make the situation worse. VBR Hans

    • Anonymous

      Thanks Hans! The physician I’m consulting is one of the top in the biz…I trust his judgment on this. And I’ll be sure to share all the good, bad and ugly about what happens for me.

  • Whyfishbite

    Keep us posted! !! Good luck!!!

    • Anonymous

      Oh, I will. 🙂

  • Adam Kosloff

    Rock Jimmy! Fingers crossed that this leads to good results. At the very least, I bet it feels like a relief to name the problem. Hopefully other LCers and Paleo people who get stuck will read your account and be inspired to start thinking/working with their docs to ID what’s screwing up their hormone/enzyme balance instead of simply cutting carbs/calories and logging more hours on the treadmill.

    • Anonymous

      That’s the goal. 🙂

  • http://carnivorehealth.squarespace.com/main/2010/9/16/low-protein-diets-longer-life-decreased-cortisol-more-testos.html
    ‘The significant negative correlation between protein and resting T concentrations is consistent with the findings of Anderson et al. (2), who demonstrated that a low-protein diet (10% of total energy) was associated with higher levels of T compared with a diet higher in protein (44% of total energy)’
    ‘Testosterone concentrations in seven normal men were consistently higher after ten days on a high carbohydrate diet (468 +/- 34 ng/dl, mean +/- S.E.) than during a high protein diet (371 +/- 23 ng/dl, p less than 0.05)’
    ‘In contrast, cortisol concentrations were consistently lower during the high carbohydrate diet than during the high protein diet (7.74 +/- 0.71 micrograms/dl vs. 10.6 +/- 0.4 micrograms/dl respectively, p less than 0.05)’


    • Anonymous

      Sure glad I don’t eat a high-protein diet!

  • looking at your hormone levels, I believe that taking testosterone will not make any difference (at least in the fertility department) your problem lies further up the line and may well be rooted in your very-low-carb lifestyle.

    I recently read your problems with almost passing out during workouts. That fits perfectly with your hormone panel, which suggests that due to the lack of a readily available energy source (and probably constantly depleted liver glycogen stores) your body is so reliant on the production of cortisol (if you do a 24h test, you will either be low or normal on all panels, because cortisol gets priority before test, and the other hormones; the classic highs and lows on the other hand will probably be absent) to keep his blood sugar levels at a level that will prevent you from passing out.

    with most of your already low hormonal production being diverted into this direction there is little left for your testosterone. Your DHEA is low as well (and that certainly wont help you lose the fat)…

    but all that being said, have you ever had your GH and IGF-1 tested? They will be bottomed out by now (after years on low to no carb; there is a study by Phinney on this one – allgedly combined with a severe caloric restriction)… but I am digressing here, check out the following review on the role of MAPK in spermatogenesis and (more importantly) function of mature sperm > http://www.ncbi.nlm.nih.gov/pubmed/19467295 and understand that IGF1 is what induces MAPK expression and yet is commonly overlooked when it comes to infertility. For a brief discussion of the context check out > http://content.karger.com/ProdukteDB/produkte.asp?doi=10.1159/000182566

    and if you still insist that you cannot raise your carb intake to sane levels (100g per day as a starter), you may at least want to take a smarter approach to restore your hormonal balance than just throwing in some test at the lowest level of the cascade. Pregnenolone, for example would be my personal first choice, in your case… if you are lucky that will refill THE WHOLE hormonal cascade.

    Kind regards

    Adel aka Dr. Andro, a fan of the show, though or maybe because I do not agree on all the messages you are sending 😉

    • Anonymous

      I appreciate your input. Yiu may be exactly right that this issue may not I prove with the testosterone. But I trust this doctor I’m working with. I do disagree that 100g carbs is “sane” for everyone but I’m constantly learning and sharing what I discover.

  • Anonymous

    Most people aren’t eating “no carb” but I hear ya. This is a topic I’d love to explore further in a blog or podcast sometime. Can you email me at livinlowcarbman@charter.net sometime to discuss your thoughts about how and why people should make the transition? Sounds fascinating. Talk after the holidays. 😀

  • Anonymous

    Hi Jimmy, I am glad that you have been getting some answers to your questions. If there is just one thing I may suggest to you. Please do not start taking the Testogel/Androgel without considering ALL your other options. I am only 38 years old and I have been on Testosterone (sustanon and Testogel) for the last 10 months. It is NOT a magic bullet and certainly can cause more problems than it addresses. I am 3 days into stopping TRT hoping and praying my body can start making it’s own Testosterone. I would not wish the way I feel upon anyone.. I was diagnosed with a damaged pituitary i.e secondary hypogonadism causing my Low Testosterone.  I am happy to help either here publicly or via email.

    I am not touting a product or anything whatsoever, just looking to help any other guys that are suffering from Low T. It’s a miserable existence without help or hope. I also have thyroid issues because of my damaged pit gland. I was healthy 2 years ago. When you add in taking T your body has no feedback loop for exogenous T. You may feel worse than you do now. I will follow your progress and wish you all the best.

    • Anonymous

      I’m on a very low dose and under proper medical supervision. I’ve had various improvememts so far with little side effects after 40 days. Appreciate your concern but I’m keeping an eye on this.

  • Anonymous

    Hi Jimmy, So glad that you are getting the right follow up care. Its absolutely critical, I’m in the UK and had no follow up care, just put on Sustanon shots for 6 months, massive panic attacks were induced and I never had had a panic attack in the 30+ years before. I was told it’s not a side effect of shots. I switched to testogel and it stopped overnight! Hey, I bet cattle get better follow up care when being gave hormones!
    Unlike alot of guys with these problems I have never meddled in Steroids for bodybuilding etc. Things like estradiol can do odd things to a guy.

    I’m just glad that you are being monitored properly. My own feeling is that TRT is not always a quick fix..some people including MD’s think it is . IF administered properly it has great efficacy, but I have found to my own detriment this is not always the case. I had too much faith placed in the medical community. I think TRT is a life saver in the right circumstances without a shadow of doubt. I am glad that it is working for you, it definitely helped me get back to feeling 70% of the man I used to be. Just not sure if it will ever get the back to the 100% hence why I’m now on my 3rd day without TRT, going cold turkey. Gonna take a month or two. I can always go back to TRT,BUT the longer you are no TRT the harder it is to go back to your own endogenous T.

    Jimmy are you taking HCG too? I never did and you maybe should consider it (if you aren’t on it already?)  Also the fact you are on a low dose will still stop ALL your own natural T production LH & FSH will go to 0. That’s why I mention the HCG to keep your own testes ticking over. Just a thought to consider especially as TRT is normally for life. Hope this helps.. Please don’t think I am getting on your case. I just wish that someone had fully explained all this to me BEFORE I started TRT. Listening to my Endo would have gave anyone the impression that it “would be all things to all men” I’m just glad you are obviously well informed and it’s working out for you! That is indeed good news!

    • Anonymous

      I’m not on the injections…just a very low-dose testosterone cream. I wouldn’t do injections until the very last resort. I’m not looking for a quick fix….just normalization again. I’m recovering from workouts faster and that wasn’t even one of the reasons for doing this. BONUS! The physician I’m working with is someone I trust and I’m confident I will not be led astray. No, I don’t take HCG and don’t personally believe in the protocol. Like I said, my doctor is monitoring all of this and we’re running follow-up tests. Don’t mind the info…just know that I’m a big boy and I’ve got my ducks in a row on this. 😀

      • Anonymous

        Jimmy, I’m sure that you have done the required research and made an informed decision. I just wanted to put this out there for others that may read this and think that it’s perhaps a fix for them too. Maybe it is.. I think you personally are lucky to have a good doctor that has clearly covered the bases. Others may not be so lucky or not have done the ‘due diligence’. best wishes.