Just recieved my free Test test results. With a normal range of 7.2-23.0 I scored a OK 15.0.
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NorCalBdyBldr said:Hi Alan,
You said:
"Just recieved my free Test test results. With a normal range of 7.2-23.0 I scored a OK 15.0."
This is a bit "abnormal" in that your free (unbound) testosterone levels are mid normal range. However, from what you told me during our chat, your total (bound plus unbound) testosterone levels are at the very bottom of normal (323 ng/dl with a laboratory reference range of 280-800 ng/dl) even with your Androgel "testosterone replacement" therapy (I did warn you that Androgel is fairly useless and will likely only raise your blood total testosterone levels by about 50 ng/dl). Frankly, you would typically expect that free testosterone should also be low if total is low under normal circumstances. So this brings up some questions and theories as this descrepancy is suggestive of possibly one or more things.
The first theory goes something like this. There used to be a medical theory that you had a set number of hormone (androgen) receptors and that number never changes. That would explain why AAS work much better for some guys than for others right from the start and not very well for some others. Some people CLEARLY have a higher receptor density and therefore a greater ability to process and utilize testosterone. The higher the number of receptors, i.e. the higher receptor density, that you have, the more testosterone you can process. This WAS and still IS, to a large degree, the CONVENTIONAL medical thinking.
Now there are some more recent theories circulating out there that the receptor density is not fixed but can fluctuate to some degree--still largely dependent on the individual genetics though. So guys that have continuously higher levels of testosterone circulating in their systems MAY actually increase the receptor density as a biological response within their specific genetic limitations. Once again, some guys will be more genetically "gifted" in this department as well. From personal observation and information, I strongly suspect that this second theory is correct. Namely, that the receptor density CAN vary in response to long term elevation of testosterone levels. This seems to make intuitive sense from a biological perspective as well.
So in your case, following this second theory, it is suggestive that maybe because your testosterone levels have been so low for so long, that the converse is true--namely that your receptor density is also quite low because there is no need to process very much testosterone simply because there just isn't much available over the long haul. Your body has just simply come to a new equilibrium so that you only process enough testosterone so that your circulating levels remain at mid normal and therefore equilibrium. This new equilibrium is what in biology is called "homeostasis"--the body's biological tendency to establish and maintain equilibrium or the "status quo." In bodybuilding, we also know that homeostasis can be changed to new equilibriums but it takes a lot of effort to overcome this. It is usually referred to in terms of body weight as changing "setpoints" but does apply, not surprisingly, to all kinds of other things like body composition, etc. as well. Once a new "setpoint" is established, your body will want to return to this equilibrium very strongly.
Assuming that the second theory is correct concerning receptor density and ability to process testosterone, it can be inferred that your body has lost its ability to process testosterone much above its current equilibrium (total testosterone levels permanently on the low side). Again, assuming the theory is correct, administration of testosterone to maintain your total testosterone levels above the mid normal range would be expected to force the body to adapt and increase the receptor density and therefore improve its ability to process testosterone in a more "normal" way over time. Anyway, this is just theory but it does seem to explain some things that have been observed in HIV patients and some others (non HIV). For example, you likely will be exhibiting symptoms of low testosterone (like depression, etc.) even though your circulating levels of free testosterone are mid normal. Remember, your free testosterone is only "available" testosterone but is not being utilized at the moment. Your total testosterone includes the bound fraction which is what is actually being processed/utilized and your total testosterone is actually very much on the low side. So you really do have to consider BOTH numbers together to understand what is going on.
The other possibility is that your body has developed some sort of hormonal resistance. This is also common in people with HIV disease. Hormonal resistance, however, tends to be more general in nature--not just testosterone specific--when it is observed. So things to watch for as indicators would also include blood sugar/glucose levels, etc. as the body CAN also develop insulin resistance with HIV disease and long term treatment. In other words, your phsycian would also be testing and looking for the same types of things that one would expect, including trends, towards developing either type II (onset) diabetes or even type I (insulin dependent) diabetes. It is also WELL known that certain HIV drugs do seem to increase the likelihood of insulin resistance and diabetes (several of the protease inhibitors in particular).
Remember, testosterone levels, both total AND free, NEED to be maintained at levels above the middle of "normal" in HIV disease because you are not only interested in testosterone replacement but also you need to offset the extremely catabolic metabolic processes tied in with HIV disease as discussed in my previous posts. Remember this is still theory and as far as I know this theory has never been actually "proven" yet.
However, that being said, it should be noted that even before ANY treatments were available for HIV, a number of West Coast physicians, in particular, did actually notice that those HIV patients that did AAS as recreational or competitive bodybuilders did, in fact, live AT LEAST 3-5 years or more longer and fared better in the interim than those that did not do AAS. Part of this is attributed to the large increased lean body mass that recreational and competitive bodybuilders carry because of AAS and lean body mass is absolutely correlative with survival with HIV disease. Part of this is also attributed to the fact that in HIV disease AAS tend to reverse some of the negative metabolic problems associated with HIV disease AND actually boost the immune system as well--this being contrary to what is normally taught in medical schools about steroids being immunosuppressive. In actuality what medical schools are REALLY saying is that CORTICOSTEROIDS are typically immunosuppressive, which is absolutely true without any question at all. And corticosteroids are normally the ONLY steroids that are administered theraputically in the United States as a matter of practice--at least until recently. They don't teach much of anything about AAS because, until recently, AAS were rarely ever administered to patients in the United States so there was no need to discuss them. Unfortunately, most physicians, because of this, actually believe that all steroids are immunosuppressive. The truth is that in HIV, they tend to BOOST immunity. This may be due to the fact that they tend to drive the bone marrow to produce things like white blood cells, platlets, etc. which offsets the bone marrow suppressive effects of many HIV drugs. These, of course, are things that also tend to fight infection and heal the body. So this actually makes sense, since the improved "resistance" from administration of AAS to HIV patients has been clinically observed many times over. They also tend to improve overall energy levels which helps offset the natural fatigue that is common with HIV disease. This is not really surprising because of the simple fact alone that they greatly increase the red blood cell counts and therefore the oxygen carrying capacity of the blood among other things. This also counteracts the tendency towards anemia on many HIV drugs. And it is well established that people with anemia typically have fatigue issues.
Additionally, it has also been my definite personal observation that those patients that are receiving AAS for anti wasting therapy as well as significant testosterone replacement are CLEARLY doing better in terms of living with HIV AND quality of life issues as well (and I know of many cases that the patient's physician allows their blood testosterone levels to be quite high because clinically the patient is doing very well that way).
So there is some more information you can float by your physician for his consideration and for further points of discussion.
Richard85 said:do u have HIV, and if you dont mind me asking, how did u get it?
NorCalBdyBldr said:I am HIV positive and have lived with it for 20 years. My experience with it in a "nutshell" is:
After suffering years of symptoms, I finally progressed to a full blown AIDS diagnosis in 1993 along with a terminal malignant cancer diagnosis (biopsy proven) as well. I refused conventional treatment consisting of radiation therapy followed by intensive chemotherapy in 1993 as the oncologist said that "there was a 95% chance of the cancer returning within 3 months of cessation of therapy." I was expected to live no more than 1-3 years at that point. I told him that common sense would tell you that radiation and chemotherapy would likely suppress my immune system severely enough (especially considering how suppressed it already was) to allow HIV to finish the job while they are putting me flat on my back with projectile vomiting from the radiation/chemotherapy. I also told him that I had to somehow continue to work for a living to afford the health insurance to pay for his little scheme. I further added that "this is a quality of life issue, not a longevity issue the way I see it. If I am to die in one to three years, then so be it. I just don't have to make it the worst one to three years of my life and can try to make it as good as I can under the circumstances." So I never received ANY treatment for the cancer. My cancer progression stalled out before I was on any anti retrovirals even though my viral load was at 3.18 million virons per ml of blood. That was 1995. The immunologist asked me at that point "why are you still alive?" He also theorized that I would not live to see six more months. I had been on and off monotherapy for years but had not been on any drugs for the previous year.
I picked out a two combination therapy of available drugs which was not accepted at that time including the new experimental but not yet approved drug 3tc at that time and the immunologist thought that my reasoning was very sound and it was worth a try. It worked very well for me. The next year triple therapy came into play and things improved considerably. I made many changes to my life which also helped and the cancer went into full remission in 1997.
Unfortunately, the price of anti retroviral therapy caused me to develop neuropathy (the meds can destroy the sheathing of the nerves over time essentially causing the nerves to "short circuit" slowly making you loose control eventually as well) in the feet and slightly in the hands so I do not have much feeling in the feet and have no ability to sense hot or cold or pressure there either. Another side effect of the meds was extreme insulin resistance along with apparent damage to the beta cells of the pancreas causing insulin dependence leading obviously to Frank (severe full blown insulin dependent) diabetes. There is no doubt in any of my doctors' minds that the HIV drugs caused this and they are seeing more and more of it. There are other negative side effects that I have dealt with and am currently dealing with from the medications.
This is not to be taken as a condemnation of the HIV meds. Clearly I would have been dead in 1996 if I had not put myself on a double combo followed by a triple combo about nine months later when the double was starting to fail. So I consider that every year that I have lived since 1996 is "bonus time for me" and I am happy for that. Fortunately, I have always worked out since I was a teenager and competed in sports and carried a LOT of extra lean body mass which is probably what carried me through some dark days.
Anyway, this is probably more information than you wanted but gives you some idea of where I am coming from.
Richard85 said:If you dont wanna say I understand dude