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What Causes A Low Testosterone Levels?

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Posted on Wed, 21 Jan 2015
Question: My testosterone was low about 300. The Doctor put me on Fortesta 40 mg a day. Last reading was testosterone of 746. I been on the Fortesta for 254 days. Before the Fortea I had controlled PVC's with Toprol xl 25 mg. Now I have 2 beat, skip, 2 beats skip,2 beats skip etc.. The Doctor wants to do an Ablation. Do you think the 40 mg of Fortesta has cause the reoccurrence of the PVC? Can I stop the Fortesta cold turkey? Appreciate the help. They did a heart monitor and want to do Ablation. He did not ask me about medication or diet. Please let me know what you think. Should I have the ablation for RVOT PVC?
doctor
Answered by Dr. Shafi Ullah Khan (2 hours later)
Brief Answer:
Go for PVC< slowly taper fortesta

Detailed Answer:
Thank you for asking

Fortesta is a testosterone supplement used topically. I wonder what has been the reason for your prescription. before answering , let me clear some of the misconceptions people use testosterones supplements for.

Testosterone therapy is not a fountain of youth. There is no proof that it will restore you to the level of physical fitness or sexual function of your youth, make you live longer, prevent heart disease or prostate cancer, or improve your memory or mental sharpness. Do not seek therapy with these expectations in mind.

If erectile function has been a problem, testosterone therapy might not fix it. In fact, it might increase your sex drive but not allow you to act on it. You may also need medication or other therapy for difficulty getting or maintaining erections.

Now the Skip beats and PVC, so that needs ablative techniques. Fortesta might have triggered it for sure as it is likely to cause cardiac complains in cardiovascular history. It should not have been used in first place with heart problems, If inevitable, should have been more follow ups for the risk assessments.

Apart from heart problems there is long list of problems it can cause. At your age prostate is likely going to be fried and hypertrophied with these testosterones. There is a reason nature has decided taper off hormones naturally with advancing age.

You should not stop it cold turkey. As you have been taking it for 254 days. Thats almost a year. In this time frame your hypothalamo pituitary axis might have been completely off the grid. So better way would be to taper off slowly. Get your doctor to help you in this regard.

Nut shell, you should have the ablation for PVCs and get your doctor to taper this thing off slowly to avoid any adverse effects or minimize it.

I hope it helps. Take good care of yourself and dont forget to close the discusion please.

may the odds be ever in your favour.

Regards
Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shafi Ullah Khan (42 hours later)
Are you saying I should or should not have the ablation for PVC's? You said I should have the ablation for PVC's and taper off slowly. Did you mean I should not do the ablation? Why do you recommend either way the ablation?

I take Fortesta because my testosterone in 300. With Fortesta it is 756. Been on Fortesta 256 days. I think the Fortesta is causing PVC's. How do I wean my self off Fortesta. I do 4 pumps a day for 40 mg. Should I reduce to three pumps for a week. Two pumps the next week. One pump the week after. Last week no pumps??????????????

My pvc's is two beats, skip, 2 beats, skip, 2 beats, skip

Dr. Wants to do an Ablation. t was controlled by 25 mg Toprol. Not controlled now.

Please read above comments first:

Do you think I should have the Ablation?
Do you think I should wean myself off Fortesta?
I increased Toprol to 37.5 mg but it has not helped. I have los pulse and blood pressure naturally. Any higher and it will be to low. Super athletic. Doctor has not asked me what I eat of about any medication causing it.
doctor
Answered by Dr. Shafi Ullah Khan (5 hours later)
Brief Answer:
Yes ablation no fortesta

Detailed Answer:
Thank you for getting back

That's exactly what I mean. You should go for ablation. And for testa I mentioned should not have been taken in first place.

Now how to wean off depends on your gonadal hypothalamus pituitary axis which is severely affected by exogenous testosterone supplements. One thing is for sure to slowly taper the dose. Now how to do that depends upon the extent of depression of inner cycle which I am sure would be too much for 256 days use is chronic one.

Let your endocrinologist be the judge of that by assessing the hormonal status and advice accordingly.

You won't die for quitting cold turkey but you will be off the grid for a while in Sexual and intimacy desires along with other adverse effects these supplements has to offer. The best course would be the one advised by your doctor.

Nutshell. You need ablation and you need to stop fortesta.
Take care.
Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shafi Ullah Khan (3 hours later)
One other thing. I am taking Minoxidil topical solution USP 5% twice a day hair regrowth treatment (twice a day). The internet said this can cause PVC's. What do your think? Should I stop it also.
doctor
Answered by Dr. Shafi Ullah Khan (35 minutes later)
Brief Answer:
Topical Does not harm.

Detailed Answer:
Thank you for asking!

Internet is one big distracting piece of information in chunks. It sure causes deranged ECGs or PVCs but only if used oral or systemically to treat resistant hypertensions. Using topical minoxin creams are very rare to cause this. I dont see any reason to discontinue a topical vasodilator for hair therapy. There is a reason they are topical to prevent its oral use adverse effects. You may reduce the usage fromt wice to once a day though.

And once again i would say let your cardiologist have a say and let him decide whether to continue or not, But i don't see any reason to discontinue topical use.

Take care
Khan
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. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

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What Causes A Low Testosterone Levels?

Brief Answer: Go for PVC< slowly taper fortesta Detailed Answer: Thank you for asking Fortesta is a testosterone supplement used topically. I wonder what has been the reason for your prescription. before answering , let me clear some of the misconceptions people use testosterones supplements for. Testosterone therapy is not a fountain of youth. There is no proof that it will restore you to the level of physical fitness or sexual function of your youth, make you live longer, prevent heart disease or prostate cancer, or improve your memory or mental sharpness. Do not seek therapy with these expectations in mind. If erectile function has been a problem, testosterone therapy might not fix it. In fact, it might increase your sex drive but not allow you to act on it. You may also need medication or other therapy for difficulty getting or maintaining erections. Now the Skip beats and PVC, so that needs ablative techniques. Fortesta might have triggered it for sure as it is likely to cause cardiac complains in cardiovascular history. It should not have been used in first place with heart problems, If inevitable, should have been more follow ups for the risk assessments. Apart from heart problems there is long list of problems it can cause. At your age prostate is likely going to be fried and hypertrophied with these testosterones. There is a reason nature has decided taper off hormones naturally with advancing age. You should not stop it cold turkey. As you have been taking it for 254 days. Thats almost a year. In this time frame your hypothalamo pituitary axis might have been completely off the grid. So better way would be to taper off slowly. Get your doctor to help you in this regard. Nut shell, you should have the ablation for PVCs and get your doctor to taper this thing off slowly to avoid any adverse effects or minimize it. I hope it helps. Take good care of yourself and dont forget to close the discusion please. may the odds be ever in your favour. Regards Khan