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Feeling tired and fatigue. Causes of testicle shrinkage and what are the test required?

Answered by
Dr. Shanthi.E

General & Family Physician

Practicing since :2005

Answered : 2408 Questions

Posted on Wed, 30 Jan 2013 in Testicle Problems
Question: Dear Doctor,
About one month back my two blood tests shows Testosterone free and total were low, SHBG was normal, after 20 days when it was again tested Testosterone free and total with SHBG were normal but DHEAS goes low, during this period Testicles were also got shrink gets very small,Urologist examines and confirmed that testicles are quite small. all day tired and fatigue.What can be done further.
There must be some underlying causes.
What may be effects of small testicles and which tests are required to be done.
Answered by Dr. Shanthi.E 9 days later

I have read your query with diligence.

Your latest test report says that your total and free testosterone is normal and that of DHEAS is low. Also, your testicles are shrunken in this period. You also seem to be tired and fatigued.

The probable reason I can think of in your state would be the low DHEAS levels. Low DHEAS levels are shown to present with symptoms of tiredness, fatigue, and low general well-being and reduced androgen synthesis.

However, this is bound to happen with advancing age. So, you must take it gracefully.

You may want to go on a trial of oral DHEAS supplementation. However, the trails on its efficacy are still underway and no conclusive results are found yet.

In my opinion, you should not worry about this as I feel it is a normal aging phenomenon. You must embrace life and move on.

Let me know if I am wrong anywhere.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Shanthi.E 12 hours later
Thanks Dr.Shanthi,
You are correct as far as advancing age, have taken appointment of Ultra Sound of Testicles, tests like FSH,LH,PROL,TESTO,IGFI .During last days ultra sound of abd,shows hepatomegly and moderate fatty liver infilteration - 18.2 cm in sagittal dimension, non alcoholic steato hepatitis, you please guide for this what can be done for this problem, does this is a serious concern.
Answered by Dr. Shanthi.E 12 hours later

Good to hear from you again.

The tests you are going to take might help to find the cause, but of little importance in the management. You may go ahead with the tests.

Regarding the Non alcoholic steatohepatitis, it is not a serious concern. You can relax on this concern. If you do consume alcohol, abstain from it.

You will need dietary changes in the form of low fat diet and high protein diet. Check your lipid profile as well and see if it is normal.

Your treating doctor may consider putting you on Hypolipidemic agents, if the lipid profile is deranged.

Write back for queries, if any.

Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Shanthi.E 11 hours later
Thanks again Dr.Shanthi,
Great support.Actually to be true no doubt every body is running to Canada but here health system is garbage. Any way please guide-
AST and ALT was tested some where in October 2012 where these were around 12 and 18 with reference to reference range 1-40. After two months or so developed sever dyreia-vomiting,loose motions and stomach pain, sweating.Clostridium difficile antigen test shows negative and stool culture was negative.Ultra sound of abd, shows changes as mentioned.this was happened in January 2013. Now doctor is telling that since many of liver function tests were done two month back as such these are not required now. Please clarify that does approach of Family doctor is dependable, how come this happens and possible that during time of dyreia/vomit/pain liver function bio markers will be same as of two month old conditions when there were no such conditions like vomit/pain/dyreia, these values will definitely may have changes with symptoms of sever vomit/dyreia/pain , Radiographer have clearly mentioned that biochemical funstion tests are recomended on the bases of present ultra sound of liver. but where as family doctor gets irritated that now these tests are not required because those were done two month back were normal, how come he is taking two month old results releventing to present conditions, as far as XXXXXXX is concerned liver function tests as per present conditions should be done or not. Yesterday we contacted family doctor for details tests of liver function as per protocol of MAYO CLINIC, he behaves like he is super specialist, please clarify these all steps what should be done. your contact tel, is not mentioned on your profile,he ordered pelvic ultra sound to rule out pelvic pathology, dont know why he just bypassed liver assessment.what do you think and suggest please
Answered by Dr. Shanthi.E 2 hours later

AST and ALT are tests for liver function. They were done in October 2012. You need to definitely repeat the liver function tests (LFT) now as you developed symptoms after this period and also the ultrasound is showing changes of Steatohepatitis.

I do not agree with your family doctor's approach. Even so, there is nothing wrong in repeating the test now.

As I said earlier, you need to get your fasting lipid profile as well as the LFT done now.

Please talk to your doctor again and request for the investigations.

You need to get the liver set right first, before going into any pelvic pathology.

I have added my contact number on the profile. You may want to check it.

With patience and perseverance, you can move your doctor too.

All the best!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Shanthi.E 6 minutes later
Thanks a lot, Let us see what happen here.
Answered by Dr. Shanthi.E 9 minutes later
Thank you too.

Wish you good health.

Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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