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Urology/Low Testosterone



My husband (37 yrs old) has been injecting testosterone enanthate for about 8 yrs since being diagnosed with a pituitary tumor which led to low testosterone.

He originally started with a dose of 300mg every 2 weeks, he would get tested on the 7th day after injecting and his levels would range between the high 300s to the high 500s (range is 241-827). They were never consistent.

We recently had to lower his dosage (because of high hematocrit) to 120mg every week, he got tested 4 days after his injection and his testosterone is 380 (range 241-827). (lowering his testosterone didn't help lower his hematocrit, they actually increased after lowing dosage)

Is this level normal? If testosterone enanthate peaks on the 4th day isn't this really low for his age? And doesn't this mean on the 6th and 7th day he is below normal?

His endocrinologist will not increase his dose and never seems concerned when his levels seem low to us.

My husband has symptoms of low testosterone - lack of energy, no motivation, depression, low libido. We try to talk to his doctor about it and it seems the doctor thinks his levels are fine (because they are in range).

I'd appreciate your advice.

Thank you


Testosterone peaks at day 3-4 after a shot.  We typically gjve 100mg per week so he is getting more.than the usual dose. He better with  a daily gel that  produces a more stable level.

---------- FOLLOW-UP ----------

QUESTION: I understand that each individual person needs different dosages to maintain a healthy level.  You didn't answer my main question. Is 380 a healthy peak level (4 days after injection) for a 37 yr old? Is this a level you would shoot for if treating a 37 yr old male patient?


380 is a little on the low side for a peak level in this age group.  I would like to see the peak level closer to 500-550 since it tends to come down from the peak and the patient is still symptomatic.  A gel would tend to give a more constant level so a lower level is usually preferred when using gels.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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