A Recipe for Success: Patient Case Study

Jul 10, 2019

Recently, a patient shared his early success story after starting testosterone replacement therapy at our practice.

J.V. is a 48 y/o who presented with a five year history of lethargy, low libido and poor results from exercise. Testosterone levels were 300 and 308 ng/dL but he was told by other physicians that he was not a candidate for hormone replacement therapy. My physical examination and lab survey were benign and revealed no other plausible explanation for his symptoms. A trial of testosterone replacement therapy was offered after a discussion of risks versus benefits.

Injectable testosterone was prescribed and titrated to achieve a testosterone trough of around 800 ng/dL. Arimidex was added for a moderately elevated estradiol level. Symptoms dramatically improved after approximately 90 days confirming the diagnosis of testosterone deficiency.

A DEXA scan (dual energy x-ray absorptiometric scan) was performed at the beginning of treatment, June, 2018 and again approximately one year later to assess body composition. Results are included below:

Total Body Fat: 11.9 percentage point decrease (from 36.9% to 25%)

Pounds of Fat loss: 26.4 lbs (from 74.8 lbs to 48.4 lbs)

Pounds of Lean Muscle gain: 17 lbs (from 127.7 lbs to 147.7 lbs)

J.V.'s case illustrates a few key points for others to consider. Men with low normal testosterone levels are often told that they are not candidates for hormone replacement therapy. However, when other causes for symptoms are carefully sought but not found, a trial of testosterone replacement therapy is medically reasonable.

Patients who combine therapy with a healthy diet and exercise can see pretty remarkable changes in body composition. Combined with close medical follow-up, this can lead to a better state of overall health.