Depression and Dysthmia vs. Low Testosterone in Males

Here is a list of symptoms from WebMD.com:

• sadness or depressed mood most of the day or almost every day
• loss of enjoyment in things that were once pleasurable
• major change in weight (gain or loss of more than 5% of weight within a month) or appetite 
• insomnia or excessive sleep almost every day
• physically restless or rundown that is noticeable by others
• fatigue or loss of energy almost every day
• feelings of hopelessness or worthlessness or excessive guilt almost every day
• problems with concentration or making decisions almost every day
• recurring thoughts of death or suicide, suicide plan, or suicide attempt

This "disease" is also associated with heart disease, sexual problems (low libido and sexual dysfunction) and pain perception.

 Here is another (slightly edited) list of symptoms from Dr. Wikipedia:

• Low or complete lack of libido (sexual desire/interest)
• Depression
• Anxiety
• Irritability
• Fatigue
• Poor sleep or sleep disturbances
• Cognitive problems such as difficulty concentrating and memory loss
• Reduced quality of life
• Hot flashes and night sweats
• Aches and pains (such as in muscles)
• Diminished or lacking pubic, underarm, and leg hair growth
• Loss of bone mass (osteoporosis)
• Increased abdominal fat
• Glucose intolerance (early-onset diabetes)
• High cholesterol/lipids

This disease is also associated with heart disease.

From the title of this post and the list of symptoms, it's probably obvious that the top set of symptoms apply to depression.  In particular, the symptoms are for chronic dysthymia - a sort of low level and chronic form of depression.

What is really interesting to me is the overlap between the two sets of symptoms. Weight gain.  Cognitive issues.  Fatigue.  Sleep problems.  Etc.

Eight years ago, when I finished the Hardrock 100, I should have been ecstatic.  It had been a personal goal for years, and when I first finished, I honestly felt nothing at all.  I simply assumed that I'd get some sleep, get some food, and I'd feel better in the morning.  But, the feelings persisted.  My wife and I talked about a month later, when I wasn't feeling any better.  She said that she felt my mood had been going downhill for a long time.

I had my doctor refer me to a psychiatrist who tried a number of different medication options until I felt better.  Well, my brain felt better.  But, the medications themselves have sexual side effects and can also lead to weight gain.  And, I was using small doses of four distinct medications on a daily basis.  These medications even interfered with each other, in terms of function.

Over the next couple of years, I became aware (through the internet, I'm sure) that my symptoms were very similar to the symptoms of low testosterone.  To me, I much more closely mapped to the low T symptoms than to depression.  In 2006, I asked my PCP to test total and free testosterone as part of my annual physical.  He agreed reluctantly.  My numbers came back within range, and as far as my doc was done, the issue was over.  The fact that I was in the bottom of the range didn't matter.  We don't treat symptoms.  We treat lab results.

Earlier this year, my depression symptoms were getting worse, my weight was near an all time high, I was going nowhere in the gym, it seemed, and I tried again.  This time, I went to the largest hospital in Vermont, and saw an endocrinologist who specializes in male hormones.  Again, my tests came back within range, but barely.  I had a few e-mail exchanges with the doctor after getting the results.  I pointed out that the definition of the normal range is very arbitrary.  While my levels were in range, this web page showed something interesting:

http://www.mens-hormonal-health.com/normal-testosterone-levels-in-men.html

My testosterone levels were at about the average level for an 85-100 year old man.  But, the normal range is defined by where 95% of the population falls rather than my symptoms and illness.  In other words, it's completely arbitrary.

Finally, the doctor basically said that it was possible that I was lying about my symptoms in order to get access to testosterone.  Testosterone is a schedule III drug as defined by the FDA.  For 8 years, I'd been taking a schedule II drug (a stimulant) on a daily basis and a schedule IV (a benzodiazepine) drug as well.  Docs had no problems dispensing those pills, but apparently, testosterone is a very dangerous medication.  And again, I was told that I could only be treated if the lab test showed an abnormal level.  Lab results, not symptoms.

To be continued...