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Heart Rate Variability - Anyone looked into this?
(07-23-2015, 05:32 PM)DocWils Wrote: Correct on all counts- you need to be hooked up to an EEG to get a good diagnosis on this. I would do the sleep test before the Testosterone treatment, because Testosterone may be a blind alley, or worse, mask the real problem. Nothing in your readings pointed to apnoea events, so I seriously thing you need to look at your thyroid, your brain and other possible explanations. Good luck.

Thanks. I wasn't really looking in the right direction! It seems that EDS (excessive daytime sleepiness) and hypersomnia might be a good fit for me. I need to look into this further. But the questions is if the low testosterone could be causing this? The fact that I have needed a nap since I was 20 (completely exhausted by 3-4 pm) might indicate I have had EDS for some time (and probably before I had any testosterone problems).

As far as thryoid goes, I have had a lot of testing on that and it is all good. I really want to do the sleep study, but at a cost of $1500, I am not sure it is the right thing to do first? My thought is that I can try the testosterone and see how I feel. Perhaps the sleep issue is directly due to low testosterone. And that would allow me to save some cost. Plus it looks like I will need to be on that either way so shouldn't I establish a "new baseline" moving forward? I guess that is a bit of a chicken and the egg.

Either way, frustrating as heck, but I think things are coming to head now (no pun intended).

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My thought would be that a neurological problem would cause a decrease of testosterone, not the other way around. You see, finding the cause for the low testosterone count (besides age, of course, which is a big factor) would be the first step in treatment, and already raising the testosterone would mask any possible cause.
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I know that guys with sleep apnea can have reduced testosterone. Their levels can increase by about 30% once the sleep apnea is corrected. But a couple things are a challenge in this case:

- Even if I were to get a 30% increase in T, it still wouldn't be a sufficient enough increase to bring me into the "normal" range. It seems I would still end up on testosterone anyway.
- If it is a neurological problem (and assuming I even know what that means, haha), isn't the course of treatment just medication that eases the EDS? I don't know that this would actually "fix" anything such that testosterone could be improved?
- Is there any potential treatment that could actually increase testosterone? Or is treatment just a maintenance of sleep patterns via medication.

In the event of obstructive sleep apnea, the problem can be "fixed" while using a CPAP, without drugs. I am not sure that would be the case for neurological related sleep issues though? Of course, this is assuming it is a neurological problem, but for kicks lets assume that for the time being.

And I totally agree with you about finding the cause of the low T. I have been searching hard for that answer for 9 months and it has been tough. I have exhausted every other route. I am really ready for some treatment. Let me think about this some more. I have accepted that I need to spend the money on the study, but I am curious to see if testosterone treatment will resolve the sleep problems. Especially since sleep related treatment may involve drugs (ugggh) and doesn't seem to fix the root cause anyway?


FYI I went ahead an scheduled the study. Since I have to keep sleep records for 2 weeks and they are backup up anyway, I it gives me time to do a quick trial of testosterone and they cycle off it. It also gives me time to adjust to move my sleep schedule up a couple hours to better fit the 2 day study. The study will be in about 6 weeks. I am convinced that I am going to do it, so with or without testosterone, it is going to happen at least.
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(07-24-2015, 05:49 AM)DocWils Wrote: My thought would be that a neurological problem would cause a decrease of testosterone, not the other way around. You see, finding the cause for the low testosterone count (besides age, of course, which is a big factor) would be the first step in treatment, and already raising the testosterone would mask any possible cause.

I was on Testosterone for around a year, and at the end I became aware that I was developing oedema in my legs and got to a doctor. I saw an internist at the local hospital and he asked me to stop the testosterone as it is a risk factor for heart failure, which it turned out I did not have. He also put me on insulin for my diabetes and said he would bet I had sleep apnea. He ordered an overnight oxymetry which I failed and then a sleep study was ordered. Medicare payed for everything and it took around 10 months to get the sleep study, and I was in the meantime referred to a resperologist.

I was tested for T levels which were very low before I went on the testosterone, by the way.

The upshot is that now, over a year after that visit to the E.R. and eight months of APAP treatment with supplemental oxygen I am still off the testosterone, on insulin (NPH) and while it took some time my energy levels are a lot better with the insulin, APAP and O2 at night, and without any testosterone supplement than I ever had on the testosterone alone.

So I suggest that such supplements shouldn't just be predicated on a measured low testosterone production alone without taking steps first to address other medical concerns which, as you suggest, testosterone supplementation may be masking.

Ed Seedhouse

Part cow since February 2018.

Trust your mind less and your brain more.

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