T Nation

27 Y/O BBing Competitor with History of Low T


#1

Long story, I’ll try to condense the past 5 yrs as best as possible. Have trained in some, way shape, or form since I was in high school for sports. Got really into bodybuilding-style training when I was in college. I’ve always been able to loose weight pretty easily if my diet and cardio are in order. Keeping a clean diet, regardless of goal, has never been a problem for me. Things were going swimmingly until my last year of undergrad, where I noticed that my libido was low, muscle gains were really subsiding, and i was starting to accumulate fat in bad places (this was a very stressful time for me).

Went to a GP and got bloodwork done (this was back in 2012). Testosterone was low for my age and she referred me to a urologist (~360 ng/dL). He immediately wanted to put me on some form of TRT (gave me a few options). I decided I’d hold off. Called my insurance company 3 times to see if it was covered, and they never returned my calls. Got fed up and decided to up my cals by 2k (from ~3.5k to 5.5k) and see if I could “outeat it”. Gained about 12-15 pounds over a 4 mo. period. Libido seemed to be a bit better (I have zero clue if it actually worked, however). Decided to cut down til August 2013, start lean, then clean bulk for a few years.

Fast forward to March 2016, things were actually going really well. I was lean, muscles looked bigger/better, libido was solid and had put on 10lbs over the past 2.5 yrs. Decided to do my first series of competitions this past October 2016. Did very well (placed top 3 and top 2 in all my classes). Started to reverse diet and back in December 2016, and the fat piled on big time (despite very small weekly calorie increases starting from my lowest prep cal level of ~2700) Libido wasn’t coming back either, so I decided to get my blood work done since it had been so long (after about 6-7wks of weekly calorie increases) . Tested even lower than back when I was 22 (~250ng/dL). This wouldn’t really have concerned me IF i didn’t have a history of low T.

So far, I’ve had 3 series of blood tests done since this past december. I will post them all, including the labs from back when i was 22. My (new) GP really wants to figure out what’s causing this. He referred me to an endo, and I also found a urologist that I could into sooner. I have appointments with both. The one with the uro is tomorrow (2/21).

The past 5 years have brought a ton of stress for me on the career-front. I work in investment management on Wall Street and just finished the CFA exams in 2016. However, I absolutely love my job regardless of the pressure it puts on me (took me 5 years to get into where I’m at now).

I’ve noticed that since I finished my show, my drive, focus, mental clarity and general sense of well-being are extremely low. That, combined with gaining fat in really bad places and low sex drive are wrecking absolute havoc on me. All this, despite slowly adding back in cals. I can’t have this affecting my life anymore. As a competitor and ESPECIALLY my career.

Any suggestions on how to guide my doctors would be much appreciated. Thank you so much for reading.

P.S. Body temps have always been low since I was little. I stopped using iodized salt back in 2010, but have always taken a multi with iodine and selenium. Read the stickies here and started taking more iodine. Upped my daily intake from 150mcg to 600mcg back in December. Took temps last week. Morning was 96.0 degrees and didn’t get much higher. Began IR and only three days later waking temp was 97.8 (perhaps this is working).

P.P.S. Also, I wondered if this could be caused by over-training and/or adrenal fatigue, but my strength in the gym is perfectly fine. I still love going, have had no performance decreases or injury occurrences.

-age: 27
-height: 6’2"
-waist: 33" (up from 28" in October 2016)
-weight: 199 (up from 189 in October 2016)
-describe body and facial hair: Hair everywhere. Runs in the family
-describe where you carry fat and how changed: Fat concentrates in weird places. Solely on the lower back and a little on the chest. Since i was 22, I’ve always had a full six-pack but unsightly love-handles, as well. Putting on lean muscle (versus just mass) has always been a challenge for the past 5-6 years.
-health conditions, symptoms [history]: Nothing major. Had various forms on mono (2x) when i was a teen.
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: Nothing at all. No AAS or perscritpion Meds.
-lab results with ranges: SEE BELOW
-describe diet [some create substantial damage with starvation diets]: 2012-2016, varied from 3.5k-4.0k daily. Higher protein (300-350g/day), moderate carbs (330-400g/day), moderate fat (90-112g/day). Cals got down to 2550 at my lowest during my prep in September 2016 (250p/275c/50c). Currently, back up to 4.0k daily. I have been supplementing with D-Aspartic Acid and PES Erase for a few years now, as this seems to be a solid combo that keeps me lean
-describe training [some ruin there hormones by over training]: late 2012- early 2016, 5x per week split. Hit each muscle group 2-3x per week for around 15 sets per bodypart. Early 2016-present, upped the volume to 20-28 sets per bodypart and did this all through prep.
-testes ache, ever, with a fever?: Nope
-how have morning wood and nocturnal erections changed: Has always been sporadic (even when i was in my teens). Non-existant post-show, but seems to be more frequent now (say 4-5x per week).

Lab Results. Most recent first; there’s alot of here. Let me know if any can be removed for irrelevance [ref ranges are bracketed]

02/16/2017
TSH: 2.810 [0.450-4.500 uIU/mL]
Thyroxine (T4): 6.4 [4.5-12.0 ug/dL]
T3 Uptake: 40 [24-39 %]
Free Thyroxine Index: 2.6 [1.2-4.9]
Testosterone, Serum: 263 [348-1197 ng/dL]
Thyroxine (T4) Free, Direct, S: 1.51 [0.82-1.77 ng/dL]
Triiodothyronine,Free,Serum: 2.8 [2.0-4.4 pg/mL]
Cortisol - AM: 16.0 [6.2-19.4 ug/dL]

01/30/2017
Testosterone Free, Calc: 68 pg/mL [47 - 244 pg/mL]
Testosterone % Free: 1.9 % [1.6 - 2.9 %]
Total Testosterone: 361 ng/dL [300 - 1080 ng/dL]
Sex Hormone Binding: 31 nmol/L [11 - 80 nmol/L]
Estradiol: 13 pg/mL pg/mL [7.63-42.6]
Iron: 123 ug/dL [59 - 158 ug/dL]
Vit D, 25-Hydroxy: 102.0 ng/mL [>=30 ng/mL]
TIBC: 360 ug/dL [260 - 445 ug/dL]
Iron Saturation: 34 % [20 - 50 %]
Magnesium: 2.10 mg/dL [1.80 - 2.40 mg/dL]
WBC: 6.1 K/uL [4.0 - 11.0 K/uL]
RBC: 4.39 M/uL [4.20 - 5.90 M/uL]
Hemoglobin: 14.3 g/dL [13.5 - 17.5 g/dL]
Hematocrit: 43.9 % [40.5 - 52.5 %]
MCV: 100.0 fL [80.0 - 100.0 fL]
MCH: 32.6 pg [26.0 - 34.0 pg]
MCHC: 32.6 g/dL [31.0 - 36.0 g/dL]
RDW: 13.7 % [12.4 - 15.4 %]
Platelets: 153 K/uL [135 - 450 K/uL]
MPV: 9.7 fL [5.0 - 10.5 fL]
Neutrophils %: 36.7 %
Lymphocytes Relative: 50.5 %
Monocytes %: 8.2 %
Eosinophils Relative Percent: 4.1 %
Basophils %: 0.5 %
Neutrophils: 2.2 K/uL [1.7 - 7.7 K/uL]
Lymphocytes: 3.1 K/uL [1.0 - 5.1 K/uL}
Monocytes: 0.5 K/uL [0.0 - 1.3 K/uL]
Eosinophils: 0.2 K/uL [0.0 - 0.6 K/uL]
Basophils: 0.0 K/uL [0.0 - 0.2 K/uL]
Sodium: 141 mmol/L [136 - 145 mmol/L
Potassium: 4.3 mmol/L [3.5 - 5.1 mmol/L]
Chloride: 99 mmol/L [99 - 110 mmol/L]
CO2: 23 mmol/L [21 - 32 mmol/L]
Anion Gap: 19 [3 - 16]
Glucose: 81 mg/dL [70 - 99 mg/dL]
BUN: 37 mg/dL [7 - 20 mg/dL]
CREATININE: 0.9 mg/dL [0.9 - 1.3 mg/dL}
GFR Non-African American: >60 [>60]
GFR African American: >60 [>60]
Calcium: 9.3 mg/dL [8.3 - 10.6 mg/dL]
Total Protein: 6.6 g/dL [6.4 - 8.2 g/dL}
Alb: 4.8 g/dL [3.4 - 5.0 g/dL]
Albumin/Globulin Ratio: 2.7 [1.1 - 2.2]
Total Bilirubin: 0.6 mg/dL [0.0 - 1.0 mg/dL]
Alkaline Phosphatase: 81 U/L [40 - 129 U/L]
ALT: 63 U/L [10 - 40 U/L]
AST: 66 U/L [15 - 37 U/L]
Globulin: 1.8 g/dL

12/09/2016<–7 weeks post contest
WBC: 4.9 [3.4-10.8 x10E3/uL]
RBC: 4.39 [4.14-5.80 x10E6/uL]
Hemoglobin: 14.0 [12.6-17.7 g/dL]
Hematocrit: 42.0 [37.5-51.0 %]
MCV: 96 [79-97 fL]
MCH: 31.9 [26.6-33.0 pg]
MCHC: 33.3 [31.5-35.7 g/dL]
RDW: 13.5 [12.3-15.4 %]
Platelets: 172 [150-379 x10E3/uL]
Neutrophils: 48 %
Lymphs: 39 %
Monocytes: 8 %
Eos: 5 %
Basos: 0 %
Neutrophils (Absolute): 2.3 [1.4-7.0 x10E3/uL]
Lymphs (Absolute): 1.9 [0.7-3.1 x10E3/uL]
Monocytes(Absolute): 0.4 [0.1-0.9 x10E3/uL]
Eos (Absolute): 0.2 [0.0-0.4 x10E3/uL]
Baso (Absolute): 0.0 [0.0-0.2 x10E3/uL]
Immature Granulocytes: 0 %
Immature Grans (Abs): 0.0 [0.0-0.1 x10E3/uL]
Glucose, Serum: 82 [65-99 mg/dL]
BUN: 33 [6-20 mg/dL]
Creatinine, Serum: 1.05 [0.76-1.27 mg/dL]
eGFR If NonAfricn Am: 97 [>59 mL/min/1.73]
eGFR If Africn Am: 112 [>59 mL/min/1.73]
BUN/Creatinine Ratio: 31 [8-19]
Sodium, Serum: 140 [136-144 mmol/L]
Potassium, Serum: 4.2 [3.5-5.2 mmol/L]
Chloride, Serum: 100 [97-106 mmol/L]
Carbon Dioxide, Total: 25 [18-29 mmol/L]
Calcium, Serum: 9.5 [8.7-10.2 mg/dL]
Protein, Total, Serum: 6.6 [6.0-8.5 g/dL]
Albumin, Serum: 5.0 [3.5-5.5 g/dL]
Globulin, Total: 1.6 [1.5-4.5 g/dL]
A/G Ratio: 3.1 [1.1-2.5]
Bilirubin, Total: 0.7 [0.0-1.2 mg/dL]
Alkaline Phosphatase, S: 78 [39-117 IU/L]
AST (SGOT): 54 [0-40 IU/L]
ALT (SGPT): 52 [0-44 IU/L]
Testosterone, Total, LC/MS: 254.9 [348.0-1197.0 ng/dL].
Hemoglobin A1c: 5.3 [4.8-5.6 %]
Estim. Avg Glu (eAG): 105 mg/dL
Thyroxine (T4) Free, Direct, S: 1.57 [0.82-1.77 ng/dL]
DHEA-Sulfate: 349.7 [138.5-475.2 ug/dL]
Cortisol: 13.2 ug/dL [Cortisol AM 6.2 - 19.4]
TSH: 2.070 [0.450-4.500 uIU/mL]
Luteinizing Hormone(LH), S: 3.9 [1.7-8.6 mIU/mL]
FSH, Serum: 4.2 [1.5-12.4 mIU/mL]
Estradiol: <5.0 [7.6-42.6 pg/mL]
Prostate Specific Ag, Serum: 0.4 [0.0-4.0 ng/mL]
Insulin-Like Growth Factor I: 226 [98-282 ng/mL]
Triiodothyronine,Free,Serum: 2.8 [2.0-4.4 pg/mL]
Sex Horm Binding Glob, Serum 32.0 [16.5-55.9 nmol/L]

08/20/2012<–5 years ago
Protein, Total: 6.9 g/dL [6.2-8.3 g/dL]
Albumin: 4.9 g/dL [3.6-5.1 g/dL]
Globulin: 2.0 g/dL [2.1-3.7 g/dL]
A/G Ratio: 2.5 g/dL [1.0-2.1]
Bilirubin, Total: 0.8 g/dL [0.2-1.2 mg/dL]
Bilirubin, Direct: 0.2 g/dL [ <=0.2 mg/dL]
Bilirubin, Indirect: 0.6 g/dL [0.2-1.2 mg/dL]
Alkaline Phosphatase: 64 U/L [40-115 U/L]
AST: 40 U/L [10-40 U/L]
ALT: 57 U/L [9-60 U/L]
Hemoglobin A1c: 5.3% [<5.7%]
Ferritin: 129 ng/ML [20-345 ng/mL)
Sodium: 143 mmol/L [135-146 mmol/L]
Potassium: 4.4 mmol/L [3.5-5.3mmol/L]
Chloride: 107 mmol/L [98-110 mmol/L]
Carbon Dioxide: 24 [21-33 mmol/L]
Creatinine: 1.36 mg/dL [0.60-1.35 mg/dL]
Urea Nitrogen: 31 mg/dL [7-25 mg/dL]
Calcium: 9.9 mg/dL [8.6-10.3 mg/dL]
TSH: 1.53 mIU/L [0.4-4.50 mIU/L]
T4, Free: 1.4ng/dL [0.8-1.8 ng/dL]
Testosterone, Total: 365 ng/dL [241-827ng/dL]
LH: 5.70 mIU/L [1.5-9.3 mIU/L]
Glucose: 80 mg/dL [65-99 mg/dL]