T Nation

29 Year Old Needs Advice


I’ve read through a ton of posts and could just use some solid advice if possible. So, about me.

AGE: 29
WEIGHT: 173-176
WAIST: 34(?)
Hair: I’m a hairy beast. Lots of facial / neck hair. Chest hair, back hair, leg hair. I’ve got hair to spare.
FAT: I carry most of my fat around my midsection and lower back, like most dudes on here. I’ve just finished a cut from 215 to where I’m at now and though I could lose a little more, don’t want to keep eating at a deficit. I’ve cut using KETO and am sticking with KETO but just not cutting.
HEALTH HISTORY: Ok, not the normal history here. Two and a half years ago I was diagnosed with congestive heart failure. My ejection fraction was at 10%, my right lung had collapsed with a liter of fluid in it. I was a wreck. Spent a month in three different hospitals around the country before I wound up where I am now. This was due to drug use (methamphetamines and benzodiazaprines, among other drugs) and hereditary heart issues. My heart is fine now though it will never be totally normal. Other than that major, two year scare, no other health issues.
DRUG HISTORY: Long and varied. I used recreational drugs for 12 years, both hard drugs (Meth) and lots of weed. Been sober since my heart gave out. I was on high doses of Beta Blockers (metoprolol) for two years along with A1 inhibitor for two years. These helped my heart but am not on anything anymore as my heart has healed.
DIET: Currently at around 2200-2300 calories a day. Try to hit the gym everyday but lift 5X a week (PHAT). Lifts have totally stalled. Like I stated, I eat KETO. I hit around 17g Carbs, 160G Protein, and 150-200G of fat a day depending on the day.
TRAINING: Was doing 6X a week PPL really just focusing on one compound lift a day. Switching to PHAT starting this week.
TESTES: Don’t ache, I don’t think. No fevers. Occasional morning and night time boners. Sex drive is definitely decreased. Energy levels are LOW, like I’m always carrying a heavy ass weight. Super moody and frustrated with things.
TT: 2X Tests, first was 417, second 402. (220-1150)
FT: Still waiting on results, not sure where this test got lost to.
E2: 22 (seems right on the money) (2-50)
TSH: 1.498 uIU/ML (0.40 - 5.50 uIU/ML)
LH: 4.2 MIU/ML (0.9 - 10.6 MIU/ML)
FSH: 2.7 MIU/ML (2.0 - 17.7 MIU/ML)

HEMOGLOBIN A1C 4.6 % (4.5 - 6.4 %)
eAG 85 MG/DL

WBC 6.1 X1000 (4.8 - 10.8 X1000)
Red Blood Count 4.80 X1,000,000 (4.7 - 6.1 X1,000,000)
HEMOGLOBIN 13.7 G/DL (14.0 - 18.0 G/DL)
HEMATOCRIT 41.6 % (42.0 - 52.0 %)
MCV 86.7 FL (80.0 - 94.0 FL)
MCH 28.6 PG (27 - 31 PG)
MCHC 33.0 G/DL (33.0 - 37.0 G/DL)
RDW 13.2 % (11.5 - 14.5 %)
PLATELET COUNT 163 X1000 (160 - 360 X1000)
MPV 10.1 FL (6.8 - 10.2 FL)

LIPID (Obviously high thanks to keto)
Cholesterol 271 MG/DL 25 - 199 MG/DL
Triglycerides 62 MG/DL <150 MG/DL
HDL 63 MG/DL >40 MG/DL
LDL 193 MG/DL <130 MG/DL
TOT CHOL / HDLC 4.3 <4.5

My doc (PCP) admits that my levels are on the low range of normal, but I feel like they are just LOW. Not like some I’ve seen but LOW enough to to attempt a restart. I’ve asked her to work with me on a Nolva / AI restart. I suggested 20mg EOD of Nolva and an AI. Is that about right? Should I ask right away for hCG. I’d rather not pin if possible since I’ve never messed with needles and don’t know what the F*&% I’m doing with them. Hopefully she is amenable. If not I’ve got an appointment with another, “hormone” doctor next week just in case, as a backup.


Sorry, not an A1 Inhibitor, and ACE Inhibitor, for blood pressure / heart issues.

Just my two cents… you are training too hard and eating too little. At 6’1 and 173 you are underweight for a guy your size. Training 5x a week will require more calories and some carbs. Your T tests are borderline but without a full panel which the next poster will likely tell you to get, its hard to tell. Your LH numbers are not low meaning your body is cycling through the process.

More calories perhaps. I’d argue that carbs are totally not necessary for muscle or T production.

Also, thanks for the advice.

You will never use hCG and a SERM at the same time.

There is a restart sticky with more info than people will type into a post.

Please check oral body temperatures as per the thyroid basics sticky.

Have you been using iodized salt? This affects thyroid function and thyroid hormones that have a huge impact on energy levels.

Note that for some people, statin drugs can induce congestive heart failure symptoms because induced CoQ10 deficiency weakens muscles and the heart.

Injecting hCG would be a #31, 5/16" 0.3-0.5ml insulin syringe, very much mostly painless.

Stickies to read found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

E2=22pg/ml is nice, but with low T, leaves you estrogen dominant.

Thanks for the advice.

  1. I use a TON of iodized salt. Keto requires me to intake about 7-10g of sodium a day to stay on top of my electrolytes and energy and most if it is iodized salt. I will try the temperature test.

  2. I’ve looked over all of the stickies but didn’t see anything in particular about meth usage and gonadal damage. I’ve read a few studies that don’t seem to say much definitively.

  3. I didn’t think about being estrogen dominant with a comparison. hCG isn’t a statin is it? Are SERMs statins? I didn’t think they were. I haven’t taken a statin in the past.

  4. I saw in the stickies that you can do either hCG or a SERM, but do you recommend trying hCG first? Is one more beneficial than the other?

Thanks KSman!

hCG is a natural human hormone, SERMs are drugs. hCG does not have any direct side effects other than often improving mood.

Your T levels and LH/FSH low and self consistent. Nothing indicative of the testes not working.

Statin drugs lower cholesterol, your doc may push that on you. CoQ10 supplement can overcome the issues that I noted.

I’m 6ft and 175 and I’m certainly not underweight! Ideally, I’d like to drop about 5lbs.

I too am in no weigh underweight. I don’t need statins for my cholesterol. Those numbers are healty. LDL isn’t indicative of anything. HDL is high and triglycerides are low. She thought the numbers for lipids were on point.

I’ll see what she says re SERMS vs hCG.

Thanks again for the input.

Most docs would push statin drugs way before 271
HDL is very protective

SERMs are less costly, no injections and travel better than hCG that needs to be kept cool and not shaken. Swapping to a SERM when traveling is an option.

Sorry guys, it was not meant as criticism but more as a diagnosis for possible cause. Low calorie diets that are high in protein are proven to lower T. I’m not saying you are puny, but you do weigh on the lower end of the spectrum for your size. So at that weight you could consume more calories if you are working out that much and still maintain the weight you have. I’m not a believer in KETO diets, I believe in quality calories and some amount of carbs are ok from good sources. You need them at 5x week lifting. You are driving a catabolic state and you wonder why?

No worries. I’m here to learn. I lift pretty hard 3-4 times per week. But I’m 54, so not looking to build lots of muscle, just want to be tone and fit. I only started lifting a year and a half ago but have had low T symptoms for many years. So working out had nothing to do with my diagnosis. When I search optimal weight for my height, I see anything from mid 160’s to mid 170’s.

Nash, thanks for not taking it to heart, I meant no disrespect. I don’t know your case but I can read some pretty obvious factors in Kramerica. For starters, he just lost a ton of weight which would show a pretty big calorie deficit recently = lowering T. Then he’s been working his butt off at the gym, which is good, but with a low calorie and low carb diet that is high in protein… this also drives down T. His LH numbers are ok and his T is borderline so it seems likely that its the current lifestyle. The whole formula screams of a catabolic state.

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Good info. I just found it funny that you thought he was small. One of the best side effects of TRT is that I can eat pretty much anything I want without gaining fat! I eat a very good, clean diet, but I can eat many more calories over this last 6 months. It’s very nice!

Def don’t take it personally. I appreciate all input. Just to add, free test came back

90 - range of 40-220. Not sure what that is. Low? Average?

It’s low especially in conjunction with symptoms.

Good to know. Thank you.

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The fighter and the kid podcast, Brendan Schwab, former college football, NFL, ufc heavyweight fairly successful, has been doing keto and said he lost good chunk weight, said he could not do keto and be competitive for a long time. I remember my mom doing keto diet in late 80’s, fad diet not sustainable. Are body’s have changed, drink out of clear stream and see what happens, the doc wont give you trt unless you are under 300 for two tests. I do know how to lower testosterone levels before test. Anyway fuck the creams etc, go with the shots , 100mg Testosterone Cypionate Weekly was way Better than 90mg a day Armpit oil. What do you wznt test for libido or metabolic (anabolic )?

Lol. Some people can be successful long term w keto. I don’t think I’m one of them. I don’t want Test at all. I wanted to know my levels cause I have symptoms of low T. I want to work with my doctor and try a restart. I don’t want to pin the rest of my life. Maybe in 10 years. If I really wanted T I’d just do it.

UPDATE: Doctor prescribed me 50mg clomid 5x a week. This seems pretty bizzare. Should I do 25mg. EOD?
She did not prescribe be an AI despite me asking for one. Should I get an OTC one? I’m sure if my levels start to spike she would be willing to give me one. Advice?