T Nation

31 - Continuing my Health Journey - Found Low T?


#1

Age: 31
Height: 6’1
Waist: 32"
Weight: 174
Location: Colorado, USA

Describe body and facial hair: Hair grows quickly on head and face full beard and head of hair. Hair heavier on chest and stomach but otherwise standard growth everywhere else.

Describe where you carry fat and how it has changed: I was always skinny growing up and lean until about age 25 where my noticeable decline really started. By age 30 I was 226 lbs. Mostly held in stomach, back, and hips. I recently lost weight starting my journey over to feel better 1/16/18 and am back down to 174lbs.

Health conditions/symptoms: No real conditions currently. Symptoms of zero libido for 5-6 years, down moods, anxiety, Overall mental decline, Social withdrawl, never able to hold on to muscle gains, joint pain, fatigue always feel like I’m dragging my own ass around, irritability.

RX/OTC Drugs, any hair loss drugs or prostate drugs. No current RX drugs and never taken anything for hair loss or my prostate. I was just put on clomid 50 migs for 3 months to “hold me off” while I try to find an endocrinologist.

Lab results with ranges: See below

Describe Diet: Current diet is 221G Protein, 195G Carbs, 65G good fats, 2321 Calories. Lean meats, chicken, vegetables, egg whites, whole eggs, berries, english muffins, sweet potato, Avocado, Chobani yogurt, white rice, and cheat meals here and there with clients.

Describe Training: 5 days/week – 10-20 minutes of cardio every day and work all muscle groups currently lower weight and high reps until I can learn it all.

Testes ache, ever, with a fever? I can recall some aching here and there in the past but always short lived and minor. No correlation with fevers noticed.

How have morning wood and nocturnal erections changed: Somewhere around 25ish area my libido disappeared and with it I never get morning wood anymore or any nocturnal erections. I can still manage an erection, but I’ve turned into the why bother attitude.

Supplementation:
AM: Omega complex, COQ10/whole heart complex, Daily Vitamin. Usually make a shake with berries mixed in with 1st phorms opti greens and level-1 protein mix.

PM: Omega complex, sleep aid

TEMPERATURE AT 1:00PM – 5-18-18 – 98.13
TEMPERATURE AT 5:00PM – 5-18-18 – 98.27

( The thermometer KSman recommended off amazon just arrived I will keep checking temps from today on)

Besides the iodine in my daily vitamin at 150 mcg’s I have no other knowledge or experience with it before reading this forum.

Labs:

Total T – 206 ng/dL [250-1100]
Free T – 23.4 pg/mL [35.0-155.0]
SHBG – Waiting on test results
TSH – 1.380 mIU/L [ 0.358-3.740]
Free t3 – Have not tested
Free t4 – Waiting on test results
Reverse t3 - Have not tested yet
Prolactin – 5.6 ng/mL [3.7-17.9]
Cortisol – Waiting on test results
LH – 0.8 mIU/mL [no range listed]
FSH – 0.7 mIU/mL [1.0-10.0]
Glucose – 79mg/dL [60-99]
BUN – 18 mg/dL [5-28]
Creatinine – 1.13 mg/DL [0.50-1.40]
BUN/Creat ratio – 16 [10-28]
Sodium – 141 mmol/L [136-145]
Potassium – 4.3 mmol/L [3.5-5.1]
Chloride - 107 mmol/L [100-110]
CO2 – 26 mmol/L [21-32]
Anion Gap – 8 [4-15]
Magnesium - 2.3 mg/dL [4-15]
Calcium - 9.3 mg/dL [1.8-2.4]
Phosphorus - 3.3 mg/dL [2.5-4.9]
Uric Acid - 6.2 mg/dL [4.8-8.6]
Protein, Total - 7.1 [6.2-8.2]
Albumin 4.4 [3.4-5.0]
AST – 17 U/L [15-37]
ALT – 37 U/L [6-60]
Alkaline Phos – 81 U/L [30-105]
GGT – 24 U/L [5-80]
Iron – 66 ug/dL [40-170]
C Reactive Protein – 0.29 mg/dL [<=0.90]
Cholesterol - 112 mg/dL [<=200]
HDL – 39 mg/dL [>=40]
LDL – 51 ml/dL [<=100]
Non-HDL Cholesterol 73 mg/dL [<=130]
Triglycerides 109 mg/dL [>=150]
VLDL 22 mg/dL [7-32]

Story – I’ve declined for quite some time and have not been able to figure it out. At age 26 after trying everything natural I could, I blindly followed doctor’s orders and was put on a shit ton of depression, anti-anxiety, bi-polar, anti-psychotics, the list goes on. Over a year of a half of taking one medicine after another to fail at solving compounding problems, coupled with very high dosages, and much worse symptoms. I finally said enough and found a medicine specialist that was angry and flabbergasted about what I was taking and how I was doing. It took me another painful year and half to slowly wean off all the medication. I had learned the hard way about being your own health advocate and not blindly following doctor’s orders. During all those wasted years I tried a lot on my own but learned very little information to date that has been relevant. After a section of giving up at age 29 and accepting this is just how it was I decided to start again. 1-16-18 I hired a coach, started another fitness plan, and a nutrition plan. I cut out all sugar, cut out all alcohol, and by 2-16-18 was able to quit smoking nicotine. My coach recommended a place to take blood test (Direct Access) and so I started on 2/15/18 with this all.

I found a urologist and took clomid as a test for 5 days and did blood tests again on each end. I found a urologist because of the Low T symptoms found on 2-15-18 listed above.

4-13-18 – 4-19-18
Testosterone, Total – 206 ng/dL [250-1100]
Testosterone, Free – 28.5 pg/ mL [35.0-155.0]
LH - .8 miU/mL no range listed
FSH .7 miU/mL [1.0-10.0]


Testosterone, Total – 471 ng/dL [250-1100]
Testosterone, Free – 63.8 pg/ mL [35.0-155.0]
LH – 2.9 miU/mL no range listed
FSH 1.7 miU/mL [1.0-10.0]
And I did a semen analysis if that is of any help.

My last visit with the doctor he threw red flags all over and it was obvious that he did not know where to go. He said try taking clomid for 90 days and come back. He was not interested in giving me anything else or really talking much about other treatment options. I seem to pick the winners.

2 weeks later his assistant called and basically admitted they didn’t know what to do and that refers to any endocrinologists in the area were 10+ months wait. She said she called a colleague in another state and ran my numbers by her. They had me take free T4, AM cortisol, IGF-1, ACTH on 5-9-18 and I have not received the results.

I have been on 50 migs clomid for 10 days plus the experimental week and do not feel much change but have had a spark of a few things take place maybe? Not sure with this medicine if that is even long enough.

I’m tired of not feeling good. I am reading and learning as much as I can and like many scrolling through forums I found this place to start narrowing this down with the help of some good knowledgeable people. I appreciate any help and input along the way. I have much to learn and I’m to the point where I will fly to another state if I must for an endo. I just haven’t been able to find one accepting new patients.

Thank you for your time. All input is appreciated.

Looking forward to continuing this journey here and your replies.


#2

Most endocrinologists are just as clueless as your previous doctor in regards to TRT, most don’t know what to do and offer protocols that just don’t work and they offer it because it’s the only thing written. There’s no standard of care model for TRT so it compounds the problem since little is written doctors put you on a path to misery.

A common protocol is 200mg once every 2 weeks which just doesn’t work when the half-life of a hormone you’re injecting is 5 to 8 days less for low SHBG guys. Most doctors don’t even know what tests to order and refuse to test and manage estrogen. They come up with these cookie-cutter protocols design for everyone so they don’t have to think or figure anything out.

How successful TRT is for you will depend on the company you keep, if you’re looking to go on TRT and feeling awesome immediately you’re going to need to leave these Insurance doctors behind, most of us pay out-of-pocket for proper care. There just aren’t any doctors that know how to do TRT right.

I will comment on your labs when you get SHBG, really need it to recommend a proper protocol.


#3

TEMPERATURE AT 9:00PM - 5-18-18 - 97.75.

TEMPERATURE AT 6:00AM - 5-19-18 - 97.28

Good information thank you systemlord… the last thing I want to do is get put on BS again.

One different thing about me is I am in the Oilfield and work anywhere from 65-110 hours a week and can be in different parts of the country. I roam currently in a travel trailer and am just lucky to have stayed in one spot for a bit.

That combined with the fact that maybe there is something wrong with my pituitary gland as my LH and FSH levels are pitiful has kept me so far on this desperate search for help with an insurance doctor… but alas I don’t fully understand the pay out-of-pocket for proper care or what that means for someone in my situation.

Thank you again I will continue posting temps and try to obtain my results as soon as possible.


#4

Nice job on the weight loss! Vitamin-D is good to get tested as well.

I’m new to TRT and am no expert but one thing that stuck out to me in your bloodwork was cholesterol. Experts don’t agree on what ‘low’ is, most say <120, which is probably too low. Cholesterol is going to help produce your body’s androgen hormones like testosterone, so you don’t want it too low. 180-200 might be a better place to be. Your HDL and LDL are low-end as well. Your diet looks pretty clean - don’t be afraid to get some not-so-lean meats in there!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074286/


#5

Taking temperature at 2pm, not 9pm as temperatures are expected to be lower by that time, otherwise you would never fall asleep. Temperature at 6am is low, it should be 97.7 or higher.


#6

Sweet thank you both that gives me things to work on… and I just checked this and its just about 2pm soo…

TEMPERATURE AT 2:00PM - 5-19-18 - 98.34.

I’ll keep taking your suggestions and learning as we go. Currently taking my free time to read through one thread after another since I’ve finished the stickies.


#7

Continuing tracking of temperatures.

TEMPERATURE AT 9:00AM - 5-20-18 - 98.05.

TEMPERATURE AT 2:00PM - 5-20-18 - 98.26.


#8

You need a maintenance dosage of iodine and selenium, check temps after a few weeks. TSH labs will become useless after starting supplementation.


#9

Thus far my Temperature readings after your suggestions have been in range with what the sticky’s and you have advised. I am still continuing it each day to see any changes @systemlord and I appreciate the help. I am going for my next set of labs on 6-27-18. I will try and paste a set of labs I have decided on thus far and if anyone has any suggestions of things to add or remove I would appreciate it. My next Doctors appointment is on 7-11-18 and I’m trying to close all the loose ends of anything I haven’t tested and where I am currently at with my 2nd month of clomid. I honestly feel much better then I did before all around besides still having zero libido. I still experience the rest of my symptoms but I feel overall better and the fact that my sleep has completely changed and allows me to get quality rest each night has been a major contributor. Has anyone else experienced big changes with sleep function after starting to level out their hormones? I will paste my current test plan for 6-27-18 below. Please share your input I still have much to learn!! Will send more updates when I can.

CMP (CHEMISTRY PANEL WITH LIPIDS)
CBC (COMPLETE BLOOD COUNT)
FREE TESTOSTERONE
TOTAL TESTOSTERONE
DHEA-S - SULFATE
ESTRADIOL
HOMOCYSTEINE
C-REACTIVE PROTEIN (HIGH SENSITIVITY)
TSH (THYROID STIMULATING HORMONE)
TOTAL T4
FREE T4
TOTAL T3
FREE T3
REVERSE T3
LH
FSH
DHT (Dihydrotestosterone)
SHBG
PROGESTERONE
PREGNENOLONE
VITAMIN B12
VITAMIN D, 25-OH D3 / TOTAL
FERRITIN
IRON, TOTAL BINDING
IRON, BINDING CAPACITY
MAGNESIUM, RBC

With the packages I was able to find all these tests will run me about $1166.00 which is alright with me as I am still collecting all the data I need BUT if I am fucked up and there is a better route then requestatest.com with LabCorp by all means let me know lol. I have found a location near by to preform the tests and am otherwise prepared at this point.


#10


#11

I created this spreadsheet to keep organized with what I plan on doing. If anyone has any suggestions please let me know :slight_smile: - My goal is to gather all available data since I am currently in a good spot to do so and then start narrowing down the paths of focus from there.