Age: 31
Height: 5’8"
Waist: ~35" and ~37" at belly button
Weight: ~180lbs
Body/facial Hair: Body hair is very light in texture, but I have it. I would look silly if I didn’t shave because it’s pretty sparse/patchy.
Where I carry fat: Mostly in my stomach/midsection
Health Conditions/Symptoms/History: Diagnosed with varicocele in late teens. Dr. told me it was only an issue if it bothered me cosmetically. My primary complaints are: low energy/motivation, frequent depression/anxiety, difficulty concentrating, low sex drive, weak/infrequent erections. Most of this has been an issue since my early-mid twenties. I may have morning/nocturnal erections once a week. I’m pretty much sedentary (IT) and currently work the night shift.
I recently went to a GP with these complaints and a list containing almost all of the tests from the lab work sticky post. She said we’d need to start with a subset and work incrementally to keep insurance from getting upset. I called to schedule a followup appointment after getting the results shown below, but she was no longer with the clinic (gone at least long enough for maternity leave), so I’ll be starting over with a new doctor. She referred me to a urologist to examine the varicocele and discuss if/how it would impact fertility (wife and I are thinking of kids in the next year or so). I was waiting for lab results to come back and will schedule that soon.
Drugs: Ambien to sleep (prescribed) and small doses (50 - 100mg) Modafinil (self-treatment) as needed to function on night shift. I spent a couple of months taking prozac a few years ago and didn’t refill because it didn’t seem effective. No hair/loss or prostate drugs.
Lab results:
== 3/2013 7:30 AM - Quest (fasting) ==
– Lipids –
Cholesterol, Total: 186 (125-200 mg/dL)
HDL: 49 (>= 40 mg/dL)
Triglycerides: 121 (<150 mg/dL)
LDL: 113 (calc) (<130 mg/dL)
HDLC Ratio: 3.8 (calc) (< 5.0)
Non-HDL: 137 (calc) (>30 mg/dL over LDL)
– CMP –
Glucose: 98 (65-99 mg/dL)
Urea Nitrogen: 16 (7-25 mg/dL)
Creatinine: .95 (0.6-1.35 mg/dL)
eGFR Non-Afr. American: 123 (>= 60 mL/min/1.73m2)
Sodium: 140 (135-146 mmol/L)
Potassium: 4.2 (3.5-5.3 mmol/L)
Chloride: 104 (98-110 mmol/L)
Carbon Dioxide: 26 (19-30 mmol/L)
Calcium: 9.9 (8.6-10.3 mg/dL)
Protein, Total: 7.1 (6.1-8.1 mg/dL)
Albumin: 5.0 (calc) (2.6-5.1 mg/dL)
Bilirubin, Total: 0.7 (0.2-1.2 mg/dL)
**Alkaline Phosphatase: 37 (40-115 U/L)
AST: 16 (10-40 U/L)
ALT: 18 (9-60 U/L)
Hemoglobin A1c: 5.3 (<5.7 % of total Hgb)
**Vitamin D, 25-OH, Total: 22 (30-100ng/mL)
Vitmain D, 25-OH, D3: 22 ng/mL
Vitmain D, 2-OH, D2: <4 ng/mL
Magnesium: 2.1 (1.5-2.5 mg/dL)
TSH w/ reflex to FT4: 1.08 (0.4-4.5 mIU/L)
– CBC –
White cell count: 5.0 (3.8 - 10.8 k/uL)
Red cell count: 5.26 (4.2-5.8 M/uL)
Hemoglobin: 14.9 (13.2-17.1 g/dL)
Hematocrit: 44.8 (38.5-50.0%)
MCV: 85.1 (80-100 fL)
MCH: 28.4 (27.0-33.0 pg)
MCHC: 33.3 (32.0-36.0 g/dL)
RDW: 14.1 (11.0-15.0 %)
Platelet count: 224 (140-400 k/uL)
Abs. Neutrophils: 2935 (1500-7800 cells/uL)
Abs. Lymphocytes: 1525 (850-3900 cells/uL)
Abs. Monocytes: 400 (200-950 cells/uL)
Abs. Eosinophils: 110 (15-500 cells/uL)
Abs. Basophils: 30 (0-200 cells/uL)
Neutrophils: 58.7%
Lymphocytes: 30.5%
Monocytes: 8.0%
Eosinophils: 2.2%
Basophils: 0.6%
**Testosterone, total: 338 (241-827 ng/dL)
Diet: On-and-off low carb (carbs/sugar/wheat makes me really tired and feel even worse than normal). It’s been pretty crappy overall w/ fast food several times a week. Since going to the doctor, beginning to educate myself, and realizing that fixing my diet might make a big difference in how I feel, I’ve been avoiding wheat and carbs and have been taking a multi-vitamin, B complex, 5,000 IU sublingual B12, 5,000 IU vitamin D, fish oil, and 500mg magnesium oxide. I ordered the following supplements which should be here tomorrow: zinc picolinate, vitamin E, Lugol’s iodine solution, magnesium citrate (to replace oxide), and some lithium orotate (to have on hand in case I want to try it). I’ve been using non-iodized salt for the last couple of years.
Training: Nothing significant
Testes ache, ever, with a fever?: Periodic aching I believe, but this is the sort of thing I would not have previously given much thought to :(.
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So, as mentioned above I’ll be making an appointment with a urologist soon. Hopefully he’ll be willing to order whatever (at least the next phase) of tests I request. I appreciate any input on which tests my previous results indicate are most important, any thoughts on my current results, what I should bring up with future doctors, and commentary on supplements. Is it possible that the low D and poor diet explain the low (based on what I’ve read should be normal for 31YO) total testosterone? Might things improve significantly after fixing these?
I’m thinking along the lines of asking (again) for: FT, DHEA-S, Estradiol, Cortisol, LH/FSH, and SHBG. I’m thinking we’re not in the clear on thyroid-related issues (see temps below), so should try for the fT3, fT4, rT3 labs. … still so much to learn.
Thanks for taking the time to read/comment on this. Let me know if I can clarify/add anything. Also, I have Lipid/CBC/CMP results from about a year ago that I can type up if they would be insightful.
Edit: I left out temperatures I took a few days ago. (6:45AM: 96.9 F), (9:04AM: 97.6 F), (12:43PM: 97.9 F), (3:08PM 97.9F), (7:09PM 97.5).