T Nation

31 Y/O, Decade of Symptoms

need help finding my way

-age: 31 / male
-height: 5’ 10 inches
-waist: 32 inches
-weight: 165lbs

-facial/body hair: Facial and pubic hair grow slow, sideburns and goatee come in full, but thin. Mustache area does not connect to sides or goatee. Some fine hair on chest and lower back and legs, but not an overly hairy person.

-fat: mainly carry in my abdomen, love handles, and breast area. Weight has been up and down, at 19 y/o I weighed 155lbs, at 27 y/o I weighed 225lbs, and now at 31 y/o I weigh 165lbs. Have always had puffy, fatty nipple area since puberty, I was a little heavy at the onset of puberty as well. When i was my heaviest diet was atrocious, sedentary and slept a lot.

Last couple of years I’ve started walking a lot, lifting weights (but never could make any gains, even with protein, eating right, creatine etc. Last 7 to 8 months diet has been awful (fast food, not eating enough, smoking again after 6 months of stopping.

-health conditions, symptoms [history]:
At 19 started experiencing ED and low libido, I had one instance of blood in urine as well, went to dr. He did lab for thyroid came back (.52) he said was fine, referred to urologist he did a DRE, cystoscopy, and checked total t levels (513), and urine. He said I was fine everything was in my head and for the ED try a cock ring and a prescription to treat UTI. I was crushed at this age to hear such a grim outlook, but i decided it was all in my head and i would carry on.

Throughout 20’s no libido, always ED, no way to get aroused without manual stimulation, always would lose erections, I would have to climax quickly during sex because I couldn’t keep aroused and would lose feeling. Early 20’s I started to experience split stream urination, spraying, and dribbling when done. Started having anxiety and panic attacks and went to Dr. He prescribed me Citalopram for depression and sent me on my way.

My weight after the anti-depressants went up. I actually have stretch marks from the weight gain. During this time no morning erections or nocturnal erections ever, but I really had not had either of those since I was about 17. Always had fits of jealousy and insecurity with wife during this time, knowing I wasn’t operating normal and feeling off most of the time.
Lost my job at 27, quit taking anti-depressants, started smoking marijuana habitually.

After almost two years finally found a new job, started dropping a lot of weight quickly, to the point everyone who sees me always comments on how thin I’ve become. Quit smoking cigarettes with sunflower seeds, walked daily, drank loads of water and for the first time ever for about a month I felt like a man, was able to think about sex and got hard, loads of precum, felt animalistic with wife, felt alive for the first time since i was a kid. That lasted a month and stopped; it sent me into a depression and started smoking again.

I have since tried to replicate that window of normalcy by quitting cigarettes for up to six months, working out etc. but can never get back to that feeling. Iâ??ve been to my doctor twice in the last two years with problems and describing a burning i got in prostate area, he said oh probably prostatis and prescribed me and antibiotic and sent me on my way, prostate symptom alleviated slightly afterwards. Started taking liquid Cialis and it is a band aid, helps with keeping it up, but at times still doesn’t work great for me.

Found this site, ordered what labs i could afford to get me started (no insurance)
-ED/low libido
-prostate issues
-urine spraying/split streaming
-brain fog; feel like Iâ??m outside of my head some days.
-depressed
-cold hands, feet
-thin arms and legs, little muscle
-blood in semen (occurred one time)
-sometimes feel depressed/delusional/mental
-cracking joints (especially in hips, knees, elbows, and shoulders)

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever:
Citalopram for 3 years (havenâ??t taken in 5 or 6 years)
Liquid Cialis.
Never have taken any RX prostate drugs, but have tried OTC prostate health vitamins a few times with no real benefits noticed.

-lab results with ranges
Body Temps:
Been tracking for over a week now:
Waking temp avg - 97.7
Mid-day avg. - 98.3
Evening avg. - 97.9

Age 19 lab results: (lab collected at 10:50am)
TSH - 0.52 (0.35-7.00 mIU/L)
Testosterone, Serum - 513 (241-827ng/dl)

Age 31 lab results: (labcorp collected at 10:19 fasted)
((Accidentally checked female, so the ref. ranges are not right))
Estradiol - 13.3 pg/mL
FSH, Serum - 9.2 mIU/mL
LH - 3.7 mIU/mL
Testosterone, Serum - 469 ng/dL
CBC
WBC - 7.0 x10E3/uL
RBC - 5.27 x10E6/uL
Hemoglobin - 16.0 g/dL
Hematocrit - 47.2 %
MCV - 90 fL
MCH - 30.4 pg
MCHC - 33.9 g/dL
RDW - 13.4%
Platelets - 251 x10E3/UL
Neutrophils - 57%
Lymphs - 34%
Monocytes - 8%
Eos - 1%
Basos - 0
Comp. Metabolic Panel
Glucose, Serum- 92 mg/dL
BUN- 12 mg/dL
Creatinine, Serum- 0.85 mg/dL
eGFR If NonAfricn Am- 92 mL/min/1.73
BUN/Creatinine Ratio- 14
Sodium, Serum-141 mmol/L
Potassium, Serum- 3.9 mmol/L
Chloride, Serum- 104 mmol/L
Carbon Dioxide, Total-23 mmol/L
Calcium, Serum- 9.1 mg/dL
Protein, Total, Serum- 6.9 g/dL
Albumin, Serum - 4.6 g/dL
Globulin, Total- 2.3 g/dL
A/G Ratio- 2.0
Bilirubin, Total- 0.6 mg/dL
Alkaline Phosphatase, S- 50 IU/L
AST (SGOT) - 15 IU/L
ALT (SGPT)- 14 IU/L

Age 31 lab results: (collected at 10:14am fasted)
TSH- 1.180 (0.470 4.680) mIU/L
T4, FREE- 1.30 (0.78 â?? 2.19) ng/dL
PSA- 1.4 (0.00 â?? 4.00) ng/ml
Cholesterol- 113 (100-200) mg/dl
HDL- 62 (40-100) mg/dl
Triglycerides- 44 (10-150) mg/dl
LDL, Calculated- 42 (20-100)
HDL/CHOL Ratio- 1.8 (1.0 4.5)
GFR, MALE- >60
WBC- 7.9 (5.0-10.0) 10x3/mm3
RBC- 5.42 (4.7-6.10) 10x6/mm3
Hemoglobin- 5.42 (4.70-6.10) g/dl
Hematocrit- 48.8 (42.0-52.0) %

-describe diet [some create substantial damage with starvation diets]
The majority of my life even as a child, I did not eat that healthy, lots of fast food and sodas, not a lot of healthy intake. I am sure Iâ??m probably Iodine deficient, wondering if next step should be the iodine protocol.

Last few years I have a job that keeps me active and 5 out of 7 days a week, I may not consume enough calories (around 1500) but I do not feel hungry that often, then there are some days I just want to eat everything in sight. I still eat a lot of fast food and not very often anything too nutritious.
I know I need to eat healthier, As I have even tried the Candida diet for a length of time, ate all organics and lots of veggies, but still did not feel that well.

I have spells where I am plagued with loose bowel movements as well, but I have noticed if I keep the fiber intake up that seems to help.

-describe training [some ruin there hormones by over training]
last few years began walking 3 to 5 miles 4 times a week, ran 2 miles twice a week, and after that tried about 5 months of weight lifting, but I never really could get any gains.

-testes ache, ever, with a fever?
Testes never really seem to ache, left testical does seem to hang lower than right and I do notice the â??tubesâ?? from the testicle that go into the body on that side seem engorged and swollen a lot.

-how have morning wood and nocturnal erections changed
Nonexistent for the most part my whole adult life, other than my window of normalcy, after taking cialis I noticed a small increase in the amount of nocturnal/morning.

I have read that low e2 can cause problems, I think the cholesterol seems low too, I just do not know where to turn next.

I know that I am probably Iodine deficient, and think that would be a thing to look into, but I also know that I do not feel right, I have no insurance and have a doctor who really could care less on helping me. I feel like Iâ??ve got to do this on my own and I will, but right now I am lost and hope someone can point me in the right direction.

Nice write up.

You really need to get cholesterol up!!! If fat restricted diet, change that.

What has your iodine intake been over time? Thyroid basics sticky…

You need to get a testicular exam? Ultrasound perhaps.

That PSA was done soon after a DRE? That can spoil the results. You PSA is too high for your age. Prostatitis can be considered.

Find a good quality probiotic. Most are rubbish.
5,000 iu vit-D3
fish oil caps
B-complex multi-vit with trace elements and iodine.

[quote]KSman wrote:
Nice write up.

You really need to get cholesterol up!!! If fat restricted diet, change that.

What has your iodine intake been over time? Thyroid basics sticky…

You need to get a testicular exam? Ultrasound perhaps.

That PSA was done soon after a DRE? That can spoil the results. You PSA is too high for your age. Prostatitis can be considered.

Find a good quality probiotic. Most are rubbish.
5,000 iu vit-D3
fish oil caps
B-complex multi-vit with trace elements and iodine.[/quote]

Thank you I appreciate the help!
For the cholesterol, I’m not on a low fat diet. I eat lots of fast food, bacon, red meat etc. But some days i only consume maybe 1300 calories total. Other days easy 2500, just depends. Maybe I should eat more?

Iodine intake over the years has probably been little to none, always ate fast food never really salted home cooked food. I will try to iodine protocol, i just wanted to make sure my thyroid levels and everything looked ok before starting.

7 months ago dr. physically checked testicles, no ultrasound

PSA was not done after DRE (that was done years before) so PSA is on the high side?

Already take D3 5000, but will start the probiotic, fish oil, and b complex. Thank you

Did my e2 levels seem low?

Thank you so much

Yes, E2 was quite low. That will also make you feel like crap and kill libido.

Can you use [edit] in your posts above and add ranges for:
RBC - 5.27 x10E6/uL
Hemoglobin - 16.0 g/dL

Labs:
DHEA-S
AM cortisol, do at 8AM
IGF-1
fT3
test for STD’s
CRP [inflammatory marker]

Labs on sale at LEF.org, better prices if you get a membership. Sale ends soon.

[quote]KSman wrote:
Yes, E2 was quite low. That will also make you feel like crap and kill libido.

Can you use [edit] in your posts above and add ranges for:
RBC - 5.27 x10E6/uL
Hemoglobin - 16.0 g/dL

Labs:
DHEA-S
AM cortisol, do at 8AM
IGF-1
fT3
test for STD’s
CRP [inflammatory marker]

Labs on sale at LEF.org, better prices if you get a membership. Sale ends soon.

[/quote]

Thank you KSman, was nice reading something that confirmed infact this all wasn’t in my head.
I added lab results and ranges for
RBC - 5.42 (4.7 6.10)x10E6/uL
Hemoglobin - 16.8 (13.5 17.5)g/dL

As soon as I can I will order those tests and post results, thank you again, I finally feel like I’ve got a bit of hope.

I must add I do have mild Hemophilia B factor 9 deficiency, but I really forgot to mention, don’t know if that would affect any results.

Should I start iodine protocol, or wait for latest round of tests? Thank you.

Is there a place you recommend for probiotics? Gnc? Puritans pride? What makes one good vs. bad

I actually just recommended this on another thread but you look like a good candidate…your hormones seem to be ‘okay’ in the sense that they are probably not causing you major issues. You do seem to have issues with motivation and depression however and tying this into libido issues (and the SSRI you took), you probably have a quasi-deficiency of dopamine. Taking selegeline and/or a dopamine agonist will probably help you more than anything! Good luck…

[quote]Receptor wrote:
I actually just recommended this on another thread but you look like a good candidate…your hormones seem to be ‘okay’ in the sense that they are probably not causing you major issues. You do seem to have issues with motivation and depression however and tying this into libido issues (and the SSRI you took), you probably have a quasi-deficiency of dopamine. Taking selegeline and/or a dopamine agonist will probably help you more than anything! Good luck…[/quote]

Thank you, I will do some research into this and see what I can find.