T Nation

31 Y/O Ngiapmac's Journey to Solving Low T


#1

Hi all, this is my log to solve my low T problem that I have suffered with for too long now. As you’ll see in my background history, there could be a number of things that contributed to my low T, and I am now more determined than ever to figure out exactly what the problem is, and how to solve it. Thanks for joining me on this journey.

Background History

I hit puberty at a normal age, and believe that I had healthy testosterone levels throughout my late teen years as evidenced by my frequent nocturnal/morning erections and a high sex drive/frequent sex with girlfriend. I did think that I had a mild case of gyno at this time, as my nipples were sensitive and I thought I felt small granules underneath them. I went to the doctor, but she said that it was a normal part of puberty and that the sensitivity should stop eventually.

Fast forward a couple years, I experienced my first case of ED when I was 21 and chalked it up to nervousness. I became extremely introverted from the age of 21-25 and started to use marijuana on a daily basis. When I did have the opportunity to have sex it would always be after a night of heavy drinking and I chalked up the ED to “whiskey dick.”

At this time I also got into bodybuilding seriously and decided to try prohormones for the first time at age 25. I did an 8 week cycle of CEL H-Drol at 50/50/50/50/75/75/75/75 and used Nolva for PCT at 40/40/20/20. I always followed the time on + PCT = time off rule, and did a second prohormone shortly after this time off. This time I used RPN Havoc for 8 weeks at 30-40mg for the entire cycle, followed again with a PCT of Nolva at 40/40/20/20.

By the time I finished this cycle + the time off I was 26 and wanted to give anabolics a try. I used Test E for 12 weeks at 500mg/week, with Arimidex at 0.5 mg EOD (if I recall correctly). My PCT was the usual Nolva at 40/40/20/20. After this cycle I decided that I didn’t want to get into the habit of using anabolics and used only natural supplements for the next year or so.

At age 27, I met the girl of my dreams and decided that it was also time to quit using pot. This is when I really started noticing problems and suspected that I had low testosterone, either from the long-term pot use or the anabolics. I had many episodes of ED with her, and when I could get it up; it was weak and would disappear quickly. As a result, I ordered some Cialis off the internet and it solved all of my ED issues – or so I thought.

My doctor refused to even authorize bloodwork for me, and as a result of my frustration, I stupidly started self-medicating with Test E, at a TRT dosage of 150mg/week. I continued to do this for a year and felt great. My erections were rock hard, and I experienced no ED whatsoever. Once I wised up and realized that I had no way of knowing if all of my hormones were within a healthy range, I decided to stop with the Test E.

This is where I think I made a horrible mistake. Instead of running a PCT like I always did, I decided that I would just go the taper down route (since I thought that the lower dosage wasn’t as suppressive) and just keep using Cialis until my HPTA restored itself to normal levels. I was 28 at this time and started dating a new girl, who I’d always keep awake because of my snoring. It was so bad that she suggested that I might have sleep apnea.

After researching the side effects of sleep apnea, I convinced myself that my low testosterone levels were a result of this, and not the stupid taper down that I did after using Test E. I went for a number of sleep studies and it was determined that I had severe sleep apnea, to the point that I would wake myself up 30 times/minute gasping for air. I have been using a CPAP machine for the last 2.5 years now, and I feel like it has helped improve things such as my daytime tiredness, however, it still didn’t solve my low testosterone issue. Fast forward to today at age 31, and I still have to use Cialis in order to get and maintain an erection.

No longer smoking pot, and using CPAP consistently has helped, as there have been a few occasions in which I was able to have sex without using any kind of PDE-5 inhibitor, however, the lack of morning wood/nocturnal erections, minor brain fog, and occasional fatigue, still tells me that I have some underlying problems (most likely from irresponsibly tapering off Test E). After this initial round of bloodwork, my free testosterone level is equal to that of a 55-64 year old, so I am hoping that my family doctor refers me to an endocrinologist so that I can test the other hormones like TT, E2, LH, FSH, and prolactin.

I am also going to get an oral thermometer to test my body temperature as it relates to the thyroid. I will update this thread with those numbers as soon as I get them. Ultimately, I am hoping that an HPTA restart comes out of all of this, and this is where I’m starting and documenting the process.

Age: 31

Height: 5’ 10”

Waist: 34”

Weight: 200lbs.

Body Hair: Hairy armpits, legs, and pubic region; fine/sparse hair up to belly button; hair around nipples; little to no chest hair; zero hair on shoulders or back.

Facial hair: Johnny Depp style facial hair; somewhat thick moustache, soul patch, and chin; sparse amounts on cheeks and sideburns.

Carried Fat: I carry the majority of fat in my midsection. It is the first place I gain it and the last place I lose it. I also have a little bit more fat than most males in my glutes; however, this could be a result of years of squats.

Health Conditions: Sever sleep apnea; suspected minor gyno through, but it has since disappeared as I started working out/aged.

Rx/OTC drugs: No hair loss or prostate drugs; Cialis; H-Drol prohormone [4-chloro-17a-methyl-androst-1, 4-diene-3-17b-diol]; Havoc prohormone [2a, 3a-epithio-17a-methyl-5a-androstan-17b-ol]; Testosterone Enanthate [4-androsten-3-one-17beta-ol, 17beta-hydroxy-androst-4-en-3-one]; Proviron (Mesterolone) [1 alpha-methyl-17 beta-hydroxy-5 alpha-androstan-3-one]

Lab Results:
Note: I asked my family doctor to test everything mentioned in the lab work sticky i.e., TT, FT, Estradiol, etc. however he said that he wants to do things systematically, and would rather have an Endocrinologist test these after he does initial testing (I clearly have what you call, an “idiot doctor.) This is what I have so far…

Hematology

WBC – 5.2 [4.0-11.0] xE9/L
RBC – 4.81 [4.50-6.00] xE12/L
Hemoglobin – 144 [135-175] g/L
Hematocrit – 0.427 [0.400-0.500] L/L
MCV – 89 [80-100] fL
MCH – 29.9 [27.5-33.0] pg
MCHC – 337 [305-360] g/L
Platelets – 262 [150-400] xE9/L
RDW – 12.6 [11.5-14.5] %

Differential

Neutrophils – 2.7 [2.0-7.5] xE9/L
Lymphocytes – 1.9 [1.0-3.5] xE9/L
Monocytes - 0.3 [0.2-1.0] xE9/L
Eosinophils – 0.2 [0.0-0.5] xE9/L
Basophils – 0.0 [0.0-0.2] xE9/L
Biochemical Investigation of Anemias
Vitamin B12 – HI 731 [138-653] pmol/L
Ferritin – 265 [22-275] ug/L

General Chemistry

Glucose Fasting – 4.8 [3.6-6.0] mmol/L
Hemoglobin A1C/Total Hemoglobin – 5.4 [<6.0] %
Sodium – 140 [135-145] mmol/L
Potassium – 4.4 [3.5-5.2] mmol/L
Chloride – 102 [98-108] mmol/L
Creatinine 102 [67-108] mmol/L
Glomerular Filtration Rate (eGFR) – 84 [An eGFR from 60-89 ml/min/1.73 m2 is consistent with mildly decreased kidney function. However, in the absence of other evidence of kidney disease, eGFR values in this range do not fulfill the KDIGO criteria for chronic kidney disease. Interpret results in concert with ACR measurement.]
Calcium – 2.27 [2.15-2.60] mmol/L
Phosphate 1.08 [0.80-1.45] mmol/L
Urate – LO 228 [230-480] umol/L
Albumin – 47 [35-52] g/L
Bilirubin Total – 12 [<20] umol/L
Alkaline Phosphatase – LO 34 [40-129] U/L
Gamma Glutamyl Transferase – LO 13 [14-62] U/L
Alanine Aminotransferase – 22 [<50] U/L
Aspartate Aminotransferase – 21 [<35] U/L
Magnesium – 0.80 [0.70-1.00] mmol/L

Muscle Enzymes

Creatine Kinase – 271 [44-275] U/L

Lipids

Triglyceride – 0.64 mmol/L
Cholesterol – 6.07 mmol/L
HDL Cholesterol – 1.35 mmol/L
Non HDL Cholesterol – 4.72 mmol/L
LDL Cholesterol – 4.43 mmol/L
Cholesterol/HDL Cholesterol – 4.5

Thyroid Function

Thyroid Stimulating Hormone (TSH) – 2.0 [0.32-4.00] mIU/L
Thyroxine Free (Free T4) – 13 [9-19] pmol/L

Reproductive and Gonadal

Testosterone Free – 283 [196-636] pmol/L

Serum Proteins

C Reactive Protein – 0.4 [<6.0] mg/L

Bone Markers

25-Hydroxyvitamin D – 136 [75-250] nmol/L

Diet: Since about the age of 21, I ate a fairly clean diet for bodybuilding purposes. It is based around optimal testosterone production, and includes a variety of healthy fat sources, complex carbs, and higher quantities of protein. A typical day would look like this:

Upon waking – Up until just recently I would drink and drink recommended by Charles Poloquin which consists of a 1/4 tsp of any colored salt, a 1oz. shot of real lime juice, mixed with water.

Meal 1 – 1tbsp coconut oil, 3 whole eggs, 6 egg whites, ½ avocado, and 120g peppers

Meal 2 – 1 scoop whey protein, handful of Brazil nuts

Meal 3 – Large salad consisting of mixed greens, green onions, peppers, carrots, cucumbers, olives, and celery; 1 can flaked white albacore tuna or 6oz. chicken breast

Meal 4 (preworkout) – 2 slices of Ezekiel bread; 1tbsp raw almond butter

Immediately after workout – 1 scoop whey protein, 5g creatine monohydrate

Meal 5 (postworkout) – 6oz sirloin steak; 1 cup broccoli; 200g sweet potatoes or 150g brown rice

Meal 6 – Cottage cheese, handful of Brazil nuts; 1 packet cream wheat

Testes Ache: Never had testes ache with or without a fever.

Morning Wood/Nocturnal Erections: Few and far between; weak and go away quickly when I do get them on occasion. I believe this was a result of me having severe sleep apnea, which I have since been using a CPAP since the age of 29.


#2

Where are you located?

"handful of Brazil nuts"
great source of selenium which is very important for thyroid, but
too much selenium is quite toxic, a handful every day is not good

Stop eating Brazil nuts for 2 weeks and then only eat 1 or2 per day. Do your own research.

Causes of selenosis

Causes of selenosis range from ingestion of excessive selenium, as in the case of regular snacking on Brazil nuts which could contain up to 90 mcg of selenium per nut. There are also many other plants which have the capability to concentrate selenium that is taken up from the soil, and they are termed selenium accumulators.

Some of the zeno-testosterones can cause major problems in some guys.

TSH=2.0 is a problem, should be closer to 1.0
fT4 is slightly below mid-range
fT3 is the active hormone and so many doctor do not test that

Are you zinc deficient?
Selenium might shift your other minerals.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.


#3

@KSman, thanks so much for your reply. It is very much appreciated.

I am located in Ontario, Canada.

I actually just started with the handful of Brazil nuts in my diet on Sunday. Is it safe to assume that I don’t have to stop eating them for 2 weeks and just start eating 1 or 2 a day since it’s only been a couple of days?

I’ve read through the “Things that damage your hormones” thread, and correct me if I’m wrong, but is xeno-testosterone any form of exogenous testosterone, or just drugs classified as 5-alpha reductase inhibitors? If it’s the latter, I have never taken any 5-alpha reductase inhibitors.

I am unsure if I am zinc deficient, but I will try and test for this via the Zinc taste test. I do supplement with 30mg of zinc daily in the form of zinc monomethionine and aspartate.

Task List

  1. Zinc taste test
  2. Taking temperature in morning and mid-afternoon to check thyroid function (this may take some time as I just came down with a cold and have a bit of a fever).
  3. Provide more lab results once I am referred to an endocrinologist.

#4

Just received a call from my family doctor and, thankfully, he is referring me to an endocrinologist for further testing on the grounds that my cholesterol is high, and my urate and gamma glutamyl transferase levels are low. No mention of my high TSH or lower FT level. I’m assuming that it’s because they fall within the lab ranges, which leads me to believe that I have an “idiot doctor.”


#5

You are OK re Brazil nuts.

xeno-testosterone: is how I refer to man made chemicals that are like or similar to T steroid hormones. For some, these get into cell nuclei and do destructing things to gene expression. Human hormones are safe, others can be dangerous to some people. Deca only gear/cycles are very dangerous, prohormones can be too and there are so many of those things that have never been properly tested for safely.

30mg zinc should be fine… testing optional

Thyroid:
Explain history of using iodized salt and/or vitamins that list iodine.

Doctors: Their role is mostly constrained to disease management. They are not into optimizing health or well-being. State medical systems enforce that as well as health insurance systems. Doctors get slammed for unnecessary medical treatment.


#6

@KSman

Great. I have reduced the Brazil nut intake to only 1 or 2 a day. Appreciate you bringing selenosis to my attention.

Also, thank you for the clarification on xeno-testosterone. I have never, and would never, touch Deca. And as for the prohormones, I tried sticking to ones that were considered “mild” i.e., I would never touch something like Superdrol (methasteron, and methyldrostanolone). But who really knows what mild means when there are so many that have never been tested properly for safety.

Thyroid:
As for my history with iodized salt, I have very little. I haven’t taken a multi for years, but when I did I used Controlled Labs’ Orange Triad which contains 150mcg of iodine (as potassium iodine). No of my current supplements contain any iodine. For the last 3 years I’ve done a drink first thing in the morning as recommended by Charles Poloquin that consisted of water, a 1 oz. shot of real lime juice, and a 1/4 tsp. of pink Himalayan sea salt (which I know now from reading the thyroid sticky contains no iodine). I could very well need to do IR, based on what my AM and mid-afternoon temperatures come in at. I’m currently working through a cold, so I’m taking the readings now with some skepticism.


#7

Checking in with today’s oral temperature readings.

Note: I currently have a cold, and what feels like a mild fever, so these readings could potentially be inaccurate. I won’t fully assess my thyroid function until I am 100% recovered

AM: 97.9°
Mid-afternoon: 98.3°


#8

Checking in with today’s oral temperature readings.

Note: I currently have a cold, and what feels like a mild fever, so these readings could potentially be inaccurate. I won’t fully assess my thyroid function until I am 100% recovered.

AM: 98.3°
Mid-afternoon: 98.1°

Edit: Also just got my 25-Hydroxyvitamin D result back and it measured at 136 nmol/L [75-250]


#9

Nice!


#10

Thanks KSman!

Knowing that my vitamin D is at an optimal level feels like a step in the right direction towards figuring things out.


#11

Checking in with yesterday and today’s oral body temperatures

Note: I’m starting to feel better from this cold, and unfortunately, I think the reading that I got this morning is starting to indicate that I may need to do an IR.

June 9th
AM: 97.6°
Mid-afternoon: 97.8°

June 10th
AM: 95.7°
Mid-afternoon: 97.3°


#12

Checking in with yesterday and today’s oral body temperatures.

Note: I’m still not at 100%, but am definitely on the road to recovery. I think that this is starting to reflect in my temperatures, and I am guessing that I’ll need to do an IR.

June 11th
AM: 96.9°
Mid-afternoon: 98.2°

June 12th
AM: 97.3°
Mid-afternoon: 97.9°


#13

IR+selenium!


#14

Checking in with today’s oral body temperatures

Note: I’d say that I’m at 90% now since coming down with a cold, and I believe that my recent temperatures are pretty close to the norm.

June 13th
AM: 97.2°
Mid-afternoon: 98.0°


#15

@KSman IR + selenium it is!

I understand the IR protocol and will be ordering Iodoral tomorrow. The goal is to get to .75 g and I will see how I can tolerate 50 mg/day. The only question that I have is, with Iodoral being 12.5 mg tablets, are you taking them in 4 separate doses throughout the day? Or are you doing something like 25 mg AM and 25 mg PM?

Also, it is my understanding that 2 Brazil nuts contain ~100 mcg of Selenium. What dosage do you recommend per day with IR?


#16

Checking in with today’s oral body temperatures

Note: I’d say that I’m at 90% now since coming down with a cold, and I believe that my recent temperatures are pretty close to the norm.

June 14th
AM: 96.8°
Mid-afternoon: 97.1°


#17

Those are very low temperatures.
97.7 AM
98.6 mid-afternoon

200mcg selenium per day and good to get started before the IR too.

No need to take iodine multiple times per day, but sounds like a good idea if you can handle the routine.


#18

@KSman, thank you kind sir.

I’d rather be precise with my selenium dosing, so I will use a selenium supplement at 200 mcg per day and cut the Brazil nuts out from my diet for the time being (I’m assuming that the mg was a typo, and you meant 200 mcg?)

I will pick up the selenium tomorrow, and the Iodoral should be arriving on Friday, so maybe I’ll wait until Monday to start the IR. Is 4 days of selenium supplementation before starting adequate?

I have no problem with the routine, so I will dose the Iodoral 25 mg in the AM and 25 mg PM.


#19

Checking in with today’s oral temperature readings.

Note: I have started on 200 mcg of selenium today in preparation for my IR. The Iodoral should be arriving tomorrow, but I may hold off starting until Monday, unless @KSman says otherwise.

June 15th
AM: 96.8°
Mid-afternoon: 97.6°


#20

Checking in with today’s oral temperature readings.

Note: My mid-afternoon temperature might be a little off, as I took it about an hour after I finished training and walking home in the heat.

June 16th
AM: 96.8°
Mid-afternoon: 98.8°