T Nation

32 Years Old - Low T - Feel Like Hell


#1

Hi everyone,

(I just saw that for some reason some of my blood test results had come out in weird script. I think I have corrected it now).

For quite a few years now I have been feeling shitty. It started around 2004 with fatigue and a drop in sex drive and some memory problems, but these were relatively mild at first. My condition has steadily gotten worse though.

For the last year now I have been feeling pretty bad. If my wife doesn't remind me about sex I could easily forget about it for weeks at a time. I always feel exhausted. My memory has gone to hell. I have become more pessimistic, irritable and generally sad. I am not actually depressed, I still find many things fun, but I am hardly ever proactive or impulsive anymore. I used to have a dominant personality, which is still there somewhere but getting harder and harder to find.

One year ago I had a TT test done, which came back at 306ng/dL with a range of 400-1080 for males aged 20-39. I did nothing about it except for worry.

Over the last month I have actually felt a tiny bitter better. This week I did some more extensive tests. Below is all the info I think you guys will want.

Background Info:
Age: 31
Height: 1m72 / 5ft7.5
Waist: 78cm / 31 inches
Weight: 71 kgs / 156 lbs
Body: Slim, narrow hips, (relatively) wide shoulders, thin wrists
Facial Hair: Decent full beard and mustache (not Santa Claus thick and bushy, but good)
Body Hair: Hardly any at all on upper body. Legs hairy.
Fat: Only around mid-section. Appeared in last 2 years when I went from 57kgs to 72kgs after starting SS.
Health: Generally good except for chronic GERD, bad migraines (one every 2 months or so) and two epileptic fits over the last 6 years (which I am not convinced are actually epilepsy rather than something else). No damage to the brain was found, (all ECGs and MRIs and other fairly extensive tests show a completely normal healthy brain and doctors have put me on medication despite this).
Medication: 100mg/day Lamictal (lamotrigine) for epilepsy. Occasionally 40mg/day Nexium for GERD for periods of two weeks (about 2-3 times a year).
Diet: Generally healthy. Home cooked food. Our meat is from organic sources from an uncle who raises and slaughters his own animals. Our eggs are also organic. We cook with a lot of olive oil which is our own and not processed in any way. Fish once a week. Healthy amounts of vegetables. If I have one dietary failing it's that I don't eat fruit, even though I actually like them. We generally don't eat too many sweets or junk food, but calorie-restriction is an unknown beast in our household.
Training: 2 times a week (always trying for 3) of fucking around not really doing RippetoeÃ??'s SS program. No cardio.
Testicles ache: Never
Morning wood: Very very rarely, if ever, for years.
Marital status: Married. I have 3 daughters the eldest is 4. No problems whatsoever conceiving. They are definitely mine :wink:
Stress: Work stress is high and has been getting worse. I also enjoy it though, sometimes.

I am trying to find a neurologist who will keep an eye on me while I try to come off the Lamictal. I really don't think I actually need it. Also, some studies have shown that it has little effect on testosterone, (or more accurately, less effect than other epi meds), and one study, on rats, has shown a significant negative effect. My symptoms of low-T started before I had my first fit and started on the meds though.

Blood Test Results:
Result (Range)
FSH: 2.14 mIU/ml (0.95-11.95 mIU/ml)
LH: 4.20 mIU/ml (0.8-7.6 mIU/ml)
Total Testosterone: 421 ng/dl (400-1080 ng/dl 20-39 years)
Free Testosterone: 13,7 pg/ml (8.7-54.7 pg/ml 19-50 years)
E2: 26 pg/ml (< 52 pg/ml)
Prolactin: 7 ng/ml (2.1-17.7 ng/ml)
Progesterone: 0.3 ng/ml (0.1-0.2 ng/ml)
DHT: (I specifically told them DHT and they did DHEA damn them).
DHEA: 3.5 ng/ml (1.9-7.6 ng/m 21-49 years)
PSA: 0.753 ng/ml (< 4 ng/ml)
Total Cholesterol: 239 mg/dl (150-200 mg/dl)
LDL: 170 ug/dl (< 160 ug/dl)
HDL: 58 mg/dl (>35 mg/dl)
Lipid Profile: 635 mg/dl (400-1000 mg/dl)
Triglycerides: 57 mg/dl (40-400 mg/dl 40-250 ideal)
TSH: 1.881 mUI/ml (0.35 - 4.94 mUI/ml)
T3: 1.15 ng/mL (0.58-1.59 ng/mL)
T4: 7.52 ug/dl (4.87-11.72 ug/dl)
Cortisol: 6.8 ug/dl (4.3-22.4 ug/dl)
D25-OH D3: 26 pg/ml (9-50 pg/ml)
Ferritin: 65.6 ng/dl (20-270 ng/dl 19-42 years)
Glucose: 94 mg/dl (70-110 mg/dl)
Iron: 104 ug/dl (30-150 ug/dl)
Magnesium: 2.3 mg/dl (1.62-2.62 mg/dl)
Zinc: 68.3 ug/dl (72,6-127 ug/dl)

Obviously my testosterone, total and free, is right on the bottom of the scale. My zinc levels are below the lower limit. My progesterone is high, I am not sure whether that is good or bad, so I am researching it on the great internetz.

Any help and advice you guys could give me would be really great.

Thanks in advance.


#2

A little more progesterone is good for support of cortisol. What hour of day was the cortisol test? If you can restore cortisol production, that will be consuming some of the progesterone.

Test fT3, fT4, rT3

What is your iodine intake? Using sea salt only?
How much sea food?
Check waking body temp and during day, record for a few days and report.

take 4000-5000iu vit-D3, should be small oil based capsules

hematocrit?
iron might be low? Any gut/diarrhea problems?

you are growing olives in England?
lab tests are not in pmol, where are you?

suggest fish oil, high potency vit-B complex, should also have zinc and other minerals

DHEA test is bogus, needs to be DHEA-S [sulfate]

DHT will be low

LH is released in pulses, your result can be misleading. The FSH level tells the true story.

Headaches or anything else to report?


#3

Ksman,

Thanks a lot for the quick reply. I have responded to your questions and comments in the same order that you asked them:

The cortisol test was done at 10:00 am. I will look up how to boost cortisol production. Will working out harder and more often do that? As a father of 3 very young children I don't get much sleep, I know that causes cortisol levels to drop (and all other hormones too, including T, right?).

I will test fT3, fT4, rT3 and report back.

I don't know what the iodine content in my diet is is. We use iodized sea-salt, which I am reading on the label has 48ppm pottasium iodide. I looked up what the recommended ppm is and it's 15-22ppm in the UK, for what that's worth. We have quite a lot of salt in our food, more than a doctor would liley approve of. We eat seafood once a week as a main meal, and I will generally get in tuna or sardines or smoked salmon or sushi at least once more. I will take my body temp a couple of times a day over the next few days and report back on that, as you suggested.

I've already started on the D3 capsules, though only 2000IU a day. I will double that.

Thanks for the link for lamotrigine. It's a weird med with many many side effects, none of which are really bad, but all are annoying. I became aware over the last few days that it can increase progesterone production. I really want to get off it as I believe I have been misdiagnosed.

Hematocrit and so on. My CBC results are pretty typical for someone with Thalassaemia B Trait. I am sure you already know this but full-blown Thalassaemia is a congenital disease where the shape and size and number of red blood cells are affected. The blood has a very limited ability to transport oxygen and without some fairly dsgusting medication a sufferer will generally die very early in life. I only have the trait, like many people of Med descent. We live totally normal lives but our blood cells are still affected. Unusually for someone with the Trait I have good (if not great) hematocrit and good iron levels.

RBC: 6.48 M/ul (4.50 - 6.00)
HGB: 13.1 q/dl (14.0 - 18.0)
HCT: 42.5% (40 - 58)
MCV: 65.6 fl (79-98)
MCH: 20.2 pg/er (26 - 32)
MCHC: 30.8 q/dl (32 - 36)
RDW: 17.1% (11.6 - 14.6)
PLT: 346 k/ml (140-450)
MPV: 8.1 fl (7.6-10.8)
PDW: 11.9%
Iron: 104 ug/dl (30-150 ug/dl)

I have no gut/diarrhea problems. All my problems in that regard are in my stomach. My intestines are bullet proof.

I am in the process of moving back to Greece from England. We get our oil from our trees in the village where our family originally comes from. I got my blood tests done in Greece. I didn't see any pmol test results. Do you mean pg/ml? I will convert everything to the measurements that most people use on this site if you want.

I'm already taking zinc, because my blood tests showed I am deficient (as you'll see above). I have seen recommended doses for people with low-T from 50mg a day to 160 mg/day. I will start the fish oil, high potency vit-B complex, magnesium and a multi-vit and a multi-mineral.

I will get DHEA-S tested and leave DHT until (and if) my TT and FT levels rise a bit.

My FSH level does seem low at 2.14 mIU/ml (0.95-11.95 mIU/ml). This result surprised me because conceiving our 3 children was very very easy. (I am a paranoid fucker and I do know for sure that they are mine). I suppose that it could just be that my wife is extremely fertile. Would getting my sperm levels checked be overkill? I have looked up "natural" ways to boost FSH but I have seen stuff like licorice and grapefruit, which are bad for testosterone from what i have read. Maybe low-T and low-FSH are pointing towards Clomid though? I hope there is another solution.

As I said in my first post I suffer from migraines. I uaed to have one a month, now it seems to have dropped to about one every two months. I used to have regular headaches at least 4-5 times a week, but now i have only one every few weeks since I stopped taking any OTC painkillers for anything other than a migraine (when they don't do shit to help anyway). I had a few weeks of terrible headaches when I guess I was going through withdrawal, but now I am better than I have been in years.

Do you have any concerns about my cholesterol levels being high? They are not really crazily dangerously high and I have a good ratio of HDL:LDL.

Thanks again for your help.


#4

If you get vitamins with zinc, you should reduce or stop the zinc supplements.

If you got on TRT, your total cholesterol should come down, looks ok 4 now, not ideal.

TRT will improve hematocrit and RBC. [You can ask if that is a good thing.] Testosterone is indicated for anemia. http://en.wikipedia.org/wiki/Thalassemia

TRT might improve your functioning with Thalassemia.

Your iodine should be in good shape. Check your body temps. With low cortisol we can expect elevated rT3 that blocks your fT3 an can create some hypo symptoms even when T3 and T4 look good. [including low T, memory problems etc]

fish oil caps are always good

Adrenals are complex. Please read this:
http://www.amazon.co.uk/Adrenal-Fatigue-Century-Stress-Syndrome/dp/1890572152/
Note, above is Amazon.co.uk

You may need cortisol for a year or two while you recover your adrenals and stressors.

labs in Europe are done in pmols, most here are only used to using pg, ng etc.


#5

Hi Kon,

I lurk on these for a long time but I have registered now because I have I think help for you.

  1. When you have moved to Greece look for Dr. Mihalis Papachristou, endocrinologos-andrologos, in Athens. You will find him on google. He work with atheletes who used steroids and also with cancer people. He is very knowing.

  2. This is very hard for me to say and not my business I think but you say you sure your kids are yours. I am aure you have checked but my friend with so low testosterone plus so low fsh (your level 2.14 but good range for men is 5-15) I am not sure how you can be so fertile to so easily as you say have 3 childrens. Please I am sorry for saying this but I have knowledge of this issue with friend who his wife was pregnant when he was on deca-cycle, not bloody likely I think and of course child was not his, big problem. I see also that sometimes low FHS is not only badly effect sperm, I do not know.

Sorry for my English,

Nikos.


#6

Geia sou Niko,

Thanks for your recommendation for that doctor. I will definitely look him up.

As for your comments on my testosterone and fsh levels and the effect on my fertility, you don't need to apologise, I understand what you are saying.

One thing I would say to that is that yes my fsh level is 2.14mIU/m but the range the lab I went to uses is 0.95-11.95 mIU/m, not 5-15 which you quoted.

I don't know what that means and if my fsh level would still be considered too low to be able to father children. It's down towards the bottom of the range but it is not off the range. Also, FSH being too high is possibly an even bigger problem in that respect. There is the "Fertile Eunuch" syndrome where men with low testosterone and LH/FSH are fertile, but I don't know if that applies to me or if my hormone levels are not THAT low.

This is not a fertility board, but I don't know if anyone here (KSman?) has an opinion on this matter. It would be academic anyway, as I have done paternity tests, which is of dubious legality and defnitely not moral or ethical on my part.

I'd still be interested to hear KSman's view though, more as an opinion on what ranges actually mean (I'm sure that's all in one of the stickies).


#7

your higher TSH says that there seems to be a problem with your thyroid. That coupled with your very low cortisol test (8am blood draw should be in the 15-20 range) says that your Reverse T3 is probably too high.

I would investigate and resolve those issues first and see how your hormone react before jumping into HRT.

check out stopthethyroidmadness.com/things-we-have-learned

They have some great information.

also with your CHOL numbers you may want to think about getting on 100-500mg Niacin.


#8

Purechance thanks for coming in on this.

Is my TSH high? My level came back at 1.881 mUI/ml for a range of 0.35 - 4.94 mUI/ml.

It is so annoying not knowing "ideal" ranges rather than "everything that doctors have ever seen" ranges. I know though that in one of the stickies someone did make a list of ideal ranges that no one really disputed.

I am going to be doing more throid tests though, as you and Ksman have recommended.


#9

I felt bad with iodine deficiency pushing TSH=0.98-->1.6

With iodine supplementation I feel a lot better and body temps have recovered.

This is one data point.

Check your body temps. - that is very informative.