Body: Lanky; probably ~ 12% BF (4-pack) 2xBW squat 2.8xBW DL
Facial Hair: 2 and a half year old beard. Full head of hair
Fat Storage: Waist and glutes. Legs are very lean. No obvious gynecomastia.
Rx/OTC: None, occasional excedrin for headaches/migraine
Lab Results: (what / [normal] / mine)
- TESTOSTERONE, TOTAL [332 - 896 ng/dL] 100
- Vitamin B12 EXT [145 - 915 pg/mL] 907
- TSH EXT [0.350 - 3.000 uIU/mL] 2.230
++ Complete Blood Panel
-WBC EXT [4.0 - 10.0 10Â³/ÂµL] 12.4 SA=SIGNIFICANTLY ABNORMAL Result
- RBC EXT [4.5 - 6.5 10] 4.9
- HGB EXT [13.0 - 18.0 g/dL] 15.6
- Hct [40.0 - 54.0 %] 44.1
- MCV EXT [80 - 100 Æ?L] 90
- MCH EXT [27.5 - 34.7 pg] 31.6
- MCHC EXT [32.0 - 36.0 g/dL] 35.2
- RDW EXT [11.0 - 16.0 %] 11.0
- PLATELET EXT [150 - 500 10Â³/ÂµL] 318
++ Metabolic Panel
- Sodium EXT [135 - 145 mEq/L] 142
- Potassium EXT [3.5 - 5.2 mEq/L] 4.2
- Chloride EXT [98 - 109 mEq/L] 103
- CO2 EXT [21 - 31 mEq/L] 30
- Glucose EXT [70 - 105 mg/dL] 75 Impaired Fasting Glucose when Fasting glucose is between 100 and 125 mg/dl
- BUN EXT [7 - 25 mg/dL] 24
- Creatinine EXT [0.70 - 1.40 mg/dL] 1.09
- eGFR EXT [>60 mL/min] >60
- eGFR, African American EXT [>60 mL/min] >60
- BUN/Creat Ratio EXT [3 - 40 Ratio] 22
- Calcium EXT [8.2 - 10.4 mg/dL] 9.9
- Total Protein EXT [6.4 - 8.9 gm/dL] 7.0
- Albumin EXT [3.5 - 5.7 gm/dL] 4.8
- Globulin EXT [2.0 - 4.0 gm/dL] 2.2
- A/G Ratio EXT [0.9 - 2.1 Ratio] 2.2
- AST (GOT) EXT [13 - 39 U/L] 22
- Alkaline phospatase EXT [34 - 104 U/L] 83
- ALT (GPT) EXT [7 - 52 U/L] 33
- Total Bili EXT [0.3 - 1.0 mg/dL] 0.4
++ Lipid Panel
- Cholesterol EXT [0 - 200 mg/dL] 167
- Triglycerides EXT [0 - 200 mg/dl] 238
- HDL Cholesterol EXT [23 - 92 mg/dL] 51
- Non-HDL EXT 116 *=Non-HDL goal: to be < 30 points above LDL goal
- Lipid panel Calc. LDL EXT [0 - 130 mg/dL] 68
- Urine Color EXT Yellow
- Urine Appearance EXT Clear
- Urine S.G. EXT 1.020
- Urine pH EXT 6.5
- Urine Leukocyte esterase EXT Negative
- Urine Nitrite EXT Negative
- Urine Protein EXT Negative
- Urine Glucose EXT Normal
- Urine Ketones EXT Negative
- Urine Bilirubin EXT Negative
- Urine Urobilinogen EXT Trace (Normal)
- Urine blood EXT Negative
- Urine WBC EXT None
- Urine RBC EXT None
- Urine Squamous Epithelial EXT None
- Urine Bacteria EXT None
Diet: Intermittent fasting. Maintaining, averaging 2600 kcal/day, eat out 1x/wk otherwise home cooked meals. 1-3 caffeinated beverages/day. Typical day: half dozen eggs + tortillas; protein oatmeal, shake, trail mix, home cooked dinner w/family.
Training: Currently DUP, 3x/wk squat and bench, 1x/wk deadlift, 1x/wk accessory. Happy to post program but I don't think I'm overtraining.
Testes: Righty never 'grew up' and was noted by pediatrician. Lefty had a testicular cyst removed 6 years ago [non-cancerous]. Vasectomy 8 years ago.
Morning Wood: Not as hard but still frequent. Sex w/wife 3-4 times/week.
Health Conditions: Former chronic migraines extremely reduced by gluten free diet (celiac blood tests came back mixed. Did not pay for a genetic test). Spent 10 years on all kinds of drugs [anti-seizure, anti-depressant, blood pressure] prior to that for migraine pain management but have been 'clean' for 2+ years.
Symptoms: I didn't go to the doc suspecting low test, I went for a physical but with the following complaints:
- Night sweats 1-2x/month
- Brain Fog
- Verbal confusion and loss of words in conversation
Based on symptoms, both my doctor and I suspected sleep apnea. I had previously been diagnosed with apnea when sleeping on my back (low blood oxygenation) but fine on my side. Instead of a CPAP I decided to try and sleep on my side. Wife rolls me over 1-2x/week when snoring on my back. Doc thought maybe I was sleeping on my back more than we realized, but wanted to eliminate (1) thyroid (2) anemia (3) testosterone. See lab results above; test is absymally low, all other labs came back great (high WBC, recovering from cold)
This all came as a shock to me, really, because I'm a competitive powerlifter who is pretty strong and, I thought, pretty lean for my age. I have sex with my wife of 12 years 3x/week which is less than when we first married but still I think pretty good for a couple in their 30s where everything is familiar and whatnot, and with a couple pre-teen kids keeping us busy. I have a thick head of hair and a prolific beard. I coach my kids' flag football team. Basically you look at me and say 'no way' but yeah, way.
After reading more and reflecting since the diagnosis with my wife, I see the following additional symptoms that are likely related:
- Irrational irritability on occasion
- Work drive is a lot lower than it used to be
- Feel fatigued easier when stressed out about things
- Fleeting interests, my wife calls them 'four day hobbies' where I get into something for a few weeks then lose interest.
I have a followup appt with doctor (internal medicine) on Monday to address some of my concerns, then we will proceed with 100 mg test injections.
+ Should we do a cortisol lab?
+ Should we do a LH/Prolactin test to try and figure out why?
+ High white blood cell count might not be getting over cold; could it indicative of an infection (or overtraining?) which may be causing low T?
I get it, my T is super low and needs to be treated, the human in me though is driven by stories and having a story to say why my T is low would make me feel better and let me put a bow on that chapter of my life.
Thanks for listening, anything else I should address with my doctor? Again trying to figure out 'why' is it possible the testicular cyst did something? We did ultrasounds before/after and blood flow was fine. I didn't notice an immediate effect of the surgery, but reflecting I can see that after the surgery my work drive depleted somewhat, and my desire for sex decreased to a point [I unhooked myself from a long standing porn habit easier than I thought I would have].