[EDITED/SHORTENED] I'm looking for some guidance on this as I've been reading through a ton of posts here for the past week and I am sincerely grateful for all the stories, advice, and support you gentlemen have to offer here...
Age - 34
Height - 5’ 8.5” at most recent dr. visit, swear I was taller when I was younger
Waist - 36-38
Weight - 206 about 25% estimated BF
Hair - on chest, stomach, back, legs and butt, full facial beard capabilities. Hair on upper body slowly filled in late 20s
Carry fat - on the midsection from the nips down to the butt crack. Was chubby during grades 9-10 slimmed down during grades 11-12 and most of 20-30s but never was ripped or “athletic” looking despite a very active/athletic lifestyle. Heavy midsection fat increase end of 2011 and unable to remove it still to this day despite clean diet and consistent training.
Rx Meds/Hair Meds: Used generic minoxidil products for about 1 year around 2004-06 and then stopped, never used oral meds for hair. The baldness has progressed slowly but I just shave it all off now and have for the past 6 years. Currently no Rx meds. Used generic provigil/modafinil (modalert 200) recently, purchased online and started around beginning of April 2016 in an attempt to remedy fatigue but it was inconsistent so I stopped.
Training - started Crossfit 8 months ago and scaled slowly to a now consistent 4-6 days per week 60-75 mins per workout. If I stop training for even a week or 2 I regress pretty bad physically feeling weak and jiggly..
Testes ache? - NO
Morning wood - I didn’t even notice it had declined so substantially until I started researching TRT and revisiting my past memories to realize that my morning wood is NOT what it used to be. Rare urges for sex.
Diet - NO iodized salt. 2000-3000 calories per day mostly organic foods, lean proteins 180-220g protein daily, vegetables, some fruits, low GI carbs, good fats. Mid-March I felt plateaued and hadn’t been improving for the previous 2 months so started this Herbalife shake deal which is basically 2 protein shakes/day along with vitamins and 2 solid meals per day being sure to eat 150g+ lean protein daily.
Past 9 days I haven’t worked out nor taken workout supplements besides vitamins listed below…
MultiVitamin by Herbalife, take 1x3 daily, Iodine 50mcg, Selenium 17mcg
Cell Activator by Herbalife, take 1x2 daily, Alpha lipoic acid 150mg, Aloe Vera, shitake mushroom, pomegranate rind, pine bark extract, rhodiola root
Omega-3, take 4 daily, 500EPA/250DHA each pill
D3, take 1x2 daily, 2000iu each
Glucosamine/Chondroitin/MSM, take 1x3 daily, originally helped relieve some major shoulder pains and my joints hurt if I miss these, even after not working out for 9 days.
BodyMint, 1x2 daily, Cholorophyllin
Supplements pre/post workouts:
Creatine powder 5g/day (was taking daily after load)
BCAA purple wraath 2 scoop/day (1 scoop pre, 1 scoop post w/o)
Naked pea protein 26-52g/day
Fatigue - major fatigue lately and progressed significantly over the past year. I almost didn't notice it till I realized I had been trying to remedy with coffee then generic provigil. Then about a week prior to this post it hit me, unable to do anything.
Lack of motivation - typically a very driven person now just feeling down in the dumps, antisocial, not excited to go out and accomplish my goals.
Extreme difficulty putting on muscle, easily put on fat. If I don't work out, I'll get fat very quickly no matter how clean I eat or how much I count my calories. Difficult recoveries from workouts.
Lower sexual libido - see morning wood above
Trouble sleeping well - I’m hot when I fall asleep and cold in the early morning (my woman is exact opposite), check my body temps below
Perspiration - I sweat more than normal. Sweat in my sleep. Sweat very quickly in the warm up at CF
Urinate frequently - I urinate way more often than I feel I should, seeming like after every time I take a drink. I drink at least a gallon of water per day.
Feeling bloated - I’m not as gassy/farty as I used to be, probably because of the cleaner diet, but still feel bloated and fater than usual at times. This is in addition to my on/off jigglyness.
Sensitivity to chemicals - I can feel it when I eat something that has MSG. Also can feel my body become inflamed if I eat dirt food like pizza/ice cream.
Elevated blood pressure: I donate blood around 4-6 times per year so I get readings of my BP and at one point about a year ago I was reading 135/95 which is moderate hypertension but at the same time I was eating a very clean diet and exercising lightly but was still overweight. It wasn’t until I started exercising heavily that my blood pressure then went down to 120/82 with my most recent reading at 124/86 on 6/15.
I'm a regular blood donor (but missed my last donation, got one next week) and notice that my body temp has always been low like 96/97, can't ever remember a 98.
6/14 mid afternoon 200pm - 97.3
6/14 mid night 730pm - 97.4
6/15 waking 630am - 96.9
6/15 mid afternoon 130pm - 97.3
6/16 waking 615am - 96.2 (woke with headache felt like a hangover, I don’t drink)
6/16 morning 930am - 96.9
Labs below from 6/9/2016:
TESTOSTERONE, TOTAL 480 ng/dL (250 to 1100) QuestDiag
TESTOSTERONE, FREE 98.0 pg/mL (35.0 to 155.0) QuestDiag
ESTRADIOL 48.8 pg/ml (0 - 56 pg/ml)
TSH 3.21 uIU/ml (0.55 - 4.78 uIU/ml)
WBC, AUTO 7.2 K/ul (4.8 - 10.8 K/ul)
RBC, AUTO 6.27 M/ul (4.15 - 6.10 M/ul)
HGB, AUTO 16.2 gm/dl (12.5 - 18.0 gm/dl)
HCT, AUTO 48.8 % (37.5 - 52.0 %)
MCV 77.8 FL (80 - 99 FL)
MCHC 33.2 gm/dl (32 - 36 gm/dl)
RDW, RBC 13.0 % (0.0 - 14.5 %)
PLATELETS, AUTO 292 K/uL (130 - 440 K/uL)
DIFF METHOD AUTOMATED
NEUTROPHILS, AUTO 3.3 / 45.3% K/ul (1.8 - 8 K/ul)
LYMPHS, AUTO 3.2 / 45.0% K/ul (1 - 6 K/ul)
MONOCYTES, AUTO 0.5 / 7.6% K/ul (0.0 - 0.80 K/ul)
EOSINOPHIL, AUTO 0.1 / 1.8% K/ul (0.0 - 0.65 K/ul)
BASOPHILS, AUTO 0.0 / 0.3% K/ul (0.0 - 0.20 K/ul)
CHOL 191 mg/dl (<200 mg/dl)
TRIGLYCERIDE 65 mg/dl (<200 mg/dl)
HDL 49 mg/dl (>34 mg/dl)
VLDL, CALC 13 mg/dl (0 - 40 mg/dl)
LDL, CALCULATED 129 mg/dl 1 (0 - 129 mg/dl)
HGB A1C %, HPLC 5.4 % (<5.7 % normal)
GLUCOSE, FASTING 96 mg/dl (70 - 99 mg/dl)
CREATININE 1.05 mg/dl (0.50 - 1.20 mg/dl)
PROTEIN, UR, QUANT 16 mg/dl (<10 mg/dl)
CREATININE, UR 207 mg/dl
PROTEIN/CREATININE RATIO 0.1
CALCIUM 9.6 mg/dl (8.7 - 10.0 mg/dl)
BUN 15 mg/dl (8 - 20 mg/dl)
VITAMIN B12 851 pg/ml (180 - 914 pg/ml)
FOLATE >22.0 ng/ml (>4.0 ng/ml)
SODIUM 139 mmol/L (135 - 145 mmol/L)
POTASSIUM 4.4 mmol/L (3.5 - 5.3 mmol/L)
CL 104 mmol/L (98 - 108 mmol/L)
CO2 26 mmol/L (22 - 32 mmol/L)
VIT D,25-HYDROXY 58 ng/ml (30 - 100 ng/ml)
AST 40 U/L (11 - 41 U/L)
ALT 58 U/L (5 - 63 U/L)
ALK PHOS 70 U/L )20 - 126 U/L)
APPEARANCE, UA YELLOW CLEAR
SP. GRAVITY, UA 1.010 (1.005 - 1.030)
PH, UA 7.0
LEUKO. ESTERASE, UA 0 0
NITRITE, UA 0 0
PROTEIN, UA 0 0
GLUCOSE, UA 0 GM% 0 GM%
KETONE, UA 0 0
UROBILINOGEN, UA NORMAL MG/DL <4 MG/DL
BILIRUBIN, UA 0 0
HGB, UA 0 0
I have Kaiser medical.
4/2016 - initially met with my PCP in about the fatigue and attempted to get a Provigil Rx but he instead he Rx'd me sleeping pills which I didn't fill because I didn't need more sleep, need more energy. Instead I just bought the provigil online and it was helpful but didn’t help much.
6/8 - the day after my major fatigue crash I saw PCP again and told him about my symptoms and asked him if it could be Testosterone related he said maybe but it's not common but he ordered the above tests anyways since it's been years since I've seen a doctor. Over the next 5 days I received the results and dug into them with pubmeds and posts here and elsewhere online.
6/14 - I emailed PCP stating that my E2 is way high for my age (referencing a study), my TSH is high (referencing AACE recommendation range change in 2002), my TT is in the range of a 75 year old (ref 1996 study), and although my FT is okay it could be moot because of my high E2 levels.
6/15 - did an early AM phone appt with PCP who told me my labs are in normal range so all good but referred me to the Endo to answer my concerns from my email.
6/15 - pulled a rabbit out of my hat and managed to book a late AM appt with the Endo. I shared my symptoms and E2, TSH, TT, FT lab concerns. DOC could give me AI to help lower my E2 but doesn't think it will make a difference in my quality of life. If I was at 380 TT DOC might consider TRT but I'm at 480.
DOC thinks my symptoms may be iron deficiency, wants to to check cortisol (24 hours of urine), orders more labs and some to be redone. Also mentioned possible sleep study for sleep apnea (I used to sleep fine last year and I don’t snore). I got a feeling DOC is opened to patients being active in their health care so I asked if I could email a list of tests to add to my lab order and the answer was yes so long as they're not crazy. I emailed 8 tests to add, DOC replied that not all of those I requested are clinically relevant to me so did NOT add rT3, Progesterone, PSA, CoQ10, to my lab order.
6/16 - blood drawn
6/17 - 24 urine testing all day
Below are new and repeat labs coming over the next week:
ANTI-MICROSCOMAL AB (ANTI-TPO)
T3, FREE, TRACER DIALYSIS
CORTISOL FREE 24 HOUR URINE
I've read all the recommended stickies (super informative gents, nicely done!) and upon KSman's suggestion I'm now looking for a high potency Iodine supplement to begin after my 24 hour urine deal. My multi-vit already contains iodine and selenium but perhaps not enough.
I'll add the lab results in as I receive them, however in the mean time do you have any suggestions?