T Nation

36 Yr Old Male, Hoping for Advice

T Replacement
#1

I apologize in advance if I did this wrong, I tried to follow the stickies as bast I could.

Age: 36
Height: 5’11"
Weight: 270
Body and facial hair - Very little body hair - very sparse facial hair with none in several areas. Wouldn’t appear to be hereditary as I am the only one in my family that I know of who isn’t fairly hairy.
Describe where you carry fat and how changed - Pretty evenly, but have a large belly and love handles, and carry some weight in the chest and legs especially the thighs.

Lab Results:
Testosterone 331 (249-836)
Free T 10.1 (8.7-25.1)
I discovered this forum after I had the labs done, or I would have done more extensive testing.

Basically, I had asked my doctor about my lack of body and facial hair, and he suggested a testosterone test. After I had the blood drawn, I did a little research and noticed that I had several other symptoms such as lack of motivation, confidence (partly because of the lack of facial hair) and energy, difficulty concentrating, and according to my wife, reduced sex drive.

The doctor’s office called today and said the doctor had reviewed the results and said the results were normal, that this wasn’t causing my fatigue, and wanted me to come back in for a TSH test and then possibly a sleep test. I was confused because I’m not particularly fatigued, it’s more a lack of motivation than tiredness. No mention of the other symptoms or the lack of hair. Should I insist on further testing and possibly even go to another doctor, or is it more likely that my symptoms are thyroid and my test results in being in the low end of normal are just because I am overweight? Wondering if anyone had some advice based on this limited information so I can decide what my next step is. I have insurance with a very high deductible, so it’s hard to go see a ton of doctors.

#2

hey mate, your story is very common and we have seen this scenario played out many times…unfortunately a lot of these docs just ignore blatant symptoms and go off into nether-nether land, until they ultimately land on “depression”…just be forewarned and do not accept that as an answer, unless you have exhausted other means (some people legitimately are depressed!)

For your situation, I would stick with this doc for a bit and see what bloodwork you can get him to order…he is both right and wrong…right in the sense that other things could be causing your fatigue, but wrong just to ignore the low T levels because they are “in range”…one thing is for sure is that they certainly aren’t optimal–now the challenge is to figure out :why:

Check out the Recommended Bloodwork stickey and push for as many of those as you can…if you aren’t sure why certain ones are needed, then ask and we will do the best we can to help you…the more bloodwork you can get, the more complete picture you can paint of your overall health and start to connect the dots…

For you, given the fact that you are overweight and your given symptoms, I would certainly push for the following (at a minimum):

-LH
-FSH
-Estradiol (E2)
-TSH
-fT3
-fT4
-8 am cortisol

If you can get the following, then they are a bonus:
-TT3
-TT4
-RT3
-SHBG
-Ferritin
-Vitamin D

Most people that don’t supplement are Vit D insufficient. I always recommend the following supplements regardless of one’s situation:
-Vit D (around 6k iu/day)
-Fish Oil (3-4 g/day)
-Good multivitamin

Vit B12 is another good supplement.

Why is facial hair such a big issue for you? Lots of men do not have grizzly adams beards and they do just fine…not trying to dictate what is important to you here, just trying to get a better understanding…

#3

Your testosterone results ARE normal…for a 70 year old man. I ran into the same issue with my primary care physician. I tested @ 308, but at 37 years old, was well below “normal” for my age. Ended up being tested again at a specialist, but came in at 213 total test. They started me on TRT immediately…and said that they would’ve treated me even at 308 due to my age. I’ve only been doing it for 11 days, so I’m not sure how well it’s going to work yet. I’d suggest another doctor who specializes in TRT. Most primary care docs (even urologists) don’t deal with TRT and don’t know what they’re doing.

#4

Thank you for that advice. I actually do take 5kIU of Vitamin D per day, a multi-vitamin, and fish and krill oil. I also take a kelp tablet since I don’t eat iodized salt.

Since he wants me to come in for the TSH test, I will definitely ask about the other tests as well and try to get them done. He wanted to do a sleep test too, but I’m going to hold off on that until I eliminate everything else since it’s expensive and I don’t feel particularly tired.

As far as the facial hair - When I was about 19 or so I was obsessed about the fact that I had less facial hair than my peers. It passed though and for the past decade and a half I’ve rarely even though about it. Lately it’s been bothering me again, and I think it’s because I worry that there is a medical cause that I haven’t gotten to the bottom of yet. I think if I knew for sure it wasn’t due to to a problem and just how I am genetically, it wouldn’t bother me so much.

#5

When you say sleep test, I assume you mean for sleep apnea? I had one done…it was a pain in the ass, but my insurance covered 100%…I didn’t even have a copay…so that may be your situation as well, not sure…

They determined that I had mild apnea and had a few “episodes” or whatever they call it during the night, but overall it wasn’t impacting my QOL…so that’s when my doc settled on “depression”…it turned out to be testicular cancer, but that is a whole 'nother story…

#6

VT did you ever go back to that doctor and tell him that in fact the depression he had diagnosed you with was actually cancer?

#7

[quote]PureChance wrote:

VT did you ever go back to that doctor and tell him that in fact the depression he had diagnosed you with was actually cancer?

[/quote]
Bah. Depression…cancer. What’s a minor little mistake like that between friends?

#8

I’ve been taping a golf ball to my back for awhile now and this forces me to sleep on my sides. I don’t snore anymore, and have no issues with apnea. Still didn’t fix my issues, and I was tested in March and total test was 320. I’ve been on TRT since then and I feel fantastic.