T Nation

38, Tired and Frustrated

38 yo
6’2"
41" waist
have facial hair but thinner and almost nothing on cheek very pubic like. No chest hair except around nipples. Hair on the belly. Arm and legs are not very hairy at all and have very little hair on lower legs below calves.
I carry fat in the gut, ass, lower pecks and upper thighs.

Right now I feel tired all the time. I usually sleep the night through but I toss and turn while sleeping. For as long as I can remember I’ve wondered what people meant when they say they woke up feeling refreshed. I started to believe it was just better than when they went to bed because I have never felt refreshed. I feel like nothing excites me like it should. I want to go out and do things I enjoy but then feel like everything is too much work. I get frustrated easily and very irritable. There have been times that I felt a lot of anxiety to where I would leave work to go make sure I didn’t leave the stove on or something like that, sometimes multiple times a week. I haven’t done that for a while though. Wife believes I have anxiety issues. I do socially with strangers but otherwise I don’t feel like I do but that may be where my anger and irritability come out from. I feel like my arms have atrophied but not sure if it is just definition lost due to weight gain. Feel like strength is hard to come by but have been able to make some progress. Size is not going anywhere. Recently overcame or close to it, what I believe to be tendonitis or impingement in shoulder for the second time in last 2-4 years.

Used rogaine for maybe 9-12 months.

SODIUM |138| 136-145 mEq/L
POTASSIUM |4.2| 3.6-5.2 mEq/L
CHLORIDE |106| 99-111 mEq/L
CARBON DIOXIDE |22| 16-29 mEq/L
ANION GAP |10| 8-16
GLUCOSE |100| 70-115 mg/dL
BLOOD UREA NITROGEN |15| 8-25 mg/dL
CREATININE |1.04| 0.72-1.25 mg/dL
GLOMERULAR FILTRATION RATE |>60| 60-130
TOTAL PROTEIN |7.1| 6.4-8.3 g/dL
ALBUMIN |4.4| 3.5-5.0 g/dL
GLOBULIN |2.7| 1.8-3.5 gm/dL
ALBUMIN/GLOBULIN RATIO |1.63|
CALCIUM |9.3| 8.4-10.2 mg/dL
BILIRUBIN TOTAL |0.4| 0.2-1.2 mg/dL
SGOT/AST|40| 5-50 IU/L
SGPT/ALT |58| 9-55 IU/L
ALKALINE PHOSPHATASE |55| 40-150 U/L

WHITE BLOOD CELL |5.57| 4.50-10.60 10 3/uL
RED BLOOD CELL |4.79| 4.50-5.90 10 6/uL
HEMOGLOBIN |15.2| 13.5-17.5 g/dL|
HEMATOCRIT |43.8| 41.0-53.0 %|
MEAN CELL VOLUME |91.4| 80.0-100.0 fL|
MEAN CELL HGB |31.7| 26.2-32.5 pg|
MEAN CELL HGB CONCENTRATION |34.7| 32.0-36.0 g/dl|
RED CELL DISTRIBUTION WIDTH |11.3| 11.3-15.6 %
PLATELET COUNT |219| 150-400 10 3/uL
IMMATURE PLATELET FRACTION %|0.0| 0.0-3.2 %
NEUTROPHILS % (AUTO) |50.1| 36.0-66.0 %
LYMPHOCYTES % (AUTO) |38.4| 25.0-44.0 %|
MONOCYTES % (AUTO) |7.0| 0.0-12.0 %
EOSINOPHILS % (AUTO) |3.6| 0.0-5.0 %
BASOPHILS % (AUTO) |0.5| 0.0-5.0 %
IMMATURE GRANULOCYTES % |0.4| 0.0-0.4 %
IMMATURE GRANULOCYTES ABSOLUTE |0.02| 0.00-0.03 10 3/uL
NEUTROPHILS # (AUTO) |2.79| 1.80-6.80 10 3/uL
LYMPHOCYTES # (AUTO) |2.14| 1.20-3.40 10 3/uL
MONOCYTES # (AUTO) |0.39| 0.20-0.90 10 3/uL
EOSINOPHILS # (AUTO) |0.20| 0.00-0.50 10 3/uL|
NRBCAB ABSOLUTE |0.00| 0.00-1.10 10 3/uL
TRIGLYCERIDES |94| 7-150 mg/dL
CHOLESTEROL |216| 7-200 mg/dL
HDL CHOLESTEROL |48| 40-150 mg/dL
LDL CHOLESTEROL - CALCULATED |149| 1-100 mg/dl
VLDL CHOLESTEROL |19| 2-30 mg/dL
CHOLESTEROL/HDL RATIO |4.5| 0.0-5.0

THYROID STIMULATING HORMONE 2.27 0.35-4.94 uIU/mL
T4 FREE 0.82 0.70-1.48 ng/dL

TESTOSTERONE TOTAL |307| 264-916 ng/dL
TESTOSTERONE FREE |11.6| 8.7-25.1 pg/mL

Diet I feel is not the cleanest right now but is not horrible. I eat a lot of chicken breast, salad and broccoli. But burgers, chips and such do make their way in occasionaly. Never really done starvation type diet but have ran keto a couple time and a high protein, moderate carb, low fat diet. I think I’m usually around 3000 cal. currently
I currently take a multi vitamin,magnesium, creatine, glutamine, whey protien and was taking but not currently ashwaghanda and l-theanine.

I usually workout 3-5 times a week using weights with very seldom cardio. Last couple of years mostly stuck with heavy 4-8 rep ranges but occasionally mix in some higher rep sets. Focus a lot on the big three lifts the last couple of years.

Have not felt too much of ache but occasionally after ejaculation I have felt a very light ache.

Never really felt I have had strong erections except right after ejaculation and some morning woods, but last couple years felt they have gotten weaker. Morning wood is almost non-existent. Doc says testes are normal and personally haven’t noticed any thing but do feel that maybe my penis has atrophied maybe just from weight gain though.

I know labs are incomplete from what you would want but that’s all I was able to get from the doctor. Was wondering if there was anything else you could glean from them that I don’t know to look for beside the the lower T.

Thank you for your time.

Has your doc talked to you about TRT? A value of 307 is pretty low for a 38 year old.

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No I haven’t talked to him about my results yet. I only know thenm because I stalked the patient portal until they were posted. I’m pretty sure it will be a no go with him though, as I did see in the note section him telling his MA to call me and say they were normal.

In the health related stuff I forgot to mention I am a former smoker. Quit about 9 years ago but may have one or two with friends every 6 months or so, so very rarely. I also use to drug a lot from when I was 18-21, did almost everything but heroin and pcp and the like, unless ecstasy or something was cut with it which is very well likely. I do drink but not too heavily and only on the weekends for the most part. I did take a baseball bat to the back of the head, hard enough to need stitches when I was around 8 but do not ever remember being diagnosed with a concussion ever.

Sounds as though you will definitely need another doctor. You need TRT and further evaluation of your thyroid, especially fT3 and rT3. Actually, you should have a lot more, FSH, LH, prolactin, E2, DHEA-S, SHBG, IGF-1, VitD, PSA.

They weren’t really diagnosing concussions 30 years ago like they do today. Almost guarantee you were concussed. Did you go unconscious?

No never went unconscious.

I figured I need TRT. The wife wants me to try getting it up naturally before anything but I can’t imagine me getting myself up high enough to matter. Just high enough to make it harder to be treated. I’m going to get myself a thermometer and monitor my temps for a little self diagnosis and will post my results up when I get them.

You must understand you are at the bottom end of the ranges and are expected to have problems, the insurance company requires two readings below 300 in order for them to give you treatment. So by the doctors saying your normal, the insurance company doesn’t have to pay out of your claim and the insurance companies win.

There’s no denying that you have the testosterone levels of a 90 year old man, so really you’re not even close to normal if you base your numbers off the average of men your age, it would place you well below average. It’s an injustice because of the diseases associated with these levels, erection troubles are only the beginning, heart disease, cardiovascular disease, dementia and alzheimer’s are to follow.

You need to get together with a new compassionate doctor.

I pay for my own TRT because I’m tired of dealing with the broke ass sick care model!

Yeah I was kind of predicted exactly what would happen with my doc. Doesn’t help his case of keeping him around now that I am being more proactive in my care. I asked to have my T checked about 7 years ago said he would when I asked about them he then said they were fine. I now know how to find them and come to find out there is no record of them even being ran.
I’ve been reading a lot of posts and your constantly stating how much you like Defy so I’m keeping them in my head. There is a new medical clinic here where I’m at that is advertising for HRT and TRT that I may check out. Has a nurse practitioner doing it and blurb about her makes her seem more into “alternative” type medicine. I like the idea of having someone local but at the same time I do worry even if she is open that she still will not understand the ins and outs of TRT. That does seem to be her focus though.
Do you know if non insurance approved TRT can still be payed for with a Health Savings Account?

Yes.

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A Total Test of 307 ng/dl is in range now. I believe last year the range was something like 350-1100.

They have lowered the reference ranges, which makes that 307 seem not as bad. Last year you would have been under.

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Lowering the reference ranges has two benefits, insurance can deny your claim for treatment and Viagra and Cialis market increases to do TRT being denied do to levels are in range. More drugs are sold when the underlying problems is low testosterone.

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They dropped it quite a bit then bringing it all the way down to 264. That’s damn near another 100 points lower and the high end is near 200 points lower then it was. I’m real frustrated right now with it all. It’s causing me to stress over it because I don’t want to have to pay for it
and that in turn isn’t helping things internally.

On iodine and selenium supplementation what is a good protocol? I went through the sticky and couldn’t find anything on it. Is it in the stickies and I’m just blind with damn brain fog? It is looking like I am hypothyroid also according to temps I have taken so far (highest has been 97.7°), so I was going to try to repair that next.

After you find out that most insurance doctors are clueless in regards to TRT, you will see the benefit of going private.

Humans are good at nickel and diming when it comes to their health, invest in your health.

I’m good at nickel and diming everything in life not just health so the struggle is real lol.

I have been bringing this up a lot lately. I feel like the ranges pretty much don’t matter (for test, I think they have a place for other markers).

What would be better is a range where nobody had symptoms associated with low T.

I think for a lot of reasons (diet, work environment, exercise levels), testosterone levels have been dropping. If the average man in the future has low T symptoms, but fits in the adjusted ranges, are we just going to accept that as normal?

Keep in mind with a service like Defy, that the first year is going to be more money.

It seems like after the first year it will be around $120/month. First year will probably work out to more like $160/month. They are pretty up front with the costs.

Based on how you feel, is there something you could give up to feel better? Cutting cable TV would probably get you at least half way there.

Cable/Sat. tv has been gone for about 4 years. Have some of the streaming services but cutting those would be a no go with the rest of the family. Rarely eat out either. I know I could swing it, just hard to swallow a lifelong payment like that. Hard to swallow a lifetime of feeling like this though too.