T Nation

40 Y/O Male 420TT, 5.1FT, Help Interpreting Labs (Brain Fog, Low Sex Drive)


#1

Would GREATLY appreciate your help with my results. I believe this is a perfect example of a test that a typical physician would look at and say "Looks good to me for a 40y/o, you just need some Wellbutrin. And a long walk on a beach with a unicorn, holding hands with a victoria secret model."

age: 40
height: 6'2"
waist: 32
weight: 185

describe body/facial hair:
light hair on legs, arms little to no hair, stray hairs on chest, none on back, facial hair wouldn't inspire envy... sideburns are sparse, hair on sides of face spotty, mustache and goatee decently thick. If I shaved my beard it would take me 6 - 7 weeks to grow it back.

Describe where you carry fat and how changed?
Don't carry much fat, never have. Hasn't changed. BF in the 10 - 12% range, clear 6 pack.

health conditions, symptoms [history]
Up until 38y/o super positive, driven, clear minded, sex every 2 days, patient

Now - Worry more, depressed feeling, fatigue, MAJOR brain fog, sex every 6 - 8 days, after sex feel grumpy for a day or so, feel like my patience with wife, kids, people in general is now into the asshole range. rarely act on it, but FEEL irritation and negative emotions in a strong way. the overall mental sharpness decrease, lack of patience and tired/depressed/lack of motivation makes me feel almost like a different person.

Rx and OTC drugs, any hair loss drugs or prostate drugs ever: No


lab results - LabCorp
Testosterone, Serum 417 <348 - 1197>
Free Test 5.1 <6.8 - 21.5>:cry:
Estradiol 17 <7.6 - 42.6>
LH 2.3 <1.7 - 8.6>
FSH 2.6 <1.5 - 12.4>
DHEA-S 175 <102 - 416>

Pregnenolone 66 <151 (Is my value low?)

TSH 1.81 <0.45 - 4.5>
Thyroxine (T4) 7.4 <4.5 - 12>
T4, Free, Direct 1.36 <0.82 - 1.77>
Triidthyronine, Free, Serum 2.8 <2.0 - 4.4>

Cholesterol, Total 183
Triglycerides 71
HDL-P (Total) 27
HDL-C 43
LDL-P 1392
LDL-C 126
Small LDL-P 434
LDL Size 21

PSA 0.3

Describe diet:
Fast until lunch 2X per week, Gluten Free diet, lots of fruits and veggies, moderate fats, moderate proteins, primarily from whole food sources, green smoothie with kale, spinach, carrots, blueberries, etc 2x a day for a snack. Problaby eat 150 - 200 gm protein, 8 - 10 servings of fruits / veggies, and around 40 - 60 gm of soluble fats

Describe training:
Just started making myself go to the gym again about three weeks ago. One of the things I stopped doing when I started feeling like this was to fall out of my training program, which I was consistent with for 14 years. Have done 5 - 6 cycles, 2 of which were 12 - 14 weeks, My last cycle tapered into injecting 100MG every 4 days for around 7 - 9 months. Have been off of AAS completely for 3 years.

Cross training / Weights 2X per week, 30 mins Cardio 1-2X per week

Testes ache, ever, with a fever? No

How have morning wood and nocturnal erections changed?
Yes. No morning wood or nocturnal erections (that I know of)

Thanks guys.

Mason


#2

Seems like you were never fully virilized. TRT should lead to more facial and body hair.

You have secondary hypogonadism and I suspect that this have been forever to some degree. But do we look for a cause?

These are unknowns:
- a blow to the head damaging pituitary
- pituitary adinoma
- a prolactin secreting adinoma that may show up if prolactin is tested
- AAS use was the cause, PCT was bad

Has your peripheral vision become reduced or still close to 180 degrees.

Thyroid:
I suspect that you have not been using iodized salt and/or vitamins that list iodine+selenium. If you do not have iodized salt in your home, whole family will be affected.
are your outer eyebrows sparse
feel cold easier now
others in home?

TSH 1.81 <0.45 - 4.5> - should be closer to 1.0
Thyroxine (T4) 7.4 <4.5 - 12> - below mid-range
T4, Free, Direct 1.36 <0.82 - 1.77> - good
Triidthyronine, Free, Serum 2.8 <2.0 - 4.4> - below mid-range

You can eval your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky.

Please read these stickies found here:

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • HPTA restart
  • finding a TRT doc

So what to do?
- respond re iodine sources and body temperatures
- read the HPTA restart sticky
- do above or get on TRT

As you virtualization seems to have been light, if HPTA restart works, you go at best back to where you were. TRT would be a good step up from there.

Many/most guys who come here have some issues with thyroid. Do not ignore this as the symptoms of low thyroid function are mostly the same as low T. So fixing low-T alone would still leave the thyroid symptoms in place. Thyroid hormone fT3 controls your energy levels and body temperature via regulation of mitochondria that make ATP, the basis of all cellular energy.


#3

Thank you for following up so quickly KSman. Suspect that I had low T my entire life. I didn't start shaving until I was 25 or 26. I looked like a freshman when I graduated high school.

When I did my first AAS cycle it changed my life. Transformed is probably a better word. More driven, more outgoing, more competitive... More confident.

At any rate, my PCT when I came off was 6 months long and included 4 months of 12.5 mg clomid, 5 days on, 2 days off. Overkill, but I went for it. Used HCG clomid and AI up front for the first 6 weeks. Didn't do blood work... This is my first TRT centric blood panel. Will do things the right way in that regard from here on out.

I am going to work on addressing the Thyroid issues to see if that helps with mental / energy. Would short term low dose supplementation of T3 allow me to more quickly rule out energy / brain fog issue link to Thyroid?

Have DR appt tomorrow to review blood work. This site and your service to its community is a blessing. Thank you sir for sharing your expertise.