T Nation

40 Year old, Low T, Constantly Tired


Hello Everyone,

Been feeling really rundown for the last few years. Also feel like I am getting old real quick. Last December 2016 I was found out I had mild sleep apnea. Ended up getting a APAP machine and have been using it ever since. In July I went to be Sleep Doctor for a follow up and according to his analysis of the data everything was looking good (AHI<3). I do feel like I am getting better sleep now. I told him that I still felt run down all the time. He then looked at my chart and saw that I was 40 years old. Told me its time to go get your Testosterone checked. Ended up getting blood work done the next day and then found out that my T was low (Total T = 271 Quest Diagnostics). Also found out I was deficient in Vitamin D and B12. Doctor put me on 50,000IU Vitimin D2 once/week for 4 weeks. Also was told to start taking sublingual B12. He also asked me to see a urologist for the Low T.

I decided I need to do some research first and found this site among others. I read through all of the stickies here. Read a few books on the subject. Based on what I found I started eating better. Started eating coconut and olive oil. Also started taking a Multi vitamin, ZMA, 1000IU Vitamin D3 daily, and Iodine supplements (Lodoral).

On the exercise front in addition to my normal resistance training I started to take a daily walk around lunch time so I could soak up some sun.

I did all of these things for about 2 months so that when I got my T rechecked I could see if they made any difference.

Last week I contacted a Dr in Tampa who specializes in TRT. Went to their office and had some more blood work done. Results came in today.

Testosterone, Serum 319 ng/dL 264 - 916
Free Testosterone(Direct) 8.6 pg/mL 6.8 - 21.5
DHEA-Sulfate 218.6 ug/dL 102.6 - 416.3
TSH 1.620 uIU/mL 0.450 - 4.500
Luteinizing Hormone(LH), SLH 4.3 mIU/mL 1.7 - 8.6
Estradiol, Sensitive 22.1 pg/mL 8.0 - 35.0
Sex Horm Binding Glob, Serum 20.1 nmol/L 16.5 - 55.9
Prostate Specific Ag, Serum 0.8 ng/mL 0.0 - 4.0

Also of note from the Metabolic panel:
ALT (SGPT) 48 High IU/L 0 - 44

So as you can see there really hasn’t been much improvement in my T level. I have a follow up appointment with the Dr on 10/31. I wanted to put this out in front of the community to get your thoughts.

I appreciate any insight you guys can provide.


Your T is a bit low. And you would probably benefit from higher levels. If nothing else your weight would likely be much easier to control.

Have you made sure you do not have any thyroid issues?

I assume you have read these stickies

So you should know what test results you should post here when you get them done. Generally finding a doctor who knows anything about Hormone replacement in men can be rough.


Thanks for the input Verne. I did see the stickies on thyroid. I know that I rarely ever put salt on my food and we never use it to cook. So petty sure I am low on Iodine. That’s the reason I started taking to Lodoral. I only take one pill each morning. This gives me 5mg Iodine and 7.5mg Iodide. Also the multivitamin has selenium in it. So I think I am covering myself there. I didn’t want to go overboard with the Iodine. Thought that slow and easy would be a better approach for me.

Based on my research I believe I am seeing the right Dr. here in Tampa. Dr Saya with Defy Medical. I read through some of the other forums on the web and he seems to be well regarded. The tests I posted are what his initial panel looks like. Not sure why he doesn’t dig deeper into the thryroid. He only tested for TSH.


Energy affected by thyroid function and cortisol. Get “AM Cortisol” tested, do at 8AM or 1 hour after waking.

Find 5000iu Vit-D3 tiny oil based gel caps.

Do you use heart burn meds? These reduce absorption if B-12 and minerals. If you get foot or leg cramps or can contract muscles and have them lock up - you are magnesium deficient. [ZMA sold in the Biotest store.]

Please check oral body temps as per below.
Low thyroid function slows your body down and promotes fat gain.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.