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42, Low T, Low Energy, Low Temp, Low Libido

42 yo Low T, low energy, low temp, low libido

Sorry for the lengthy post, but I wanted to provide sufficient information.

I’m 42 years old.

Over the last 2 years or so, I’ve been experiencing low energy, brain fog, and my libido has drastically dropped off.

I still enjoy sex and want to have it, but for about the last 2 years, given the choice between sleeping or having sex, most of the time I’ll choose sleep.
(I can’t believe I’m even saying this. Choosing sleep over sex used to be such a ludicrous idea, something I couldn’t even imagine.)

I’ve also experienced some mild ED. (again, something I could never conceive of happening a few years ago.)
In the spring and summer of 2012, there were some times when my wife and I would be building up to sex, but if things weren’t progressing fast enough, it was hard to keep my interest/focus and I’d lose my boner. There were also some times when I had a naked behind right in front of me, and I wasn’t sure if I was going to be able to get it up. There have also been a few times when I was actually having sex with my wife, but never could get myself to the point of orgasm and had to give up. (I didn’t even think it was even possible for that to happen to a man.)

At the same time the sexual issues were developing, I also started having real trouble focusing at work (experiencing the brain fog I’ve see mentioned in other posts). I’m also tired most of the time. Or I’ll feel good in the morning, but be shot by the end of the day. (I work with computers, so I’m sitting at a desk all day long.)

The more I think about it, low energy is probably the bigger problem. If I had more energy, I’d probably have a lot more sex, but most of time, even if sex sounds like fun, it seems like it’s just too much work and I just don’t have the energy for it.

I began wondering if low T was my problem, so I had a CBC and TT taken about a year ago (March of 2012 - results below).

Then in August 2012, I decided to try to boost my T naturally, so I started exercising regularly, 20min a day 3 or 4 days a week and trying to eat healthy.
I’ve cut out most of the simple carbs (sweets, breads, sweetened beverages) and started eating more eggs, meat, and vegetables. I’ve also tried to add a lot of monounsaturated fatty acids to my diet (lots of mixed nuts and olive oil).

Here is some of my personal info:

-age: 42
-height: 5’9"
-waist: ~34"
-weight: 160lb (170 6mos ago, in August)
-body and facial hair:
I’ve always had much less body hair than most men. I have a full head of hair and haven’t experienced any hair loss.
I have no hair at all on my chest and never have. I have typical male hair on my legs from the knee down. No back hair. Minimal armpit hair. Not much hair on my arms. Can’t grow a real beard or mustache, but do have to shave my mustache area and the end of my chin. None of that has changed, that’s the way I’ve always been.

-describe where you carry fat and how changed
I’ve always been skinny and not carried much fat. Since I started exercising in August, I’ve lost about 10lbs (170 -> 160). It came off in an thin layer all over my body (arms, legs, etc) revealing more muscle definition. I still have a layer of fat on my gut that I’d like to get rid of, but it’s not very much. I can see my 6 pack, but it’s not as defined as I’d like for it to be and the lower 2 are kinda flabby.

-health conditions, symptoms [history]
(described above) No real health issues ever.

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
Never have taken any hair loss or prostate drugs. Have always had good health. Never had to take many drugs. Mainly seasonal allery medications (zytec, benedryl, chlortabs) and the occasional anti-biotic (amoxicillin, zithromax), usually for a sinus infection. Have always had issues with heartburn and have taken anti-acids regularly at various times in the past. Haven’t had to take much anti-acid since I started working out and eating healthy.

-lab results with ranges


03/13/2012 (these first labs are from a year ago)
taken in a NON-fasting state, so some values may be off

CBC
White Blood Count 4.3 (4.3-11.0)
RBCX10E12 5.16 (4.44-5.67)
Hemoglobin 15.2 (13.4-17.4)
Hematocrit 44.2% (40.2-50.8)
Mean Corpuscular Volume 85.7 (82.5-98.5)
Mean Corpuscular HGB (MCH) 29.5 (27.5-33.5)
Mean Corpuscular HGB conc. (MCHC) 34.4 (31.9-35.7)
neutrophil 49.6%
lymphocyte 38.9%
monocyte 8.4%
eosinophil 2.6%
basophil 0.5%
neutrophil absolute 2.13 (1.80-7.80)
lymphocyte absolute 1.67 (1.00-4.00)
monocyte absolute 0.36 (0.20-0.90)
eosinophil absolute 0.11 (0.00-0.45)
basophil absolute 0.02 (0.00-0.20)
platelet count 232 (156-367)
mean platelet volume 10.0 (9.4-12.9)
RBC distribution width 12.7% (12.1-14.5)

TSH 1.255 (0.300-5.000)

TT 353 (300-1000)


02/11/2013 (these second set of labs are from a month ago)
taken in a NON-fasting state, so some values may be off

CBC
White Blood Count 4.9 (4.3-11.0)
RBCX10E12 4.65 (4.44-5.67)
Hemoglobin 13.8 (13.4-17.4)
Hematocrit 41.1% (40.2-50.8)
Mean Corpuscular Volume 88.4 (82.5-98.5)
Mean Corpuscular HGB (MCH) 29.7 (27.5-33.5)
Mean Corpuscular HGB conc. (MCHC) 33.6 (31.9-35.7)
neutrophil 71.4%
lymphocyte 18.5%
monocyte 7.5%
eosinophil 1.8%
basophil 0.8%
neutrophil absolute 3.52 (1.80-7.80)
lymphocyte absolute 0.91 (1.00-4.00) *** below range ***
monocyte absolute 0.37 (0.20-0.90)
eosinophil absolute 0.09 (0.00-0.45)
basophil absolute 0.04 (0.00-0.20)
platelet count 192 (156-367)
mean platelet volume 10.2 (9.4-12.9)
RBC distribution width 13.0% (12.1-14.5)
RDW - RBC distribution-SD 41.8 (38.3-49.1)

Comprehensive Metabolic
Glucose Random 88 (70-100)
Urea Nitrogen Blood (BUN) 13 (5-23)
Creatinine 1.22 (0.50-1.30)
sodium 138 (135-145)
Potassium serum/plasma 4.5 (3.5-5.5)
chloride 102 (96-108)
bicarbonate 30 (18-30)
calcium 9.6 (8.5-10.5)
protein Total 6.5 (6.7-8.2) *** below range ***
albumin 4.1 (4.2-5.1) *** below range ***
bilirubin total 0.2 (0.1-1.4)
alkaline phosphatase 60 (38-114)
aspartate transaminase (AST) 44 (0-50)
alanine transaminase (ALT) 43 (0-60)
anion gap 6 (5-16)

Calculated GFR
GFR Non African American >60 (>60)
GFR African American >60 (>60)

Triiodothyronine (T3) Free 3.2 (2.4-4.5)
TT 350 (300-1000)
Vitamin D Total (25 Hydroxy) 28 (30-100) *** below range ***

So after 6 months of actively trying to improve my TT through diet and exercise, it was 5 points lower that it was the previous year.

-describe diet [some create substantial damage with starvation diets]
Never been on a starvation diet. I’ve cut out most of the simple carbs (sweets, breads, sweetened beverages) and started eating more eggs, meat, and vegetables. I’ve also tried to add a lot of monounsaturated fatty acids to my diet (lots of mixed nuts and olive oil). For while (over the last few months) I was calorie counting and trying to drop unwanted fat. I’ve stopped calorie counting and I’m just trying not to eat junk (very often). Currently my diet runs pretty close to this:

Breakfast: Protein shake (w/ creatine added)
Lunch: (if at work) Meat/vegetable bowl from an asian restaurant. (beef, chicken, cabbage, broccoli, carrots, and 3 or 4 bites of brown rice)
(if at home) 4 eggs, fried in olive oil and a spinach salad (with 5 or 6 baby carrots and olive oil/balsamic vinegar dressing)

Afternoon: 2nd protein shake and an apple, maybe some sunflower seeds.
Dinner: Usually some kind of meat and vegetables
Evening Snack: Greek yogurt with oats, mixed nuts, dark chocolate chips, and dark chocolate syrup mixed in. Sometimes popcorn.

-describe training [some ruin their hormones by over training]
20 minutes a day 3 days a week. Mostly bodyweight exercises, but I incorporate a couple of 10lb weights in there where I can.

-testes ache, ever, with a fever?
My testes have ached occasionally, usually just one at a time. Not sure if it’s always been the same one. I think I might get one a little twisted occasionally. My brother had issues with one twisting and had a surgery that installed a little clamp inside his scrotum to keep things from twisting. Usually I can jiggle/re-arrange my balls and the pain goes away pretty quickly.

-how have morning wood and nocturnal erections changed
For a while there I was rarely, if ever, having morning wood. Nocturnal erections were also sparse. For the last month I’ve been taking 3 ZMA every night and 4 maca capsules in the morning and I’m getting nocturnal wood every night and morning wood most mornings.

Supps currently taking:
1-2 whey protein shakes a day w/ 4 or 5 grams of creatine added to the morning shake
l-carnitine 500mg
glucosamine/chondroitin 500/400mg
maca 4 capsules 500mg each standardized 4:1 extract
omega-3 fish oil 180mg/120mg epa/dha
vit C 500mg

all of the above I’ve been taking for a while.

Mar 1 I started taking 30mg of iodine in the morn and 18mg iodine in the eve.
also started 5000iu vit D-3

Started taking the iodine after reading posts on T-Nation about iodine deficiency.
I starting taking my temp and here’s what I’m getting:

Mar 1 Fri (started iodine this day)
4:44a 97.0
6:15a 97.3 (waking)
Noon 96.9
2:00p 97.9
4:15p 97.7

Mar 2 Sat
6:50a 96.9 (waking)
5:50p 97.6

Mar 3 Sun
7:15a 97.5 (waking)
4:15p 98.0

Mar 4 Mon
6:15a 96.8 (waking)
7:45a 97.7
11:45a 97.5
4:00p 98.2
5:00p 98.3

Mar 4 Tue
6:15a 96.8
10:30a 97.9

So it looks like my waking temperature is too low AND I had not been getting to 98 degrees during the day. I’ve started hitting 98 in the afternoon, so I hope my temps are slowly improving.

Started taking 48mg iodine on Mar 1. Plan to keep taking 48mg iodine for 2 weeks in hopes that my temps will continue to get better, then I’ll probably drop down to a maintenance dose.

I’m going back to the doctor somtime in the next month or two to get some fasting blood work done. Based on what I’ve read here, I’m going to ask that the following tests be run:

TSH
T3
T4
rT3
rT4
LH
FSH
FT
E2

Should I get another TT taken or will it matter since I just had one in Feb?

Should I exclude any of the tests I’ve listed above?

Are there any tests I should add?

I’ll probably have to pay for these labs out of pocket, so I don’t want to pay for anything unnecessary, but I DO want to get whatever I need.

Best workup I have seen! -thanks

Drop rT4, add fasting cholesterol amd AM cortisol, do at 8AM

Drop T3 and T4, add fT3, fT4

Do a test for occult blood in your stool.

Add 5000iu vit-D3, high potency B-complex multi-vit with iodine.

Thanks so much for your reply, KSMan. I was hoping you’d weigh in.

Will do and I’ll update when I have new info.

I found some labs from last summer that give cholesterol numbers.

This information is from a different lab associated with a health program at work.

Age: 41
Gender: M
Fasting: Yes

LABORATORY REPORT
Date: 07/25/2012

Panel Test Name Reference Range

Lipid Profile

Cholesterol, Total 218 MG/DL 160-240 MG/DL
Cholesterol/HDL Ratio 3.8 RATIO-UNITS <5.0 RATIO-UNITS
HDL 57 MG/DL 35-80 MG/DL
LDL 148 MG/DL 90-171 MG/DL
LDL/HDL Ratio 2.6 RATIO-UNITS 1.5-5.5 RATIO-UNITS
Triglycerides 66 MG/DL <200 MG/DL

Diabetes

Glucose, Serum 94 MG/DL 60-109 MG/DL
Glycosylated Serum 244 UMOL/L 50-270 UMOL/L
Protein

Kidney Panel

Creatinine, Serum 1.2 MG/DL 0.6-1.4 MG/DL
Urea Nitrogen (BUN) 12 MG/DL 8-25 MG/DL

Liver Profile

Alanine 16 U/L <50 U/L
aminotransferase (ALT
or SGPT)
Albumin 4.8 G/DL 3.8-5.0 G/DL
Albumin/Globulin ratio 2.0 RATIO-UNITS >1.0 RATIO-UNITS
Alkaline phosphatase 72 U/L 39-117 U/L
Aspartate 16 U/L <40 U/L
aminotransferase (AST
or SGOT)
Bilirubin, Total 0.6 MG/DL <1.4 MG/DL
Gamma Glutamyl 25 U/L <65 U/L
transferase (GGT)
Globulin, Total 2.4 G/DL 2.2-3.7 G/DL
Protein, Total 7.2 G/DL 6.5-8.3 G/DL

Bone and Minerals

Calcium 9.5 MG/DL 8.4-10.2 MG/DL

Time for an update.

I’ve been taking iodine since Mar 1.

Temps haven’t really changed much.

Here’s the last few days:

Apr 4
started taking thytrophin at the recommendation of my wife’s nutritionist.
2 tablets 2 times a day

Apr 5
6:00a 97.1 waking
5:15p 98.5

Apr 6
6:30a 97.5 waking

Apr 7
7:30a 97.0 waking

Apr 8
6:15a 97.0 waking
5:15p 98.3

Apr 9
7:00a 96.7 waking
6:45p 96.8

Apr 10
6:30a 97.0 waking

Apr 11
7:00a 97.1 waking

Apr 12
6:15a 96.7 waking
5:10p 98.1

Apr 13
7:00a 96.8 waking
6:45p 97.4

I had bloodwork taken about a week ago, but haven’t gotten the results back yet.

I’ll post as soon as I get them.

Got my most recent lab results today.

Posting pictures of them below so I don’t have to type in all the info.


pg 3 of lab

pg 4 of lab

In regard to the latest lab results above (summarized below):

(taken 04/04/2013)
TSH 1.965 uIU/ML (0.300-5.000)
Free T4 1.09 NG/DL (0.80-1.80)
T3, reverse 26 NG/DL (11-32)
FSH 2.6 MIU/ML (1.4-18.1)
LH 2.9 MIU/ML (1.5-9.3)
Estradiol 20 PG/ML (0-56)
T Ref Lab 454 NG/DL (250-1100)
T Free 62.3 PG/ML (35.0-155.0)
Cortisol Total 15.2 mcg/dL (4.6-20.6)
Cortisol Free 0.39 mcg/dL (0.07-0.93)

on 02/11/2013 my TT was 350 (range 300-1000) from RML-TUL

on 04/04/2013 my T Ref Lab was 454 (range 250 - 1110) from Quest
and T free is 62.3

I’m assuming “T Ref Lab” from quest is the same as TT. If that’s the case, my TT went from 350 to 454 in a little less that 2 months. Either that or I’m getting way different TT results due to the tests being run by 2 different labs.

If my calulations are correct, “T Ref Lab” of 454 and “T free” of 62.3 gives a %T free of 1.4%

My interpretation is:

Estradiol is good.
TT is lower that I’d like it even at 454.
%T free is 1.4% is lower that I’d like (should be 2-3% I believe)

I don’t think there’s any issues with TSH, free T4 or rT3 (correct me if I’m wrong).

Not sure about LH, FSH, and AM Cortisol.

Would like input on the above results.


Sorry, here’s lab page 2 that should have been above.

Free T4 1.09 NG/DL (0.80-1.80)

Should be near 1.3, so that is ~20% below something optimal.

Do not know where fT3 is but assuming that it is below optimal too and rT3 may be an issue.
“”" STTM: With the RT3 labwork, you are not necessarily looking for a Reverse T3 result high in the range, though that in itself can be a good clue. Instead, you are looking for a problem in the ratio between the RT3 and the Free T3. i.e dividing the Free T3 by the Reverse T3 (Free T3 ÷ RT3). For healthy amounts of RT3, The ratio result should be 20 or larger. If lower, you may have a problem. Janie has noted that many patients without an excess RT3 issue have a result of 23 or 24.
“”"

What was time of day for the labs?

Total mg’s iodine so far? Your fT3 is low and/or blocked by rT3, that is why your temperatures are done. If you are not iodine deficient, then rT3 is the problem, or there is something wrong with the thyroid. fT3 would resolve things.

PC didn’t want to pull a fT3 since we had taken one 2mos earlier and the results were “normal”, so the only fT3 I have is from 2 mos before the rT3 was taken.

fT3 on 2/11 was:
Triiodothyronine (T3) Free 3.2 (2.4-4.5) pg/ml RML-TUL lab

rT3 on 4/4 was:
T3, reverse 26 NG/DL (11-32) Quest lab

With the fT3 being a smaller number than the rT3, the formula you provided doesn’t work at all. I’m assuming this is due the tests coming from different labs or the intervening 2mos between tests being an issue. Darn.

The rT3 labwork was taken about 8:30-9:00am.

As far as iodine, I took 48mg/day for the first week or two starting Mar 1st, then dropped down to 30mg/day for couple of weeks, then down to 18mg/day every day since then.

You say, “fT3 would resolve things”. How do you increase fT3?

Do you think my TT really increased 100 points in 2 mos, would you lean toward that just being a difference in the labs doing the test?