T Nation

49 YO with Low T. Lab Results Finally :(

49 years old (50 in a few week!)
208 lbs.
36 inch waist

normal facial hair
full head of hair on top of my head
no chest hair and minimal leg hair
Had high bp, controlled now with meds
BP meds amlodopine, losaartan and chlorthaladone
vit/supplements - fish oil, krill oil, saw palmetto, Vit d, c, mens multi vit, Iodoral, magnesium, dhea, protein powder shake after lifting weights.

Head injuries- bad car accident, head hit windshield, lacerated forehead, broken nose, knocked unconscious. Did combat sports for a few years competitively.
Cartilage loss in knee

body fat - mostly my gut…have had that since I was a little kid
training- lift free weights Mon,wed, fri…low impact lower body workout tues, thurs.
testes ache? no
morning wood most mornings
brain fog, waining libido, slower reflexes.

I finally got around to getting my labs done and as suspected I have low t. I found out that my thyroid is jacked up also…hypothyroid I think. KSman what do you think? how big of a mess am I?


TSH is very high. This indicates hypothroidism. Suggest reading thyroid stick and supplement with iodine.

LH and FSH is low indicating secondary hypogonadism. SERM could be effective.

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thanks gonadthebarbarian

At the time of the labwork, were you feeling sore muscles or bruised muscle?
Any other physical injury?

Glucose is high for a fasting state. Your insulin sensitivity may be poor. TRT can improve this. You could eval your status better with A1C lab test. Your regular doc can order this for you.

Chloride, sodium was low.
Was this a result of your restricting salt intake?
Can also be from diuretics which may cause you to drink more water and piss it out, carrying off some electrolytes more than others [including iodine].
Avoiding salt can be avoiding iodine.
So this can be side effect of your high BP meds.

AST/ALT are mildly elevated. I am assuming that they are not elevated because you were working out.

Cholesterol is good!

Hemoglobin, hematocrit are good. RBC reflects your low T status.

Total proteins are surprisingly good relative to your T levels.

Calcium seems high. Might be from fasting-dehydration or BP meds. But with low-T, calcium can easily be leaving your bones to your blood and getting pissed out. TRT will reverse that trend.

Triglycerides are quite low. Something good from your diet and daily occupational work.

TRT may resolve part of your LDL.

Low DHT is a result of low FT to support FT–>DHT

TSH is terrible
fT4 is slightly below mid range
fT3 is lowish
You were not using iodized salt.
You need to get iodine and MUST have selenium in your supplements.
Monitor body temperatures and watch for improvement and improved metal clarity and energy.
However, you are still limited by low T

Increase intake of Vit-D3

E2 is low because low FT leads to less FT–>E2
That is sort of expected.
But SHBG=52.8 is a major problem as we are not looking for cause of high SHBG that is not E2.

But note that low FT can increase SHBG, but that does not explain everything.
Perhaps your BP meds are a factor.

TRT can reduce BP by improving how arterial muscles can relax to accommodate each pulse of blood.

Take 25mg DHEA
Take fish oil, flax seed oil/meal, nuts
Take Vit-D3
Do not take any of these things with high fiber meals [oat meal].

Cortisol is good!

You need TRT.
Your thyroid is a mess, so there is a high expectation that transdermal T will not work for you.
So you need to inject T.
You need to watch E2 as this might make SHBG worse before increased FT improves.

See these sticky/links:

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

I will go with you to your doctor is doctor is OK with that.

Thyroid, get iodine and selenium on board and watch temperatures. Do repeat labs for TSH later. Do not start thyroid meds at this time as you may have a simple iodine deficiency.

Seek TRT, I can recommend a health management doc, but it is $$$

Labs: A1C to very eval insulin sensitivity

Diet: Work to avoid more simple carbs, quench hunger if needed with whey protein shakes.

[I now know this guy in real life and have also written above to things that were not disclosed in the opening post.]

Thank you so much for taking a look at my lab work. My mom has hypothyroidism. She said that she has something called Hashimoto Thyroiditis. She said that her dad had hypothyroidism as well. Is this TSH # something I can control with the Iodoral pills? I have been taking one of those a day. Should I up that dose of the Iodoral? how long should I do this before I have more blood work done to check TSH again?
I currently take 2 2000iu vit. D3 daily. How much more should I take?
Do you have a link for a good 25mg DHEA?
I did do the LH/ FSH lab. Its at the very bottom of the labs.
At the time that I did these labs I had been going to summit to lift weights, after lifting I have been getting in that infrared sauna for 30 min. daily. Only lifting heavy on M,W,F. Lighter, lower body workout on T, and Thurs. No workouts or sauna on weekends. I wonder if weight lifting, sauna/sweating and drinking a lot of water could have caused the low sodium.
I’m hoping to find a doctor that will let me self inject. I’ve heard its difficult to find one that will work with you. Does the health management doc let you self inject?
I will edit the beginning of the thread and add more info. I was in a hurry to get my labs posted.
Thank you so much for looking at them and giving me the your feedback, I really appreciate it.

You could get tested for thyroid auto-immune markers.
With that lab result and family history, your regular doc probably will do that.
— and A1C

Lets assume lifting elevated AST/ALT

DHEA, all eventually traces back to a few producers in China. Get whatever you find in the vitamin shelves.

Many allow self-injection. If they insist on office injections - run.
Your wife is definitely able to assist you and don’t forget that you will be using #29 0.5ml 1/2 insulin syringes.

hCG is optional, but still important for a few reasons

Watch your body temperatures. That will tell us a lot more that lab work at this point.
Does your wife have a good thermometer? I use a ovulation thermometer, reads/repeatable to .01F degrees, accurate to .1 degree.

The best evaluation of arterial health is homocysteine - more lab work to consider.

We should discuss that doctors brochure that you showed me.

You gave me that glass thermometer that’s is kind of big. I will start logging my temps
Should I up the dosage of the Iodoral? I have been taking 1 a day for the past few weeks…

Stay on that dose until we get some temperature data.

Were you taking iodine before doing the lab work? That can exaggerate TSH levels.

ok, will do. yes, I was taking the Iodoral for a couple of weeks probably before doing the labs.

4/2/16 morning temp 5:22am still in bed 97.3 f
afternoon temp 1:20pm 97.6 f

am temp 97.1°
pm temp 98.6°

Having enough iodine is key. However, if a person has Hashimoto’s, it’s like throwing gasoline on a fire.

The inflammatory processes causes by low selenium levels can trigger such autoimmune problems. That is why I stress selenium intake, which is very important during iodine replenishment.

This is an excellent result.
Keep monitoring.

How are you doing re changes in energy, mood and mental alertness?

my last 2 afternoon temps have been 98.8 and 98.9. Have had much better energy, alertness. However if I eat a bunch a sugar/crap, it wipes me out.

I’ve been taking my mens multi vitamin that has some selenium in it plus I have been eating 2 Brazil nuts every morning and evening. Thats around 400 mcg of selenium just for the Brazil nuts.