Symptoms seemed to gradually get better, but not disappear. Libido is about normal, ED is infrequent, but I’m pretty much unable to climax during intercourse (which sucks, but is much better than ED). Had a VO2 max and lactate test done, VO2max was ~49mL/kg/min, just above average, which was very surprising because of my poor athletic performance. 49mL/kg/min also corresponds to over 5 L/min.
I’m about 235lbs, if I weighed 150 and pumped the same amount of air, I’d be Tour de France material ;). The lactate threshold test however was abnormally low… started out at 1.8, only made it to 3.0, and then after the VO2 max test blood lactate only got as high as 4.8. The person who administered the test suggested I see a coworker who is an MD that specializes in sports medicine, and when I saw that doc, he advised ferritin and thyroid antibody tests, as well as IGF1 and IGF-BP3. Test results:
Hematocrit: 46.4 (37.5-51)
Cholesterol, Total: 174 mg/dL (100-199)
Triglycerides: 51 mg/dL (0-149)
HDL Cholesterol: 54 mg/dL (>39)
LDL Cholesterol Calc: 110 mg/dL (0-99)
T. Chol/HDL Ratio: 3.2 ratio units (0.0-5.0)
Insulin-Like Growth Factor 1: 494 ng/Ml 71-241
Interleukin-6, Serum: 1.7 pg/mL 0-15.5
Thyroglobulin, Antibody: <1.0 IU/mL 0.0-0.9
IGF-BP3: 5.8 mg/L 3.5-7.0
Ferritin, Serum: 78 ng/mL 30-400
Thyroid Peroxidase (TPO) Ab: 7 IU/mL 0-34
So, TRT hasn’t hurt my cholesterol any, and my hematocrit is better than before TRT. Thyroid tests again look normal, but I’m still often cold in the morning. IGF1 is high out of range, but from what I’ve read, IGF1 ranges depend strongly on age, and my value of ~500 is normal for an 18 year old. I definitely appear to have visual symptoms of acromegaly (2XL hands, big feet, coarse features, slight brow ridge), but I don’t know if my value of IGF1 could explain poor athletic performance. From what I’ve read on acromegaly and heart enlargement, it leads to a sub-normal VO2 max (like 20mL/kg/min!), and mine’s a bit above average. I went for a 5.5 mile jog with a friend last week and was able to keep up a conversation at about a 11 minute/mile pace. That’s not a great performance, but it’s worlds better than I seem to do in bursty repeated activities like rugby (lots of sprints, tackling, sharp cuts, repeatedly for 80 minutes).
I’d like to know if my shortcomings in activities like rugby are related to my abnormal blood lactate response to exercise, but I haven’t found any information online that seemed useful, except some mention of people having blunted lactate response when ill or overtrained. I feel overtrained, but I’ve not been working out much, and resting for weeks doesn’t help the situation.
TRT has seemed to improve muscle strength significantly, even with sporadic training. I can squat 315 for 5 reps, and I haven’t been hitting the gym regularly. Before TRT, even sticking with Starting Strength religiously for months, and eating well, sleeping well, I could only get my 5RM up to 275lbs, and couldn’t maintain it there consistently. I’ve also lost body fat and put on muscle mass, again without regular strength training or following a diet religiously.