T Nation

Am I Asking a Question I Already Know the Answer to?


#1

-age 35
-height 6'0
-waist 34
-weight 180
-describe body and facial hair LOTS
-describe where you carry fat and how changed ABS
-health conditions, symptoms [history] HYPERTENSION, DEPRESSION
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
SEVERAL ANTIDEPRESSANTS OVER THE YEARS, BP MEDS, AMBIEN FOR SLEEP NO OTHER DRUGS EVER TAKEN EXCEPT A 6 MONTH TRT REGIMEN
-- real dangers! see this http://propeciahelp.com/overvi...
-lab results with ranges
-describe diet [some create substantial damage with starvation diets] NORMAL, NOTHING CRAZY
-describe training [some ruin there hormones by over training] 3 TIMES WEEKLY
-testes ache, ever, with a fever? NO AND NO
-how have morning wood and nocturnal erections changed , YES MORNING WOOD MAYBE TWICE A WEEK

Alright fellas, I'm pretty well versed in hormones at this point but always like to hear knowledgeable opinions. Have been tracking labs since age 30 and to make a long story short and not going into every scenario top result in the TT since then has been 401. Last year I took the plunge and started trt, 150 injections weekly 1.0 arimidex weekly, no hcg. This was an anti aging clinic and the costs were extreme and after a job loss was unable to afford. While I self medicated with Clomid 25 EOD for 4 weeks along with some arimidex I was back to baseline. Symptoms have persisted, fatigue, no libido, just feel like shit constantly.

How did I feel on TRT- I would say 80% better, did have some trouble w dosage and am clearly an arimidex overesponder so it was extremely hard to get dialed in. I started having hemotacrit issues at 52. and BP rose significantly. Most of my problems seem to be created when levels where 1200 TT and 30 + ester. Tried lowering my dose but was never exactly where I wanted to be. I think i know the answer to this but at 35 I am having a hard time accepting the fact that maybe i have to do this for life. Current labs, I am going to post the most relevant in the mere case someone or KSMAN has some other thoughts.

Trigl- 187 high, <150
Cholesterol- 210
all others HDL and LDL in range

Prolactin 11
TT-242
SH BINDING- 27.10 10-80 NMOL
Free- 7.9
TSH-1.3
fSH-4.3
lh-4.9
est- 22
glucose- 97

Results to me indicate Secondary ????

Should I just accept the fact I'm stuck on TRT?


#2

Seems a bit secondary. Had the testes examined for physical problems?

You need to be looking for causes and regard your low T as a symptom.

Please read the advice for new guys sticky and note comments about other health conditions. ?stress?

Check your body temperatures and eval your long term intake of iodized salt.

Prolactin and E2 do not seem to be causes.

High BP at your age suggests that there may be a common issue.

High BP:
- fish oil and/or other EFA's - nuts, flax seed oil/meal
- natural source vitamin E
- 5000 iu.day vit-D3, tiny oil based caps, take 25,000 per day for first 5 days
- vitamin C and other antioxidants
- high potency B-complex multi-vit with trace elements and iodine
- mini aspirin
- DHEA 25mg if DHEA-S is low [should not be at your age, red flag is low]
- ubiquinol form of CoQ10, 50mg

Some guys feel like crap with clomid. Try same dose of nolvadex.

How do you react to major stress?

Lab results: ?
ALT/AST
CBC
AM cortisol [please do at 8AM]

Hematocrit: are you eating any iron fortified food? [should not]

Some BP meds can interfere with hormones and libido.

Any other health issues?


#3

Ksman,

High Bp seems to be hereditary, have tried all of the list you named and little to no effect. Anxiety runs in the family as well and I clearly don't handle stress well thats for sure. Seems to be no rhyme or reason to BP issues whether medicated or not. I can imagine that I do suffer from some adrenal fatigue, everything I have read is pretty disheartening regarding this however as there seems to be no quick or elusive fix.

Hematocrit- 46.1 - rose to 51.2 on TRT gave blood but was off TRT shortly after so never examined the results. Oddly enough TRT was the only real thing that helped my anxiety and also oddly enough thru me into borderline hypo. Was 1.3 when started by the end of TRT therapy was near 4.0. Seems now my dose was too high as i was hitting 1200 TT. Was on 75mg twice weekly. Have read all the sticky's and now know this was probably too much.

A.M. Cortisol was 11.2
AST/ALT where 19/24 respectively both go on a 0-40 scale
do not have a CBC to report

I hear you address the thyroid/Salt issue a lot and to be honest thats the one thing I am uneducated on. I can tell you this, I have never once in my life put salt on anything, I despise anything with salt, I also am never thirsty, have to force myself to drink. I can go two days on one glass of water no problem! Maybe you have some thoughts on that?

No other health issues to speak of, I did have a vasectomy two years ago. Also was diagnosed w moderate sleep apnea which was just barely in the range of where you need something, in my opinion not really effecting anything, I have a dental device for this but can't tell any difference at all. In my opinion much like the blood pressure issue these numbers often get dictated and lowered by the pharm industry to make more money, they are real problems but often docs are too quick to pull the trigger. My BP runs about 135/85 at home. Always higher in the doc office(white coat).


#4

OK, you may be iodine deficient and you might see of iodine replenishment is helpful.

Its not about the salt, its about the iodine.

Is there iodine in your vitamins and have you used those for years?

Iodine deficiency can run in families if iodized salt is not used.

Body temperatures? THIS IS IMPORTANT

Please read the thyroid basics sticky.


http://www.google.com/search?q=hypothyroid+symptoms+heart+palpitations
search?q=hypothyroid+symptoms+heart+palpitations


#5

98.2 morning temp, 98.6 afternoon, no history of any use in vitamins of iodized salt. Have doc appt on tuesday and he is willing to go the TRT route but he's not very educated and just wants to throw androgel at the problem which I won't do. Can always go back to the TRT clinic and pay outrageous fees and hope my ins will reimburse me.

Anything else you can think of I might be missing? Coming of TRT was the worst thing I have ever done and I was damn near suicidal so If I commitment again this time there is no turning back. Can try the nolvadex in place of climid but wondering at 35 if as good as its gonna get in the 400 range like I have been since 30?? Thanks for looking at my case thread buddy.


#6

You are correct in having concerns that a SERM will not deliver high-normal T levels. As far as hormone levels go, nolvadex will not do what clomid could not do.

OK, temperatures are good. However, your TSH might be higher compensating for low iodine. Is your thyroid enlarged, asymmetrical or lumpy? A long term lack of iodine can lead to changes in the thyroid gland that can take one down a path to hyperthyroidism and possibly cancer.


#7

so am I hearing this correctly? try the iodine supplementation and switch to novladex for about 4 weeks, retest and if I am still stuck then I can feel confident about going the TRT route?


#8

Yes

When you do labs on Nolvadex:
- TT
- FT
- E2
- LH/FSH

"est- 22 "
Is that estradiol?


#9

yes that was E2. My doc called to today and said that was a mistake that it was 122! And his words were, well their is no real barometer for E2 on guys, I said doc thanks for the call and please don't take offense to this but might wanna revisit some of medical literature before you kill someone if you truly believe that. This is amazing how this got out of whack so quick, less than 3 months ago was in the 20-30 range. Jesus I wish I could find a competent doctor that take insurance. Well at least I know where to start now, thanks buddy.