T Nation

Bro Bro's TRT Thread (35yo)


#1

Here is my TRT thread. I welcome your reviews and comments. THANK YOU to all the posters on this forum - your information and participation is a fantastic resource.

35 yo male
6.1 tall
34 in waist
181 pounds
currently 15%BF; not much facial hair
carry fat in the belly and hips; possibly more visceral fat

health conditions: hypertension; ADD

meds and OTC: lisinopril (10mg) (for last 4 years); adderall XR (5mg) (for last 15 years); multivitamin; ground flax seed; fish oil caps; creatine; whey protein; glutamine; BCAAs

diet: high protein, moderate fat and carbs; eat very clean (chicken, veggies, etc); no junk food; little to no alcohol; 2200-2500 cal/day
training: 4 days of intense weight training (45min); 5-6 days of light running (1-3 miles)
testes ache: no
how have morning wood and nocturnal erections changed: don't often occur anymore

lab results with ranges (these are LabCorp)

CBC w diff platelet
WBC 6.1 (range 4.0 - 10.5)
RBC 4.66 range 4.14 - 5.8)
Hemoglobin 13.7 (range 12.6 - 17.7)
Hematocrit 41.5 (range 37.5 - 51.0)
MCV 89 (range 79 - 97)
MCH 29.4 (range 26.6 - 33.0)
MCHC 33.0 (range 31.5 - 35.7)
RDW 14.0 (range 12.3 - 15.4)
Platelets 287 (range 140 - 415)
Neutrophils 54 (range 40 - 74)
Lymphs 35 (range 14 - 46)
Monocytes 9 (range 4 - 13)
Eos 2 (range 0 - 7)
Basos 0 (range 0 - 3)
Neutrophils (absolute) 3.2 (range 1.8 - 7.8)
Lymphs (absolute) 2.1 (range 0.7 - 4.5)
Monocytes (absolute) 0.5 (range 0.1 - 1.0)
Eos (absolute) 0.1 (range 0.0 - 0.4)
Baso (absolute) 0.0 (range 0.0 - 0.2)
immature granulocytes 0 (range 0 - 2)
immature grans (abs) 0.0 (range 0.0 - 0.1)

Comp. Metabolic Panel
Glucose, serum 97 (range 65 - 99)
*BUN 30 (range 6 - 20) HIGH
Creatinine, serum 0.84 (range 0.76 - 1.27)
eGFR if nonafricn 114 (range > 59)
*BUN/Creatinine ratio 36 (range 8 - 19) HIGH
Sodium, serum 139 (range 134 - 144)
Potassium, serum 4.5 (range 3.5 - 5.2)
Chloride, serum 100 (range 97 - 108)
Carbon dioxide, total 26 (range 19 - 28)
Calcium, serum 9.8 (range 8.7 - 10.2)
Protein, total, serum 7.2 (range 6.0 - 8.5)
Albumin, serum 4.7 (range 3.5 - 5.5)
Globulin, total 2.5 (range 1.5 - 4.5)
A/G ratio 1.9 (range 1.1 - 2.5)
Bilirubin, total 0.8 (range 0.0 - 1.2)
Alkaline phophatase, s 77 (range 44 - 102)
AST (SGOT) 26 (range 0 - 40)
ALT (SGPT) 26 (range 0 - 44)

Lipid Panel with LDL/HDL
Cholesterol, total 158 (range 100 - 199)
Triglycerides 61 (range 0 - 149)
HDL cholesterol 71 (range > 39)
VLDL cholesterol Cal 12 (range 5 - 40)
LDL cholesterol Calc 75 (range 0 - 99)
LDL/HDL ratio 1.1 (range 0.0 - 3.6)

FSH and LH
LH 3.2 (range 1.7 - 8.6)
FSH 3.7 (1.5 - 12.4)

Test, Free and Total
Test, serum 402 (range 348 - 1197)
*Free test (direct) 8.2 (range 8.7 - 25.1) LOW

Dihydrotestosterone 44

Hemoglobin A1c 5.6 (range 4.8 - 5.6)

Thyroxine (T4) Free, Direct, S
T4, Free (direct) 1.42 (range 0.82 - 1.77)

DHEA-Sulfate 356.0 (range 160 - 449)

TSH 1.720 (range 0.450 - 4.500)

Estriadiol (Roche ECLIA methodology) 20.0 (range 7.6 - 42.6)

Prostate-specific Ag, serum 0.3 (range 0.0 - 4.0)

*IGF-1 342 (range 71 - 241) HIGH

Reverse T3, serum 16.1 (range 9.2 - 24.1)

Vitamin D, 25-Hydroxy 35.0 (range 20.0 - 100)

Estrogens, Total 85 (range 40 - 115)

Thyroid Peroxidase (TPO) ab 8 (range 0 - 34)

Antithyroglobulin Ab <20 (range 0 - 40)
[Seimens (DPC) ICMA methodology]

Triiodothyronine, Free, Serum 3.5 (range 2.0 - 4.4)

Sex Horm Binding Glob, serum 33.0 (range 16.5 - 55.9)

Protocol
My doctor prescribed the following regimen each week:
100mg/mL test (one dose)
250iu HCG (divided into 2 doses)
1mg Arimidex (divided into 2 doses)
Also 5,000 vitamin D pill daily

Doc stated the elevated IGF-1 may be due to my BCAA supplementation, so I stopped taking it. We will re-test IGF-1 levels in a few weeks to see if they return to normal range.

I've only been on TRT a week, so nothing to report yet - no noticeable changes. This website has been a great help in research and understanding.


#2

Cholesterol is to low... Would have been nice to see you improve this and the. See where that landed you naturally.

We're the glucose and A1c fasting?

thyroid looks good rt3 looks good to me

Curious about adrenal function

Is stress a big factor to you and do you handle stress well?

What symptoms were you having?

Prolactin would be good to see here.

ACTH

Cortisol

C peptide

Insulin and fasting glucose again

High igf-1 shouldn't be ignored. You may have a pituitary micro/macroadenoma

Gh stimulation test and or MRI should b considered


#3

iw84aces-

Thanks for the quick feedback. I do have a high-stress job, coupled with the demands of my family (they are great). I like to think I have a strong ability to handle stress, but certainly stress adds up over time.

I didn't fast prior to the labs, so the glucose and A1c numbers were not while fasted. The doc acknowledged that and said she also wants me to stop any whey/workout drinks with artificial sweeteners. She thinks my glucose and A1c will be lower next time we do labs.

Regarding cholesterol, what do you see as too low - the triglycerides? My total cholesterol is in healthy range and my HDL is very good and a negative risk factor for CHD.

Prior to these labs, I tried for over a year to naturally increase my test levels through diet and exercise. I was surprised to see the levels were this low when the labs came back.

Regarding symptoms, I experince the following: lethargy; foggy head; trouble sleeping; decreased libido; increased ease to gain fat; difficultly to gain muscle. Still feel that way, but again I just only started TRT a week ago.


#4

Total cholesterol below 160 is attributed to all cause mortality. 180 is better, lab ranges are not optimal health

Cholesterol is the precursor to all steroid hormones. You need healthy fats in your diet.. Red meat, cheese but hormone free


#5

What are your oral body temperatures as per the thyroid basics sticky?

Cholesterol is lowish, diet too clean. No red meat? If not fasting, number may be lower than indicated.

A1c is not affected by fasting or not for labs. What carbs do you eat in terms of starches? You need to avoid spiking serum glucose levels. Read about glycemic index.

fT3 and fT4 seem good, but TSH level seems odd. What is your iodine intake history from vitamins or iodized salt.

TRT sometimes improves blood pressure. This improves the muscle tone of the blood vessels.

Do you have a dry cough?
A persistent dry cough is a relatively common adverse effect believed to be associated with the increases in bradykinin levels produced by ACE inhibitors, although the role of bradykinin in producing these symptoms has been disputed.[14] Patients who experience this cough are often switched to angiotensin II receptor antagonists.

More to read here: http://www.lef.org/protocols/heart_circulatory/high_blood_pressure_01.htm

"""
Likewise, in males, low testosterone levels are predictive of hypertension and cardiovascular disease risk (Torkler 2010). Life Extension suggests that aging men maintain free testosterone levels of 20 ? 25 pg/ml for optimal health.
"""

You may be able to get off of Lisinopril. You may be having side effects from it. This class of drugs can also lower testosterone. Can also lower libido and cause some ED effects.

TRT can improve insulin resistance and lower 1Ac. Elevated insulin is toxic to endothelium and endothelial dysfunction is the root of arterial disease.

I would not worry about your youthful IGF-1 levels at this point. My doc wants mine over 300. Your IGF-1 is only high for your age adjusted range.

When do you feel that your testosterone levels were slipping lower?
When did BP get elevated?

Do you have high BP from caffeine and energy drinks?

Do an 8AM cortisol, fasting and redo cholesterol when fasting.


#6

Lol tsh of 1.7 is not odd..

Not every person on gods green earth needs to load up on 50 mg of iodine FFs man the whole world revolves around iodine with you... I listened to you and now my thyroid is fucked!!

As I said test the adrenals... Thyroid is fine...

You really should start supplementing vit D

Ksman your doc is a quack look up the effects of high I-gf1

http://www.news.harvard.edu/gazette/1999/04.22/igf1.story.html

I can list links all day and the man may have a gh secreting adenoma... Great advice man

I guess you know more the endo journals ksman..

http://www.sciencedaily.com/releases/2010/03/100301091417.htm <~~~ older men.. This is you ksman

It's funny to me how ranges are already to broad and we know this but when it comes to growth hormone it's ok to blow the doors wide open..

Dude your a drug addict and had you seen a naturopath a long time ago you might not need 30 000 different drugs to feel well..


#7

iw84aces-

Doc already started me on extra vitamin D daily. So I should be good with that.

I can ask my doc to do labs (fasted, in the morning) for the following?

Prolactin
IGF-1 (expected to be down with the cessation of BCAAs, but if it is not, the plan is to follow up with other testing)
Cortisol
C peptide
Insulin and glucose

Possibly follow that up with ACTH testing.

Thanks


#8

KSman-

Thanks for the quick response and appreciate the attention to my post.

My temperature is pretty much 98.6, no problems there and never have experienced low body temp as I can recall. I get dietary iodine from multivitamins (Animal Pak) plus foods like dairy, etc. I never add salt to my food.

Regarding insulin, the carbs I eat are low-GI, slow digesting, and whole grains. I dont drink sodas or juice. I rarely snack on crackers or whole wheat bread. I don't eat white potatoes, pasta, rice, etc. The only exception to this is a post-workout shake of Vitargo (dextrose) with my post workout protein. The doc said artificial sweeteners can also contribute to elevated A1c, so I've significantly reduced that intake.

Never had dry cough and I seem to tolerate the lisinopril well. My doc mentioned TRT can mitigate hypertension, so that would be great to reduce or eliminate the lisinopril. But hypertension is in my family... My elevated BP first appeared in my mid-20s and I've been on lisinopril for 4+ years. I would imagine the hypertension is aggravated by caffeine intake. I used to consume approx 700mg caffeine daily, but stopped that when I stopped taking the A.O. Energy drink mix from Optimum (the source of my high BCAA consumption).

I felt the symptoms associated with low test for the last 2-3 years. Would've been nice to have done some labs in the past for a comparison, but didn't really know anything about low test or TRT back then.

Thoughts? I REALLY appreciate everyone's time and sharing of information and experiences.

Thanks


#9

How do you feel and what are your energy levels during the day? Do you sleep well?

I would like to see AM cortisol. ADD meds might have some effects.

We see thyroid function issues as low temperatures when waking, low temperatures mid afternoon or both.

You never salt your food at the table. You use salt when cooking? Is that sea salt [no iodine] or iodized salt. Most people in North America are iodine deficient. IW wants to ignore an easily corrected deficiency. He wants to rule the world with his experience. He ignores the fact that while his result is very unusual, he gave the same bottle of iodine to a friend who also had similar unusual experience. IW concludes that iodine is the problem when the probabilities suggest that the particular product that he had may be the problem.

How long have you used vitamins that list iodine? If one is iodine deficient, that not something that iodine RDA can correct very well.

I still think that your thyroid is a bit unusual. Please check your waking oral body temperature.

IW:
"This is the first population-based study to show an association of higher IGF-I levels with increased risk of a cancer-related death in older men,"

Which is to say that all prior studies showed no such relationship. So we need to discard decades of other reports and panic over this one.

The endo journal did not do the research or write the paper, they simply accepted it for publication. I would like to see more data from the study. The average age going into the study was 73 and the study spanned ~15 years. Because of this, there will be many deaths of natural caused.

If you study the paper you will find: "In this study, IGF-I levels were not associated with all-cause or noncancer mortality in Rancho Bernardo men, supporting the specificity of the IGF-I cancer mortality association reported here. "

If we prevent heart attacks, Parkinson's, senile dementia, liver failures, kidney failure, strokes, bone fractures etc; we will all die of cancer because we do not live forever. If you reduce non-cancer deaths in a segment of a population, cause of cancer deaths will increase. Note above that there were no increased or decreased rates of all cause mortality. This means that the higher IFG-1 members had reduced non-cancer death rates in those who died. If I can have higher IGF-1 levels and be part of a group with less deaths associated with other type of degeneration, that would not be a bad outcome.

So I could come up with a drug that would prevent all of those non-cancer cause of deaths. The result would be that almost every death in a population would be cancer. So someone can then publish a study that shows that this drug that prevents all of those other causes of death leads to more cancer causes of death. What is the merit of that?

IW, I find that your provision of insight and knowledge is more predicated on attacking me that intellectual integrity.


#10

http://www.mayomedicallaboratories.com/media/articles/communique/mc2831-0306.pdf

Your telling the man to ignor this.... This is wrong

I gain nothing by attacking you I hate that you think you know about things that are not very well known to anyone...

You led me in a direction that landed me more ill and take no responsibility for it.. You tell everyone iodine is iodine and it doesn't matter.. Iodine at high levels can be dangerous and I listed a number of fucking links showing this.. They were up for a couple days and you had them taken down.. I do not state iodine is bad I state 50 mg of iodine can be fatal and should be done under the care of a thyroid speacialist (which you are not even close) to make sure the person doesn't end up In the hospital with heart palpitations like my friend or an enlarged thyroid like me.. What would the product have done that was different then any other Iodine or iodine/iodide combination?

It directly effected the thyroid in both cases so ummm let's see what is in the pill that directly effects the thyroid????

IODINE!!!! My god you are dense sometimes

I am not wrong for saying he should check and see why these levels are high.. If infact it is because of supplements or amino acids he is taking great...

You come on and tell him he shouldn't worry about it...<~~~who is attacking who..After I said he should have it checked.. <~~~ to be safe

Decades of reports where!?? The function of igf-1 and its impacts are not well known.... But ofcourse you know right?! Common man your head is to big

http://labtestsonline.org/understanding/analytes/igf1/tab/test read this bro


#11

IW is not addressing my arguments.

Why are you hi-jacking every ones threads with your rants.


#12

The fact is I actually care that people desperately looking for help don't make the mistake of listening to one guys distorted opinion and follow like sheep..

My recommendation is to research the stuff yourself and make informed decisions based on your own knowledge not that of one person...

As for highjacking..Do you own this domain?? U sure think you do.. Stfu quack


#13

It's been approx 2 weeks now and I've just had my third test shot. No dramatic changes yet noticed. Morning wood is a change, but no raging libido or anything like that. Gym and weights seems the same as before. My cloudy head may be clearing up a bit.

Haven't had any follow up labs yet, but those are scheduled soon.


#14

Hey just a thought but I suggested it to another guy and he seems to think it may be working.

Look up coconut oil and it effect on brain fog anf function.. Recommended 1 to 2 table spoons per day.. Make sure it organic extra vergin I think is the recommendation.. Can't hurt and has healthy fats in it;)

Good luck sir with your quest to feeling better