T Nation

Diagnosed with Low T at 30 & Need Overall Guidance


#1

Good Morning everybody,

I hope you fellas can help me out! i apologize if the posit is a little long.

As requested, here is my stats:

-age 30
-height - 5’8
-waist - 32
-weight 163lbs
-describe body and facial hair - full beard - no issues growing
-describe where you carry fat and how changed - don’t carry a lot of fat as i am very active.
-health conditions, symptoms [history] - Diagnosed with depression and anxiety - no meds as i have tried them and they did more harm than good - I always felt there was a “deeper” issue that pills don’t correct.
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever -none
– real dangers! see this propeciahelp.com/overview43
-lab results with ranges - Low t Center gave me only my test level, not other bloodwork. Please read description below.
-describe training [some ruin there hormones by over training] - been having to pull myself out of bed to go to the gym. it was not like this 6 months ago as I am more than pumped to go lift everytime. I recently switched to a simple 5x5 workout to save time as i am in wedding planning mode.
-testes ache, ever, with a fever? No pain
-how have morning wood and nocturnal erections changed - Non existent for either.

30 years old doing very well in life. i have recently build my first home, I am marrying my best friend on 1/15/17, and i have 0 debt. Overall, just a normal dude who has slumped in to a deep depression with intense anxiety. I have been down this road before years ago and it did not end well. The medications caused me to lose 23lbs, and I slept 16 hours a day - not something that i want to experience again. Also, I always told my doctor that I felt like there was a deeper issue and that the medications didn’t work.

Fast forward to now and over the past 6 months my quality of life has been very poor. I have no drive to go out and socialize, nor do I have desire to have sex. My diet is nearly perfect because my Fiance is a dietitian and we grow all of our own vegetables in our home garden. I have to pull myself out of bed to go to the gym and do things that I would love to do. I am fatigued all of the time and i can go to bed around 3 p.m in the afternoon - i could go on and on but I won’t. Let’s just conclude it that i should have NO REASON to be experiencing these things, as i have very little stress in my life.

I have been to 2 doctors, 1 being an endocrinologist and they want to put me back on anti-depressant pills, and shoot down the idea about taking my bloods to test my testosterone. After much push back i decided that if he wasn’t willing to atleast do my bloods, then I don’t want him to be overseeing me. i then went to the Low T center and they tested me twice. Both being on the low end of “normal” with the first draw being a 389ng/dL, and the second 3 weeks later 350ng/dL. the PA told me that i was treatable, but not by Aetna and I’d have to pay an outrageous monthly fee for a weekly visit to the doctor and a injection. With my work schedule i can’t make that happen as it is in Africa in comparison to where I live.

My question is this:

  1. The low T center never took a full panel test. They just tested my SBHG and Free T. I am wanting to get a baseline blood test done, but it’s hard to wrap my head around which one I need to do? i am seeing some for $60.00, and others for $250.00 - does it matter which one is performed to get the most accurate results?

  2. under Dr. John Crisler’s TRT regimen. He suggests to front load 200mg of Test C, then wait a week to fall down to 100mg for 5 weeks until the first blood work is scheduled to be done to determine E2 and test levels. Should I take an A.I beginning day one? Correct me if I’m wrong, shouldn’t a newbie on TRT hold off on the A.I until the 5-6 week mark when blood work is taken to determine E2/Test levels? i just don’t want to mess up and feel like crap.

  3. if I begin now, what kind of positive and negative effects will I be feeling around 1/15/17? i want to make sure it’s a day to remember for my Fiance and I don’t want to be feeling any negative sides around that time.

Any guidance would be appreciated and Merry Christmas ahead of time.


#2

You need to get the full TRT hormone panel done which includes T, Free T, E2, FSH, LH, Prolactin, DHT, SHBG and sometimes thyroid hormones (couldn’t hurt). That way you can find out the cause of your low T. After initial treatment you won’t need to test all those again, just a small panel.

  1. You don’t need to front load. I recommend from my experience starting no AI, testing at 6 weeks and adding an AI according to how your E2 response. Others will say just to add 1mg from the start.

  2. It takes 3-6 weeks for some to feel any affect at all. I think anybody who ‘feels’ it immediately is getting a placebo affect from feeling positive about a new treatment.


#3

Blshaw,

Thank you for the feedback. I am getting a full hormone panel on Monday.


#4

Please read the stickies found here: About the T Replacement Category

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

Your energy can also be down from low thyroid function, often from not using iodized salt, --> iodine deficiency. Training with your issues with adrenalin can cause adrenal fatigue.

So were are you located? Africa?
This affects your diagnostic and treatment options.

Labs:
TT
FT
E2
prolactin
LH/FSH
fasting cholestol - may be too low <160= :frowning:
TSH
fT3 - these if oral body temps are low, see thyroid basics sticky
fT4


#5

KSman,

Thank you for chiming in - I appreciate your feedback. Unfortunately, I just got the full male hormone panel through discounted labs. I did not get the T3 and T4 tests this time as I was unaware, but I will see if I can get it added on.


#6

You can also order your own labs in most USA States via the Web.


#7

Awesome. Thanks KSman, I appreciate it. i got my bloods taken yesterday so we will see what they say.


#8

Here is the results of my test. Note my Free test is low, but other is in range.

Any suggestions?

CBC With Differential/Platelet

WBC 8.2 x10E3/uL 3.4 - 10.8 01

RBC 4.97 x10E6/uL 4.14 - 5.80 01

Hemoglobin 15.1 g/dL 12.6 - 17.7 01

Hematocrit 43.7 % 37.5 - 51.0 01

MCV 88 fL 79 - 97 01

MCH 30.4 pg 26.6 - 33.0 01

MCHC 34.6 g/dL 31.5 - 35.7 01

RDW 12.9 % 12.3 - 15.4 01

Platelets 216 x10E3/uL 150 - 379 01

Neutrophils 54 % 01

Lymphs 32 % 01

Monocytes 7 % 01

Eos 7 % 01

Basos 0 % 01

Neutrophils (Absolute) 4.4 x10E3/uL 1.4 - 7.0 01

Lymphs (Absolute) 2.6 x10E3/uL 0.7 - 3.1 01

Monocytes(Absolute) 0.6 x10E3/uL 0.1 - 0.9 01

Eos (Absolute) 0.6 High x10E3/uL 0.0 - 0.4 01

Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 01

Immature Granulocytes 0 % 01

Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1 01

Comp. Metabolic Panel (14)

Glucose, Serum 92 mg/dL 65 - 99 01

BUN 17 mg/dL 6 - 20 01

Creatinine, Serum 0.79 mg/dL 0.76 - 1.27 01

eGFR If NonAfricn Am 120 mL/min/1.73 >59

eGFR If Africn Am 139 mL/min/1.73 >59

1.00

qWERtyUi Patient Report

DOB: 07/03/1986 Patient ID: DL 3541 Control ID: B0052620438 Date collected: 12/27/2016 1617 Local

Date Issued: 01/03/17 1110 ET FINAL REPORT Page 2 of 3

This document contains private and confidential health information protected by state and federal law.

If you have received this document in error, please call 713-856-8288

© 1995-2017 Laboratory Corporation of America® Holdings

All Rights Reserved - Enterprise Report Version:

TESTS RESULT FLAG UNITS REFERENCE INTERVAL LAB

BUN/Creatinine Ratio 22 High 8 - 19

Sodium, Serum 145 High mmol/L 134 - 144 01

Potassium, Serum 4.2 mmol/L 3.5 - 5.2 01

Chloride, Serum 102 mmol/L 96 - 106 01

Carbon Dioxide, Total 24 mmol/L 18 - 29 01

Calcium, Serum 9.5 mg/dL 8.7 - 10.2 01

Protein, Total, Serum 7.2 g/dL 6.0 - 8.5 01

Albumin, Serum 5.1 g/dL 3.5 - 5.5 01

Globulin, Total 2.1 g/dL 1.5 - 4.5

A/G Ratio 2.4 1.1 - 2.5

Bilirubin, Total 0.7 mg/dL 0.0 - 1.2 01

Alkaline Phosphatase, S 57 IU/L 39 - 117 01

AST (SGOT) 17 IU/L 0 - 40 01

ALT (SGPT) 20 IU/L 0 - 44 01

Lipid Panel w/ Chol/HDL Ratio

Cholesterol, Total 199 mg/dL 100 - 199 01

Triglycerides 135 mg/dL 0 - 149 01

HDL Cholesterol 48 mg/dL >39 01

VLDL Cholesterol Cal 27 mg/dL 5 - 40

LDL Cholesterol Calc 124 High mg/dL 0 - 99

T. Chol/HDL Ratio 4.1 ratio units 0.0 - 5.0

Please Note: 01

T. Chol/HDL Ratio

Men Women

1/2 Avg.Risk 3.4 3.3

Avg.Risk 5.0 4.4

2X Avg.Risk 9.6 7.1

3X Avg.Risk 23.4 11.0

FSH and LH

LH 6.1 mIU/mL 1.7 - 8.6 01

FSH 4.9 mIU/mL 1.5 - 12.4 01

Testosterone, Free+Total LC/MS

Testosterone, Total, LC/MS 657.6 ng/dL 348.0 - 1197.0 02

Adult male reference interval is based on a population of lean males

up to 40 years old.

Disclaimer: 02

This test was developed and its performance characteristics

determined by LabCorp. It has not been cleared or approved

by the Food and Drug Administration.

Free Testosterone(Direct) 6.0 Low pg/mL 8.7 - 25.1 02

DHEA-Sulfate 228.6 ug/dL 138.5 - 475.2 01

1.00

qWERtyUi Patient Report

DOB: 07/03/1986 Patient ID: DL 3541 Control ID: B0052620438 Date collected: 12/27/2016 1617 Local

Date Issued: 01/03/17 1110 ET FINAL REPORT Page 3 of 3

This document contains private and confidential health information protected by state and federal law.

If you have received this document in error, please call 713-856-8288

© 1995-2017 Laboratory Corporation of America® Holdings

All Rights Reserved - Enterprise Report Version:

TESTS RESULT FLAG UNITS REFERENCE INTERVAL LAB

TSH 1.280 uIU/mL 0.450 - 4.500 01

Prostate-Specific Ag, Serum

Prostate Specific Ag, Serum 1.0 ng/mL 0.0 - 4.0 01

Roche ECLIA methodology.

According to the American Urological Association, Serum PSA should

decrease and remain at undetectable levels after radical

prostatectomy. The AUA defines biochemical recurrence as an initial

PSA value 0.2 ng/mL or greater followed by a subsequent confirmatory

PSA value 0.2 ng/mL or greater.

Values obtained with different assay methods or kits cannot be used

interchangeably. Results cannot be interpreted as absolute evidence

of the presence or absence of malignant disease.

Estradiol, Sensitive 12.1 pg/mL 8.0 - 35.0 02

This test was developed and its performance characteristics

determined by LabCorp. It has not been cleared by the Food and

Drug Administration.

Methodology: Liquid chromatography tandem mass spectrometry(LC/MS/MS)

Triiodothyronine,Free,Serum 3.5 pg/mL 2.0 - 4.4 01

Thank you for the suggestions ahead of time. As i am a very proactive person, I have 3 10mL vials dosed at 200mg Test C Pharma grade. i don’t have any A.I’s yet. But Everything is ready to go IF ONLY I need to go down that route.


#9

@KSman, can you give me some insight?


#10

Any idea why sodium was high?

fT3=3.5 suggests that body temperatures should be good, but you can check as per the thyroid basics sticky.

Low FT means less FT for FT–>E2 and E2 is low.

TT is mid-range
FT is low
This suggests that SHBG may be elevated, creating more T_SHBG that reduces FT and inflates TT

https://en.wikipedia.org/wiki/Sex_hormone-binding_globulin

Elevated E2 is not the cause of suspected elevated SHBG

Please explain what may be atypical about your diet.

LH/FSH seem almost high given your FT levels. So there may be a weak testicular function.

Could there be an issue with Rx or OTC meds or ???


#11

If you want to make certain that you’re not feeling any worse that you currently are for your wedding and honeymoon, then I would not start TRT until afterwards.

Realize that while there are guidelines for dosage and protocols, such as the ones found on this site, they are simply starting points and your mileage may vary.

You may get lucky and things work, but you may also feel much worse than you do now.

I began TRT a month ago. In 3 days time I felt like superman. Definitely no placebo affect. Everything changed - mood, wood, outlook on life all got better. Wood so strong that it woke me up and annoyed me in the middle of the night. That lasted 11 days.

Then I felt like absolute shit for a week.

Then 8 good days.

Followed by 2 bad days, and today I am feeling better, but still not great.

Bad days are really bad…much worse than before I went on TRT. I feel incredibly tired from the moment I wake up, nothing excites me. I work for myself, and I hide how badly I’m feeling from my wife. I go to work and get hardly anything accomplished.

So I would advise you to do everything you can to not start TRT until after this once in a lifetime day is done. You also need to make sure your wife understands that when you start TRT that your hormones may be unstable for a while and you might not be yourself while you tweak and troubleshoot.

You can read more about my story here.


#12

My test was taken after Christmas and that is the one time of year that i don’t eat the healthiest, so i am assuming that is why sodium was high.

My diet for the most part very clean. My fiancee and i grow our own vegetables and avoid any food with bad fats. However, I am a BIG fan of Nutter Bars, and they have a good amount of Saturated Fat, so i tend to eat those sometimes, but avoid all other sugars (besides the small amount in my protein powders). So I’ll cut that out as it is can be associated with a few issues the panel reflects.

No OTC meds besides an occasional aspirin when I have a headache.


#13

Thanks for bringing that to my attention @tallyho_bitches However, i have already considered TRT and the lifelong commitment that follows the protocol. Also, my wife is the one who has been a big advocate because she has been through my frustrations and disappointments as she has been with me at every office visit i go too.

i don’t want to be jabbing a needle in my body twice a week, but if it will give me a better quality of life by 10% from how I feel now, I’d jump on it. it’s getting to the point where I could see myself losing my job because i am falling asleep at my desk after 10 hours of sleep and good food. i have 0 stress in my life as i am very good about “letting it go”, so there is no reason for me to be feeling like this.

So every consideration, including the duration it takes to dial in, has been addressed. I’d like to have at least some days that i am not wanting to fall asleep while driving home or having 0 interesti n anything, is better than feeling how I am now daily.


#14

@red15 I look forward to following your journey and wish you the best of luck. If you do nothing until after the wedding, you pretty much know how you’re going to be - same as now, right? But if you get on TRT, you don’t really know what you’re going to get. That’s all I was trying to say. Could be worse off until you get things tweaked.