T Nation

Executive Meathead Looking For Advice


Gentlemen, any advice or recommendations would be greatly appreciated. I love strongman and lifting, but for the past year and a half I’ve felt like garbage and the strength gains have been nearly non-existent. Would love to figure out why. I’m getting to the point where I want to sell all my weights as it just doesn’t seem worth the time and effort. I know that is a bad idea and a ticket to an early grave, but it has been brutal.

Body Measurements & Descriptions

  • Age: 31
  • Height: 6’3”
  • Waist: 48”
  • Weight: 314 lbs
  • Body & Facial Hair: Decent amount of body hair (including the sexy back hair/upper arm hair), full head of hair (fairly thick, no receding hair line) and decent facial hair (thick mustache/goatee, can grow neck beard, very little hair on cheeks/sideburns)
  • I have always carried my body fat in my upper body. I have, even since a kid, had man boobs, a belly and brutal love handles. This has stayed the same, but my belly and love handles have not improved at all, despite hard training and a “decent” diet. Belly has gotten bigger in the past year or so.

Health Conditions & Symptoms

  • Slightly higher blood pressure: 142/76. This tends to go down into normal ranges once I get outside and start doing more strongman training during the season. The winter is spent in the garage, lifting only and eating to try and put on size.
  • Sleep Apnea: I was diagnosed with severe OSA. I was put on a CPA with full face mask, and have been using for 6-8 hours a night for the last 2+ months. My AHI is no consistently under 5.
  • Originally started taking a more active interest in my health about a year ago. My symptoms included: exhaustion, fat gain, muscle loss, significant strength loss, low libido, no morning wood, weaker erections, brain fog, inability to concentrate at work, loss of confidence, terrible bad mood. I could sum a lot of this up by saying I felt like a giant pussy. The CPAP has helped with the exhaustion and a little with the mood, but I still feel pretty tired, the lifting is pretty crappy and I’m having a hard time focusing at work.

RX & OTC Drugs

  • Advil and Tylenol occasionally
  • Flonase for seasonal allegories

Most Recent Labs (taken 3-25-2016)
LH: 1.9 miu/mL 1.2 – 8.6 miu/mL
FSH: 0.8 miu/mL 1.3 – 19.3 miu/mL
TT: 359 ng/dL 240 – 950 ng/dL
FT: 9.33 ng/dL 4.85 – 19.0 ng/dL
E2 42.0 pg/mL 20 – 47 pg/mL
Prolactin 4.2 ng/mL 1.4 – 24.2 ng/mL
DHT Doc doesn’t offer that test, can get done separately
PSA & DRE Doc says that at 31, these are not necessary
Vitamin D, 25OH, TOT (S) 44.9 ng/mL Optimal 30-10 ng/mL

CBS with Differential with Platelet
WHITE BLOOD COUNT (L) 5.8 K/UL 4.0 - 11.0 K/UL
RED BLOOD CELL COUNT 5.03 M/UL 4.50 - 5.90 M/UL
Hemoglobin 15.2 G/DL 13.5 - 17.5 G/DL
Hematocrit 43.4 % 41.0 - 52.0 %
RED CELL DISTRIBUTION WIDTH 13.3 % 11.0 - 15.0 %
Platelet Count 438 K/UL 140 - 400 K/UL

Metabolic Panel
Glucose 85 mg/dL 65 - 99 mg/dL
Sodium 141 mmol/L 136 - 144 mmol/L
Potassium 3.9 mmol/L 3.3 - 5.1 mmol/L
Chloride 106 mmol/L 95 - 110 mmol/L
CARBON DIOXIDE § 28 mmol/L 22 - 32 mmol/L
BLOOD UREA NITROGEN § 25 mg/dL 8 - 20 mg/dL
CREATININE 0.91 mg/dL 0.50 - 1.50 mg/dL
BUN/CREA RATIO 27.5 10.0 - 20.0
ANION GAP 7 0 - 18
CALCIUM 9.3 mg/dL 8.5 - 10.5 mg/dL
CALCULATED OSMOLALITY 296 mOsm/kg 275 - 295 mOsm/kg
AST 27 U/L 15 - 41 U/L
ALT (SGPT) 49 U/L 17 - 63 U/L
ALK PHOSPHATASE § 56 U/L 32 - 100 U/L
TOTAL BILIRUBIN 0.7 mg/dL 0.3 - 1.2 mg/dL
TOTAL PROTEIN 7.2 g/dL 5.9 - 8.4 g/dL
Albumin 4.5 g/dL 3.5 - 4.8 g/dL
GLOBULIN, TOTAL 2.7 g/dL 2.5 - 3.7 g/dL
A/G RATIO 1.7 1.0 - 2.0

Lipid Panel
DL Cholesterol 32 mg/dL
CHOLESTEROL § 173 mg/dL 110 - 200 mg/dL
TRIGLYCERIDE § 124 mg/dL 1 - 149 mg/dL
CALCULATED LDL 116 mg/dL 0 - 99 mg/dL
CALCULATED NON HDL 141 mg/dL <130 mg/dL


  • I eat a diet that I would call 70% clean. I try to hit about 3700 calories with 324g of Carbs, 103g of Fat and 370g of Protein.
  • I eat 3-4 food meals and have 1-2 shakes a day.
  • Protein is from eggs, chicken, beef, pork tenderloin, whey
  • Carbs are from mostly rice, tortillas, the occasional sweet potato, Gatorade during most workouts
  • Fat is from Milk, meat, GF butter,
  • During the winter when I am focusing more on hypertrophy, I do eat some junk on the weekends. The idea being that I am trying to put on some mass this will help with a calorie surplus. This is usually only for dinners. This isn’t to say it’s a ton of fast food, but maybe a frozen pizza and some protein pudding for dinner.
  • Have needed to eat like this to maintain any semblance of strength. IF I cut calories, I feel like shit and my strength goes to crap.


  • Currently Wendler 531: Boring But Big during winter……back off on hypertrophy and add Strongman events in summer
  • I lifted a ton in college and got decently strong and big. I took off between 23-28 to work and party my ass off. I acknowledge I did probably did a lot of damage to my body with tons of junk food, smoking and alcohol 5-7 nights a week.
  • Got married at 28. Started working out again to get in shape. After married, needed to find a positive hobby so I started powerlifting. Used Stronglifts for 8 months and did a power meet with a 419 squat, 297 bench and 485 deadlift (@299).
  • Strength kept coming for the 6-9 months after that, but have been in the crapper for the last two years. I am barely stronger than I was in December 2013.
  • No steroid use ever.

Tested do not ache, that I can think off and I don’t have a fever.

Very, very rarely get morning wood and very rarely nocturnal erections.


  • Get stronger
  • Be healthy and happy
  • Love to get my confidence back and be able to focus.
  • Would love to drop some lbs, but if the strength was getting better, I wouldn’t mind that so much.


I forgot to add one thing. The wife and I would like to have a second child in the next year. Understanding that TRT is probably not the best route if that is the goal, is there anything in my blood work that would be concerning? Especially the low FSH.



Man, my first response would be to recommend you lose some weight. Your T levels aren’t great, but that’s a lot of poundage. That’s just my gut reaction. I’m 6’1’ and was at 220 with sleep apnea. I got the apnea handled first (cpap) and then the low T and am now down to 184 (but a weak fucker compared to you).

Just my thoughts, good luck!


Thanks for the recommendation. I agree that I should lose some weight, it’s just been next to impossible to do so. And when I do, I really have to cut calories and carbs. That’s all well and good, but my training goes to shit. And perhaps I need to suck that up, but it’s really a tough pill to swallow.

I train to compete in strongman and powerlifting. Without the ability to compete, the training just isn’t worth it.


Please follow these links found here: About the T Replacement Category

  • advice for new guys
  • thinks that damage your hormones
  • protocol for injections
  • finding a TRT doc
  • thyroid basics explained – check oral body temperatures as suggested

Major influences on weight/fat:

  • T levels, FT is more important than TT
  • E2 because it reduces FT
  • SHBG because it reduces FT and E2 increases SHBG and FT reduces SHBG
  • thyroid function

You have secondary hypogonadism and E2=42 is a huge factor.
You fat is increasing T–>E2 aromatization

Thyroid need iodine to make T3, T4 hormones.
If you have not been using iodized salt, you are deficient.
Low thyroid function can make your outer eyebrows sparse and reduce your energy and promote fat storage.

DHT: Do not care. With low T, DHT will be low.

Labs - you have some now:
AM cortisol [at 8AM please]

With T+AI+hCG your fertility should be OK.

You probably need TRT simply to enable fat loss.
Thyroid and cortisol have to be good as well.
If correctable problems with thyroid and cortisol, you might be able to avoid TRT now.
But you do need anastrozole now and I suggest 1mg/week in divided doses. E2=42 is really messing you up.


You mean secondary hypogonadism, right?

His LH and FSH are super-low.


thanks for pointing that out, now fixed