T Nation

FlyBoy Case Thread


#1

Hello all

Brand new here. Guess I'll start from the beginning.

52 y.o. male, morbidly obese: 5' 8", 280 lbs. 42% BF

I am in a profession which requires an annual physical so I need to get a handle on my health if I am to continue with my career. As a result, I went to my PCP for blood tests to establish a baseline and see where I was at and among several other issues (I'll get to those later), it was discovered my T was very low: 190 (241-827 ng/dl). I was also exhibiting all the classic symptoms of low T but never considered that and simply attributed my symptoms to age and physical condition. Anyway, doc started me on 60mg (2 pumps) Axiron daily and it initially worked very well. Total T went up to 711. I felt better than I could have imagined and actually WANTED to start working out again. (over 5 years since I touched a weight or worked out in any way). Well, that was six months ago (Dec 2014) and now the symptoms are returning. I have been doing extensive research since this all started and feel like I have a fairly good grasp on chemistry, mechanisms, symptoms, protocols etc. I do have a good PCP but he is not interested in pursuing anything past treating my total T so I am enrolled in a program with a popular and reputable online testosterone treatment clinic. Not sure if I can name it here. I'm due to receive my kit in a few days and am very excited to get started. It's a combination of the big 3: T-Cyp, HCG and Anastrozole if needed.

OK, let's get to some numbers:

-age: 52
-height: 5' 8"
-waist: 42 (abdomen 52)
-weight: 280
-describe body and facial hair: Light body hair, full beard. Shave everyday.
-describe where you carry fat and how changed: Abdomen, butt, thighs, man tits (not gyno, just fat)
-health conditions, symptoms: Fairly positive health history with no major illness or injury. Vasectomy back in 1991 with discovery of varicocele. Not sure if varicocele was repaired but vasectomy was successful.
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: Axiron, 60 mgs (2 pumps) daily. Some supplements I'll list separately below. No hair loss or prostate meds ever.
-- real dangers! see this http://propeciahelp.com/overvi...
-lab results with ranges: See below
-describe diet: Absolute shit right now. Most likely paleo very soon.
-describe training: None at this time.
-testes ache, ever, with a fever?: Never
-how have morning wood and nocturnal erections changed: Morning wood 2-3 times a week since starting Axiron. Sex drive better but not good yet.

Labs to follow


#2

Initial labs prior to TRT were drawn Nov, 2014. Total T was 190 ng/dl which prompted TRT, Axiron 60mg daily. High cholesterol and crappy HDL/LDL ratios. Everything else in range. Hematocrit 42.2 (38.5 - 50.0%).

Next labs were drawn Feb 2015: Total T jumped up to 711 ng/dl. Felt like a million bucks. Cholesterol and ratios remained about the same. Hematocrit came up a little, 45.9.

Latest labs in detail: Drawn Apr 24, 2015 (5 months on Axiron). I ordered and paid for these myself through WellnessFX using Quest Diagnostics lab. I dosed with 30 mg, 1 pump Axiron 2 hours prior to the blood draw. (My normal routine is one pump a.m. One pump afternoon).

TT: 623 (250 - 1100 ng/dl)
FT: 136.0 (35.0 - 155.0 pg/ml)
Calculated Free T: 2.6%
Calculated Bioavailable T: 63.7%
LH: <0.2 (1.5 - 9.3 miu/ml)
FSH: <0.7 (1.6 - 8.0 miu/ml)
SHBG: 22 (10 - 50 nmol/l
DHEA-S: 261 (38 - 313 mcg/dl)
Cortisol, total: Taken at 0745 a.m. 9.5 (4.0 - 22.0)
Estradiol: 41 (< or = 39 pg/ml) Quest standard test, not ultrasensitive.
Progesterone: <0.5 (<1.4 ng/ml)

Thyroid

TSH: 1.02 (0.40 - 4.50 miu/l)
T4 Free: 1.1 (0.8 - 1.8 ng/dl)
T3 Free: 3.5 (2.3 - 4.2 pg/ml)
T3 Total: 115 (76 - 181 ng/dl)
T3 Uptake: 34 (22 - 35%)
T4 (Thyroxine) Total: 5.9 (4.5 - 12 mcg/dl)
Free T4 index (T7): 2.0 (1.4 - 3.8)
T3 Reverse: 14 (8 - 25 ng/dl)

WBC: 6.2 (3.8 - 10.8 thousand/ul)
RBC: 5.09 (4.20 - 5.8 million/ul)
Hemoglobin: 15.7 (13.2 - 17.1 g/dl)
Hematocrit: 48.4 (38.5 - 50.0%)

IGF-1: 97 (50 - 317 ng/ml)
Z Score (male): -0.8 (-2.0 - +2.0 SD)

Iron all within range

Lipid panel available if needed. Thanks for looking.


#3

Early morning temps taken orally prior to rising average 96.6 to 97.2 for the last 2 weeks.

Started Iodoral 12.5mg iodine just today. Will continue to track temps and post here weekly.

Due to receive T-cyp and HCG in a few days. Will post dosages and protocols here.

Anastrozole will come a little later if needed. Planning monthly blood draws.


#4

You need anastrozole with E2=41 and your target should be 22pg/ml

T4 is low.
Are you using iodized and/or taking vitamin that lists iodine?
You need selenium in your daily vitamins too.

IGF-1 indicates that GH is really sub-optimal. HGH would be helpful in many ways, but expensive.

There are 7 stickies in this forum. These are important for you:
- advice for new guys
- protocol for injections
- thyroid basics

No need to ever test FSH/LH again, always -->zero on TRT [unless a FSH secreting tumor].

Are you certifications OK with injecting T?
hCG does not travel well/easily.

Loss of effect of transdermal T can be thyroid related and/or effect of estrogen poisoning [E2=41].


#5

Thanks for looking KSman. Your advice is welcome and well respected.

I have read the stickies and that is what prompted me to start taking Iodoral as my morning temps are on the low side. I'm hoping to bump up T4 and raise morning temps. I'll be posting results here.

I have changed from a TD to injectable and my new meds are on the way. They include T-cyp, HCG and Anastrozol so I'm anticipating the ability to control E2. Also, I'm working on my obesity issue but I have a lot of weight to lose so that's going to involve several months. Increasing my TT definitely helped as I could barely get off the couch before I started Axiron.

I missed the low IGF-1 and will be doing further research.

Yes my certifications allow for TRT. Travel is not an issue and I will have the ability to keep mixed HCG cold.

I plan on BW every month to get dialed in and will be tracking all the recommended tests listed in the sticky.

Thanks again KSman