T Nation

I've Got the T Level of a Prepubescent Girl


#1

I'm 43.5yo 6'2" 220lbs(~20%bf) and probably have never had crazy amounts of T (mild body hair etc.) My lifts are going up, but it's only getting back to where I was 10 years ago.

I ordered the male panel from LEF and labcorp did the tests.

Iron, serum - high - 164(40-155) - Looks like time to give blood.

Free T (direct) - 8.3(6.8-21.5) - 10% of reference range

Total T (serum) - 393(249-836) - 25% of reference range
I had this tested in early October 2010 473(241-827)RR.

DHEA-S - 261.5(88.9-427.0) - 51% of reference range

SHBG (serum) - 36.6(14.5-48.4) - 65% of reference range

Estradiol - 19.2(7.6-42.6) - 33% of reference range

TSH - 1.570(0.450-4.500) - 28% of reference range

Cholesterol:
Total - 210
LDL - 141
HDL - 51
Tri - 84

I was hoping that my E2 levels were going to come back high and with a little judicious use of anastrozole, I'd have a nice bump in free T. No joy. I'm thinking the only real options are to get the bodyfat back down and add some exogenous T.

Any other thoughts?


#2

hey there.

any other symptoms or Quality of Life issues?

do you have medical insurance?
are you looking for a doctor in your area to work with you?

If so, some additional tests could be helpful like free T3, ferritin, D25-OH, B12, 8am Cortisol


#3

Yes, I've got insurance, but I've also got the funds to pay for it out of pocket if necessary.

I'm planning to talk to my GP first and see to what extent she is comfortable writing scripts and monitoring things for me. If not, my next door neighbor in med school said that I should try a doctor that specializes in geriatric medicine as HRT is fairly common in that age group. Not sure on that one, but it's a thought.

Regarding symptoms and QOL. I'm unsure which are related to poor lifestyle hygiene and which are likely related to my hormone levels.

I seem to be more tired than I used to for a given lack of sleep. That is, I've been getting too little sleep for a long time, but I'm more tired these days generally speaking. I probably drink too much(roughly 20 oz of alcohol on the weeks the kids are with their mother and none when they're with me).

Morning wood a couple of times a month, but certainly not every day. I've had what's seemed to be a degradation in my mental faculties for several years and that's been much more noticeable than anything else.

The thing more than anything that got me looking into this is that as I added bodyfat since the beginning of the year. It's been distributed differently than it ever has before. It's been much more concentrated in the front of my belly relatively speaking than in the past. My med school friend says insulin sensitivity is likely more responsible for that, but hell I don't know.


#4

"Estradiol - 19.2(7.6-42.6) - 33% of reference range "

I find that puzzling given the body fat percentage and new distribution. So your not taking any anti-e supplements ? I guess with less T to convert into E it makes sense. Even more puzzling is the trend since October - worsening T levels. It drops with age but that was a substantial drop in less than a year. Any significant diet/lifestyle changes ?


#5

Err, well Rez-V is SUPPOSED to help with estrogen (http://www.T-Nation.com/store/supplements/rez-v.jsp) I take it and have been pretty regularly. That might have something to do with things.

In October, I was a couple of months into a no-grains/paleo-lite diet (basically no to sugar and grains). A pretty restrictive V-Diet/MAG pulse fasting regimen from mid-November until the end of the year (down to 204lbs at 14%). Once work started getting hot and heavy again in the new year, it was back to comfort eating of what the hell ever I wanted and thus, back up to 220+ at 20%bf.

I was taking tribulus then, but I'm not convinced it has any efficacy.


#6

I get the feeling most guys here are better at eating clean than I. Many days I eat completely clean, but eventually I wind up eating speed food because 1) There is no cleanup and 2) I am in a hurry and there is also no prep time. That messes up the whole insulin sensitivity thing and I go from lean and next to zero body fat to fat around the middle accumulation and crashing energy levels. I was also reading up on my kidney numbers and it said you could have protein convert directly to fat so that makes 2 negative outcomes from trying to eat only protein. Aiming for more middle of the road now with long grain rice and normal amounts of protein. Did pullups with 60 lbs draped over my shoulders today, felt really strong and abs are getting shread again. So apparently all that protein was not helping as much as I thought.

Unless the guys here have some better insight I would follow the sticky if you can guide your doc to it:

TRT: Protocol for Injections

  • 100mg test cypionate or ethanate injected per week with two or more injections per week.
  • 250iu hCG SC EOD [every other day]
  • 1.0mg Arimidex/anastrozole per week in divided doses.

#7

I've got an appointment with my primary doc on Monday morning. So, we'll see what she has to say.


#8

Well, my doc said a) that low test is defined as < 250 which would mean that you're not low unless you're below the bottom of the reference range. So, it doesn't matter if you're a sexless eunuch with the belly to match, you're OK as long as your TT is above 250.

From there, I'll be getting a referral to an endocrinologist. At this point, I'm willing to work in the system and I didn't expect any love from my primary doctor.


#9

Didn't have anything to add, so didn't post anything here. Now, I've been to the endo. I didn't like her answer.

Recap:

Free T (direct) - 8.3(6.8-21.5) - 10% of reference range

Total T (serum) - 393(249-836) - 25% of reference range
I had this tested in early October 2010 473(241-827)RR.

Summary:
- Lady doc only wanted to talk about TT which implies to me that she's not particularly educated in regards to TRT.
- Her comment was that a) she wouldn't put anyone on TRT until their TT was 150 or below. She didn't offer a reference range, but given we were talking about me and my labcorp test where the bottom of the RR = 249, I took that as a statement of fact that she was unwilling to put anyone on TRT until they were a sexless eunuch, and b) her goal with TRT is to get someone's TT(there she goes again) up to about 500 and thus, my 473 last October was just fine.

I basically told her that I didn't like her answer and I was instead going to go find a doctor that would work with me.

The whole thing pisses me off. It's akin to telling someone that no, they can't have reading glasses for their presbyopia because it's just a natural effect of aging, so suck it up.

Grrr.


#10

Yup endos are pretty useless when it comes to this stuff...as long as you are able to walk in and out of the door, then you're likely not going to find one to be very helpful...have you read and implemented the "Finding a TRT Doctor" stickey thread?


#11

TSH is up, not "high", but can be an indicator of problems for some.

Are you iodine deficient? Using iodized salt? Iodine in vitamins?

Checked waking body temps? Better near 98 than 97. Getting to 98.6 during the day?

Free T varies quite a bit. TT is a steadier measure for 'natural' guys.

Where were AST/ALT ["liver markers"]

I have had wild swings in serum iron [with labcorp], so I don't worry much about that. Where is hematocrit?


#12

there is no single magic pill, shot, patch, etc. so looking to HRT as a total solution and ignoring your (self disclosed) lifestyle issues will simply lead to more problems. even with HRT (if you really need it) you would still need to get sufficient sleep, eat correctly, exercise, etc. etc. etc. why not cut out the drinking for a month, get 8 hours sleep every night, eat correctly, take the appropriate supplements, and then retest your levels after 30 days and see where things stand. 474 TT is not terrible by any means.