Jim13o's Journey - Symptoms, Log, and Hopeful Recovery

Pharma / TRT Testosterone Replacement
1

Good morning all,

I have recently been to the doctor for noticeable symptoms of Low T. Personally I experience the fatigue, low libido, and brain fog the most. Wife urged me to go to the doc after seeing me mope around for too long. Bless her heart.

Bio: I’m a 26 year old male, 5’11" 175 lbs with a mesomorph physique. I’ve been married for a year and 8 months. I’m in the Coast Guard Reserve and a full time project manager/estimator where I sit at a desk most of the day. I typically get 6-8 hours sleep. Try to make it to the gym atleast 3 days a week. After my last Physicians visit, Urologist visit, then finally and Endo visit, I was prescribed 50k IU of Vitamin D once a week because of a Vitamin D deficiency. I started 1 week ago.

Sex history: I waited until marriage, and masturbated frequently as an adolescent. I no longer wake with morning wood, can’t remember last wet dream, sex life with the Mrs. is struggling mostly due to myself not feeling the urge or not being horny.

Body and facial hair: Hairy legs, armpits, have quite a bit of chest hair, some hair on shoulders and back, but beard isn’t as full as I’d like.

As a teenager and kid I was usually on the small side of the growth chart.

Testes hurt? I occasionally get a dull pain in either one, not particular, and nothing excruciating but a little reminder every once in awhile.

Mood: I have lost a lot a motivation recently, not like I used to be out of Boot Camp, where I felt I had the world by the balls.

Get cold easily? Yes
Dry Skin?: Yes
Use iodized salt? Always thought of salt to be a dirty vice, but since coming here that has changed my opinion of Iodized Salt.
Eat much sea food? Occasionally
Exposure to chemicals? A lot of chlorine in my days as a life guard
Ever used hair loss drugs? No
Medical History: No past history of any disease, surgeries, never had to go to the hospital for any reason. Been healthy as can be most of my life.
Rx and Medications: Recently on Vitamin D 50k IU per week
Outer eyebrows: normal

Haven’t taken temps yet.

===================
First set of blood tests from Physician

11-08-16

  • WBC 5.8 THOUS/uL 4.1 - 10.9 THOUS/uL

  • RBC 5.41 MIL/uL 3.35 - 5.50 MIL/uL

  • Hemoglobin 14.7 GM/DL 12.9 - 16.6 GM/DL

  • Hematocrit 44.9 % 38.0 - 48.0 %

  • MCV 83.0 FL 81.0 - 95.0 FL

  • MCH 27.2 PG 27.0 - 33.0 PG

  • MCHC 32.7 G/DL 33.0 - 37.0 G/DL

  • RDWCV 12.9 % 11.5 - 14.5 %

  • RDWSD 38.4 FL 35.0 - 42.0 FL

  • Platelets 234 THOUS/uL 130 - 400 THOUS/uL

  • MPV 11.3 FL 7.4 - 10.4 FL

  • nRBC 0.0 /100 WBC’S 0 /100 WBC’S

  • ABS NRBC 0.0 THOUS/uL 0.0 THOUS/uL

  • Differential Type AUTO

  • Neutrophils 49.4 % 42.2 - 75.2 %

  • Lymphs 29.0 % 20.5 - 51.1 %

  • Monocytes 12.5 % 1.7 - 9.3 %

  • Eos 7.9 % 1.0 - 3.0 %

  • Basos 1.0 % 0.0 - 2.0 %

  • IMM Gran 0.2 % 0.0 - 0.4 %

  • Neutrophils Absolute 2.9 THOUS/uL 1.7 - 8.7 THOUS/uL

  • Lymphocytes Absolute 1.7 THOUS/uL 0.8 - 5.6 THOUS/uL

  • Monocytes Absolute 0.7 THOUS/uL 0.1 - 1.0 THOUS/uL

  • Eosinophils Absolute 0.5 THOUS/uL 0.0 - 0.3 THOUS/uL

  • Basophils Absolute 0.1 THOUS/uL 0.0 - 0.2 THOUS/uL

  • ABS IMM Gran 0.01 THOUS/uL 0.00 - 0.04 THOUS/uL
    ===================

  • GLUCOSE 85 MG/DL 70 - 99 MG/DL

  • BUN 17 MG/DL 8 - 23 MG/DL

  • CREATININE 1.2 MG/DL 0.6 - 1.2 MG/DL

  • Sodium 139 MMOL/L 136 - 145 MMOL/L

  • Potassium 4.1 MMOL/L 3.5 - 5.4 MMOL/L

  • Chloride 105 MMOL/L 98 - 107 MMOL/L

  • CO2 RENAL 27 MMOL/L 20 - 33 MMOL/L

  • Calcium 9.7 MG/DL 8.7 - 10.4 MG/DL

  • Total Protein 7.5 G/DL 6.0 - 8.2 G/DL

  • Albumin 4.4 G/DL 3.4 - 4.8 G/DL

  • A/G Ratio 1.4

  • Bilirubin, Total 0.5 MG/DL 0.3 - 1.2 MG/DL

  • AST 23 U/L 0 - 39 U/L

  • LIVER ALKP 99 U/L 25 - 100 U/L

  • ALT 17 U/L 10 - 40 U/L

  • Est GFR >60 ML/MIN/1.73sq.m >60 ML/MIN/1.73sq.m

  • GFR Comment IF PATIENT IS AFRICAN AMERICAN, MULTIPLY RESULT BY 1.21

  • ANION GAP 11 MMOL/L 7 - 14 MMOL/L

  • TSH, High Sensitivity 2.85 uIU/ML 0.55 - 4.78 uIU/ML

  • Tot Testosterone,Male 228 NG/DL 276 - 957 NG/DL
    ===================
    11-10-16

  • LH 2.8 IU/L

MALE 20-70 YRS 1.5-9.3

  • FSH 2.1 IU/L

MALE 1.4-18.1

  • Prolactin 5.7 NG/ML 2.1 - 17.7 NG/ML

===================
11-28-16

  • PSA 1.01 NG/ML 0.0 - 2.0 NG/ML
  • Tot Testosterone,Male 392 NG/DL 276 - 957 NG/DL
  • Sex Hormone Binding Globulin 23.4 NMOL/L 14 - 93 NMOL/L
  • Free Testosterone 95 PG/ML 43 - 227 PG/ML

Blood Work from the Endocrinologist

12-22-16

===================
VITAMIN D 25 HYDROXY 12/23/2016 (#68297340, Final, 12/22/2016 8:15am)

  • 28 Range 30-100 ng/mL

(NOTE)
Vitamin D Status 25-OH Vitamin D
---------------- ---------------
Deficiency <20 ng/mL
Insufficiency 20-29 ng/mL
Optimal > or = 30 ng/mL

  • LUTEINIZING HORMONE 4.0

AGE: >/= 18 YEARS

       LH REFERENCE VALUES
       ===================

MALE: 1.5- 9.3 mIU/mL

  • PTH, INTACT 51 9-69

  • CALCIUM,PTH 9.7 8.4-10.2

  • TSH,3RD GENERATION 3.64 0.35-4.94

  • FREE T4 1.0 0.7-1.5

  • PROLACTIN 9.2 3.5-19.4

  • FSH 1.4 MIU/ML

    FSH REFERENCE VALUES mIU/mL
    MALE: 0.9- 11.9

  • TESTOSTERONE 300 241-827

===================

The Endocrinologist prescribed Vitamin D. Can this restore all my symptoms? I am skeptical. Again, I am married with no kids yet, but hope to in the future. Thank you so much for your time and advice.

Random thoughts: My NP said my thyroid levels were fine… but my senses tell me that this may still be a concern based on the symptoms, and the fact that my preconceived notion of salt was bad (could be an ID). Not sure if its related but, I started getting grey patches on the top of my head when I lifeguarded one summer, very weird. After research Chlorine wreaks havoc on Iodine (but I’m not sure they are related to this day) Since then the greying has stopped, but still remains. I’ve always tried to eat clean, stayed out of drugs, etc.

My check up with the Eurologist seemed to go fine after getting a physical done. Will check back. Thank you for the input

2

You have consistently low LH/FSH and lower T values. Pretty much speaks to secondary hypo as long as you are having symptoms. Also your TSH is pretty high, but so is mine and my endo keeps saying my other T3/T4 is normal so its a non issue.

3

Thanks blshaw for the reply,

In your case what was the next step? I’ve been pretty unsatisfied with the doctors here, and at this point feel like I have to take matters into my own hands if I want to feel better.

Reading up on secondary hypothyroid now. Or do you mean secondary hypogonadism?

Thank you.

P.S. the more I think about it, the more I am pissed off at the Endo, for only prescribing Vitamin D and wanted me to come back in 3 months. I think I need a second opinion. Any more input as to what direction I need to take would be greatly appreciated.

4

No, sorry to confuse. I mean secondary hypogonadism. Its when you have a problem with your HPTA leading to low testosterone. If you are primary, your LH and FSH would be high trying to signal the production of T but your testes won’t produce. In secondary, as in your case, you have consistently low LH/FSH readings causing the low T. Your low T is borderline but if you are symptomatic then T replacement could help you. That’s a tough personal choice when you are borderline.

As far as the thyroid goes you might want to test that again to check for consistency.

5

Thanks for clarifying,

I have another appointment set up for this Thursday with the Endo. Assuming its Secondary Hypogonadism, what do I need to address the doc with to get the most out of my visit? Obviously I want to know the cause and treatment, but what are some questions I can ask to better steer the conversation. What medications should I be reading about in advance? Should I be concerned with an MRI?

Thank you in advance.

6

We see a lot of low thyroid function cases here and many from not using iodized salt.
Some evidence that thyroid problems cause secondary low T.

TSH should be nearer to 1.0, ranges are silly, 11:1 range is perfect for all?
T3, T4, fT3, fT4 should be mid-range or better.

Just for the record, no one here has ever reported their doctor asking about iodine. T3 hormone has 3 iodine atoms and T4 has four. Iodized salt introduced almost 100 years ago to address very serious problems.

Please read the stickies found here: About the T Replacement Category - #2 by KSman

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

Please post oral body temps ASAP.
If your wife not using iodized salt, check her too.

Vit-D3 is very important. Do not get T-tunnel vision, you need to be looking at multiple health factors to regain quality of life. Vit-D3 convert to Vit-D25 which is an absolutely critical steroid hormone needed to enable proper gene expression. Affects every cell in you body.

Reference to sea food is for another iodine source.

The stickies will be very helpful, but a lot of reading.

7

Thanks KSman,

I’ll work on the temperature readings. Blshaw referenced secondardy hypogonadism, however you think it could possibly be a problem with the thyroid? Are the two interrelated? (Just read your thyroid sticky, that answered that question :slight_smile: ) I am starting to take a multivitamin that contains Iodine 150 mcg or 100% daily value. (Also noticed in your sticky this has little effect on your body if you are deficient, thanks)

So are you saying I should test T3, T4, fT3, and fT4 as well? I think I’m off to a good start, and don’t want to go off the deep end and just start messing with my hormones. Granted I consistently feel tired, low libido, brain fog, etc… I just am really looking forward to feeling better and tired of the symptoms. Still should I worry about an MRI?

Thanks KSman and blshaw.

8

I’m going to turn this into a log basically. Hopefully someday it will help others with similar symptoms.

Just took my evening temperature 7:00 pm: 97.7 F.
Will update in the morning.

Once I got home from work I took my Vitamin D3 Supplement 50k IU for the week. Feeling a bit nauseous and light headed right now and for most of the day, tired, ready to just sleep… going to go eat something then go to bed, won’t make it to the gym today.

9

Took morning temperature 7:00 am: 97.2 F

Hit the snooze button about 10 times between 6:00 am and 7:30 am ><

10

Going to the Endocrinologist tomorrow (this will be the second visit with him)

I’ve got some things I want him to test, is there anything I’m missing?

fT3, fT4, TSH, LH, FSH, TT, E2, Cholesterol, Selenium, Iron, Zinc

Just other random thoughts came into my mind to further lead me to think its a thyroid problem. The NP where I got my first blood test said the TSH level was high “so no problem there” according to her. But she didn’t test for fT3 or fT4 so how could she know. I am always wearing a jacket indoors at work, my house is set to 74.

After reading the material by KSman and my own observations on my life, my instincts are pointing to Hypothroidism, which may have led to Secondary Hypogonadism, thus the relatively low T, am I connecting the dots here?
Again, everyone on these forums has more experience in these matters then I have so please stop me if I’m going in the wrong direction.

11

Evening Temp: 97.2 F
Morning Temp: 96.5 F

12

Just completed my second visit from the Endocrinologist.

I feel indifferent about this visit, but am simply trusting in the doctors judgement. Since my T levels were borderline, we focused more on the thyroid. I told him I would like to get more blood work done for the fT3 and fT4 but he said he tested the T4 already. Anyway, so he mentioned he wanted to possibly test the antibodies for the thyroid. Ok. We went and did some sort of ultrasound, where he named off a bunch of numbers ranging from 1 to 4 and his test concluded my thyroid was “Irregular”.

Now I just had blood work done for:

Thyroglobulin AB
Thyroid Peroxidase (Tpo)
PTH (parathyroid Hormone), Intact + Calcium

He may prescribe thyroid medication upon my next visit in a week or two depending on the labs. Thoughts?

P.S. I went to GNC and picked up an Iodine Supplement from Natures Way with Kelp.
300 mcg Iodine
35 mcg sodium
600 mg Kelp (whole thallus)

@KSman

13

following…

14

As I was driving to Drill today, about a 3 hour drive, I was getting really drowsy. The long drives have become harder for me lately, but I noticed my iodine supplement beside me. I hadn’t taken it yet, but I wanted to see if there was anything to it. I didn’t have any water or anything to drink with it. I decided to just swallow it whole thinking I have nothing to lose. Within 5 to 10 minutes I noticed an immediate relief of drowsiness. I don’t know if I’m making too much out of it, but this is the most encouraged I’ve been yet.

15

Just thought I would give an update…

After getting my thyroid checked, and the thyroid antibodies, it turns out I have what they call Hashimotos Disease, basically a failing thyroid. So they put me on levothyroxine sodium (synthroid).

Doc said I would feel an improvement in 4-8 weeks. However, I think between the iodine, muilti, vit D, and now this I’m already feeling a little better.

I am glad there’s an explanation for my symptoms, but wish it were just a deficiency and nothing lifetime… I’ll report back in a couple weeks with an update on my symptoms.

Anyone here experience a similar diagnosis?

16

Yes there are others here with that.

Please get the labs to post.

Can be caused by a lack of iodine and low selenium intake. Normal thyroid activity produces free radicals that can damage tissue and immune system cleans up damaged cells, but can get confused and go autoimmune. Enzymes that clear the free radicals require selenium to function and do not do the job if deficient. You will see me stressing selenium, especially with iodine supplements.

Iodine deficiency and increased TSH can increase thyroid stimulation, increasing free radical generation and the risks of a lack of selenium.

Read the thyroid basics sticky please.

17

I know its been awhile since I have posted. I went through an MRI yesterday on my brain/pituitary to look for causes for the low Pituitary hormones and symptoms.

FINDINGS:
The ventricular system and cortical sulci are normal in size, position, and
configuration. No midline shift or mass effect is noted. No intracranial
hemorrhage or extra-axial fluid collections are seen. No abnormal areas of
signal intensity or enhancement are noted. There is no evidence of acute
infarction. The vascular flow voids are unremarkable. The visualized paranasal
sinuses and mastoids are clear. The pituitary gland is normal. No masses or
abnormal enhancement of the sella turcica.

IMPRESSION:
Normal MRI of the brain and pituitary.

By all indications it looks like this is great news, but it still leaves me looking for answers.

Recent Blood Tests: May 03, 2017
FSH 2.8 IU/L MALE 1.4-18.1
LH 2.9 IU/L MALE 20-70 YRS 1.5-9.3
Thyroid Peroxidase AB 1390 U/mL 0 - 60 U/mL
Thyroid Peroxidase AB Comment CROSS REACTIVITY MAY EXIST WITH AUTO-ANTIBODIES ASSOCIATED WITH OTHER MEDICAL CONDITIONS.
DHEA 5.950 ng/mL 1.330 - 7.780 ng/mL
T3, Free 3.3 PG/ML 2.3 - 4.2 PG/ML
Tot Testosterone,Male 218 NG/DL 276 - 957 NG/DL
Sex Hormone Binding Globulin 18.9 NMOL/L 14 - 93 NMOL/L
Free Testosterone 55 PG/ML 43 - 227 PG/ML
% Free Testosterone 25.2 %
Vit D 25 Hydroxy 42 NG/ML 30 - 100 NG/ML
Free T4 1.10 NG/DL 0.80 - 1.76 NG/DL
TSH, High Sensitivity 2.42 uIU/ML 0.55 - 4.78 uIU/ML

Current Prescription: Synthroid 50 mcg everyday
Endocrinologist just prescribed Clomid 25 mcg 3 days/week (have yet to start taking)

I still feel sluggish, some pressure around my thyroid yesterday, little motivation, low libido, tired, etc. In a way I feel like i’m back to square one. I’m going to do some more reviewing of threads here, to find any clues on where to pick back up.