T Nation

KSman - Frustrated and Confused, Please Help


#1

Hello.. I am 34 years old and recently started to go to doctors after not needing to go for 10 years. I have been bothered lately by losing my hair although i larger problem has been not being able to lose weight no matter how hard i try for years. I seem to exhibit all symptoms of low t as well as estrogenic fat deposits.

I went to see an endocrinologist after a neorpathic dr had me take a blood test and my total testosterone level came back at a dismal 288. After that the endo had me take a much more in depth lab..
Here are the results:

-age---- 34
-height---6'
-waist--- 36"
-weight----230
-- hair on chest/stomach/ back and limbs--spotty/patchy/thin slow growing beard
-- noticeably thinning hair on crown of head and receding front
-carry fat on love handles/ around waist and upper thighs
-all symptoms of low-t
-no prescriptions currently-- tried deca for a cycle over 12 years ago
-Total Test: 288 Lab 1 (2pm) {28-800 range}
356 Lab 2 (9am) {348-1197 range}
-LH- 4.9 (1.7-8.6)
-FSH- 2.8 (1.5-12.4)
-prolactin- 13.0 (4.0-15.2)
-Estradiol (E2)- 17.5 (7.6-42.6)
-progesterone- 0.25 (.1 - .84)
vit d 48.6 (30-100)
Testosterone free direct- 9.9 (8.7-25.1)
SHBG- 23.2 (16.5 - 55.9)
Cortisol- 12.0 (6.2- 19.4)
-pregnenolone= 82 (7-188)
Lipid panel:
- total cholesterol- 200 (100-199)
- triglycerides- 139 (0-149)
- hdl 42 ( >39)
- vldl- 28 (5-40)
- ldl- 131 (0-99)
Thyroid:
tsh- 1.39 (.450- 4.500)
t4 (free direct) 1.16 (.82-1.77)
t4 total- 6.9 (4.5-12.5)
t3 uptake 46.1 (32.0-48.4)

  • diet processed carb heavy/meats/coffee (switched to paleo style diet one week ago
    -sporadic gym schedule-- circuit style weight training and spinning for cardio often dont have energy for gym
    -occasional testicular pain
    -morning wood very rare

I know that something does not feel right with my body and i would like to eliminate all the symptoms ( lack of energy/focus, low libido, slight depression, concentration problems{head in clouds feeling}, maintaining erection etc.

also i cant figure the hairloss if the testosterone is so low- is it converting to dht? also

endocrinologist first wanted to put me on a trt drug after the first reading of , but after the second test came back at 356 she said i was in normal range. I know i am not an endocrinologist but you dont have to be one the know that a total test of 356 for a 34 year old man seems anything but normal.

Please help with some advice..
Thank You


#2

Forgot to add morning temp 97.0


#3

Please check body temps when you wake AND mid-afternoon.

Have you been using iodized salt steadily for many years? [or vitamins that list iodine]

Feel cold easily?

See the thyroid basics sticky.
Also read the advice for new guys sticky.
There are 7 stickies, also one for finding a TRT doc

What time of day was the cortisol lab? 1 hour after waking up?

I have seen guys wrecked by deca only cycles, and it seems to only require one go at it.


#4

Have not used iodized salt… I do hate the cold bc I feel cold very easily

I think the hormonal issues maybe more congenital although the decay may have brought them out.

Either way I am very confused as what to do next to try to bring all my hormonal levels back into normal ranges and feel “normal”

Thank you for your help so far


#5

Your body temps are low and you don’t have a good source of iodine. Please read those stickies!

You need to start getting iodine into your body. Please also get a multi-vit that also has selenium and iodine. Selenium IS VITAL for iodine processing in your thyroid and selenium deficiencies are associated with thyroid auto-immune diseases.

Sometimes low T will resolve when thyroid issues are fixed, sometimes not.

Many guys here have low T and thyroid problems.

What time of day was it when you did the cortisol lab?


#6

Labs were done at 9 am

Also can the problems caused by deca if any be reversed

The endo wants to put me on andro gel

What are your thoughts on that

Thank you for the advice so far. I will start on the iodine and selenium today


#7
  • T3 Uptake: This test is mentioned only as a warning not to use it. In fact, it does not measure T3 levels at all ? the name is misleading. It is an old test designed with a purpose of indirectly measuring T4! It was developed before we were able to accurately measure T4 levels. The assumption was that if the patient had a high T4 level, the blood proteins would be saturated with it. Therefore when mixed with T3 (which is easier to measure), the blood proteins would take up very little T3. Thus a low T3 uptake implies elevated T4 levels and vice versa. Thus the T3 Uptake test is actually an antiquated, inaccurate way to measure T4 levels.

Your thyroid levels are strange. We know that thyroid problems often lead to inability to absorb transdermal T. Try to get self injecting 100mg/week as per recommendations in the stickies. Also try to get hCG and anastrozole as required to get near E2=22pg/ml.

The one guy that I followed a lot with a deca cycle problem was not responsive to a HPTA restart and had to do to TRT. Don’t have a pool of data. Deca+T is probably safe. Deca is not a T ester, its a synthetic beast can break gene expression in some guys. Pro-hormones and hair loss drugs also can do this. Welcome to modern medicine.


#8

Spoke to the endocrinologist and she said the HCGis “garbage” and that she doesn’t prescribe arimadex
Claims estrogen conversion probably won’t happen and not to worry about it

Sounds like I need a new endocrinologist

Do you think that with my low test, free test, and fsh, the androgel is even worth taking or should I try with a serm, hcg or one then the other

I am also going back for more labs to check cortisol agai, also kyrotype, LH and FSH to see if primary or secondary hypogonadism


#9

You can try a SERM for a HPTA restart, you need to look up about that here.

Suggest nolvadex but docs like to Rx clomid and they do not know about the side effects that some guys get.

SERM might be enough. Do you need to have more kids? hCG alone might also work, if not there is TRT.