T Nation

Ksman - Need Suggestions and Advice

I would like some advice on getting hormones and low t back into line,but i am not looking to start on TRT right now will leave that for later if needed as my libido is pretty good,but some times erection is not strong,i am starting to exercise to lose weight and relieve stress.

-age 49
-height 5’11’
-waist 56.5
-weight 330
-describe body and facial hair hair on chest and arms can grow beard but im clean shaven
-describe where you carry fat and how changed chest and waist have put on quite a few pounds in the last 3 yrs
-health conditions, symptoms [history] asthma
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever alupent no other drugs
-lab results with ranges
-describe diet [some create substantial damage with starvation diets] diet was poor been tracking for two weeks now under 2000 calories that is now changing
-describe training [some ruin there hormones by over training] just starting riding exercise bike and bodyweight exercise
-testes ache, ever, with a fever? no
-how have morning wood and nocturnal erections changed very seldom morning wood for a couple of yrs now nocturnal is decent

prior to lab test did not take vitamins or use salt that has now changed now take the following

B complex 100
vit, c 2000 mg
vit.e 800 iu
vit.d3 5000 iu after reading vitamin d council reports i am taking 35000 iu twice a week for 8 weeks than will retest
Dhea 25mg
fish oil
magnesium 500 mg
vitamin mineral
zinc 50 mg
after reading others reports and seeing your responses will be starting iodine replenishment next week also have Doctors appointment next week.
wakeup 3 hrs later 3 hrs later bedtime
97.3 97.1 97.4 98.3
97.4 97.6 98.1 98.1
97.4 98.1 97.9 98.3
96.9 97.2 97.4 97.4
97.0 97.7 97.9 97.2
97.4 97.2 97.4 97.6

Sorry this is the second page they didn’t load at the same time

Iodine 150mcg in the vitamins?

New labs:
TSH, fT3, fT4 [not interested in the in-active globulin bound T3, T4]
AM cortisol [8 AM]
rT3 [can be from stress, starvation and/or adrenal fatigue]

With your weight and hormone status, glucose, you may be developing metabolic disorder aka syndrome X. The hallmark of that is insulin resistance. Correcting the T problem can improve insulin sensitivity.

What is your blood pressure?

Nice work on the temperatures. Were you using sea salt?

Ksman thanks for the response

as to the iodine in vitamins not in there but i will buy a new bottle with iodine included this week

new labs will get them this week just got some melatonin to help with sleep as i dont get to sleep at night to well

you mentioned rt3 for stress,starvation diet and/or adrenal fatigue i would agree with some of all three have been out of work for three years,diet was lacking have been making improvements to both

have been working on improving insulin sensitivity thru nutrition

also no i wasn’t using sea salt

went to doctor this week blood pressure is 129/71
doctor was not to concerned with lab results he said he was more concerned with me losing weight as he felt that was the reason for some of the results their labs use higher numbers for test.

Got the new labs also improved on Dhea,Vit d,but my test serum levels went down had estrodiol
test ran but it wasn’t the sensitive one,can you offer any help to why that would happen

TSH -3.450 -uiu/ml -0.450-4.500 range
T4 free(direct) -1.32 -ng/dl -0.82-1.77 range
T3 free(triiodothyonine free serum) -2.8 -pg/ml -2.0-4.4 range
RT3 serum -32.5 HIGH -ngdl -9.2-24.1 range
AM Cortisol -21.8 HIGH -ug/dl -6.2-19.4 range
Glucose serum -110 HIGH -mg/dl -65-99 range
Dhea s -302.8 -ug/dl -44.3-331.0 range
Testosterone serum -263 LOW -ng/dl -348-1197 range
FSH serum -2.4 -miu/ml -1.5-12.4
Luteinizing Hormone(LH) -4.7 -miu/ml -1.7-8.6 range
Estradiol -39.8 -pg/ml -7.6-42.6 range(this not the sensitive one)
Vitamin D -48.2 -ng/ml -30.0-100.0 range

can you help with advice as to improve have lost some weight

Ft3 is a little bit low. rT3 is blocking that too and temperatures are low, other symptoms of hypothyroidism, including mental and weight
Temperatures improving?
LH/FSH are not good, but T very low, possible some primary hypogonadism and secondary.
Suggest self injected TRT. With thyroid problems, transdermal T expected to fail.
E2 lab type is OK.
E2=40 is a major problem, extreme estrogen dominance

  • Anastrozole will be needed! Very critical!
  • creates high CVD and insulin resistance risk
  • glucose=110 suggests insulin risk
  • get diabetes lab workup to estimate average glucose levels
  • start with metformin, need fish oil, ubiquinol and others
  • TRT may correct insulin resistance

You could try 1mg.week anastrozole in divided doses and see if you HPTA responds, but at your age, I think that this would be futile.

Get tested for thyroid antibodies, Hashimoto’s etc


  • lot T --> TRT self injected, you are expected to be a transdermal non-responder
  • thyroid problems - might need some T3 to normalize temperatures, prehaps not needed later
  • check for Hashi’s
  • nutrients and supplements
  • insulin resistance is a huge risk factor, get more labs
  • test fasting insulin, if high, that is toxic
  • estrogen control is essential
  • read Wilson’s book on adrenal fatigue. Cortisol not crashed, but rT3 is a major threat to QOL.
  • fT3 can reduce T4–>rT3 production

You gave a lot of thing to get done.