T Nation

Lab Work Finished | Saw GP |


I'm going to begin here the personal log on my journey, and I'm still undecided about TRT. I'll leave everything out in the open and honest and will take 100% of opinions and recommendations with weight.

Quick (edit happened to not be too quick) back-story: Historically through my youth have been an ectomorph... thin frame, hard to gain weight, felt a bit "prepubescent" but generally "looked good" and had a trim, but skinny, build. I changed up my diet about 8 years ago and have since eaten all-natural/organic and am a vegetarian (no eggs though); I am today a C-level exec, healthy in my book (and on paper other than T) and doc says I'm the spitting image of health. I love to cook and make all of our meals from scratch from our garden and CSA. I count my macros, have my caloric needs detailed for my body, have a great personal coach in Ryan Miller out of Minneapolis of Growth Stimulus Training, and have been training semi-dedicated for 4 years now (much more in past few months). I currently take l-glutamine, BCAAs, citrulline, beta alanine, creatine, epa/dha, multi-vitamins, protein powders (plant based), etc. (I can give doses if necessary).

I am doing well in the gym, though since I'm toning down my bodyfat from 20% (now at 16.9%) the strength isn't as there. I'm fairly fit, but always had a suspicion that I had low T. Went into doc a month ago because I suspected I may have gyno (I have a pea sized lump under my left nipple that is very sensitive if hit); I was diagnosed with gyno but doc thought best left untreated for now. I talked to him about T at that time, and long story short expressed that I wanted complete blood work done, to which he didn't think insurance would all cover (and didn't know of all the tests anyhow). I followed my mother-in-law's advice and went to labdirect.com and ordered all the tests I wanted (will post results below); sure enough, low T. Brought results to doc today as I had the lab work already scheduled (to just check T) and we discussed everything. He was very amazed that I self-diagnosed myself twice and came in with evidence to back it up. He's a very good doc, and is very open to learning (the enthusiastic GP) and seems very excited to help me on my journey here; he did recommend flat-out TRT, though he admitted it wasn't his strong area and wanted me to see the youngest-looking endo in the tri-state area (as they'd be more up-to-date on these things). Have that appointment scheduled for two months from now, so I have a bit of time now here to share and glean the wisdom and experience of others.

So without further ado, my stats:

-age: 31
-height: 5'11"
-waist: 33"
-weight: 186
-describe body and facial hair: hairy legs; hair on toes/feet; hair on forearms but not overly thick, hair on tummy/chest/ass, can grow full beard very easily (and wearing one) though doesn't completely fill in between stache and cheek area (small but noticeable 1" dip)
-describe where you carry fat and how changed: mid section (tummy and lower/mid back)... was a very hard gainer fat-wise but "bulking up" changed that proved I could gain weight, now I'm in the process of cutting that down and will forgo the entire bulk/cut routine and utilize caloric +/- 500 of maintenance.
-health conditions, symptoms [history]: I have a very strong will, so it's hard to describe symptoms. I do get morning wood, but could always be hornier... I usually put myself in the mood and rarely am just in it. Sexual anxiety has been an issue, and I can sometimes go partially limp after erection and during intercourse. I have my days of energy and days of none, but typically plod through whatever. Brain has been a bit more foggy as of late, I'm a bit more of an asshole (don't waste my time) than usual, but still functional.
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: Not on any on-going prescription drugs, and haven't ever been; no hair loss or prostate drugs ever.
-- real dangers! see this http://propeciahelp.com/overvi...
-lab results with ranges: (see below)
-describe diet [some create substantial damage with starvation diets] Morning smoothie (berries, flax seed, hemp seeds, hemp oil, protein powder, kale, etc.), mid-morning ProBar, lunch is typically leftovers, cheese sandwiches/soup or Garden of Life Fit shake, mid-afternoon protein/fit shake, normal home cooked large dinner and one more protein/fit shake at night. Total calories of 2400, 220 carb, 180-200 protein, 70-100 fat (depends on train/rest day).
-describe training [some ruin there hormones by over training]: Growth Stimulus Training (squat day, pull day, push day, press day) focuses on core/compound lifts (squat, deadlift, etc.); this will consume 4 days "per week" and HIIT on another 2. Details can be found easily via Google search.
-testes ache, ever, with a fever? No
-how have morning wood and nocturnal erections changed: Have pretty much always had morning/nocturnal erections.

Lab Results (posted as image to imgur as many tests and much easier):

So thoughts on where I should be starting first; do I have a chance of restarting my natural T production first? I'm not opposed to TRT, but realize it a life decision and I am very not opposed to exhausting other options either.


34 years old
6'0" 205lbs waist 33"
Test Results as follows:
LH 1.59 mIU/mL
FSH 5.66 mIU/mL
ESRADIOL E2 20 pg/mL
PROLACTIN 23.97 ng/mL

I have made the assumption for years that I have low T. I confirmed this yesterday with my new doctor. While I can gain mass, I don't have much lean mass. I don't grow much body hair, and my drive in life is quite low. I have always attributed this to drug abuse, as I am a long time abuser of opiate medication. I am currently taking suboxone 4-8mg per day, but have had issues with T since before the opiates.

After years of internet research and talking to doctors I started a TRT plan yesterday. Is is as follows:
200mg Testosterone Cypionate IM every two weeks
Axiron 2% 2 pumps per day.

I am looking for a place to discuss this and to see if anybody is currently in the same type of treatment. Not sure exactly what to expect, but looking forward to finding out.

Trying to gather information, such as using HCG, to minimize the permanent damage I could do to my body while trying to figure out of TRT is right for me, or if it will improve my quality of life enought to endure the risk. Sexual performance is not a problem and never has been. Have no children, but want to some day.

Any response would be greatly appreciated...



Hope everything works out for you, but please start your own thread instead of injecting in another's thread; thanks.


Your low cholesterol is contributing to your hormone problems as cholesterol is the foundation for your steroid hormones, including Vit-D and cortisol. Cholesterol <=160 is associated with increased all-cause mortality. You should be eating eggs.

Vege proteins: Might be some negative effects from soy phytoestrogens. Might also increase SHBG. TRT can push SHBG down if E2 is managed properly.

Thyroid function: check body temps as per the thyroid basics sticky.

You are estrogen dominant; considering your T levels.

Liver function is a problem: If not from problem with something identifiable that you ingest or absorb through your skin, there may be a liver pathology at work. But note that muscle soreness/damage from training can elevate those numbers. So you need to lay off training to get fully recovered then retest AST/ALT. You may have multiple amino acid deficiencies that in combination with your training may be causing some odd effects.

Do you take vitamin D3? 4000-5000 iu/day suggested.

How are you getting EFA's from your diet? E=essential.

If your fat intake is low, that is a problem.


Thanks very much for the reply!

As far as vege protein goes, I do not take soy (I really don't have anything soy-based in my diet); the vege protein is from over a dozen sprouted grains, lentils, beans, etc

Thyroid function: I'll look into performing this test, though the blood work shows my thyroid functions as good?

Don't disagree with the estrogen dominance; I certainly guestimate that some sort of AI would be in my bill?

The GP said not to even look at the AST/ALT numbers as they were mis-guiding, and due to fasting? I do take a faull profile of Amino Acids (I only ingest, when supplementing, complete protein sources like hemp protein). I also take BCAA's and other AA's in their single form.

I only take 400IU/day of D3 via multi; you recommend upping this? What is the thought behind this (curious)?

I get EFA's from hemp seeds, hemp oil and sometimes supplement with EPA/DHA algae caps; based on my morning smoothie alone, with the hemp seeds and hemp oil, I get 8g of Omega-3.

As a side note, I just received my results from a second lab for testosterone (the doc only measured TT, Serum this time) and that came back as 410 on a scale from 154-1488; he wrote in a letter that he cannot explain the differences between my DirectLabs 290 and this 410, but said regardless of off-the-chart low and on-the-chart low, he'd still like me to continue on and seek treatment. My appointment with the endo is in October.


Vit-D3 RDA of 400iu prevents bone deformities in children and is now recognized to be inadequate in view of what is optimal. Vit-D3 stores are converted to Vit-D25, a vital steroid hormone that is transported to the cell nuclei where it enables proper gene expression. You can find a huge amount of info on the WWW

Your thyroid labs to appear to be OK, but are not conclusive. Body temperature is the bottom line for thyroid function. I do not know what to make of this: http://en.wikipedia.org/wiki/Thyroid_function_tests#Free_thyroxine_index

Thyroid hormone uptake (Tuptake or T3 uptake) is a measure of the unbound thyroxine binding globulins in the blood, that is, the TBG that is unsaturated with thyroid hormone.[2] Unsaturated TBG increases with decreased levels of thyroid hormones. It is not directly related to triiodothyronine, despite the name T3 uptake.[2]

Your T3 uptake is high normal: "Unsaturated TBG increases with decreased levels of thyroid hormones"

TSH is better closer to 1.0
If you have low iodine, you can have problems. You use iodized salt or eat seaweed?

I do not know how you can increase you cholesterol with your diet. You can expect that you will have problems from this effect of your diet. Do not ignore this.