T Nation

Late 30's, Overweight, ED, Low Energy, Blood Panel Included


#1

37 male, 6’2", 300+ pounds and I have been battling for a few years with depression, low energy, ED, and weight-loss.

After several trips to the doctor, including a second opinon, all of which resulted in a different medications prescribed (initially fluxotenine -awful- and more recently citalopram + bupropion) or generic sleep, exercise, eat better etc. advice, I have decided to take matters into my own hands.

7-8 months ago I started a training program and started feeling better generally so I dropped all meds ~5 months ago. While energy and mood have improved I really only feel ‘good’ during and immediately after working out. (compound lifts 3x weekly)

While my physician pulled blood 1+ year ago all he would say is everything is ‘fine’. When I specifically inquired re: T levels, he said they didn’t test for that, despite the fact I had specifially requested it. Regardless, he said, all I needed was some medicine and everything would be A-OK.

So I went online and ordered a blood panel. Shortly after doing so I was referred here so went through the stickies and started logging basal temp a.m. and afternoon for a week.

I’ve been ‘cold-natured’ as long as I can remember and my outer eyebrows are in fact thin.

Mean body temp a.m. : (don;t have my notes in front of me but these are close) 96.6 F
afternoon: 97.7 F

Initially I used two diff digital thermometers and they were within .1 - .2 degrees of each other, so I stuck with 1 for the rest of the week; and also verified it’s repeatability.

I wasn’t on any meds prior to the blood test, save a couple of ibuprofren a few weeks before blood draw. Today I started an ECA stack to try and get my appetite under control after holiday binging.

Body hair: middle of the road, perhaps leaning towards sparse side.

Fat accum: I have the spare tire around waist build.

Training regimen: Starting Strengh 3x week

Morning wood, nocturnal erection: What’s that?? j/k…but seriously; can’t remember when I had reg morning wood. It’s been at least 12 - 18 months since I’ve had any morning wood at all.

ED: I can get an erection but not maintain. When I am with a women med-long term, rare these days, it inevitably causes problems as she thinks I’m not attracted to her or whatev. I’m beginning to think I’ll never have a normal sex life. An unsettling thought to say the least.

Bloodwork 12/20/2016:

As you can see my platelet count is the only thing flagged as out of range, but a couple of things seem suspect to me; expecially TSH @ 2.49.

My T seems fairly low considering I have been >90 days of a strict training program with linear progression which should increase T level and I have been eating a surplus since Thanksgiving. Obv. I don’t really know which is why I am here.

My concern is ceteris parabus a deficit and low carb are correlated with lower T levels, which corroborates my experience in deficit mode where all of my symptoms don’t improve despite me having better diet, sleep, and regular training. I absolutely must get in a prolonged deficit to get some weight off of me. It feels a little hopeless tbh.


#2

IMO, you should be applauded for taking a route that involves diet and exercise instead of meds. You’re too young to be on meds the rest of your life. You say you’ve been eating a surplus since Thanksgiving? I don’t think that’s a good idea. For someone with ~100 lbs to lose, I think steady, longterm weight reduction should be priority #1. Eating clean but sustainably and permanently changing the habits that got you where you are need to be the focus.

Your blood results are a baseline, and once you work on yourself for another year or so, go back and re-check your levels. Keep your eye on the big picture, and know that with consistent exercise and healthy eating your body will go to where it needs to go. In addition to your weight training, I would like to see you add regular walks each day for 30 min - 60 min. Take this time to relax, listen to a podcast or music, and the low impact exercise will add up over the days, weeks, and months. The mental aspect is important for well being.

Best of luck on continued success.


#3

antiquity,

Thanks for the reply.

re: eating at a surplus; It wasn’t on purpose. It was a consequence holidays coupled with poor impulse control that got me here.

Generally speaking, I can eat a deficit and hit all my macros for a prolonged period. Say 60-90 days. Inevitably an event-read: excuse-comes along and I blow it out for a few days and it’s all downhill from there.

re: regular walks…yea I agree. A serious problem I have is lack of activity. I work at a comp and live in suburban area…consequently I have low organic activity levels. My phone pedometer averages <2.5k steps/day. Pathetic.

So bad that I know how little I do and still don’t get active. I just feel like shit most of the time…weak I know, but it’s the truth.

I am right at the edge of moving to a new area and living a car free life to force greater activity.


#4

First of all, know that you are like tons of guys who feel like shit and their drs wont treat them holistically. Pisses me off!

Your Test is too low, and your TSH is too high. All of these things are connected and need to be treated together.

My advice is to find a new Dr (one who will listen to you) and get yourself on a bi-weekly dose of Test and Arimidex. Your life will change, your mood will improve, your erections will improve, your libido will improve. Ask your (new) Dr. about Armour Thyroid. I take it and its great.

To be honest, you dont really know how crappy you feel until you restore your Test levels to optimal ranges (i.e. > 800) and your TSH below 1


#5

T is lowish. FT is pulsatile and we cannot read to much into that. Expect that average FT is lower.

What has been your source of iodine? Iodized salt? Vitamins listing iodine+selenium?

TSH=2.5 is a problem, docs will think great.

Low thyroid function can be a significant source of low energy, mood and libido. Low-T pushes you in the same direction. Training through these problems creates risk of adrenal fatigue.

Better to be testing TSH, fT3, fT4

Fasting? Cholesterol better near 180, <160 associated with increased all cause mortality.
[Note that statin drugs can deeply lower energy levels in a few individuals.]

Now that we see that T is low, need:
LH/FSH
prolactin
+
fT3
fT4
DHEA-S [not DHEA]
AM cortisol - at 8AM please


#6

KSman,

re: iodine sources; I have been a religious user of sea/kosher salt for years. After receiving results and reading itf I recently ordered 12.5mg Iodaoral + 200mcg Selenium. Will track temp as I supplement I.

re: fasting; I was in a fasted state when blood was drawn…~15 hours.

re: additional tests; I am going to take studhammer’s advice and try another doc, my third; this time I will be armed with my panels + better information. Which is all by way of saying I will be getting the tests you asked for done, but I’m going to wait until I get an appointment after the new year so I can avoid possible extraneous tests.

Thanks for the feedback.