T Nation

Low T, Low SHBG, Low E, Frequent Urination, Cold Intolerance, Chronic Sinusitis


#1

I have been suffering from my condition for about 13 years (I am currently 33 years) I think and recently I have been trying to find the root cause of my condition / low Testosterone levels. I have been doing my own research to find cause of my low T and other health problems I have.

My symptoms:

1) Erectile dysfunction
2) High fatigue, especially since I started having ED
3) Extremely low stamina
4) Very low confidence professionally (although I have done ok) and low motivation at work
5) Minor depression
6) Extreme negative thoughts
7) Chronic stress and tension
8) Huge belly fat (I used to be very skinny till I was 22);
9) Brain fog
10) Cold intolerance
11) Frequent urination
12) Suffer from cervical and lower back pain
13) Chronic sinusitis and headache
14) High cholesterol
15) Chronic acid reflux (GERD)

Have got various tests done in the past for which I am listing the results below.

RED BLOOD CELL COUNT 5.72 High (4.5 - 5.5 mil/μL)
HEMOGLOBIN 15.4 (13.0 - 17.0 g/dL)
HEMATOCRIT 45.1 (40 - 50 %)

GLUCOSE, FASTING, PLASMA 88 74.0 - 99.0 mg/dL
GLUCOSE, POST-PRANDIAL, PLASMA 113 (Upto 140 mg/dL)
CHOLESTEROL 188 (< 200 Desirable, 200 - 239 Borderline High, >/= 240 High mg/dL)
TRIGLYCERIDES 154 (Normal <150; Borderline high: 150 - 199, High: 200 - 499, Very high: > or = 500)
CHOLESTEROL HDL 32 (< 40 Low; >/=60 High)

Thyroid profile:
Free T3: 3.03 pg / ml (2.5-3.9)
Free T4: 0.99 pg / ml (.61-1.12)
TSH: 1.75 uIU / ml (.34-5.6)
Peroxidase antibody: 53.2 uIU / ml (<60)
Thyrglubin Antibody: 16.1 uIU / ml (<60)

TOTAL T: 270.09 ng/dl (241.00 - 827.00 ng/dl)
FREE T: 5.84 pg/ml (8.9 - 42.5 pg/mL)
FSH: 5.75 mIu/ml (1.40 - 18.10 mIU/mL)
LH: 4.16 miu/ml (1.50 - 9.30 mIU/mL)
SERUM PROLACTIN LEVEL: 11.39 ng/ml
SERUM ESTRADIOL E2: <10 pg/ml
SHBG: 12.8 nmol/L (14.5 - 48)

I had started with 25mg Clomid every day for little more than 6 weeks.

After about 6 weeks on clomid:

TESTOSTERONE, TOTAL 424.20 (241.00 - 827.00 ng/dl)

TESTOSTERONE,FREE 11.30 (8.9 - 42.5 pg/mL)

LUTEINIZING HORMONE 8.29 (1.50 - 9.30 mIU/mL)

FOLLICLE STIMULATING HORMONE 15.34 (1.40 - 18.10 mIU/mL)

PROLACTIN 7.37 (2.10 - 17.70 ng/mL)

Then I met an endocrinologist who asked me to stop clomid and retest after 4 weeks.

The following is 4 weeks after stopping clomid:

TESTOSTERONE, TOTAL 236 (241.00 - 827.00 ng/dl)

LUTEINIZING HORMONE 2.8 (1.50 - 9.30 mIU/mL)

FOLLICLE STIMULATING HORMONE 6.1 (1.40 - 18.10 mIU/mL)

SHBG: 14.1 nmol/L (14.5 - 48)

PSA 0.7 (<4 ng/mL)

TOTAL TRIIODOTHYRONINE (T3) 60 ng/dl (60 - 200)

TOTAL THYROXINE (T4) 5.1 µg/dl 4.5 - 12.0)

THYROID STIMULATING HORMONE (TSH) 2.20 µIU/ml (0.30 - 5.5)

FREE TRIIODOTHYRONINE (FT3) 3.2 pg/ml (1.7 - 4.2)

FREE THYROXINE (FT4) 1.44 ng/dl (0.70 - 1.80)

ANTI MICROSOMAL ANTIBODY (AMA) C.L.I.A 7 IU/mL Negative : <34

Met the endo and he wanted me to start me on TRT but suggested an insane protocol of 250 mg Testterone enanthate every 3 weeks. When I told him this would not be suitable especially for me (my SHBG is 14.1) he didn't agree and wanted me to stick to the insane protocol. He also suggested an MRI of pituitary to rule out the possibility of a tumor.

I am from India and all these tests and medications / TRT is out of pocket for me. However, testosterone is quite cheap here if I were to get on it eventually.

So just wanted to have some thoughts on my underlying disease / condition / syndrome and the next course of action. Any help is appreciated.

Thanks,
Red-devil


#2

Peroxidase antibody: 53.2 uIU / ml (<60)
This may be a problem. I would like you to find some vitamins that list selenium. A selenium deficiency can cause some thyroid autoimmune problems.

Is your thyroid enlarged, lumpy or asymmetrical?

Cold intolerance:
Have you been using iodized salt or are you iodine deficient?
Cold intolerance also suggests thyroid problems.
Get an oral fever thermometer, check body temperature when you wake up. 97.7F is a problem. 97.7F would be OK. Also see if you can get 98.6F in the middle of the afternoon.
Please see the ‘thyroid basics’ sticky

Thyroid problems sometimes cause testosterone problems.

  1. High cholesterol

CHOLESTEROL 188 (< 200 Desirable, 200 - 239 Borderline High, >/= 240 High mg/dL)
TRIGLYCERIDES 154 (Normal <150; Borderline high: 150 - 199, High: 200 - 499, Very high: > or = 500)
CHOLESTEROL HDL 32 (< 40 Low; >/=60 High)

  • I do not understand. Are you taking statin drugs to reduce cholesterol?

Please describe diet, list all medications and supplements.

When you stop any SERM {Clomid, Nolvadex …} you must taper off of the drug slowly. Stopping suddenly can cause problems.

If you want to understand some things better, please read the advice for new guys sticky. Note causes of low testosterone.

Have you had any pain or discomfort in your testes?
-TESTOSTERONE, TOTAL 424.20 (241.00 - 827.00 ng/dl)
-FREE 11.30 (8.9 - 42.5 pg/mL)
-LUTEINIZING HORMONE 8.29 (1.50 - 9.30 mIU/mL)
-FOLLICLE STIMULATING HORMONE 15.34 (1.40 - 18.10 mIU/mL)
These suggests testicular impairment. - primary hypogonadism
And your first and last labs suggest secondary hypogonadism.


#3

Thanks for your detailed reply. I do have lot of symptoms of Hypothyroidism but my FT3 and FT4 values are more than adequate as per my endo. My body temperature today morning was ~97F. Shall check it throughout the day and report back. I don’t think I can be iodine deficient as we use iodized salt for cooking.

I am not on any drugs to reduce cholestrol. Diet is mainly non vegetarian (chicken, red meat, eggs) along with few veggies and pulses. Currently taking Vit D, multi - vitamin, calcium and Vit C as supplements.

Had to stop Clomid abruptly as my endo wanted me to.

Have no discomfort or pain in testes. However, my urologist said that the testicular size is on the smaller side.

I have gone through a lot of literature on this awesome site however still really confused about the cause of my low T and next course of action.

Any help pls?


#4

Switch to vitamins that have selenium!!!
You need to see if this will help with your auto-immune thyroid problem.

Testing rT3 would be interesting.

You do have a lot of reading to do. Please revisit my post above at times as you may see more in it or things that you missed.

I was looking at salt in the store recently. The packaging is confusing. The iodized table salt and the non-iodized table salt were almost packaged the same. Best to look on your shelf and confirm what you have.

Low T and high RBC while HTC is OK seems odd. Makes me wonder if you get too much iron. Are you eating any iron fortified prepared foods/cereals?

Have your testes been checked for vascular abnormalities?

Focus on thyroid. Take selenium, check tT3. You may need Rx thyroid meds to restore body temperatures; but that may be difficult as most docs with think that your thyroid levels are perfect.


#5

[quote]KSman wrote:
Switch to vitamins that have selenium!!!
You need to see if this will help with your auto-immune thyroid problem.

Testing rT3 would be interesting.

You do have a lot of reading to do. Please revisit my post above at times as you may see more in it or things that you missed.

I was looking at salt in the store recently. The packaging is confusing. The iodized table salt and the non-iodized table salt were almost packaged the same. Best to look on your shelf and confirm what you have.

Low T and high RBC while HTC is OK seems odd. Makes me wonder if you get too much iron. Are you eating any iron fortified prepared foods/cereals?

Have your testes been checked for vascular abnormalities?

Focus on thyroid. Take selenium, check tT3. You may need Rx thyroid meds to restore body temperatures; but that may be difficult as most docs with think that your thyroid levels are perfect.[/quote]

Hi KS - I have been researching post your reply and am a bit confused. You mentioned that I may have an auto immune thyroid problem because of my Peroxidase antibody: 53.2 uIU / ml (<60). However, my ANTI MICROSOMAL ANTIBODY (AMA) is 7 IU/mL (range is Negative to <34). I thought both were the same blood tests, and I was initially concerned about my peroxidase antibodies and hence went for the repeat thyroid tests which included AMA.

Could you please let me know if both tests are same? I am from India and all the tests are out of pocket for me, so I need to be a bit picky on which tests to get. also I have no discomfort or pain in testes. I do seem to produce more than enough sperm but not enough testosterone.

Regarding your other points:

  1. I don’t think my thyroid is enlarged, athough I do have trouble wearing ties and cuffing the buttons on the top.

  2. my salt is iodized I checked.

  3. I have high RBC because of 2 reasons I assume - I suffer from frequent urination which might have led to dehyrdation and hence high RBCs. Also I have breating problems for my nose / sinus and according to my ENT that can also lead to high blood pressre / RBCs. MY blood pressure though is normal.

  4. Never had testes checked for vascular abnormalities. Should I? I thought vascular abnormalities generally affect only one of the testes, but both my testes although smaller than average are of same size.

Rt3 blood test is priced a bit steep, do you think it would be worth it?

Thanks again. You have been of a great help.


#6

[quote]red-devil wrote:
Thanks for your detailed reply. I do have lot of symptoms of Hypothyroidism but my FT3 and FT4 values are more than adequate as per my endo. My body temperature today morning was ~97F. Shall check it throughout the day and report back. I don’t think I can be iodine deficient as we use iodized salt for cooking.

I am not on any drugs to reduce cholestrol. Diet is mainly non vegetarian (chicken, red meat, eggs) along with few veggies and pulses. Currently taking Vit D, multi - vitamin, calcium and Vit C as supplements.

Had to stop Clomid abruptly as my endo wanted me to.

Have no discomfort or pain in testes. However, my urologist said that the testicular size is on the smaller side.

I have gone through a lot of literature on this awesome site however still really confused about the cause of my low T and next course of action.

Any help pls?

[/quote]

Next course of action:
a.) go on TRT for the rest of your life, deal with the side effects, hormonal imbalances, shitty doctors, fertility problems, some people experience erectile dysfunction on TRT if the doc isn’t managing the right hormones.

b.) no drugs, start eating organic and exercising regularly. Low T can be caused by environmental issues as well as psychological issues (depressed people often have low T. Going organic can weed out a ton of nasty shit in your body that you never even knew was there. Exercise, diet and stress relief activities can greatly help in these situations. Lifestyle changes are harder than getting a shot but are safer and will benefit you down the road.

So many people buy into this whole “low T” title that the pharma companies invented to sell more drugs. Sometimes people’s T gets low when they overtrain. Sometimes it is a result of an illness or chronic stress. Some people are just born with low T and they do fine without needing steroids and blood tests every month.

I have had my T checked A LOT and it always comes back where a 26 year old should be (TT at 750) but it does fluctuate. I have gone in for bloodwork after training, after resting, after smoking weed, and after martial arts competition. The numbers always fluctuate but stay around the 600-800 zone. Alcohol, tobacco, a lot of recreational substances can contribute.

Weed is a toss up for me. I’ve read the studies where they gave monkeys 30 joints a day and their T levels dropped, but that never happened to me. My total T came back 740 after I smoked a few joints, and I have been a consistent smoker for the past few years. There are lists online that show what drugs have been proven to lower testosterone.

There are also lists of ways to naturally increase your testosterone(supplements too). Shit I saw a study that arimidex given SOLO to older men raised their T-E ratio drastically and cleared up a lot of estrogen related issues they were having. Baclofen raises LH i believe as well. As far as SERMs go you could try the BB method and go 300/150/100/50. It sounds terrible because clomid has so many side effects but I hear it works.


#7

A1C test would rule diabetes in or out. Your frequent urination is a symptom of diabetes. Can also be prostatitis. Suggest urinalysis that looks for interesting things.

You have not posted more body temperatures.

You need to have been using iodized salt for years, not just now.