I could really use some eyeballs on the info below. I have a urologist appointment next week and I'm preparing for it. I've convinced myself now that the root of all my problems is due to varicoceles ---- I'd appreciate anyone who can help affirm or deny that opinion, or offer any other interpretations, or even just offer solace about my tiny nuts.
There is a lot of data in the second post of this thread. Hopefully someone will point out any bit of info that I've missed.
I'm going to hope for a varicocele surgery soon to see if my hormones stabilize at better levels. Id be interested in hearing from anyone else who had a similar case.
-waist: 36; I was wearing size 32 jeans this time last year.
-weight: 207; I was 180lbs this time last year.
- BF%: probably around 25%. Up from 11% late 2008.
-describe body and facial hair: normal; hair was thinning (male pattern baldness runs in the family) but virtually stopped falling out around age 30. (Low DHT?). Body hair seems normal to me.
-describe where you carry fat and how changed: currently: inner thighs, love handles, lower abdomen. A lot of chest fat, and fat around serratus anterior. (High E2?). For history of fat gain and loss, see below.
-health conditions, symptoms [history]
I was born with an undescended left testicle (cryptorchidism) which was not corrected until age 15 via an orchidopexy. I had an inguinal hernia repair at the same time. After the orchidopexy I recall that my left testicle was much smaller that my right testicle. I complained to the surgeon (thats how I remember that lefty was smaller than righty at one time).
Ages 15-20 I was skinny, but very strong. At 18 I was ~140lbs.
At age 20 I was hospitalized for 12 days with a diagnosis of pneumonia, hepatitis A, and mononucleosis. My temperatures were dangerously high for days straight. Another guy died with the same condition at the same time.
Throughout my 20s I had recurring night sweats, recurring episodes of excessive sweating (sweating without cause), and recurring episodes of the shakes (hypoglycemia?) for which I would eat a sugar food. I hovered around 170-185lbs, but I recall carrying a disproportionate amount of fat on my chest.
Starting age 26, I began a decade of fat accumulation, ending up around 280lbs by age 36.
At age 30 I was diagnosed with oligospermia (count was 600,000/mL) after a few years of failed attempts having kids. Never give up hope though --- five attempts of IVF/ICSI later, and my kid is sitting beside me now while I type this :).
At age 37 I dropped my weight from 257lbs down to 150lbs by following a low calorie low carb diet, and hiking, rollerblading, etc. No resistance training. Most likely I took the weight off too fast, but I felt great throughout.
From age 38 to 39 I lifted weights with a passion, and by age 39 I was 180lbs at ~11% body fat. I was getting strong too.
At age 39 I was having pain in my lower left abdomen so I was referred to urologist. The diagnosis was a taut spermatic cord (I supposed due to adhesions from my surgery at age 15). At the time I had an ultrasound and testicular atrophy was noted for both testicles. The left testicle was slightly small, compatible with a previous cryptorchidism and on ultrasound was homogeneous, and the right was even more atrophied, suggestive of prior insult, either infectious or ischemic in origin and on ultrasound was diffusely heterogeneous. I still have the pain in my lower left abdomen, especially when doing (for example) walking lunges.
Also at age 39, chiropractic treatment resulted in neck injury, leading to discovery of moderate osteoarthritis of the cervical spine, including disk bulges from C2 to C5, and a disk extrusion at C5/C6. Shortly before I turned 40 I had a transient ischemic attack due to an occlusion of my left vertebral artery. This was a severe vertigo episode. Follow up MRIs did not detect brain damage, but I had a severe continuous headache for a month following the episode. I hit the gym hard anyway, and a year later on a follow-up MRI my left vertebral artery looked completely healed. I have some cord compression at the C5/C6 level. I have some radicular pain as well.
At age 41, starting in January and February last year, I noticed loss of strength and stamina and started getting numerous muscle pulls and tendon inflammation. Also noticed brain fog and word-finding difficulty. This was horrible (I'm a professor of electrical engineering --- losing muscle is one thing, losing my cognition is something else!).
Symptoms abated over the summer of 2010.
Then, this year starting in January and February, I again noticed loss of strength and stamina. More muscle injuries and tendon inflammation. Slow wound healing. Heart palpitations, excessive sweating, anxiety at night. Shortness of breath. Brain fog, lack of concentration. General apathy.
Last month (at age 42 now), I had an ultrasound again on my testicles, and this time the ultrasound technician found bilateral varicoceles (e.g. 3mm left side, 4.1mm right side) with evidence of reflux. The right testicle has atrophied to 6mL, is inhomogeneous, and has several hypo-echoic foci on ultrasound. The left testicle is 12mL and otherwise normal. I am now azoospermatic (three tests, all zero count).
Lately I've noticed some discomfort around my upper left quadrant abdomen. I think its related to my spleen. I've had it before, even back in 2008, but this time its not going away. My platelet count is low.
Summary list of Symptoms
Note: I started supplementing with a few items and I noticed improvements in a number of the symptoms listed below. I marked symptoms that have improved with *** (I still have the symptoms, but they are less noticeable).
- Low libido, not generally zero, but goes to zero for a period (weeks) then returns
- Anxiety, mostly upon waking
- Apathy, reduced work performance
*** Mental confusion (e.g. cannot think of route when driving)
*** Irritated easily
*** Problems with word finding, apparently not so noticeable to others
*** Forgetfulness, mostly short term memory
- Atrophied testicles
- High blood pressure (normally ~120/80, but spikes occasionally)
- Spinal problems (osteoarthritis of cervical spine)
- Insomnia, then early morning waking with anxiety
- Afternoon/evening energy crashes
- Loss of stamina
- Loss of physical strength
- Long recovery time after physical activity
- Unfavorable change in body composition despite exercise and diet regime
- Frequent muscle injuries and tendon inflammation
- Slow wound healing
- Some joint pain (elbows, knees, shoulders)
- Low morning body temperature (averages 36.3 degrees Celsius)
- Incomplete urination (BPH?)
- Facial dandruff (chin and eyebrows)
- Female fat distribution; carry fat in chest, lower abdomen, and hips
- Water retention
- Shortness of breath
- Cholesterol slightly high
*** Heart palpitations (verified by ECG)
*** Hot flashes
*** Night sweats (none within last six months)
*** Dry eyes
*** Low resting heart rate (52 bpm)
*** Fasciculations (calves, sometimes quadriceps)
*** Frequent cold sores
*** Excessive sweating for no reason
- Libido (as above)
- Infrequent morning erections
- No spontaneous erections
- Loss of erection without direct constant stimulation
- Loss of sensitivity
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
Never used drugs of any kind, except for SudaFed and Otrivin when I was younger (e.g. age 14-20) due to hay fever/pollen allergies.
-describe diet [some create substantial damage with starvation diets]
Weekdays are low carb, weekends are high carb. Basically the Anabolic Diet (or Body Opus diet), or CKD, or whatever you want to call it. I'm eating a lot of fats weekdays (saturated and monounsaturated, little PUFA) -- about 55-60% of my calories. Almonds, walnuts, coconut oil and olive oil for fats. The rest is protein (meat, eggs, some fish), except for trace carbs (net carbs below 30g/day). I dont count vegetables and leafy greens, but eat them. I'm trying to cut my body fat right now (E2 is high) so I'm eating ~2000 calories weekdays and averaging 3500 calories Saturday and Sunday. Average for the week is then ~2400 calories/day. I am not losing weight at this calorie intake, which makes no sense (to me) given my workout calorie burn plus my BMR. I tried eating more, but just put on weight. The Anabolic Diet worked wonders for me in 2008, but it's failing me now.
Not long ago I was anti-supplement. Not so much now.
Prior to two months ago, I generally took:
fish oil (5g/day)
Vitamin C (2000mg/day)
Vitamin D (6000IU/day)
Vitamin E (800IU/day)
Magnesium oil (topical)
BCAA+glutamine during workouts
Starting around two months ago, I changed my supplement regime to the following:
zinc picolinate (90mg/day)
potassium iodide/kelp (450mcg/day)
magnesium glycinate (480mg Mg/day)
fish oil (5g/day)
Vitamin C (2000mg/day)
Vitamin D (6000-10000IU/day)
TADS adrenal support (freeze-dried from bovine, 165mg/cap x 3 caps/day)
BCAA+glutamine during workouts
(I dropped the Vitamin E because it was alpha-tocopherol only, and my gamma-tocopherol tested at rock bottom. Apparently supplementing with alpha-tocopherol depressed my gamma-tocopherol).
One month ago I also added:
Calcium/Magnesium (666mg Ca/day + 333mg Mg/day (total Mg is now 813mg/day))
Lipoic acid (600mg/day)
Grape seed (100mg/day)
ESTROsmart (4 caps/day, basically I3C+DIM+Green Tea for E2 removal)
Vitamin B6 (75mg/day)
(Based on my lab results, something is boosting my total testosterone and improving a few of my symptoms. I need to pare this list down and see whats working for me best.)
I also experimented with Tribulus and Nettle Root. They worked short term. Morning wood returned, and I generally felt better. However, my E2 rose, causing my LH to drop, causing my T to drop, putting me back where I started except with higher E2. So I discontinued using nettle root and tribulus. I might try cycling this combination soon.
All workouts 9am-11:30am
Monday, Heavy legs
Tuesday, Heavy chest/shoulders
Wednesday, Heavy back
Thursday, sometimes light cardio, sometimes light accessory work, triceps, biceps,
Friday, light cardio
Saturday, depletion (full body, very light weight)
Saturday noon until Sunday evening, Carb-up
Most of my lifts are down 20-40% from two years ago. At best I've kept a few lifts constant.
-testes ache, ever, with a fever?
Ache, yes, perhaps commensurate with varicoceles.
-how have morning wood and nocturnal erections changed
From normal (teens-30s) to non-existent (40s) to occasional now (while supplementing).
-lab results with ranges
EDITED Dec 8/11 to add missing asterisks and apostrophes.