I promise I'll try and be as brief as possible while giving as much background info as I can to help get some relevant answers.
-age : 33
-height : 5'11"
-waist : 34
-weight : 215
-describe body and facial hair : I can grow a mean red viking beard if work allowed it.
-describe where you carry fat and how changed : stomach, some chest, always been that way.
-health conditions, symptoms [history] : I honestly didn't know I had any until I had some wonky labs come back. Then some of the fatigue, tiredness, inadequate ratio of work going into the gym to aesthetics of physical appearance, decreased libido, etc.
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever : Synthroid 50mg (part of the ongoing story) Multi, D3, ZMA, COQ10, Fish Oil, Bcomplex, Glucosomine/MSM/Condrointin
one brief exposure to adrosteintdione when it first came out, but it had saw palmetto and was guaranteed not to aromatize right? haha...
-lab results with ranges : Posted below in detail.
-describe diet [some create substantial damage with starvation diets] : Not the best, not the worst. I eat cleaner than the majority of the population, but am not afraid to eat.
-describe training [some ruin there hormones by over training] : I'm a firefighter so I train two days on 1 day off constantly. Presently doing 5/3/1 total body programming on second day off with a hybrid of dynamic effort lower and upper days with sprints and prowler on first day off.
-testes ache, ever, with a fever? : oddly enough, yes inexplicably and very few and far between.. no fever though
-how have morning wood and nocturnal erections changed : never a nocturnal emission guy.. morning wood really comes and goes. oddly enough this past week had it all the time, before that can't really remember it regularly...
With the introductions out of the way I'll get to the gist of the story. I'm a 33 y/o firefighter. Part of our department physical is a full body work over including ultrasound of organs and blood work. I went into this test for my second time expecting nothing out of the ordinary and was quite surprised to see the results of some of my labwork. The year prior yielded nothing out of the ordinary. Prior to this physical I had been feeling a bit more tired and run down with decreased libido (commented on extensively by my girlfriend), but I figured it was just part of a new assignment and par for the course for being up for 24 hours. The labwork showed as follows (parts of concern)
Quest Diagnostics 2/15/11
TSH 7.24 (0.4-4.5 MIU/L)
T4 free 1.5 (0.8-1.8 ng/dL)
Test Total 192 L (241-827 ng/mL)
PSA, Total 0.2 ( < or = 4.0 ng/mL)
Needless to say these came as quite a shock which lead to a follow up with my physciain whom which I had not visited in 5 years or so...
Physician of course wanted his own results before Tx and lead us to...
Unsure of Lab used 3/18/11
TSH 7.59 (0.34-5.6) uIu/mL)
Which lead to the following more complete panel
Unsure of Lab used 3/23/11
Ferritin 99.3 (23.9-336.2 ng/mL)
Free T4 0.8 (0.6-1.6 ng/dL)
T3 free 3.4 (2.5-3.9 pg/mL)
FSH 4.3 (1.3-19.3mIU/mL)
LH 2/8 (1.2-8.6 mIU/mL)
Prolactin 10.2 (2.6-13.1 ng/mL)
Test total 283 (249-836 ng/dL)
Test Free 9.54 (5.00-21.00 ng/dL)
% Free Test 3.37 (1.50-4.20)
At this point Dr. decided it would be best to focus on my thyroid first and see how that affected my other labs. He was very open with discussing TRT and mentioned having no problems starting me on it, but wanted to see how my thyroid responded first. 50mg of synthroid daily and fast forward to now...
Unsure of Lab used 9/20/11
TSH 4.2 (0.34-5.6) uIu/mL)
Test total 408 (249-836 ng/dL) as of Oct 17th per my lab sheet new ranges will be 348-1197
Test Free 12.44 (5.00-21.00 ng/dL)
% Free Test 3.05 (1.50-4.20)
So here's where we are and where my questions begin...
Thyroid therapy actually had a fairly profound initial effect on fatigue, mood, body comp etc. I do feel better most of the time than I do days prior, but this entire process has also made me more aware of when I feel bad, brain fog, unusal fatigue, slow recover from minor injury (wrist tweak, thumb sprain etc)... I know the new standard for TSH is 0.3-3.0 and will have my Dr. focus on adjusting my meds to reach that goal soon, but had questions regarding TRT first and wanted to get opinions on what is going on with me...
1) Did the synthroid have a positive effect on test? I.e. was I so out of whack hormonally this medication started this upward trend and will it continue without TRT or is that just a stretch.
2) At this point giving the way I feel and the fact that I am in the bottom basement of the new acceptable range I feel comfortable pushing for TRT. I plan on requesting the following protocol unless anyone has anything better to suggest..
- 100mg test cypionate or ethanate injected per week with two or more injections per week.
- 250iu hCG SC EOD [every other day]
- 1.0mg Arimidex/anastrozole per week in divided doses.
Does this sound like the right move or do I need to give it more time and adjust TSH first?
3) I have yet to have my estradiol measured. I plan on doing this before starting TRT to get a baseline obviously, but meet with my Dr. in 2 days and wanted to somewhat hardball him into making a TRT decision... Is there any chance I could be having T suppressed do to excess E2 and is that something that management on it's own with an AI could take care of without TRT or does TRT look like it's the inevitable future
4) I work 1 day on 2 days off... Is there a huge issue with organizing injections around E3D which would be exponentially easier to program with my schedule for HCG/ Adex, and Test etc, or is the EOD method the best way to do things.
Thanks so much for any and all help coming my way. I do apologize for the last minute posting and requesting of help on short notice, but any advice and making sense of this mess would be greatly appreciated. I have decided that I have lived life in this fog for entirely too long and am willing to do what it takes to function happily and normally hormonally and hope I'm on the right path...