waist: 32 in.
Weight: 168 lbs.
body/facial hair: hair over most of body, very little on back and shoulders. Plenty of facial hair (which I shave regularly).
Fat: Most is carried in midriff. Total body fat last measured at 16-17%.
I’ve been experiencing throat symptoms and psychological symptoms for a few years now. Throat: Choking sensation, a tightness/pain in throat that comes and goes. Feeling of something stuck in throat. Frequent need to clear throat. Difficulty swallowing food (I usually need to drink water at the same time as chewing). Hoarse voice. Psychological: occasional depression (despite being on Wellbutrin XL 450 mg/day). Low energy.
Sometimes mentally foggy, forgetful. In general often don’t feel “myself” – energetic, confident, social, mentally sharp and present. Repeated tests have shown low or below normal T levels. For thyroid, repeated blood tests have shown low or below normal levels for certain thyroid hormones (T3, TSH), and one test showed slightly above normal levels of thyroid antibodies (suggesting possibility of auto-immune system attacking thyroid, aka “Hashimoto’s disease”. But no doc has confirmed that I have Hashimoto’s).
The most recent doc I went to see is Dr. Raphael Kellman here in NYC. He did several blood panels. Started me on T cream (175 mg/ml, 1 ml/day) and anastrozole (0.5 mg, 3 times/week). So far, has said little about thyroid, but he upped my dosage of Liothyronine (from 10 mcg/day to 15 mcg/day). Tests showed that I have a genetic condition (which may or may not be related to either) – I have a MTHFR C677T mutation (heterozygous). This has to do with the body’s ability to convert folic acid into methylfolate. Dr. Kellman has loaded me with a number of supplements with regards to this, but my research indicates that C677T heterozygous is likely not a big deal:
“Experience demonstrates that those with 1 copy of the C677T MTHFR mutation do not need much methylfolate beyond what is found in the Optimal Multivitamin line. The MTHFR enzyme is working at nearly 70% or so effectiveness in heterozygous individuals, while in homozygous individuals, it is working at only 30% effectiveness.”
Bupropion XL (450 mg/day)
Liothyronine (15 mcg/day)
Anastrozole (1.5 mg/week)
Most recent lab results:
From Lipid Panel (I include thyroid and adrenal here):
Testosterone: 423.4 (ref range: 348 - 1197 ng/dl)
TSH: 0.47 (ref range: 0.5 - 6.0 ulU/ml)
Free T3: 2.52 (ref range: 2.0 - 4.9 pg/ml)
Free T4: 1.11 (0.75 - 1.54 ng/dl)
Cortisol: 12.8 (10.4 - 26.4 ug/dl)
From Free & Total Testosterone Tests:
Testosterone Total: 3.41 (ref range: 1.75 - 7.81 ng/mL for males 18 - 66 years)
Testosterone Free Calculated: 24 (ref range: 24.3% - 110.2% for males 20 - 50 years)
Sex Hormone Binding Glob: 50 (ref range: 13.3 - 89.5 nmol/L for males 20 - 50 years)
My diet is about 40% protein, 40% carb, 20% fat. I’m currently cutting, so I eat 1,500 calories per day plus whatever calories I burned off that day from exercise (which puts me on a 500 calorie/day deficit). For breakfast I typically have eggs, fruit, Isopure Zero Carb, almond milk, shredded wheat, and 2 tbsp of phophatidylcholine.
For lunch I typically have a sandwich (deli turkey on 100% whole wheat bread), salad (greens, tomatoes, carrots, celery, olive oil), Greek yogurt (Fage 0%) and banana, plus Isopure Zero Carb. For dinner, it varies. In general, I get my protein from salmon (wild), chicken or turkey (organic, no hormones or antibiotics), eggs, tofu, quinoa, nuts, and Isopure Zero Carb. I avoid cow dairy. I avoid breads other than 100% whole grain. I tend to avoid sugar and saturated fat.
My training is mostly with weights. I’ve been lifting regularly for about 6 months. I’m seeing a personal trainer for an hour every Friday. Previously I was working out only 1 or 2 times a week, but I’ve upped that to 4 or 5 times a week (starting 2 weeks ago). I try to do at least 30 minutes of cardio at least once per week, but aerobic exercise really irritates my throat after 20 minutes or so. My ultimate goal is to get down to 10% body fat, weighing 170-180 lbs.
Morning/evening wood: Used to be virtually nonexistent, especially in the morning. Since starting on the T cream, that’s changed - I now get morning erections more times than not. Nocturnal ones less frequently, but now and then.
Like many newcomers I suspect, I’ve had a hard time trying to find a doc qualified to handle my low T problem. I appreciate Dr. Kellman’s thorough set of lab tests, but I sense that TRT isn’t exactly his specialty, given the fact that just about everything I know about TRT I’ve gotten from my own research and not from him. He also prescribed me anastrozole without testing my e2 levels first, which leads me to question if he’s the right doc for me.
Fortunately, I saw an old post on this forum in which a member recommended three andrologists here in the NYC area, so I’m going to see one of them (Dr. Natan Bar-Chama) on the 27th.
As for finding a doc for my thyroid, so far that’s been even trickier. I’m almost positive my throat symptoms are from a thyroid that gets swollen and inflamed throughout the day, from some as yet unknown cause. But most endocrinologists, it seems, don’t want to bother dealing with thyroid conditions (other than thyroid cancer). That’s how I found Dr. Kellman - supposedly he does treat thyroid conditions, but so far he hasn’t has much to say about it. It could be something as simple as an iodine deficiency, but again, I had to find out about that possibility from my own research.
Ideally, I’d like to find a doc who can identify the underlying causes of my low T and of my thyroid condition, and determine if they’re at all interrelated.