T Nation

My Story and Possible Hormone Issues 28 Y/O


#1

So a few months ago, back in June, I had my testosterone levels checked and I will list the results below but first wanted to give a little background information. I am 28 years old, workout consistently and follow a clean diet, rarely drink, try to get 7-8 hours of sleep per night, etc.
The past few months before I had to get surgery (hip dislocation to fix hip socket impingement on my right side) I tried to eat a little bit more to increase lean mass but basically I only ended up adding fat in my chest, and lower belly and love handles unfortunately. Right now I am currently recovering from surgery but started doing some light upper body work just to keep myself from going crazy.

So I never thought about getting my levels checked basically I thought I was fine being in my 20s, following a good diet and exercise plan, no alcohol but decided to ask my doctor to have my levels checked just to be safe because I had noticed I was getting fatigued real easy, was losing some strength and gained some fat and when I got the results back he was fine with them because they were within ‘range’. I talked with him again and he referred me to an endo… met with the endo and she basically told me to try viagara.

After reading more and more about low T, I realized that maybe some of the issues I had in life that I previously thought were just a normal part of living, may actually be caused by some deficiencies. As long as I can remember I have had really bad anxiety, issues falling asleep/ staying asleep, no major depression but 1-2 times a week it seemed like out of no where I would just get really bummed out for no apparent reason. Recently things have gotten worse with concentration issues at work and in general, issues with remembering things, no motivation even though in my mind I want to do a lot more but when it comes to it my motivation isnt there when I need it.

From doing some reading here I need to start with taking my temperature 3x a day, I noticed recently I do get cold rather easily. I dont take any iodine salt in my diet right now but that may be a good place to start? I am just looking to feel ‘normal’ and I appreciate help from anyone.

Here are my labs from June, I hope to get them retested soon and go from there.

HGB 14.1 g/dl 14-18 g/dl
TSH 2.66 mIU/L .4-4.0
T4, free 1.04 ng/dl .8 - 1.5
TT 362 ng/dl 250-1150
Free T 64.4 pg/ml 35-150

-age 28
-height 6’1
-waist 34
-weight 210
-describe body and facial hair - body hair is limited mainly to arms and lower legs. Not much elsewhere, outer eyebrows very thin, facial hair is patchy and slow to grow
-describe where you carry fat and how changed - In the past few months I seemed to be storing a lot more fat in my lower stomach and love handles and in my chest
-health conditions, symptoms - no major health conditions - i did have surgery on my hip 4 weeks ago to fix labrum tears and reshape my femur to sit better in my hip socket
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever - no
– real dangers! see this http://propeciahelp.com/overview35
-lab results with ranges
-describe diet [some create substantial damage with starvation diets] - diet is clean, 35p/35f/30c, lean proteins, eggs, veggies, fruits, etc.
-describe training [some ruin there hormones by over training] - just started doing some light upper body lifting this past week after having surgery a few weeks ago. would typically do light cardio a few times a week such as incline walking but cant do that currently.
-testes ache, ever, with a fever? I guess thinking back on it now there were a few instances in which I would get random pain in the testes but didnt really think anything of it. It was just completely random and nothing too persistent
-how have morning wood and nocturnal erections changed - morning wood rarely happens anymore these days, maybe 1 time a month if lucky. will still get some nocturnal erections every once in a while if i wake up in the middle of the night and have to go pee.


#2

Thyroid is a major issue for you.
Please read the thyroid basics sticky.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • thyroid basics - post oral body temperatures
  • protocol for injections
  • finding a TRT doc

Need labs with ranges.

Labs:
TT
FT
E2
LH/FSH
prolactin
TSH
fT3
fT4
CBC
hematocrit
fasting cholesterol - can be too low
fasting glucose

Are your outer eyebrows sparse?
How long not using iodized salt?
Why not using iodized salt? - others living with you also iodine deficient?


#3

Thank you for the quick response KSman. I started reading through the sticky about thyroid basics and saw you recommended reading the Adrenal Fatigue by Dr James Wilson, would that be a good spot for me to start along with recording my temperature and getting my blood work checked.

Thank you for your help


#4

You’re reading too much into your ‘symptoms’, I think. You’re labs with your free testosterone at 64.4 may be a hair low for your age, but really just a hair. Stress and environmental factors can play a large role in how you feel and how your body reacts. Even on T replacement with a rock steady high-average testosterone level you will have ups and downs. Nights you cannot sleep, times you don’t feel like having sex, more or less body fat, etc. Most of what you describe seems the result of natural aging and stress.

Stress plays a much higher role in how you feel day to day. True T replacement is a commitment and if you need it, it’s well worth it.
I had toilet level T in my mid 30’s so T replacement was a wonder for me.

Really, if you want to get more built through chemistry, do a good, safe cycle. Otherwise, there are natural Testosterone enhancers that may just do enough to pump those T numbers a little higher without the commitment of T-replacement.

NOTE: The one thing I always caution people though, don’t screw around with testosterone if you naturally have a bad temper. If your temperament is good and even testosterone won’t change that. But if you have a bad temper, testosterone will make it worse. Only you know what you are, so just becareful.

Your free T is not bad, so I wouldn’t really worry about it right now.


#5

Pat, we do not see bad temper or intolerance issues on TRT when E2 is managed near 22pg/ml. Elevated E2 causes significant mood, energy and libido problems when otherwise T is high normal or above range.


#6

If you feel that Wilson’s book applies to you, you must have been experiencing stress.


#7

I agree and I know you are well educated on the matter, just most people aren’t that careful. To me it’s just a caveat emptor, if a person has a normally bad temperament, it’s best they stay away from hormone replacement or monitor it very carefully if they do need it.
My evidence is all anecdotal…


#8

Well I was reading the thyroid stickies and saw some people recommending it and saying that if you fix potential adrenal fatigue that may fix thyroid and test issues. I am just trying to start with the basics before I think about TRT , etc. I am just hoping to feel good and enjoy life, I feel like I should be in the prime of my life right now not feeling like a senior citizen.


#9

So I had some more bloodwork done recently and attached the results. Ive also been logging my temperatures upon waking and later on in the day. I bought a new thermometer just to make sure I was getting accurate results… I also ordered iodoral and will begin taking that. I think either a combination of thyroid or adrenal issues are causing my lower T numbers and all my symptoms.

Here are my morning and evening temps (sometimes forgot to take evening temp)

95.7 97.7
96.5
95.4
96.8
95.8 97.1
96.2 97.5
95.8 (this morning)

Any help is appreciated. Looks like tsh is a bit high, isnt it optimally supposed to be around 1? I’ll probably have to call the doctor back and have some more tests run hopefully.

SODIUM 143 135-145 MMOL/L
POTASSIUM 4.2 3.5-5.2 MMOL/L
CHLORIDE 107 97-109 MMOL/L
CARBON DIOXIDE 30 21-32 MMOL/L
CALCIUM 9.3 8.5-10.4 MG/DL
ALKALINE PHOSPHATASE 91 41-125 UNITS
AST 22 4-50 UNITS
ALT 36 2-60 UNITS
BILIRUBIN,TOTAL 0.6 0.2-1.5 MG/DL
GLUCOSE 72 65-99 MG/DL Glucose reference range based on fasting specimen.
Random glucose reference range: 65-125 mg/dL.
UREA NITROGEN 20 7-25 MG/DL
CREATININE 1.1 0.9-1.4 MG/DL
BUN/CREATININE RATIO 18.2 7-25
PROTEIN,TOTAL 6.9 6.2-8 GM/DL
ALBUMIN 4.1 3.6-5 GM/DL
GLOBULIN,CALCULATED 2.8 2.1-3.5 GM/DL
A/G RATIO 1.5 1.1-2.2
GFR ESTIMATED >60 >59 ML/MIN/1.73M2 The GFR Estimate is not adjusted for race. If the patient’s race is African-American, the GFR Estimate must be multiplied by a factor of 1.21.
TSH 2.70 0.4-4.5 mIU/L QAC
T4,TOTAL 7.0 4.5-12 mcg/dL QAC
CBC W/DIFF and PLT QAC
WBC 3.3 L 3.8-10.8
TH/UL RBC 4.94 4.2-5.8 MIL/UL
HGB 14.4 14-18 GM/DL
HCT 42.3 38.5-50
PERCENT MCV 85.8 80-94
FL MCH 29.2 26-34 PG
MCHC 34.0 32-36 GM/DL
RDW 13.4 11.5-15
PERCENT PLATELET 159 140-400
TH/UL MPV 10.0 7.4-10.4 FL


#10

So I had more blood work done recently - basically had to beg the endo to retest me again and he wouldnt test for certain things such as rt3 and others. I have continued to take my temp upon waking and still regularly in the 95s or 96s. I get cold easily still, have no energy, cant lose any weight and seem to be gaining fat although i cut out gluten, diary, taking in no processed foods at all, dropped caffeine, havent had a sip of alcohol in 6+ months. When i try to work out Im literally using half the weight i used to and every muscle and joint aches and I’m full of pain when im working out… not sure where to go from here, ive been using iodized salt since Oct, but ive been taking vitamins with iodine+selenium for years. I also worked up to iodoral 4x 12.5 a day back in November but didnt seem to help much.

1/31 tests

ComponentStandard Range Your Value
TSH/Thy.Stim.Horm 0.40 - 4.50 mIU/L 3.90 mIU/L
FREE T4 0.80 - 1.80 NG/DL 1.25 NG/DL
Free T3 2.3 - 4.2 pg/mL 3.5 pg/mL

Any help is greatly appreciated.


#11

I got back some more blood work that i recently had done. Still checking temps in the morning and still 96s daily. TSH was recently at 3.9 but ft3 and ft4 looked to be mid range so could it be possible that rt3 is high which may be causing problems? TT was up to 643 but FT was low out of range. Ive changed all the lifestyle aspects possible, clean diet, no drugs/alcohol, good sleep, exercise regularly, now I am ready to start feeling the way a healthy 28 year old should.

Any help or advice is always appreciated!

Test Low Normal High Reference Range Units
Dhea-Sulfate 277.9 138.5-475.2 ug/dL

Cbc With Differential/Platelet

Test Low Normal High Reference Range Units
Wbc 3.5 3.4-10.8 x10E3/uL
Rbc 5.20 4.14-5.80 x10E6/uL
Hemoglobin 15.0 12.6-17.7 g/dL
Hematocrit 43.7 37.5-51.0 %
Mcv 84 79-97 fL
Mch 28.8 26.6-33.0 pg
Mchc 34.3 31.5-35.7 g/dL
Rdw 14.3 12.3-15.4 %
Platelets 162 150-379 x10E3/uL
Neutrophils 35 %
Lymphs 54 %
Monocytes 9 %
Eos 1 %
Basos 1 %
Neutrophils (Absolute) 1.2 1.4-7.0 x10E3/uL
Lymphs (Absolute) 1.9 0.7-3.1 x10E3/uL
Monocytes(Absolute) 0.3 0.1-0.9 x10E3/uL
Eos (Absolute) 0.0 0.0-0.4 x10E3/uL
Baso (Absolute) 0.0 0.0-0.2 x10E3/uL
Immature Granulocytes 0 %
Immature Grans (Abs) 0.0 0.0-0.1 x10E3/uL

Prostate-Specific Ag, Serum

Test Low Normal High Reference Range Units
Prostate Specific Ag, Serum 0.5 0.0-4.0 ng/mL

Testosterone,Free And Total

Test Low Normal High Reference Range Units
Testosterone, Serum 643 348-1197 ng/dL
Comment: Adult male reference interval is based on a population of lean males
Free Testosterone(Direct) 7.7 9.3-26.5 pg/mL

Estradiol, Sensitive

Test Low Normal High Reference Range Units
Estradiol, Sensitive 15.6 8.0-35.0 pg/mL

Lipid Panel W/ Chol/Hdl Ratio

Test Low Normal High Reference Range Units
Cholesterol, Total 142 100-199 mg/dL
Triglycerides 29 0-149 mg/dL
Hdl Cholesterol 56 >39 mg/dL
Vldl Cholesterol Cal 6 5-40 mg/dL
Ldl Cholesterol Calc 80 0-99 mg/dL
T. Chol/Hdl Ratio 2.5 0.0-5.0 ratio units

Comp. Metabolic Panel (14)

Test Low Normal High Reference Range Units
Glucose, Serum 94 65-99 mg/dL
Bun 21 6-20 mg/dL
Creatinine, Serum 0.87 0.76-1.27 mg/dL
Egfr If Nonafricn Am 117 >59 mL/min/1.73
Egfr If Africn Am 136 >59 mL/min/1.73
Bun/Creatinine Ratio 24 8-19
Sodium, Serum 143 134-144 mmol/L
Potassium, Serum 4.4 3.5-5.2 mmol/L
Chloride, Serum 103 96-106 mmol/L
Carbon Dioxide, Total 24 18-29 mmol/L
Calcium, Serum 9.6 8.7-10.2 mg/dL
Protein, Total, Serum 6.6 6.0-8.5 g/dL
Albumin, Serum 4.7 3.5-5.5 g/dL
Globulin, Total 1.9 1.5-4.5 g/dL
A/G Ratio 2.5 1.1-2.5
Bilirubin, Total 0.3 0.0-1.2 mg/dL
Alkaline Phosphatase, S 93 39-117 IU/L
Ast (Sgot) 20 0-40 IU/L
Alt (Sgpt) 17 0-44 IU/L


#12

Anyone have advice? TSH at 3.9 is not very optimal from everything I’ve read but my FT3 and FT4 seem to be okay so is it possible that everything is okay thyroid wise? Or should I run tests on RT3 and ferritin or thyroid antibodies?

Please anyone with advice chime in. ksman what would you suggest, ive read wilsons book and cut out sugar, gluten, caffeine and the little alcohol i would consume on occasion. Body temperature still usually in the 96 range in the morning and mid 97s during afternoon.

Please help!