T Nation

My Story: Much Appreciation for Repiles

With this being my first post, I want to be as brief and concise as possible. This forum, more specifically the people in this forum have been valuable educators for me on the subject of low test and all hormones associated with it. I have spent four months reading and being tested by many incompetent dr’s and finally one competent doctor. I’m finally taking the plunge and posting my results and story for you all to read and give your much respected advice.
-age: 33
-height: 6
-waist: 31
-weight: 182

-describe body and facial hair: Not a very hairy male at all on my extremities and trunk. I honestly have about 10 chest hairs, no kidding. Facial hair can be shaved every three days. I should also mention I didn’t shave until my freshman year in college. Needless to say puberty came vey late.
-describe where you carry fat and how changed: I carry body fat on my abdomen and lower back (spare tire). My body fat is at 18-20% per skin caliper testing.

-health conditions, symptoms [history]: I was an extremely overweight child. I was a 36 in the waist in the 6th grade and ballooned up to a 42 waist as a sophomore in high school. Over the summer between sophomore and junior yet, I just completely stopped eating. My family had a lawn business and I just mowed grass all day, every day just living off mostly water. I began to have insomnia, extreme loss of hair and finally my family caught on to what was going on, probably too late. I started back to school a 30 in the waist. That is not a fabrication, I lost 12 pants sizes and most of my hair and muscle tone. These days the symptoms are extreme anxiety, up to five panic attacks a day. Cold sweats, low blood sugar, muscle twitches and poor concentration. A scary symptom is severe brain fog; I forgot how to get home a month ago and had to call my wife. I have physical fatigue and metal fatigue. Right now as I type this, my ability to compose thoughts is compromised. If I don�?�¢??t eat at least 3000 calories, I will lose weight extremely fast, 10 to 15 lbs in a week. Life generally sucks for me and my family. I�?�¢??ve lost my zest for life.

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: Propecia for 6 years. I�?�¢??ve stopped five years ago as we couldn�?�¢??t conceive, it took over a year. I started back after conception but immediately stopped as my nipples became extremely sensitive and swollen and I literally couldn�?�¢??t feel my penis, zip, zero, nada.

-lab results with ranges:
Test Attribute Value(Normal Range)
CBC WBC 4.5 K/UL (4.5-10.5)
ANA screen CCP Antibody lgG dsDNA antiboy ANA screen CCP Antibody lgG dsDNA antiboy .5 u/ml (.0-5) 5 u/ml (0-99)
CBC LYM 1.7 K/UL (0.6-4.1)
CBC %L 37.3 % (10.0-58.5)
CBC NEU 2.1 10e3/uL (1.8-6.7)
CBC %N 45.7 % (42.0-72.0)
CBC RBC 5.01 M/UL (4.69-6.13)
CBC EOS 0.2 10e3/uL (0.0-0.5)
CBC HGB 14.9 g/dL (14.1-18.1)
CBC %E 4.6 % (0.6-6.0)
CBC HCT 47.5 % (43.5-53.7)
CBC BASO 0.0 10e3/uL (0.0-0.1)
CBC MCV 95 fL (80-97)
CBC %B 0.8 % (0.3-2.0)
CBC MCH 29.7 pG/cell (28.0-32.0)
CBC PCT 0.2 % ()
CBC MCHC 31.3 g/dL (32.0-36.0)
CBC PDW 23.7 10(GSD) ()
CBC RDW 12.7 % (11.5-14.8)
CBC PLT 153 K/uL (145-450)
CBC MPV 11.1 fL (0.0-99.8)
CBC Mono 0.5 10e3/uL (0.1-1.1)
CBC %M 11.6 % (3.0-14.0)
Estradiol Level ESTRADIOL 27.90 pg/ml ()
Testosterone, total T. TESTOSTERONE 421.00 ng/dL (270.00-1730.00)
Prolactin PROLACTIN 6.67 ng/mL (2.50-17.00)
CMP ( CMP and D Bili) BUN 25.0 mg/dl (10.0-26.0)
CMP ( CMP and D Bili) CREATININE 0.9 mg/dl (0.6-1.4)
CMP ( CMP and D Bili) GLUCOSE 86.0 mg/dl (70.0-100.0)
CMP ( CMP and D Bili) CALCIUM 9.4 mg/dl (8.8-10.4)
CMP ( CMP and D Bili) SODIUM 141.0 mg/dl (130.0-149.0)
CMP ( CMP and D Bili) POTASSIUM 4.2 mg/dl (3.5-5.5)
CMP ( CMP and D Bili) CHLORIDE 106.0 MEQ/L (94.0-112.0)
CMP ( CMP and D Bili) CO2 28.0 MEQ/L (21.0-32.0)
CMP ( CMP and D Bili) BUN/CREATININE 27.8 RATIO (8.0-36.0)
CMP ( CMP and D Bili) ANION GAP 7.0 RATIO (4.0-34.0)
CMP ( CMP and D Bili) ALBUMIN 4.1 G/DL (3.5-5.0)
CMP ( CMP and D Bili) TOTAL PROTEIN 6.5 G/DL (6.3-8.1)
CMP ( CMP and D Bili) DIRECT BILI 0.2 MG/DL (0.0-0.6)
CMP ( CMP and D Bili) TOTAL BILI 0.6 MG/DL (0.2-1.3)
CMP ( CMP and D Bili) ALKALINE PHOS 73.0 IU/L (40.0-150.0)
CMP ( CMP and D Bili) AST/SGOT 19.0 IU/L (5.0-34.0)
CMP ( CMP and D Bili) ALT/SGPT 23.0 IU/L (0.0-55.0)
CMP ( CMP and D Bili) INDIRECT BILI 0.4 MG/DL (0.0-1.0)
CMP ( CMP and D Bili) eGFR 103.3 ()
Cortisol level CORTISOL (8am) 13.4 ug/dL (2.50-25.00)
Testosterone, free @ Free Testosterone(Direct) 7.3 pg/mL (8.7-25.1)
Testosterone, free @ Free Testosterone 99.6 pg/mL (50-244.0)
Uric Acid Uric Acid 5.7 pg/mL (2.6-7.2)
Cortisol level Cortisol (2:30pm) 9.37 ug/dlL (2.6-7.2)
LH Leutizing Hormone 2.9 ml (1-9ml)
FSH Follicle Stimulating Hormone 3.5 ml (2-10ml)
ACTH ACTH Hormone 42 (0-46) 10:30am

New test results below. …
SHBG 29nmol /L (16.5-55.9)
Thyroid panel
FT3 3.74 (1.8-4.2 pg/ml)
FT3 1.130 (.8-1.9)
TSH 1.89 (.4-4.0)
Progesterone .3 ng/ml (no reference given)
24 hr Cortisol 12.80 (2.5-25.00)
Dhea-s 176.8 ug/dl (160-449)
New free testosterone: 6.6 pg/ml (8.7-25.1)
Total T 229 (279-1730 ng/dl)
PSA .81 (.09-4.00ng/ml)

-describe diet [some create substantial damage with starvation diets]: Diet is clean and roughly 3000 calories a day. I follow a ratio split of 40 pro, 30 carb and 30 fats. Saturday�?�¢??s are honestly my best days as I eat everything in sight with no regard who�?�¢??s plate its sitting on. My sons learn to run because the food monster will come and munch on their sweets!

-describe training [some ruin their hormones by over training] : I�?�¢??ve been training for the past 10 years off and on. Started at 170 and within two years through diet and hard work made it to 210. These days it�?�¢??s just Big Beyond Belief 4 days a week and honestly I�?�¢??m just going through the motions. I can�?�¢??t honestly remember a good workout without gassing 30 mins in.

-testes ache, ever, with a fever? No, never.

-how have morning wood and nocturnal erections changed: I haven�?�¢??t woke up in a teepee in a long, long time! I wake up stressed with high heart rate and anxiety about how bad this day will be.

Other concerns: I have a few questios that a few seasoned vets may be able to answer.
Will my anxiety get worse?
Will this be forever?
Is a SERM restart possible?
How long can treatment be administered�?�¢?�?�¦safely?
What negative side effects have worried you the most?

Again, I understand each of you have lives to live and your life requires your attention and energy, so any information offered up and given will be very much appreciated.
Regards,
Test-one

Wow,you been through a lot.Your analysis of damaging your metabolic system as a result of starvation probably is a contributing factor to your childhood and adult metabolic stndrom. I can relate to Panic attack’s.I was injured at work and as a result of pain and worrie,I to developed an anziety disorder.My suggestion regarding your nutrition is get a dietician to design a proper protein,carb and fat’s to help you build a foundation,as steroid’s require a high protein diet to build and repair muscle tissue and keep your bodyfat low,or maybe even to reduce fat,as high fat mean’s Low testosterone and high estrogen. bset of luck john

Thanks for your reply Johnny.

I’ve worked with the late Swolecat aka Chris Juanz in regards to training and nutrition. I now follow Beradi’s precision nutrition guidelines as a lifestyle these days, but you are certainly right, a true relationship with a respected nutrition professional could only help.

What have you found to help you in your day to day struggle.

Your E2 would be acceptable, but not optimal, for a guy with twice your TT level. So your E2:fT level is not very good and this might be part of the reason that your LH/FSH is low. Reducing your E2 level seems to be the best think to try at this point.

We see lots of guys who focus on T levels when there are other problems that are not been recognized or addressed.

You have read the advice for new guys sticky. Please look at the iodine, body temperature, thyroid concerns. And your comments about stress suggest that adrenal fatigue should be considered. Your cortisol levels appear to be OK, but your adrenals may not be able to cope with the stress that you have.

Vitamins?
Fish oil?
Vit-D3?

[quote]KSman wrote:
Your E2 would be acceptable, but not optimal, for a guy with twice your TT level. So your E2:fT level is not very good and this might be part of the reason that your LH/FSH is low. Reducing your E2 level seems to be the best think to try at this point.

We see lots of guys who focus on T levels when there are other problems that are not been recognized or addressed.

You have read the advice for new guys sticky. Please look at the iodine, body temperature, thyroid concerns. And your comments about stress suggest that adrenal fatigue should be considered. Your cortisol levels appear to be OK, but your adrenals may not be able to cope with the stress that you have.

Vitamins?
Fish oil?
Vit-D3?
[/quote]

Thanks for the feedback KSman.

How would you advise the minut lowering of my E2? Arimadex? SERM? Or is this best accomplished by natural means through various mentioned herbs?

I’ve chased the Adrenal//thyroid rabbit but all test came back great. I followed the temp protocol as outlined in the sticky and all temps for a week were pretty steady at 97.3 with no major fluxs. This was all done four months ago as I began this journey of education and knowing thyself.

I’ve read about iodine deffficientcy and began to supplement with iodized salt (1/4 teaspoon) on all three main meals and I put a 1/4 of a teaspoon in the water I drink twice a day. This equates to a teaspoon and a half a day of extra salt in addition to what’s cooked with. As I type this I remebered the iodine skin test for deficiency. I will give that a try and see how quickly it may or may not be absorbed.

I don’t take any vitamins or fish oil. I honestly try and eat a lot of veggies and fruit each day with my meals or by mixing them in a shake. I will eat the occasional kid vitamin I give to me children from time to time. While on the subject of vitimans, I was told I have low platelets and was given all natural B12 methlycobalamine and within three days the muscle twitching stopped and I felt I could breath better and deeper. Take that for what it’s worth.

With your comment, “We see lots of guys who focus on T levels when there are other problems that are not been recognized or addressed”, are you inadvertly saying my testosterone total and free testosterone looks ok and it could be another hidden causative factor causing all of this disruption?

To be honest, I’m not looking to get on hormone therapy for the rest of my life. I’ve been fortunate to find a doctor in Amarillo TX that is willing to prescribe the trifecta of therapy mentioned so many times here, but I’m not yet willing to go that route just yet, not at least until I exhaust every other option first.

T replacement is not something that is simply tried for the sake of trying…or is that an option. I’ve considered running a three month trial and see where I land but before I do that I really wanted all of the feedback I could get in this forum. It’s like your at a car dealership and you’ve done the research and your ready to buy but you want someone to be the tipping point for you to take the plunge and in effect I’m opening up myself for that to be done here.

Again, your comments are treasured. This is a fight and knowing you have fellow sojourners somehow makes it easier.

New news is listed below…

I had an MRI performed and no pituitary tumors were found; however there were two things found. Terrible sinues, to quote him,“some of the worst I’ve ever seen”. More importantly something called Chaiari malformations were found. Essentially my cerebellum tonsils are displaced and are close to putting pressure on my brain stem.

Mean while back on the hormone ranch…

My physician also asked me something intriguing. He asked me have I ever been bitten by a tick. I respond yes I have and I immediately ask him, is Lyme disease on your radar? Yes, he responds.

The physician ran all new blood work to get a base of all my health markers before therapy begins in January.

Anyone traveled down the Lyme disease path before? It’s something I’ve never considered or contemplated.

Anyone?

Lyme disease is nasty. Not something you ever want. Yes, it can be treated. But for those with problems, if they have it, a diagnosis is good because things can get started.

You will be on antibiotics. This will mess up your gut bacteria [flora]. You will need to reset with a high quality broad spectrum probiotic. From a health food store and should be a refrigerated product.

You can read this or set it aside and see if the lab test is positive for Lyme.

How long ago was the tick bite and did you have a rash or bull’s eye rash? Your lawn work did create increased risks for that. Most tick bites do not cause any problems. People can get tick exposure via their pet cat or dog.

I am inquiring about a few posts regarding adrenals. Is there any way I can contact you outside of T-Nation? You seem to be quite knowledgeable so I’d like to run a few things by you…

Thanks!

This site has killed PMs. I do not have another account on another site that is PM enabled. I may be able to change that. If you want to have me go to a site where I can PM you, perhaps that will work.

You could set up a burner gmail account. That’s what I did.

Email addresses get deleted or the post with that gets deleted. The idea is to protect people who do not understand the spam risks, or from someone posting someone else’s address with mal-intent. Spam robots walk the WWW looking for @/’./’*

No Lyme disease…whew.

My latest results are on page one.

What could be causing very low free t? Symptoms described are still present.

I’m anxious to get my thyroid and cortisol test results back to really bring the picture into focus.

Thanks fir any responses.

Waking body temp should be near 97.7, 97.3 is the problem point.

Please add time of day to ATCH

Need cholesterol data. Concern is too low.

FT can be low because T is released in pulses and has a short half life. So the lab results have limited usefulness. Still a low number. With your TT and E2, you are getting estrogen dominant. SHBG could be lower, fits with the estrogen dominance.

AM cortisol is low. DHEA is getting low.

You have chronic sinus infections/inflammation? That can contribute to adrenal fatigue.

Thanks for the feedback, its really appreciated.

ACTH ACTH Hormone 42 (0-46) 10:30am

New test results below. …
SHBG 29nmol /L (16.5-55.9)
Thyroid panel
FT3 3.74 (1.8-4.2 pg/ml)
FT4 1.130 (.8-1.9)
TSH 1.89 (.4-4.0)
Progesterone .3 ng/ml (no reference given)
24 hr Cortisol 12.80 (2.5-25.00)
Dhea-s 176.8 ug/dl (160-449)
New free testosterone: 6.6 pg/ml (8.7-25.1)
Total T 229 (279-1730 ng/dl)
PSA .81 (.09-4.00ng/ml)

Yes I’ve had sinus issues my whole life but I usually just let it runs its course without the use of meds.

No obvious inflammation to speak of ie joints, arthritis, high blood pressure, etc.

My doctor has given me a script for Axiron or testosterone cypionate, the choice is up to me as to which to fill.

He said an AI (arimedex) can be given should E2 levels rise.

Hcg is a very tricky matter as my insurance may or may not cover it.

Ksman,I’m so very tired…as bad and as much as I don’t want to travel the trt road this young, I cant continue to be a sojourner on the current path I now find myself on.

Btw…body temps are rising and feet and hands are now warm after getting 500-1000mcg of iodine via good old fashioned table salt (surprisingly food taste better).

Of note. These test were taken after a minth of no traing whatsoever.

In your very brilliant opinion, is therapy a wise choice at this point?

Thanks again for your time. What you do for many men such as myself is extraordinary.

FT3 1.130 (.8-1.9)

should be

FT4 1.130 (.8-1.9)
–^

Better if fT4 is mid range, near 1.35

You will need more than table salt to build up iodine levels and see what comes of that.

You need to take DHEA, may be limiting T production.

Cholesterol?

If you could find a resolve issue(s) creating your secondary hypogonadism, then you could avoid TRT. If not, and if testes viable, hCG monotherapy might be an option, but then you are still doing injections.

You can try getting E2 down with anastrozole as well. There may be a few factors.

Ft4 has been corrected.

Ive tried to uncover issues upstream that could be the cause of low T but all of the things I’ve been tested for (thyroid, pituitary, adrenal issues, lyme, thyroid antibodies, addisons, cushings, comorbids, lupus, cancer, ms) has lead me to low T.

Hcg monotherapy does sound interesting but the issue then becomes procurement.

What other issues could I be overlooking? Ill read links if you wish to post.

How does one know with certainty that trt therapy is the answer?

?
How does one know with certainty that trt therapy is the answer?

Whatever your problem, low T is not making anything better.

hCG is available if needed. Least cost via compounding pharmacies.

We often see combinations of low T, subclinical hypothyroidism and adrenal fatigue.