T Nation

New- 40 and Low T

Hi all,

I’ve enjoyed reading up on T replacement therapy and I’d like to share my details…

At the age of 28 i went to my GP complaining of tiredness, not feeling like myself and somewhat depressed, he prescribed a AD (Efexor 75mg) and sent me on my way… If i knew then what i know now i would have never started on this path, it’s been a horrible experience… fast forward 10+ years and 100 lbs heavier i had high blood pressure, they put me on BP meds and again sent me on my way…

I really tried to get my high BP on track and after several conversations with my Doc she stated that the Efexor might be causing it, so she switched me to Zoloft 50mg and at that time i tested at 241 ng/dL total T and 10.1 free T ng/dL, GP stated that i was in the normal range and that i was fine. Also tested Vit D and that was low so i’ve been taking 50,000units weekly.

I went in for my 6mos check up for Meds and she wanted to test my Vit D again so i asked if she could test my Testosterone again. Well to our surprise it was Low, 221 total ng/dl and 8.2 free t ng/dl. At this point she refereed me to a Endo and after meeting with her she stated that she is treating people with TRT and she wanted to do more blood work to figure out if it was my Pituitary or Testies that was causing the issue. At this point she checked my Prostrate and my Testicles to my surprise… :slight_smile:
Age 40
Height 5’9
Waist 46
Weight 300
Body hair - chest and belly, not real thick, barely any hair in armpits, my Dad was the same way, facial hair is not real thick.
I carry the Fat pretty much in my upper body, stomach, and ass, legs are pretty muscular, i have a big frame.
On AD’s for the past 10 years, currently on Sertaline 50mg per day, vit d

CREATININE 1.03 0.72 - 1.25 mg/dL
PSA SCREEN 0.63 < 4.00 ng/mL
TESTOSTERONE,TOTAL 235 241 - 827 ng/dL
HEMATOCRIT 40.5 37.0 - 53.0 %
FSH 2.8 Undefined mIU/mL
LUTEINIZING HORMONE 2.3 See Range Chart mIU/mL
PROLACTIN 20.3 3.5 - 19.4 ng/mL
CORTISOL, TOTAL 13.1 Undefined ug/dL
IGF-1 (SOMATOMEDIN C) 224 106 - 277 ng/mL
T4,FREE 0.80 0.70 - 1.80 ng/dL
TSH 2.03 0.35 - 4.94 UIU/mL
ALT (SGPT) 35 8 - 45 IU/L
GLUCOSE 111 65 - 100 mg/dL Fasting

Diet - I have a vitamix gren smoothie for breakfast every morning the rest of the day I eat ok i guess, it could be a lot better, I usually eat cereal before bed.
Training - just started NROL (new rules of lifting) just completed week 2
Testes don’t ache normally but sometimes after sex it does, doesn’t last long

She stated that my Prolactin was slightly elevated and that it could be the Zoloft causing it but she scheduled a MRI of my Pituitary to rule out any tumors.
Results of the MRI indicated no Tumor and everything looked good…

I started on T cyp injections this past Monday 12/31/2012 100mg per week…

I have not really felt much of a difference and it seems from reading on here that it might take some time…

My symptoms at this time
No Morning wood - haven’t had that in years
Erections are good - no loss of erections during intercourse.
There are times, especially in the morning that i can not ejaculate - Probably due to AD’s
I’m always tired, love to take naps
Severe Brain fog
Never want to go do things

I put it this way with the Endo… and i think it best describes my situation.

I’ve always been the guy that had no issues talking to anyone, starting conversations or in-gauging in them…

12+ years ago, i could walk into a room full of strangers and have the best time of my life and walk out of there with a few new friends… Now - I WOULDN’T STEP into that room.

You can add data to your post above with the [edit] in the post’s lower RH corner.

SSRI’s can reduce the liver’s capacity to clear estrogens, thus decreasing T. You problems are deeper than that. Zoloft and all SSRI’s have sexual side effects. Wellbutrin does not and does not rewire your brain.

Effexor can act like a stimulant and burn calories and Zoloft is more calming. You may have noticed this effect. You could consider going back to Effexor if you feel that that was better. Wellbutrin can also be stimulating.

As prolactin goes up, dopamine goes down and vise versa. So a brain med that increases dopamine may lower prolactin. Prolactin is HPTA repressive. Wellbutrin may improve your dopamine and mood

Glucose is worrying.

Read these stickies:
-advice for new guys
– come back with more data and lab data
-protocol for injections
– you need to inject more than once a week
– with you body fat, estradiol could be a major problem
– understand T+AI+hCG
-the estradiol sticky
-thyroid basics
– post your body temperatures
– report iodine in supplements, use of iodized salt.

There is a lot of reading. Take your time. You need to understand this stuff and cannot be passive. You need to manage your own health care and will need to know more than your doctors.

fT4 is low, suspect subclinical hypothyroidism. Low thyroid function can make you fat and lower your T levels as well.

Labs:
TSH
fT3
fT4
total cholesterol
homocysteine
blood pressure
E2 !!!

To loose weight you need:

  • high normal TT and FT
  • E2 in the lower 20’s, E2=22 suggested E2 management is mission critical
  • optimal thyroid levels, fT3 and fT4 mid range or a bit better

Note that TRT will increase your metabolic rate, but if your thyroid or adrenals cannot keep up, you will hit the wall hard or just not feel that TRT is working. You need to consider these things.

Hey ksman,

My injection protocol is 1x week at 100mg, I 'm worried about my next labs being off if I jump to 2x week, I have a upcoming appointment in 2mos and she stated that I need to draw labs on the 4th day after my injection.

For the next labs I will ask the endo to add the following.

Ft3
Total cholesterol
E2 esterdiol
homocysteine

I don’t take any supplements tha include iodine and I just checked my Sea salt and it does not have any iodine. Should I try taking a iodine supplement? I will start taking oral temps and report back. For the Zoloft I’d really like to tapper down once the T is optimal as I’d like to get off AD’s in general, I believe that low T or hypothyroid could be the issue.

I have also been reading your stickies and trying to stay on top of this stuff, it’s a lot to take on… :slight_smile:

Thoughts?

I also forgot to mention that I have sleep apnea and on a CPAP machine for the last 2 years.

Oral Temps

Day 1
This morning as i woke up - 97.8
Checked it around 1:15 in the afternoon and it was 98.3

Day 2 Morning 97.7
Day 2 afternoon 98.3

Day 3 Morning 97.6
Day 3 Afternoon 98.5

I hav also just added fish oil and a wide spectrum multi vitamin.

Temps are not so bad, but you are iodine deficient and will need to supplement. The iodine in vitamins [.15mg 150mcg] or in iodized salt will not get the job done. So try the replenishment in the thyroid basics sticky.

[quote]KSman wrote:
Temps are not so bad, but you are iodine deficient and will need to supplement. The iodine in vitamins [.15mg 150mcg] or in iodized salt will not get the job done. So try the replenishment in the thyroid basics sticky.

[/quote]

Thanks KSman,

So in the thyroid basics you mentioned that you started at 50mg and went to a lower dose after it effecting your gut bacteria, what dose did you get down to and is it helping you maintain?

Just wondering if i should start on a lower dose than 50mg?

You can do 1/2 for twice as long. Body temperatures are a good guide post. In my case, I felt a lot better as well.

I’m on my 4th week of therapy now, injecting 100mg 1x week and i’'ve noticed some weight gain, keep in mind that I’ve been lifting weights 2x week. This past week I have gained 1lb a day and feeling really frustrated…
I decided to reach out to my Endo and ask that she order me a esterdiol E2 test to make sure my levels are not getting to high.

Here is her response…

“Hi, I wouldn’t recommend checking an estradiol level for you. If it is high, then that would indicate that you are on too much testosterone - and the appropriate treatment would be to lower your testosterone.
Instead, I recommend having your testosterone level/safety labs drawn - they should be drawn midway through your injection cycle - if injecting once weekly - then have labs drawn four days after an injection.”

I am completely at a loss for words, this seems to go against anything I’ve read, does she know something that I don’t?

She has a world view that is narrow. Do your own labs.

[quote]KSman wrote:
She has a world view that is narrow. Do your own labs.
[/quote]

Anyone know where i can my own labs done in MN?

Thanks!

“Age 40
Height 5’9
Waist 46
Weight 300 I carry the Fat pretty much in my upper body, stomach, and ass”
“GLUCOSE 111 65 - 100 mg/dL Fasting” <-- prediabetic!
“I’m always tired, love to take naps
Severe Brain fog
Never want to go do things”
“zoloft…sertraline…”
“I have a vitamix gren smoothie for breakfast every morning the rest of the day I eat ok i guess, , I usually eat cereal before bed.”

“it could be a lot better” <–Cereal? yes it sure could.

I was you 2 years ago, only 5" taller and 40 lb heavier still. I gave up grains (refined & “healthy” alike) along with sugar/soda/juice/milk (cut total carbs to ~50-75 gr/day) and embraced what ‘they’ say will kill ya (red meat, saturated fat, cholesterol) in the form of minimally processed fatty meat, poultry, fish, eggs, fresh greens/veggies, aged/fermented full-fat dairy and fresh fruits.

After 22mos of this deadly 66% fat diet I’m now sitting at 215 lb with healthy BP, blood sugar/A1c and lipid #s, and no more zoloft, beta-blockers or ppi’s…and minus the continual brain fog and fatigue and a host of other health complaints.

Guess I’m a broken record today, but I would urge you to read some Gary Taubes or Mark Sisson or William Davis, and re-evaluate the diet, regardless of what you do for HRT.

Farrago’s thread is here if interested: http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/help_hack_my_trt

Sounds like a great result.

Not everyone’s metabolism is the same.

[quote]farrago wrote:
“Age 40
Height 5’9
Waist 46
Weight 300 I carry the Fat pretty much in my upper body, stomach, and ass”
“GLUCOSE 111 65 - 100 mg/dL Fasting” <-- prediabetic!
“I’m always tired, love to take naps
Severe Brain fog
Never want to go do things”
“zoloft…sertraline…”
“I have a vitamix gren smoothie for breakfast every morning the rest of the day I eat ok i guess, , I usually eat cereal before bed.”

“it could be a lot better” <–Cereal? yes it sure could.

I was you 2 years ago, only 5" taller and 40 lb heavier still. I gave up grains (refined & “healthy” alike) along with sugar/soda/juice/milk (cut total carbs to ~50-75 gr/day) and embraced what ‘they’ say will kill ya (red meat, saturated fat, cholesterol) in the form of minimally processed fatty meat, poultry, fish, eggs, fresh greens/veggies, aged/fermented full-fat dairy and fresh fruits.

After 22mos of this deadly 66% fat diet I’m now sitting at 215 lb with healthy BP, blood sugar/A1c and lipid #s, and no more zoloft, beta-blockers or ppi’s…and minus the continual brain fog and fatigue and a host of other health complaints.

Guess I’m a broken record today, but I would urge you to read some Gary Taubes or Mark Sisson or William Davis, and re-evaluate the diet, regardless of what you do for HRT.
[/quote]

Farrago,

Thanks so much for taking the time to comment, I’ll be reading your thread and looking up the others you mentioned. You are giving me some hope…

Help!!! Help!!!

I’m having a hard time getting and keeping a erection, I never had a issue in the past… The only thing I experienced was low drive before TRT.

You really need to get E2 tested. More than likely it is high E2 causing the ED. If your doc won’t test you need to go online and order your own blood tests and self medicate with arimidex if needed. There is a good sticky on E2 that you should read and take notes from.