T Nation

New Guy: 43, Labs, Not Sure Where to Go from Here


#1

43 years old
5' 11"
220lb
40in waist
health conditions: none
medications: none
I weight train
I eat well (240g protein, 275g carbs, 75g fats), plenty of red meat, all the veggies, very little if any processed foods
Bald for 20 years, plenty of body hair, very full beard
I eat seafood and use iodized salt- I've taken temps with satisfactory results
Testes very rarely ache- maybe twice in the past few years

Symptoms:
I'm wiped out most of the time, no matter how much I sleep
Mental fog
Recovering from workouts is getting worse
Libido is hit or miss, steady decline in the past 10yrs
Morning wood is hit or miss. Some days it's great, many others there's nothing
Erections are going away faster than they used to
Carrying a stubborn spare tire
Moody

Test Results:
Testosterone, Total 342 ng/dL 175 - 827 ng/dL *
Testosterone, Total Ultrasensitive 452 ng/dL 250 - 1100 ng/dL
Testosterone, Free 79.1 pg/mL 35.0 - 155.0 pg/mL
Estradiol 19 pg/mL <=47 pg/mL
FSH 7 mIU/mL <=18 mIU/mL
TSH 2.4 uIU/mL 0.3 - 5.6 uIU/mL

CBC- everything in range.
Same with the Comprehensive Metabolic Panel.
LH can't be done in network for some reason. I'd have to go outside for that.

  • First Testosterone test was one week earlier than the ultrasensative

My PCP was/is ready to prescribe Clomid, as she feels the TT (first test) is low. I'm not sure where it'd take me, but willing to give it a try if it might be helpful.

Looking at the latest results, I may not be a candidate for TRT... but honestly don't feel I've got the quality of life I'm satisfied with at the moment.


#2

But there is often more to that story.
Hematocrit?
RBC?

TSH is way too high. Something is wrong. Please double check label on salt container.
Please share AM and mid-afternoon oral body temperatures.

Are your outer eyebrows sparse? That is a sign of thyroid problems.

FSH quite high relative to T levels. Could be primary hypogonadism. LH would be good context for other concerns. LH should be in-network, because lower LH and high FSH can be from a FSH secreting testicular cancer. However, such cancers typically show up at an earlier age.

Clomid will increase LH/FSH, but FSH is relatively high now and seems like a lame idea. There does not seem to be much headroom left in LH/FSH. Have your testes been examined for any abnormalities?

Please read these stickies found here: https://forums.t-nation.com/t/about-the-t-replacement-category/38/2?u=ksman

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

#4

Hematocrit 43.9 % 40.1 - 51.0 %
RBC 5.14 M/uL 4.63 - 6.08 M/uL
(complete results below)

Salt: Himalayan, "Serving Size (1/2 gram), 250 micrograms of iodine"
I also eat a lot of eggs, grass fed/raw dairy, etc.

Outer eyebrows: somewhat sparse I suppose, though they've always been.

I'll re-take my temps, though here are my last results from June:
Morning: 98.0 (averaged over 5 days, but within .1)
Mid Afternoon: 98.6 (the same each day)

LH test: I'll try getting it through my DR, otherwise I may have to do discountlabs or something like that. My DR is pretty cool with this, but the provider/insurer, which has its own lab, is pretty conservative and apparently won't allow some tests without a fight. Lame? Yes.

Testes: They've been examined, by a professional, even. :smiley:

edit: I've also read the stickies and have been following/lurking the forum for some time, while researching.

8/23/16
White Blood Cells 5.04 K/uL 4.23 - 9.07 K/uL
RBC 5.14 M/uL 4.63 - 6.08 M/uL
Hemoglobin 14.8 g/dL 13.7 - 17.5 g/dL
Hematocrit 43.9 % 40.1 - 51.0 %
MCV 85.4 fL 79.0 - 100.0 fL
MCH 28.8 pg 25.7 - 32.2 pg
MCHC 33.7 g/dL 32.3 - 36.5 g/dL
RDW-SD 40.30 fL 35.10 - 43.90 fL
RDW -CV- 13.00 % 11.60 - 14.40 %
PLT 252 K/uL 135 - 400 K/uL

Glucose 99 mg/dL 60 - 99 mg/dL (wasn't fasting)
Creatinine. 0.8 mg/dL 0.7 - 1.3 mg/dL
BUN 23 mg/dL 7 - 25 mg/dL
Total Bilirubin 0.6 mg/dL 0.3 - 1.2 mg/dL
Total Protein 7.2 g/dL 6.0 - 8.3 g/dL
AST 29 U/L 14 - 50 U/L
ALT 62 U/L 10 - 35 U/L (heavy squats = elevated enzymes)
Albumin 4.8 g/dl 3.4 - 5.0 g/dl
Alkaline Phosphatase 90 U/L 35 - 104 U/L
Calcium 9.5 mg/dL 8.6 - 10.3 mg/dL
Sodium 137 mEq/L 135 - 145 mEq/L
Potassium 4.1 mEq/L 3.6 - 5.0 mEq/L
Chloride 100 mEQ/L 98 - 107 mEQ/L
CO2 28 mEQ/L 21 - 31 mEQ/L
Glom Filt Rate, Est 101.1 mL/min/1.72 m^2 >59.5 mL/min/1.72 m^2

edit:
futher Thyroid tests from last year:
TSH 2.29 0.27 - 4.2
Total T4 7.6 4.5 - 11.7
Free T4 1.48 0.93 - 1.70
Total T3 1.2 0.8 - 2.0
Free T3 3.4 2.0 - 4.4

AND... as of moments ago, the DR doesn't want to do anything... just "exercise more and eat healthier"
I squat 400+lb 2 days/week, deadlift, bench... I lift pretty hard. I also eat well... all organic, grass fed, all that jive. My wonderful wife works in the natural food industry- we eat well


#5

5 days of temperatures:

Morning 97.9 average, 97.6 - 98 range

Afternoon 98.6 average


#6

KSman, I could use your help with my topic on low E2 and high total E if you can help.


#7

That seems odd. Most salts as they crystallize reject iodine. Does package state iodized?

I cannot find any references to support "Serving Size (1/2 gram), 250 micrograms of iodine"

I have seen other guys on this pink salt who have been iodine deficient.

Thyroid labs good, but too much TSH needed to push thyroid to get work done.


#8

The package only states what is quoted, which I'm willing to take with a grain of salt :smiley:

I'm not opposed to taking an iodine supplement, if it'd help. My Dr was pretty dismissive of thyroid in general, so I've given up asking her. I've kinda given up asking her much of anything...

I showed my labs to a family friend who's an ND. Her first questions were thyroid related, and she's referred me to another ND who specializes in hormones & thyroid.


#9

Anything to report?
Iodine supplements?


#10

Nothing to report yet- I have to meet with the new ND, but there's been other family health concerns that have been taking my time and energy. I'll get on it in the next couple weeks.

In the meanwhile, I've been eating seaweed and got an iodine/selenium supplement.

Updates to follow...


#11

Met with the new doc... more blood taken... another appointment tomorrow to get started.

so far his "standard" suggested protocol to begin with is 50mg Test Cypionate 2x/week, subcutaneous with 1/2" #29 (or 28- I forget) 0.5ml insulin syringes, Anastrozole if needed... and HCG if I want it (I don't), bloodwork at 30 days (and quarterly thereafter) and adjust as needed to get test to ~1100 and keep estrogen ~22 as well as see how I feel overall, monitor hematocrit, etc.
Basically everything I've read here...

I've been supplementing with iodine & selenium for the past month. Further update when those test results come back.

I will say it's refreshing talking to a Doc that actually LISTENS, explains clearly, and takes an overall holistic approach. A lot of that is probably because he's a Naturopath. NDs can be a PCP in Oregon, so I'm jumping ship from the corporate DR I've been seeing.


#12

You want the hCG. It mimics LH so that all of these gold star enzymatic conversions happen. Keeps all the other hormones behind Testosterone in balance.