T Nation

New Member, Please Help Guide Me

New Member. Please help me.
Hi all. This will be long, but I want to join the brotherhood.
6 month deep lurker, now I’ve decided to join.
I wanted to wait until I got my second lab set to join so I can post accurately.
Let me introduce my situation; I’m 31 years old, 6’1, 295 lbs., caucasian, and am happily married. I am en ex-arena football player (linebacker) and current baseball player.
I’ve been a medic since 18 years old, and always very active in the gym and martial arts. A year ago, I had a complete mental breakdown due to a large prednisone shot
in the ER that literally destroyed the man I built for 30 years. I gained anxiety, depression, brain fog, and ptsd from the med, as well as losing lots of money. For 6 months straight I puked blood, almost died twice, and am only about 40% recovered from what happened, despite my thorough efforts. I am pre-med in college, high honors (almost finished), and have a very strong understanding of the body systems/functions. I’m not arrogant, am very empathetic, and have a willingness to learn. I have an appointment this coming Friday for a reputable men’s anti-aging clinic in San Diego, with what seems to be an up-to-speed Dr. I originally started paperwork with Defy, but the wait was long, and finding a physical proved to be challenging. My goal is to get started at this place, then switch to Defy when the time is right. My father-in-law is an Endo, and is pushing for me to do test replacement, he actually brought it up. I have been donating sperm just in case HCG does’t work out, last two donations are this week.

Current Meds:
Valium- 7.4 mgs, tapered down from 25 mgs. (hell on Earth)
Remeron- 11.75 mgs, tapered down from 30 mgs. Gained 50+ lbs. on this in 6 months
Zoloft- 16.75 mgs
Asthma Medication. Lifelong asthmatic here
I’m going to be honest, I absolutely hate psych meds. Been on them 1 year, there’s just nothing like them.

OTC Supps-
As time goes on I’ll post them, because there are just so many to list.
But yes, I do take iodine and selenium.

No alcohol, smoking, or drug use. Some CBD oil. No previous steroid use, despite prednisone (evil).

Nitty Gritty: Symptoms, info and labs
Depression, brain fog, lack of energy and major sluggishness, cold and feverish feelings frequently, minimal gym results despite various methods, anxiety, loss of zest for life (quiet and down a lot), sexually ok but could be better, mood swings. Sleeping way too long and not feeling refreshed, I even use nasal strips on an elevated tempur-pedic bed. I’ve got a sleep study on the way to check for sleep apnea; 18 1/2" neck, 56" chest, and asthmatic. Gained 50+ lbs. in about a year, got up to 330lbs. despite solid efforts. Got weight back down a bit by tapering down some psych meds, and cutting out some sugars. I’ve got a bloated/pregnant body builder look going on, not digging it at all. Diet is what I think to be ok, no fast food, use grass fed meats, aged cheeses, coconut oil and olive oil, fish oil, grass fed butter for fats. I do enjoy red meat, but eat cuts like top sirloin, new yorks, and ground sirloin, lots of fish such as salmon and tuna, and egg whites daily. No chicken or poultry, I’m allergic (but can eat eggs, I know, weird isn’t it?!). Sugar is my raisin bran for desert, 1 16 oz. cup of gingerale with dinner, and kefir in the mornings. I have one half-caf coffee a day, nothing but coconut oil added.

Labs: Some have previous results, some do not
I’ll spare you all the unimportant ones.

*Testosterone, Serum: 196 ng/dl Low, previously 284 ng/dl Low, range-------- 264-916 ng/dl
*Testosterone, Free: 7.5 mg/dl Low, previously 8.0 mg/dl Low, range------- 8.7-25.1 mg/dl
*Glucose, fasted: 99 mg/dl Normal, previously 99mg/dl Normal, range------- 65-99 mg/dl
*A1C-: 5.2% Normal, previously 5.2%, range------- 4.8-5.6%
*TSH: 5.63 High, previously 5.070 High, range-------- 0.450-4.50
*T3- they did total: 115 ng/dl Normal, range----- 71-180 ng/dl
*T4- they did total: 5.9 ug/dl Normal, range------ 4.5-12 ug/dl
*Hematocrit: 44% Normal, previously 43.4% Normal, range--------37.5-51.0%
*PSA: 0.8 ng/ml Normal, range-------0.0-4.0 ng/ml
*LH: 3.5 Normal,range------------1.7-8.6 mIU/ml
*FSH: 4.1Normal,range----------1.5-12.4 mIU/ml
*SHBG: 21.1Normal, range -------16.5-55.9 nmol/L
*Estradiol, Sensitive: 32.9 Normal, range------8.0-35.0 pg/ml
*Vitamin D, 25 Hydroxy: 103.0 High, previously 30.6, range-----30-100 ng/ml
*Vitamin B12: 931, no range
*Folate: >20, no range
*Total Cholesterol: 200 High, previously 199 High, range------100-199 mg/dl
*Triglycerides: 223 High, previously 256 High, range------0-149 mg/dl
*HDL Cholesterol: 36 Low, previously 37 low, range----- >39 mg/dl
*VLDL Cholesterol: 45 High, range-------- 5-40 mg/dl
*LDL Cholesterol: 119 High, previously 89 Normal, range-------- 0-99 mg/dl

From my scientific mind, I am suffering from low testosterone likely idiopathic and secondary hypo, sluggish thyroid pushing towards if not hypothyroid, and good possibility of sleep apnea. Two years ago, testosterone was mid 700’s, TSH 1.5. I’m likely going to do Test Cyp on an EOD or ED protocol, and a small amount of HCG daily 50-150, with the goal of using very little AI as possible. Will likely get on a small dose of NatureThyroid or WP Thyroid, and try titrating up. I’d love feedback, all kinds, give me what you got. I want to be part of the team and fix my fuc&%$! life. What are your thoughts on the SHBG? What are your thoughts on the E2 sensitive? I paid over $300 for labs to make sure I had most of the info I/you all needed. I await and look forward to your responses, thank you for your time.

Welcome to T Nation,

The first thing I must mention is you need to get off these medications especially Valium, these medications will wreak a guy’s testosterone levels and cause pituitary disorders. Previously 30 year Klonopin user here and know how bad withdrawal can be and is the reason I’m on TRT.

These medications will greatly diminish TRT’s effectiveness and you will not feel as good as you should, these are mind altering drugs and they’ll do you no favors in the long term, quite the opposite.

Thyroid disorders can cause depression, anxiety and emotional problems. Low testosterone can also cause emotional disturbances such as mood swings, crankiness like an 90 year old man.

There are a lot of dudes out there with undiagnosed thyroid issues and low testosterone who are routinely prescribed SSRI’s to deal with their emotional disturbances. Sound like anyone you know?

You need a full thyroid panel checking fT3, rT3, fT4 and antibodies. You need to inject 50mg twice weekly, 250iu HCG 2-3 times a week and .5mg anastrozole taken with T-Cyp injections.

It would be interesting to see what would happen to your testosterone production if you were able to fix your thyroid issues and stop these medications, you might regain control of your testosterone production. You say two years ago your testosterone was in the 700 range, when did you start taking all that medication?

Your SHBG level will likely rise once you address your thyroid, when thyroid function is low SHBG is usually low. Aromatase activity lives in the fat tissue and this will increase your estrogen levels, lose the fat and you reduce the AI dosage requirement and or completely eliminated it all together.

Thanks for the reply.
Trust me, my goal for a year straight now, has been to get rid of these damn meds. It has been absolute hell. Even done slowly, water titration, is painful. I know one day I will be free, just don’t know when that one day will be.

I’ve taken these meds for one year now, after the prednsione. Before this, nothing but supplements and asthma meds. Like I said, 2 years ago, 700 test and normal thyroid numbers. I suspected a thyroid and testosterone problem about 7 months ago when a barrage of symptoms slammed me that I’ve never had. I’m likely going to start on a small dose of WP Thyroid and see where that takes me. I start testosterone this Friday, more than likely at 100mg weekly. I’ve been talking to those who’ve worked with Dr. Crisler and Dr. Saya at Defy, who have done well with ED or EOD smaller injections of both test and hcg. I will consider other routes, but am probably headed that way.
I’d love to keep the floor open and see how others have done, or what can suggest. I’m a learner!

Don’t expect anything from TRT until you address that thyroid, TRT attempts to restore metabolic rates and a low-functioning thyroid can make you feel worse as the thyroid cannot keep up with the demands. Lots of guys that come here have undiagnosed thyroid issues and start TRT and wonder why doesn’t work or why they feel worse.

I agree with this below

I’ve heard firsthand accounts where a guy had full hormone panel performed 6 months before he went on Lexapro and he had a TT of 900+ and a year later after starting Lexapro he scored a TT of 300!

Finally got off most meds. Still working on my thyroid, I’ve been given sub clinical hypothyroid now. Testosterone has been incredibly frustrating. I’ve tried so many methods. Trying to find out how to microdose aromasin. Any ideas? Got 25 mg pharm pills, only 6 of them though. Took 6.25mg to help and day 2 horribly depressed and dry. On scrotal cream now, was doing ok. Would love to find out how to pm you systemlord because you’ve gone through a lot of what I dealt with.

I think 6.25mg aromasin is too much, you need to start lower, try using a pill cutter and cut into smaller pieces and take it once weekly and see how you do. It can take awhile to dial-in thyroid and TRT, of course having a good doctor is most important.

It can take a while to dial-in thyroid sometimes. I think you gave up on injections too soon at a time when your thyroid was still struggling.

There are no PM’s on T-Nation.

Those meds you are on are causing these issues. Low t and thyroid is bad. Your levels are low like mine were. How you function and go to school god knows. I couldn’t do it.

Get your thyroid fixed ASAP with armor thyroid and or compounded t4/t3. It fixed my fatigue and etc. Trt didn’t work until I started thyroid. So don’t waste your time if your going to do trt alone.
You will eventually start thyroid complaining of fatigue and depression.

Why don’t you just tell your father in law to be your doc :slight_smile: he’s probably just waiting.