T Nation

Newbie - Lab Results


#1

Hey guys

Wanted to share my story (condensed version) with you guys. Been doing a TON of research on T and T-replacement. Read Jay Campbell’s book, been all over this site and others and i’m continuing to learn as much as I can. 3.5 months ago, I knew very little about this subject, other than a relative or two on it.

So, quick story:

Have always been healthy. 37 years old, 6’3, 200lbs, played college and European pro hoops. Married with 3 girls - 8, 6, 2. Eaten paleo for last 5 years, 10% body fat, no health problems (that I knew of).

Had vasectomy done 3.5 months ago.
About 3-4 days after, experimented with the plumbing downstairs, which at the time felt fine. After that point, all systems seemed to go haywire. That seemed to be the turning point and since then have had the following issues:

  • ED - loss of firm erection, very little nocturnal erections (if at all), trouble maintaining erection, 100% not the same. For about a week after day 4/5 I had NO FUNCTIONING down there
  • Pain in Epi - had brutal infection about 1.5 months ago (2 months after). Left side blew up like a tennis ball, very painful, fever, chills, etc. Been on Doxy for 4-5 weeks now, which calmed everything down. Epi pain is down to about a 2 vs. an 8/9 when I eventually had to go ER one nice with the 8/9 pain.
  • prostatitis problems - pressure, frequenet urination off and on,
  • Joint pain - knees, neck (chronic stiff neck), crepitus in knees - never had any of this before
  • Brain Fog
  • Anxiety/Depression issues
  • strange feeling post ejaculation (lethargy, tired, almost hungover feeling)
  • overall fatigue - tired in AM, muscle fatigue, weakness, etc.

I’ve felt OFF basically since day 4/5 post V. I’ve gotten better, symptoms have improved, but no where near where I want to be.

I decided to have my blood work done. Total T seems good range, but other hormones seem really off. I’ll post below. Let me know if you would like to see other numbers.

Total T - 689 ng/dl (348 - 1197)
Free T - 9.8 pg/ml (8.7-25.1)
Pregnenolone - 29 ng/dl
DHEA - S - 123.6 ug/dl (102.6 - 416.3)
Cortisol - 12.7
Estradiol - 23.2 (7.6 - 42.6)
DHT - 54 ng/dl
SHBG - 53.7 nmol/L (16.5-55.9)
Hematocrit - 49.7 (37.5-51)

Current supplements for about the last month - Vitamin C 3-5g per day, Vitamin D 10,000 per day, Vitamin B complex, L Arginine, L-Glutamine, Probiotic, Stinging nettle, think that’s it.

I’ve done a lot of research about how certain hormones tank post V.

Would love to hear thoughts on the above #'s.

I can try to upload all lab results if it makes sense.

Thanks guys


#2

Have you tried lowering SHBG? I only know of testofen for this (Fenugreek supplement), but I’m sure there is other stuff out there that does that. Is that why you’re taking the stinging nettle?


#3

Just got these results yesterday. Didn’t know my SHBG was high and Free T was being impacted by it. Just knew i’ve been feeling like shit.

Seeing Dr. soon that is on progressive side so hopeful he’ll be able to help.

But, wanted to see thoughts from all of you guys so that I was prepared heading into my appointment.


#4

I would work on that SHBG and see what happens there. Your Total T is fine, but your free T is low. So, you’re making the test but it’s not available. I can’t comment on the vasectomy, don’t know anything about that.


#5

Vitamin D and Nettle both supposed to help with SHBG, which i’ve already been taking.

Other things that could impact me feeling like shit are really low pregnenolone and DHEA.

Vas can mess with hormones, I have no doubt about that now.

Thanks for the feed back @illuminatus5.


#6

Please read these links found here: About the T Replacement Category

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

Your T is low, but you do not know if its the testes or lack of LH/FSH. Do not start TRT before testing LH/FSH. Many docs do not do proper diagnostics.

Any other lab results?
Need:
TSH
LH/FSH

Take 5000 - 6000iu vit-D3, find tiny oil caps that strong each.
Take 25mg DHEA with lower fiber higher fat meals

Have you been using iodize salt? - history

E2 is not bad, but with FT=9.8, you are very estrogen dominant.
SHBG is high and that leads to more T+SHBG that is not bio-available and less FT

So you had a post-op infection from V?
Any exposure to ticks and perhaps Lyme disease?

Time of day for the lab work?


#7

You need to understand( most are unable to) that TT is not your actually T production. I have posted about this a lot recently, cause I have the same sort of blood work.
I have spent almost half a year on researching about this and have read books and expert opinions about shbg. Shbg does NOT eat up your FT. You need to process that first. Your TT is being inflated by high shbg. Shbg slows down clearance of T hence inflating TT in blood measurement. The FT is the only T that is relevant, maybe bio available is too but TT is useless when shbg is elevated or when low.

FT is the actual production of T. Do not think of that your T is very good and being “blocked” by shbg. Primary testicular problems seem to show this type of labs more as I have seen. In my case, my LH and FSH are good, but FT is low and shbg high as well. This is bro science that shbg eats up T. If you act on reducing shbg directly such as by taking danozol (rX), you will see that your FT will remain the same but your TT will drop. It’s clear there’s some dysfunction in the testes, since the timing of your symptoms appearing.

Suggest to stay away from stinging nettle root and likes, these inhibit T—>DHT conversion which can mess up things beyond repairing if you’re unlucky.

Search bill Roberts shbg on this forum, he had posted some good analogies to understand how shbg and TT work speaking in bio chemistry perspective.

This is my 2 cents! You will have to take your informed decision.


#8

Thanks so much for the reply. I actually did get tested for Lyme’s and was negative. I am in a high exposure area in the Northeast and my parents live up on the mountain where I’m staying right now as I am selling my house and building one. One of my daughters has had lymes as has my father. Interesting that you bring that up.

I don’t have LH/FSH or TH unfortunately.

I am taking 10,000 vitamin D already. This ok?

I have DHEA but haven’t been taking that. Wanted to wait til I got proper feedback.

I haven’t done anything with iodized salt.

Blood work 9am on empty stomach.


#9

Very, very interesting.

My TT has definitely perplexed me. In fact I had it 3 weeks after V and it was low 500s. And FT was 12.3.

What are you doing for your personal regiment if you don’t mind me asking? Curious since you said our blood work is similar.

I am going to research Bill Roberts when I have a moment.

Appreciate you guys!!


#10

If you are not using iodized salt, you are iodine deficient.
Please check your oral body temperatures as suggested in the thyroid basics explained link.


#11

Thanks @KSman.

Frequently have had cold feet, hands and nose since the vasectomy as well


#12

After considerable weighing up , I’m young so had a lot to weigh up. I’ve started TRT 2 days back only as a matter of fact. I will update you as to my symptom alleviation. I will get back to you a couple of months in.


#13

Good luck to you man. Thx for your feedback. What form of T are you taking?


#14

This may be indication of low thyroid function.
Please explain re iodized salt.


#15

Good info, I did not understand that relationship between SHBG and free T. I always thought it was the cause of low Free T, broscience be damned.


#16

I’m wrong. I did have TSH measured.

1.63 (.45-4.5)


#17

Any direct links regarding the SHBG connection? Want to read up as much as I can on it. Thanks


#18

There’s nothing on the Internet to explain it like I did. But a lot of papers I read about hypogonadism screening said “normal TT could be misleading in people with primary testicular disorder where low testosterone levels and increased aromatisation in the testes stimulate the production of shbg from the liver, which results in higher total testosterone measurement than would otherwise be expected with low circulating testosterone.”

It’s the body builder crowd that make it sound like your shbg is the problem. The truth is that shbg measurement serves no purpose other than determining the level of free testosterone from total testosterone, it is not causative of it.

From the number of threads I have also browsed through here or at other forums, I have seen people with increasing TTs while FT remaining same, only due to the increasing shbg levels. You will also see people with higher shbg seeing their shbg dropped after some time and you’ll see that their FT remains the same but their TT drops.

I know it’s hard to take in, bro science has explained it in a very different way. Even if you can’t understand or acknowledge this, know that the end result for your treatment wouldn’t change. There’s no natural way of improving FT or for people with normal shbg and TT unless you’re very overweight, don’t eat right and have other diseases. Shbg is lowered by FT and increased by estrogen, in any case T is needed.

Go to a doctor who knows his stuff in TRT, if you see any expert talking about TRT, they’ll stress how they sometimes don’t even check TT when managing TRT.

I’ll try to pull up some of the papers i read later. My initial protocol is the one suggested on here. 100mg T enanthate divided into two subQ shots, 250 iU hCG EOD and 1mg/week anastrozole. Will make adjustments to the dose after 1st follow up blood reports. Aim is to get fT on the higher end of the range, TT will be inflated due to high SHBG, this needs to be ignored for most part, e2 to be modulated near 20-25 pg/ml. SHBG should drop considerably over time if fT is high and e2 is controlled.


#19

Thanks for the reply. @equalo212. You’ve provided some awesome advice and understanding of the connection between SHBG and Free T, TT.

I saw a Dr yesterday down in CT that specializes in Thyroid, Adrenals, and Hormone therapies. He is concerned that I am a fairly complex case. Did I have underlying issues before? One thing that definitely muddies my waters, which I failed to mention in my initial post, is that I had a candida overgrowth found in my esophagus about 6-7 years ago, which is what prompted me to cut sugars, carbs, breads, pastas etc out of my diet and ultimately led me to a paleo lifestyle. I probably eat paleo 90% of the time and this seems to control symptoms. This was discovered because I was struggling with frequent heartburn. I am attributing this overgrowth to two separate rounds of IV ABx because of blood poisoning, frequent ABx when younger and a normal college lifestyle - beer, booze, pizza, etc.

My Dr was concerned with this. He was concerned with another interesting thing. I have NO REFLEXES. Haven’t for years now, probably first noticed around the time of the Candida discovery. If he tests in the knees, achilles, etc there is NO reaction.

He is exploring the Thyroid angle for sure because of symptoms - cold feet/hands, fatigue, mood swings, etc. I had a bunch of blood work done this AM so we’ll see how this looks.

I took armpit temperature first thing this AM with mercury thermometer, which was 97.4. I know @KSman mentions in sticky to NOT do armpit but this is what Dr told me to do.

Couple of other side notes after reading around the forum with regards to my background. I’m 6’3 and always been on skinny/lean side. Since college i’ve definitely bulked up through playing sports/training programs. Always been about 190-205 range since college days. body fat always under 15%. VERY little chest/body hair. Can grow beard okay, pretty full.

With regards to my issues from the Vasectomy. One of the reasons that TRT really interests me is because of the shutting down the sperm production, for two reasons. I’ve been having epididymitis pain, based on ultrasound and Uro diagnosis, which is something that can happen post-vasectomy…of course NOT something that is discussed by Uro beforehand. Anyhow, it’s on one side (left) and can be from infection, and resolve, or can be from congestion, which i’m starting to feel like I have. With congestion pain, one of the treatments is TRT because it shuts sperm production down, thus eliminating the backup of sperm. There’s a lot of research on this. Additionally, without the sperm production, the Autoimmune response that can happen after vasectomies is also mitigated.

I am concerned now though that I may be suffering from AI issues.

So, with my situation, I have low Free T, a bunch of other hormonal numbers being off - DHEA, Pregnenolone, SHGB, etc plus the Vasectomy reasons to possibly start TRT.

Just curious to hear thoughts based on additional info provided.

Thanks guys for your help thus far.


#20

Repeat:
This may be indication of low thyroid function.
Please explain re iodized salt.