T Nation

Pondering TRT, Here are My Labs


#1

-age: 32
-height: 5'11
-waist 35 inches
-weight: 195
-describe body and facial hair: Hair grows like a weed, beard is full and thick.
-describe where you carry fat and how changed: Stomach primarily.
-health conditions: Started messing around with pro-hormones at 17, did one cycle of sustanon 250 at 18 years old, never did a proper PCT, but didn't have symptoms at that time. Developed anxiety/panic disorder at about 19-20 years old, was smoking a lot of pot, not working out. Started working out again from 20 on up and felt better. Was active duty Air Force from 2004-2010, afterward started nursing school and got addicted to caffeine, currently take in about 350mg/day. I am a full time RN currently and have noticed increased brain fog, increased anxiety, lack of motivation, evening time fatigue, irritability, easy weight gain, mediocre gains in the gym.

-Rx and OTC drugs: No Rx drugs currently

-describe diet: Low gluten, about 150 grams of protein/day, occasional beer drinking on the weekends.
-describe training: 5 days per week, I left 3 days per week with (chest, bi's, back/tri's, legs/shoulders) and I box the other two days.
-testes ache, ever, with a fever: Never
-how have morning wood and nocturnal erections changed: Minimal morning word, but erections during/after dreams.

Labs:

CBC normal
Electrolytes normal

Serum Glucose 84 (65-99)
BUN 12 ( 8-19)
AST 34 (0-40)
ALT 24 (0-44)

Testosterone, serum 194 (348-1197)
Free Testosterone 14.9 (8.7-25.1)

LH 3.2 (1.7-8.6)
FSH 4.0 (1.5-12.4)

Cortisol 34.6 (2.3-19.4)
Estradiol 12.4 (7.6-42.6)
Hemoglobin A1C 5.2 (4.8-5.6)
PSA 0.5 (0.0-4.0)
TSH 0.622 (0.450-4.500)
Vitamin D, 25-Hydroxy 95.2 (30.0-100.0)

I had asked for DHEA, but I guess they didn't include it with this blood draw. This is from a reputable TRT clinic and the staff know what they are pretty competent. Again, my main symptoms are lack of motivation, lack of focus, brain fog, easy weight gain in mid section, addictions seem to be amplified (beer, caffeine, porn) and waaay more anxiety. I don't really get depressed, and my anxiety will sometime completely dissapear ( I do not take anxiety meds). However, my sex drive is still going and I can still get erections rather easily. I am seriously contemplating taking the plunge into TRT, but I am a little nervous that the surge in hormones will trigger off more anxiety and panic attacks, but that may just be my current anxiety being pessimistic from the low T. My clinic provides injections on a weekly basis of Test Cyp with a goal of therapeutic range of 650-800 total test. Arimidex is 0.5mg once a week on injection day. hCG is 25 units on day 5 and 6 (two days prior to weekly injections). Any feedback would be greatly appreciated.

Edit* I had consumed alcohol the night before this test, not sure how much it would mess with my test numbers. I tested my total test about two weeks prior to these numbers and it comes back at 375. Low, but not 194 low.


#2

Please check body temps as per the thyroid basics sticky, both when you wake up and mid-afternoon [resting, not working]. Body temps are more useful than TSH. If body temps are low, do TSH, fT3, fT4 rT4

Have you been using iodized salt long term?

Many do better injecting twice a week.

There are 7 stickies here, have a look.

Cortisol level is very high and might not be sustainable. Adrenals fatigue is possible, AKA burn-out
Stress can elevate rT3 that blocks fT3, lowering fT3 that gets inside your cells.

At your age, low-T is a symptom and you need to find a cause. Something that many docs skip.

Get prolactin tested as that can be a strong HPTA repressor.


#3

[quote]KSman wrote:
Please check body temps as per the thyroid basics sticky, both when you wake up and mid-afternoon [resting, not working]. Body temps are more useful than TSH. If body temps are low, do TSH, fT3, fT4 rT4

Have you been using iodized salt long term?

Many do better injecting twice a week.

There are 7 stickies here, have a look.

Cortisol level is very high and might not be sustainable. Adrenals fatigue is possible, AKA burn-out
Stress can elevate rT3 that blocks fT3, lowering fT3 that gets inside your cells.

At your age, low-T is a symptom and you need to find a cause. Something that many docs skip.

Get prolactin tested as that can be a strong HPTA repressor.

[/quote]

Thanks KSman, I will check out the body temperature guide for thyroid. I use Himalayan pink salt frequently, and I often eat seaweed. As for the 2x per week method, something like 70mg Bi weekly? What are there positives to this? And I do have a feeling I have burned out my adrenals from a ton of caffeine and stress from nursing school. I am going to reduce my caffeine intake, but currently I am working 12 hour shifts and I usually take in about 350-400mg of caffeine daily. I am on a product for my adrenals called “Adrenaplex” which is amazing, but I feel like until I drop the caffeine, my adrenals are not going to recover. I have read that low testosterone also puts added stress on the adrenals, which is making me want to take the plunge into TRT just to give my adrenals a break and lower that cortisol and start feeling better. I’ll tell you, having low T and high cortisol is really ramping up my anxiety. About two years ago when I suspected myself of having adrenal insufficiency, my DHEA was high and my cortisol was low. Fast forward a couple years later and now my cortisol is high.


#4

You are an adrenalin junkie ! :wink:

There is no [useful amounts] iodine in Himalayan salt.

The amount of iodine in seaweed products varies vastly, so largely an unknown.

In the thyroid basics sticky, and advice for new guys perhaps, you will find references to:

  • adrenal fatigue
  • stress
  • Wilson’s book
    You need to avoid the burnout and crash as you can’t fix that with a pill.

#5

I hope your insurance is picking up the tab on the tests, since any doc can order them. I’m not too familiar with TRT clinics… same thing as anti-aging clinic? Insurance covers them?

If you want them to test DHEA on your next test make sure its DHEA-S, not DHEA.
I wouldn’t start any treatment until you resolve the stress issue and are taking in adequate iodine for your thyroid.


#6

[quote]acfixerdude wrote:
I hope your insurance is picking up the tab on the tests, since any doc can order them. I’m not too familiar with TRT clinics… same thing as anti-aging clinic? Insurance covers them?

If you want them to test DHEA on your next test make sure its DHEA-S, not DHEA.
I wouldn’t start any treatment until you resolve the stress issue and are taking in adequate iodine for your thyroid.[/quote]

Yeah my insurance picks up the labs and trt treatment, I just pay my co-pay of $25x4 visits a month.

Well, I need to ask you guys something, I feel like I am definitely secondary and something else is causing my low T. I made a compulsive decision to go into my throat clinic and get a shot, however, I feel a sense of guilt like I did not explore all my avenues. I feel trt should be the absolute last resort. I took 140mg of Test Cyp IM, one shot of this shouldn’t be enough to shut me down correct? I am not going to get another shot. I am going to really go after diet/nutrients and probably going to go see an endo for a more in depth look into my labs and will stay off the Pharmaceuticals. But again, one shot of 140mg of Test Cyp isn’t going to shut me down, right?


#7

You should be OK and normalized with that shot in 3-4 weeks.

You would want to be self injecting twice a week.


#8

that is what I am thinking, sub Q 70mg bi weekly would be more tolerable and reduce androgen shock, particularly on guys prone to anxiety. I think the rush of Androgens on a body used to have low androgens along with any norepeniphrine spikes and estrogen spikes can cause anxiety and panic attacks, thats why its listed as an adverse effect for testosterone. I took 140mg which isn’t a lot, but it was enough to make me feel pretty anxious. If I get another shot I may roll with 100mg week until I can get on some self injecting protocol.