T Nation

Poor T - A Reason for TRT?

I am 53 old, training in my home gym 5 - 6 days/week. In addition I run 4 - 5 days /week (~ 30 - 40 km/week); 180 cm, 76 kg, body-fat <18 %. I am looking good for my age.
But the last months the training motivation is very low, my mood is tending downstairs. Therefore I go to my Doctor. He made a blood test:

T 4 ng/ml (2 - 8,1)
SHBG 55 nmol/l (10 - 57) !!!
DHEA-S 64,6ug/dl (70 - 310) … poor results.

Cortisol is high 17 ug/dl (4-22)
Cholesterine 219 (< 200)

What is to do?
Take DHEA and look, if the rest will become normal?
Or start a TRT?
What do you think?

At your age, most men are loosing T. This is simple age related decline, not a specific pathology. If a specific pathology can be identified and cured/managed, T levels can rebound, but that is still age limited.

T4 should be mid-range, near 5.0, you are 20% below that. At this point we would like to see at a minimum, TSH. Best data would be TSH, fT3, fT4. We see many many cases of hypothyroidism are complicated by subclinical hypothyroidism and/or iodine deficiency. Read the advice for new guys sticky. Report your body temperatures [C and F please].

TRT will probably reduce your cholesterol. Do you have HDL and LDL data.

If you have more lab data, we need to see it, not just the out of range data.

Why is cortisol=17 high? [you can edit your post above, see the [edit]]

Provide more data about you as per advice for new guys sticky.

All too often we see guys and doctors tunnel visioned on T, who ignore broader health issues.

I have some more data.

HDL 54 mg/dl (>35)
LDL 132 md/dl (<130)
Trigylceride 143 mg/dl (<140)

Cortisol is high, I think, because of too much work, family problems, not enough sleep. It would be interesting to have the Adrenaline/Noradrenaline datas, but I have not.

TSH 1,53 ulU/ml (0,4 - 4)
ft3 3,11 pg/ml (2,3 - 4,2)
ft4 0,95 ng/dl (0,8 - 1,8) all in the normal range, I think.

Erys, MCV, MCH and MCHC a little bit too much,
Leukos low
the rest of my blood datas is normal.

Thank you for assesing my datas, KSman.

“the rest of my blood data is normal”
Unfortunately that does not mean healthy, many issues get missed.

Read the advice for new guys sticky. NEED data about you.

Thyroid is suspicious.

*** Report your body temperatures [C and F please]. ***

Are you using iodized salt? Iodine in vitamins?

Thyroid problems can lower your T levels, amongst other problems.

Do you take vitamin D3 supplements?
Getting much sun exposure on skin?

Can you get 25mg DHEA?
Is your skin complexion dark? - that reduces your ability to make vit-D3

Do you take fish oil capsules or other EFA’s

Your cortisol seems OK, bit your adrenal glands need to adjust cortisol levels to meet the demands of the moment. There may be times where your cortisol levels are too low, during stress events, that can leave one feeling drained. That is a degree of adrenal fatigue. We can all cope with a lot of stress sometimes, but repeated major stress events can wear out the adrenals. Major stress: divorce, job loss, debt, death of someone you are close to, surgery, infection, accident, infection, parasites, chronic inflammation etc.

Thank you for your answer.
I am using iodized salt. yes.
But no supps. I am living in the country, I am outdoors min 2 hours every day, enough to produce Vit D, or?

DHEA - yes. I asked a good friend. He is pharmacist. He can produce DHEA capsules, DHEA alone or in combination with Q10 (he recommended).

My skin is not dark. I will post an up-to-date photo later.

And I added the pages of the lab. There is all informaation I have.

the lab data…

trying again to upload the data…


et voila…

Vit-D should be good!

TSH is slightly elevated and fT4 is lower than midrange.

DHEA 25mg + CoQ10 would be good. But if you can get CoQ10 in oil caps that is better and the Ubinquinol form is the best. See http://en.wikipedia.org/wiki/Ubiquinol

Homocysteine would be lower if your endothilial cells and ateries were perfectly healthy. Your cholesterol levels are good. Fish oil cals, high potency B complex vitamins may reduce this inflamatory marker that is specfic to ateries. CoQ10, DHEA are also needed.

*** Report your body temperatures [C and F please]. *** See advice for new guys sticky.

I suspect that your lab ranges for T have been age adjusted. From a TRT point of view, you want to be refereing to the lab ranges for young men, not old men.

SHBG is high. SHBG is made in the liver and when E2 levels are higher the liver makes more. So we need E2 estradiol lab results. If E2 is high, you will not feel good. E2 can also be elevated if your liver is not removing E2 and that can be from the interference of drugs, alcohol or liver problems. We look at lab data ALT and AST. http://en.wikipedia.org/wiki/Liver_function_tests#Alanine_transaminase

What drugs, off the shelf or prescribed are you taking routinely.

Did you get sick prior to all of these problems?

May consider Vit D. A couple of hours out side daily may not be enough depending on how much skin is exposed. I work in the landscape industry and am outside all day with just my head and arms exposed. I am currently taking 6000Iu daily supplement and I at midrange. Just something to consider.

This are photo taken a few days ago.
It´s OK for 53.
But the last 2 month, the bodyweight raised and the bodyfat too (+2 %) - training and eating habits are the same.

I know it is harder the last years to control body composition. And I have to train harder to get the same results. The change had come to pass slowly. But now the problems are difficult to manage.

*** Report your body temperatures [C and F please]. *** OK. I will do so. Tomorrow I will buy a thermometer.

And I will go to my doc to measure E2, ALT and AST.

I am not taking any drugs routinely.

Next week, I start with Q10 an DHEA (I will get DHEA capsules with olive oil).

[quote]Mac79 wrote:
May consider Vit D. A couple of hours out side daily may not be enough depending on how much skin is exposed. I work in the landscape industry and am outside all day with just my head and arms exposed. I am currently taking 6000Iu daily supplement and I at midrange. Just something to consider.[/quote]

May be you are right. I only expose head and arms too. Thank you.

My temperature (oral measurement): 36,8 C = 98,2 F
Why it is important to know the temperature?

[quote]KSman wrote:

T4 should be mid-range, near 5.0, you are 20% below that. [/quote]

Just a correction: He said his testosterone was 4, not his T4.

Lower body temp upon waking can indicate iodine deficency and possibly thyroid. Take temp first thing when you wale before getting out of bed then every 3-4 hours duting the day. Ideal would to be 98.6 by mid afternoon.

What was the time of day for the temperature reported? Need waking and mid afternoon. Ideal when you wake would be near 97.7 and at 98.6 during the afternoon. 97.3 or lower when you wake is considered a problem.

T4 is .95, should be mid range near 1.2

Yes, “T 4 ng/ml (2 - 8,1)” confused me.

Minor thyroid problems can be from iodine deficiencies and that is easy to fix.

97,3 in the morning
98,2 at 3.30 pm
I am a cool fellow, or? :wink:

Read this for some context:
https://www.google.com/search?q=ksman+has+a+thyroid+problem

I get the DHEA/Q10 capsules today and start with 30 mg DHEA and 50 mg Q10/day.
I also start with iodine, 150 ug/d

What do you tink? No needs to start TRT now?

Working on your thyroid and body temperature should be done, but this does not mean that T will increase.

Iodine 150 ug/d will not replenish iodine. Your body can store 1 - 1.5 grams of iodine, yes, grams. So if you need to replace 0.75 grams at 150ug/day, how many days will that take? And during that time, you are loosing iodine every day. Note doses here: https://www.google.com/...thyroid+problem

Homocysteine would be lower if your endothelial cells and ateries were perfectly healthy. Your cholesterol levels are good. Fish oil caps, high potency B complex vitamins may reduce this inflammatory marker that is specific to arteries. CoQ10, DHEA are also needed.

high potency B complex vitamins

We need the new lab work.