T Nation

Tendinosis Pain, Fatigue and No Libido

@KSman and others, hope someone can guide me in the correct direction.

GP’s ignore me (I’m just old apparently!)

-age. 48
-height. 172cm (5’6")
-waist. (34")
-weight 80.5kg

-describe body and facial hair…
hairy chest and back. Used to be thick but now back hair is softer, thinning and leg hair bare on calves. Shave every three to four days. I have only once had a 5 o’clock shadow which lasted a week or so. Never again.

-describe where you carry fat and how changed…
fat around waist. Very lean shoulders and arms, but still carry hard to shift spare tyre around waist.

-health conditions, symptoms [history]

General fatigue, depression (well a lack of drive really, cannot be bothered to go out and find it hard to socialise) general stiffness when getting up after resting. Eases with time. Restless legs at night.

Asthma which I seem to have mostly grown out of. Had taken Ventolin and Salbutamol since I was about 8yrs old. So nearly 40yrs. But weened myself off and now don’t need them.

Have had joint and muscle pain for years which is getting worse. Diagnosed with Chronic Fatigue but seems to be a catch all diagnostic and told to just take it easy. But when I rest the joint pain worsens, I have to keep moving.

Multiple tendinosis, elbows and shoulders but also ankles and feet. Train eccentricity which helps but problems getting worse.

Joints dislocate and click, knock etc. Both thumbs have trigger finger and my bench press and general strength has dropped over the last year as the joints move.

Taking collagen, gelatin to try to help.

No libido. ED issues.

Mother and Sister both hypothyroid and mother also has adrenal fatigue.

I had a DEXA scan and spine is in osteoporosis but hips are normal. GP won’t do anything.

Tried T4 and T3 and Natural thyroid but none had any effect. Didn’t matter how much a took, I could stop, start, take large does and nothing. Genuine tablets. I used my mothers genuine drugs. Thyroid has always been low normal for years. Since around 40yrs.

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever

No RTX currently. No hair loss or prostate drugs.

Vit D 10,000 IU balanced with

Vit K-MK7 100mcg

Vit B6 500mg

Omega 3

Pregnenolone 50mg

Started Magnesium Malate today…

As much collagen and gelatin as I can get from home made chicken broth and beef broths plus collagen protein shakes. (As I cannot tolerate whey proteins)

General testosterone boosting supplements tried over the years. Nothing made any difference.

Always kept active and like to keep fit and strong but pain increasing and energy reducing.

Have tried HcG which did work but started to get gyno. Really felt testicles ache. But a nice ache. Felt alive down below. But this would only last a few weeks and slowly the effects would diminish and back to square up one.

Tried testosterone ethanate for two weeks but nothing. So either crap drugs or body countering the extra test.

Prolactin is high normal and high but not high enough for MRI scan. So is it cortisol based problem ? Never checked cortisol over 24hrs.

SHBG is high normal with testosterone low normal and below normal albumin. Which makes free test below normal. GPs say it’s not significant as my total T is in range.

Trying to reduce SHBG and Prolactin with supplements but not having much luck.

-lab results with ranges

Sports Hormone Test (Serum Sample Date 01/03/17)

[details=Red Blood Cells]
HAEMOGLOBIN (G/L) 138 g/L 130.00 - 170.00
HCT 0.400 0.37 - 0.50
RED CELL COUNT * 4.38 x10^12/L 4.40 - 5.80
MCV 91 fl 80.00 - 99.00
MCH 31.4 pg 26.00 - 33.50
MCHC (G/L) 344 g/L 300.00 - 350.00
RDW 13.1 11.50 - 15.00[/details]

[details=White Blood Cells]
WHITE CELL COUNT 6.9 x10^9/L 3.00 - 10.00
NEUTROPHILS 3.18 x10^9/L 2.00 - 7.50
LYMPHOCYTES 2.73 x10^9/L 1.20 - 3.65
MONOCYTES 0.75 x10^9/L 0.20 - 1.00
EOSINOPHILS 0.19 x10^9/L 0.00 - 0.40
BASOPHILS 0.05 x10^9/L 0.00 - 0.10[/details]

[details=Clotting Cells]
PLATELET COUNT 301 x10^9/L 150.00 - 400.00
MPV 9.9 fl 7.00 - 13.00[/details]

[details=Kidney Function]
SODIUM 140 mmol/L 135.00 - 145.00
UREA 5.8 mmol/L 1.70 - 8.30
CREATININE 97 umol/L 66.00 - 112.00[/details]

[details=Liver Function]
CK 140 IU/L 38.00 - 204.00
GAMMA GT 18 IU/L 10.00 - 71.00[/details]

TOTAL PROTEIN 65.6 g/L 63.00 - 83.00
ALBUMIN 35.5 g/L 34.00 - 50.00
GLOBULIN 30.1 g/L 19.00 - 35.00[/details]

[details=Diabetes Test]
HBA1C (MMOL/MOL) 36 mmol/mol 20.00 - 42.00[/details]

[details=Iron Profile]
IRON 20.57 umol/L 10.60 - 28.30
FERRITIN 80.29 ug/L 30.00 - 400.00
Lipid Profile
TRIGLYCERIDES 0.8 mmol/L 0.00 - 2.30
CHOLESTEROL 4.19 mmol/L 0.00 - 4.99
HDL CHOLESTEROL 1.18 mmol/L 0.90 - 1.50
LDL CHOLESTEROL 2.65 mmol/L 0.00 - 3.00[/details]

[details=Heart Disease Risk]
HDL % OF TOTAL 28.16 % 20.00 - 100.00[/details]

[details=Cardiovascular Disease - Inflammation]
CRP - HIGH SENSITIVITY 1.3 mg/L 0.00 - 5.00[/details]

Thyroid Function
FREE THYROXINE 14.57 pmol/L 12.00 - 22.00[/details]

FOLLICLE STIM. HORMONE 3.61 IU/L 1.50 - 12.40
TESTOSTERONE 15.98 nmol/L 7.60 - 31.40
FREE-TESTOSTERONE(CALCULATED) * 0.261 nmol/L 0.30 - 1.00
SEX HORMONE BINDING GLOB 53.05 nmol/L 16.00 - 55.00
17-BETA OESTRADIOL 86.87 pmol/L 0.00 - 191.99
PROLACTIN * 358 mIU/L 86 - 324 (sample 03/16) has been in the 500’s[/details]

-describe diet [some create substantial damage with starvation diets]

Calorie control to 2000 a day and make sure to get plenty of protein and fats. Cut refined sugars but eat potatoes, pasta and rice for carbs. Plenty of chicken and meat and veg.

-describe training [some ruin there hormones by over training]

45mins to 60mins three times a week. cardio 15mm and weight training 45min, plus 1hr martial arts a week.

Hard to gain muscle. If anything, loosing strength and muscle.

Legs really tire quickly so hard to do circuits.

Thumbs, wrists, shoulders and elbows all have tendinosis.

-testes ache, ever, with a fever?

Used to ache when I could tell LH was rising with HCG but no more. Only ache now is from a hydrocele.

Currently untreated.

Had Prostatitis over Xmas 2016 which made me very ill for two months. Antibiotics, chest infection, eye infection then stomach ulcer. Now lactose intolerant, helped by healing my gut with collagen. Tested for all STI’s but none detected.

-how have morning wood and nocturnal erections changed

No nocturnal wood. Maybe when I need the toilet but it’s not a subconscious response. No morning wood and no wet dreams for years. Erectile strength reducing, now about 65%

Have to use Cialis when I do want sex, which currently is about once a year :frowning:

However my brain says I’d like sex but I get zero response to any stimulus.

No libido. No thoughts at all even when presented with it on a plate.

Very very occasionally for about two weeks in every year my libido rockets and I can think of nothing else, but that soon passes and then nothing for the rest of the year. I have never been able to work out why or how I could replicate it. I did think B6 and Omega3 had the largest map to but that didn’t last long.

Just don’t know where to turn…
Advice appreciated…

Can hydrocele be surgically corrected?

hCG does not increase LH - ever~
If hCG increases T and/or E2, LH and FSH go to zero.

Describe how you dosed hCG. IU’s needed, not needle volumes.

Have you used probiotics to recover from the antibiotic mess?

SHBG is very high when we expect low from low FT.

High SHBG creates a lot of SHBG+T, which is not bioavailable, which inflates TT number and reduces FT.

SHBG is made in the liver to scavenge sex hormones from the blood. Increased T lowers SHBG and increased E2 increases SHBG. We do see that SHBG can be increased by liver disease/conditions. ALT is high, but can easily be high from training and sore muscles.

Test FT directly please.

CRP is not cardio specific as was determined many years ago, your medical community has it wrong. Homocysteine is cardio specific, detecting the inflammatory processes that damage the one cell thick lining cells in arteries - aka endothelial dysfunction.

TSH is way to high. Should be nearer to 1.0
Thyroid lab ranges are useless/insane.
What is your history of using iodized salt?
Please eval overall thyroid function via last paragraph in your post.
Thyroid labs:
TSH= 3.94 — way too high
fT4=14.57 12-22 — this is low, should be midrange [17] or a bit higher

Thank you for a great opening post!

Please read the stickies found here: About the T Replacement Category

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

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

Thanks for the quick response KSman.
I do have many years of serum blood results. Mainly focusing around Thyroid. With full fT3 rT3, T4 etc etc and Antigens etc.
I tried T3 as well as T4. Had massively high T3 due to taking T3 tablets but never got any extra energy, no high heart rate. It was like nothing had happened. Tried for a good month on super physiological doses. Genuine prescribed drugs, but gave up as nothing happened. I suspected something else was blocking the conversion of T3.
My mother had similar symptoms to me at my age but now has a crumbled spine, ankolysing spongilitus ? Spelling? So I’m keen not to end up the same way.
Thumbs are aching just typing this on my iPad.

I have my results on a google spreadsheet which I can share with you or somehow attach? To this post?
I’ve done leaky gut tests, hair analysis etc etc but cannot focus on what to do.

As for fT. I’ve never seen a dedicated test in the UK for that. Only ever a calculated one based of albumin and SHBG.

Had a synacthen test a few years ago, the costisol buzz afterwards was the best I’ve felt in years, terminator for a day.

As for HCG I was taking 500IU per week. Felt testifies ache after a week. I meant I connected a similar ache to maybe an increase in LH, t think now is was the hydrocole. I think they can drain the water, but they seem to push this to the bottom of the priority lists.

Never taken iodine through supplements. Only tried iodine rub on testicles. I do eat with normal sea salt.

As for stomach yes probiotics and gentle care of stomach was needed. Chicken broth did wonders. I’ve kept off lactose and my stomach feels good. Before would be bloated after eating.

I need to read up on SHBG as I thought that if that was high it bound up testosterone and with the testosterone bound to my albumin as well it didn’t leave much left to use. And as the albumin is low I guess that is also a reason for poor muscle/strength etc.

My TSH has always been high normal and T4 always low normal. That’s over 5 years of testing.

Should I post my replies here, or edit the original post with details. Guess results etc in the original ?

T3 does not convert to anything else that is an issue.

T3 should have depressed TSH and T4.
T3 should increase body temps.

Your thyroid problem is iodine deficiency. Your mom’s probably too.
In UK, one is expected to get iodine from dairy products, even as iodine teat wash is getting phased out. You need to read the thyroid basics sticky re iodine replenishment and very important, note that selenium is critical for you.

When fT3 is mid-range and body temps are low, we suspect rT3 and adrenal fatigue.

fT3 acts on mitochondria inside your cells that make ATP, your energy source. Mitochondria need CoQ10 that is made in the liver. Statin drugs can lower CoQ10 that depends on some of the same enzyme pathways that are inhibited by statin drugs to lower cholesterol. So fT3 is getting blocked or CoQ10 might be low.

Ok I’m going down the more Iodine route,

It appears that Doctors recommend 50mg a day, (which agrees with your research) so about 20 drops of 5% lugols. A lot more than I ever thought you needed.
Read KSman pages on Thyroid and Iodine and also Iodine source here

Not sure how you can tell how much iodine is in the sea salt. They don’t seem to give a figure.
That seems to be what you are saying as well I think.

Do you think it ok to drop 20 drops of lugols iodine liquid (5%) straight on top food? Or do you mix wth water and drink? I worked that out at around 50mg Iodine. Drinking that in water made my throat burn a bit.

I can see the salt being a good maintenance method but not sure how you load up iodine and push all the other bromides out etc without taking extra iodine direct.

I took my temps and so far
35.5 (95.6) on waking, rising to
35.9 (96.6) by 11am
35.6 (96.1) 4pm
Back to 35.3 (95.5) 10pm

From your posts it’s really low!

I can be sweating yet body temp only just gets to 97. But why testicles are withdrawn, cold and extremities are also cold.
I seem to suffer with poor regulation of temps.

I’m trying to do a better measurement over next few days.
Very many thanks for your valuable help.

Need to research your Selenium details next…


Iodine does not taste very good, so maybe not on food.

Sea salt looses/rejects all iodine during crystallization. There are some brands of sea salt that are iodized and labelled clearly to that effect.

First thing I noticed was feeling better and increased clarity of thought. But my T and E2 were great at the time. With low-T, that puts a ceiling on things.

If taking things to calm down joint and tendon pain, Rx meloxicam 15mg per day single dose works very well for me. 800mg/day naproxen did nothing but mess with my kidney markers. Meloxicam at USA Walmart is very inexpensive. I have doc write it up for a 12 months supplied at once. Ask for a trial if you feel like you might benefit from that.


Well I’ve been taking iodine (lugols) since I last posted. So just over two months. 10 weeks.

I must say it was pretty bad for the first month. Seemed everything that could happen did. Spotty face, very very tired etc… but now…

Oh boy! I’ve been able to get to the gym and have to force myself to go home after two hours. 4 to 5 times a week.

My muscles have not grown but I am stronger. So I guess what I have denser stronger muscles.

But the biggest thing I notice which makes me smile each time I look is the hair on my legs.

I have gone from bald calves, only hair on shins and very sparse on glutes. But now I have hair all over, evenly distributed, hair down to my ankles and over the top of my feet. Hair on my backside (glutes) . It seems so alien to me to see hair their. It’s very very clear I’ve got hair back where it has not been for years. … and all this in 10 weeks.

However I have such a huge appetite it is hard to keep the weight off. It’s going up but all in my waiste. So I’m not sure if this is due to my lack of salt loading? Sorry didn’t do it as it made me feel so sick. Do you think I should start salt loading protocol? Have I left it too late?

A big thanks for identifying iodine. I use it all over now. Curing, infection, skin tags, warts. I drink two droppers full each day.

Early on it would burn but now I mix wth juice and it’s fine. I even want to take it… I make my own now. Very cheap to make so long as you are clean and careful making it.

I am going to get another round of blood tests in the next week to so to see if the testosterone has gone up as I feel it has.
I hoping my 24hr cortisol (saliva test ) has gone down as this is over range at all times…
no increase in libido yet, but early days I guess.

Oh and i now have a full beard…

Any further advice welcome.

Thanks again…

Pete, I hope that you have taken need for selenium seriously.

Sounds like great progress.

So iodine made you feel ill for a while. Could this been ejecting stored bromines? Not too many cases of that, but when it happens one can have a foul fishy odor and then one has to think about how bromines were ingested.

Ventolin and Salbutamol are the same drug and it does not contain bromine.
Other meds? UK used to have bromines in bread until 1990.

Yes I take 200mcg selenium a day along with various B vitamins, and all the other recommended vitamins.

I think all the spots, the candida, extreme fatigue was all detoxing. Bromides? Unknown. But certainly getting rid of bad stuff it seemed.

Early days but good progress. Iodine is a mans best friend.

Not sure what you meant by ventolin and salbutamol. But I spent my whole life taking these until about two years ago when I weened myself off. In the end I only needed them with hayfever and colds, now even that is no longer needed. I have better VO2 max than mos twenty year and olds. As a child I was constantly having respiritory problems.

I do wonder if the salbutamol and beclomethasone has caused my cortisol problems? Being mild steroids.

Seems like a productive line of thought.

Apparently your IR did not involve any bromine odor, so bromines not a consideration. Some meds contain bromines, so I was checking those meds.

Great that you grew out of those respiratory problems.

Vit-D and thyroid have a large influence on your immune system.

You make lots of Vit-D3 windsurfing if not wearing a wet suit. Many have suboptimal levels.