T Nation

Update: 90 Day Labs. High E. Input Welcome


#1

Hi folks.
Just signed up on the forum. Have been gleaning info from the site for some time now.

So about me…48 yo male.
6’2" 208lbs
I do not, smoke, drink, use drugs, drink soda’s or energy drinks.
No prescription drugs.
I take a multi vitamin daily
I do take a baby aspirin every evening
Diet is “OK”…my wife make all our meals using whole foods, etc.
Overall health is pretty good.

About 1 year ago I just started feeling low. Low energy. Lower sex drive. Low motivation to workout.
I then gained about 10 lbs, mostly in my mid section.

My family doctor is willing to do gel, but admits his knowledge on HRT/TRT is very limited. So I reached out to one of the better known clinics and got some blood work done.

Below are the results. The second set of T levels included the SHBG…looks high.

I also read the sticky about thyroid problems. And noted min is a bit higher than the recomended optimal range of 1.3-1.8.
Looking at labs from 5-6 years ago, my TSH level was 1.5 then.

My morning temps have been 97.2 but day temps are 98.7 and right before bed usually around 98.

If I start iodine and selenium, how much should I take of each?

I have my initial consultation with the clinic this week and I am hoping they can help me out. That being said, I am anti-meds and do not like the idea of being tied to taking them for…well…ever.

Any input or incite will be very welcome.


#2

SHBG is not been elevated by E2, lower T will increase SHBG a bit. Liver problems can increase SHBG. SHBG is made in the liver to scavenge sex hormones for return to and metabolization in the liver. Some simply have unexplainable high or low SHBG.

Your glucose and cholesterol labs were fasting?
Cholesterol should correct with low-T and thyroid issues resolved.

Your most obvious problem is thyroid and TSH should be close to 1.0, we are taking optimal and doctor are talking diseases.

fT3 is the only active thyroid hormone and should be tested directly. fT4 should also be tested directly. T3 uptake and free thyroxine indexes are indirect and not obsolete.

“my wife make all our meals using whole foods, etc.”

Not all whole foods are healthy.

With your thyroid numbers I think that you could easily be a T-gel non-absorbed and then injections are what you will need, 100% absorbed and also least cost.


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

  • advice for new guys - need more info about you
  • 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.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re Thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab numbers and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.
Your thyroid issues may be from an iodine deficiency and your wife may be using sea salt. She would be deficient too and she needs temperatures checked as well. Yes sea salt and pink salts are natural, but thyroid problems are a natural state as well when not using iodized salt and iodine from supplements.

Does your multi-vit contain 150mcg iodine and 150-200mcg selenium?

Total T4=6.3 should be near mid-range and your result suggests iodine deficiency.

Is stress a major factor in your life? Any major stress events? accidents, surgeries, illnesses etc?

GH and DHEA status looks great.


#3

Hello and thank you for the reply.

To answer your questions.

Yes, fasting for my blood draws.

Multi vitamin contains 90mcg of iodine and 100mcg selenium…yep…low.

LOTS of stress in my life. Self employed and work pretty much 7 days a week.
Was hit by a drunk driver two years ago and sustained a slipped disk in lower back.
That is much better these days.

Understand about Whole Foods…my point is we rarely eat out and pretty much never eat fast foods.
Lots of greens, chicken, turkey, some red meat maybe 2-3 times a month.

Onther thing that I changed about 1 1/2 years ago was I use to tan 3-4 days a week.
I stopped that. About 4-6 months later is when I started to feel crappy.
Not saying there is a a connection, but thought it would be worth mentioning…low vitD?


#4

Three days of temps:

Day 1 Morning 97.2 mid day 98.6 evening 98.2
Day 2 morning 97.3 mid day 98.7 evening 98.0
Day 3 morning 97.2 mid day 98.4 evening 98.3


#5

Body temps are good!
That suggests that fT4–>fT3 is very efficient.
But TSH and T4 show that your thyroid system is struggling to do this. Elevated TSH for years creates risk of thyroid nodules and everything else that can lead from there.

Stress can increase rT3. Read about that in the sticky.

Dropping Vit-D status could certainly have a pile on effect with other things. You can take 5000iu Vit-D3 per day, find tiny 5000iu oil filled gel caps and take with meals that have more oils and less fiber.

Your DHEA status suggests that adrenals are in good shape. Stress can be a factor. If you ever test cortisol, should be ‘AM cortisol’ done at 8AM or one hour after waking. Stress can increase cortisol but cortisol can drop if the adrenals are getting beat up.


#6

Thank you for the input.

Yes…my stress level is high. Not sure how to stress less. I am self employed and the household relies solely on my income so I basically work 7 days a week.

I have my consultation this week and am interested in hearing what they recommend based on my labs.

I will keep posting as things progress. In the mean time I have started using iodized salt and have picked up some selenium and iodine supplements.


#7

The hallmark of adrenal fatigue is mid-range fT3 or higher with low body temperatures. Your body temperatures are on the right side of the fence.


#8

So I had my consultation and will be starting TRT as soon as the meds and supplies show up.

I will be taking .40ml of T twice a week.

500iu of HCG twice a week.

I will receive a supply of AI, but the doctor wants me to hold off taking it unless needed as he wants my E in 30-40 range.
He commented that with my high SHBG and my sore joints, that my free E is most likely low and causing those issues.
He said if I do take the AI it would only be .125mg twice a week.

Also wants me taking 25mg of DHEA at bed time and fish oil daily.

So…a new phase of my life will began shortly. I am excited and a bit leery at the same time. I will update as things progress.


#9

Just a quick update.

I took my first T and HCG injections two days ago. What I learned so far…IM is not fun! Switching to sub q for the T.
Just ordered some smaller needles.

Will update as things change…good or bad.


#10

What type of needle did you use for IM? What site did you inject? I have done sub q and IM and prefer IM. I perform the “shallow im” injection @ the delt with a 28g insulin needle. Painless. Loads pretty easy. Comfortable to pin.


#11

I used 25g 5/8” for the IM.

It seems everyone has the personal preference on either sub Q or IM.
Just need to find what works for me I guess.


#12

Just curious what site you injected? What did you find unpleasant about the IM injection?


#13

I was doing it in my outer thigh. Did sub q on the upper top of my thigh and barely felt it. Much easier for me.


#14

I did IM on my quads for 4-5 months with 25g 1" needles, started with 1.5" needles and didn’t like those bastards. It wasn’t always great as it seemed like every other time my quad would twitch while the needle was going in. Made it so I had to psych myself up a bit for the shots. I moved to SQ about a month ago injecting into my belly with 30g .5" needles and its painless.


#15

Hi Folks.
Just seeking some advice/input.

I have high SHBG and am currently doing my T and HCG twice a week and I can feel the HCG and by the 2nd day I can feel the HCG is pretty much gone.

So…thinking if switching to EOD. But from what I have read, that might not be good for high SHBG folks like myself.

Thank you in advance.


#16

Dude it’s only been 11 days since you started TRT + HCG, you have yet to go through the TRT honeymoon phase which will see your pituitary gland shut down and you will feel bad for awhile. It usually takes 6 weeks to start feeling good again after the pituitary shut down, if you lack patience you will end up quitting TRT like so many others.

Also all your hormones are fluctuating wildly for the first 6 weeks, it takes this long for blood levels to stabilize. EOD and high SHBG will end in failure, you shouldn’t even be doing injections twice weekly.

If you micromanage your protocol before the 6 weeks is up and you’ll NEVER make any sort of recovery, you’ll stuck in limbo for several months wondering why you never feel good and eventually give up on TRT.

Everytime you make a small change to your protocol that 6 weeks until blood levels are stable is reset and it begins all over again.

I’ve been on TRT for almost a year and I’m in the middle of a protocol change, I’m having days where I feel good and days where I’m not. I got 4 weeks until my bloods are stable, this is when I expect to feel good again.


#17

I get it…yes I am just starting. That being said, I do not use ANY form of alcohol, caffeine, energy drinks, etc.
And I take no meds other than the HRT stuff.

I have a very clean system and I am very sensitive to changes in my body. So what works for one person (like you) might not work for others (like me).

I am going through the same clinic you are and you speak highly of them. So I am going to go with they started me out with a program that should work…talking about the twice a week T injections.

That being said…as I wrote above…I can feel the hcg and know when it is out of my system.

Thanks for the input.


#18

You can do 250iu hCG EOD and use less hCG.

No real direct hCG-SHBG connection.

As for talking about IM… I did that with #29 1/2" for a few years, my quads became hard and massage therapist could not get them supple. So stopped IM and after a year or two the problem was resolved. Needle damage is real.


#19

Thank you for the reply KS.

Yep, I went to sub q after my first IM. MUCH easier and less painful.
The IM left a knot for about a week. I could see muscle damage from that over time.


#20

I have to take a four day trip out of town. My normal T injections are Tuesday mornings and Friday evenings.
I don’t really want to take all my meds, syringes, etc., with me. I am particularly concerned about the hCG as it needs to be kept refrigerated and I will be driving 3+ hours to the airport plus the flight, and then another 2 hour drive to the hotel before I would be able to refrigerate it again.
And then all that again on the return trip.

Yes…I have a cold pack travel insulin kit, but it does not stay frozen very long.

So…I was thinking of just moving my injection day up by one day (Monday morning instead of Tuesday morning) and then get back on schedule Friday.

Would this be a “really big deal”? My thoughts are no, but just thought I would get input from those with more knowledge.

Thanks you.