What Am I Missing? Low T, Fibro, Thyroid? Docs No Help

I’ve been taking a MV for approx 2mo 5 days a week. It has 3mg of B1 (200% DV), 3.4mg of B2 (200% DV), B3 30mg (150% DV), 4mg B6 (200%DV), B9 400mcg (100%), B12 18mcg 300%, B7 300mcg (100%) and B5 15mg (150%)

I’m getting Cortisol tested and tested for Lyme in the next week.

I don’t think I’ve had my DHEA tested. I just went through my labs and don’t see it.
Is this something I should add and have tested @KSman ?

Never test DHEA, test DHEA-S
At age 40, possibly an issue. Thread is getting too long for a exhaustive review of other factors that might shed a clue. Your cholesterol is good, so cholesterol–>pregnenolone–>DHEA not limited by low cholesterol. Not seeing cortisol lab results to have any idea re pregnenolone–>progesterone–>cortisol. Puzzled as to why you make remarks about cortisol.

It was on your initial list of labs (June 8th) to be done and I’ve never had it tested. I’ve read about it and seems to be a good one to test.

@KSman, @gonadthebarbarian, @Nashtide and fellow T-Forums peeps,
I’m 8-9 weeks in. Since I dont have any follow up HRT bloodwork for 6 months, I thought about tweaking my protocol to see if I feel any better. I do feel better, maybe 20% overall. I thought about doing one of two things. Should I try to increase T more? Should I try to adjust my e2? Should I stay the course?

I thought I would check what E2 of 30-32 felt like to see if I’m one of the minority that feels better higher than the normal 22 target. My last lab was at 25. So using new dose= old dose x (current e2/optimal e2). I would expect .2 x (25/32) = .156 (or .16) I thought if I felt worse, I could always go back to my .2mg?

What about trying to increase T? I was pretty happy of my new levels initially.

Living in a society of instant gratification, am I being impatient? I was hoping that I would feel “normal”. Since I am older (40), should I expect this to take longer for me?

Current Protcol / Meds:
Multi Vit 5 days/week
Vit D 5K IUs 5 days/week

Here’s my 6 week numbers (about two+ weeks ago)

Still planning on testing Cortisol and for Lyme in the next week.

Bio-T suggests that you need more T and SHBG=51.4 is probably inflating TT with T+SHBG.

More clomid may cause E2 problems. LH/FST and FT would be useful.

You can try more E2 to feel what that does. But that will increase SHBG and lower FT.

Big surprise, I agree with @KSman. I will say, making changes without labs can cause real problems. Be patient and make informed changes in the protocol following labs. Having said that, I’d start with an increase in T rather than a change in Adex. Also, try to focus on the things E2 really effects. Libido, morning wood, strength, fat loss, etc. Don’t get caught up in energy, focus, etc. those things can be effected by lots of factors. If you are pretty horny, having nocturnal and morning wood regularly and you see obvious body recomp, then E2 is good.

FT is on the low side. Like KSMan said, high SHBG is inflating TT.

I changed from 12.5 ED to 25mg ED and it did give me a boost. I did have to increase my arimidex also, but not a huge amount.

@KSman @Nashtide

Not sure I understand this correlation yet.
Can you elaborate or link a sticky or something?

In simple terms, TT is a combination of FT and bound T. Bound T cannot become FT. So the more bound T you have the higher your TT will be while your FT will be lower. So the greater the amount of binding agent you have in your blood the higher your TT will be while still having poor FT. This is why guys with high SHBG need more exogenous T to reach good FT levels.

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Consider this.


The more SHBG you have, the lower your FT. So, while it appears your levels are great, FT tells the real story. Also, I believe that SHBG keeps the T around longer also (its not bio-available) so it doesn’t get proceessed out as quick either, thus inflating TT.


Symptom Discussion - Brain Fog - #4 by KSman

@gonadthebarbarian, since you were asking me specifics about my case I bounce back into it.

I was hoping TRT would give me a little boost. Like I said, I was working out in 2015 when some sort of crash or viral infection (swollen lymph node) happened that sent me down this rabbit hole. I lost 30 lbs working out but I’ve gained 12 back. I’ve tried to get back to the gym several times but it’s been a struggle.

I’ve got orders to test Cortisol and for Lyme. I’m thinking about paying to have Estradiol-Sensitive (lapcorp) test done just to compare to the Urologist test since its not a lapcorp test and I dont know if its the sensitive test or not.

I have an appointment with a rheumatologist in December to rule out an arthritic or inflammation issue. I was hoping to solve this and cancel that appointment as I’ve already spent thousands of dollars on this.

Well, your numbers look good.

At the risk of sounding like a nag, you don’t need to lift to eat 500 calories under TDEE. At your weight and T numbers, you would lose nearly all fat, no muscle. Just make sure you do get some protien.

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OK, Here’s an update…

I’ve did the ELISA test for Lyme antibodies, which was negative. Reading up, this test is only 50-60% accurate and the Western Blot test is a much better test. Not sure if Ill get it or not.

I also finally got my Cortisol test done (waiting for results by mail) but when the nurse called me, it was in the middle of the normal range. It was done at 8am.

I had an issue with my prescription, so I’ve been off of HRT for about 14 days. After about 5 days, I got my script situation fixed and I thought I would experiment. After 8 days my fingers started to feel better and some of the brain fog stuff has been better. There’s been a few days that I felt pretty good. There must of been a sweet spot in there. I’m not sure if I’ve “restarted” or my system likes more E2 than the 25, my last test showed. However, I’ve yet to verify if it was the sensitive test, although the range would indicate it was and some of my old aces and pains have come back.

I went to a rheumatologist, he put me through a series of tests, results are attached below the nurse said everything looked normal except my vitamin D and prescribed me a “megadose” of 50,000 IUs of D2 once per week. This surprised me since I do take 5,000 IUs of D3 5 days a week typically. I had ran out the weeks leading up to the Rheumatologist visit. I usually take 10K IUs of D3 5 days / week in the winter.

Still convinced I may have a thyroid issue because of the soreness around my neck (again, I had a CT scan in october 2015 and an MRI in march of 2016, drs have said my thyroid has looked fine). Some times it feels like I have a tight turtle neck on. My last Thyroid panel was pretty good (see thread above for results). I started to think perhaps parathyroid? I’m surprised PTH is not included in a complete Thyroid panel. I read up on it, and typically high calcium is an indication. I looked at my last 3 calcium tests, all three labcorp:

2012 - 9.7 (Range 8.7 - 10.2)
2013 - 9.6
2/2016 - 10.0
3/2016 - 9.6

When I was reading the info sheet from my D2 prescription, it mentions parathyroid a lot. Thought that was interesting. I’ve read d3 is better for you that d2, not sure if its the same thing.

Anything jump out to anyone? Should I start the clomid/Adex back up targeting a higher E2 number? Maybe I’m an over-responder Think I should get my parathyroid checked? Anyone with some insight in the D2 vs D3?

Current symptoms:
-Tenderness at the base of my neck / tendon and muscle area
-Pain in my adams apple / area

Edit - Added labs and tagged @KSman

@gonadthebarbarian @Nashtide @KSman
Bump regarding update above. Any feedback? What about RBC being high? I know I’ve read where you should donate blood at some point, not sure if I’m approaching that or not?

New update:
Here’s a clip of me coming off of TRT (cold turkey mind you):

As you can see it started out good but didn’t finish well. I felt really good in the beginning (week 2 and 3) but had then I had some symptoms return, mostly body aches and lipoma pain. My finger stiffness and pain disappeared. This is important for me bc I play guitar in a band. This lump in my throat feeling worsened too. Emotionally, I felt good in the beginning, excited that my fingers improved, but then I’ve been a hot mess. Anxiety through the roof (mainly over the turtleneck / lump feeling) causing sleep issues. Fear of dying returning, thought that mid life crisis was behind me.

I started back up. I’m took dose three last night. I feel very jittery today.

CLOMID: 25mg EOD (Same as before)
ADEX: .12mg EOD (Was .2mg before)
D3: 10K IUs ED for 5 days, 2 days off.
Muti Vit: ED for 5 days

You have complicated symptoms, I’m really hestitant to comment, but I’ll do so anyway.

If you quit clomid, felt better for two weeks, then crashed, you might want to start a lower dose. Consider doing 12.5mg EOD. Clomid has a 6-7 day half life, so it stays in your system, at a lower level, for quite some time.

It is not uncommon for some guys to have higher RBC and hematocrit [HTC].

But your HTC is fine. Suggest that you avoid iron fortified foods [breads, pasta, cereals] and men should not take multi-vits that list iron.

Blood donation is not needed, but always a great thing to do for others. I was up over 3 gallons before I hit the age ?cut-off? and they also closed the clinic in my town.

@KSman, @gonadthebarbarian, @Nashtide
I’m currently 7 weeks off of TRT. I found that it was causing my Adams apple to swell and become very painful and hard to swallow. Now that I’m off, it’s improved by 80% but I can tell my Adams apple gotten a little bigger. Wonder if I’ve had low(er) T all my life as my post TRT numbers wasn’t through the roof and causing this pain/problem. I’m concerned about perm hurting myself not knowing this will normalize or not? Not sure if at my age, my adams apple could grow without pain? I did have a prepubescent testicle injury where I fell off some furniture and landed on the corner on my testicles with my feet off the air. Pediatrician examined me and said I was fine but I was “lucky”. Guessing I was 6-8 yo.

I was feeling pretty good before quiting, vision improved, body aches/pains and join pain improved, improved energy and erections were great.

I’ve searched the forums and surprising, no post mentioning Adam’s apple pain. Thoughts and/or advise?

Well, yes, if you have been low-t your whole life, you might expect some masculinizing changes. I never could grow a beard, because my facial hair was too patchy, but I could now if I wanted.

If the pain were tolerable and didn’t last longer than a few months, I’d probably keep at it myself. But that’s your call to make.

Edit: Are you sure it’s not thyroid related? Getting enough iodine, etc? Good bloodwork numbers?

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I had a full thyroid panel done in Aug. See post #46 above.

Well, your thyroid numbers are better than mine. That’s probably not causing it.