31 y/o with Waning T

Pharma / TRT Testosterone Replacement
1

I am a 31 y/o male. I take care of myself and eat healthy 90% of the time. I lift heavy and hard 5 times a week. No steroid use. Lately I have felt lethargic, low energy, low sex drive, decrease in erection duration and hardness, depression, anxiety, urinary frequency (just generally a “bad piss” feels like i need to keep emptying) and general carelessness. My T level 3 years ago was mid 600’s if i remember correctly. The number now is below.

-age 31
-height 6’4"
-waist 33-34
-weight 227

-describe body and facial hair
I have a beard and mustache, lower back hair, some hair on fingers and hands

-describe where you carry fat and how changed
I carry fat in my lower abdomen and back

-health conditions, symptoms [history]
I only have seasonal allergies. Within the past 4 months I developed a rather uncomfortable bladder issue. I usually have to urinate frequently and it feels impossible to hold for about an hour after emptying my bladder. Dr has not diagnosed anything yet. I see him monthly.
Depression, no meds. Lifting has been my psychotherapist but it doesn’t work as well anymore.

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
Multivitamins, typical lifters supplements, no steroids or test

-lab results with ranges
Rdw: 13.0 % Final
Platelet Count: 150 thou/mcL Final
Mpv: 10.1 fL Final
Low Neutrophil: 39.9 % Final
High Lymphocyte: 47.8 % Final
Monocyte: 10.1 % Final
Eosinophil: 1.7 % Final
Eosinophil Absolute: 0.10 thou/mcL Final
Monocyte Absolute: 0.80 thou/mcL Final
Basophil Absolute: 0.00 thou/mcL Final
Neutrophil Absolute: 3.20 thou/mcL Final
Lymphocyte Absolute: 3.80 thou/mcL Final
Basophil: 0.5 % Final
WBC Count: 7.9 thou/mcL Final
Red Blood Cell Count: 5.03 million/mcL Final
Hemoglobin: 15.4 gm/dL Final
Hematocrit: 45.1 % Final
Mcv: 89.6 fL Final
Mch: 30.6 picograms Final
Mchc: 34.1 gm/dL Final
Testosterone, Total, Serum Testosterone Level: 4.02 NG/mL

I am sorry ranges were not provided in test results. Lab provided Only low/high. I also have urinalysis if interested.

-describe diet [some create substantial damage with starvation diets] eat healthy, chicken, rice, greens, healthy fats and oils, no fast food, no soda, drink 3-4 alcohol beverages a week

-describe training [some ruin there hormones by over training]
I lift free weights and machines 5 times a week. I go as hard as i can dependent on my energy

-testes ache, ever, with a fever?
testes have ached in the past, no fever that i am aware of

-how have morning wood and nocturnal erections changed
less nocturnal erections, morning wood goes away quickly, quantity (and quality) of ejaculate is significantly less than it was a year ago.

Thanks for the help. I have not felt like myself since November of 2015. It is March of 2016 now.

2

You are too young for BPH. So I have to wonder about prostatitis.
Has your urine been cultured to check for bacteria?
Has urine been checked for more than chemistry to look for cellular fragments or white blood cells?

Please follow/read these links in the 2nd post of the 1st forum topic:

  • advice for new guys
  • things that damage your hormones [over training?]

Has your thyroid been checked and thyroid hormones?
Have you always used iodized salt?
Do you feel cold easier now?
Outer eyebrows sparse?

You need to get LH/FSH tested to see if the problem is in your testes or pituitary.

Labs:
TT
FT
E2
LH/FSH
prolactin
CBC -done
hematocrit -done

Generalized hair thinning?

Any blows to the head last year?

3

Has your urine been cultured to check for bacteria?
yes, urologist noted no discrepancies

Has urine been checked for more than chemistry to look for cellular fragments or white blood cells?
I dont know, i am assuming the doctor did this when he looked at my urine under microscope

  • things that damage your hormones [over training?]
    I will take a look, I cannot imagine my 4-5 days a week do that much damage…

Has your thyroid been checked and thyroid hormones? I do not know, they did many panels, i will post the others below

Have you always used iodized salt?
Yes i suppose

Do you feel cold easier now?
If i miss more than 3 days of lifting i might be a little colder but typically i am always hot. room has to be around 60 to sleep well

Outer eyebrows sparse?
I am not sure what you mean so i will have to say no.

I have always thought that my symptoms (bladder urgency and frequency, and my lower back pain) resemble that of cuada equina syndrome. I mentioned to dr. He overlooked. Honestly this is my last hope for figuring this whole disaster out. My mood is terrible and i just push people away, most recently a gf. I lived a healthy life and it did not matter in the long run. My dr seems to think it is some sort of bladder issue but i am concerned it is something different. Please see test results below, these were taken the same day. I have a tough time extracting the information’s meaning. I do not know what “corrected” means, everything else is posted as “final.” I see the doctor on tuesday. Any questions i could ask him would be greatly appreciated. thank you

PSA Diagnostic: 0.74 NG/mL Corrected
PSA Free Percent: 36.5 % Corrected
Squamous Epithelial Cells Urine: rare Final
WBC Urine: <1 /hpf Final
RBC Urine: <1 /hpf Final
Thyroid Stimulating Hormone: 0.79 mciu/mL
ABNORMAL Color Urine: straw Final
Appearance Urine: clear Final
Specific Gravity Urine: 1.008 Final
pH Urine: 7.0 Final
Glucose Urine: normal Final
Ketones Urine: negative Final
Bilirubin Urine: negative Final
Blood Urine: negative Final
Urobilinogen Urine: normal Final
Leukocyte Esterase Urine: negative Final
Nitrite Urine: negative Final
Protein Urine: negative Final

Sodium Level: 139 mmol/L Final
Potassium Level: 3.8 mmol/L Final
Chloride Level: 103 mmol/L Final
Carbon Dioxide Level: 26 mmol/L Final
Glucose Level: 100 mg/dL Final
Bun: 19 mg/dL Final
High Creatinine: 1.44 mg/dL Final
Calcium Total: 9.6 mg/dL Final
Protein: 6.6 gm/dL Final
Albumin Level: 4.4 gm/dL Final
Bilirubin Total: 1.2 mg/dL Final
AST/SGOT: 29 units/L Final
ALT/SGPT: 24 units/L Final
Alkaline Phosphatase: 74 units/L Final
Anion Gap: 10.0 mmol/L Final

4

Nothing there catches my attention.

Could also check for CRP, a generalized marker for inflammation.

STD’s tested?
DRE? digital rectal exam
Might need a urologist for this diagnostic work.
Ultrasound after pissing will show urine retained in bladder and will also image prostate.

5

Thanks for the info. The first urologist did not think I had prostatitis, I will talk to my gen phy tomorrow either way. I had a prostate exam (non-digital). Years ago I had and was cured of chlamydia… although some symptoms I have (now) resemble that disease, I do not have the same symptoms I had back then. They did two ultrasounds and said that 1-2 ounces left was normal.
The lethargy, lack of care, low energy, erections and mood bother me the most.
The doctor mentioned doing an exam in which they stick a tube camera up your urethra and “look around” in your bladder. I have not done this…as it seems very unpleasant.

They did do a CT of my lower abdomen and into my groin. Everything was normal.

Does anyone know what intersisital cystitis is? Could I potentially have those symptoms?

Is no one shocked that I am at a 400 level T?
If I was 650 three years ago and I am at 400 now…then what does that tell me about the next two years? Am I destined for low T? It really feels like I am on the low end. As much as I do not want to take Test, I do have some and have never experimented with it…

thanks for the help it is greatly appreciated…

6

intersisital cystitis is outside of my knowledge base
Looks like your diagnostic work as been extensive

We see guys with low T all of the time here, that is the point of the forum.
Please see my first post for suggested lab work.