35, Need Opinions. Low T Related

Pharma / TRT Testosterone Replacement
1

Age: 35
Weight: 199lbs
Height: 6’
Waist: 36 3/4"
body and facial hair: Chest, abdomen, lower lats, shoulders, back of triceps and Face. Full head of hair.
Carrying Fat: Most of my fat is in the abdominal area and love handles. Some in my chest.
health conditions: clicking left elbow. Seasonal allergies (get sinusitis 2-3x a year)
Rx and OTC drugs: Flonase. I do have a prescription for anti-biodics and Budesonide (steroid) which I use in a nasal wash if allergies are very bad or i feel like i have a sinus infection starting up.
Symptoms: I didn’t really notice much of anything. However If I am being picky a little bit of fatigue. Past week or two I’ve had some brain fog.

Diet: Mostly clean foods Past 5 weeks 3100 calories on work out days 1600 - 2000 calories on non work out days (no carbs except during dinner) I do drink beer and vodka, however it varies greatly in my consumption. Its been close to a month since I’ve had a beer as of late.
Training: Currently Monday - Thursday weight training includes compound and isolation lifts. Monday - Wednesday HITT for 30 seconds on 30 off for 8 rounds. I’ve been doing this for 6 weeks. Prior I spent 3 months doing Jim Wendlers Get big in 3 months ‘5/3/1’ work out which I did for 4 months.

testes ache, ever, with a fever? - nope… and no fever either.

how have morning wood and nocturnal erections changed Hardly happens, mostly when it does is during the summer.

Temperature (just started yesterday)
96.7F 4:00pm 3/9/2017
96.8F 6:00am 3/10/17

Lab results with ranges: Lab test from 03/03/2017 7:40 AM
TESTOSTERONE 285 ng/dL 249 - 836 ng/dL
PHOSPHATE 3.1 mg/dL 2.4 - 4.7 mg/dL
MAGNESIUM 2.1 mg/dL 1.8 - 2.5 mg/dL
Total Cholesterol 145 mg/dL 100 - 200 mg/dL
Triglycerides 61 mg/dL 25 - 150 mg/dL
HDL Cholesterol 35 mg/dL 40 - 59 mg/dL
Non-HDL Chol (Calc) 110 mg/dL 0 - 159 mg/dL
LDL Cholesterol 98 mg/dL 0 - 129 mg/dL
THS 1.80 uIU/mL 0.27 - 4.20 uIU/mL (Thyroid Stimulating Hormone)
White Blood Cells 4.2 THO/uL 4.0 - 11.0 THO/uL
Red Blood Cells 5.21 MIL/uL 4.30 - 5.80 MIL/uL
Hemoglobin 15.7 g/dL 13.5 - 17.5 g/dL
Hematocrit 44 % 40 - 52 %
RDW 12.8 % 11.5 - 14.5 %
MCH 30 pg 27 - 33 pg
MCHC 36 g/dL 31 - 36 g/dL
MCV 85 fL 80 - 100 fL
Platelets 151 THO/uL 150 - 400 THO/uL

Glucose 87 mg/dL 70 - 99 mg/dL
Urea Nitrogen 27 mg/dL 8 - 20 mg/dL
Creatinine 1.11 mg/dL 0.64 - 1.27 mg/dL
Sodium 140 mmol/L 136 - 144 mmol/L
Potassium 4.2 mmol/L 3.6 - 5.1 mmol/L
Chloride 105 mmol/L 101 - 111 mmol/L
Carbon Dioxide 30 mmol/L 22 - 32 mmol/L
Anion Gap 5 3 - 12

Calcium 9.5 mg/dL 8.9 - 10.3 mg/dL
Protein, Total 6.9 g/dL 6.1 - 7.9 g/dL
Albumin 4.4 g/dL 3.5 - 5.1 g/dL
Bilirubin, Total 1.1 mg/dL 0.3 - 1.2 mg/dL
Alkaline Phosphatase 96 U/L 38 - 126 U/L
AST 19 U/L 15 - 41 U/L
ALT 17 U/L 17 - 63 U/L

% Neutrophils 67.4 % %
% Lymphocytes 21.1 % %
% Monocytes 8.3 % %
% Eosinophils 2.6 % %
% Basophils 0.6 % %

Neutrophils 2.90 THO/uL 1.80 - 7.50 THO/uL

Lymphocytes 0.90 THO/uL 1.00 - 5.00 THO/uL

Monocytes 0.40 THO/uL 0.10 - 1.00 THO/uL

Basophils 0.00 THO/uL 0.00 - 0.20 THO/uL

Eosinophils 0.10 THO/uL 0.00 - 0.40 THO/uL

Note I didn’t think I had ‘low T’ I gained some muscle over the winter (T-shirts went from L to XL and some people mentioned that I look bigger then before) and overall I have no problem getting it up. I got the blood work as my wife was insisting that I get my blood work done for cholesterol and more heart related issues that happen as we age. I had asked my Doctor internal med who works with NHL players for some more T blood work to be done however he said due to the fact i am in good shape and i have ‘no issues’ with muscle that my insurance wouldn’t cover additional T testing other then free T. I am now waiting to see an endocrinologist which happens in early may. I am looking for ways to boost my free T as TRT is not an option for me at this point as my wife and I are trying to conceive.

After reading the sticky’s i did note that I had stopped taking 3,000 IUs of D3 about a month before my blood work as I wasn’t sure if it was really doing anything. I also just got off of a course of anti-biodics and the Budesonide steroid about a week prior to my test. Could this cause a low number? Also, while my thyroid is at a 1.8 after reading some things about body temp so I am going to be supplementing with iodine.

Currently I am going to add 7,000 IU of D3 a day. As well as 25.mcg of iodine to my daily supplementation plan.

2

This is pretty damn low for a Total T number. I’m surprised you don’t feel worse. Low T is like that old story of a frog in a pan, where you can slowly turn up the heat until it cooks him, he never knows whats happening to him.

As someone who has been where you are, I can tell you that you don’t know how bad you feel until you begin to feel like you used to when your T was as proper levels.

When you get your T levels back up and your E2 under control, you will feel like you did when you were young.

When you go see your Endo, insist in getting your Estradiol checked. And dont let him start you on TRT without a plan to control E2.

3

TSH=THS?

Are you having some issues with typos etc?
Are the body temp numbers correct?

TSH should be closer to 1.0
You were not using any iodized salt on the table or cooking?
Are outer eyebrows sparse?
Your wife also affected, women as a group have more thyroid issues than guys.
See last paragraph in this post.

Total cholesterol is too low, 180 is ideal. Cholesterol is foundation for creation of all of your steroid hormones, including cortisol and Vit-D3. Most docs are brainwashed into thinking that cholesterol cannot be too low.

HDL can be increased with high potency B-complex mult-vits. Get product that does not contain iron, listing trace elements including 150-180 mcg iodine and 150-200mcg selenium.
Your wife needs vitamins that list iron. Fertile women loose iron, men do not and when they do, a GI bleed is suspected.

25.mcg of iodine is 25 micrograms - trivial
You mean 25mg?

When younger guys or otherwise vital are training hard when T and/or thyroid levels are adverse, this often is adrenalin overcoming low energy levels. This is a major stress and one needs to be looking out for possible adrenal fatigue. The gold standard for diagnosis is mid-range or higher fT3 with low body temperatures and elevated rT3 cabs can confirm. As your TSH is normal, you can expect docs and insurance to do little if anything.

You need to study up and take charge, you cannot be passive. Order your own labs, available in most USA States. Passive does not work.

To follow up on low-T, you need to test LH/FSH to determine if problem is in your testes or low pituitary output. Also test prolactin as that can be HPTA repressive. Prolactin increases from orgasms, cuddling puppies and babies etc. So you need to refrain for a few days to get clean lab results.

DO NOT START TRT before doing above suggested labs.
With your low thyroid function, T gels and creams probably will not absorb properly and self-injected T is your best option.

If LH/FSH are high, testes are not performing and doc can do physical exam to see if cause is correctable vascular abnormality. [But we often see mixed primary/secondary signals.]

With any form of TRT, you will need to manage E2 and must inject 250iu hCG SC EOD to preserve testes and fertility.

Many guys here have been on T+hCG and had babies.
With TRT you will definitely increase odds of sperm+egg.
SERMs, low dose, can be used to improve sperm quality as well when trying for pregnancy.

Your body and facial hair suggests that you were fully virilized and you may also have strong male facial bone structures. In cases like this, we expect the effects of low T to be normally worse than for a guys who never had high T levels.

Corticosteroids can lower T levels, use should be short term only.

Most docs that you run into are going to do TRT and manage thyroid issues wrong. Do not think that endos are then better, they seem to be the worse with arrogance multiplied by ignorance.

Where are you located, affects diagnostic and treatment options.

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • 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.

4

Love this statement KSMan!