Aloha T Nation-ers,
I have been lurking for some time and finally decided to post because I cant seem to figure things out and I cant seem to get a doctor to care…unlike the members here! I realize the blood tests below aren’t complete, but this is what I have managed to get done so far. I will be ordering per the stickies on my own dime soon to try to figure things out.
So the short story is that ever since I came back from Iraq in 2007 I have been having sleep problems, fatigue, lethargy, brain fog. The docs would run a few tests and I would be a prescription for Ambien. It seemed as if they didn’t believe me or didn’t care because only after going back numerous times did I finally get a sleep study which indicated moderate sleep apnea and I started CPAP. I still had many of the same issue, but I just got tired of going to the doctors and gave up. I then moved from New Mexico to Hawaii in 2013 and after about a year I couldn’t take the symptoms and went to the doc again. Turned up a vitamin D deficiency and it took two rounds of prescription vitamin d to get it into range. Since then I have been taking sups. Despite the CPAP and the vitamin d fix I have still been feeling like shit, but none of my docs cared… within the last 6 months things have gotten worse and I now have zero sex drive, can barely get an erection, when I do it is never full and almost never lasts, my fatigue/lethargy/brain fog have gotten 10 times worse and that is what drove me here. I went to my primary doc who did a thyroid test and said I was good. I then went to my shrink (ADHD) who listened a little and ordered a testosterone/free test. I also saw my pain management doc who, just so happened to, started selling testosterone pellets so he ordered most of the tests below.
This is where things are confusing. I took two testosterone tests one day apart and the first it showed 517 total test (264-916) and 8.6 Free test(8.7-25.1 ng/dL) which is low, but the second showed 636 total test (250-1100 ng/dL) and 75.9 (35-155 pg/mL). I did not get SHBG from either doc, but I am guessing that is why one free test was low? I googled why free test would be low and it said SHBG, but I couldn’t find if high SHBG is a chronic or acute condition.
I am positive I am missing something in the blood-work/symptoms/history, but I am at my wits end. Any help would be infinitely appreciated and if I can provide any info to help please don’t hesitate to ask.
Blood Tests: ( Test type - my value / lab range)
CBC w/o diff:
White blood count - 5.94 / 3.8-10.80 x10(3)/uL
red blood count - 5.03 / 4-6.2 x10(6)/uL
hemoglobin - 15.7 / 13.7-17.5 g/dL
hematocrit - 45.5 / 40.1-51%
MCV - 90.5 / 79.4-98.4 fL
MCH - 31.2 / 26-34 pg
MCHC - 34.5 / 32-36 g/dL
WBC morph comments - DNR /
platelet count - 256 / 151-424 x10(3)/uL
mean platelet vol - DNR / 7.5-11.5 fL
platelet comments - DRN
RBC morphology - DNR
RDW - 12.2 / 11.6-14.4%
RDW stand deviation - DNR / 35.1-46.3 fL
Comp metabolic profile:
glucose - 91 / 70-99mg/dL
BUN - 24 (High) / 6-23 mg/dL
creatine - 1.0 / 0.6-1.4 mg/dL
sodium - 142 / 133-145 mEq/L
potassium - 4.9 / 3.3-5.1 mEq/L
chloride - 103 / 95-108 mEq/L
CO2 - 27 / 21-30 mg/dL
calcium - 9.5 / 8.3-10.5 mg/dL
SGOT (AST) - 21 / 0-40 IU/L
SGPT (ALT) - 19 / 0-41 IU/L
alkaline phosphatase - 104 / 35-129 IU/L
bilirubin total - 0.5 / 0-1.2 mg/dL
total protein - 7.4 / 6.4-8.3 gm/dL
albumin - 4.8 / 3.5-5.2 gm/dL
globulin - 2.6 / 2.1-3.7 gm/dL
albumin/globulin ratio - 1.8 / 1.0-2.2
PSA total - 0.66 / 0-2.4 ng/mL
TSH - 1.3 / 0.27-4.2 uiU/mL
T4 total - 7.7 / 4.8-10.4 mcg/dL
T3 free - 3.6 / 2-4.4 pg/mL
anti TPO microsomal - <10 / <34 IU/mL
vitamin D - 33 / >=30 ng/mL
thyrotropin - 1.242 / 0.35-5 mcIU/mL
thyroxine free - 1.04 / 0.8-1.6 ng/dL
Estradiol - 15 / <61 pg/mL
Testosterone total - 517 (Lab 1 taken 15 Dec 17 aprox 2:00pm) / 264-916 ng/dL
Testosterone total - 636 (Quest lab taken 16 Dec 17 aprox 1200) / 250-1100 ng/dL
Testosterone free - 8.6 (Low) (Lab 1 taken 15 Dec 17 aprox 2:00pm) / 8.7-25.1 pg/mL
Testosterone free - 75.9 (Quest lab taken 16 Dec 17 aprox 1200) / 35-155 pg/mL
Symptoms: Why are you here
-Brain fog - I have actually went to the doctor several times over the last 10 years for this very complaint
-Social withdrawal - 50-50. Half the time it is withdrawal the other half has been from fatigue/lethargy
-No boob issues
-I carry a lot of fat in my abdomen, thighs and ass
-Moodiness fair amount
-Can’t get it up? Another reason I went to the doctor and was given Viagra
-It is up, now it’s gone. Viagra has worked fairly well, but has failed me on more than one occasion
-My testes are softer and smaller - cant say I have ever paid attention, but could be smaller than before
-No testes ache
-No real scrotum tightness
-Nocturnal erections - once in a blue moon
-“morning wood” - extraordinarily rare…
-Why do really hot looking women and girls now look like art instead of lust? This is a good way to put how I feel. I still check out every woman I see, but it feels like a cognitive desire not a physiological one.
-I felt great when I started TRT, where did that go? Week 2 so not a problem yet
-My TRT seems ineffective or never was. Things that crash in the night.
-Why do I feel cold easily or all of the time? I have been taking my temperature and it is very consistently low. I have been working on IR to see if it clears things up.
-Why do I have a chronic cough - I don’t take a statin drug, but I have talked to my doctor because it has seemed like I get a cough for a long time
-I have visual field disturbances - static, tracers, and dots that look exactly like migraine aura signs
-My joints have started to ache - about average ache
-TRT and now leg cramps - I have had significant leg cramping issues before starting TRT. I have been taking extra magnesium and it seems to have helped.
-TRT and wife says I am snoring more - sleep apnea and on CPAP machine
-I am not depressed, I just don’t care about anything, no joy, no motivation, no reward - very true, but when I talked to my doctor they just threw SSRI/SNRIs at me, but I have always had bad side effects from them.
-I want sex twice a day and my wife/GF is freaking out. If I ever get to this point, I will consider it a godsend