38 YO Looking for Advice

Pharma / TRT Testosterone Replacement
1

In your case/thread opening post:
-age 38

-height 5 feet 8 inches

-waist 34

-weight 198

-describe body and facial hair - Head has MPB. I shave head bald. Body- Very hairy arms, chest and legs. Back has hair but not as bad as rest of body

-describe where you carry fat and how changed- I have always carried in my love handles, belly button area and chest. I can see abs. I do not have a hard fat belly but I have soft fat where I do have it. (Pics in dropbox folder)

-health conditions, symptoms [history] I have always felt relatively healthy. Was a smoker from 18 to 26. I did have shingles about 6 years ago. Very mild case. Right at the end of January 2014 I made a commitment to try to get myself extremely healthy. Started going to a very reputable doctor/nutritionist back in March 2014. He did blood work and it was discovered I have a blood mutation called MTHFR. I am on supps to supposedly help that condition. When I first started seeing this Dr he had me take my temp 4 times a day for a week. I ranged anywhere from 97.1 to 97.3. He did not seem to even address these temps. Are they of concern? Reason I am even exploring T-Nation is my nutritionist said we HAVE to get my E down and my T up yet his only suggestion was taking various over the counter suppps. I seem to have plateaued for the last month and a half to two months. Fat is not going anywhere.

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever- No hair loss or prostate drugs.

Supplements started in March: Nutritional Frontiers T-Boost, SAMe, 2000mg Vitamin D, 50mg DHEA, Multivitamin, Methyl Protect, Neo-40, Zinc, Fish oil, ZMA, Melatonin 3mg

Supplements after June blood draw: MHP T-Bomb, DHEA 75mg, Myomin for estro control, Fish oil, 2000mg Vitamin D, liquid zinc, ZMA, Melatonin 3mg

I was always a skinny kid and when I was about 14 years old my father bought me the Original HOT STUFF which I am pretty sure was taken off market for having steroids in it. I took it for several months. When I had taken it I began to develop my fat storage on my chest and love handles. My body changed forever right then and there.

-lab results with ranges - see drop box attachment. I attached my original labs when I first saw my nutritionist in March as well as the repeat set taken in June. I also attached my body comps. No idea how accurate the body comp tests are but putting here for more insight into my process

-describe diet - Eat 6 meals a day. Body for life style. Avoid wheat and gluten. Track calories, Strive to be between 2000 â?? 2200, Aim for 40,30,30 Carb, Pro, Fat. I quit added sugar for the most part. Rarely drink but if I do I will have a few.

-describe training - 6 days a week. 3 day I weight train 45 minutes to an hour and 3 days I either do 20 minutes of HIIT or Insanity workouts.

-testes ache, ever, with a fever? Don’t know if I have a fever along with it but occasionally after training my nuts get a twinge when I take a piss. Doesn’t last long. Nothing I was ever alarmed by.

-how have morning wood and nocturnal erections changed - I honestly never paid attention to morning wood but have for the past few weeks. I have it occasionally. I would say 4 or five out of 7 days its there but it isn’t a rock hard boner. I will say I used to be the most horny dude on the planet. That has changed over the last year. No signs of ED but the urge that was always there just isn’t anymore. Don’t beat it hardly ever. Used to quite a bit LOL.

In conclusion I am on T-Nation because I want to know if I am just spinning my wheels at this point. I train hard. I eat well, could probably still use to sleep better. Workouts are good to sometimes great. Strength has improved but lately I feel stuck. Could it be my test levels and estro levels? I am sick of having a fatty chest and love handles. I can see an excellent shape with 6 pack abs under the soft belly fat. I am attaching some photos showing me in January when I started and current ones now. There has been a definite improvement but the damn man boobs and belly are hanging tough. Any help is appreciated. I feel like if T and E are really an issue for me throwing over the counter supplements that may or may not work is probably not the way to go. I’ve read the stickies and did my best to provide as much info as possible. Thanks in advance for any help that you guys can offer.

March blood work - Dropbox - 3-16 Blood.pdf - Simplify your life

June blood work - T went down and was swithced from T-Boost to T-Bomb and Myomin. Dropbox - 6-30 Blood.pdf - Simplify your life

Body Comps - Dropbox - Error
January Body - Dropbox - Error
Dropbox - Error

Current Body - Dropbox - Error
Dropbox - Error

2

CRP is not cardio specific, but reflects general inflammation. Homocysteine is cardio specific. Test homocysteine.

TSH is near 4.0, you have hypothyroidism but other thyroid labs do not read that way. This might explain a lot of your issues. Read the thyroid basics sticky and check your waking AND mid afternoon body temperatures and eval your long term use of iodized salt. And you have thyroid auto-immune markers.

Your thin blood could be from a GI bleed. Do you have digestive issues? You can get an occult blood test to see if there is blood in your stool.

Get 5000 iu vit-D tiny gel caps. One per day, take 5 per day for first week.

E2=27 is not high, but relative to your FT, you are estrogen dominant. You could take 1/2 mg anastrozole per week in divided doses.

Read the advice for new guys sticky carefully

Summary:
Thyroid is a mess, you will check temps and look at iodine issues, post labs here and tag me in the ‘ksman is here thread’
Blood is thin, check for a GI bleed “Avoid wheat and gluten”
See if you can get anastrozole
Read both stickies
check homocysteine
check prolactin

Melatonin, only at bed time

3

KSman thanks for taking the time to look this over.

Two things real quick. I think Homocysteine was checked in June blood. See page 5 of 6. It says:
Homocysteine, Serum 7.8 (NR 5.8-12.0 uMOL/L) Is this the Homocysteine test you talked about?
CRP (cardio HS) 1.8 (NR 0-3.0 MG/L) This was down from March blood.

Second question. I have the 5000 Vit D. Do I take 5 over the course of the day for the first week or 5 all at once? What is that targeting?

Finally I do not think I have GI issues. Stool is never dark. It’s always light if anything. Could blood be thin from either too much fish oil or possibly the Neo-40 supplement he put me on. Neo-40 is a beet powder based nitric oxide helper. I was taking heavy amount of fish oil but have stopped and went to normal dose of 600 EPA and 400 DHA. Was taking 2400 EPA and 1600 DHA up until June.

I ordered an analog thermometer to do my temps with. Will have it tomorrow. Do not trust the digital I used when I first saw the Dr.

I guess my test numbers would be OK if estrogen came down? I will try to seek a Dr to prescribe Anastrozole

Off to re-read the stickies again.

4

vit-D25: Humans in temperate climates store vit-D3 with sun exposure and this is slowly converted to vit-D25 through the winter months. There have been studies where people took 300,000iu 4 times per year. Your vit-D25 should be higher than we are seeing with 2,000iu.

Thanks, I could not find the homocysteine data in those documents. Things look good. The idea of the testing is to rule some factors in or out. Please to not dismiss my suggestions so easily. My suggestion is based on hundreds of lab work reports from guys and their health issues/outcomes.

Many here take fish oil and have hematocrit in the upper 40’s. The blood loss would not be enough to make stools black.

5

Took 3 vit D 5000 this morning. Will take 2 tonight. Will continue that for 5 days and then maintain with one a day.

I was not dismissing anything. Was just assuming GI bleed would lead to dark stool. Naive I guess you could say. Also concerned that Dr is just throwing shit against the wall with some of the supplements he has me taking. Was thinking they could be cause of thin blood. I do have slight pressure from time to time under might right lower rib cage. Gassy sometimes too. I will try to get script for occult blood test.

Found out today that half my mothers side of the family is on thyroid meds. Could be hereditary. I am going to start temp tests tomorrow with good analog thermometer. Do you feel the iodine replenishment is needed. Read the sticky but am still a little confused on best way to accomplish this. Could you tell me in black and white how to do this and for how long.

Finally I made an appointment next month with an endocrinologist I hear is very good with thyroid issues. Young woman who has treated a friend of mine. Quite a distance but supposedly very good. I will mention Anastrozole to her as well. Hopefully she is open minded.

I appreciate your time. As with anything your time has value. If you want to be compensated for reviewing my case I would have no problem doing so. You could pm me or email me.

6

Doc will have a home test kit for that test, they will hand it to you.

prolactin!

No one else seems to not understand iodine replenishment. You would take 50mg per day for two weeks or less for longer to get the same amount of iodine on-board.

You never responded to the question of your long term use of iodized salt.

7

We use iodized sea salt if/when we use it. I add salt to my eggs every morning and will put it on my steak if I have one. Don’t really add it to anything else throughout the day. I would not consider myself a large salt user by any means.

Some of the posts under the sticky had me confused on the IR protocol. Once the 50mg pd for two weeks is over do you need a maintenance dose or from there out just need added iodized salt in diet? Should I wait to redo temps to start IR?

I will ask doctor to check prolactin. I have an appointment scheduled for 9/2/14

8

You need an iodine maintenance intake of course. Some are then taking 6mg iodine every week or two weeks.

9

KSman

Reading through the thyroid sticky again it seems some feel an autoimmune thyroid should not treat with iodine. Do my high levels of TPO show an autoimmune thyroid? Is iodine still recommended?

Also are my test levels fine? Is there no concern about test levels?

10

Your call. I have not spent much time lately reviewing such issues. You will not find any research that advocates that thyroid autoimmune conditions should be treated by inducing iodine deficiencies. There was a series of posts by one individual who had a bad reaction to iodine and he had his friend try it who also had problems. My inclination is that the product might have not been as advertised.

11

Ok. I am going to give it a shot. My temps are consistently low. 97.4 is about the highest I have seen.

If you get a look at this thread again should I be ruling out TRT totally at this point and only be looking for Anastrozole?

12

I think that you should get thyroid under control before TRT as starting TRT with hypothyroidism can have a poor outcome. You may need more than iodine, but do you want to jump onto the livelong Rx thyroid band wagon before you explore what IR will do?

13

Iodine will be here Tuesday. I will report back soon. Thanks KSman.

14

KSman… New blood work. Prolactin on page 3. Did Iodine replenishment a while ago now. Advice???

Have not taken any prescription drugs yet. Went to two Dr to talk about thyroid and and T/Estro levels and both told me I was fine. Still trying to find a local Dr who gets it. Thought the second was going to be the right one but obviously not.

15

"KSman don’t want to be a PITA but if you could give this new lab work a look and give me your input I would really appreciate it. Iodine got my body temp regulated and I feel better but even on a strict clean diet with very little grain intake I am not able to shed the belly fat, the chest fat and the love handles. My E2 is down to 22 and I guess it is from the product given to me by my nutritionist. Test and free T still seem low??? "

I thought that I responded to those labs already.

Labs are looking better, but you seen to have thyroid auto immune issues.

You will feel better with fT3 mid-range and may need meds to get there.

How much iodine in total and what are current body temperatures?

16

KSman - When I started taking temps they ranged between 97.1 and 97.4. As for iodine I took 12.5mg a day since august and now I am hitting 98.6 in the evening. Planned on stopping in another week.

Along with the iodine I was put on a product called DSF by my nutritionist for adrenal support.

After this blood was taken he now wants to put me on a thyroid support product not an Rx but another over the counter product.

Had prolactin checked. Is it within range? 9.3 - range 2.1-17.7 ng/mL

Are test and free t ok?

Do you feel I need to get a Rx for thyroid meds? Overall I feel pretty good. Just can’t lose the fat even with extremely clean eating and very hard workouts both strength and cardio.

17

Here is my January blood draw. My body temps have been very good. I wake at 97.2 and get to 98.6 by afternoon. Only change from prior draw with diet and supps is I have cut gluten down considerably and had raised my DHEA dose a lot on the advice of my doctor. I eat zero processed foods and am typically in a 40/30/30 protein/carb/fat zone.

I had gotten the Estro number down and my DHEA up at last blood draw but my doctor still told me to up my DHEA to 75mg a day hoping to raise my test and free test. I am convinced that caused the spike in my estrogen. I am back to a 25mg dose of DHEA now.

Am I a canidate for thyroid meds? My sleep still sucks. I can’t lose any body fat and I eat very well and work out 6 days a week. Extremely frustrating.

January Blood draw at link below as well as a summary of the three prior draws on the last page. KSMAN please look at my last post as well as this one and comment. Thank you in advance.

18

Age 38 and T levels are low.
Please post your LH/FSH labs into this thread so I don’t have to do an easter egg hunt.

If DHEA is low, that might lower T production and an intact HPTA would try to increase LH/FSH.
Restoring low DHEA is one thing. But high DHEA levels do not increase testicular T production!

Your blood is thin, TRT would fix that. Ferritin is good, so probably not a GI blood loss.

E2 was high relative to T levels and you were estrogen dominant and that would drive down LH/FSH creating a effect opposing the wished for increase in T from high DHEA dosing.

It is very important to have an identifiable source of selenium as a deficiency can lead to an thyroid auto-immune problem!
See updated thyroid basics sticky. CHECK YOUR SUPPLEMENTS

With TPO high, the notion that your low thyroid state is a result of low T is in doubt.

Your thyroid hormones are substantially below midrange [optima]; except fT3 is good.
Your AM body temperature is low and you eventually get to 98.6. This suggests that you might have rT3 contributing to low body temperatures by reducing the amount of fT3 that gets into your cells.

CRP and homocysteine are good!

Vit-D25 very good.

Thyroid function:
Are you feeling cold easily?
Dry skin?
Sparse outer eyebrows?

If you have been getting selenium in your supplements, you may be stuck with high TPO. But your body temps should be better with your good fT3, which brings us back to rT3. If rT3 is a problem, taking T4 thyroid meds can simply increase fT4–>rT3. Read the thyroid basics sticky again.

TRT is worth some serious consideration unless a cause can be found for low LH/FSH that can be fixed. Sometimes thyroid problems can do that; so that muddies the waters. You would certainly feel better with TRT. Getting rT3 tested would resolve some unknowns. Stay on top of the thyroid, rT3 and TPO issues.

19

Thank you for the detailed reply.

I just looked through all my previous labs and do not see any test of LH/FSH. I will ask for it on the next test as well as getting rT3 checked.

My multi pack has:
Selenium (as selenium aspartate and selenomethionine) 140 mcg 200%

That is my only supplement that has any Selenium in it.

Thyroid function:
Are you feeling cold easily? ALWAYS!!! Hands and feet are always cold and I hate winter. If outside too long in cold temps my hands become almost too painful to deal with.

Dry skin? Yes, red patches on scalp, flaky scalp my whole life

Sparse outer eyebrows? Yes, they are thinned from when I was younger. Stop well short of where they used to.

One other possible symptom I have is my sleep sucks. Always has. I sleep in two hour spurts.

I am seeing a new Dr Thursday. He is a thyroid specialist who claims to deal with TRT as well. He has my mother, who has not slept in years and has high TPO like I do, sleeping again. He took her off her long prescribed Synthroid and got her on Nature Throid. She said she feels like a new person.

20

LH/FSH is a must to know is you are secondary or primary. If primary, go straight to TRT, do not pass go.

So your problem is not selenium. You need rT3. If rT3 elevated, you need to read thyroid basics noting references to adrenal fatigue, rT3, wilson’s book, stress, infections, inflammation, accidents etc. With elevated rT3 you will take T3 med as T4 will T4–>rT3

Scalp is a bit different, dry skin would be elsewhere as well.

You do sound like thyroid would improve your life. You can get rT3 issue settled then do a thyroid med trial and see is that improves your life. If improved, you will want to stick with it.