Bloodwork Results, US Veteran Needs Help

Pharma TRT
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First things first:

Thank you for reading this, and I apologize for any stupidity in the way I pose the coming question and also apologize for my overall lack of knowledge on this board.

Long story short, I am a US Army Veteran with Traumatic Brain Injury which I believe has somehow thrown off my pituitary gland, and my hormone levels have followed. I have been experiencing all the symptoms of what people would call Low T, namely I am constantly tired, depressed, have ED, lack of motivation, etc. I used to be doing three or four competitive athletic events a year, and now I can barely jog down the street without becoming completely exhausted. I got bloodwork done several times, and I am including the results for two of them including the doctors notes that they wrote to me.

I feel like I am being dicked around and I need to know if that is the case.

Please look at the results attached and let me know if things look right or if they do not look right. I keep asking to see an actual endocrinologist which they have been giving me a very hard time about because they say that my testosterone falls into the normal range, even though my free test is bottomed out and a few other things arent optimal.

I am getting the feeling that the normal range is for really weak people who dont do anything, and feel that maybe for most of my life while I was doing all of my athletics and during my time in the military, my testosterone was at a level that was normal for me, (but maybe substantially higher than some others) and then when I suffered my brain injury, it dropped my levels down to what is normal across the board?

I don’t know. I am not a smart man to begin with, plus I have a brain injury, so I am asking you to please take a look at the attached medical records and advise me on if I am being fucked around and actually need to look into this further as a medical issue, or if I am actually healthy in this area and need to STFU and stop bugging the VA about it.

Also please give me advice on what to say to get in to see who I need to see etc. I have 100% service connected disability so all my health care is free I just need to know what to say so that they dont dick me around in my appointment with my primary care provider.

THANK YOU for taking the time to look and respond.

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You are in the right place. A lot of reading to do as you will end up knowing more about some things than your doctors.

Please read the advice for new guys sticky. Note the first paragraph. We are looking for causes of your low T.

LH and FSH make sense compared to TT.
SHBG indicates that E2 [estradiol] is probably high. ALT/SAT does not disclose a liver problem as a cause of that. However, your medications might be a factor as you will see in the sticky.

One lab showed TSH=3.91
This is indicating probably low thyroid function. The best situation would be an iodine deficiency and you fix that.
Have you been using iodized salt for years? If not, probably deficiency.
Check oral body temperatures when you first wake up AND mid-afternoon. Should be around 97.7-97.8 when you wake up, 93.3 and below are a problem. And you should be able to hit 98.6 in the afternoon.

The lab ranges for thyroid hormones are stupid. See the thyroid basics sticky.

Thyroid labs:
TSH
fT3
fT4 [do not get tested for T3, T4, we don’t care about thyroid hormones that are bound to TBP]
rT3

Reverse T3 [rT3] blocks fT3 from activating fT3 receptors in your cells. rT3 can be elevated from living stress, stress from infections or inflammation or from trauma or surgeries etc. So you may be affected from this.

Other labs:
TT
FT
E2
prolactin
IFG-1 [growth hormone status, could be affected by damage to pituitary]

Statin drugs [cholesterol]: These can lower CoQ10 and a CoQ10 deficiency can cause muscle pains and chronic low level coughing. You can supplement CoQ10 if needed. The “ubiquinol” form has much higher boo-availability.

Action items:
read the two stickies [there are 7 in total]
get the labs suggested above
post info re body temperatures and iodized salt
post more info about you as per the advice for new guys sticky

Where are you located? - affects medical options

Please post labs as text in a post in this thread and I will review side effects etc.

How does the time line of your testosterone issues relate to time line of head injury, surgeries, introduction of drugs etc?

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UPDATE 2/8

Catch up from original post, starting right:

30 year old male
5"9
35
190lbs

I have noticed body hair thinning extensively over the last year or two, facial hair seems to have come in thicker while heair on the top of the head maybe slight thinning but not balding yet

I carry fat in my midsection and trunk mainly, this has not changed much, I have actually been experiencing extreme weight fluctuations over the last year and am now sitting at about 190lbs at a medium build with a decent diet.

Health Conditions:
Multiple Traumatic Brain Injuries
Multiple Concussions
PTSD
Gastro/Abdominal issues
Pinched nerve in neck

My current supplement/medication list: (This is EVERYTHING going into my body that isnt food)

Multivitamin (Unicomplex-M Rugby Brand) VA Prescribed
Fish Oil 6kMG (Super Omega3 3T Brand) VA Prescribed
D3 2kIU (Major Brand) VA Prescribed
Ramelteon (Time release melatonin for sleep) VA Prescribed

My most recent labs are in the original post, I am getting an appointment set up this coming week where I need to ask for the following labs to get done:

TSH
fT3
fT4 [do not get tested for T3, T4, we don’t care about thyroid hormones that are bound to TBP]
rT3
TT
FT
E2
prolactin
IFG-1 [growth hormone status, could be affected by damage to pituitary]

My current Diet:
Breakfast:
Protein Drink (Naked Fruit juice brand)
Bagel with cream cheese

Lunch:
Random deli style sandwich made with good ingredients though

Dinner:
Usually a steak and potato

I am obviously not dieting for training right now. I am in fact not training at all, the most I can do is take my dog for a walk twice a day. I used to train jiu jitsu and compete state-wide, and I have spent almost the entire last decade in the military being very physically active, so this is torture for me and I do not know what to do. My testes I have not noticed particularly aching, though the fever with what seems like temperature shifts happen frequently. My sex drive is in the dumps, let’s just put it that way.

I am located in Napa, CA.

So thank you so much for your response, I just read it and started reading through your article on iodine, got to

the part about how you normally have to ask somebody three times to take their temperature and I didnt want to be

that guy. Took my temperature and It’s about noon, I’ve been up for hours, and I’m sitting at 97.4 body

temperature. This is about how I feel every day. Read a few paragraphs further about rT3 and how life stress can

cause that to be stored in the body, and I cannot imagine how through the roof that reading must be after almost a

decade in the military, a divorce, and a drug addiction problem in my rearview mirrior.

IODINE ISSUE:
I read the thyroid and iodine sticky, after taking my body temperature just sitting here on the couch I feel this

could clearly be an issue. I ordered Optimox Iodoral from Amazon which comes in 12.5mg tablets. From my

understanding your article said up to 50mg a day was permissible so I am planning on dosing every 6 hours or so

depending on how well my stomach holds up with it. I also added NOW foods selenium 200mcg to my shopping list per

your article but am not clear on how it should be dosed. Should I take it once per day or with each Iodine tablet?

Both are ordered and should be here by the beginning of next week. Also from reading your article I am expecting

to probably be very sick due to the high level of bromine that is probably in my system. How bad have you seen

this get? Will it just be nausea and diarrhea or vomiting as well? I also browsed the stopthethyroidmadness page

and can identify with virtually every symptom of adrenal fatigue they have listed on there. I also see that they

seem to be VERY against T3 and T4 being used, which seems kind of like the opposite mindset than what most of this

site holds. I feel personally that I would be open to almost anything offered to me that would help but I am

realizing that this might put me in a very dangerous position. Thoughts?

FINDING A TRT DOC:
I found a local endocrinologist here in Napa that says right on their website they do consults for Low-T, and

thyroid issues. I do not know if sharing the specific doctor is following the board protocol so I will withhold

the name for now. I requested an appointment via their website but it’s Sunday so I am sure I will not hear back

until tomorrow afternoon at the earliest. If I do not hear back from them by Wednesday I will follow up and make

some additional attempts to find another doctor.

I have 100% insurance from the VA which should include, at least theoretically, ALL things I could need medically as they relate to this, but I need to be able to show them what the situation is, and show them what needs to be done (possibly all on my own and all out of my own pocket).

My testosterone issues and the timeline all starts during and after my deployment to Iraq, I don’t know which explosion or bang to the head to officially blame.

When the labs come I will post them here as text, is there a certain format that is used here on the boards that is preferred?

Any and all suggestions to daily routine / diet / supplementation / medication are appreciated

THANK YOU again for reading and responding, I cannot wait to get my daily energy levels off the floor from zero.

-AC

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Multivitamin (Unicomplex-M Rugby Brand)

  • find better
  • does not contain iodine or selenium

Vit-D3 5000iu probably better, tiny oil based gel caps

Ramelteon (Time release melatonin for sleep)

  • you can also try 5-6mg time release melatonin from Walgreen’s etc. See if that has any advantages
  • not exactly melatonin Ramelteon (Time release melatonin for sleep)
  • Melatonin - Wikipedia
  • Ramelteon - Wikipedia

I use time release melatonin and trazodone, an effective and cheap generic, $40/year at Walmart.

Diet: See if you can shift away from those simple carbs 3 times per day [potato, breads etc]

No need for a discrete selenium supplement if you get a different multi-vit. Take 200 mcg [micrograms] per day at any time. The selenium will be taken up in enzyme structures.

You can add AM cortisol to your list of labs, do at 8AM.

VA - we have seen a lot of stupid shit from the VA with posts in this forum. So don’t set your self up for a disappointment.

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Tracking on all points, I have an appointment with an endo that I am paying out of pocket for on Thursday. I am going to bring all of the VA labs, and also the list of labs suggested from you that I should get and insist she gives me a referral for those. I don’t know how crazy pricing could get so we will see tomorrow.