Getting Informed & Looking for Help

Pharma / TRT Testosterone Replacement
1

I am new to this website and have been reading the wealth of information (stickys) contained in all these forums. It is a bit overwhelming but I am learning a lot. In the last couple of months I have not been feeling myself and am seeking answers. I figure Ill throw out all my background info here & hope the resident experts can guide me.

Age 41
Height/Weight 6ft / 185#
Body Type Very lean arms, butt & legs, carry extra weight in the chest, belly, upper back
Exercise History Have worked out & played sports routinely for most of adult life. Past couple of years has been mostly weightlifting with minor cardio. Currently doing the 5/3/1 program for past 4 months and have had some success. But as always, putting on muscle & gaining strength is not at all what Id like.

Issue I have been very fatigued the past couple of months. My endurance (cardio) is down, interest in sex is down (can still perform no problems) and have been moody & stressed for no real major reason. And as a result, went to my Dr. last month for a full physical. Results were;
Echocardiogram OK Stress Test � finished just under 10 minutes, 3 years ago did it in 14 minutes. Dr. noticed minor anomaly so Ive been referred to a cardiologist. Will have a nuclear stress test in 2 weeks.
Blood Work;
Lipid Panal Cholesterol, Total 169
HDL Cholesterol 46
Triglycerides 58
LDL-Cholesterol 111
CHOL/HDLC Ratio 3.7
Comp. Metabolic
Glucose 89
UREA Nitrogen (BUN) 23
Creatinine 0.85
Sodium 140
Potassium 4.5
Chloride 103
Carbon Dioxide 26
Calcium 9.4
Protein, total 7
Albumin 4.2
Globulin 2.8
Albumin/Globulin Ratio 1.5
Bilirubin, total 0.6
Alkaline Phosphate 67
AST 21
ALT 18
Hemoglobin A1c 5.5
Vitamin D 28 (Identified as low � now taking Vitamin D3 5000)
Creatine Kinase, total 136
TSH, 3rd Gen. 1.48
T4, fREE, 1.3
T3, Free 3.3
Thyroglobulin Antibodies <20
Thyroid Peroxidase Antibodies <10
Dihydrotesterone 49
Estrogen, Total, Serum 69
CBC
White Blood Cell 5.9
Red Blood Cell 5.02
Hemoglobin 15.8
Hematocrit 47.5
MCV 94.6
MCH 31.5
MCHC 33.3
RDW 13.3
Platelet Count 283
Absolute Neutrophils 3640
Absolute Lymphocytes 1634
Absolute Monocytes 496
Absolute Eosinophils 83
Absolute Basophils 47
Neutrophils 61.7
Lymphocytes 27.7
Monocytes 8.4
Eosinophils 1.4
Basophils 0.8
Iron, Total 84
Iron binding capacity 362
% Saturation 23
Ferritin 38
Vitamin B12 772
DHEA Sulfate 62
FSH 1.6
LH 4.8
Progesterone <0.5
PSA, Total 1.7
Testosterone, Total, LC/MS/MS 651
Free Testosterone 106.1

So outside of the low Vitamin D & needing to see a cardiologist, the Dr. says Im fine and does not see any medical reason for the fatigue. Id appreciate any feedback about my bloodwork or anything else. Sorry for this being so long but I figured Id throw it all out there.

My goal is to get as informed as possible before going back to the Dr. Also if anyone knows of a good Doc in the Orlando, Fl area - please let me know. Until then I’ll continue to study the stickys.

THANKS

2

Hard to respond without lab ranges. I guess I could try to look them up… but I won’t.

E2=69pg/ml? That would appear to be the root of your problems.

Tell me about:

Age=41
weight 185
waist
height 72 inches
where do you carry fat - chest, belly, upper back
how has that changed
are you now stressed out easily
do you get cold easily
Do you used iodized salt?
Iodine in you vitamins
check body temp when you FIRST wake and record for a while, Near 97.8 is great, near or below 97 is not.
you should test for homocysteine
test for PSA, should not be a problem at age, but with E2=69…
when did the problem start
any blows to the head or whiplash leading up to that
any reduction in peripheral vision
I would not like to see total cholesterol any lower. Are you use medication for that?
describe diet
extreme dieting?
Some drugs, OTC or Tx can load up the enzyme pathways that remove E2 from the blood. List any meds or meds leading up or through the problems. PM me if not comfortable doing that here.

I think that your problem is E2 and that your T levels are not the issue, E2 is interfering with the T. You need a large reduction in E2 and I don’t think that there is any alternative. Read the sticky about estrogen.

Estrogen creates arterial problems, ED, brain fog, moody/depressed, low energy, apathy…

3

I’ve seen you guys ask about waking body temps a bunch now… Why do you ask for this, and what can it tell us?

Cheers,

  • Hakrjak
4

Please add units of measure and ranges for test results.

5

check out the blood test sticky - I added a post about body temps: Lab Work, Blood Testing and Symptoms - Testosterone Replacement - Forums - T Nation

short answer:
body temp reflects body metabolism
body metabolism is controlled by thyroid and cortisol
low body temps = a sign of possible thyroid and/or cortisol issues

6

Total Estrogen at 69 is worthless. you need to test for Estradiol.

sodium seems a tad below ideal range 142-144
potassium is ideal, but at the highest end of ideal
those two together may point to a ratio imbalance which then points to a possible Aldosterone issue.

do you have any issues with easily sweating, swelling ankles, above average urination, knee/hip/ankle pain?

if so you may want to try the salt water test or pupil dilation test.

Your TSH seems highish, but your ft4 and ft3 look good - which may indicate a problem with high Reverse T3 which if true would indicate a problem with too little Cortisol (which would also support the Aldosterone issues - low Aldosterone and low Cortisol seem to occur together more often then not).

ferritin is extremely low. I hear men should be around 150. I can’t get my levels up that high, but your Thyroid and hormone system need ferritin to transport everything around. low ferritin can equal a stressed thyroid (ie. TSH > 1). you may want to consider increasing your iron intake.

Total CHOL looks good, but ratios don’t. May want to consider taking Niacin to help raise your HDL and lower your LDL.

Calcium and Albumin look below ideal ranges. low D can result in low calcium. taking D3 can help your calcium levels. I am not sure how to impact Albumin.

you may want to consider starting off with double the vitamin D3. Then reduce if needed once you get your next blood test that confirm where your new levels are at.

If you want a more complete picture, I would recommend requesting tests for Reverse T3, Estradiol, and 8am Cortisol.