Low T, Now What?

Pharma / TRT Testosterone Replacement
1

the last year or so, I’ve gradually lost more and more interest in sex and just chalked it up to getting older (i turn 31 in January) and to generally not having a spontaneous sex life. in the 12 weeks prior to last week, I dieted down from 201 lb/~21% bf to 185 lb/~18-19% bf (taken by 3 site pinch, I intend to verify via bod pod soon), following a modified Mountain Dog template (4 week phases of normal volume, increased volume, then normal volume/increased intensity) with gradual reductions in carb intake accompanying each phase. the lowest I had gotten my total cals was around 1400-1500 cals on off days.

I never took any real breaks from the gym in the last year or so, maybe an odd week off here and there, and effort in the gym was always 10/10 gut-busting intensity. the last 4-5 weeks felt pretty crappy so I had total testosterone checked with a cholesterol/lipid panel. taken at 0730 on 11/6, it was 324 ng/dl.

total cholesterol 179
HDL 58
LDL 105
triglycerides 79

I had the following labs checked on 11/9. unfortunately due to trouble getting the Rx, I couldn’t get the labs drawn until noon:

11/9 labs

estrone 15pg/ml (10-50)
estradiol 12pg/ml (8-35)
total test 247 ng/dl (348-1197)
free test 9.6pg/ml (8.7-25.1)
free T4 1.5 (0.82-1.77)
DHEA-S 425.8 ug/dl (160-449)
cortisol 19.4 ug/dl (2.3-19.4; AM 6.2-19.4; PM 2.3-11.9)
TSH 1.61 uIU/ml (0.45-4.5)
LH 5.4 mIU/ml (1.7-8.6)
FSH 3.5 mIU/ml (1.5-12.4)
free triiodothyronine 3.2 pg/ml (2-4.4)

since 11/6 I’ve cut down volume and intensity to half of normal, while still eating according to the low end of these macros (except for chest/shoulders day where I eat the high end of carbs on low day):

low days: p:1.25-1.5 g/lb, c:0.5-1 g/lb, f:0.25-0.5 g/lb
p: 230-275g/32-38 oz meat
c: 90-180g
f: 45-90g
medium days: p: 1.25-1.5 g/lb, c:1.25-1.75 g/lb, f:0.25-0.5 g/lb
p: 230-275g/32-38 oz meat
c: 230-275g
f: 45-90g
high days: p:1 g/lb, c: 2-4g/lb, f: as low as possible
p: 185g
c: 360-740g

in the last week or so, my libido has improved a bit, I am going insane holding back in the gym and I started taking the following stack to ease irritability and sleeplessness noticeably:

100mg rhodiola rosea (standardized to at least 5% rosavins)
1g L-cysteine
200mg L-theanine

info as per the template in the stickies:

-age 31
-height 5’8"
-waist 32-33"
-weight 185-187 lbs
-describe body and facial hair pic here: side chest 11/3/2013 post-12 weeks diet, 185 lb | fr0ivian | Flickr
-describe where you carry fat and how changed: mostly abdominal/oblique, then back-chest-legs in that order
-health conditions, symptoms [history]: seasonal allergies, nothing serious
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
taken daily:
generic multi 1 cap bid
omega 3/6/9 caps as above, 3 caps bid
psyllium seed fiber husk 500mg, 4 caps bid
GNC triflex 2 caps bid (rough total of vit c 39 mg, Na 169 mg, glucosamine hcl 1950 mg, chondroitin sulfate sodium 1560 mg, MSM 1170 mg, hyaluronic acid 6.5 mg)
GNC vitamin d3 800 iu bid
GNC ZMA 4-8 caps hs
GNC melatonin 3-8mg hs, depending on how badly I need to fall asleep

taken only on training days:
GNC creatine mono 10g (divided preWO and intraWO)
ALR Humapro 25g EAA’s (divided intraWO and postWO)
primaforce citrulline malate 6g
primaforce gplc 4.5g
primaforce agmatine 1g
200-300mg caffeine
MindNutrition Neurostim, 4 caps, divided over two doses at work
Otsira metformin hcl 500mg, 0-3 doses a day depending on number of carb-containing meals

-lab results with ranges: as above
-describe diet [some create substantial damage with starvation diets]: as above. also did 3.5 weeks of Lyle McDonald’s Rapid Fat Loss… for the unfamiliar, it is basically a ketosis-inducing diet but does not exclude EFA’s nor vegetables. I ate fatty meats without much regard to fat restrictions.
-describe training [some ruin there hormones by over training]: as above
-testes ache, ever, with a fever? never
-how have morning wood and nocturnal erections changed: they have perhaps become less frequent before the past 2 weeks, however degree of hardness has not changed

useful recommendations would be appreciated.

2

Vitamins or fish oil? You need EFA’s.

No need to test estrone. [E1]

Post cholesterol numbers. Edit into the above. Low cholesterol can mess with your hormones.

More labs? AST? ALT?

Read, fully, the advice for new guys sticky. Advice for New Guys - Testosterone Replacement - Forums - T Nation

Note first sentence there.

Thyroid hormones appear OK, but TSH creates some concerns. Note iodine, stress, cortisol and rT3 in the sticky. If you have some adrenal fatigue issues, hard training might make things worse. Ditto starvation diets or extreme low fat diets.

You may gave a combo primary secondary hypothyroidism. If you cannot identify and fix a cause, you should start TRT. The stickies are very useful. The main obstacle is finding a doctor that is not an idiot. What has your doc suggested so far?

3

[quote]KSman wrote:
Vitamins or fish oil? You need EFA’s.

No need to test estrone. [E1]

Post cholesterol numbers. Edit into the above. Low cholesterol can mess with your hormones.

More labs? AST? ALT?

Read, fully, the advice for new guys sticky. Advice for New Guys - Testosterone Replacement - Forums - T Nation

Note first sentence there.

Thyroid hormones appear OK, but TSH creates some concerns. Note iodine, stress, cortisol and rT3 in the sticky. If you have some adrenal fatigue issues, hard training might make things worse. Ditto starvation diets or extreme low fat diets.

You may gave a combo primary secondary hypothyroidism. If you cannot identify and fix a cause, you should start TRT. The stickies are very useful. The main obstacle is finding a doctor that is not an idiot. What has your doc suggested so far?[/quote]

I have been taking these oil caps for probably half the year: http://www.naturemade.com/products/supplements/triple-omega
2 caps bid, bumped up to 3 caps bid in the last week or so. was taking just fish oil caps 2 caps bid from the same brand previously. I take a generic multi.

I’ve anticipated the usual “but your numbers are in the normal range” response from my primary, so he doesn’t know about these results. I got the Rx from a PA at work.

cholesterol info edited into the first post.

no current AST/ALT, historically they have never been significantly elevated.

I’ll look into the stickies, thanks.

4

Goodness Gracious Man, Low T at 31 Years of Age already? Is that a Typo?
I’m older than that and can cut Diamonds with my Junk, but honestly dude you really need
to do something about that before you start crying at movies, or confused whether to
lead or follow on the dance floor.
What you disclosed is ALOT of Training…too much with too little time off to recover
overall, and that’s messed up your Andrenals.
All this specific biological info here can be objective, everyone’s so different one
just has too monitor their Penis Activity for responses…that’s it, a gauge, Kindergarten Simple,
people make shit here WAY too complicated to the point sometimes where it sounds erudite
to some with all seemingly important specific info, when in reality that crap really doesn’t
matter.
You’ve come to the point already when you don’t workout, you’ve become irritable, you
REALLY need to step back and reboot, which sounds like you’re doing that already and
I commend you for it.
Stimulate yourself with Erections without Climaxing, Erections in THEMSELVES flood the Body
with T. Laugh, I Laugh alot and Laughing frequently floods the body with T, DON’T be afraid
to Laugh frequently in front of Strangers around you either…Fuck 'em, because the emotion
of Self-Conciousness DECREASES T in your body and drops like a Rock.
So yeah, all these useless numbers and fractions I see all the time on this Forum sometimes
makes me go…WTF?
So just don’t overthink it, keep it simple Man, at your age you should already to do
what works for you, and what doesn’t.
So, just my 2 cents Guy, get yourself some DVD’s of “AnchorMan”, “Superbad”, “Knocked Up” etc.,
and don’t be afraid to Laugh…Start with that, and don’t think so much about Carbs, Numbers,
Yada Yada useless Technical Bullshit, Learn from some “Old School” Natural BodyBuilders where E.D., and
Low T, was rarely ever an issue…ever.
It’s only the NEW Gen of Bodybuilders that seem to have an issue with it nowadays more than
the past…somethings wrong, overtraining is a HUGE part of it…fix it, Good Luck.

5

Karado: We have guys in the 19-24 YO range with very low T levels. We do not tell them to watch TV. There are exacting methods that can be used to understand these problems and help guys recover or get on TRT if needed.

I notice that your other posts are not very technical. We do not do bro-science here.

6

KSman - I was a bit unclear on your reply, should I try to self-diagnose from the info in the stickies? or do you suggest that I see my primary with the most recent set of labs?

or should I continue deloading in the gym for another two weeks, re-test and report those results here?

7

KSMan Sez: “Karado: We have guys in the 19-24 YO range with very low T levels.”

Something’s wrong with that alone…this is a new phenomenon with the New Gen, what are your
theories on that? The almost unavoidable GMO’s Maybe? Some of Their Parents smoked too much Weed in the 1980’s
etc. etc.?

“We do not tell them to watch TV”

Automatically assuming that I recommended watching TV for hours at a time, which I did not.
Of course sitting on your Ass for hours at a time is bad, that’s a given.
What I recommended was 2 Proven ways to Increase T that have never been recommended
before. what’s wrong, immoral, or unethical with that?

Never underestimate “Bro-Science” BTW, the very best example of this “Bro-Science” is the
subject of the movie “MoneyBall”…the Vast Majority of Baseball insiders, experts, and
critics thought that the system implemented was fucking insane…they were wrong.
I fully realize it’s another Sport, I fully realize I’m not comparing myself to any
comparable ‘system’ or anything, 'point is sometimes one has to be open minded to go
off the beaten paths for solutions, rather than to do what’s popular and follow the crowd.

8

fr0IVIang, Clearly you have hypogonadism. That is a diagnosis. From there you can look to see if there a reason can be identified. And that might be something that can be dealt with and perhaps that allows T levels to rise. Your primary will may want to treat the low T and might not seek what else might be involved.

If your body is not able to support your training activity level at this time, then things will go wrong. You can try a lighter routine and see if you notice any positive changes. With T that low, one way or another, things are not going to be like they were. Your T levels may not spring back. Some attempt a PCT type recovery before committing to TRT.

Are you onto that stickies?

9

Karado: here are some samples of what we see here, I coached some cases like this via PM, but that is not possible anymore.

What you cannot understand, until it happens to you, is the apathy and lack of joy that can come with low T. Funny movies are not funny to some in this situation. Everything changes.

Young guys-

Some causes seen here: just happens, cimetidine [OTC], hair loss drugs, thyroid problems, adrenal fatigue, one deca only cycle with no PCT [never recovered], blood vessel testicular problems, pituitary adinomas, over training, starvation diets…

samples, [too lazy to try to find more]

http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/19no_libido_help_understanding_labs_at_a_loss

We are hijacking the OP’s thread.

10

fr0IVIang
It would be wise to try to figure out your issue, but if you can’t or Docs wont track it down (typical of them)
don’t sweat it. Get on HRT and you can look forward to feeling so much better than you ever have.
Read the stickies, and be educated about the choices you will need to make.
My .02 go straight to injections, don’t waste your time with transdermals.
Good Luck.

11

[quote]KSman wrote:
fr0IVIang, Clearly you have hypogonadism. That is a diagnosis. From there you can look to see if there a reason can be identified. And that might be something that can be dealt with and perhaps that allows T levels to rise. Your primary will may want to treat the low T and might not seek what else might be involved.

If your body is not able to support your training activity level at this time, then things will go wrong. You can try a lighter routine and see if you notice any positive changes. With T that low, one way or another, things are not going to be like they were. Your T levels may not spring back. Some attempt a PCT type recovery before committing to TRT.

Are you onto that stickies?[/quote]

I read through the stickies and some of the linked info (to thyroid-related causes in particular), but other than your statement that my low TSH is a bit concerning, I couldn’t figure anything else out. I did get the gist that TRT is not a decision to be taken lightly, and basically constitues a change in lifestyle akin to being a diabetic (due to frequent injections and blood tests), and that finding the proper resources will likely be difficult.

12

I did not say ‘low TSH’ at all. TSH=1.0 seems to be ideal. With higher TSH levels, one should look for possible issues as these seem to be common with TRT guys here. Check and post your body temperatures!!!

So you have always used iodized salt?

Iodine in vitamins? If so, how long taking?

Your fT3 and fT4 look great. If body temperatures are low, then we would suspect elevated rT3 that is blocking fT3. That in general then implies adrenal fatigue, stress, starvation diets, over training possible factors.

Vit-D3=800iu is considered inadequate. Find 5000iu tiny oil caps.

13

LEF has an article in this month’s issue talking about Vit D absorption.
The gist is that you should be taking your Vit D supplement with your largest meal of the day.
It also helps if that meal has the highest fat content.

14

[quote]KSman wrote:
I did not say ‘low TSH’ at all. TSH=1.0 seems to be ideal. With higher TSH levels, one should look for possible issues as these seem to be common with TRT guys here. Check and post your body temperatures!!!

So you have always used iodized salt?

Iodine in vitamins? If so, how long taking?

Your fT3 and fT4 look great. If body temperatures are low, then we would suspect elevated rT3 that is blocking fT3. That in general then implies adrenal fatigue, stress, starvation diets, over training possible factors.

Vit-D3=800iu is considered inadequate. Find 5000iu tiny oil caps.
[/quote]

I’ll have to start logging my body temps. do I need to check more than once a day or is once a day first thing in the morning sufficient? I typically run hot, even now. everyone at work will be wearing sweats over their scrubs and I’ll be very comfortable just in my scrubs. at home, my fiancée will be wearing sweats under the covers, and after I warm up from being outside, I have to strip down to my shorts and get out from underneath the covers.

actually, we use sea salt in the kitchen. also, I’ll have to check and see how much iodine is in my multi and other supps.

my total vit-d3 for the day is 2600iu. 800iu from vit-d3 pills and 500iu from my multi, and I take both twice a day. I guess I should nearly double my intake of vit-d3 from what you guys are saying.

15

oral temp taken first thing in the morning is 97.5*F.

also, my multi has 150mcg of iodine as potassium iodide, so I get 300mcg iodine per day.

side note: my preWO shake and ritual has failed to really get me going for a while now, but today I got that old feeling of wanting to run through walls and rage while I was on the way to the gym. hopefully that is a good sign of recovery.

16

If iodine deficient and you need to get 1/2 gram of iodine on board, .0003 grams per day will never get the job done.

Context: KSMan? - Testosterone Replacement - Forums - T Nation

Check temperature mid afternoon to see if you hit 98.6

Walmart has the tiny 5000iu vit-D3 oil caps.

17

just checked a few minutes ago, 98.2*F

18

Below or at 97.3 when you wake is a concern. 97.7 would be good. You need to get to 98.6 during the day, mid afternoon, when not talking, eating or drinking for a while. If you are stuck at 98.2, that is not good. Keep the thermometer at hand and check frequently for a while.

19

ok. I waited at least 5 minutes after drinking to check, I’ll wait longer next time.

edit: 98.5 today

20

the last few days I was waking up at 96.8F, but I was sleeping with just a sheet covering me, a fan pointed at me and I woke up both days feeling cold. last night I slept under a comforter and woke up to 97.9F. also, yesterday at around 5pm at work I hit 98.6*F.