New Guy, Low T, Lab Results

Pharma / TRT Testosterone Replacement
1

Hey guys. I have been reading this site for about 6 months since I first found out that I had low T. I have done a bunch of research here and elsewhere but I am still confused about things. Hope you all can give some insight.

My symptoms have been:

Major lack of libido. Difficult time keeping erections for more than a few minutes. I have been very lethargic and have been bordering on depressed. I have never had depression issues in the past so this has all been new to me. No real drive for anything. More and more I am being described as very apathetic. I have no desire to go out and do social things; I had rather just stay home and take a nap. I have a difficult time concentrating and remembering things lately.

I also have real hard time losing weight but I put it on extremely fast.

Info:

-29 Years old

-6 foot 1 inch

-34-36 waist

-215lbs. 25% body fat (Hydrostatic dunk test)

-Thick head of hair. Decently hairy chest, arms, legs. I can grow a decent beard. Almost no hair on the back of my body.

-I tend to carry fat all over but especially my love handles, gut, lower back, and thighs.

-Had digestive issues my whole life. Turns out that it is almost all due to egg allergies. I was on GERD medication for 10 years (Prilosec, etc). Quit that all last year when I found out about the allergies. GERD issues are mostly under control.

-No RX drugs except for the GERD medication. Never any hair loss or prostate drugs.

-Diet isn’t the best but it is better than it used to be. Hardly any fast food. Mostly organic stuff unless I eat out. I would say that a typical day is 1700-2300 calories with the occasional binge.

Diet was horrible while growing up. I was always pretty overweight until I was 19. I went from 225lbs to 165lbs in 2-3 months by basically starving myself. I started eating again after being accused of anorexia by my family. My digestion was completely screwed up for years afterwards. I would get sick to my stomach after almost every meal. That led to other digestive tract issues.

I started working out in college and went from 165 to 185. Stayed there at about 13-15% body fat until I got married at 22. Over the next 8 years I got up to 230 by overeating, drinking, and not working out hard enough.

  • Working out. For about 15 months I’ve been working out again. I’ve dropped 15 pounds and put on a bit of muscle. I am nearly back to my college strength levels but still need to lose about 35 pounds of fat. I have been lifting weights a couple days a week and boxing about 4-6 hours per week. I am definitely not overtraining.

-My testes have never ached that I am aware of, with fever or without.

-No major injuries except cracking the base of my head pretty good when I was 5 years old. Needed 6 or 7 stitches.

-I almost never have morning wood. Libido has dropped significantly in the last few years and I have a hard time keeping it up. I will typically only want to have sex about once per week which is a definite decrease, although I have never had a “healthy” libido. Even in my early 20’s I would only want sex every couple of days and definitely not more than once per day.

-Lab results

I go to a Naturalpathic doctor who first suggested testing my T about 8 months ago because of the above symptoms. The only pertinent tests she ran were:

Total T - 417 Range (241-827)
Free T - .96 Range (.95-4.30)
Vit D - 33.3 Range (33-100)
TSH - 1.29 Range (.30-2.50)

Lipid panels and other typical tests which were all ok, other than the Lipids not being stellar.

She was ready to put me on a compound T cream but I wanted to do a bit of research and got overwhelmed. I decided to just keep working out, researching, and trying things like Alpha Male.

I decided to get tested again at the beginning of December. Test results were:

Total T - 280 Range (241-827)
Free T - .71 Range (.95-4.30)
Vit D - 26.5 Range (33-100)

Ferritin - 143 Range (16-323)

Lipid panel and other typical things. Lipid ratios were much better, I think due to better eating.

I brought in a bunch of research that I’d done along with some of the stickies from this forum. After reading everything, she seems totally onboard for HCG use and Aromatase inhibitor use, if we do decide to do TRT. She’s also willing to go with injections although I haven’t talked with her about the details yet.

I wasn’t ready to jump into TRT so I decided to start supplementing Vitamin D (15,000 per day) and Iodine (1.5mg a day) and then retesting in January. I also knew that I needed a bunch more tests to be ran before trying TRT.

My lab results from last week:

Total T - 500 Range (241-827)
Free T - 1.21 Range (.95-4.30)
Vit D - 66.4 Range (33-100)

LH - 3.00 Range (2.00-12.00)
FSH - 2.50 Range (1.0-18.0)
Prolactin - 6.1 Range (1.6-18.7)

TSH - 1.512 Range (.300-2.50)
T4, Free - 1.22 Range (.75-1.76)
T4, Total - 9.0 Range (5.0-12.0)
T3, Free - 3.3 Range (2.3-4.2)

(I asked her to test rT3 and rT4 but I think she was confused)

DHEA-S - 246 Range (80-560)

Pregnenolone - 62 Range (13-208)

E2 - 20.0 Range (11.6-41.2)

(edited to add in E2 results) She told them to test for E2 but they screwed up so we have to re-do that one, I should know in about 5 days.

She also gave me a 24 hour Cortisol test to do so we should have that back in about 2 weeks.

I’d really appreciate some help in deciphering these test results. According to her hormone references (not sure what she was using), she thinks my DHEA and Pregnenolone are a bit low so she gave me some supplements of those. I don’t want to start taking them until I hear what you guys think, though.

My T of 500 is better than it’s ever been before so I’m happy about that but the Free T is still quite low. I thought it was interesting that such a big jump happened from only increasing Vit D and taking some Iodine, although I’m not sure if the Iodine helped at all. I want to get my Vit D up to about 80 stay there for awhile to see if my T keeps rising.

Summary and concerns:

T has gone up from just taking Vit D and Iodine. I was on no other supplements for that whole month.

I definitely don’t want to jump into TRT but it looks like I’m with a good doctor if we decide to do it.

Anything stand out about my test results to you guys?

Do you think supplementing DHEA and Pregnenolone is a good idea?

Thanks very much, everyone.

-Todd

2

Your doctor sounds excellent. Except for not starting you on Vit D sooner. I was scratching my head at that point. But she does seem to be willing to work with you, which is excellent (and rare).

I agree that your DHEA and Preg are a little low. But I’m not entirely sure this is your issue.

What are your lipids?

Your LH/FSH is a little on the low side, which indicates some degree of low pituitary output. It is hard to say what the cause of this is, but most common scenarios are:
-Stress
-Thyroid issues
-Suppression from exogenous Test (steroids)
-blows to the head damaging pituitary
-Pituitary andenoma
-Idiopathic (nobody knows why)

Many people with low pituitary output do well with a trial of HCG monotherapy and depending on results, a SERM restart. In your case, you can probably skip the HCG monotherapy (since your testes seem to already be responding) and go for the SERM restart. That is what I would investigate if I were you.

But try the preg/dhea first and see how that helps.

Also need cortisol, E2, and RT3 to really put the picture together;.

3

Thanks so much for the response, VTballa34.

In fairness to my Doc, she did put on my 5,000 Vit D per day back about a year ago, before we ever thought of T as an issue. I ran out though and never bothered to get more (I was a dumbass). So, she wasn’t too thrilled with me about that.

My Lipids:
4-13-2011

Cholesterol 174 Range (150-200)
Triglycerides 204 Range (50-150)
HDL 44 Range (>40)
LDL, Direct 107 Range (<100)
Cholesterol/HDL 4.0 Range (not listed)
Direct LDL/HDL Ratio 2.4 Range (0-4.9)

Lipids
12-8-2011

Cholesterol 217 Range (150-200)
Triglycerides 175 Range (50-150)
HDL 62 Range (>40)
LDL, Direct 132 Range (<100)
Cholesterol/HDL 3.5 Range (not listed)
Direct LDL/HDL Ratio 2.1 Range (0-4.9)

Some of the numbers were higher but she was happy that the ratios were better.

I’ll start researching the SERM restart. I’ve seen that word around but haven’t learned much about it. I’ll also start the preg/dhea.

I should have my E2 numbers by next week and Cortisol in 14 days or so.

Thanks again. I really appreciate you taking the time to respond.

4

there is no RT4… just RT3.

everyone reacts differently to DHEA and Pregenelone. Could be great for you, could do nothing, or could be terrible.

getting the cortisol and E2 levels will be helpful.

5

Thanks PureChance. I got confused about that.

E2 came back at 20 (Range 11.6-42.2)

That seems to be at a good level. I’m still waiting for the 24hour Cortisol tests to come back.

Just started on DHEA and Pregenenlone today.

6

you may want to stop one…

starting more things at the same time means you have no idea what impact each is having. if you feel great, is it because of the Preg or the DHEA. what if you feel nothing? could be the preg helping but being offset by negative side effects of DHEA, etc. etc. etc.

why not try pregnenolone for a week and see how you do then add in DHEA if you like and wait a week… then maybe think about changing doses, etc.

7

Very good advice, PureChance. Thank you, again.

I’ll stop the DHEA and just stick with the pregnenolone for a week or two.

8

lab corp has been giving some false numbers
20 on their 7.6-42 is more like 30-40 on quest e2 4021 test. I have a lot of Dr’s patients been getting burned on this big time even they have striaght e2 symptoms with no question.

9

Hmm, interesting. Thanks for the info.

What is the solution for someone who has high e2 but isn’t on TRT? Is it just a smaller dose of an AI?

Given that I still have 30lbs of fat to lose and am not on TRT, I wonder if this is something that I should pursue, or if e2 will just go down naturally with time and exercise?

10

[quote]PureChance wrote:
you may want to stop one…

starting more things at the same time means you have no idea what impact each is having. if you feel great, is it because of the Preg or the DHEA. what if you feel nothing? could be the preg helping but being offset by negative side effects of DHEA, etc. etc. etc.

why not try pregnenolone for a week and see how you do then add in DHEA if you like and wait a week… then maybe think about changing doses, etc.[/quote]

Pure and I are about as different as night and day as you can get on approaches to adding stuff in. He has good points and involves a logical flow. But I am more impatient and don’t want to sit around fiddle-farting trying one thing at a time in an iterative approach. I prefer to go nuclear and throw everything at a problem except the kitchen sink and see if that helps. If it does, then you know stuff is working. You can then eliminate stuff as needed and gauge your feedback.

11

You can also do trans-dermal Magnesium to get you DHEA numbers up. Probably a good idea to add some mag and zinc anyway.

Taking pregnenolone might also help raise DHEA. I would try that by itself first. This is what i am going to do next anyway. Some think supplementing a little preg will stimulate the body to create more on it’s own. That should help with lipid profile.

You could also test progesterone to see if preg is getting converted through that path. Cortisol would probably give you a clear enough picture on this if you plan to do that anyway. If it is, then getting DHEA up through mag gel or straight DHEA might be more effective than preg.

Boron is supposed to help the effectiveness of supplementing D.

12

Dhickey, Thanks for the info. Sorry I didn’t see this sooner.

I got my Cortisol test back. The results are:

6am-8am 9nM Range 13-24 nM
11am-1pm 6nM Range 5-10 nM
4pm-5pm 4nM Range 3-8 nM
10pm-12am 6nM Range 1-4 nM

It looks like I’m low in the morning but high at night. Not sure what that all means. My doctor gave me some Adrenal Support stuff to try.

I haven’t really noticed any changes from taking the Prog or the DHEA. Libido and erection issues seem to have been a bit worse than normal but it’s difficult to tell.

I’d appreciate any advice from you guys.

Thanks much.

13

So, as a summary of what’s going on with me, this is what I see:

Low Free T
Low Total T (although that seems to be improving)
Slightly low LH/FSH
Slightly low DHEA
Slightly low Pregnenolone

Cortisol levels are off. I’m way low in the morning and too high in the evening.

My thyroid appears to be ok. I haven’t had RT3 tested but all the other thyroid numbers seem acceptable. In a case like mine, would it be worth getting RT3 tested just to make sure?

Vitamin D is now at a pretty good level although I’d like to see it a bit higher. I’ll test that again in a couple months to be sure it’s on the right track.

E2 appears to be at a good level, unless the test results are off. I’ll get that tested again when I get my T tested, just to make sure.

All of my other vitamin and mineral tests have come back normal, I don’t appear to be deficient in anything.

I’m still suffering from most of the Low T symptoms. Almost no libido, fatigue, erectile dysfunction, “exercise intolerance” (anything more than moderately active wipes me out), etc. I don’t want to jump into HRT because my numbers seem to be improving, even though my symptoms aren’t.

I’m currently taking Pregnenolone everyday and I added the DHEA in about a week ago, as I wasn’t noticing any real change from just the Preg. I haven’t noticed any change since adding the DHEA either, nothing substantial anyway.

I’ve researched the SERM restart that VTBalla mentioned but I’m a bit confused about the how it works. I’m pretty sure my Doc would be willing to try it, if I could explain it to her, but I’m having a hard time finding good info on it. I don’t want to suggest that we try it without having a good grasp of the process, as it will probably fall to me to educate her on it.

I’ve also been researching my Cortisol issues but I haven’t come up with much on that either. I know that some people take Hydrocortisone to replace their low Cortisol but my doctor has put me on an herbal supplement first to see how I react. Link - http://www.easyhealthzone.com/adrenoplex-90-capsules-p/pr0238.htm

Anyone here have Cortisol issues that they’ve fixed with Hydrocortisone or through some other method? I’m not really sure if my Cortisol levels are even a big deal so I’d love some suggestions regarding it.

Since my numbers seem to be improving a bit with just getting the Vitamin D higher, I’d like to see how I react to fixing the Cortisol issues. As it stands though, I’m not sure if the Cortisol issues are the cause of my Low T or the result of Low T. Does it make sense to get those in the normal range before trying a SERM Restart or HRT?

Thanks, everyone.

14

Regarding SERM Restart: It is basically PCT used by steroid users. Consists of a SERM (clomid or nolvadex) daily use for about a month…first two weeks higher dosage, second two weeks lower dosage…don’t remember the dosages, but you can find plenty of info on PCT in the steroids forum here on this site.

15

Thanks VTBalla. I’ve found some more info on it now and I understand it a bit better.