Would Appreciate Any Help or Advice - Thanks!

Pharma / TRT Testosterone Replacement
1

Hi everyone and thanks in advance for any help or advice. I apologize in advance for such a long first post. Anyway, a very knowledgeable poster at another TRT forum recommended I post here for possible assistance or help. He spoke very highly of KSMan and other posters here so I thought I should follow his advice.

Anyway, I basically copied and pasted my post from the other forum, i hope that is ok, apologies if not.

Again, my apologies at the length and thanks in advance for any help, truly!

July 13, 2014 4:33 PM
Hi everybody! Thanks everyone for this wonderful resource. Thanks especially to Y55 if you’re still around and Ackman (the New Y55!) for your help also!

To anybody who cares to read this account of mine and/or offer any advice thanks in advance!

I’m a 52 y.o. male who has read through this entire thread twice, jotting down copious notes the second time, trying to follow as best I could when the brain fog wasn’t the worst ever. To be honest it was kind of a blur after awhile but I did the best I could.

To be honest, I’ve pretty much kinda had life long low T symptoms, always been kind of the sensitive type.

Anyway, I’m kind of self employed in home renovation so I get health care through the VA and two years ago I told my primary care doctor the standard symptoms I was having of no energy, fatigue, terrible brain fog, depression, anxiety, insomnia, low libido, etc. to get him to run some tests. I was very carefull to not mention testosterone replacement directly as I kind of knew I might get the cold shoulder.

Labs were normal except low Vit D and was placed on a supplement for that which I have taken and brought my levels up.

Heres some of the labs:

June 2012

Testosterone: 212 males 20-50 (132-813)
males >50 (71.8-623)

LH: 3.0 (2-12)

TSH: .61 (.465-4.68)

Thyroxine (FT4): 1.06 (.8-1.8)

Well, I was told I was the picture of health and since I had just turned 50 a few months before, when I carefully alluded to the possibility of T-replacement I was told no, I was in range and there was nothing they could do. So basically if my total T was 71.8 or above I was good to go now get lost.

I should mention that I was being treated for depression and anxiety related to a number of issues at the time and they were more than willing to give me ungodly amounts of anti-depressants and anxiety pills and pills for any other unrelated medical afflictions by the bucket load if necessary but the only resistance to the massive pill pushing at this hospital I witnessed was with hormone replacement because God forbid we prescribe that!

So I trudged on for a few years and in February of this year I had a slight health scare of slight chest pain while doing heavy snow removal outside in super sub zero wind chill weather so I went in to get checked for safety reasons. I thought it was probably from sucking in so much frozen air into my windpipe but wanted to play it safe. My heart was fine for my age but they started me on 40mg/day of Lipitor, which I thought was a pretty stout dose but OK.

Anyway,so I gave up working out over 10 years ago because my body would not recover sufficiently waiting a week between workouts. I was very religious about it for a long time before, which is an understatement. I figured I needed to get in shape and build up some stamina so I went back to the gym as best I could. It has been about 4 months and I have made some progress but I have to wait at least 12 days between upper and lower body workouts because my body just won’t recover.

So I feel like Y55, a defeated man trying to exercise, work on the house, clean up the home and yard, etc. with absolutely no energy at all.

I used to work six days a week 10 hours a day and now I can’t do jack s*** without being practically bed ridden for two days.

So since I wasn’t making hardly any money on home renovations I swallowed my pride and applied for the medicaid exemption part of Obamacare through the state of Michigan and went through all the hoops and did as much research as I could and found a primary doctor who I thought might be empathetic to my pathetic condition and went to see her finally after 3 months of paperwork and other hassles.

I took all of my notes and wrote out a detailed synopsis of my symptoms (fatigue, brain fog, depression, insomnia, inability to tolerate heat or cold anymore (morning temp. about 96.6, afternoon about 97.1), low libido, e.d., etc.

I directly asked her if she would consider hormone therapy and she said yes we do that, we do injections, so I was immediately elated to hear that and that I wasn’t dismissed right off the bat.

I also gave her a list of lab tests I was hoping she would perform (T, T Free and Bioavailable, SHBG, LH, TSH, E2, FSH, and some others and she was big on
some and not on others.

I also gave her some notes on protocols (Gels and creams vs. injections, E control, HCG, etc. that I had written out.

Bear in mind that I gave carefully reasoned rationales for why each of these tests and protocol ideas were important in my opinion.

I also had in hand the Endocrine Societys Testosterone therapy guidelines and their Low Dose HCG report along with Doctor Crisler’s old current best thoughts on TRT along with his HCG update.

Unfortunately I think she became slightly exasperated and would not take the printed material but begrudgingly took my hand written pleadings and put them in my file.

So she agreed to run some labs and here were the relevant results:
June 27 2014:

CBC, metabolic, lipid panels normal. PSA, ECG normal.

Testosterone: 2.65ng/ml (1.80-7.80) which I think converts to a regular 265
ng/dl

TSH: .88 (.34-5.60)

Free T4: .84 (.58-1.64)

T3 Total: 1.24 (.87-1.78)

Oh, and I forgot she prescribed Seroquel for insomnia. I had it filled but have not taken it yet.

So anyway she said she would call me if they could get me started on anything but instead sent the standard here’s your lab results, everything is normal, you’re perfectly fine B.S. letter.

So all I got was another here’s some dangerous psychotropic medicine we love to prescribe willy nilly now have a nice day.

To be fair she was really nice, clearly overworked and overwhelmed with patient load that day and has to treat hundreds if not thousands of disorders so I can see why PCP’s aren’t up to date on current TRT protocols but I was still pissed off.

So I called the office saying I need to discuss these lab results and asked for a different doctor and was given an appointment in a couple of weeks. I will come armed for combat but am not all the optimistic. At this point I’m hoping I can get home injections of T and hold very little hope for HCG or anti-E.

Halfway thru trying to get medicaid help I regretted it and started looking for low-T clinics in SE Michigan but there aren’t any that I could find. I would love to see Dr. Crisler in Lansing but I can’t afford it and the few A4M clinics are super expensive too, don’t take any kind of insurance either but I would love to see them if I had the money. The reviews for any so called bio-identical hormone therapy clinics around here don’t seem all that great and seem kind of sketchy and also kind of expensive.

So at this point if all else fails I am looking at travelling to a clinic in Chicago I found on another TRT board but I can’t go anywhere at the moment. I don’t know if I can mention them by name but they are up to date and do T, HCG. and anastrazole at a price that is not cheap but cheaper than Dr. Crisler or A4M.

So a few days ago I did the private md labs hormone panel for females so I would have at least a baseline E2 and here’s those numbers:

Labcorp: 7 July 2014

Testosterone: 450 (?-I wish?) (348-1197 in lean males under 40)
Was supposedly 265 from hospitals lab less than two weeks ago
I know, different labs and ranges but WTH?

LH: 3.0 (1.7-8.6)

FSH 2.7 (1.5-12.4)

Estradiol: 18.4 (7.6-42.6)

Actually I expected the E2 to be higher and the T lower based on my symptoms (very emotional, tear up at TV programs, movies, ect).

And any ideas on these seemingly lowish LH and FSH numbers?

Also, I ordered some DHEA, pregnenolone, zinc/copper, B Complex and Vit. C thinking I might need them but haven’t received them yet.

Anyway, thank you to anyone who took the time to read this and I would appreciate any input anyone might be inclined to give. Everything I know about low T I basically learned from this thread so thanks for that also.

My long nightmare continues but I’m trying to keep pushing forward …

2

Also, I am pretty sure I might have adrenal fatigue and be a victim of the so call pregnenolone steal so I started 25mg of DHEA and 30mg of pregnenolone today in the hopes of improving my t-levels and symptoms. I am always under stress so I wouldn’t be surprised if my cortisol is sky high and I’m always in a catabolic state. Thanks.

3

Your fT4 is low. Are you using iodized salt? Your body temps are low. Please read the thyroid basics sticky. Your low energy levels could easily be thyroid/iodine related.

Some degree of secondary hypogonadism is typical in older males. So your LH/FSH is not unusual at all. And the output of the testes for a given level of LH also declines. Long term thyroid issues can sometimes lead to lower T [and visa versa].

E2 does not need to be high to create estrogen dominance when T is also low.

Please post fasting cholesterol numbers and:
hematocrit, RBC, albumin, protein, ALT, AST, fasting glucose

40mg Lipitor is huge. You can get muscle pain and weakness from that, as well brain fog.

Trazodone is effective for sleep and might have fewer side effect concerns, also very inexpensive. 90 days/$10 at Walmart. Time release melatonin is also good.

4

[quote]KSman wrote:
Your fT4 is low. Are you using iodized salt? Your body temps are low. Please read the thyroid basics sticky. Your low energy levels could easily be thyroid/iodine related.

Some degree of secondary hypogonadism is typical in older males. So your LH/FSH is not unusual at all. And the output of the testes for a given level of LH also declines. Long term thyroid issues can sometimes lead to lower T [and visa versa].

E2 does not need to be high to create estrogen dominance when T is also low.

Please post fasting cholesterol numbers and:
hematocrit, RBC, albumin, protein, ALT, AST, fasting glucose

40mg Lipitor is huge. You can get muscle pain and weakness from that, as well brain fog.

Trazodone is effective for sleep and might have fewer side effect concerns, also very inexpensive. 90 days/$10 at Walmart. Time release melatonin is also good.
[/quote]

Thank you so much for the reply KSman!

I’ve been reading all the stickies in the last few days - I think I get plenty of iodized salt but I’m not 100% positive. I’ve always had somewhat lower body temps and to be honest if you looked at me you might think I’m hyperthyroid (I realize alot of the symptoms overlap). I was lucky to get the thyroid tests I did even though I requested TSH,ft4,ft3, and rt3.

If I had the money I would’ve gotten the SHBG test also as I understand that increases with age also and I was afraid that might be part of my problem if that was high and binding up any free T.

My cholesterol levels were: Chol. 117 (100-199mg/dl)
HDL 41 (40-151mg/dl)
LDL 58 (0-99mg/dl)

I actually only take between 1/4 to 1/3 of an 80mg Lipitor pill I have to break up because I realized that is to high of a dose and especially since I found out cholesterol is the “mother” hormone and gets a bad rap anyway. I haven’t experience the muscle cramping associated with the statins fortunately.

Other labs: Hematocrit 45.1 (37.5-51%)
RBC 5.04 (4.14-5.80 million/uL)
Albumin 5.1 (3.5-5.5 g/dL)
Protein 7.4 (6.0-8.5 g/dL)
AST (SGOT) 36 (0-40IU/L)
ALT (SGPT) 30 (0-44IU/L)
Glucose 89 (65-99mg/dL)

I’ve only taken the seroquel once and it left me so zoned out the next day I couldn’t even drive anywhere. I’m pretty sensitive to meds anyway especially when they’re new and I know I would build up somewhat of a tolerance but I’ve had to many commitments to take a chance again on getting zonked out like that the following day. I’m actually prescribed Klonopin for anxiety which I refused to take for 4 years because of all the horror stories of addiction to benzos that I read but finally when I couldn’t take it anymore I started taking the 1mg before bed so I could stay asleep (which gets me about 6 hours straight which is a godsend actually). I tried to reduce it to .5mg but would wake up at 3:30 wide awake again so had to go back to the 1mg/night.

Thank you so much for looking at my info, you have no idea how grateful I am for the help KSman!

5

KSman, I had always assumed there was so much salt in all of the processed food out there that it was impossible to be iodine deficient in America. I didn’t realize that alot of food producers used non-iodized salt. I have some Morton table salt and pepper shakers that I use sometimes and just verified on their website that it is in fact iodized salt.

Anyway I just checked my temp on two thermometers that agreed at 98.1 at 6:00 pm.
I did raise body temperature with two different doctors but they insisted I was fine even at 97.1 during the day so I doubt I can get anywhere with them and based on the trouble I had getting the labs I did I really expect a hard time asking for rt3 but I will definitely give it a shot.

Thanks.

6

KSman, since you asked for AST and ALT I just noted that they seemed kind of high with a normal range that begins at 0 so I did some further reading. I was told years ago when AST was called SGOT that I had a high reading but since I worked out alot that it was very common and nothing to worry about. I have been exercising some lately; do you think that may be the reason I have a higher range level at this time or do you think it’s from prescription medicine or dietary supplement processing maybe? I hate to think I may be overloading my liver at this point. I drink no alcohol and don’t touch any recreational drugs ever.

Just intrigued since you mentioned it and then I looked closer at the labs and results. Thanks again!

7

Well, I made a visit to a different doctor today in hopes of getting some help. I succeeded in getting a referral to an orthopedic specialist to look at my bum knee which was one of my goals but had no luck in the TRT department. I could tell that after all my research and planning that I had picked a decent primary practice but I wasn’t going to get anywhere with hormone replacement. I’m ashamed to admit it but I could see how stressed the doctor was and how busy the practice that I didn’t even push for just testosterone even and that can of worms. It’s hard for me to describe the vibe but I ended up feeling like a big loser asking for help. To think that at 52 years old I’ve had to ask for charity for the first time and it’s the worst feeling in the world, especially when you feel your whole life caving in around you and can’t figure out what’s wrong.

I had already decided that if I was going to do TRT I was going to do it right with HCG and an AI and it wasn’t happening at this place. Thank god I have my nuclear option out of state if necessary as all signs point to that being my best option. After literally reading hundreds if not thousands of TRT forum posts I’ve finally gotten a decent grasp on it and if they just wrote me the prescriptions and threw me out the door I would be able to buy the stuff for cash (not that expensive if you know where to look as i’ve learned) and run a decent program but oh well, back to square one.

Back to reading and re-reading the stickies, lol!

8

Chol. 117, if that is not a typo, that is seriously wrong. Levels at or below 160 are associated with increased all-cause mortality. 180 is ideal.

When statin drugs cause muscle cramps, what is really happening is that the drug has depressed CoQ10 production in the liver and you end up with a deficiency. That in turn compromises the functioning of the mitochondria in your cells that are the energy source for all of your cells. Also, thyroid hormone levels regulate mitochondrial activity to regulate body temperatures. One can take CoQ10 supplements [which are hard to absorb]. The Ubiquinol form is much more bio-available.

Waking body temp?

9

Thanks for the reply KSman and sorry it has taken me this long to respond.

That chol. of 117 is correct with a range of 100-199mg/dl

I don’t know if it is of any help but here are some lipid panels I have had done with the dates:

                   June 2012    March 2013    Feb 2014    May 2014    June 2014

Total Chol. 179 173 162 103 117

HDL 42 43 43 42 41

LDL 114 110 104 52 58

Triglycerides 117 99 77 47 88

All tests were the same lab except for the most recent and Lipitor was started after the Feb 2014 test. I was diagnosed with a 30-40% blockage of the Left Anterior Descending heart artery, everything else normal. Doc says this is fairly normal for my age group so they may be acting overly cautious but I’m still to paranoid to not take the statin at all. I take about 20-30mg a day at this time. I have a cardiology follow up in September and plan on bringing this up but expect to be brushed off with flowering praise of all things statin.

I was thinking of starting to take a CoQ10 supplement anyway and will look for the Ubiquinol form you recommend.

My waking body temps are almost always about 96.6 with daytime temps maxing out at around 97.1 which from everything I read on the forums are indicative of sub clinical hypothyroidism but all doctors have brushed off this info to my face claiming it’s fine and that my thyroid labs are completely “normal”. I may have to pay for an rt3 lab privately when I can as I would love to try armour at a low dose to see if that would help if I could get my hands on some.

Part of my problem is I look extremely young and healthy for my age and up to two years ago would get carded and would probably still be if I drank at bars when I go with someone.

I have been lifting weights but progress is slow. I look pretty good for someone who is 52 but I really don’t have the strength of my youth.

Any thoughts or advice is gratefully appreciated!

10

Docs have a ranges for TSH that are insane that do not reflect levels that convey well-being. Go with my recommendations for lab ranges and see what you can manage.

Are you iodine deficient. Thyroid bulky or lumpy?

Statin drug: Any low grade chronic cough? That is deep CoQ10 deficiency.

Tell doc about low body temps and ask to have a Rx T3 trial to see if that resolves body temperature. Explain its value as a diagnostic tool. You can get T3 as a research chem.

11

Thank you so much for your reply KSman! I really appreciate it - you are a true blessing to this forum and have probably helped more guys than most of the doctors out there who get paid alot of money to do so and end up being useless or worse.

After reading the thyroid sticky a couple of times I have to admit I am more confused than ever in my understanding of that department in regards to myself. I do have lower body temps than normal but have had my thyroid palpated (if that is the right word) many times and there is definitely no indications at all of lumps or abnormalities as far as that goes.

I almost ordered some iodoral(sp?) but instead decided to add quite a bit of iodized salt to my foods but it had no effect on my body temps and made me bloated after awhile. I am usually hot and have always slept with my socks off sticking out of the sheets even in the winter if that means anything.

I keep the thermostat at 62 degrees and will wear a pullover if necessary. Everybody else thinks its to cold but I like it and have always preferred it that way. I’m starting to think maybe lower body temp is ok and normal for me after all but I plan on keeping it in mind.

I have had no noticeable side effects from the statin but I have reduced the dose to no more than 20mg a day. Absolutely no coughs but I did order the brand of CoQ10 you recommended but have not received it yet. I would be more than willing to replace the statin with that if doctor agrees, which I doubt, but may do anyway in between labs as a test.

I am actually feeling quite abit better. I have always been a hard gainer and ectomorph type which I have read can make it really easy to over-train even with normal hormones. I have discovered that I am better off under-training than over-training as I easily tax my system if I do alot of yard work, exercise, contruction labor, etc without sufficient rest.

I basically exercise by doing an upper body day with barbell and dumbell roughly every 12 days and then I started Yoga for the flexibility after my upper body day then a lower body workout and then more yoga before repeating the cycle. Lower body work is also barbells and such so I try to hit it hard when I’m there. I have started doing more of the hard core type yoga classes which may sound prissy but trust me actually work the core and upper and lower body quite a bit. I had serious back problems and it has been absolutely life changing for that with the stretching and flexibility benefits.

Other than the DHEA and pregnenolone I am still not on a hormone program but I feel 900% better already and a couple of people have commented that they can tell I have been lifting weights which never happened in the old days when I was alot younger and stronger for some reason lol.

Thanks again for all your help and assistance!

12

Sorry I forgot I meant I keep the thermostat lower in the winter not summer to keep from getting to hot. I think if I raise my body temps to the more normal range I would probably just feel hotter.

I’ve also been reading a ton on adrenal function and adrenal fatigue so I’m also heavily pursuing that angle. It’s weird when you start reading on the internet on any subject there is so much out there that it’s easy to get sucked down a rabbit hole where everyone is convinced this one thing is the problem but then I think oh yea I forgot about the other stuff. Like KSman says everything seems to be interrelated to each other so all you can do is keep experimenting.

Have been taking Vit D3, zinc, copper, Vit C, B Complex, Fish Oil, DHEA, pregnenolone, multi so they seem to help. Fatigue, brain fog, anxiety and depression, insomnia, and low libido all seem much better for the moment so I’m keeping my hopes up!

13

Most with thyroid issues do not have lumpy[nodules] or enlarged, but need to ask.

You cannot fix an iodine deficiency with iodized salt or other small measures.

14

KSman, I was considering the iodine loading to bring that up and also leach out the bromides and other poisons. Do you know if that causes the heavy bloating like NaCl does or is it different in that regards? Thanks!

15

For about the last week I have taken a very small dose of Seroquel (25mg) at night for sleep and it has been fantastic. (Ksman recommended Trazadone instead but I asked the shrink about it and they said no. Will ask PCP on next visit). Don’t know if and when the effects might wear off but for now it is great. Have lots of energy to work out and other stuff during the day.

I don’t see it mentioned much on this forum but does anyone know if quality of sleep effects how much human growth hormone might be released at night. Obviously I could never afford to take pharma grade HGH even if I knew how to get it but I was just wondering if this could be part of the reason I feel so much better in the last 4 or 5 days. Thanks.

16

I think that if you were getting good sleep for a week with trazodone, you would feel the same.

This is not a GH thing. When someone who is GH deficient takes GH injections, it take around 6 weeks to get a good result.

Please also note my recommendation re time release melatonin.

Bloat is from excessive sodium. A few mg’s of circulating iodine will not have any effect like that.

17

Have not posted in awhile due to still not being on a TRT program for a variety of personal, family medical issues, etc. Had to search to find my thread but no complaints, lol.

Anyway, per the thyroid sticky I began Iodine Replacement 6 days ago with 32.5mg/day of potassium iodide, selenium, magnesium, and Vit C. The brand is the same one someone else reported getting sick on but have not had to many problems. Felt a little poor on days 3 and 4; don’t know if from Bromide elimination or just being under the weather.

I posted higher up in the thread that I didn’t mind being cold but last winter wasn’t that great and I am getting chilled somewhat in the midwest. Daily temps haven’t moved yet but if nothing else after two or three weeks will at least be able to know if iodine is an issue (will take to 750mg total if no problems)

Anyway, just wanted to keep the thread alive and thanks to anyone who reads this for all the help this forum provides!

18

Just wanted to update thread: took 32.5mg of iodine per day for a month (975mg total) along with selenium and pro-biotic with absolutely no change in body temps. I was really hoping this would make a difference but at least I can rule out iodine deficiency as a cause of low body temps.

Will have to look into checking rt3, even if I have to pay for the test throught privatemdlabs.

At this point I would love to try a course of low daily doses of cortef, T3, testosterone, and HCG to see what the results would be. Hey, I can dream can’t I?