Unanswered Bloodwork and questions

[mondata]

For the last several years I have been dealing with reduced libido and fatigue (especially in the afternoons). After I started a keto-ish diet (14 weeks ago), things seemed to get even worse especially on the libido front so I decided to order a full blood panel to see if anything was out of the ordinary.

Stats:
5' 11"
35 years old
204 lbs
Weight lifting: 4x week.
Keto diet consuming 1500-1800 calories per day. More on weekends.
Avg. Macros: 100 g Fat, 78 g Carbs (25-30 is soluble fiber) and 97 g Protein
16 hours intermittent fasting 4-5 days per week
Never messed with AAS's.

Total Testosterone (Mass Spec): 360 ng/dl (Ref: 270-1100)
Free Testosterone: 5.51 ng/dl (Ref: 4.65-18.1 for 35-39 YO)
SHBG: 26 nmol/L (Ref: 10-50)
Total Serum Estrogen: 131 pg/ml (Ref: 60-190)
*Should have gotten estrodiol measured but I didn't.

Other things that were in the normal range but not optimum (according InsideTracker).
Total Iron: 70 mcg/dl (Ref: 50-180)
Vitamin B12: 400 pg/ml (Ref: 200-1100)
Homocystein: 12.8 (Ref: <11.4)

Everything else was in the optimal range.

After such a long post I guess my questions are:

1) Unfortunately I do not have a reference test level before I started doing a lower carb diet, but is it likely that my lower test level is completely due to the reduction in carbs and calories? If so, does anyone have a general recommendation about how many more carbs and/or calories I should consume. Based on apps, my maintenance caloric intake should be around 2200-2500 per day.

2) At this point what would you guys do? Up calories and carbs a bit and get re-tested in a few months? I expected my test levels to be low but honestly I didn't expect 360.

 

[ValiantThor08]

First thing, you are not eating enough. When you do not eat enough testosterone plummets.

 

[ValiantThor08]

Don't worry about carbs if you still want to do a fat based diet. Double your protein, eat more fat, and definitely more saturated fat. Your total estrogen also seems high even though we cannot see estradiol. You may want to at least look into a natural aromatas inhibitor, or you can wait and get retested. If you do want an AI, look into Letrone, something I am taking now, and it is a great natural AI, shown to lower estradiol via blood test.

 

[MrKleen73]

I don't think it is carbs, but could be too low of calories causing more stress on the system. Hormones are definitely effected when in too deep of a deficit. At your body weight you are not eating much food at all if you are training hard too then I would increase calories a bit. I doubt carb levels have much to do with it.

Basically IMHO you simply need to eat more. Give it a little time and get it checked again. If that doesn't do it then you might want to start talking to your doc about possible TRT via test or restarting or stimulating your production via Clomid or something...

 

[Resolve10]

If things got worse on Keto then add some carbs back in.

In general your caloric intake does indeed seem low and you would probably be best served working your way back up.

 

[Matthersby]

You could run a kickstart/restart.
HCG/Clomid for 6 weeks.
I’ve seen them bring guys up significantly for quite a while.
But eventually, you may want to more than what you’ve got naturally 350-400 isn’t that bad, but in 3-5 years, you probably won’t love 270.
Who knows, maybe a month of Serm/HCG will get you to 700 for a bit?
Very little risk this routez

 

[ValiantThor08]

You could run a kickstart/restart.
HCG/Clomid for 6 weeks.
I’ve seen them bring guys up significantly for quite a while.
But eventually, you may want to more than what you’ve got naturally 350-400 isn’t that bad, but in 3-5 years, you probably won’t love 270.
Who knows, maybe a month of Serm/HCG will get you to 700 for a bit?
Very little risk this routez

I would do the restart protocols after upping the calories, and retesting, and seeing if the test did not raise.

 

[Matthersby]

I would do the restart protocols after upping the calories, and retesting, and seeing if the test did not raise.

Ya fair enough.
There’s more to the story probably and diet and rest could be huge factors right now

 

[mondata]

Thanks for all the responses fellas. Will up calories a bit via primarily fats and protein. Also supplementing with iron, b12, and boron which I do not expect to have much impact on test levels. For the past 12 weeks I have been lifting in the 16-20 rep range with lighter weight. Today I moved back down to the 4-6 rep (5 sets) range using about 80% of my 1-rep max. Supposedly heavier lifting can increase test even if only for short periods of time.

 

[ValiantThor08]

Thanks for all the responses fellas. Will up calories a bit via primarily fats and protein. Also supplementing with iron, b12, and boron which I do not expect to have much impact on test levels. For the past 12 weeks I have been lifting in the 16-20 rep range with lighter weight. Today I moved back down to the 4-6 rep (5 sets) range using about 80% of my 1-rep max. Supposedly heavier lifting can increase test even if only for short periods of time.

I recommend 10 to 20mg boron a day.

 

[mondata]

I recommend 10 to 20mg boron a day.

Damn really? The research I have seen showed 6 mg/day increased the availability of free test. I haven't seen an upper limit though. Taking 6 mg at the moment.

 

[ValiantThor08]

Damn really? The research I have seen showed 6 mg/day increased the availability of free test. I haven't seen an upper limit though. Taking 6 mg at the moment.

I'll tag you in a lecture.

 

[Matthersby]

Thanks for all the responses fellas. Will up calories a bit via primarily fats and protein. Also supplementing with iron, b12, and boron which I do not expect to have much impact on test levels. For the past 12 weeks I have been lifting in the 16-20 rep range with lighter weight. Today I moved back down to the 4-6 rep (5 sets) range using about 80% of my 1-rep max. Supposedly heavier lifting can increase test even if only for short periods of time.

Don’t buy too much of that for real numbers that you’ll actually see on paper year after year.
What will, is sleep, alcohol use, opiate use, antidepressant use, fat intake, and a few other real factors such as medications known to lower test. Those can drop numbers fast and adjusting them can bring it up 100s if points inside of a month.
Can’t hurt to lift heavy though.

 

[mondata]

Don’t buy too much of that for real numbers that you’ll actually see on paper year after year.
What will, is sleep, alcohol use, opiate use, antidepressant use, fat intake, and a few other real factors such as medications known to lower test. Those can drop numbers fast and adjusting them can bring it up 100s if points inside of a month.
Can’t hurt to lift heavy though.

Yeah I could certainly sleep more. I average under 7 a night for sure. I don’t drink or smoke and do not take any medications though. I also do not consume sugar and drink a ton of water every day along with being in the gym 3-4 times a week. Either I just have naturally low T or it’s my nutrition (i.e. low cals and/or carb intake).

 

[Matthersby]

Yeah I could certainly sleep more. I average under 7 a night for sure. I don’t drink or smoke and do not take any medications though. I also do not consume sugar and drink a ton of water every day along with being in the gym 3-4 times a week. Either I just have naturally low T or it’s my nutrition (i.e. low cals and/or carb intake).

See how it looks once adjusted like Valiant stated
Then maybe find a good restart protocol, or try one with a men’s health clinic.
If all else fails TRT is great. Just takes some responsibility and oversight.

 

[Chrisbenches]

I agree with many of the previous poster’s recommendations on upping calories.

100 grams of fat and 90 some grams of protein is NOT Keto by the way. That’s just starving.

Bump that fat up to 160g+ and you will feel way better.

 

[The Express 42]

I recommend CEL M test. Some impressive blood work results floating around out there for m test. I would do at least 8 weeks.

 

[Smont]

Right off the bat, your eating the amount oc calories a 130lb girl should be eating

 

[Smont]

If things got worse on Keto then add some carbs back in.

In general your caloric intake does indeed seem low and you would probably be best served working your way back up.

Keto probably has nothing to do with it. Not eating is far more likely the culprit

 

[Smont]

By the way, there's no such thing as ketoish, either your in ketosis or not. If your going above 40/50gm of carbs your most likely getting kicked out of ketosis and your basically just on a low carb diet

 

[Smont]

If your avg is 78gm carbs your never in ketosis.

 

[ValiantThor08]

If your avg is 78gm carbs your never in ketosis.

If you are fat adapted, and apply carb night or carb backloading by John Keifer, previously called "the anabolic diet", you can load your muscle with glycogen, and be right back into ketosis once your insulin level drops again. I have verified this many times with ketone blood test strips.

 

[Smont]

If you are fat adapted, and apply carb night or carb backloading by John Keifer, previously called "the anabolic diet", you can load your muscle with glycogen, and be right back into ketosis once your insulin level drops again. I have verified this many times with ketone blood test strips.

It takes 30 to 90 days of being in ketosis to become fat adapted, let's start with that. Once you become fat adapted, which most ppl never will, then those rules apply with refeeds

 

[Smont]

That time frame varies but that is for the average person to become adapted

 

[mondata]

If you are fat adapted, and apply carb night or carb backloading by John Keifer, previously called "the anabolic diet", you can load your muscle with glycogen, and be right back into ketosis once your insulin level drops again. I have verified this many times with ketone blood test strips.

Approximately 30 grams of that is fiber (primarily soluble). I was eating around 30 g of net carbs per day but recently upped my carbs a bit. I dropped around 31 lbs over the course of 12 weeks and I am happy with my currently weight thus the reasoning for upping carbs.

 

[mondata]

If your avg is 78gm carbs your never in ketosis.

See below. For 12 weeks I was keeping net carbs at or around 30 g. Ketones measured via blood samples were typically around 2.0 mmol?L although they ranged from 0.5 to almost 3.0 mmol/L.

 

[mondata]

By the way, there's no such thing as ketoish, either your in ketosis or not. If your going above 40/50gm of carbs your most likely getting kicked out of ketosis and your basically just on a low carb diet

Yeah I agree. The reason I said that is I recently upped my carbs to around 50 g net per day. I haven't measured my ketone levels for about two weeks but I suspect I would be in that 0.5 mmol/L range which is the "start" of ketosis.

 

[mondata]

Right off the bat, your eating the amount oc calories a 130lb girl should be eating

I just spit my coffee out. Yeah cals are low. I have tried to up them but I am just not hungry at this point. I have to force myself to consume even 1800 calories. I am sure my stomach was shrunk.

Great discussion guys. I am appreciate the advice.

 

[BlockBuilder]

How fat are you? Being fat will destroy your t levels.

 

[Matthersby]

I’m not a big eater, but for over 200lbs, that’s crazy low cals.
My post workout shake and meal go over your whole days cals, and I have the appetite of a baby bird.

 

[mondata]

How fat are you? Being fat will destroy your t levels.

Started at 234 and 26.8% BF in April.
Currently 202 and 20% BF. May be a touch lower now but no less than 19%. I haven’t had it checked in about two weeks.

Up until about two years ago when I started a business I was always in shape and fairly lean (15-16% BF). Being on the road all the time took its toll.

 

[Jinsun]

Hormones always drop when cutting. For example, if you look at precontest natty's lab results, they are basically hypogonadal! That's an extreme example, as they drop down to low single digit bf % but it goes to show how much dieting can effect your hormones.

1. Up your kcals to 3000
2. Buy some tamoxifen/clomid/toremifen and take a small amount of it for a month.
3. Buy a naturall Ai like arimistane, letrone, etc. that also lowers shbg. Take that for the duration of the serm plus a few weeks after.

You'll have higher test levels after that.