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DrexelHavoc
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So I recently went to a functional medicine doc with complaints of low energy, low motivation and mental fog. They ran a bunch of tests which can be seen below. I have been hypothyroid for awhile but on my 75 mcg of hypothyroid my TSH was still quite elevated. My total testosterone was 516 ng/dl which the doc said was low and put me on 100mg/wk test cyp with no AI or HCG.
I wonder if jumping straight to trt was premature. Below are my results. I also had a few tests done 6 years ago so I will post those as well. In contrast ever since I was maybe 17-18 I have had a tough time putting on muscle, never been able to squat or bench over 200 lbs. Always pretty weak and not so masculine.
-age: 32
-height: 5'10
-waist: 30"
-weight: 155 lbs
-describe body and facial hair: Very light facial hair on face, cant grow a beard really at all. Light hair on chest
-describe where you carry fat and how changed: I have always carried fat in chest region and stomach and ass most.
-health conditions, symptoms [history] I have Depression, Diabetes type 2, Hypothyroid, 15 year history of alcoholism sober now 1.5 years, Mild sleep apnea (which is well treated)
-Rx and OTC drugs: Remron, Prestiq, levothyroxin, Metformin (feel better off, considering controling with diet only)
-lab results with ranges
This first one was when I was 26 and I believe I was on a pretty restrictive diet. Mostly lean meat and vegetables. No clue on training or sleep, can't remember. Blood was drawn in AM
Cortisol Morning: 2.2Low ng/ml (3.7-9.5)
Cortisol Noon: 2.1 ng/ml (1.2-3.0)
Cortisol Evening: 2.8High ng/ml (0.6-1.9)
Cortisol Night: 0.5 ng/ml (0.4-1.0)
Estradiol: 40 pg/ml (12-56)
Total T: 430 ng/dL (400-1200)
SHBG: 37nmol/L (15-50)
Ratio T/SHBG 0.4Low (0.7-1.0)
DHEA: 199 ug/dL (70-325)
PSA: <0.5 ng/ml (<0.5-4)(optimal 0.5-2)
Free T4: 1.6 ng/dL (0.7-2.5)
Free T3: 3.3 pg/ml (2.5-6.5)
TSH: 2.2 uU/ml (0.5-3.0)
TPO: 6 IU/ml (0-150) (70-150 borderline)
-lab results with ranges
This was the most recent lab. I had not been sleeping particularly well before this draw. 6 weeks prior I started a 4 week cycle of trandermal DHEA and that seriously messed up my sleep. This was not resolved at the time of draw even after 2 weeks of being off.
Also I should note I was also trying to resolve some gyno from puberty with 60 mg a day rolaxifine that I had been running for 8 weeks. I found out later this can scew TT and FT up 20% or so. Regardless below is the results of my latest labs. There were a lot more tests run than I will report here as much of it is not applicable to TRT. This was 3:00 PM blood draw.
25-hydroxy-Vitamin D: 95 ng/mL (30-100)
Homocysteine: 8 umol/L (<11)
Vitamin B12: 1555 pg/mL (>400)
RBC Folate: 1510 ng/mL (>750)
Albumin: 4.8 g/dL (3.5-5.2)
Iron: 55Low ug/dL (59-158)
Ferritin: 67 ng/mL (30-400)
TSH: 3.42 uIU/mL (0.27-4.2)
Free T4: 1.47 ng/dL (0.93-1.7)
Free T3: 2.6 pg/mL (2.0-4.4)
Reverse T3: 17 ng/dL (8-24)
Estradiol 16.8 pg/mL (7.63-42.6)
Estrone: 52 pg/mL (12-72)
FSH: 2.3 mIU/mL (1.5-12.4)
LH: 2.9 mIU/mL (1.7-8.6)
Progesterone: 1.35 ng/mL (0.2-1.4)
SHBG: 50 nmol/L (10-80)
Testosterone: 516 ng/dL (280-800)
Free Testosterone (calculated): 8.33 ng/dL (4.7-24.4)
Cortisol: 18.9ug/dL (2.3-11.9)
We are going to test the adrenals soon also.
Interestingly enough my bioavailable testosterone levels with respect to both tests were virtually identical.
-describe diet
I had recently been incorporating intermittent fasting to try to reduce fat. I was up to 170 lbs and my face was quite puffy which I didn't like at all. That is way better now at my current weight of 150-155. I have a very small frame so this weight isn't quite as light as it would otherwise seem. I'm like 15% bf. I would cycle high carb training days with low carb low intensity cardio days.
Training days: 2250 cal, 240g carbs, 160g pro, 72 g fat
Rest days: 1804 cal, 50g carbs (green veggies), 160g pro, 110g fat.
Diet was paleo so meats, eggs, vegetables fruits and sweet potatoes. I did throw in a few non paleo foods like white rice and whey protien.
-describe training
Was doing compound lift weight training 3 days a week. Workouts were 40-50 min in length. On off days about 50% of the time I would walk an hour or so.
So anyhow my current thought is that testosterone injections may have been prescribed too soon before resolving other issues. I see the doctor again in 3 weeks to get new blood work. I am trying to figure out my best path forward at this point. My current thought is to maintain the 50mg bi weekly injections until I go back to the doc to get blood work to at least see what effect that had.
There is a notable difference in the volume of my muscles when compared to 2 weeks ago so I know it is doing something. However I do feel a bit edgy, possibly just getting used to it. At that point I think I am going to suggest that I go off T injections for now and work on getting my thyroid and adrenals situated (if I have an adrenal issue).
Do to my lowish FSH,LH levels I am also considering running the HPTA restart protocol that using Nolvadex and Arimidex for 6 weeks using research chems. Also I'm going to try to up calories to maintenance and up carbs on rest days to 50-75 from starchy sources. BTW the doctor also took me off levothyroxine and put me on T3 only to resolve my reverse T3 and high TSH. After awhile we will be switching to Nature throid.
Or I could just be way over thinking this and should stick with the T injections as my bioavailable testosterone and free T seems sub par at best and has been for 6 years at least.
Any advise or related experiences would be greatly appreciated.
I wonder if jumping straight to trt was premature. Below are my results. I also had a few tests done 6 years ago so I will post those as well. In contrast ever since I was maybe 17-18 I have had a tough time putting on muscle, never been able to squat or bench over 200 lbs. Always pretty weak and not so masculine.
-age: 32
-height: 5'10
-waist: 30"
-weight: 155 lbs
-describe body and facial hair: Very light facial hair on face, cant grow a beard really at all. Light hair on chest
-describe where you carry fat and how changed: I have always carried fat in chest region and stomach and ass most.
-health conditions, symptoms [history] I have Depression, Diabetes type 2, Hypothyroid, 15 year history of alcoholism sober now 1.5 years, Mild sleep apnea (which is well treated)
-Rx and OTC drugs: Remron, Prestiq, levothyroxin, Metformin (feel better off, considering controling with diet only)
-lab results with ranges
This first one was when I was 26 and I believe I was on a pretty restrictive diet. Mostly lean meat and vegetables. No clue on training or sleep, can't remember. Blood was drawn in AM
Cortisol Morning: 2.2Low ng/ml (3.7-9.5)
Cortisol Noon: 2.1 ng/ml (1.2-3.0)
Cortisol Evening: 2.8High ng/ml (0.6-1.9)
Cortisol Night: 0.5 ng/ml (0.4-1.0)
Estradiol: 40 pg/ml (12-56)
Total T: 430 ng/dL (400-1200)
SHBG: 37nmol/L (15-50)
Ratio T/SHBG 0.4Low (0.7-1.0)
DHEA: 199 ug/dL (70-325)
PSA: <0.5 ng/ml (<0.5-4)(optimal 0.5-2)
Free T4: 1.6 ng/dL (0.7-2.5)
Free T3: 3.3 pg/ml (2.5-6.5)
TSH: 2.2 uU/ml (0.5-3.0)
TPO: 6 IU/ml (0-150) (70-150 borderline)
-lab results with ranges
This was the most recent lab. I had not been sleeping particularly well before this draw. 6 weeks prior I started a 4 week cycle of trandermal DHEA and that seriously messed up my sleep. This was not resolved at the time of draw even after 2 weeks of being off.
Also I should note I was also trying to resolve some gyno from puberty with 60 mg a day rolaxifine that I had been running for 8 weeks. I found out later this can scew TT and FT up 20% or so. Regardless below is the results of my latest labs. There were a lot more tests run than I will report here as much of it is not applicable to TRT. This was 3:00 PM blood draw.
25-hydroxy-Vitamin D: 95 ng/mL (30-100)
Homocysteine: 8 umol/L (<11)
Vitamin B12: 1555 pg/mL (>400)
RBC Folate: 1510 ng/mL (>750)
Albumin: 4.8 g/dL (3.5-5.2)
Iron: 55Low ug/dL (59-158)
Ferritin: 67 ng/mL (30-400)
TSH: 3.42 uIU/mL (0.27-4.2)
Free T4: 1.47 ng/dL (0.93-1.7)
Free T3: 2.6 pg/mL (2.0-4.4)
Reverse T3: 17 ng/dL (8-24)
Estradiol 16.8 pg/mL (7.63-42.6)
Estrone: 52 pg/mL (12-72)
FSH: 2.3 mIU/mL (1.5-12.4)
LH: 2.9 mIU/mL (1.7-8.6)
Progesterone: 1.35 ng/mL (0.2-1.4)
SHBG: 50 nmol/L (10-80)
Testosterone: 516 ng/dL (280-800)
Free Testosterone (calculated): 8.33 ng/dL (4.7-24.4)
Cortisol: 18.9ug/dL (2.3-11.9)
We are going to test the adrenals soon also.
Interestingly enough my bioavailable testosterone levels with respect to both tests were virtually identical.
-describe diet
I had recently been incorporating intermittent fasting to try to reduce fat. I was up to 170 lbs and my face was quite puffy which I didn't like at all. That is way better now at my current weight of 150-155. I have a very small frame so this weight isn't quite as light as it would otherwise seem. I'm like 15% bf. I would cycle high carb training days with low carb low intensity cardio days.
Training days: 2250 cal, 240g carbs, 160g pro, 72 g fat
Rest days: 1804 cal, 50g carbs (green veggies), 160g pro, 110g fat.
Diet was paleo so meats, eggs, vegetables fruits and sweet potatoes. I did throw in a few non paleo foods like white rice and whey protien.
-describe training
Was doing compound lift weight training 3 days a week. Workouts were 40-50 min in length. On off days about 50% of the time I would walk an hour or so.
So anyhow my current thought is that testosterone injections may have been prescribed too soon before resolving other issues. I see the doctor again in 3 weeks to get new blood work. I am trying to figure out my best path forward at this point. My current thought is to maintain the 50mg bi weekly injections until I go back to the doc to get blood work to at least see what effect that had.
There is a notable difference in the volume of my muscles when compared to 2 weeks ago so I know it is doing something. However I do feel a bit edgy, possibly just getting used to it. At that point I think I am going to suggest that I go off T injections for now and work on getting my thyroid and adrenals situated (if I have an adrenal issue).
Do to my lowish FSH,LH levels I am also considering running the HPTA restart protocol that using Nolvadex and Arimidex for 6 weeks using research chems. Also I'm going to try to up calories to maintenance and up carbs on rest days to 50-75 from starchy sources. BTW the doctor also took me off levothyroxine and put me on T3 only to resolve my reverse T3 and high TSH. After awhile we will be switching to Nature throid.
Or I could just be way over thinking this and should stick with the T injections as my bioavailable testosterone and free T seems sub par at best and has been for 6 years at least.
Any advise or related experiences would be greatly appreciated.
