On the road to TRT...lancerevo's chronicles

[lancerevo]

Wanted to start a fresh thread to log my journey on the path of TRT. Found out I had low T back in April and have been spending countless hours of research everyday since then to get a full understanding of what's going on. I feel like I've done or am doing almost everything to get my test up without actually starting TRT. Below are my chronicles.

Background:
Been having symptoms for years, but just recently got the time to get blood work done. 26 y/o male been having symptoms of Low T - poor sleep, constant fatigue, absolute no sex drive. I train very seriously, lift 4-5x a week, and my nutrition is spot on. Currently 183 pounds around 14% BF, waist ~33 inches. Just been having poor recovery which is what got me to get BW back in April. Kinda new I had low test as I had it checked when I was 22 and was in the mid 400s then for total t. Have never done anabolic steroids before

Medical history
High blood pressure - used to run high at 160 but with lifestyle changes now down to 130
Diagnosed with hiatal hernia so have acid reflux from that

Current med list:
Omeprazole for a acid reflux
Isotonix Multi vitamin, B vitamins, OPC-3, calcium
Vitamin C 2-4g
Vitamin D 10K IU
Fish oil 2 caps
DHEA 50mg
Pregnenolone 50mg
Glutamine
Creatine

All blood work uses labcorp values

April blood work:
CBC:
WBC 5.1
Hemoglobin 15.3
Hematocrit 44.3
MCV 88

CMP:
Glc 87
BUN 16
Cr 1.16
Sodium 139
Potassium 4.3
Chloride 101
Carbon Dioxide 25
Calcium 9.8
AST 36
ALT 34

Lipids:
Total Cholesterol 134
Triglycerides 55
HDL 38
LDL 85
VLDL 11

Hemoglobin A1c 5.3

Thyroid Panel
TSH 2.070 (0.450 - 4.5)
Free T4 1.30 (0.82-1.77)
Free T3 3.7 (2-4.4)
Reverse T3 19.7 (9.2-24.1)
Thyroid Peroxidase Antibody 6 (0-34)

Adrenal Panel
Aldosterone 5.6 (0-30) Borderline low
ACTH 27.5 (7.2-63.3)
Cortisol AM 14.1 (6-19)
DHEA Sulfate 144.9 (138.5-475) Borderline low
Pregnenolone 105 (<150)

Vitamin B12 1287 HIGH (211-946)
Folate 13.2 >3
Vitamin D 25 Hydroxy 28 LOW (30-100)
Magnesium 2.1
Selenium 144 (79-326)
Zinc 149 HIGH (56-134)
Ferritin 39 (30-400)
Iodine 69
Homocystein 5.8
ESR 2
CRP <1.0


Total Testosterone 438 (348-1197)
Free Testosterone 6.8 LOW (9.3-26.5)
FSH 3.9 (1.5-12.4)
LH 3.3 (1.7-8.6)
Prolactin 13.6 (4-15.2)
Estradiol 18.8 (7.6-42.6) (not sensitive)
PSA 0.2



After these tests I started on vitamin D, DHEA, vitamin c

Repeat tests in June:

Total test 515
Free test 8.8
SHBG 37
Estradiol sensitive panel 4 (3-72)
DHEA 233
Vitamin D 41

I also got a sleep study to rule out sleep apnea which came back negative.

Also got an MRI head which show a VERY tiny pituitary microadenoma which was 1mm in size.

Rechecked my prolactin which came back at 8
Don't think pituitary is a cause for my low test.

Saw an anti aging doc and endo who both wanted to start me on test. I opted to start for clomid first as a trial and they both agreed.


Some things that I have also changed and tried:
Went almost fully organic, including organic shampoo lotion soap etc
Water filters and boiling all my water
No plastics
Did a parasite cleanse with wormwood - no change from this
Tried ZMA - have me decent sleep but got bad headaches from this
Currently trying to reduce any electromagnetic frequency while sleeping to reduce all that sleep disruption

[lancerevo]

So currently these are my theories on my low testosterone :

1. Some form of adrenal fatigue. All my adrenal hormones are low. I have started supplementing pregnenolone for the past 3 weeks, also have been eating a ton more eggs to increase my cholesterol. Will be checking BW again in 2 weeks.

2. Some form of thyroid disruption. TSH is a tad high at 2. Even though my free T3 and Ft4 are great, my rT3 is high with a ratio of 18.8 for fT3:rT3 and I know the optimal ratio is >20. This is further compounded by the fact that my body temps are very consistent at 97.3-97.7 all day long. Am starting iodine supplementation tomorrow and will recheck levels. Elevated rT3 could also be from stress and adrenal fatigue.

3. Iatrogenic low T. If the preg, eggs, iodine don't help fix my T, I will be starting clomid at the beginning of sept.

[lancerevo]

I've also been pondering about my SHBG. I see it is on the higher side...I've been doing everything I can except actually taking reversitol to bring it down naturally.

Sucks having a Total T in 500's (which is normal for some ppl on TRT to be on) but having a free test of 8!!

[lancerevo]

2 days into Iodine treatment....body temps have already started improving - running 97.7-98.2 now with the same thermometers. Definitely feeling a little bit more energized..maybe a placebo effect? we'll see what blood work shows in 2 weeks

and I'd also love any feedback from anyone! Am i on the right track and right thought process? Things to change? things to try out? Thanks for reading!

[lancerevo]

The first 5 days of Iodine treatment literally felt like a god with so much energy.

Now the past 3-4 days that has resolved and I'm back to baseline....which sucks. I need to find out how to get back to that feeling again! Blood work coming up this Tuesday morning

[lancerevo]

So thought I'd give a little update:

Got repeat BW done:
TT: 542
FT: 8.7
Estradiol Sensitive: 6
SHBG: 36.5

I'm still confused with my results. Do'nt know why I have such low Estradiol - may the low Estradiol is what is causing all my "hypogonadal" symptoms. But If I have low E2, that means I don't have enough Test to convert to the E2?

Also got a Semen analysis. Results showed <100,000 sperm/ml, where normal is around 20 million sperm/ml. I have the results of an infertile man.

I started Clomid at the beginning of the month - to see if my test levels increase at all (whether I'm primary or secondary) and to see if it helps with my sperm count for when I want to have kids. Haven't felt any relief in the "hypogondal" symptoms in the past 2 weeks I've been on Clomid...will be getting BW and semen analysis again next week to check results. I will most probably be stopping Clomid next week as I definitely feel more anxious, moody, depressed, and emotional all around since starting it.

[kelkel]

Hi Lance,

A pituitary tumor of 1mm can still wreak havoc on your hormones. Consider the average pituitary may only be 6mm or so. My pituitary is exactly that with a 2mm adenoma. Said adenoma totally shut down my T production to a 59 level and dropping. My point? Your doc saying it's a small tumor and not seeing a rise in prolactin is erroneous if that's his gauge for determining whether it effected T production or not, imho. Not all pit tumors are prolactinomas. They can have singular or multiple effects. Some even increase your TSH.

Remember as well that there's not always a singular cause for low T. It could be several things and you are on the right track with self-education and investigating all avenues.

SHBG does not really appear high if the scale is similar to Labcorps or around 19 - 76. That said, a bit lower is fine as well. Too low is not. Double your current Vit D level and maybe add some stinging nettle or avena-cosides to help. In reality the quickest way to lower shbg is to increase test levels.

When it comes to your E being so low, some people simply convert less and you are relatively lean. Be sure you're not taking anything that will inhibit it from rising. It will come up as your test level rises.

When it comes to stopping therapy, you need to give things time. Improvements are not over night. It can take months.

[lancerevo]

Thank you so much for the reply kelkel! I actually was taking 10K IU of Vitamin and forgot to include but my vitamin D level came back at 98! (with 100 being the upper limits of normal). So I will be backing off a tad bit on the Vit D.

How do I go about evaluating this pituitary microadenoma and seeing what exactly it is affecting? I believe it is too small for medications or surgery, so seems like I would have to fix the effects as opposed to the cause.

And since you stated SHBG is relatively normal, what's the cause for my somewhat normal total test but below normal free test?