I'm a mess... Blood test advice, please.

[dankoni]

Where to begin...

tl;dr? If you jump to the bottom, you can just check my blood test results, my current goals, and the options I'm weighing.

I just had a blood test yesterday, so my main reason for posting is to get some advice on what steps to take, but I suppose background info would be helpful. If you want to tl;dr, that's fine, as this might get lengthy. I will try to keep it as brief as possible.

Drug history:
- Started smoking cigarettes in early teen years and still do, but have recently lowered my cigarette use and I'm trying to ween down/quit.
- Currently prescribed to Adderall (started about 6 months ago), but thinking of changing to Focalin or nothing at all. I certainly need help with focus, but feel as though the Adderall is depleting my dopamine too much and possibly destroying what little muscle I have.
- Recklessly took DHEA on and off for the last 3 years or so. I shouldn't have started without a blood test and bounced around on the dosage too much. Weaned myself off for the third time about a month ago and used a maca supplement to help. I started taking it for light depression and loss of libido.

Physical Activity:
- I played sports actively until the age of 15. Basketball and baseball were my main sports, with a few years of soccer and football in there as well.
- Since the age of 15, I have barely engaged in much physical activity. I had a couple stints at gyms and working out at home, but nothing has really lasted.

Illness:
- In February of this year I got a terrible case of epididymitis, which progressed to epididymo-orchitis in the left testicle. Just when I was ready to start getting healthy and oozing with motivation, I was confined to bed rest and put on 2+ months of cipro (after Bactrim DS did nothing), which really wrecked the tendons in my feet and shoulders, not to mention messed with my head. At its worst, my tesitcle was swollen to about 3 times its normal size. When it finally got better, I started with light physical activity (which was actually a lot compared to when I was 40lbs heavier and bedridden), then the orchitis came back. I was put back on cipro and re-confined to bed rest. Spoke to a new urologist and stopped the cipro. At this point, it had been about 4-5 months since my epididymo-orchitis began. I also realized that the epididymo-orchitis coincided with my abruptly stopping DHEA. Because of this, I decided to go back to 50mg of DHEA once a day, due to it reportedly helping with the immune system and testicular function. The epididymo-orchitis finally seemed to be going away, although I still had pain after sex for a few months, but nothing like before.

Recent Events:
- About 1 month ago, I weaned off the DHEA again (carefully lowering my dose this time) and started taking a maca supplement to ease the transition. It seemed to work very well, as I had far fewer side effects from stopping DHEA than ever before. About 1-2 week ago, I noticed the affected left testicle was significantly smaller than the right. I believe this is atrophy due to the chronic epididymo-orchitis and possibly related to my years of stupid DHEA use. At my highest use, I would take 100mg in the morning and sometimes 50mg at night. That was a couple years ago and those levels we only for a relatively short time period.
- In the last month or so, I've noticed a creeping malaise and depression, couple with extreme lack in libido. I rarely have an issue getting/maintaining an erection, but the desire to have sex with my beautiful wife and ever masturbate is practically gone. It comes back once in a while, but my libido has never been this low. These symptoms coupled with the shrunken left testicle prompted me to research hormone imbalances and low testosterone , so yesterday I had a blood test. I was so depressed yesterday with no apparent cause related to the drug/withdrawal induced depression I've become accustomed to, so I took 100mg of DHEA yesterday and 50mg this morning. I don't want to, nor plan to keep it up, but I needed something to get me over the hump until I had my test results and could find a better path. One hour after I took the DHEA, I felt much better and took a long walk.
- Also in the last month, I've started eating better and resumed light physical activity. I dropped 35lbs, some of which seems to be muscle. I've also been dealing with crazy leg/foot pain and circulation issues in my feet. They are constantly either extremely cold or producing incredible pain.

So, that was probably too long, but I enjoy writing and want to get as much info in here as possible before I lose motivation again and go another month without seeking help. Also, I am currently without health insurance. Here is my current dietary/supplement regimen and my blood work from 10/23/13.

Morning:
- 750mg Raw Maca (6:1 concentrate from NOW)
- One B-Right (Jarrow Formulas)
- Sublingual B12
- 500mg Muscadine Grape Seed (nearly every day)
- 1500mg MSM to help with shoulder injury and tendon issues from the cipro (usually 4-5 mornings a week)
- 500mg Cordyceps mushroom extract. (I was taking Reishi mushroom extract too, but recently stopped. Thinking of starting again for immune system.)
- 1 generic excedrin for pain. I was taking two in the morning and many throughout the day. Also take ibuprofen or aleve at times, but trying to stop all NSAIDs as much as possible, due to possible liver/intestine damage.
- 50mg DHEA (today is my first morning taking it in about a month. I'd like to stop in favor of a better solution)

About 30-60 minutes later, I take 30mg generic Adderall IR.
30-60 minutes after the Adderall, I drink a protein shake from PlantFusion, made with almond/coconut milk. This change (I never really ate breakfast for most of my life), seems to be the major cause of my weight loss. My wife dropped about 20lbs since starting this routine as well.

At some point before my second Adderall, I usually have a banana or some almonds for a snack.

4-5 hours after my first Adderall, I take a second 30mg IR Adderall. Some days I take 15mg/15mg morning/afternoon. Typically on the weekend, I only take one 30mg Adderall, or none at all, to control tolerance and side effects. I never abuse it and I don't seem to have any withdrawal when I skip a day or lower my dose on the weekends.

PM/Dinner:
- I typically eat a healthy and balanced dinner, although pizza and chinese takeout occasionally shows up. Most nights, I cook something like chicken breast, with a salad or green beans. Very healthy compared to my past.
- Curcumin/Turmeric (Source Naturals or Viva Labs)
- Omega-3 EPA/DHA
- Calcium/D (recently started this again. Thinking of changing to just a Vit D supplement)
- Men's multivitamin
- Probiotic
- CoQ10
- Vitamin C
- l-tyrosine (About to start up again. Ran out, which might partly explain my recent perceived dopamine drop)

About an hour after dinner, I typically take about 6 tablespoons of psyllium husk fiber and 2-3 tablespoon of chia seeds. This all but cures my IBS symptoms and makes me regular for the first time in my life.

Sometimes I take something for sleep. Recently started with melatonin again after stopping for over a year. Ambien doesn't seem to work well for me.

Now, if you were kind enough to read that novel, here is my 12hr fasted blood work from 10/23/13:

CBC With Differential/Platelet:
WBC 13.6 HIGH 3.4-10.8 x10E3/uL RN
RBC 5.10 4.14-5.80 x10E6/uL RN
Hemoglobin 15.6 12.6-17.7 g/dL RN
Hematocrit 45.1 37.5-51.0 % RN
MCV 88 79-97 fL RN
MCH 30.6 26.6-33.0 pg RN
MCHC 34.6 31.5-35.7 g/dL RN
RDW 13.6 12.3-15.4 % RN
Platelets 339 155-379 x10E3/uL RN
Neutrophils 72 40-74 % RN
Lymphs 22 14-46 % RN
Monocytes 5 4-12 % RN
Eos 1 0-5 % RN
Basos 0 0-3 % RN
Neutrophils (Absolute) 9.7 HIGH 1.4-7.0 x10E3/uL RN
Lymphs (Absolute) 3.0 0.7-3.1 x10E3/uL RN
Monocytes(Absolute) 0.7 0.1-0.9 x10E3/uL RN
Eos (Absolute) 0.1 0.0-0.4 x10E3/uL RN
Baso (Absolute) 0.0 0.0-0.2 x10E3/uL RN
Immature Granulocytes 0 0-2 % RN
Immature Grans (Abs) 0.0 0.0-0.1 x10E3/uL RN

Comp. Metabolic Panel:
Glucose, Serum 109 HIGH 65-99 mg/dL RN
BUN 12 6-20 mg/dL RN
Creatinine, Serum 0.86 0.76-1.27 mg/dL RN
eGFR If NonAfricn Am 115 >59 mL/min/1.73 RN
eGFR If Africn Am 133 >59 mL/min/1.73 RN
BUN/Creatinine Ratio 14 8-19 RN
Sodium, Serum 141 134-144 mmol/L RN
Potassium, Serum 4.8 3.5-5.2 mmol/L RN
Chloride, Serum 106 97-108 mmol/L RN
Carbon Dioxide, Total 22 19-28 mmol/L RN
Calcium, Serum 10.0 8.7-10.2 mg/dL RN
Protein, Total, Serum 7.4 6.0-8.5 g/dL RN
Albumin, Serum 4.8 3.5-5.5 g/dL RN
Globulin, Total 2.6 1.5-4.5 g/dL RN
A/G Ratio 1.8 1.1-2.5 RN
Bilirubin, Total 0.3 0.0-1.2 mg/dL RN
Alkaline Phosphatase, S 56 44-102 IU/L RN
AST (SGOT) 19 0-40 IU/L RN
ALT (SGPT) 22 0-44 IU/L RN

Hormone Panel: (I added the prolactin. Figured Bioavailable Testosterone should be next test)
Testosterone, Serum 356 348-1197 ng/dL RN
Luteinizing Hormone(LH), S
LH 6.5 1.7-8.6 mIU/mL RN
FSH, Serum
FSH 12.6 HIGH 1.5-12.4 mIU/mL RN
Prolactin 3.8 LOW 4.0-15.2 ng/mL RN
Estradiol 13.9 7.6-42.6 pg/mL RN
Roche ECLIA methodology

tl;dr -
My overall goals are to balance my hormones, aid my depression, increase motivation/focus (without Adderall), start actively working out (I'd like to turn these tits into pecks for the first time in my life), and boost my libido/erections.

Rx Options I'm looking into:
- TRT until my levels are higher and I can naturally sustain them through supplements and exercise
- The hCG , Toremifene citrate, clomid route to "fixing" my hypothalamic-pituitary-gonadal axis

Supplement driven routes I'm researching:
- Bulk Maca
- Tribulus (extract/concentrate)
- Fenugreek
- DAA w/ PES Erase
- L-Dopa w/ P5P and EGCG
- Tongkat (extract/concentrate)
- Stinging Nettle Root Extract
- Bps EndoSurge (if it's a better choice than getting nettle/l-dopa individually)
- Fadogia Agrestis

Any advice is greatly appreciated. Thank you for taking the time to read.

[Novice489]

I'm sure one of the more experienced members will be able to give you more information. Your total test is low. Many people in the mid 300's experience symptoms of lowT. You need to get your Free Testosterone checked.

The fact that your FSH is high may indicate some form of testicular damage which your medical history hints at. If this is the cause hCG won't do much for you. What has your doc told you?

[bass]

OP edit your post and add ranges.

[dankoni]

Thanks for the replies! I will post the ranges in about an hour. As for the free testosterone , I am getting that test done next. Please let me know if there are any tests I should add to it. In regards to my doc, I am seeing him on Tuesday morning.

[Bonaparte]

Could you please highlight the question?
Really don't feel like reading through all that...

[dankoni]

OP edit your post and add ranges.

Ranges added to OP. Please let me know if you need any other info or if I could better format the results.

Could you please highlight the question?
Really don't feel like reading through all that...

NP. I'll just post the tl;dr from the OP:
tl;dr -
My overall goals are to balance my hormones, aid my depression, increase motivation/focus (without Adderall), start actively working out (I'd like to turn these tits into pecks for the first time in my life), and boost my libido/erections.

Rx Options I'm looking into:
- TRT until my levels are higher and I can naturally sustain them through supplements and exercise
- The hCG , Toremifene citrate, clomid route to "fixing" my hypothalamic-pituitary-gonadal axis

Supplement driven routes I'm researching:
- Bulk Maca
- Tribulus (extract/concentrate)
- Fenugreek
- DAA w/ PES Erase
- L-Dopa w/ P5P and EGCG
- Tongkat (extract/concentrate)
- Stinging Nettle Root Extract
- Bps EndoSurge (if it's a better choice than getting nettle/l-dopa individually)
- Fadogia Agrestis

[imnotnatty]

Aderrall is scary, stay away from that stuff.

[Java Man]

I agree with Aux in that your FSH is on overdrive but your balls aren't responding. Your test is low, so FSH goes up to signal your testes to produce more. That all seems to be working up to the testes. They don't seem to be producing more test as directed. Something might be wrong with your ability to produce test naturally. If that is the case, youre primary and hcg , clomid, prayers, etc. won't help.

You need to see a doctor.

[dankoni]

I agree with Aux in that your FSH is on overdrive but your balls aren't responding. Your test is low, so FSH goes up to signal your testes to produce more. That all seems to be working up to the testes. They don't seem to be producing more test as directed. Something might be wrong with your ability to produce test naturally. If that is the case, youre primary and hcg , clomid, prayers, etc. won't help.

You need to see a doctor.

Appt with my doc tomorrow morning. There is definitely something wrong with my testicles (at least the left one), as it is in atrophy following the ~6month fight with chronic epididymo-orchitis =(

Aderrall is scary, stay away from that stuff.

I'm switching to dexmethylphenidate this week and hoping to go off that in a month or two.

[Bonaparte]

I agree with Aux in that your FSH is on overdrive but your balls aren't responding. Your test is low, so FSH goes up to signal your testes to produce more. That all seems to be working up to the testes. They don't seem to be producing more test as directed. Something might be wrong with your ability to produce test naturally. If that is the case, youre primary and hcg , clomid, prayers, etc. won't help.

You need to see a doctor.

FSH stimulates sperm production (in the presence of testosterone ), not testosterone production.
LH is responsible for signaling testosterone production.

[Bonaparte]

OP, none of your hormones are looking that bad, really.
The test is borderline low, but that can come up naturally through diet and lifestyle changes.
Just get into a regular exercise routine and try adding in some Torem for 2 months (I'd try around 80mg daily). Get retested first thing in the morning.
Fix your diet and put together a clean, well balanced cutting diet (no more than a 300-500 cal deficit). Try to wean yourself off the ADD meds.
HRT would be a permanent solution, not to be used as a temporary crutch.

[dankoni]

Bonaparte:

Awesome! Thank you, sir! I'm also coming off a few years of substance abuse/addic (one of the factors I believe contributed to the epididymo-orchitis), so low testosterone /libido is to be expected.

Here is my current morning regimen before working out:
- Stick with the Chocolate PlantFusion morning protein shakes in Blue Diamond almond/coconut milk (I have some issues with dairy tolerance). Does anyone see any issues with this powder?
- 3g of DAA, 5g of micronized creatine, and 5g bulk maca in the shake. How long do you recommend before dropping the DAA?
- Also with the shake, green tea and/or green tea extract along with a muscadine grape seed pill to act as natural aromatase inhibs.
- I also grabbed some fenugreek seed and nettle root extract pills. Not sure if/when to take these.
- Reishi/Cordyceps/Maitake mushroom extract pills. Thoughts?

And if you knowledgeable gents don't mind, would you give you opinions on the following?
- 50mg Pregnenolone with 25mg DHEA in the morning, followed by 25mg DHEA in the afternoon. I've kind of painted myself into a corner with my stupid DHEA use in the past, so it seems necessary in the short term.
- Thoughts on kombucha, gelatin, fermented cod liver oil, coconut/MCT oil, L-phenylalanine, and Vit D supplements?

[Bonaparte]

Try to drop everything you can do without at this point and see where your baseline is. Then you can add in supps one at a time to see which ones are actually working (I doubt most of what you listed will do anything noticeable).

[kelkel]

Bonaparte:


And if you knowledgeable gents don't mind, would you give you opinions on the following?
- 50mg Pregnenolone with 25mg DHEA in the morning, followed by 25mg DHEA in the afternoon. I've kind of painted myself into a corner with my stupid DHEA use in the past, so it seems necessary in the short term.
- Thoughts on kombucha, gelatin, fermented cod liver oil, coconut/MCT oil, L-phenylalanine, and Vit D supplements?

Let blood work dictate if you need dhea or not.

Try to drop everything you can do without at this point and see where your baseline is. Then you can add in supps one at a time to see which ones are actually working (I doubt most of what you listed will do anything noticeable).

There's your answer in bold. Don't over-complicate this just yet. Occam's Razor.

[dankoni]

Thanks for taking the time to respond! Back to basics.