39 and low T

[ta406]

I’m 39, 5’9” , 200 lbs; and around 15% bf, and have been dealing with low testosterone symptoms for several years now. I have had a sleep study done around the age of 35 and do not have sleep apnea. My diet is decent but I’m sure there is room for improvement. I stay away from processed and junk food as much as possible. I really don’t exercise any more but between feeling like crap all the time and a very active two year old and a three month old its pretty hard right now (poor excuse….I know).

I believe that the symptoms started not long after I discovered a varicocele at age 34. Over time my left testicle, which at one time was larger than my right, began to shrink. I had the varicocele repaired at age 35 and now my left testicle is probably 60% the size of my right and is fairly soft. As my symptoms became worse, I saw a few doctors who said everything from “its all in your head” to “I would like to put you on antidepressants”.

I suffered through the next few years and recently found a doctor who was willing to listen and who happens to be on TRT himself so he understands what its like living with low T. He agreed to do some initial lab work and checked TT, FT, E2, Vitamin D. My TT came back at 290 ng/dl, FT 5.6 pg/ml and E2 was 17.3 pg/ml, Vit D 54.3 ng/ml. We discussed TRT and he said that he would like to start me on a transdermal like Axiron if I would like. I asked about E2 management and he stated that he likes to keep his patients in the low to mid 20’s. I also asked about injections and adding HCG . He said he would ok with that too. Before I started TRT I asked for more lab work which I listed below. I also got a complete metabolic panel and CBC, all of which were normal and I did have a follow up appointment to go over the labs. We discusses trying to lower my cortisol and cholesterol levels. I did notice that my estrogen levels are very low too. With the lab work I would also like to add that it was first thing in the morning and I did have a mild cold and was slightly dehydrated. I was actually a little surprised that my TT was as high as it was in the second test. It is strange but I have always been able to maintain a better erection when I had a mild cold than if I felt well. As soon as I am over the cold, my erection quality fades. I have done some research on the subject and am aware of the pros and cons but I’m tired of feeling like crap and would like to ask for you help in making sure TRT is the right choice. Any help would be greatly appreciated.

Result Reference range

Cortisol: 12.7 ng/ml morning 7.0 - 10.0
7.4 ng/ml midday 3.0 - 7.0
5.4 ng/ml afternoon 2.0 - 4.0
7.9 ng/ml evening less than 1.5

Testosterone 464 ng/dl 348 - 1197
Free T 7.9 pg/ml 8.7 - 25.1
LH 12.5 mUI/ml 1.7 - 8.6
FSH 10 mUI/ml 1.5 - 12.4
Estradiol 13.6 pg.ml 7.6 - 42.6 Roche ECLIA methodology
TSH 1.8 uIU/ml .450 - 4.50
T4 Free 1.17 ng/ml .82 - 1.77
T3 Free 2.6 pg/ml 2.0 - 4.4
Prolactin 9.4 ng/ml 4.0 - 15.2
Progesterone .4 ng/ml .2 - 1.4
SHBG 46.1 nmol/L 16.5 - 55.9
PSA .5 ng/ml 0 - 4.0
Cholesterol 217 mg/ml 100 - 199
LDL 142 mg/dl 0 - 99

[xthedukex]

welcome

[BallSak]

Not much doubt the varicocele has given you primary hypogonadism IMO. Your pituitary seems to be functioning well. What does your new doc say about the varicocele? High cortisol needs to come down and that will help you feel a little better but your free T is deep in the gutter. Total T number doesn't really matter. Also your free T3 needs to come up closer to 3.5-4.0. Do you have any more labs for thyroid?

[ta406]

welcome

Thank you

[ta406]

Not much doubt the varicocele has given you primary hypogonadism IMO. Your pituitary seems to be functioning well. What does your new doc say about the varicocele? High cortisol needs to come down and that will help you feel a little better but your free T is deep in the gutter. Total T number doesn't really matter. Also your free T3 needs to come up closer to 3.5-4.0. Do you have any more labs for thyroid?

Thanks for the reply. The doc said he has seen patients with varicoceles have low test. Since it was repaired a few years ago there isn't much more that can be done. That was it as far as thyroid labs. Is there anything that can be done to raise T3 short of pharmaceuticals? I have started to supplement with iodine recently. I can't say that I've noticed anything different. And I just stumbled on stopthethyroidmadness.com so I have a lot more research to do