New member looking for answers in Hampton Roads, VA

JohnnyQuest

New Member
New member trying to become more educated here since the doctors, including an endo and a uro, don't seem to have the answers to the questions I'm asking. I'm hoping the smart people on this forum who have been dealing with similar issues can help.

My background - I'm a 50 year old male, about 5-9 and 260. I have gained about 45 lbs in the last 10 years, and I don't know why. I know I don't get as much exercise as I should, but I do push mow a half acre lawn twice a week, edge it, and so on along with other yard work of pulling weeds, so I'm not completely without exercise. My doctor has been telling me the usual, watch what you eat, exercise more, and lose weight. However, I've been telling him I don't have any great energy when I get home from work. assumed this is because I don't sleep well. I do get up a couple of times at night to urinate, but i have no prostate issues, my doctor checks it annually - last result was 0.605 on a range <2.000 NG/ML.

Last fall, I asked my doctor to check my vitamin D since my wife learned hers was low. Turns out, it came back low (little did I know HOW low until I started researching Low T later), at 22 on a scale of 32-100 ng/ml. My doctor didn't seem alarmed and just said to take a supplement.

In December of 2013, I saw commercials on TV for Low T, and that it can cause lack of energy, etc. so I asked my doctor to check my T level. It came back at 221, which he said he did not believe, so we check it again in January 13, 2014 and it was even lower, at 163. LH was 7.3 on scale 1.7-8.6 MIU/ML, FSH was 7.2 on a range 1.5-12.4 MIU/ML.

He said "you have Low T and we need to treat it", so he gave me a 100 unit shot of depo-testostorone January 14. I told him a week later I didn't feel much effect, so we did 200 unit shot on Jan 28th. He re-did the T level test Jan 28th and it was 179, with free at 4.80.

My wife kept asking why, what was the root cause? The only thing I could think of was perhaps Crestor, which I had gone on for my high cholesterol. I asked to be sent to an Endocrinogist for more info, which the earliest availability end of March. So my doctor and I agreed to go off of Crestor and HRT until that visit and see what happens. The results came back from a March 28th test with T at 214, and free at 4.58, so it appeared to be going up. The endo also tested SHBG, and it came back at 19.5 on a scale of 19.3-76.4 nmol/L. DHEA-S came back at 170.5 on a range of 71.6-375.4 ug/dl.

The endo said my triglyceride levels have gone up to 252, so the endo recommended going on Tricor, which I am on now. He also put me on 50,000 units (don't know which) of Vitamin D once a week for 3 months to fix my low Vitamin D levels. He recommended shots or Testim.

However, I read about Testopel and thought maybe that would be an answer, so I met with a urologist since they're the only ones that seem to do that. However, when I asked him about HCG, zinc, estradiol, etc., he said "you have low T and need to treat it, I don't deal with the rest". I however don't want to sub-optimize my body, I want someone that knows and can help me with all of it, so I left that meeting and won't see him ever again.

Right now, I'm using Androgel 1.62 at 4 pumps per day, and I'm scheduled to meet with the Endo in late September, along with my regular doctor to re-check my levels. In the meantime, I ordered the micronutrient test from Spectracell to see what else may be a problem.

I have been looking into BHRT, but none of the doctors in VA that I can find that deal with it seem credible. I talked with someone who spoke with Dr Krup from Rejuvinage (www.rejuvinage.com) in VA Beach with my test results, but they said that since I had high blood pressure (which I take hydrochlorothiazide for), have high cholesterol and Low T, they will not treat me. What???? I thought that's what they are in the market for?

I did find one in Hampton Roads at a place called Synergy in Chesapeake (www.snyergy.com) that I am scheduled to visit late next month, but since they mostly deal with women, I'm not sure about what I will learn there either.

I have read about Alpha Male Medical Institute in Ohio with Dr. Rob Kominiarek, and my wife's parents live about 3 hours away from it, so I could consider going there.

What I really want is someone who can answer my questions and take a holistic approach. Questions like:

1. Should I be on HCG?? Otherwise, won't I be adversely impacted by a drop in pregnenolone?

2. Any chance I have Hypometabolism? My temperature is always hovering around 97.1, 97.3, etc. when I go to the doctor, and I read the following:
A body temperature pattern that averages consistently below normal is more than enough to explain the complaints and symptoms of MED, and Wilson's Temperature Syndrome should be one of, if not the first, possible causes considered.

http://www.wilsonssyndrome.com/ebook/what-is-wilsons-temperature-syndrome/


3. Estradiol: My estradiol is 33, and although it is within the test limit shown, I have read anything over 30 is not good. More importantly, my testosterone / estradiol ratio is nowhere near 30 or 40-1. If we average my testosterone at 200, 200 / 33 = 6.

Also, in TRT, as T goes up, won't estradiol go up also? Do I need an aromatase inhibitor? Anastro-Pro?

4. What statin do I need? Simvastatin? Dr. Dan Purser, author of Improving Male Sexuality, Fertility and Testosterone recommends that. However, Dr. Crisler recommends Crestor.

5. Is it possible, that after correcting hormone deficiencies and then hopefully achieving some weight loss, T levels might be sustainable without TRT?

I know I posted a lot of info, but I'm hopeful I have given enough info that someone can offer guidance about what doctors I should consider.

GREATLY APPRECIATE ANY ADVICE, and thank you Nelson for such a wonderful resource.
 
Last edited:

Nelson Vergel

Founder, ExcelMale.com
Johnny

I am glad you joined us.

The first two things I would do if I was you is to have a complete thyroid panel done and to get on the Atkins diet for two months. I would then switch to a diet like the one I describe : https://www.excelmale.com/forum/showthread.php?8-The-Science-of-Healthy-Eating

I would not use gels or pellets due to your high fat content. Injections of 100 mg of testosterone cypionate twice per week would probably get your total testosterone above the 600 ng per dL mark needed for faster weight loss.

If your thyroid results show dysfunction, then thyroid hormone supplementation will also help you lose that weight faster. Chris will add more info about this.

Please email Jasen Bruce at [email protected] to find out how they can help you. Jasen is active on this forum and is one of the smartest guys I know. Dr Saya works with him and they make a great team.

You may also want to peruse this information.

https://www.excelmale.com/forum/showthread.php?613-Nelson-s-Top-Tricks-for-Fat-Loss

As you lose weight, your lipids will improve and you may not need medications to control them.

Please feel free to ask questions since you are just starting your journey and we are here to help.

Nelson
 

JohnnyQuest

New Member
Nelson,
Thank you greatly for your feedback, I will take it all into consideration.

if I really wanted to meet with a doctor that takes the big picture view (zinc, HCG, estradiol, Vitamin D, T levels, thyroid, pregnenolone, DHEA-S, etc.), what would you suggest as my top 3 or 4 options would be? I realize I would have to probably go out of state, staying East of the Mississippi would probably be best in terms of travel time and expense.
 

JohnnyQuest

New Member
Also, I have read elsewhere the following is a good protocol for TRT, which you gave me the first, but not the other two. Any thoughts about them?

* 200mg test cypionate or ethanate injected per week with two or more injections per week.
* 250iu hCG SC EOD [every other day]
* 1.0mg Arimidex/anastrozole per week in divided doses.
 

Vettester Chris

Super Moderator
JQ, welcome to Excel! Glad you joined!! As you noted, there's a lot of information posted. That's a good thing, I might only address a few topics at a time, then post more later ...

I agree with Nelson, you should probably look at the injection route over any of the gels or creams.

Here's the thing, your first physician didn't do you any justice with jumping you on TRT, then doubling your dosage two weeks thereafter because you weren't seeing results. The general rule is to run baseline labs, then run follow up labs six (6) weeks thereafter. It takes a little time for the serum levels to get up and stabilize. That's also a good time to really see how other variables like E2, PSA, etc.

Your baseline gonadotropin profile (LH, FSH) is by no means suppressed, which would make one to lean to believe your diagnosis would have been 'Primary Hypogonadism'. HCG just mimics LH, so it's hard to imagine that HCG will have any real effect on your testes with endogenous production of testosterone. I could be wrong, but these are reasons why men should be working with physicians that specialize in this area of treatment.

I suspect you have some concerns that need addressed with the thyroid, and other related areas that will affect the thyroid. I wouldn't get too wrapped up the Wilson's temp syndrome stuff without covering all your bases. You need a variety of other labs .. TSH, Free T4, Free T3, Reverse T3, Antibody (TPO & TgAb) .. 4x Saliva Cortisol & DHEA panel w/circadian profile, iron serum, TIBC, ferritin, vitamin D, and magnesium. Will also be interested to see your your metabolic profile, plus of course the lipids & CBC's.

Not sure if your E2 is sensitive or ultra-sensitive, so don't get too fixated on AI's or other compounds until you get all the facts with your BW, and when you get the right physician-partner to see you through on all of this. The key is getting "everything" balanced. If your thyroid is under active, or if the transport agents like glucose are preventing T3 from effectively getting into the cells of the body, then TRT by itself isn't really going to be a game changer. Get the other variables dialed in at the same time, create a solid diet plan with physical activity, and then your body and mind will react accordingly.

Lastly, if there's one piece of advice that I can give it is READ UP on this stuff and get overly familiar with how it works. Nelson's book is readily available online. If you spent a day or two with that, and then spend a day or two going through a site like stopthethyroidmadness.com, you will be light years ahead of most. If you can get ALL your labs put together, I will gladly provide my thoughts, and I know many knowledgeable members here will do the same.
 

JohnnyQuest

New Member
Chris,

Thanks! You and Nelson provide amazing insight, the forum is lucky to have both of you as resources. I have been reading and researching everything I can, and I will read Nelson's book next.

Some of the things you list I already have but perhaps missed above.

[TD="class: nameCol srchbl"]TSH[/TD]
[TD="class: infoCol"]Range 0.27-4.20 mcU/mL[/TD]
[TD="class: importantCol"]My results: 1.27[/TD]


[TD="class: nameCol srchbl"]T3 FREE [/TD]
[TD="class: infoCol"]Range 2.3-4.2 pg/mL [/TD]
[TD="class: importantCol"]My results: 3.3[/TD]


[TD="class: nameCol srchbl"]T4 FREE[/TD]
[TD="class: infoCol"]Range: 0.9-1.8 ng/dL[/TD]
[TD="class: importantCol"]My results: 1.3[/TD]


[TD="class: nameCol srchbl"]VITAMIN D, 25 HYDROXY[/TD]
[TD="class: infoCol"]Range; 32.0-100.0 ng/mL[/TD]
[TD="class: importantCol"]My results: 24.8[/TD]


Lipid Profile:

[TH="bgcolor: #F5F5F5"]Component[/TH]
[TH="bgcolor: #F5F5F5"]Standard Range[/TH]
[TH="bgcolor: #F5F5F5"]Your Value[/TH]

[TD="class: nameCol srchbl"]Cholesterol NMR[/TD]
[TD="class: infoCol"]<200 mg/dL[/TD]
[TD="class: importantCol"]213[/TD]

[TD="class: nameCol srchbl"]HDL Cholesterol NMR[/TD]
[TD="class: infoCol"]>=40 mg/dL[/TD]
[TD="class: importantCol"]34[/TD]

[TD="class: nameCol srchbl"]HDL-P (Total)[/TD]
[TD="class: infoCol"]>= 30.5 umol/L[/TD]
[TD="class: importantCol"]24.8[/TD]

[TD="class: nameCol srchbl"]LDL NMR[/TD]
[TD="class: infoCol"]<100 mg/dL[/TD]
[TD="class: importantCol"]118[/TD]

[TD="class: nameCol srchbl"]LDL Particle[/TD]
[TD="class: infoCol"]<1000 nmol/L[/TD]
[TD="class: importantCol"]1982[/TD]

[TD="class: nameCol srchbl"]LDL Size NMR[/TD]
[TD="class: infoCol"]> 20.5 nm[/TD]
[TD="class: importantCol"]20.6[/TD]

[TD="class: nameCol srchbl"]LP-IR Score[/TD]
[TD="class: infoCol"]<= 45[/TD]
[TD="class: importantCol"]76[/TD]

[TD="class: nameCol srchbl"]Small LDL-P[/TD]
[TD="class: infoCol"]<= 527 nmol/L[/TD]
[TD="class: importantCol"]823[/TD]

[TD="class: nameCol srchbl"]Triglyceride NMR[/TD]
[TD="class: infoCol"]<150 mg/dL[/TD]
[TD="class: importantCol"]306[/TD]





[TH="bgcolor: #F5F5F5"]Component[/TH]
[TH="bgcolor: #F5F5F5"]Standard Range[/TH]
[TH="bgcolor: #F5F5F5"]Your Value[/TH]

[TD="class: nameCol srchbl"]Zinc Blood[/TD]
[TD="class: infoCol"]56 - 134 ug/dL[/TD]
[TD="class: importantCol"]72

[/TD]



[TH="bgcolor: #F5F5F5"]Component[/TH]
[TH="bgcolor: #F5F5F5"]Standard Range[/TH]
[TH="bgcolor: #F5F5F5"]Your Value[/TH]

[TD="class: nameCol srchbl"]MAGNESIUM[/TD]
[TD="class: infoCol"]1.6 - 2.5 MG/DL[/TD]
[TD="class: importantCol"]2.1[/TD]


[TH="bgcolor: #F5F5F5"]Component[/TH]
[TH="bgcolor: #F5F5F5"]Standard Range[/TH]
[TH="bgcolor: #F5F5F5"]Your Value[/TH]

[TD="class: nameCol srchbl"]PHOSPHORUS[/TD]
[TD="class: infoCol"]2.4 - 4.7 MG/DL[/TD]
[TD="class: importantCol"]3.2[/TD]



Acrobat 2.jpg
Acrobat.jpg

I think what I am missing from your list above are the following:
Reverse T3, Antibody (TPO & TgAb) .. 4x Saliva Cortisol & DHEA panel w/circadian profile, iron serum, TIBC, ferritin
Now I need to see where to get those labs from, not sure if my primary doc will do those. If he won't, any recommendations?

I will check out stopthethyroidmadness.com also, I hadn't heard of that.

Thanks!
 

JohnnyQuest

New Member
Jaboman,

thanks, good to know. I visited their website, and couldn't tell - do they also check things like your estradiol, DHEA-S, LH, etc, etc? The urologist I visited does not.

What I'm looking for is a doctor that takes a holistic view, which I kind of equate to a puzzle, like the metaphor I made below.
 

Attachments

  • image.jpg
    image.jpg
    67.2 KB · Views: 429

JohnnyQuest

New Member
No, I actually called and spoke with a lady named Chelsea today. I also mentioned your name and Excelmale as where I had heard of them (before she even asked). I assume since you referenced them you believe in their services? Would be great to hear some experiences with them.
 

Vettester Chris

Super Moderator
JQ, real quick on the thyroid ... Ideally, FT3 and FT4 would be in the 50% to 80% area of the lab reference range .. Your FT3 is hovering just a bit over 50%, your FT4 is a tad under 50%. However, throw that out the door until you know your Reverse T3 and antibodies.
 

Vettester Chris

Super Moderator
You can get it at privatemdlabs.com, which uses Labcorp. If you go that route let me know, I usually get a 15% discount coupon every week with them via email.
 

Online statistics

Members online
8
Guests online
7
Total visitors
15

Latest posts

Top