39 and dealing with low t symptoms

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ta406

Member
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. 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.





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
 
Defy Medical TRT clinic doctor

ratbag

Member
Your cortisol levels indicate you may have cushing's. There are two types of cushing's.... cushing's syndrome and cushing's disease. Googling it will get you more info. Both types of cushing's are different but result in high cortisol levels. It can lead to ED and low libido or it can do the opposite and put you in overdrive. Either way this should be looked at closer. Also your SHBG looks too high. I realize it's in range but we typically see somewhere around 25 as normal. Higher shbg prevents testosterone from binding to it's receptors. High cortisol also prevents thyroid from working. High cortisol also lowers your immune system and subjects you to frequent colds, viruses and ailments. Peter
 

Gene Devine

Super Moderator
ratbag you are diagnosing and we can't do that here.

His Cortisol levels are slightly elevated and that could be caused by a ton of reasons like just being nervous in the Doctor's office or just before his blood was drawn.

We can't go scaring members like that.

ta406, your Total Testosterone is ok but I've seen guys at that level and present with symptoms like yours.

Your Free is low and that's the panel that counts the most.

You are binding up do to the higher SHBG levels.

Injecting one dose once a week will help put some downward pressure on SHBG and free up more Testosterone.

I believe you would do better on injections as opposed to transdermals.

Your Free T3 is a bit low and we like to see that in the upper end of the reference range.

You may want to look into your Thyroid a little more and get RT3 and antibodies done; hypothyroidism has many of the same symptoms of hypogonadism and in fact can cause the same.
 

paco

Member
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

It does seem that it would be worth looking further into your cortisol levels. I'm assuming these were salivary cortisol tests? Typically, cortisol should be highest in the morning upon waking, then should gradually decrease throughout the day to a low point at night. More info on cortisol can be found here:
http://www.stopthethyroidmadness.com/adrenal-info/
 

Gene Devine

Super Moderator
I've had even higher elevated Cortisol levels and I don't have Cushings Syndrome.

His levels are only slightly elevated and there could be a ton of reasons for that like getting nervous about getting stuck with a needle at the Doctor's office.

He would need a series of tests done over time to come up with a better picture like the 24 hour salivary test.

I wouldn't be concerned right now if I were the OP.
 

ta406

Member
Thank you for the reply's. I did have a follow up appointment with the doctor and we discussed lowering my cholesterol and cortisol levels. Yes, the cortisol test was a salivary test. I have noticed over the last couple of months that I do feel more anxiety than normal but I have been dealing with a bit more stress too.

One thing that I've noticed is that my estrogen level is pretty low too. I've found a couple articles about low estrogen in men can lead to low bone mineral density and all kinds of nasty things like osteoporosis. It seems that a lot of men that are on TRT have elevated estrogen, so if I decide to start TRT I'm hoping that may raise my levels to a safer range.

paco, thanks for the link. Thats a very informative site.
 

ta406

Member
ratbag you are diagnosing and we can't do that here.

His Cortisol levels are slightly elevated and that could be caused by a ton of reasons like just being nervous in the Doctor's office or just before his blood was drawn.

We can't go scaring members like that.

ta406, your Total Testosterone is ok but I've seen guys at that level and present with symptoms like yours.

Your Free is low and that's the panel that counts the most.

You are binding up do to the higher SHBG levels.

Injecting one dose once a week will help put some downward pressure on SHBG and free up more Testosterone.

I believe you would do better on injections as opposed to transdermals.

Your Free T3 is a bit low and we like to see that in the upper end of the reference range.

You may want to look into your Thyroid a little more and get RT3 and antibodies done; hypothyroidism has many of the same symptoms of hypogonadism and in fact can cause the same.

Thanks Gene. I will see the doc in a few weeks and will talk to him about doing some additional thyroid testing. After doing a bit of research on stopthethyroidmadness.com it seems they are a big proponent on natural desiccated thyroid. Is there anything else that can be done to help raise T3 levels in the mean time? They also suggest using zinc and Phosphatidyl serine prior to bed time to help lower cortisol levels at night so I will definitely try that a try to help improve my quality of sleep.
 

Gene Devine

Super Moderator
Thank you for the reply's. I did have a follow up appointment with the doctor and we discussed lowering my cholesterol and cortisol levels. Yes, the cortisol test was a salivary test. I have noticed over the last couple of months that I do feel more anxiety than normal but I have been dealing with a bit more stress too.

One thing that I've noticed is that my estrogen level is pretty low too. I've found a couple articles about low estrogen in men can lead to low bone mineral density and all kinds of nasty things like osteoporosis. It seems that a lot of men that are on TRT have elevated estrogen, so if I decide to start TRT I'm hoping that may raise my levels to a safer range.

paco, thanks for the link. Thats a very informative site.


I think the bold says it all.
 

ratbag

Member
Gene, I said "may" have cushings. The word may is permissive. I also said it should be looked at closer. I did not diagnose, I only indicated a possibility. Did you note that he said he had a cold in his first post? It's common for people with cushings to often have colds. People post their labs hoping someone will see something. I've read a lot of ZRT salivary labs and I've never seen one like this. So it's important that someone recognises that it's a potential problem and more importantly he get it checked out further. Just his evening lab is over 5 fold over the limit. He's over on all of them. The only thing that's scaring anyone is the lab results. There are lots of other symptoms related to this and if he googles it he can see them. It good to supply relevant and helpful info. Peter
 
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