Introduction + Labs

[rhino5169]

I've been reading and devouring as much as possible from this forum for the last week or so. This is probably the most comprehensive forum i've ever been a part of, and the knowledge here is superb.

I'd like to receive some help with my lab work if some of the more experienced members can shed some opinions if you would.

I actually just spend about 40 minutes typing out my history and current state, but lost it when I tried to upload these labs, Ughh.

Im going to post the labs but i'll re-write the post tomorrow if you don't mind. I know you need as much info as possible, and believe me it was all there, and will do it again in the morning. I'd just like to get these up so they can be seen.

Thanks!

 

[johndoesmith]

You are diabetic most likely. I'm no doctor, but it seems pretty clear to me.

On top of that, you have severely low testosterone, and E2. I can only imagine the amount of piss you're producing, or how thirsty you are. You ever get joint pain, hot flashes that itch, anhedonia, and dry skin?

You seem mixed secondary/primary, but I'd say it's more secondary IMO.

TSH is rather high but without free T3 and free T4 it's hard to say more. Might be hypothyroid.

CRP is high, that's not good.

You also seem mildly anemic, which is common with low test, but you'd need an iron panel to be sure.

Unfortunately, not great news, but fixing the testosterone deficiency and other possible hormonal problems, will help your diabetes, and vastly improve your quality of life.

That's the good news. That with so many issues, you can achieve a major improvement IMO with the right doctor. Primebody and Defy Medical are site sponsors for a reason.

Defy has treated me well. I wouldn't go with anyone else myself.

 

[Vince]

I would not go on testosterone (TRT). You have too many other problems. I would concentrate on your blood sugar, thyroid, and lipid panel. I'm would be very concerned about lipoprotein(a) and C-reactive protein.
I think you should start with a good "Lipidologist".

 

[rhino5169]

You are diabetic most likely. I'm no doctor, but it seems pretty clear to me.

On top of that, you have severely low testosterone, and E2. I can only imagine the amount of piss you're producing, or how thirsty you are. You ever get joint pain, hot flashes that itch, anhedonia, and dry skin?

You seem mixed secondary/primary, but I'd say it's more secondary IMO.

TSH is rather high but without free T3 and free T4 it's hard to say more. Might be hypothyroid.

CRP is high, that's not good.

You also seem mildly anemic, which is common with low test, but you'd need an iron panel to be sure.

Unfortunately, not great news, but fixing the testosterone deficiency and other possible hormonal problems, will help your diabetes, and vastly improve your quality of life.

That's the good news. That with so many issues, you can achieve a major improvement IMO with the right doctor. Primebody and Defy Medical are site sponsors for a reason.

Defy has treated me well. I wouldn't go with anyone else myself.

Thanks JDS,

So I'll reply as much as I can right now, I'll fill in more tomorrow, I'm in bed with my tablet, I try to get in bed to unwind around 8 every night.

So I think my new functional dr is capable and on the right track but I'm going to keep who you mention in mind.
Yes I am diabetic for 15 years now. No I don't have any of those symptoms you wrote, except for some joint pain. I don't piss a lot (anymore) am not thirsty like used to be.
I'm 47 and currently 260lbs. Down from 350. My a1c used to be around 13 it's now a 7. My sugar reading that morning was a little high because I have dawn phenomenon.

Before diabetes I was in good shape, about 230 14% bf. Gained 130 pounds in a year and half. Slowly got back down to 300. I have 2 stents. 2nd one put in august of 2015 and then started going back to the gym after a 15 year hiatus. I got down to 270 and with struggling would hit 260 for a couple days and then back up to 270-275 and that cycle repeated for 3 months and that's when I decided to see a functional dr, my traditional endo only wanted to prescribe insulin. I was taking 4 shots a day plus metformin.
I have been off all my meds for 10 months. Getting off meds was one of my goals.

I started seeing new dr 3 months ago. Upon first meeting he mentioned possibility of leaky gut. Fast forward through a bunch of testing turns out I have a yeast overgrowth in digestive system plus bad bacteria.
Been on a candida diet for 2 months and have held at 260ish, so slight progress.

I saw him last week and we left off that we'd now discuss trt, which previously he wanted to hold off on. My last t was 294 2 months ago, so he hasn't even seen this latest number yet. (194)

He wants to get my yeast in order plus get my cortisol up but this will take time and now he seems open to trt.
My concerns are that I don't want to make my cardiac situation worse. I have 2 young kids so I can't be giving myself a heart attack, though I realize that a lot of this will improve with the therapy.

2 months ago my numbers were better as far as lipids but when I started this candida diet which is low carb I started eating more fats for energy. Was eating 3-5 eggs a day but also a ton of coconut oil, way too much.
I got labs 3 weeks ago and my numbers reversed, ldl was up, hdl was down, etc etc but since I received those results I immediately dropped the eggs and saturated fat and in only 2 weeks the numbers have gotten better, moving in the right direction again.
The CRP on these labs is actually higher than it was a couple months ago, before the candida diet. Conversely, lipoprotein a went down by about 30 points since 2 months ago.

 

[rhino5169]

Vince, thanks.
You replied while I was typing. Yes those 2 things are what I'm concerned with.
The endo I was seeing (no more) had said at one point my thyroid was ok, though we know some endos see things different. My current dr is a functional dr. (Treats the cause not the symptom). He hasn't mentioned thyroid yet.

So to just give an overview, my diabetes is pretty much under control, no thanks to my endo because I did myself through the last 1.5 years in the gym and with diet. A1c from 13 to 7. Off all those meds, in fact my a1c was higher while I was on all the meds than it is now.

Did I mention I have 2 stents.
My last ekg or whatever it was showed normal heart function, though the CRP and lipoprotein a were never brought up by my cardiologist. My new functional dr ordered those tests and explained to me.

Last piece of info, though probably not as important I'll mention anyway.
Back in the summer I was trying different test boosters, none seemed to work then in July and August I was taking some tongkat ali, I think it was spiked. I noticed something in a couple days so I stuck with it. At about the 4th or 5th week it kicked in it was insane. I was doing yard work in 100 degree heat like it wasn't even there. I had energy like I've never had. I had wood like steel throughout the day. My mood was great, my body was recomping. I had slight acne behind my shoulder so with all this I figured my test was rising from the tongkat ali. It made me realize that this is what normal should feel like. I realized how bad I have been and that's what pushed me to see the functional doctor.
So I ran out of the supplement and returned to "normal." The supply of TA was out so I didn't have any for awhile but just for shit and giggles I ordered some more when it was back in stock. It's not having the same effect this time, so I figured last batch was spiked.

Anyway, that's where I'm at. Trying to get to the bottom of this and treat several things at once
Low t
Yeast
Low cortisol
CVD
Diabetes

So this new dr I'm seeing does seem to know what he's doing but I'm definitely interested in soaking up any knowledge or advice I can get in addition.

Thanks

 

[rhino5169]

By the way, my cortisol is actually up from an 8 on the last test.
When I saw the 8, I was surprised as I have symptoms of high cortisol but my dr wasn't surprised. Once he explained I understood.
Probably have some adrenal fatigue from years of stress and not eating right.

What I'm also trying to understand is what came first and caused the other things.
Did adrenal fatigue come first and cause everything else or was it the diabetes that caused everything. ...

 

[rhino5169]

So to sum it up:
15 years ago in decent shape, then got diabetes.
Gained ~130 lbs in 1.5 yrs.
On meds for long time, insulin/metformin. During this time developed, or more likely was developing same time as the diabetes, was heart disease. Have had 2 stents put in and on plavix. Was also on bp med and statin. Currently only taking aspirin and plavix.

During the 15 years very tough to lose weight and everything was declining health and symptom wise.

My weight gradually came down to 300 in the last 10 years so thats where I was holding. im 6'2.

In the last 1.5 years I started back at the gym. Got down to 270 but then struggled to lose any more, but in the process off all the insulin, metformin and havent been taking any bp meds or statin im trying to do naturally. My bp these days is averaging slightly high but I feel if I go back on the meds for bp and a statin it's putting me back in the wrong direction.

All my numbers reversed and were great, at one point my triglycerides was a 44, HDL was high, and LDL was low. I was happy, then I found out about lipoprotein "A" and its mostly hereditary and nothing I can really do about it?

At that point found out I have yeast, low cortisol and bacteria. Went on candida diet very strict but overdid it with the saturated fats and numbers reversed again this time the wrong way. All of this time, maybe the last 2-3 years since i've started having labs done my total T ranged from 294 to 326.

3 weeks ago I modified my diet and 90% cut down saturated fat. Had more labwork done last week which makes it 2 weeks on the modified diet and my lipid numbers improved and those are the labs you see. T went down to a paltry 194, maybe because I cut down on the fats?

Anyway, that's where i'm at. Caught in a pretty good pickle here. Ive got my health much better than it was by myself but now need help to keep moving in the right direction. That's why im seeing my new dr. instead of the ones that just want to write more prescriptions and "monitor" me.

I'm anxious to see my dr after the holidays to find out what his thoughts are on this new blood work and what the course of action might be.
As I eledued to, I really want to go the TRT route as it should improve my overall quality of life for myself but more importantly for my family. On the other hand I dont want to make my situation worse regarding cardiovascular.
I know hematocrit can be monitored and taken care of and my lipid numbers are turning around again to the right direction so im a little concerned with that but not too much as I see they can be improved based on diet. My Dr isnt too concerned with the lipid numbers either. I "think" he is most concerned with raising the cortisol and when that happens my T will come up and a lot of other things will improve, maybe not 100% but far enough to then work on the remaining issues. That's just the vibe I get so far because we've been doing this testing and haven't got to the point of treatment yet, but that's coming.

So what concerns me is Lipoprotein "A" which is a risk factor indicator, and CRP.
I am taking
niacin
multivitamin
vitamin d
vitamin e
zinc
b-12
vitamin c
hawthorn berry
citrulline
grape seed
grapefruit seed
peppermint oil + rosemary
garlic
probiotic VSL#3
alpha gpc
ubiquinol
fish oil with much higher O3 than O6
aspirin
plavix
FIBER

sometimes:
celery seed
different forms of carnitine
macuna pruriens - not sure if this does me any good so not really taking it

Thanks for reading guys. Thanks for your opinions.
Glad to be a part of this lifelong group.
Happy Holidays.

 

[rhino5169]

So, I just checked out in a little more detail hypothyroidism. Didnt think it was a primary cause in my condition and stiill may not be but I have 9 of the symptoms on the chart on this page.
https://www.endocrineweb.com/conditions/thyroid/hypothyroidism-too-little-thyroid-hormone

How the hell do I know if those symptoms are from hypothyroid or from my other conditions, it seems as if some of the symptoms overlap with defferent medical conditions...

 

[rhino5169]

By the way, did I put this in the correct forum?

 

[Vince]

I'm 62, I do have hypothyroidism and insulin resistance. I do follow a high-fat diet, I'm always changing and adjusting to my lipid panel. At one time I was fat and had a big belly, that's long gone. It did take a lot of work on what I could and cannot eat. I'll post my labs and picture.
https://www.excelmale.com/forum/showthread.php?8533-My-New-LabCorp-Labs
https://www.excelmale.com/forum/threads/do-i-still-need-protein-if-im-trying-to-tone-vs-bulk.13299/
https://www.excelmale.com/forum/showthread.php?8541-My-Latest-Cleveland-Heart-Clinic-Labs

 

[rhino5169]

I'm 62, I do have hypothyroidism and insulin resistance. I do follow a high-fat diet, I'm always changing and adjusting to my lipid panel. At one time I was fat and had a big belly, that's long gone. It did take a lot of work on what I could and cannot eat. I'll post my labs and picture.
https://www.excelmale.com/forum/showthread.php?8533-My-New-LabCorp-Labs
https://www.excelmale.com/forum/threads/do-i-still-need-protein-if-im-trying-to-tone-vs-bulk.13299/
https://www.excelmale.com/forum/showthread.php?8541-My-Latest-Cleveland-Heart-Clinic-Labs

Looking good man.
Im trying to get where you're at, and stay alive at the same time, lol.
Congrats.

 

[johndoesmith]

Thanks JDS,

So I'll reply as much as I can right now, I'll fill in more tomorrow, I'm in bed with my tablet, I try to get in bed to unwind around 8 every night.

So I think my new functional dr is capable and on the right track but I'm going to keep who you mention in mind.
Yes I am diabetic for 15 years now. No I don't have any of those symptoms you wrote, except for some joint pain. I don't piss a lot (anymore) am not thirsty like used to be.
I'm 47 and currently 260lbs. Down from 350. My a1c used to be around 13 it's now a 7. My sugar reading that morning was a little high because I have dawn phenomenon.

Before diabetes I was in good shape, about 230 14% bf. Gained 130 pounds in a year and half. Slowly got back down to 300. I have 2 stents. 2nd one put in august of 2015 and then started going back to the gym after a 15 year hiatus. I got down to 270 and with struggling would hit 260 for a couple days and then back up to 270-275 and that cycle repeated for 3 months and that's when I decided to see a functional dr, my traditional endo only wanted to prescribe insulin. I was taking 4 shots a day plus metformin.
I have been off all my meds for 10 months. Getting off meds was one of my goals.

I started seeing new dr 3 months ago. Upon first meeting he mentioned possibility of leaky gut. Fast forward through a bunch of testing turns out I have a yeast overgrowth in digestive system plus bad bacteria.
Been on a candida diet for 2 months and have held at 260ish, so slight progress.

I saw him last week and we left off that we'd now discuss trt, which previously he wanted to hold off on. My last t was 294 2 months ago, so he hasn't even seen this latest number yet. (194)

He wants to get my yeast in order plus get my cortisol up but this will take time and now he seems open to trt.
My concerns are that I don't want to make my cardiac situation worse. I have 2 young kids so I can't be giving myself a heart attack, though I realize that a lot of this will improve with the therapy.

2 months ago my numbers were better as far as lipids but when I started this candida diet which is low carb I started eating more fats for energy. Was eating 3-5 eggs a day but also a ton of coconut oil, way too much.
I got labs 3 weeks ago and my numbers reversed, ldl was up, hdl was down, etc etc but since I received those results I immediately dropped the eggs and saturated fat and in only 2 weeks the numbers have gotten better, moving in the right direction again.
The CRP on these labs is actually higher than it was a couple months ago, before the candida diet. Conversely, lipoprotein a went down by about 30 points since 2 months ago.

You posted a LOT of information. Remember, people can give input and such, but you are a fairly complicated case, there are multiple comorbidities involved, and understanding how they all interact is above most people's knowledge level.

I am certainly not qualified to say anything, so take what I say with a grain of salt, and find a doctor who you trust, and has lots of experience dealing with multiple endocrinologic issues.

At 47, and with multiple issues, I personally don't see a point in clomid or hCG. Yeah there's a possibility it works, but it's a lot of effort, and much less likely to result in the benefits you're looking for.

I do think TRT will help you with your insulin sensitivity, and it's been shown to in multiple studies.

You mentioned you got diabetes, then gained weight, are you sure it's not the other way around?

How does one "Get their cortisol up"?

Also, testosterone under 550ng/dl has been associated with higher risks of cardiac events.

 

[rhino5169]

Thanks.

Diabetes:
I was 230lbs approx 14% bodyfat. Was playing multiple sports some at a semi pro level. In the gym 5-6 days a week.
That is when I got diabetes. All of a sudden I was getting tired every day, so much that I had to take a nap one or two times a day, and the weight gain was off the charts. I went in the gym one day while this was happening and weighed myself to find out I gained 20 lbs from the week before.
So no, definitely diabetes before the weight gain.

Increasing cortisol....
https://draxe.com/cortisol-levels/

I know about the cardiac risks with low T, it's a double edged sword because increasing it might have other issues such as hematocrit, lipoprotein A....

Thanks for the reply. Yes I definitely have multiple things going on that's why it's so freaking confusing.
I forgot to even mention I've been forgetting minor things, or a better description is that they slip my mind. I'll have a thought about something then think about something else for a minute but then forget the first thing I was thinking about. I've always been able to mentally multi task.
The last week or so, i've been cold. Not terribly cold and not all the time but feeling a little colder than normal.

Anyway, thanks again. Just trying to piece things together.

 

[johndoesmith]

Thanks.

Diabetes:
I was 230lbs approx 14% bodyfat. Was playing multiple sports some at a semi pro level. In the gym 5-6 days a week.
That is when I got diabetes. All of a sudden I was getting tired every day, so much that I had to take a nap one or two times a day, and the weight gain was off the charts. I went in the gym one day while this was happening and weighed myself to find out I gained 20 lbs from the week before.
So no, definitely diabetes before the weight gain.

Increasing cortisol....
https://draxe.com/cortisol-levels/

I know about the cardiac risks with low T, it's a double edged sword because increasing it might have other issues such as hematocrit, lipoprotein A....

Thanks for the reply. Yes I definitely have multiple things going on that's why it's so freaking confusing.
I forgot to even mention I've been forgetting minor things, or a better description is that they slip my mind. I'll have a thought about something then think about something else for a minute but then forget the first thing I was thinking about. I've always been able to mentally multi task.
The last week or so, i've been cold. Not terribly cold and not all the time but feeling a little colder than normal.

Anyway, thanks again. Just trying to piece things together.

Are you type 1 or 2?

That's really really odd that diabetes would come on so suddenly if it's not type 1. Interesting man.

Also what's interesting is that the symptoms of diabetes is weight loss, not weight gain. Heh.

I think that increasing cortisol page is equivalent to the increasing testosterone pages. Basically it's all eat better, sleep better, and reduce stress! It's cookie cutter advice.

Also, HCT concerns are easily managed with donations, and you're on the low end of the range right now anyway, so you have plenty of room to increase. You're probably iron deficient as it is right now.

That's another symptom of low test, mild anemia, or low normal HCT, HGB, and RBC.

Your low end E2 is a bit of a priority IMO though, as that causes some big issues long term, so I'd get on all of these issues pronto. Thyroid, testosterone, diabetes, and adrenals.

Low E2 and brain fog, poor cognitive function, and terrible focus go hand in hand. No way are you going to be able to function with that low of an E2 level, PLUS all these other issues, I do hope you find a great doctor. Defy is always there if you can't.

 

[rhino5169]

Yup! Came on suddenly. Before that zero issues. I know it's weird because im type 2 and anyone i've heard has lost weight not gain. My primary dr at the time was the one I went to and he did blood tests and when I went back is when I found out. He also said I was probably pre diabetic for 10 years.
I think what brought it on was that I was so active with training and spors it was staving it off but I tore my hamstring so was taking some time off and I got to used to it, lol. I laid off and was basically coasting and status quo and then after approx a year is when it started to kick in.
But yes, very weird.

The cortisol page is basically what you said, and i've been doing those things for a while now. It did come up though, 2-3 months ago it was an 8, now 12.5.

E2. I'm hoping will come up to good level when I get my T up. What do you think on that?

It's funny, I am functioning, but I know I should be a LOT better.

 

[johndoesmith]

Yup! Came on suddenly. Before that zero issues. I know it's weird because im type 2 and anyone i've heard has lost weight not gain. My primary dr at the time was the one I went to and he did blood tests and when I went back is when I found out. He also said I was probably pre diabetic for 10 years.
I think what brought it on was that I was so active with training and spors it was staving it off but I tore my hamstring so was taking some time off and I got to used to it, lol. I laid off and was basically coasting and status quo and then after approx a year is when it started to kick in.
But yes, very weird.

The cortisol page is basically what you said, and i've been doing those things for a while now. It did come up though, 2-3 months ago it was an 8, now 12.5.

E2. I'm hoping will come up to good level when I get my T up. What do you think on that?

It's funny, I am functioning, but I know I should be a LOT better.

There it is! So it wasn't like one day you're fine next day you're in a diabetic crisis. You stopped working out for a year while it slowly came on which makes perfect sense.

Yeah, cortisol is a hormone that fluctuates, day to day and throughout the day. Was the 8 test the same time of day as the 12.5? I don't put much weight on "naturally raising" any hormone. It's all things you should do anyway, but due to the low hormones is much harder to do, thus it being a catch 22.

E2 will absolutely increase when you increase testosterone. No doubt about it. E2 follows test.

The bright side is that you have SO MUCH room to improve. Honestly. I can't imagine the changes you will experience mentally, physically, and emotionally. Not to mention sexually.

Plus IMO TRT will help you with weight loss significantly, after the initial weight gain it causes.

 

[rhino5169]

Thank you JDS!

These are the gaps I need to fill in. Maybe it's the "mental fog".
The cortisol 8 was taken about 8:00 - 8:15 the 12.5 was the latest one taken approx 7:30.

I appreciate you taking the time to read my thread and post, you definitely have given me some hope and inspiration.

 

[SoCal Guy]

Did your doctor instruct you to stop the metformin? Or did you do that on your own?

You mention you've cut out eggs and saturated fat. Are you now eating high-carb?

What are your go-to meals? Are you eating sugar?

 

[rhino5169]

No they didnt instruct me I stopped on my own. What was happening was that as my diet and exercise and health improved I was getting HYPOglycemic when taking the meds, even at lower dose. I decided to stop the insulin and the metformin, and since I did my levels have been better without it. Im trying to get off and stay off as many meds as possible.

Not eating high-carb. Im still on an anti candida diet to reduce yeast. I am eating some low glycemic and good carbs such as oatmeal and more broccoli.

NO SUGAR.

My go to meals:
I have to prepare everything myself.

Turkey loaf
organic grass fed turkey, 1 egg, breadcrumbs i make myself from almond crackers and some spices

Turkey meatballs - kind of same thing but with different spices and organic marinara sauce

oatmeal

broccoli

some organic grass fed free range chicken

just started incorporating beans - beans, onions, celery, organic broth, spices

Yogurt - triple zero by oinkos.

Thats it.

 

[SoCal Guy]

I'd recommend getting a copy of Dr. Bernstein's Diabetes Solution. I know that title sounds a little spammy, but Bernstein is actually the guy who invented home blood glucose testing. He is still practicing and going strong in his mid-80s, despite being a Type 1 diabetic who was told he'd be dead in a few years -- fifty years ago.

This is him: http://www.diabetes-book.com/about/

And this is his book on Amazon: https://www.amazon.com/Dr-Bernsteins-Diabetes-Solution-Achieving/dp/0316182699/

And other people here will know more than me about diet, but I'm not sure that oatmeal is anything a diabetic should be eating.

I would take your blood sugars before and after oatmeal just to see how it spikes you. I suspect you will be surprised.

Finally, I'm also not sure dropping metformin was the right move. Metformin is getting a lot of attention in life-extension circles and has lots of effects that might benefit you, such as helping control CRP.

Good luck.