Labs and Symptoms - 31yo/6ft1/167lbs - Advice Requested

[daysleeper]

Hello,

New poster here, so firstly hello and good day! I'd like to know what you knowledgeable gents have to say about my bloodwork/symptoms if you'd be so kind. (see physical stats in topic)

Background/timeline:

- Undescended testicle as a child, was operated w/ bilateral orchiopexy at age 9 or so to have 'em held in place
- Several fractures in puberty, was extremely active/athletic (had osteoporosis worries but was dismissed by GP as slight bone structure)
- Sleep study (came back ok, no apnea)
- Septoplasty (septum deviation surgery), assumed bad sleep/snoring was causing my daily fatigue -> lack of motivation - still have issues
- On last checkup, doctor noted variocele in left testicle, commented that they were smaller than avg

Symptoms:
- Gyne (Tanner 2) since puberty which has persisted AND stern fat in mid-section/lovehandles
- Lack of motivation/fatigue as long as I can remember
- Sleep disturbances as long as I can remember, always waking up and never feeling rested even when I enforce at LEAST 8hrs
- Skinnyfat as of now, even after solid bodyweight HIIT and keeping a really good diet (counting cals, hitting macros, no alchohol/cigs) - dropped from 185-167 in the last 4 months from aforementioned regime
- Lack of strength/energy - I'm just honestly tapped out, I'm sleeping after work in order to feel like I can do some kind of workout

Ultimately nothing has changed, I'm still suffering the above symptoms even through the strict lifestyle change I've taken that should supposedly raise T. I don't want to feel like this anymore... I'm seeing a urologist in 2 weeks.

Here are my results from a few months ago:

PARAMETER	RANGE	RESULTS (11.02.17)
Hb g/dl	13,5-17,5	13,50
HKT Vol%	40,1-51	41,20
Ery. c/pl	4,63-6,08	4,62-
Leuko. c/nl	4,23-9,07	4,71
Thrombozyten c/nl	140-360	227,00
MCV fl	79-92,2	89,20
MCH pg	25,7-32,2	29,20
MCHC g/dl	32,3-36,5	32,80
Ferritin ng/ml	30-400	96,90
Eisen µg/dl	33-193	93,00
Transferrin g/l	2-3,6	2,37
Transferrinsät. %	16-45	27,80
GOT U/l	10-50	28,00
GPT U/l	10-50	22,00
GAMMA GT U/l	10-71	14,00
Creatinin mg/dl	0,7-1,2	1,14
glom.Filt. ml/min	0-0	80,00
Calcium mmol/l	2,15-2,58	2,38
anorg. Phos. mmol/l	0,81-1,45	1,18
Cholesterin mg/dl	0-200	172,00
HDL mg/dl	35-150	43,00
LDL mg/dl	0-160	119,00
Triglyceride mg/dl	0-200	50,00
TSH basal µIU/ml	0,27-4,2	1,80
FT3 pg/ml	2-4,4	2,90
FT4 pg/ml	9,3-17	12,60
HbA1c	4-6	5,20
HbA1c mmol/mol	20-42	33,00
Cortisol ng/ml	0-0	114,70
ACTH ng/l	4,7-48,8	15,60
DHEAS µg/dl	0-0	488,80
Testosteron ng/ml	2,49-8,36	3,640
f. Andr.Index	15-95	34,62
SHBG nmol/l	10-57	36,50
E2 pg/ml	0-45	39,80
LH mIU/ml	0-8,6	5,70
FSH mIU/ml	1,5-12,4	8,80
Prolaktin ng/ml	4,04-15,2	9,10
Inhibin B ng/l	100-400	27,90-
IGF-1 ng/ml	0-0	283,20+
Vitamin B12 pg/ml	191-663	520,00
25 OH Vit. D nmol/l	50-150	67,70
AFP Tumormarker µg/l	0-5,8	2,20
HCG Tumormarker IU/l	0-2,6	<1.2 mIU/

Where to go from here?

 

[Ricardo Borges]

Find a good doctor and be happy. Your T seems really Low.

 

[CoastWatcher]

Welcome to Excelmale. Based on your references, you live outside North America; can you tell us where? What are your options for testosterone replacement therapy? What was said in regard to your LH and FSH - primary, secondary, or mixed hypogonadism? You are unlikely to have access to the sensitive estradiol test, but has that level been steadying? Vitamin D could be higher. Any sexual/libido-related symptoms? Sleep, lack of it, can certainly hammer your testosterone.

 

[daysleeper]

Welcome to Excelmale. Based on your references, you live outside North America; can you tell us where? What are your options for testosterone replacement therapy? What was said in regard to your LH and FSH - primary, secondary, or mixed hypogonadism? You are unlikely to have access to the sensitive estradiol test, but has that level been steadying? Vitamin D could be higher. Any sexual/libido-related symptoms? Sleep, lack of it, can certainly hammer your testosterone.

Thank you, and thanks for the hasty reply.

Correct, based in Germany. Nothing progressive was said about my labs other than "you're in range, normal, but you might need fertility help based on the INHIB-1 result...". I asked the doctor about my testosterone level citing my diet/sleep/nutrition, questioning why I feel so low energy/low motivation/weak with such a high-T 'lifestyle' and he said depression. I laughed and said the only thing I'm low about is suffering these symptoms and that my emotional mood and outlook is actually very positive or I wouldn't be taking such good care of myself. The conversation ended there basically.

These questions you ask about primary/secondary, I'm not sure but I'll explore with the urologist this time if they deem bloods necessary.

Not sure a sensitive E test is available here and those labs I posted were my first set.

My libido is ok, sometimes I have an issue keeping an erection but it's seldom.

Sleep, because I know myself, is one thing I do not take lightly. I cannot function properly if I don't get at least 8 hours, it's ridiculous. Anything less and I am a nightmare, whilst being in a nightmare.

I feel due to the insurance in Germany I'm going to need to be below 249 total T for them to even consider treating low T and even then I'm unsure what the options are. I'm seeing a urologist in two weeks and I'd like to think I'm a little more prepared this time for the exchange. Either way, I've gone to the extent of being operated on to try and solve this, at some point a doctor has to take the symptoms and my extensive history (which all points to hormonal disturbance) serious, one would hope?