6 weeks in and not feeling better

[hebejebe]

Yes, Yes, Yes x 1000.

Sleep quality/duration is far too often overlooked and underappreciated. Without enough QUALITY sleep, our body just doesn't thrive...it's as simple as that. Everyone should view sleep as a vital nutrient, hormone, etc necessary for the body to function and thrive.

This is why untreated and undiagnosed sleep apnea is such a huge problem for many folks.

Ive been tested a few times for sleep apnea. Both times I was negative. My sleep does in fact suck. Wife says I snore. I never used to snore. She says its been for the past 4-5 years. I dont know if that has to do with weight gain or not. I was in the 170's while in my late 20's and early 30's. Something happened in my early 30's to where I started to slow down a little. I work in the HVAC field which was always great until I started sweating really bad. We all sweat when its 95 degrees out with high humidity but I was getting to the point that I needed a shower and change of clothes every hour lol. Im to the point now that a casual walk in the summer, while wearing light weight and light color t-shirt and gym short, has me sweating to the point that I need to carry a hand towel. Im sure some of the weight gain was due to me cutting out some of those activities that I would normally do during the warm weather time of year. Now, just sitting on the couch watching tv, i get bad under arm sweats. My groin area sweats to the point that I need to apply some powder to keep from chaffing lol. No doctors can explain it. So with all that said...... I lay in bed with hopes of falling to sleep before midnight. Maybe 1 or 2 nights I cant fall asleep until 1, ,2, even 3 am. Wake up at 530. Cycle the snooze button 4 times. Feet are on the floor by 6. Within an hour Im feeling ok. By 10-11 am Im feeling tired. Eat lunch, feel a little better. Make it thru the afternoon. Get home around 4. Make dinner, help with homework, interact with family. by 5-6 pm I'm exhausted. Usually hit the gym between 6 and 8. I just push through the fatigue. Usually feel pretty good after workout (weights/cardio 1-1.5 hours). Get home and though I feel tired, I cant fall asleep. This same pattern repeats with or WITHOUT a visit to the gym.

Had blood drawn on MLK day. Here are the results

Cortisol- 14.4 (4.6-20.6)
TSH- 2.33 (0.40-4.50)
T4 Total- 7.4 (4.5-12)
Free T4- 2.6 (1.4-3.8)
T3 Uptake- 35% (22-35)

Glucose- 68 (65-99)

BUN- 19 (7-25)
Creatinine- 1.02 (.6-1.35)
eGFR Non-AfrAm- 92 (<60)
Sodium- 139 (135-146)
Potassium- 3.7 (3.5-5.3)
CO2- 29 (20-31)
Chloride- 102 (98-110)
Calcium- 9.7 (8.6-10.3)
Total Protein- 7 (6.1-8.1)
Albumin- 4.3 (3.6-5.1)
Globulin- 2.7 (1.9-3.7)
Alkaline Phos- 72 (40-115)
AST- 22 (10-40)
ALT- 15 (9-46)

WBC- 6.2 (3.8-10.8)
RBC- 5.31 (4.2-5.8)
Hemoglobin- 14.9 (13.2-17.1)
Hematocrit- 45.3 (38.5-50)
MCV- 85.3 (80-100)
MCH- 28.1 (27-33)
MCHC- 32.9 (32-36)
RDW- 12.9 (11-15)
Platelet Count- 250 (140-400)
MPV- 9.8 (7.5-12.5)
Absol Neutrophils- 2988 (1500-7800)
Absol Lymphocytes 2102 (850-3900)
Absol Monocytes 713 (200-950)
Absol Eosinophils 329 (15-500)
Absol Basophils- 68 (0-200)
Neutrophils- 48.2
Lymphocytes- 33.9
Monocytes- 11.5
Eosinophils- 5.3
Basophils- 1.1

DHEA-S 114 (106-464)

Reverse T3- 17 (8-25)

Opinions......... thoughts.......... help?...........

 

[Dr Justin Saya MD]

Ive been tested a few times for sleep apnea. Both times I was negative. My sleep does in fact suck. Wife says I snore. I never used to snore. She says its been for the past 4-5 years. I dont know if that has to do with weight gain or not. I was in the 170's while in my late 20's and early 30's. Something happened in my early 30's to where I started to slow down a little. I work in the HVAC field which was always great until I started sweating really bad. We all sweat when its 95 degrees out with high humidity but I was getting to the point that I needed a shower and change of clothes every hour lol. Im to the point now that a casual walk in the summer, while wearing light weight and light color t-shirt and gym short, has me sweating to the point that I need to carry a hand towel. Im sure some of the weight gain was due to me cutting out some of those activities that I would normally do during the warm weather time of year. Now, just sitting on the couch watching tv, i get bad under arm sweats. My groin area sweats to the point that I need to apply some powder to keep from chaffing lol. No doctors can explain it. So with all that said...... I lay in bed with hopes of falling to sleep before midnight. Maybe 1 or 2 nights I cant fall asleep until 1, ,2, even 3 am. Wake up at 530. Cycle the snooze button 4 times. Feet are on the floor by 6. Within an hour Im feeling ok. By 10-11 am Im feeling tired. Eat lunch, feel a little better. Make it thru the afternoon. Get home around 4. Make dinner, help with homework, interact with family. by 5-6 pm I'm exhausted. Usually hit the gym between 6 and 8. I just push through the fatigue. Usually feel pretty good after workout (weights/cardio 1-1.5 hours). Get home and though I feel tired, I cant fall asleep. This same pattern repeats with or WITHOUT a visit to the gym.

Had blood drawn on MLK day. Here are the results

Cortisol- 14.4 (4.6-20.6)
TSH- 2.33 (0.40-4.50)
T4 Total- 7.4 (4.5-12)
Free T4- 2.6 (1.4-3.8)
T3 Uptake- 35% (22-35)

Glucose- 68 (65-99)

BUN- 19 (7-25)
Creatinine- 1.02 (.6-1.35)
eGFR Non-AfrAm- 92 (<60)
Sodium- 139 (135-146)
Potassium- 3.7 (3.5-5.3)
CO2- 29 (20-31)
Chloride- 102 (98-110)
Calcium- 9.7 (8.6-10.3)
Total Protein- 7 (6.1-8.1)
Albumin- 4.3 (3.6-5.1)
Globulin- 2.7 (1.9-3.7)
Alkaline Phos- 72 (40-115)
AST- 22 (10-40)
ALT- 15 (9-46)

WBC- 6.2 (3.8-10.8)
RBC- 5.31 (4.2-5.8)
Hemoglobin- 14.9 (13.2-17.1)
Hematocrit- 45.3 (38.5-50)
MCV- 85.3 (80-100)
MCH- 28.1 (27-33)
MCHC- 32.9 (32-36)
RDW- 12.9 (11-15)
Platelet Count- 250 (140-400)
MPV- 9.8 (7.5-12.5)
Absol Neutrophils- 2988 (1500-7800)
Absol Lymphocytes 2102 (850-3900)
Absol Monocytes 713 (200-950)
Absol Eosinophils 329 (15-500)
Absol Basophils- 68 (0-200)
Neutrophils- 48.2
Lymphocytes- 33.9
Monocytes- 11.5
Eosinophils- 5.3
Basophils- 1.1

DHEA-S 114 (106-464)

Reverse T3- 17 (8-25)

Opinions......... thoughts.......... help?...........

Your adrenals are suffering from lack of sleep, as evidenced by your relatively low DHEA. Your doc should run the 4 sample salivary cortisol next labs to see the pattern and levels of cortisol throughout the day. It is not uncommon with adrenal issues to have a paradoxical increase in cortisol at bedtime (which can contribute to insomnia). In the meantime you could try supplementing with some DHEA before bed...25mg would be a good place to start.

You'd be better suited to set your alarm for 6:00 and get straight up (instead of alarm at 5:30, snooze button a few times and then up at 6:00). Seems like a minor point, but it is a common mistake and given the precious little sleep you are getting, sacrificing that last 30 minutes of sleep isn't ideal - hitting the snooze, although it may FEEL good, isn't productive as the few minutes of "sleep" really do nothing as you aren't completing a sleep cycle. 30 more minutes of (real) sleep every morning is an additional 3.5 hours of sleep per week (precious time for your body, adrenals (and other glands) to heal and rejuvenate).

 

[Dr Justin Saya MD]

Lastly, how recent was your last sleep study? If you gained weight and began snoring AFTER your last negative sleep study...it is quite possible that negative study may now be positive!

 

[hebejebe]

Thanks for the input. I was gaining weight and snoring when I did the sleep studies. I never stopped breathing and my O2 sat never dropped below 98%.

When I was using androgel, my T didn't move so doctor told me to use 2 packets per day instead of one. For about 3-4 days I felt good, and slept like a baby. I woke up like and felt good. My mood was much better. After those few days it all stopped. In early 2016 I used an OTC test booster from vitamin shop. After a few weeks, I noticed I felt better in the mornings. Eventually stopped pills because I got tired of take 6 horse pills a day.

Anything I can do to improve my sleep? I don't want a sleeping pill that makes me feel hungover or groggy in the morning. I've tried melatonin and it was much help. Will supping dhea make a difference?

 

[Systemlord]

We call it the TRT honeymoon phase. Your pituitary gland likely shut down, it's perfectly normal and it happens to everybody. Your pituitary gland sees testosterone circulating in your blood and in response shuts down LH production which then shuts down your natural testosterone production, it can take weeks or months to start feeling better as the testosterone starts to go to work.

Did your doctor not explain this to you? Mine didn't, he didn't know anything about TRT.

 

[hebejebe]

I'm secondary. My LH and FSH were very low. LH was .8. Four weeks of 1000iu hCG M/W/F got me to 730 TT, 162 FT, 29 E2, and 25 SHBG. I have yet to feel any better. I'm in my 3rd month now. Diet and exercise are good. He believes poor sleep quality is my problem. I tend to agree to an extent. I took an OTC test booster a few years ago and felt great in the mornings. That product had ashwanda (spelling?) and that is supposed to help settle your nervous system and help to get better rest. He recommends me trying to get better sleep and go from there. All recent bloodwork looked good except dhea was on the low end of clinical. I think I'll start supping that for a while.