Ideas on body composition - weight won't budge

[GeauxBears]

Wanting to pick some brains here to see if there's something I'm missing. I am 35 years old, 6'2", 216 lbs and am on a stable TRT protocol due to a pituitary mass that left me with secondary hypogonadism 5 years ago or so.

I cannot seem to lose weight over the past year or so; in fact, my weight is the highest it's ever been, although it is stable. In the last 90 days, I have begun:

- Intermittent fasting - 6:30pm - 11:30am
- Focusing on two meals, eliminating simple carbs, drastically cutting back on alcohol, focusing on healthy proteins, fats, veggies and some complex carbs
- 30-45 min Peloton HIIT biking sessions near end of fasting cycle (~10AM) + 10 min strength training class
- Tons of water all day

But I've seen literally no improvement, perhaps a bit more weight gain.

Current Medicine Protocol
TRT - 12mg daily
HCG - 500ius twice a week
Cabergoline - 0.125 twice a week
Anastrozole - 0.1 daily
Cialis - 5mg daily
Doxazosin - 1mg AM, 1mg PM
Armour - 60mg daily
Viibryd - 40mg daily

Latest Labs
Total T - 752 ng/dl (300-1080)
Free T - 254.1 pg/ml (47.0-244.0)
SHBG - 11.6 nmol/l (16.5-55.9)
E2, Ultrasens - 14.5 pg/mL (10.0-42.0)
Free T3 - 4.8 pg/ml (2.2-4.2)
Free T4 - 0.90 ng/dl (0.80-1.90)

I bought one of those scales that reports out 13 different metrics. Attached today's output. Ideally I'd want to be 195-200 as most of my excess weight is in my belly and would like to go from a 36 to 34 waist size, but some of these numbers don't look that bad?

Any recommendations? I feel like I am missing something. I'm not sure how I can "work" any harder than the above.

 

[Systemlord]

E2, Ultrasens - 14.5 pg/mL (10.0-42.0)

The E2 appears low and with your SHBG at 11.6 may or may not be an issue. When I had low E2 (when using AI's) I noticed my stomach was bigger and have heard how AI's can throw off fluid balance in the body.

Also have you checked rT3 lately?

 

[GeauxBears]

The E2 appears low and with your SHBG at 11.6 may or may not be an issue. When I had low E2 (when using AI's) I noticed my stomach was bigger and have heard how AI's can throw off fluid balance in the body.

Also have you checked rT3 lately?

Funny you mention E2 as I’ve been have a plethora of other issues (ED and libido) that have crept up recently and I’m thinking we may have over done the AI.

 

[Outcome]

Try Ipamorelin. Watch the belly fat disappear. Seriously. One of the best things I’ve added to my protocol, done for myself.

 

[Systemlord]

Funny you mention E2 as I’ve been have a plethora of other issues (ED and libido) that have crept up recently and I’m thinking we may have over done the AI.

It's confirmed, low E2 does increase fat, was watching a YouTube video and the doc specifically said low E2 will increase fat deposits especially in the belly.

Maybe try taking the AI every other day which would give the AI concentration in the bloodstream a little more fluctuation possibly allowing E2 to rise a little more.

 

[Vince]

It makes a lot of sense to drop your AI.

It's not the exercise that will make you lose weight, it's a food you put in your body. I'm a low carb guy, but I know more food, more calories, more weight on your body.

 

[sammmy]

Cutting processed sugar and milk is good - decreases water weight.

In your place, I would start counting calories, target 1500 calories/day, there are phone apps for counting. Eat some meat with every meal (keeps you full longer) with the lunch being the most caloric meal and the dinner before 6:30pm the lightest (your body will want to do the opposite!). Incorporate salads. All that may decrease your body energy production and life enjoyment (yes eating junk food is a type of pleasure) and you may feel tired/depressed. To counteract, use mild stimulants like coffee, green tea, or guarana powder.

I would also drop the HITT and substitute it with 1-1.5 hours walking daily. Getting exhausted with HITT or with excessive strength training will only make you hungrier and stuffing yourself with calories.

 

[GeauxBears]

Appreciate the comments here. I simply can’t believe the magic bullet is in any more adjustments on the food and exercise front. I’m candidly tired of all of the different perspectives (nothing personal here specifically, just in general). I eat healthy, minimal simple carbs, good proteins and veggies, some complex carbs when I feel I really need them, exercise during a completely fasted state - none of this is my problem. I am burning more calories than I take in every day. Something is counteracting the work I’m doing. Am going to start with E2 as I have been having some unexplained erection issues despite PDE5 + Dox, which is unbelievable. Will also look into ipamorelin with Dr. Saya.

 

[goolapsh]

Appreciate the comments here. I simply can’t believe the magic bullet is in any more adjustments on the food and exercise front. I’m candidly tired of all of the different perspectives (nothing personal here specifically, just in general). I eat healthy, minimal simple carbs, good proteins and veggies, some complex carbs when I feel I really need them, exercise during a completely fasted state - none of this is my problem. I am burning more calories than I take in every day. Something is counteracting the work I’m doing. Am going to start with E2 as I have been having some unexplained erection issues despite PDE5 + Dox, which is unbelievable. Will also look into ipamorelin with Dr. Saya.

Yes I think your problems are e2 related but the low libido erection issues could be from Viibryd as well. You are on a lot of medications for someone who is 35. Medications are not without side effects

 

[GeauxBears]

Yes I think your problems are e2 related but the low libido erection issues could be from Viibryd as well. You are on a lot of medications for someone who is 35. Medications are not without side effects

Tending to agree...

 

[sammmy]

If you are "burning more calories than you take in" and still not losing any weight, then you are a miracle contradicting the law of energy conservation ...

I strongly suggest that you actually start counting the calories of everything you eat with a phone app. You will be surprised! A typical SlimFast microwavable dinner is 300 calories and I doubt you will feel full with two of those.

 

[madman]

If you are "burning more calories than you take in" and still not losing any weight, then you are a miracle contradicting the law of energy conservation ...

I strongly suggest that you actually start counting the calories of everything you eat with a phone app. You will be surprised! A typical SlimFast microwavable dinner is 300 calories and I doubt you will feel full with two of those.

Keep in mind that driving calories too low let alone when combined with excessive training (cardio/weights) can be a recipe for disaster and easily put a dent in one's weight loss goals.

This can have a negative impact on not only metabolism but taxing the adrenals and top it off that having a healthy functioning thyroid will play a significant role when it comes to body composition.

Hard to gain any muscle in such a situation let alone enhance fat-loss even when using a therapeutic dose of T.

 

[madman]

Think twice before you drive your estradiol levels too low!

Testosterone Needs to Be Converted into Estradiol to Prevent Fat Accumulation

How Targeting Fat Cells’ Estrogen Receptors Could Fight Obesity Tracy Hampton, PhD In adipocytes, fat cells, a particular estrogen-receptor appears critical for energy supplying mitochondria to function properly. The discovery points to a potential drug target for boosting fat tissue...

www.excelmale.com

Hypogonadism and bone

Late Onset Hypogonadism (LOH): bone health Abstract Background. Bone health is underdiagnosed and undermanaged in men. Bone loss occurs in men with hypogonadism and in aging men. Thus, patients with a diagnosis of late-onset hypogonadism (LOH) are at risk of osteoporosis and osteoporotic...

www.excelmale.com

DHT and estradiol regulate fat in different areas of the body

Testosterone metabolites differentially regulate obesogenesis and fat distribution Zachary L. Sebo, Matthew S. Rodeheffer Abstract Objective: Low testosterone in men (hypogonadism) is associated with obesity and type II diabetes. Testosterone replacement therapy has been shown to reverse...

www.excelmale.com

* In this study, we have shown that testosterone has potent anti-obesogenic effects. Notably, testosterone blocks the expansion of both visceral and subcutaneous fat (Fig. 3E, G), whereas DHT specifically impedes subcutaneous fat growth (Fig. 3E, G) without significantly impacting total fat mass (Fig. 3B). Estradiol, on the other hand, specifically prevents the expansion of visceral fat (Fig. 3E, G). Thus, the conversion of testosterone to DHT and estradiol likely contributes to the regulation of depot-specific fat mass.

 

[madman]

 

[GeauxBears]

Update here. My fasting insulin tested high, and we started metformin about a week ago. Not surprising considering my father has Type 2, mother and sister have Type 1.

Will post results as I have them - hoping it will drop insulin levels and I can lose some weight as I am in a good routine of workouts and healthy food consumption.