Need help, getting worse by the day I feel

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helpneeded

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Hello everybody, this is going to be quite long and I apologize. I’m goin to make it as simple as possible

31, male, 5’11, 215-220lbs. I’ve been lifting literally my entire life. I did an oral cycle in ~Jan 2010 of superdrol. I did the preached PCT of the time, but it was all natural, OTC stuff.. Well, actually I did take Tamox but that’s it. I made HUGE gains.. I was ~22 or so, and I was huge and looked great.

I lifted of and on most of my life.. The army got in the way of my lifting for 4 years from ~2006-2010.

Immediately prior to my second cycle.. Bigger, stronger, faster feeling than ever in my entire life. Hard workouts, looking decent etc. Never paid a trainer or dietician in my life

I did a cycle 28Nov2016 consisting of 350mg eq, 500mg cyp. Ran a 12 week cycle, ending SLIGHTLY early because I got burnt out pinning my quads (HATED it). Last pin date was 21 Feb. PCT started 3March.. During cycle, arimadex ED. Post cycle, super-dosed Clomid (100mg/day for 2-3 days, 50/day for a few days, then like 25mg/day the remainder) but only for ~3.5 weeks until I ran out (I didn’t order anywhere near enough). Long story.. This cycle.. I’m really, really confident that some part of my “stuff” was bunk. Made very minor gains, but could run for hours and had crazy vascularity. I believe the EQ was the only good stuff (I just didn’t take enough of it)… test was bunk. My labido completely tanked. But, what’s interesting is this. I was almost never in the mood for sex.. But my girl could get me in the mood. Once I was actually IN the mood, I was harder than ever before, and blew bigger, stronger, further loads than EVER before. My BF did decrease a bit on cycle, but I only went from ~209 to 218… which could have been due to me eating more carbs than normal.

Post-cycle.. Felt great. For probably a few months i felt fine. There was no real crash that everybody dreads.

Now, here I am, 31 as of June. My doc asked for a blood panel for the first time ever…

Free test 3.1 and 6.8
Reg test 278.8 ng/dl
SHBG 21.3


They told me I”m “all normal”. I told them BS. They referred me to endocrinology. Endo got back to me 3 weeks later.. Said I’m “low-normal”. They TOLD me I’ve used anabolics. They said white blood cell count is low, could be HIV (I’ve had low WBC count for years now.. Not new). They said Hemoglobin is high due to testosterone deficiency. They said this could be due to sleep.. Apnea likely. I need a sleep study (years ago in the army I told them I feel I have apnea, they gave me lunesta). Low SHBG is likely genetic.

I feel like I sleep like a tank! No complaints. I wake up at 5am and most days feel like I could run a marathon I’m so energized. With that said, I’m told I snore, I know that ONCE in a while I wake up gasping for air, and sometimes have bad dreams (symptoms of apnea). This is likely due to a deviated septum and large turbinates in my nose I’ve had for years, I feel.

So, why am I here? I have had high blood pressure for years, my memory has always been foggy but I feel its worse (grandfather on mom's side had alzheimer's), I have like no energy at the gym (I’m not exactly tired… just no drive or energy). My bodyfat is EXTREMELY hard to keep in check and I’m pretty damn good with my diet. I’ve got this damn tire around my belly button, some love handles too… high estrogen? My strength has gone down, but this is likely to me not doing crazy heavy workouts like I used to during/pre cycle.. Much more low weight high intensity bodybuilding stuff now.


This whole thing is sucking the life out of me. Why am I getting fat for that first time in my existence even with my diet being fucking incredible for a non competitor? Why am I losing drive and muscle?

My balls shrunk during cycle but feel normal now. I don't have much sex drive but I can still get hard and blow decent loads etc.
 
Defy Medical TRT clinic doctor
Would like to see more labs, need to see Estrogen and a good set of labs if money allows you to run them.

Total Test
Free Test
(ultra) Sensitivie Estradiol LC/MS/MS
SHBG
THS
Free T3
Free T4
Antibodies
Reverse T3
 
I'm a veteran so I use the VA. They'll pretty much give me what I want most times. I'm waiting on a call back from my nurse anyways, I was curious to know my estrogen and e2 levels look like in my past 2 labs. I'll ask about those other things too. I have had 2 labs in the past 3 months or so. I'm assuming these will work?
 
Rather than compiling labs from this time to that if you can, get them run altogether so that there's a clear snapshot in time. Be certain even if you stand over them that they run that Estradiol test specifically as I listed...any other test is for females and tends to overestimate levels in men.
 
They've run 2 full blood panels in the past 3 months for this very purpose... The second one my endo clinic ran because I refused to accept the doctors answer that my bloods were 'completely normal'.

This is really getting the better of me. I'm more stringent in my diet and lifting than I've ever been in my life and day by day I'm feeling and looking worse
 
FYI, The VA does not offer the sensitive e2 test. If they do offer it to you, let me know.

Follow Vince's advice and get a complete thyroid panel done.
 
Wait, this is called a thyroid panel? Hmm I'll have to ask about this. I wonder if this was covered in the panel the endo office ordered a few weeks ago?

One of the scariest things is my foggy memory. My grandfather had alzheimers and my memory is getting so bad at only 31. The lady tells me something, an hour later I swear in my life I've never heard her say that and when she tells me what my reply was, it slowly starts coming back.
 
most Endo at best if they're typical to what we see around here has only run TSH, maybe T4, maybe T3 but the 5 plus iron and ferritin are an inclusive panel...panel being a misleading word./
 
Vince's advice included a comprehensive set of tests for thyroid function which is why i referred to it as thyroid panel. The tests as a whole are not a thyroid panel.


These would be a thyroid panel. Like VC stated, most doctors only check a few of these. Which is basically useless without the others.

TSH
Free T3
Free T4
Antibodies
Reverse T3
Iron
ferritin
 
............These would be a thyroid panel. Like VC stated, most doctors only check a few of these. Which is basically useless without the others.

TSH
Free T3
Free T4
Antibodies
Reverse T3
Iron
ferritin

Normally you won't get iron and ferritin in a Thyroid Panel but they can be added to a Thyroid Panel, or, one can add an Iron Panel with a Thyroid Panel. Typically, an Iron Panel will include the following:

Iron, serum
TIBC (Total Iron Binding Capacity)
UIBC (Unsaturated Iron Binding Capacity)
Iron Saturation
Ferritin
 
Ugh so the nurse called me back. The only additional info I found was this
Lh 3.3
FSH 3.3
Free 6.86
Total 278.8

He's scheduling an appointment with the endo doc in a few weeks, maybe they'll have more answers.

Any other input or direction in this? I've got vials of clomid coming, going to attempt to self medicate for a while. Honestly I may jump on a low dose cycle here soon to hold me over.
 
No way is the VA going to run a full thyroid panel, you'd have to be on your deathbed for that to happen. The VA is cracking down on excess TRT prescriptions and men who have a clinical need are being told they're levels are normal.

The VA and TRT go together like oil and water, Nelson has a study that shows the VA isn't following guidelines and properly monitoring men on TRT. You go to the VA for TRT in your asking for trouble.

278 ng/dL is normal? Proof guidelines are being ignored.

https://content.govdelivery.com/accounts/USVAOIG/bulletins/1e8ce4a#.Ws4kufVjngM.twitter
 
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If the VA won't run a full thyroid panel, I'm not sure what to do?

I'm not doubting you guys, but what good will a thyroid panel do with this?

System lord, my primary doc told me that 278 ng/dl was completely normal. The endo doc said I'm low-normal. I'm not sure I'd trust the VA to do trt on me, but I'd take an external referral lol
 
I can ask for any blood work I want at the VA, if they offer it, they run it for me. No reason they should not run the requested bloods.
 
If the VA won't run a full thyroid panel, I'm not sure what to do?

I'm not doubting you guys, but what good will a thyroid panel do with this?

System lord, my primary doc told me that 278 ng/dl was completely normal. The endo doc said I'm low-normal. I'm not sure I'd trust the VA to do trt on me, but I'd take an external referral lol

Apparently your doctor is ignoring the endocrine society guidelines, 300 ng/dl was chosen for the cutoff point to be considered low testosterone. However it's not as simple as that, men with higher SHBG has much less free testosterone than a guy with lower SHBG, so they require more total testosterone in order to have the same free testosterone as a lower SHBG guy.

Also there are multiple studies showing cardiovascular disease below 440 ng/dL, rinse and repeat we see men beginning to experience low libido when dipping in the high 400 ranges. We are all genetically unique and everyone has their own optimal range they operate best, doctors would have you believe we are all clones of the same person.

The majority of doctors don't even know what tests to order and have no real understanding how to read the test results. When a doctor doesn't know what the heck their doing, their going to tell you you're fine just to get you out of their office.

Most doctors want nothing to do with TRT, too much risk for a doctor that has no clue.

There are hundreds of studies like this one that provide beyond a shadow of a doubt that the endocrine society's claiming anything below 300 ng/dL is what constitutes low testosterone is wrong and serious flawed.

There are some doctors that claim to know that this 300 cutoff point was chosen by the endocrine society because it sounded like a good number. I believe it wholeheartedly because all the studies confirm it.

https://www.ncbi.nlm.nih.gov/pubmed/27843074
These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men. Poor sexual performance, decreased morning erection, and loss of libido had an impact on the testosterone threshold for CVD risk. The threshold level was higher in men with sexual dysfunction. Further study is required to evaluate the validity of these testosterone thresholds for CVD risk.
 
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So at this point what are my options? Do I keep blowing up the phone to my primary and endo until they actually do something? Do I self medicate? Do I wait until married and then use her insurance to go to a real trt doc? Do I suck it up? (PS not happening... I'm dealing with it for now until I get a solid plan of action)
 
So at this point what are my options? Do I keep blowing up the phone to my primary and endo until they actually do something? Do I self medicate? Do I wait until married and then use her insurance to go to a real trt doc? Do I suck it up? (PS not happening... I'm dealing with it for now until I get a solid plan of action)
Squeaky wheel gets the grease my man. Keep pestering the VA until you get those tests ordered. But even with those tests, you might not have an answer.

Honestly, Your best bet is to pay out of pocket and get with a clinic such as Defy. Even using defy for my TRT, I still get the VA to run all the required blood work.
 
Beyond Testosterone Book by Nelson Vergel
I dont deal with the VA, as long as my miserly 10% rating is intact and the check comes every month, I just pay for insurance through work and avoid the place, this is a good example of why.
 
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