Need Input...Conflicting Results and I'm at a loss

MikeWazowski · Mar 10, 2015

Background: 36yr. old male. I have sleep apnea (severe) and didn't know it. Haven't got on CPAP yet as I'm awaiting a fitting for it.

I have a lot of the typical symptoms of low T. I thought on a whim to have my blood checked.

I had a Testosterone reading of 260. Things started to make sense about how I've felt over last 4 years or so. My eyes are dry, my drive is lower, I'm fatigued (granted I'm sleep deprived and didn't know it), depression and anxiety... libido is not as strong, etc.

He prescribed more bloodwork and it was about 1 month after last draw.
Results:

LH 5.3 (2.1 to 17.7)

Prolactin 8 (2.5 to 17.0)

Total Testosterone 443 (348 to 1197)

And here's the weird one, Free Testosterone was greater than 50 for a range of (8.7 to 25.1).

Estrogen was 56 (40 to 115).

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I don't get it. Only thing I can think of is that I have been sleeping slightly better and I was working out more and on L-Arginine in the 1 month after the first low T reading.

I know 443 is still not stellar, but my Free T is absolutely insanely high. it makes NO SENSE.

Urologist basically said he'd be performing malpractice to prescribe Testosterone Replacement for me seeing as I'm "Normal". He even noted the high Free Testosterone, but 50 sounds insane.

He did just prescribe another blood draw for check on my thyroid levels, so maybe there's some answers there.

I did not take arginine day of and I only take it 1hr before workouts. I'm not consistently loading up on it, so I don't know if it would have made a difference.

Should I just give the CPAP a try first and see where levels come out after using it for a bit? Urologist did say he'd be willing to check my testosterone, LH, prolactin, everything in 3 to 4 months. At least by then I should be on CPAP and who knows, maybe higher.

Any input is appreciated. thanks. I'm at a loss. I know it's a good thing not to be on meds your whole life, but I was really hoping to try it and see if it alleviated my eye issues and my overall funk.

MikeWazowski · Mar 10, 2015

What supplements should I be looking at if I'm destined to be denied TRT?

I can't obtain these things w/out prescription. I would lose my job if not prescribed.

I'm an engineer by trade and very analytical. If you guys know of specific things I need checked for more input into an informed decision, let me know.

Nelson Vergel · Mar 10, 2015

What's your height, weight and neck size? Is your sleep apnea induced by high BMI or does it run in your family ?

i would not start TRT even if prescribed. I would give the CPAP a try first. Some men may have improvements in T levels after their sleep quality improves. Cortisol goes down and testosterone tends to improve.

You are lucky to have such nice free testosterone. I would not freak out since you may be one of those men whose bodies tend to bind less testosterone. I have coached a few of those lucky men and they usually tend to have better sex drive.

Arginine has no effect on testosterone.

As supplements go, it's hard to tell without knowing more about your blood work, diet, goals, exercise, etc

MikeWazowski · Mar 10, 2015

Nelson - thanks for quick reply.

Here's my breakdown (supplemental feedback):
1. Weight is currently 215
2. Height is 5' 9"

I do have a thick/big neck. I'm well muscled but definitely could shred about 15 lbs. to 20 lbs. or so and be what I'd consider ripped. Wide shoulders and a barrel chest to thinner waist. No apnea in family history. Mom probably has it but that's due to her obesity.

My diet is clean. I've recently lost about 25lbs. from clean diet and my workouts are good. I spend about 1hr tops in the gym and it's a mix of high intensity workout and weights. Think 15min of jump rope mixed w/ bandwork and free weights like squats, deadlift, etc. I try not to overtrain and usually can handle an hour of workout time. After that I'm done. Motivation is lacking at times but I force myself to do it because the alternative is being a fat pos.

Are there supplements that would work for someone in my spot? My goal is to lose 15 to 20 more pounds.

As for coaching those who don't bind well. Coach away. What should I do? do you know on average how much of a boost in test I would get if I am no longer sleep deprived? I can't find any literature on this. This is like a dark science lol.

MikeWazowski · Mar 10, 2015

specific on diet:

mostly veggies (green ones) mixed w/ protein such as eggs, chicken, and tuna. I for the most part eat no processed grains/foods. I drink ONLY water w/ an occasional coffee in the morning.

no overdoing on sugar or dairy which is hard but alternative is feeling like crap.

My biggest goal w/ TRT was to see if it helped alleviate my dry eyes. I don't have meibomian dysfunction. I have inflammation due to lacrimal gland not secreting enough moisture or quality moisture. I read that there were medical studies performed that showed increasing testosterone alleviated symptoms. My friend had dry eyes due to low T and after a few weeks on the shots his eyes are perfectly fine. fixing my eyes would be like a god send, but I will give CPAP an honest try.

MikeWazowski · Mar 25, 2015

Well... I met with ent and am going to get on CPAP.

any thoughts on supplements? Why low total and high free? What's my go forward plan?

ERO · Mar 25, 2015

Also with your free T that high, I bet you have really low SHBG. I would start with the CPAP and see how that goes, but if you do end up on TRT, I would check SHBG. If its really low like mine (I average 7-13 on a scale where normal is 20-70) TRT can be difficult. By that I mean, difficult to feel anything good on it even with good numbers on your blood work. Google Low SHBG and TRT and you'll see what I mean.

MikeWazowski · Mar 26, 2015

Thanks for reply. What does one do if low shbg and TRT dosnt help in terms of alleviating symptoms? Take injections just to take them? Something must work right?

ERO · Mar 26, 2015

For me, TRT gives me more energy and takes away the brain fog and while I cant seem to build muscle, it allows me to work out hard and not be sore for days. Sadly, what it does not do for me (and for many guys with truly low SHBG - and by low I mean well below the bottom of the normal range) is help with low libido, with erections or ED, nor with fat burning or building muscle

I stay on because its slightly better on than off, but I don't get that "Wow - I feel awesome and like a much younger man again" feeling that many if not most guys get. I have been on TRT for 4 years and have tried every protocol out there except for the injected pellets (state of the art treatment circa 1950) or the long-lasting Test like Nebido that I believe is only used in Europe.