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Started By
Message
Bloodwork results: advice on my next steps?
Posted on 4/14/24 at 5:39 pm
Posted on 4/14/24 at 5:39 pm
TL;DR - testosterone is 262. What do I do next?
Age: 39
Height: 5’7
Weight: 174
Body fat: 23% DEXA
Weight is carried primarily in love handles and midsection. Not really a belly and my legs have zero fat to them. Pronounced glutes if it matters.
Lifts:
Bench: 245 max
Squat: 275 max
Deadlift: 315 max
I lift 4 days a week. I find it very, very hard to complete my full workouts. I try to run an upper/lower split. 3 push exercises (bench, seated DB shoulder press; lat raises), 3 pull (pendlay rows, pull ups, db bicep curls) for upper. 3 leg for lower (squat or deadlift, rdls or split squats, hip thrusts)
I run twice a week. One 2-3 miler. One higher intensity day of intervals.
Again, I struggle to complete these workouts due to just wanting to quit. Like not really tired as much as I get to the point I don’t feel like it. I’ve tried to “David Goggins” it, but I don’t have it in me anymore. I ran a marathon in 2018. I get super “done” after a few miles now even though I’m not out of breath or worn out.
I get really tired the afternoons after exercising and I’m zonked the next day. After squats or deadlifts, I’ll be irritable, kind of depressed. Just want to lay around not because of soreness but because of being drained of life.
Sleep:
I get around 6 hours of sleep per night. If I practice good sleep hygiene and go to bed early, I’ll pop awake around 3am. My alarm goes off at 5:30am, so I need to be out by 10pm to get 7.5 hours.
I did get in pretty good shape a little over a year ago. More so than I’ve ever been. Dropped weight to 156 and was doing great. But it was a major struggle. I quickly went back to binge eating and am almost 20 pounds heavier.
Bloodwork:
Total Testosterone 262
Free Testosterone 4.5
TSH .7
T4 Free, Direct 1.2
Total cholesterol 205
HDL 51
LDL 129
Tri 139
HDL/LDL ratio 2.7
Vitamin D 50.5
Diet:
130g-150g of protein per day (mostly animal sources like meat, yogurt, or whey)
25g-30g of fiber daily
80g-90g of fat
I do eat carbs from fruit, vegetables, and some refined sources like pasta or tortillas.
I binge sugar almost every day. It’s a problem that probably needs a therapist to address.
Sorry for so many details, but my doctor didn’t even want to run testosterone with my blood work. She asked if I was having erectile dysfunction problems or feeling depressed. She said I’m muscular for someone who would have a testosterone issue and unless I had symptoms, she didn’t want to worry about it. I insisted.
I think I am having symptoms, more so than I probably even realize. I’m just so busy, responsible, and organized that I don’t really think much about how I feel. Like with sex - how often am I actually horny? It’s honestly pretty rare. I just mentally know I like sex, so I pursue it with my wife when I can.
Finally - and I know this is a god awful long post - I worry that my low t is what is keeping me from sleeping, making consistent food choices, and finishing workouts/staying consistent. I wish I could just get my shite together for the long term, but my history says I never will.
So is the T clinic next?
Age: 39
Height: 5’7
Weight: 174
Body fat: 23% DEXA
Weight is carried primarily in love handles and midsection. Not really a belly and my legs have zero fat to them. Pronounced glutes if it matters.
Lifts:
Bench: 245 max
Squat: 275 max
Deadlift: 315 max
I lift 4 days a week. I find it very, very hard to complete my full workouts. I try to run an upper/lower split. 3 push exercises (bench, seated DB shoulder press; lat raises), 3 pull (pendlay rows, pull ups, db bicep curls) for upper. 3 leg for lower (squat or deadlift, rdls or split squats, hip thrusts)
I run twice a week. One 2-3 miler. One higher intensity day of intervals.
Again, I struggle to complete these workouts due to just wanting to quit. Like not really tired as much as I get to the point I don’t feel like it. I’ve tried to “David Goggins” it, but I don’t have it in me anymore. I ran a marathon in 2018. I get super “done” after a few miles now even though I’m not out of breath or worn out.
I get really tired the afternoons after exercising and I’m zonked the next day. After squats or deadlifts, I’ll be irritable, kind of depressed. Just want to lay around not because of soreness but because of being drained of life.
Sleep:
I get around 6 hours of sleep per night. If I practice good sleep hygiene and go to bed early, I’ll pop awake around 3am. My alarm goes off at 5:30am, so I need to be out by 10pm to get 7.5 hours.
I did get in pretty good shape a little over a year ago. More so than I’ve ever been. Dropped weight to 156 and was doing great. But it was a major struggle. I quickly went back to binge eating and am almost 20 pounds heavier.
Bloodwork:
Total Testosterone 262
Free Testosterone 4.5
TSH .7
T4 Free, Direct 1.2
Total cholesterol 205
HDL 51
LDL 129
Tri 139
HDL/LDL ratio 2.7
Vitamin D 50.5
Diet:
130g-150g of protein per day (mostly animal sources like meat, yogurt, or whey)
25g-30g of fiber daily
80g-90g of fat
I do eat carbs from fruit, vegetables, and some refined sources like pasta or tortillas.
I binge sugar almost every day. It’s a problem that probably needs a therapist to address.
Sorry for so many details, but my doctor didn’t even want to run testosterone with my blood work. She asked if I was having erectile dysfunction problems or feeling depressed. She said I’m muscular for someone who would have a testosterone issue and unless I had symptoms, she didn’t want to worry about it. I insisted.
I think I am having symptoms, more so than I probably even realize. I’m just so busy, responsible, and organized that I don’t really think much about how I feel. Like with sex - how often am I actually horny? It’s honestly pretty rare. I just mentally know I like sex, so I pursue it with my wife when I can.
Finally - and I know this is a god awful long post - I worry that my low t is what is keeping me from sleeping, making consistent food choices, and finishing workouts/staying consistent. I wish I could just get my shite together for the long term, but my history says I never will.
So is the T clinic next?
11
Posted on 4/14/24 at 6:30 pm to StringedInstruments
Don't apologize for your "long" post, I know people bitch, but they need to stfu and just read. What needs to be said should be said. I'll never complain.
I think it's time for the T clinic as you say, or a better doctor. Sounds like you've found a "typical" pcp that does not give a shite about your goals here. Just rip that bandaid off and go find someone else.
I've only had my test checked twice, and I did so because I felt pretty much exactly like you describe. On August 2nd, 2022 mine was 339, and I wanted to re-check after 1 month just to verify and on September 8th, 2022 it was 273. I haven't gone back to get any further bloodwork done yet. I was doing this on my own, not through a doctor, but I wanted to know where I was and I found out.
The reason I'm bringing me up in a thread about you is to illustrate how stupid and meaningless your doctor's comment about your testosterone levels sound to me. As you can see, my T levels from 2022 are similar to yours now(I was 43 at that time), and I lifted about 3 days a week and (not trying to brag or flex on you) I'm stronger and probably have much more muscle than you, (but also much more fat, I'm 5'7" & 265lb, & at that time my 1RMs were 345BP, 510SQ, 420DL, 235OHP), so trust me, you can be muscular and strong and have lower T levels. You and I aren't the only ones in this boat. I got big and strong when I was young, you probably did too, doesn't mean you don't need to address your hormone levels when they are low, which they are, so you should go on a provider search as soon as possible.
Also, you're obviously already aware, but yes, there are other things like sleep, lose fat, improve diet, that should improve your T levels, but even if you did all of that you may still need something, and if not now, you eventually will...it seems.
I think it's time for the T clinic as you say, or a better doctor. Sounds like you've found a "typical" pcp that does not give a shite about your goals here. Just rip that bandaid off and go find someone else.
I've only had my test checked twice, and I did so because I felt pretty much exactly like you describe. On August 2nd, 2022 mine was 339, and I wanted to re-check after 1 month just to verify and on September 8th, 2022 it was 273. I haven't gone back to get any further bloodwork done yet. I was doing this on my own, not through a doctor, but I wanted to know where I was and I found out.
The reason I'm bringing me up in a thread about you is to illustrate how stupid and meaningless your doctor's comment about your testosterone levels sound to me. As you can see, my T levels from 2022 are similar to yours now(I was 43 at that time), and I lifted about 3 days a week and (not trying to brag or flex on you) I'm stronger and probably have much more muscle than you, (but also much more fat, I'm 5'7" & 265lb, & at that time my 1RMs were 345BP, 510SQ, 420DL, 235OHP), so trust me, you can be muscular and strong and have lower T levels. You and I aren't the only ones in this boat. I got big and strong when I was young, you probably did too, doesn't mean you don't need to address your hormone levels when they are low, which they are, so you should go on a provider search as soon as possible.
Also, you're obviously already aware, but yes, there are other things like sleep, lose fat, improve diet, that should improve your T levels, but even if you did all of that you may still need something, and if not now, you eventually will...it seems.
Posted on 4/14/24 at 7:39 pm to StringedInstruments
quote:
Pronounced glutes if it matters.
Oh, it matters to me.
Posted on 4/14/24 at 7:53 pm to StringedInstruments
quote:
Height: 5’7
Weight: 174
Losing some of the extra pounds will help. A lot of environmental chemicals are fat soluble and some mimic estrogen. So less body fat = less of those chemicals being stored in your body.
Get down to at least 155 and you should see some improvement just from that.
quote:
Bench: 245 max
Squat: 275 max
Deadlift: 315 max
This is good. You definitely aren't starting from scratch.
Posted on 4/15/24 at 7:14 am to StringedInstruments
There will be better responses than mine, but I suggest getting your T levels up. It will help a lot with your issues.
262 is low enough for insurance to cover your TRT.
262 is low enough for insurance to cover your TRT.
Posted on 4/15/24 at 7:48 am to StringedInstruments
My performance would be really terrible if I binge ate sugar every day and slept for 6 hours per night. It seems like you have some low hanging fruit you might be able to attack in the short term while you get to the bottom of the hormone issue.
I start to get what feels like CNS fatigue if my sleep falls off. I feel less sensitive to that when I’m taking creatine and beta alanine, but I ultimately have to sleep more to get out of it.
I start to get what feels like CNS fatigue if my sleep falls off. I feel less sensitive to that when I’m taking creatine and beta alanine, but I ultimately have to sleep more to get out of it.
Posted on 4/15/24 at 9:22 am to StringedInstruments
quote:
Total cholesterol 205
HDL 51
LDL 129
Tri 139
HDL/LDL ratio 2.7
Your tri/hdl ratio is 2.7 - way too high. Cutting that sugar should bring that in the preferred zone over 2.
Thanks for being so open in your description. It really helps other people speak up themselves.
Question: what should the T numbers be? I'm going for bloodwork soon but have never paid attention to anything beyond my lipid panel before.
Posted on 4/15/24 at 9:54 am to StringedInstruments
Completely cutting daily sugar external intake (meaning not from food during meals, or even an occasional dessert or cocktail but from added sugar in coffee, sugary snacks, and sugary drinks) and aiming to get at least 7 hours of sleep has really helped me in my adult years.
Posted on 4/15/24 at 6:21 pm to StringedInstruments
quote:
TL;DR - testosterone is 262. What do I do next?
I was kind of in the same boat too. Started test last year at 44yo with a test level of 304. I was feeling run down and fatigued. My workouts never really suffered because I've been training forever and it's just a part of my life. But, my recovery was terrible. That's what I've found was the most impactful for me. I've never slept well, but on test my body just recovers so much faster. I don't feel run down anymore.
Good luck with your journey.
Posted on 5/2/24 at 11:18 am to StringedInstruments
You cant just take a snapshot of your T levels and make a judgement.
All that said, I think you are doing too much. Your body is probably in too much of a stressed state with not enough rest. Id try cutting out the running and replace it with weighed walks or incline walking.
The workouts, id go down to 3x/week and go full body. Id remove exercises and sets until you start feeling better during workouts. Find your sweet spot of work. You should shoot for the satisfied feeling, not the broken down feeling after lifts. Leave a little in the tank...you can always add more later if your body can handle it.
This is because high intensity complex lifts like squats/deads heavily tax your nervous system. Id try sticking to one day of high intensity legs.
Some of us have the same struggle. I have to occasionally do a long fast to reset. The more sugar I eat, the hungrier I am and the more I want. What works for me is a simple treat. Either 1 banana or one soft serve ice cream from Mcdonalds or DQ. If you can build up the discipline, add in one cheat day. For me its Cracker Barrel Pancakes on Saturday. The rest of the week for me is usually bacon, eggs, steak and a banana or soft serve.
In all honesty, you are already doing better than most of the population
All that said, I think you are doing too much. Your body is probably in too much of a stressed state with not enough rest. Id try cutting out the running and replace it with weighed walks or incline walking.
The workouts, id go down to 3x/week and go full body. Id remove exercises and sets until you start feeling better during workouts. Find your sweet spot of work. You should shoot for the satisfied feeling, not the broken down feeling after lifts. Leave a little in the tank...you can always add more later if your body can handle it.
quote:
I get really tired the afternoons after exercising and I’m zonked the next day. After squats or deadlifts, I’ll be irritable, kind of depressed. Just want to lay around not because of soreness but because of being drained of life.
This is because high intensity complex lifts like squats/deads heavily tax your nervous system. Id try sticking to one day of high intensity legs.
quote:
I binge sugar almost every day. It’s a problem that probably needs a therapist to address.
Some of us have the same struggle. I have to occasionally do a long fast to reset. The more sugar I eat, the hungrier I am and the more I want. What works for me is a simple treat. Either 1 banana or one soft serve ice cream from Mcdonalds or DQ. If you can build up the discipline, add in one cheat day. For me its Cracker Barrel Pancakes on Saturday. The rest of the week for me is usually bacon, eggs, steak and a banana or soft serve.
In all honesty, you are already doing better than most of the population
Posted on 5/2/24 at 1:55 pm to StringedInstruments
quote:
StringedInstruments
I've been in the same boat as you going on about 18 months
42 y/o
6'3"
195
I workout 3 days a week, and am in decent shape. I carry extra weight in my lovehandles and I hate it. I am the same with sweets as well. I eat well for B/L/D, but every few weeks I go crazy on sugar around 8 pm.
I find myself tired all the time. I usually workout 3 days a week after work and it is getting harder and harder to find motivation. I'm sore after every workout- almost like I am out of shape.
Sex is the same way you described. I know I like it, I can get it up anytime, but I am never "horny" anymore.
I went and got full labs done last summer and my Total Test was 600, and Free Test was 6.1. The total number is great but the free is showing a little lower than normal. My PCP didn't seem to think anything was wrong, but here I am almost a year later and feel the same way. I was expecting my total T to be a lot lower.
I ran a half marathon in Jan 2023 and entertained the idea of training for it again last fall. I ran for about 2 weeks before I gave it up. I just didn't have the "want to".
All of that being said, I haven't done anything to change it, other than hope the feeling goes away. I attribute it to getting older, but man it seems like something more than that.
Just wanted you to know you're not alone.
This post was edited on 5/2/24 at 1:58 pm
Posted on 6/5/24 at 9:39 am to StringedInstruments
Update:
Urologist was quick to suggest TRT. I felt like it was a “no bullshite” kind of appointment. He said if you’ve got low T and symptoms, you can go on TRT. He doesn’t recommend any other treatments like clomid.
He ran bloodwork to make sure it was low enough for insurance and it actually went down.
My test was 241. This was at 9am.
I have to admit I’m terrified of going on TRT. I have pretty good hair that I don’t want to lose. I have a decent set of balls that I don’t want to shrink. I don’t want to set myself up for future issues. I’ve always been intentional with my own health. I workout. I eat nutritious food. I don’t drink or smoke and never really have.
My only issue has been binge eating sweets, which I just can’t seem to kick.
I asked the nurse if I could take a few months to try to raise it naturally and she supported it. She said taking TRT is definitely not something to take lightly, which only intensified my fears.
But I know I’ll frick it all up. Keep bingeing sweets because I have undiagnosed adhd. Not sleep well from the bingeing. Struggle to complete workouts because I’m tired, bloated, have heartburn, in pain because I can’t recover due to low T.
Sucks, men.
Urologist was quick to suggest TRT. I felt like it was a “no bullshite” kind of appointment. He said if you’ve got low T and symptoms, you can go on TRT. He doesn’t recommend any other treatments like clomid.
He ran bloodwork to make sure it was low enough for insurance and it actually went down.
My test was 241. This was at 9am.
I have to admit I’m terrified of going on TRT. I have pretty good hair that I don’t want to lose. I have a decent set of balls that I don’t want to shrink. I don’t want to set myself up for future issues. I’ve always been intentional with my own health. I workout. I eat nutritious food. I don’t drink or smoke and never really have.
My only issue has been binge eating sweets, which I just can’t seem to kick.
I asked the nurse if I could take a few months to try to raise it naturally and she supported it. She said taking TRT is definitely not something to take lightly, which only intensified my fears.
But I know I’ll frick it all up. Keep bingeing sweets because I have undiagnosed adhd. Not sleep well from the bingeing. Struggle to complete workouts because I’m tired, bloated, have heartburn, in pain because I can’t recover due to low T.
Sucks, men.
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