Lethargy, bloodwork

[qbkilla]

Some background. Late 30's, 190lbs pretty lean. I try to stay lean year round so don't push the dosages just .6cc prop ed and .3cc mast, thats a blast for me. Over the years ive been getting low sodium readings out of range. Doctors have chalked it up to intermittent fasting and drinking too much water (I used to think the more the better). Around 6 liters. I've also been feeling really fatigued over the years as I get older, not sure if its from keeping a low body fat but I eat decent calories at 3k so not starving.

Got a physical and my sodium again came back low. The doctor said drinking too much water should not cause this, and suggested I see an endo as I may have a small tumor on my pituitary that causes my body to not regulate sodium. I told him I was also concerned about my kidneys as my creatinine would be high many years ago when I was bigger (think permabulker 240-240lbs) and I would have protein in my urine when using orals. He tested me and no protein, kidneys look great, prolactin was slightly high, test was off the charts (due to my cycle).

I then saw an endo and she did additional tests and they came back. Out of range is below...

Prolactin Serum 35 (4-15)
Monemeric Prolactin ICMA. 31 (HIGH). <---Is this a normal elevation due to my dosage or indicate a tumor?
BUN 22 (6-20)
Alk Phos 40 (44-121)
A1C 4.7% (4.8-5.6) <-----I have been using gh and having high over 100 fasted AM glucose readings, so I cut back on carbs. But I guess this alleviates my concerns about being pre-diabetic, although its low out of range?
T4 Free. .8 (.82-1.77). <------not sure if significant, maybe from the gh? TSH was normal.

Everything else was in range. Some specific numbers..
Creatine .86
Sodium 138
Iron 59 (38-169)
Iron Saturation 20% (15-55%)
TSH 3.5 (.45-4.5)
Ferritin 110 (30-400)

Anything stand out? I had then test my iron and ferritin as I read the thread see some of us may be deficient. After reading that thread I started eating beef liver, so if this was a cause of my fatigue before I guess its normal now. I also decreased my sodium intake from about 10g to 7g. I don't try to eat that much but its what MFP calculates it at so thought that was high, cut back on water too. Overall I don't think anything suggests I have a tumor or kidney issues since sodium is fine. I do feel much better lately after adjusting sodium and water just wanted to get some other opinions as I know people here are very health conscious.

 

[Crazy_jay]

I be curious to see what your free t3 is. THS of 3.5, while in range on labwork, is actually a little high. There was a group of endocrinologist at one point that wanted the top end range of tsh to be 3. It used to be 6. Too many people show hypothyroid symptoms with tsh above 3. As you pointed out, free t4 is low, barely but is. Hypothyroidism can cause high prolactin, and also cause insulin resistance, blood sugar issues. Maybe it's just from the gh.

 

[qbkilla]

Interesting I was able to see past tests. A few months ago 2.3 ...1.7 a few years ago.

 

[pickapeck]

Your sodium is normal. How is your sleepe and your use of stims? MAybe cut back on coffee and try to get better sleep.

 

[Reno911]

What's your Estradiol? I feel like shit when mine is low. 25 to 30+ I feel way better/more energy. Often I feel just fine at 60-70+

From my experience sub 15 and you'll feel like shit and want to sleep.

 

[Cerberus777]

When my prolactin creeps up I feel exhausted. As mentioned low Free T3 causes this, as does high histamine. It's worse when we elivate hormones.

Sodium dosnt look too low for someone who sweats regularly.

 

[jeroendebleser]

Some background. Late 30's, 190lbs pretty lean. I try to stay lean year round so don't push the dosages just .6cc prop ed and .3cc mast, thats a blast for me. Over the years ive been getting low sodium readings out of range. Doctors have chalked it up to intermittent fasting and drinking too much water (I used to think the more the better). Around 6 liters. I've also been feeling really fatigued over the years as I get older, not sure if its from keeping a low body fat but I eat decent calories at 3k so not starving.

Got a physical and my sodium again came back low. The doctor said drinking too much water should not cause this, and suggested I see an endo as I may have a small tumor on my pituitary that causes my body to not regulate sodium. I told him I was also concerned about my kidneys as my creatinine would be high many years ago when I was bigger (think permabulker 240-240lbs) and I would have protein in my urine when using orals. He tested me and no protein, kidneys look great, prolactin was slightly high, test was off the charts (due to my cycle).

I then saw an endo and she did additional tests and they came back. Out of range is below...

Prolactin Serum 35 (4-15)
Monemeric Prolactin ICMA. 31 (HIGH). <---Is this a normal elevation due to my dosage or indicate a tumor?
BUN 22 (6-20)
Alk Phos 40 (44-121)
A1C 4.7% (4.8-5.6) <-----I have been using gh and having high over 100 fasted AM glucose readings, so I cut back on carbs. But I guess this alleviates my concerns about being pre-diabetic, although its low out of range?
T4 Free. .8 (.82-1.77). <------not sure if significant, maybe from the gh? TSH was normal.

Everything else was in range. Some specific numbers..
Creatine .86
Sodium 138
Iron 59 (38-169)
Iron Saturation 20% (15-55%)
TSH 3.5 (.45-4.5)
Ferritin 110 (30-400)

Anything stand out? I had then test my iron and ferritin as I read the thread see some of us may be deficient. After reading that thread I started eating beef liver, so if this was a cause of my fatigue before I guess its normal now. I also decreased my sodium intake from about 10g to 7g. I don't try to eat that much but its what MFP calculates it at so thought that was high, cut back on water too. Overall I don't think anything suggests I have a tumor or kidney issues since sodium is fine. I do feel much better lately after adjusting sodium and water just wanted to get some other opinions as I know people here are very health conscious.

I've experienced strong lethargy on 2 occasions so far.

Once when I pissed out too many electrolytes and they were all out of whack by drinking way too much fluids. I was drinking around 10l of total fluids per day then. But 6l is still too much so if you're still doing that... Either lower it or take extra electrolytes to compensate.

The second occasion is basically my standard state with high AAS-dosages. I don't know if it's the hormones themselves that cause the lethargy or whether it's a byproduct of having thicker blood or something related.

My second occasion doesn't apply to you so I would look into my first.

Have you tried supplementing with electrolyte formulas from the pharmacy? You should be able to get those without a prescription and it's probably worth the shot...

 

[jeroendebleser]

I be curious to see what your free t3 is. THS of 3.5, while in range on labwork, is actually a little high. There was a group of endocrinologist at one point that wanted the top end range of tsh to be 3. It used to be 6. Too many people show hypothyroid symptoms with tsh above 3. As you pointed out, free t4 is low, barely but is. Hypothyroidism can cause high prolactin, and also cause insulin resistance, blood sugar issues. Maybe it's just from the gh.

I've had undiagnosed Hashimoto's for years (so hypothyroidism) and I never experienced lethargy or at least not lethargy that makes you want to nap half of the time like I've had in the 2 instances I mentioned in my previous post.

I'm not saying you're wrong just to be clear, just that I deem hypothyroidism unlikely as the cause.

QB how bad is your lethargy?

 

[Bleed]

How many days a week do you workout? How long are your workouts? Cardio? How much and what type?

 

[qbkilla]

I only take caffeine pre workout, an energy drink. Sleep is Good I can always pass out but always wake up prior to my alarm. The lack of energy wasn't really sleepy just kinda unmotivated, fatigue, take forever to go in gym after parking, just sit there, hard to describe. But now that I cut back on water and cut my sodium intake from 10g to 6 or so, feel way better. Also started the beef liver a while ago after noticing on mfp I get little iron, so maybe I was getting too little. I had already started making sure I got enough iron before the ferritin test so maybe it was low before?

But dietary iron, less water, less sodium has me feeling Normal just now hoping nothing alarm is present in my blood work but nothing looks too crazy indicating a tumor or kidney problems.

 

[qbkilla]

I've had undiagnosed Hashimoto's for years (so hypothyroidism) and I never experienced lethargy or at least not lethargy that makes you want to nap half of the time like I've had in the 2 instances I mentioned in my previous post.

I'm not saying you're wrong just to be clear, just that I deem hypothyroidism unlikely as the cause.

QB how bad is your lethargy?

It was pretty bad for a while, it was the sort of lethargy you feel when dieting extremely hard very low calories for a long period of time. The only difference not quite as severe and no loss of libido like extreme dieting.

Not sleepy per day more "I just pulled up to the grocery store don't feel like getting out of my car to go in" "just finished bicep curls ughhhh I have to walk across the gym to the next machine" almost like a lazyness.

But I'm just now feeling better I honestly think maybe eating 10g of sodium today was making me piss so much my numbers were low?

 

[qbkilla]

I've experienced strong lethargy on 2 occasions so far.

Once when I pissed out too many electrolytes and they were all out of whack by drinking way too much fluids. I was drinking around 10l of total fluids per day then. But 6l is still too much so if you're still doing that... Either lower it or take extra electrolytes to compensate.

The second occasion is basically my standard state with high AAS-dosages. I don't know if it's the hormones themselves that cause the lethargy or whether it's a byproduct of having thicker blood or something related.

My second occasion doesn't apply to you so I would look into my first.

Have you tried supplementing with electrolyte formulas from the pharmacy? You should be able to get those without a prescription and it's probably worth the shot...

I was drinking Gatorade and using plenty of salt but never used the pharmacy ones.

 

[qbkilla]

How many days a week do you workout? How long are your workouts? Cardio? How much and what type?

I tend to switch routines, no switching of routine really ever made it worse and weeks off didn't help

Currently the DC Instagram split

Chest with some tris and delts
Bis and rear delts
Legs and traps +30 Min stepmill in the am
Off (cardio 45 min elliptical)
Delts/tris
Back and a set of his
Off (cardio 45 min)

If we count a rest pause set as 3 sets, about 8-10 sets per body part per week. So intense but low volume. 120 min cardio a week

Diet
Workout days 350/250/80
Off days 350/40/90

Eggs, beef, beef liver, turkey, fruit, rice cakes, mushrooms, fish oil, casein, Greek yogurt, almond milk , walnuts are food sources

 

[pickapeck]

I only take caffeine pre workout, an energy drink. Sleep is Good I can always pass out but always wake up prior to my alarm. The lack of energy wasn't really sleepy just kinda unmotivated, fatigue, take forever to go in gym after parking, just sit there, hard to describe. But now that I cut back on water and cut my sodium intake from 10g to 6 or so, feel way better. Also started the beef liver a while ago after noticing on mfp I get little iron, so maybe I was getting too little. I had already started making sure I got enough iron before the ferritin test so maybe it was low before?

But dietary iron, less water, less sodium has me feeling Normal just now hoping nothing alarm is present in my blood work but nothing looks too crazy indicating a tumor or kidney problems.

Have you considered that you might have lon COVID or Epstein Barr? Both of these are relatively prevalent right now.

 

[pistonpump]

I've had this before from a m1t only cycle... 10mg a day I couldn't even walk a quarter mile to the gym

 

[pistonpump]

BTW what are u on it could be a compound/dose making u feel that way

 

[jeroendebleser]

It was pretty bad for a while, it was the sort of lethargy you feel when dieting extremely hard very low calories for a long period of time. The only difference not quite as severe and no loss of libido like extreme dieting.

Not sleepy per day more "I just pulled up to the grocery store don't feel like getting out of my car to go in" "just finished bicep curls ughhhh I have to walk across the gym to the next machine" almost like a lazyness.

But I'm just now feeling better I honestly think maybe eating 10g of sodium today was making me piss so much my numbers were low?

That's very probable yes.

I would also check your other electrolytes just to be sure because they can also be affected by too large a fluid intake.

 

[Bleed]

I was wondering if you were overtraining, it doesnt look that way but you may need to try upping your calories on your off days. Doesnt seem to be gear or training related and I dont remember you saying you had issues with rest.

3000 calories "sounds" like a decent amount and it might be for most people your size but you seem from your posts to have ectomorph traits. Regardless of whether you are trying to get huge or not, your baseline calories may not be enough. If you're training DC and getting progressively stronger every workout, you almost have to up your calories.

Just spitballing but if your goal is to be lean all your round, sticking to a strict diet and training DC and getting stronger may be the culprit.

Maybe try upping your calories and see how you feel, optimally on your off days. Just a thought. Maybe try doing all your cardio and lifting on the same days so your off days are your off days. Im doing an hour of cardio 6 - 7 days a week (seems like a lot but it keeps my bp and rhr just about perfect even while on and I feel great) but I have two days a week where I eat a couple cheesesteaks, burger/frys from 5 guys, go to steakhouse and get whatever, or smash a couple bowls of ramen with fried chicken, and/or the occasional large pizza. I think if you something like this you would be better off (maybe not as much cardio if not needed and not so much food you get sick).

TLDR: I think your issue is calorie/training related.

I tend to switch routines, no switching of routine really ever made it worse and weeks off didn't help

Currently the DC Instagram split

Chest with some tris and delts
Bis and rear delts
Legs and traps +30 Min stepmill in the am
Off (cardio 45 min elliptical)
Delts/tris
Back and a set of his
Off (cardio 45 min)

If we count a rest pause set as 3 sets, about 8-10 sets per body part per week. So intense but low volume. 120 min cardio a week

Diet
Workout days 350/250/80
Off days 350/40/90

Eggs, beef, beef liver, turkey, fruit, rice cakes, mushrooms, fish oil, casein, Greek yogurt, almond milk , walnuts are food sources

 

[qbkilla]

I was wondering if you were overtraining, it doesnt look that way but you may need to try upping your calories on your off days. Doesnt seem to be gear or training related and I dont remember you saying you had issues with rest.

3000 calories "sounds" like a decent amount and it might be for most people your size but you seem from your posts to have ectomorph traits. Regardless of whether you are trying to get huge or not, your baseline calories may not be enough. If you're training DC and getting progressively stronger every workout, you almost have to up your calories.

Just spitballing but if your goal is to be lean all your round, sticking to a strict diet and training DC and getting stronger may be the culprit.

Maybe try upping your calories and see how you feel, optimally on your off days. Just a thought. Maybe try doing all your cardio and lifting on the same days so your off days are your off days. Im doing an hour of cardio 6 - 7 days a week (seems like a lot but it keeps my bp and rhr just about perfect even while on and I feel great) but I have two days a week where I eat a couple cheesesteaks, burger/frys from 5 guys, go to steakhouse and get whatever, or smash a couple bowls of ramen with fried chicken, and/or the occasional large pizza. I think if you something like this you would be better off (maybe not as much cardio if not needed and not so much food you get sick).

TLDR: I think your issue is calorie/training related.

Its hard for me to figure my body type. I can gain weight easily or lose weight easily by small adjustments in calories. I have no troy losing fat, but I can also gain weight very easily just fat much more quickly than muscle even with gradually increasing calories and eating clean. If I wasn't so into staying lean and ate when hungy id be much bigger heavier and fatter. Maybe constantly being below my setpoint is part of it. But I definitely will bump up calories a bit, maybe dosage a tiny bit so those calories are more likely to be used vs stored as fat

 

[Bio]

Have you done a sleep study?