Rundown of a new person's situation

infoseeker

New Member
OK, pcgamer was nice enough to respond to my question about two people I don't even really know from a message board. Now I'll go into why I'm interested in this subject in the first place. I tripped over this board looking for detailed lab information. I get frustrated by others implicitly trusting their lab and not even understanding what the numbers mean. I'm detail-oriented and a bit of a science-head.

Now, let me first say that my husband (and me) are not athletes or body-builders or anything. I don't know if it's OK to post here as just a person from the general public or if you try to keep this board to serious athletes or something. Now, that said, he's really large and I don't mean fat (well, he is fat and knows it and is losing the fat; already lost a large amount of weight in the past and is now working on the last estimated 40 lbs.) Body build is not a trivial detail, so that's why I'm mentioning it. He's got a large frame, large bones (not biggest in world, just large) and muscular build also, without working out. You know - some have more muscles to start with, even if they don't particularly cultivate the muscles... for example, his doctor said at his recent exam - "What's up with your legs? You look like Terrell Suggs"(Ravens football player.)

So he's having a problem millions of other men across the country are having - difference being that he's doing something about it instead of saying, "Guess I'm just old and fat like everyone else, oh well, it's my destiny." Familiar sad story I'm sure you've all heard of) overweight, (about 40 lbs. needed to lose), type 2 diabetes or perhaps just pre-diabetes by the diagnosis for which he is now on Metformin XR 1000 mg once per day, for two weeks now (been monitoring his own blood glucose for two months before even going to see the doctor and doing everything he can with diet and exercise, the doctor was impressed since most of his patients are not nearly as motivated), and libido and erectile problems (what else gets a man's attention and sends him to the doctor like that one does?!?!) as of only the last six months; specialized lipid panels and testosterone level pending right now. Wouldn't you know it, the doctor only wrote "testosterone level" on the lab slip, which I assume means only a total will come back, nothing else.

The doctor is a lipidologist, by the way, in internal medicine practice. HIs specialty is blood lipids and prevention of cardiac disease, so I think he's pretty familiar with the entire endocrine system, which is all interconnected, of course. I don't believe any T meds are under consideration, even though labs are still pending; I'm thinking the doctor fully expects the T to be low considering the whole big picture.. now, you can correct me if I'm wrong, but my research tells me that correction of blood glucose levels and insulin levels improve sex hormone status, as does reduction of body fat (which produces estrogen - you can see I have at least a rudimentary understanding of these things, which, believe me, is more than the average Joe or Jane on the street who says estro what? Huh?), in particular, reduction of the belly fat. As the doctor said, which we already knew, the belly fat is basically the villian in all of this. He has lost weight, but SO SLOWLY through eating less than I do (a 5-10, 150 lb. female, and he's 6-1, 230 lbs., 45 years) and there's no doubt that fat's been lost, I can see and feel the missing layer of fat that used to cover the muscles, I touch skin and muscle now, not the same with thin covering of fat, but the progress is just so slow; the Metformin is supposed to kick-start the weight loss. Even his belly has shrunk but it's got a long way to go. It's the problem. His waist-hip ratio is not as bad as you'd expect for a fat guy, probably because like I said, he's actually got some muscles elsewhere, not one of those guys witht the balloon belly and no butt. His waist measurement is 43 and hips 44, so he's already at or below that 1.0 ratio and headed for the .95 they say is better; I don't imagine his butt has much room to lose much more fat but the belly will definitely deflate by a lot with continued weight loss. I know you guys (athletes) are thinking, "Whoa - fat guy for sure!" which is true and he knows it, but give the guy a break - he's only human and did ten years ago lose nearly 100 lbs. So he could have died of obesity years ago but chose not to take that path and while he stalled at 80% there for nearly the last ten years, he's determined now to take it all the way and get to "ideal" weight.

I don't mind being frank here; I'm not a babe in the woods or anything and being in a forum full of men does not bother me in the least so just speak as if I'm one of the guys. To give complete information, while of course my top concern and his top concern is overall health and longevity (avoiding a heart attack like his father just had probably due to total flagrant disregard of paying any attention whatsoever to his type 2 diabetes) the problems causing great stress between us for which he got motivated to go see a doctor were (in addition to diabetes symptoms like numb toes which has reversed as he's reversed his blood sugar problems) a libido prompting him to seek out sex probably less than one time per month, don't know how infrequently because he may have given in before really being truly interested, although he does demonstrate plenty of interest short of actually getting down to it, and a disturbing (to him) pretty sudden reduction in erectile function (not totally lost by any means but not the same as before and intermittently pretty bad) including telltale lack of or at least great reduction in the classic morning boners. The doctor, of course, says this is all pointing toward low T but the dr. is of course focusing on correcting the "metabolic syndrome" problems now to keep the man alive and then maybe next they'll look into the specific sex hormone aspect if it doesn't improve in lockstep with the glucose/insulin problems.

All right; wanted to sketch out the situation. Of course, both of us would bet money that the total T will come back low but I don't know, maybe it won't and there are other levels within the panel that wasn't actually done, that would point toward some of his problems. Any comments/input/advice is welcome.
 
Last edited:
infoseeker said:
OK, pcgamer was nice enough to respond to my question about two people I don't even really know from a message board. Now I'll go into why I'm interested in this subject in the first place. I tripped over this board looking for detailed lab information. I get frustrated by others implicitly trusting their lab and not even understanding what the numbers mean. I'm detail-oriented and a bit of a science-head.

Now, let me first say that my husband (and me) are not athletes or body-builders or anything. I don't know if it's OK to post here as just a person from the general public or if you try to keep this board to serious athletes or something. Now, that said, he's really large and I don't mean fat (well, he is fat and knows it and is losing the fat; already lost a large amount of weight in the past and is now working on the last estimated 40 lbs.) Body build is not a trivial detail, so that's why I'm mentioning it. He's got a large frame, large bones (not biggest in world, just large) and muscular build also, without working out. You know - some have more muscles to start with, even if they don't particularly cultivate the muscles... for example, his doctor said at his recent exam - "What's up with your legs? You look like Terrell Suggs"(Ravens football player.)

So he's having a problem millions of other men across the country are having - difference being that he's doing something about it instead of saying, "Guess I'm just old and fat like everyone else, oh well, it's my destiny." Familiar sad story I'm sure you've all heard of) overweight, (about 40 lbs. needed to lose), type 2 diabetes or perhaps just pre-diabetes by the diagnosis for which he is now on Metformin XR 1000 mg once per day, for two weeks now (been monitoring his own blood glucose for two months before even going to see the doctor and doing everything he can with diet and exercise, the doctor was impressed since most of his patients are not nearly as motivated), and libido and erectile problems (what else gets a man's attention and sends him to the doctor like that one does?!?!) as of only the last six months; specialized lipid panels and testosterone level pending right now. Wouldn't you know it, the doctor only wrote "testosterone level" on the lab slip, which I assume means only a total will come back, nothing else.

The doctor is a lipidologist, by the way, in internal medicine practice. HIs specialty is blood lipids and prevention of cardiac disease, so I think he's pretty familiar with the entire endocrine system, which is all interconnected, of course. I don't believe any T meds are under consideration, even though labs are still pending; I'm thinking the doctor fully expects the T to be low considering the whole big picture.. now, you can correct me if I'm wrong, but my research tells me that correction of blood glucose levels and insulin levels improve sex hormone status, as does reduction of body fat (which produces estrogen - you can see I have at least a rudimentary understanding of these things, which, believe me, is more than the average Joe or Jane on the street who says estro what? Huh?), in particular, reduction of the belly fat. As the doctor said, which we already knew, the belly fat is basically the villian in all of this. He has lost weight, but SO SLOWLY through eating less than I do (a 5-10, 150 lb. female, and he's 6-1, 230 lbs., 45 years) and there's no doubt that fat's been lost, I can see and feel the missing layer of fat that used to cover the muscles, I touch skin and muscle now, not the same with thin covering of fat, but the progress is just so slow; the Metformin is supposed to kick-start the weight loss. Even his belly has shrunk but it's got a long way to go. It's the problem. His waist-hip ratio is not as bad as you'd expect for a fat guy, probably because like I said, he's actually got some muscles elsewhere, not one of those guys witht the balloon belly and no butt. His waist measurement is 43 and hips 44, so he's already at or below that 1.0 ratio and headed for the .95 they say is better; I don't imagine his butt has much room to lose much more fat but the belly will definitely deflate by a lot with continued weight loss. I know you guys (athletes) are thinking, "Whoa - fat guy for sure!" which is true and he knows it, but give the guy a break - he's only human and did ten years ago lose nearly 100 lbs. So he could have died of obesity years ago but chose not to take that path and while he stalled at 80% there for nearly the last ten years, he's determined now to take it all the way and get to "ideal" weight.

I don't mind being frank here; I'm not a babe in the woods or anything and being in a forum full of men does not bother me in the least so just speak as if I'm one of the guys. To give complete information, while of course my top concern and his top concern is overall health and longevity (avoiding a heart attack like his father just had probably due to total flagrant disregard of paying any attention whatsoever to his type 2 diabetes) the problems causing great stress between us for which he got motivated to go see a doctor were (in addition to diabetes symptoms like numb toes which has reversed as he's reversed his blood sugar problems) a libido prompting him to seek out sex probably less than one time per month, don't know how infrequently because he may have given in before really being truly interested, although he does demonstrate plenty of interest short of actually getting down to it, and a disturbing (to him) pretty sudden reduction in erectile function (not totally lost by any means but not the same as before and intermittently pretty bad) including telltale lack of or at least great reduction in the classic morning boners. The doctor, of course, says this is all pointing toward low T but the dr. is of course focusing on correcting the "metabolic syndrome" problems now to keep the man alive and then maybe next they'll look into the specific sex hormone aspect if it doesn't improve in lockstep with the glucose/insulin problems.

All right; wanted to sketch out the situation. Of course, both of us would bet money that the total T will come back low but I don't know, maybe it won't and there are other levels within the panel that wasn't actually done, that would point toward some of his problems. Any comments/input/advice is welcome.


Hi!

Great informative post and "No", I don't think anyone here in the Mens Health board minds you being a woman. There have been other women post here as well as women bodybuilders over on the bodybuilding forum. Phil (pmgamer) is a good guy and pretty knowlegable as he has been dealing with his situation for a long time.

OK, in regards to your husband. You already know part of his problem. He is working on the weight and that is awesome he is losing. I would offer a couple of suggestion to help him out. The Metaformin will help him metabolize the sugar by allowing his insulin to work better. You did not mention if your husband exercises or not. Exercise can help tremendously in insulin resistant individuals. I would say maybe some very light cardio 2-3 days per week coupled with weights starting out if he is able to handle it. I would also recommend spreading his meals out to 4-5 small meals a day instead of 2-3 meals. The reasoning for my two suggestions are the following.

1. Exercise will help the body begin to use carbs and ultimatly sugars more efficently (Forgive my spelling) It will also help increase muscle which is more metabolicly active than fat.

2. Smaller and more frequent meals (2-3 hrs apart) will keep insulin levels from spiking. It will also help his body which is already having a problem metabolizing sugars process them more efficently.
It will speed up your husbands metabolism and help with weight loss.

I don't think drastically cutting calories is the best answer for your husband. There are at least two problem with this.

1. The metabolism will slow down. It will go in to starvation mode and store everything as fat for later use.

2. He may not be getting enough calories/protein to support his current muscle mass and may be losing muscle.

You are a science techie so, get on the internet and find a BMR calculator. Figure out your husbands BMR and this is roughly how many calories he uses sitting still. If you subtract 100 calories from this coupled with burning about 300 -500 calories with light exercise and the frequent meals this should help greatly with his insulin problems as well as losing weight quicker without sacraficing muscle.

It sounds like your husband has syndrome-X or metabolic syndrome. The symptoms of which are

1. Fat deposits especially in the belly.

2. Carb sensitivity

3. Insulin insensitivity

4. Pre diabetic condition

5. Hormone imbalance (High estrogen, Low testosterone)

6. Sugar cravings.

There are more but these come to mind.

We really do need to see the testosterone levels. You can use the test from your Dr. if it is low to suggest the following other tests.

1. Free and Total Testosterone
2. E2
3. SHBG
4. TSH.
5. LH
6. FSH
7. T3/T4

Syndrome X can cause lower testosterone levels in men as well has high estrogen due to the high levels of the aromatase enzyme from fat.

Men's testosterone levels also start to decline in their late 20's to early 30's and get lower as they age. Depending on his tests one might be able to deduct the reason for low testosterone but not always. If he continues to lose fat these levels could improve. If not then he might want to look at replacement. This all assumes he is low to begin with.

Being over weight can be linked to almost every deadly disease we get as humans. There is such a cascade of health issues that can happen when it come to being over weight and sedintary.

Best wish's for you and your husband. You are a good wife for taking the time to write and care about him.


Paul
 
Thanks - you guys are an excellent source of comprehensive information as well as seeming pretty nice, also.

You are completely right on the money, and we are lucky we found a great doctor. Actually, I hand-picked him, and don't chuckle, but the guy specializes in prevention of cardiac disease in menopausal women. He's on the cutting edge in that new field. Why would I send my husband to him? Well, he sees both men and women, and I figured that if he knows every in and out of female hormones and hormone replacement in connection with cardiac risks, he must be on the ball. He must know about men, too (no doctor operates in a vacuum and learns only about one little sub-specialty or one gender.) So I'm hoping he is sharp enough with the entire hormonal picture since after all, men or women, we're all human and have all the same hormones, only in different ratios.

One good thing in my husband's favor, regarding this "syndrome X" is that he does not have high blood pressure. I have to think that is a good sign. The dr. is a little worried about his high heart rate, though. Not worried enough to put him on meds for that yet but may if it doesn't come down.

Not specifically connected to syndrome X, but he also does not have protastatic hypertrophy. He was really keen on avoiding that test (finger) but it was done, felt like every organ was grabbed every which way, and the verdict was: no enlargement whatsoever. Don't know if that has to do with his probably low testosterone or not - etiology of prostate problems makes my brain hurt, to tell the truth, but thankfully it's a moot point. And the doctor said that's a good thing as most men by age 45 are starting to get a good bit of enlargement but he had none.

YES, I did completely forget to note that he does exercise. By that I mean brisk walking, usually pushing the 40 lb. kid in the jogging stroller, up and down hills, for 30 mins. - 1 hour per day. He does have weights, just the 15 lb. hand weights and uses them but not consistently. Not working out at a gym like I assume you guys do, but he's done that in the past and (not bragging, just being factual as all people are different, I'm pretty spindly for example) he says when he does so, it takes almost no effort whatsoever to bulk up muscles really fast - that's just his build.

I also have suspected that his calories are too little. Like I said, I'm slim enough, not a muscular person at 150 lbs. and almost 6 feet, but the amount he eats might make me keel over and faint, I'd be so hungry. I think that's about 1500-2000 per day and let me tell you, I consume more than that and don't gain. He does concentrate on protein, though, and limits carbs sharply.

I'll let you guys know when the test result is in. Probably on the doctor's desk right now. I'm sure if he asks for the detailed panel the dr. will order it, or he can always get it on his own but it would be nice for insurance to pay something on it. Thanks again!:
 
All right, after all my speculation (maybe I put it in the other thread - I blathered on in both threads) I don't need to speculate much anymore. Test results are in. Not surprised that there's an LDL cholesterol problem.

Other problem according to doctor: testosterone VERY LOW. And you guys know how sometimes the everyday docs can just blow off a number as "within normal limits." If he said it's very low, it's gotta be bad. I'm sort of sad to hear this, even though I was expecting it and otherwise would have wondered what in the heck is behind some of these complaints. I feel sort of knocked-over right now, feel worried about how/whether he's going to be treated correctly. He's not seeing the doctor till next week so we'll have time to mull all of this over. I may even direct my husband here.
 
Personally I see that as a huge positive!

Now you both know exactly what the problem is.
Now you can fix it.
 
infoseeker said:
All right, after all my speculation (maybe I put it in the other thread - I blathered on in both threads) I don't need to speculate much anymore. Test results are in. Not surprised that there's an LDL cholesterol problem.

Other problem according to doctor: testosterone VERY LOW. And you guys know how sometimes the everyday docs can just blow off a number as "within normal limits." If he said it's very low, it's gotta be bad. I'm sort of sad to hear this, even though I was expecting it and otherwise would have wondered what in the heck is behind some of these complaints. I feel sort of knocked-over right now, feel worried about how/whether he's going to be treated correctly. He's not seeing the doctor till next week so we'll have time to mull all of this over. I may even direct my husband here.
Ok next thing is to find out why he is so low. It can be a pituitary glaind problem this means his testis work just not getting the messages to make it. Or he can have Adrenal Fatigue so much can do this it all needs to be checked and at www.allthingsmale.com in the link TRT: A Recipe for Success the tests need and why are there. Dr. John is one of the best Dr. on low T around and puts a lot of his time on the boards helping men. His nick here is SWALE. All most all of he tests are blood work so he should find out why fast. If a pituitary problem then an MRI will show why.
Here is a link to the AACE Guildlines read this also.
http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf
And get the book by Dr. Shippen called "The Testosterone Syndorme" dam good book and a fast read.
 

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