Kyphosis, Osteoporosis, Testosterone and lifting

Hi,

Sorry up front for any typos, long message created on cell phone.

This is a very complex situation and I have some questions and would love you guys advice. I trust you and you’re smart! I’m not really excited to share all this but I want to provide a good history.

I have always had a very kyphotic posture, doing barbell training is actually improving this mightily but it is pretty pronounced when I Deadlift.
example here https://youtu.be/RDBMtyau3hU

So question 1 is, should I even worry about that or just keep lifting?

Now to the tough questions.
Let me provide some honest history;
I was diagnosed with primary osteoporosis at the age of about 35, 12 years ago. I am male, and there was no underlying cause found, other than I had vitamin d levels of about 15. I had t scores that looked like a 90 year old skeleton.

I know I have numerous genetic polymorphisms that give me scrappy absorption of vitamin d, and through testing every 3 months have found I need about 10,000iu a day supplement wise to stay in the 50-60 range where I feel best.
I was also a chronic alcohol user, basically on the GOBAD diet, from about 13-23. I also was semi-homeless for much if that time and ate like Crap. So I’m sure this probably messed up my development and tanked my testosterone leading to my swiss cheese like bones.

I also smoked, weighed about 120 pounds at 5’11 and was never athletic past about 15.

Okay, so at 40 I quit smoking, about 5 years ago I took up martial arts and received 2 yearly recast injections. T scores looked better, skeleton of 70 year old man. At this point I’m probably 225 and fat.

Then after about 18 months of bouncing around with things like stronglifts and finding SS my last dexa scan shows my t scores are mildly below normal, just at osteopenia range. I’m about 220, still lots of fat and platueing at weak lifts.

So 8 months ago I went to the doctor as I was having some problems for a while, for which I was given cialis, which did nothing. Then after several testosterone tests in the low 200’s I was put on I/m test cyp at 100mg weekly self injected. My doctor refused to do a baseline test of anything else, I had read about estradiol, shbg etc but he wouldn’t do it. Anyway I try this out, suddenly I feel 1000 times better mentally. My penis works, which is always nice, but what I was never expecting is that now I’m calm, cheerful, positive etc.
It doesn’t magically make me bigger, stronger or faster but It does make my waist size go from a 38 to a 34 over 3 months with no change in diet or training. It also allows me to train 3x a week and recover instead of 2x.
Okay, six weeks ago I have my yearly check up and my hematocrit is 54, hemoglobin 18.6, trough test is 689. For reference my ranges are always just below threshold, e.g. 17.whatever and 48-49.

Doctor flips his lid and says I can’t use testosterone, or if I do it has to be cut in half. Then we will test it again in 6 months.
My response was can we cut it 25% and test it in 6 weeks? I told him I did a meta analysis and couldn’t find a direct link between increased red blood cells from test and stroke or heart attack, that I couldn’t find anything showing whether it was dose dependent and wondered if it was just the body adjusting and setting a new baseline, I have read it will come down or stabilize on its own. I also remarked I would be not willingly go back to feeling how I did 8 months ago.
He says " if you want to do anything other than stop, go see this endocrinologist, he’s smart."
So, I have been taking 60mg 1x weekly. I did my own labs last week, hematocrit was 50.1, hemoglobin 17.5, trough test was 530, free test was 24.3 =4.5%, shbg 36.9, estradiol sensitive 33.2

I am seeing the endocrinologist next week. I turn 47 Friday. I am progressing slowly in my LP, I am 200lbs and about 20% bf. Had quite a bit of “shrinkage” but I have 3 children and 3 grandchildren so w/e I’m done.

If you guys can help with any of the following I am eternally grateful!

I need help and advice on what I should ask or expect of the endo?
What levels should be my target?
Any advice on trt protocol?
Does my current tx seem appropriate?
Should I try to seek an underlying cause at this point?
Any hope of kickstarting my own test at this point or am I stuck?
Does my dose seem appropriate?
Should I inject more or less frequently?
If I want to “be a beast” should I worry about fat aromatizing my test?
Do my numbers look okay?
What about the red blood cell thing? Is it even a concern?
What about just donating blood, does this solve the problem or jus mask it?

Okay, that’s a lot. If you can help thanks. If not I understand. Any other questions I will answer honestly.

Did you ever get your testosterone levels checked when you were initially diagnosed with osteoporosis at 35? Based on this history, it seems likely that you have been hypogonadal ever since then. You should first expect the endocrinologist to complete the evaluation for other causes of your hypogonadism and osteoporosis - it’s extremely unusual to be diagnosed with severe osteoporosis at that young of an age, especially in a male.

I would express your other concerns to the endocrinologist, who should be able to help you with the specific treatment protocol, target levels, and discuss prognosis for the future. These are not things I can provide you with individualized advice on through this forum. Elevations in hematocrit are common, and chronically elevated levels do increase the risk of cardiovascular and clotting issues, so many folks in this situation just donate blood and might be instructed to take a baby aspirin (though again, I can’t provide these specific recommendations to you without knowing more about you).

Your estradiol appears to be in a reasonable range, so I wouldn’t worry too much about aromatization for now. I would worry more about restoring normal bone density.

Austin.

Thank you.
I don’t ever remember them testing my levels then, which seems pretty stupid, but it is in the past. My bone density is my primary concern as well. I am guessing since it was already improving the testosterone will only help this process along.

I appreciate you taking the time to answer,. Hopefully my experience will help someone else. I understand you can’t provide all the answers I was seeking in this format, hopefully the endocrinologist is a good doctor.

Happy New Year!