I have a number of symptoms that are leading me to believe I am deficient in T, but then again it could also be due to regular alcohol intake and a  high level of physical exertion and sports every day. (wife is not happy and feeling neglected)

 

ok, so I have already accepted there is a problem, where is my next step? Is it to a hospital doctor and ask for a blood test; or a regular doctor who possibly cannot, or a pharmacist to buy something, or is there some other procedure to rule it out?

Go to the hospital for a check up and blood test.  Government hospitals are not expensive for that.

 

Don't try to guess the problem yourself... only wasting time.

You can't just walk into a government hospital and ask for T level. Have to see a doctor, who may or may not (quite likely not) order the test and refer you to specialist etc.

 

Consult a doctor specializing in this is my advice. If you want to save a bit of money get the lab work at a lab first and bring results with you and then buy any meds at an outside pharmacy.

 

While getting labs, and assuming one of the symptoms is fatigue, also get a CBC to rule out anemia.

 

Alternately you could start by getting an overall physical exam (all the hospitals offer packages) and ask them to add on T level to the bloodwork. That way you also exclude a number of other problems.

 

Where do you live?

 

 

Regular alcohol intake is known as "brewer's droop" for a reason. From personal experience, I can say my libido is certainly more active when I am abstaining.

Thanks for the replies. Yes I do have thr standard check up done every 18month or so but obviously the doctor would comment on deficiencies.

I am in Chiang mai, and the Rajavej is my local hossie, I dont want the full Check up just now, only this test or blood test.

Its not a brewers droop issue at all, well not the amount i drink but several things, fatigue, poor muscle build,lack of interest,unexplained aggressive reactions to trivial stuff, age, stress.

Understand you shoulddnt put 2+2 together but often cannot be helped.

 

6 hours ago, eyecatcher said:

Thanks for the replies. Yes I do have thr standard check up done every 18month or so but obviously the doctor would comment on deficiencies.

I am in Chiang mai, and the Rajavej is my local hossie, I dont want the full Check up just now, only this test or blood test.

Its not a brewers droop issue at all, well not the amount i drink but several things, fatigue, poor muscle build,lack of interest,unexplained aggressive reactions to trivial stuff, age, stress.

Understand you shoulddnt put 2+2 together but often cannot be helped.

 

Have them check for Vitamin B12. Thai diets do not include much beef, which is the only natural source. Pork, chicken and fish won't cut the mustard. Easily rectified with a supplement.

4 hours ago, Lacessit said:

Have them check for Vitamin B12. Thai diets do not include much beef, which is the only natural source. Pork, chicken and fish won't cut the mustard. Easily rectified with a supplement.

I didnt know that, i havnt eaten beef since I came here 7 yr ago as I dont trust it and the wife will not eat it.

 

But on a positive note I can fit more Yorkshire puddings on the plate.

 

Thank you

4 hours ago, eyecatcher said:

I didnt know that, i havnt eaten beef since I came here 7 yr ago as I dont trust it and the wife will not eat it.

 

But on a positive note I can fit more Yorkshire puddings on the plate.

 

Thank you

You're welcome. Like you, I had rarely eaten beef in Thailand for some years. I was quite surprised when my GP in Australia informed me I was B12 deficient. He then explained to me beef is the only source. Humourless doctor, but has the virtue of keeping up with all the medical information. He did also explain B12 deficiency can lead to diabetes, which is pretty scary.

I take a B12 supplement every couple of days, and my levels are back to normal. Should be readily available here.

Eyecatcher; not weird that you have not heard that beef is only B12 source; because it is not true; https://www.healthline.com/nutrition/vitamin-b12-foods

Cheers!

Yes, there are a number of sources, including eggs, dairy products, most meat and fish. In addition fortified foods (cereals, breads etc) are often fortified with it.

 

Except for vegans, one is unlikely to be B12 deficient due to inadequate diet, but as people age their ability to absorb B12 diminshes and they may become deficient despite adequate dietary intake.  Some intestinal conditions and autoimmune diseases will also cause that.

 

Easy to check B12 levels with a simple blood test and good idea for anyone experiencing unusual fatigue, mental fogginess, mood swings etc, especially if an older person.

 

Just looked at my last check up report...ouch 2 years to the day, need another.

re the blood tests.

This is the list of items that gets a result. I can pick out some obvious ones but is there anything relative to a testosterone or even the vitamins here or is it something i need to ask for.

And this one

liver function is important.......  liver enzymes, etc  ( done in most tests).  From what i see yours look good (within range)

Edited August 30, 20187 yr by rumak

4 hours ago, Sheryl said:

Yes, there are a number of sources, including eggs, dairy products, most meat and fish. In addition fortified foods (cereals, breads etc) are often fortified with it.

 

Except for vegans, one is unlikely to be B12 deficient due to inadequate diet, but as people age their ability to absorb B12 diminshes and they may become deficient despite adequate dietary intake.  Some intestinal conditions and autoimmune diseases will also cause that.

 

Easy to check B12 levels with a simple blood test and good idea for anyone experiencing unusual fatigue, mental fogginess, mood swings etc, especially if an older person.

 

With all due respect Sheryl, my GP in Australia does keep up with modern medicine and looks after me very well. The fact remains I became B12 deficient while living in Thailand with very little red meat intake. In contrast, in Australia I was eating beef  4 - 5 times a week.

Perhaps some information on the B12 contents of eggs, dairy products etc. relative to that of beef would give some perspective.

I can accept the ageing process would alter one's ability to absorb B12.

6 hours ago, eyecatcher said:

Just looked at my last check up report...ouch 2 years to the day, need another.

re the blood tests.

This is the list of items that gets a result. I can pick out some obvious ones but is there anything relative to a testosterone or even the vitamins here or is it something i need to ask for.

A check up package will not include B12 or Testosterone level routinely, you have to ask them to add it.

2 hours ago, Lacessit said:

With all due respect Sheryl, my GP in Australia does keep up with modern medicine and looks after me very well. The fact remains I became B12 deficient while living in Thailand with very little red meat intake. In contrast, in Australia I was eating beef  4 - 5 times a week.

Perhaps some information on the B12 contents of eggs, dairy products etc. relative to that of beef would give some perspective.

I can accept the ageing process would alter one's ability to absorb B12.

https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/

 

lists content for different foods. 3 oz of beef not much more than 1 cup of milk or 2 eggs. Fish has far more than beef.

 

As does 1 serving of fortified breakfast cereal (considerably more in some cases - depends on the amount of fortification). However I am not sure how well fortified cereals  are here in Thailand.

Zinc supplements might also help. Lots of zinc in pumpkin kernels .

High blood pressure also maybe a factor. Smoking obviously bad. Lots of sleep and reduced stress help. Exercise is good but not to the point of exhaustion.

 

Unfortunately, as you get older the machine ,like an old car , starts breaking down more. Lots of things can go wrong , this is just one of them.

 

As for alcohol. The damage from too much can go beyond brewers droop in as much as that in old age,the body can not bounce back like it used too.

Edited August 30, 20187 yr by Denim

9 hours ago, Sheryl said:

https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/

 

lists content for different foods. 3 oz of beef not much more than 1 cup of milk or 2 eggs. Fish has far more than beef.

 

As does 1 serving of fortified breakfast cereal (considerably more in some cases - depends on the amount of fortification). However I am not sure how well fortified cereals  are here in Thailand.

Sheryl, the table you have supplied does not support your claim. Liver and beef have at least 10 times the B12 content of foods such as milk, fish and eggs. Moreover, most steaks I have encountered are 6 ounces, not 3. The only food that is superior in B12 content are clams. Which are apparently popular as a Thai foodstuff, but not as part of farang diets here.

2 eggs are 0.6 micrograms of B12. That's a far cry from the 70.7 microgram B12 content of beef. One would have to eat more than 8 dozen eggs a day to match a single steak.

Edited August 30, 20187 yr by Lacessit

Lots of liver about, Nam Tok pork noodle soup often has a fair bit

3 minutes ago, scubascuba3 said:

Lots of liver about, Nam Tok pork noodle soup often has a fair bit

That may explain why Thais are not B12 deficient. I tend to avoid dishes with liver in them due to concerns with parasites. Probably an unwarranted concern, but we all have our phobias.

Edited August 31, 20187 yr by Lacessit

Sheryl, the table you have supplied does not support your claim. Liver and beef have at least 10 times the B12 content of foods such as milk, fish and eggs. Moreover, most steaks I have encountered are 6 ounces, not 3. The only food that is superior in B12 content are clams. Which are apparently popular as a Thai foodstuff, but not as part of farang diets here. 2 eggs are 0.6 micrograms of B12. That's a far cry from the 70.7 microgram B12 content of beef. One would have to eat more than 8 dozen eggs a day to match a single steak.

 

That 70 mcg is for beef LIVER not beef. Beef is only 1.4mcg vs 1.2mcg in 2 eggs or a cup of milk. Not much different. 

3 oz is considered a normal seving for meat. Of course someone might consume a double serving at once. They might also consume a 3 or 4 egg omelet or 2 cups of milk. The chart is comparing normal serving sizes.

 

Someone habitually consuming 6 oz portions if beef at one go is likely to run into problems with weight, cholestetol etc. Once in a while is OK but that is not a normal or recommended portion size.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

 

That may explain why Thais are not B12 deficient. I tend to avoid dishes with liver in them due to concerns with parasites. Probably an unwarranted concern, but we all have our phobias.

I didn't know about parasite risk but the liver is in thin strips and is always cooked through. I also like the blood in Nam Tok

55 minutes ago, Sheryl said:

That 70 mcg is for beef LIVER not beef. Beef is only 1.4mcg vs 1.2mcg in 2 eggs or a cup of milk. Not much different. 

3 oz is considered a normal seving for meat. Of course someone might consume a double serving at once. They might also consume a 3 or 4 egg omelet or 2 cups of milk. The chart is comparing normal serving sizes.

 

Someone habitually consuming 6 oz portions if beef at one go is likely to run into problems with weight, cholestetol etc. Once in a while is OK but that is not a normal or recommended portion size.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

 

The devil is in the detail. The table states Liver, beef, cooked. I would have thought the punctuation unnecessary unless it is specifying two foodstuffs. Beef liver ( unpunctuated ) would be the normal expression.

There is a blood testing lab on the North Side of the Moat, sorry cannot rmember name. It is on the Northeast section of the moat. They will do any test you ask for also get your estrogen levels checked.

You can google blood test chiang mai and this lab has a website.

1 hour ago, Lacessit said:

The devil is in the detail. The table states Liver, beef, cooked. I would have thought the punctuation unnecessary unless it is specifying two foodstuffs. Beef liver ( unpunctuated ) would be the normal expression.

The devil is indeed in the detail. You posted initially that beef is the only source of B12. People have taken the time to educate and you are still trying to prove them wrong or find fault when it was you who was initially wrong.

 

You might be best to say thank you to the poster and leave it at that.

 

On 8/28/2018 at 11:01 PM, eyecatcher said:

Thanks for the replies. Yes I do have thr standard check up done every 18month or so but obviously the doctor would comment on deficiencies.

I am in Chiang mai, and the Rajavej is my local hossie, I dont want the full Check up just now, only this test or blood test.

Its not a brewers droop issue at all, well not the amount i drink but several things, fatigue, poor muscle build,lack of interest,unexplained aggressive reactions to trivial stuff, age, stress.

Understand you shoulddnt put 2+2 together but often cannot be helped.

 

 

If you were in Bangkok I would suggest going to BRIA Labs.   

https://www.brianet.com/en/clinic/health-check-up-program/

32 minutes ago, Farangwithaplan said:

The devil is indeed in the detail. You posted initially that beef is the only source of B12. People have taken the time to educate and you are still trying to prove them wrong or find fault when it was you who was initially wrong.

 

You might be best to say thank you to the poster and leave it at that.

 

I'm relying on information given by my family GP. It would not be the first time medical opinions diverge.

Let me know when you've dismounted.

22 minutes ago, seancbk said:

 

If you were in Bangkok I would suggest going to BRIA Labs.   

https://www.brianet.com/en/clinic/health-check-up-program/

Haha yes thank you, I will save this post as a reminder so that when you are looking for something I will tell you where it is in Chiang Mai

38 minutes ago, eyecatcher said:

1 hour ago, seancbk said:

 

If you were in Bangkok I would suggest going to BRIA Labs.   

https://www.brianet.com/en/clinic/health-check-up-program/

Haha yes thank you, I will save this post as a reminder so that when you are looking for something I will tell you where it is in Chiang Mai

 

We are not the only ones reading this thread, it's quite possible someone is in Bangkok and would find the info useful, or that you might be coming to Bangkok and choose to have the tests done here.  

1 hour ago, Lacessit said:

It would not be the first time medical opinions diverge.

 

Measurable elements that make up food product is not opinion. It is measurable fact. Quite unlike the fallacies you are clutching to in this thread.

Edited August 31, 20187 yr by Farangwithaplan