T Nation

22 Year Old Considering TRT After Steroid Abuse

#1

Hi guys, after reading many topics on this forum for a few years, I have decided to talk about my situation. I am 22 year old male who used steroids two years ago. My first cycle consisted of Test E 500mg for 12 weeks, I made good gains and I recovered quickly without any symptoms of steroid induced hypogonadism.

Two months after PCT ended, I began another one consisting of Test E 500mg/week and Tren ace 400mg/week for 8 weeks. But this time, in the middle of my cycle I lost my libido and had severe ED even though i was using arimidex 0.5mg twice a week and cabergoline to control estrogen and prolactin.

When this issues began, I immediately decided to drop everything and began pct for 6 weeks with clomid. After PCT ended, I was feeling horrible with fatigue, depression, mood swings, low energy, lack of libido, severe ED etc. So I decided to go and do some blood work and thats when i discovered that i was still very suppressed.

02-AGO-2017


FSH 3.38 mUI/ml Range: 1.4 - 18.1mUI/ml
LH 2.23 mUI/ml Range: 0.5 - 5.3mUI/ml
Prolactin: 1.71 ng/ml Range: 2 -18 ng/ml
Testosterone 158 ng/dl Range: 41 - 827ng/dL
Progesterone 0.66 ng/ml Range 0.28 - 1.22 ng/ml
Estradiol 39.3 pg/ml Range 0 - 39.8pg/ml

After I got this results, I went with an endocrinologist. He prescribed nebido 1000mg every 8 weeks. At the beginning i felt pretty good, libido and erections coming back, mood was more stable, energy levels increasing, but after a few weeks i got massive bloating, mood swings, low libido and soft erections. So I tested my hormones and my results were:

16-JUL-2018

FSH 0.84 mUI/ml Range: 1.4 - 18.1mUI/ml
LH <0.07 mUI/ml Range: 0.5 - 5.3mUI/ml
Prolactin: 18.18 ng/ml Range: 2 -18 ng/ml
Testosterone 878.46 ng/dl Range: 41 - 827ng/dL
Progesterone 1.0 ng/ml Range 0.28 - 1.22 ng/ml
Estradiol 95.5 pg/ml Range 0 - 39.8pg/ml

T4 total: 8.13 Range 5.1 - 11.2µg/dL
T4 free: 1.20 Range 0.73 - 1.55ng/dL
TSH: 1.43 Range Range 0.4 - 4.0µUI/mL
T3 total: 88.98 Range 59 - 155ng/dL
T3 free: 2.80 Range 0.4 - 4.0µUI/mL

DHEA: 384.0 ug/dL Range 80 - 560 ug/dL
DHT 47 ng/dL Range 30 - 85 ng/dL

I had a conversation with my endo and he told me that my elevated estrogen was normal and that there was no need for an AI.

Because of the amount of side effects I was getting from the increased estrogen, I decided to get off TRT and see if I could recover my endogenous test production. weeks go by after my last injection of nebido and I noticed a complete loss of libido, mood fluctuations and lack of energy. I had morning erections and the overall ability to get an erection was present.

Despite the low libido, mood problems and lack of energy, I thought that overtime it would be alright but it has been 15 months since my last nebido shot and i am having the same symptoms i had when i stopped nebido

  • low energy
  • libido is completely absent
  • mood swings
  • dificulty concentrating

These symptoms are not as bad as coming off tren but still, I don´t feel normal. Morning erections are present and getting it up is possible only with physical stimulation. I don´t remember when was the last time i had a random erection and I am worried because a feel like my libido is never coming back.

My latest labs are

16-MAR-2019

Total testosterone 411.02 Range 118 - 948ng/dL
SHGB 35.47 nmol/l Range 10.7 - 69.6 nmol/L
Free Testosterone 7.62 ng/dl Range 9 - 30ng/dL
Free Testosterone % 1.85 Range 2-3%
Bioavailable testosterone 198.5 Range 110 - 575 ng/d

T4 total: 8.60 Range 5.1 - 11.2µg/dL
T4 free: 0.89 Range 0.73 - 1.55ng/dL
TSH: 2.03 Range 0.4 - 4.0µUI/mL
T3 total: 85.08 Range 59 - 155ng/dL
T3 free: 2.04 Range 0.4 - 4.0µUI/mL

HbA1c 5% Range 4 - 6%

CBC and metabolic panel are normal

I have researched a lot about my situation but would like to know what you guys think about the labs and if they could be related to my symptoms. I am starting to think that i should go back on TRT and control my estrogen so it doesnt go up like the last time on nebido. My diet is super clean and I have tried many natural supplements like ZMA, vitamin D and gingseng.

Thanks

Sorry about my english, I am not a native speaker

Test Cycle at 17, What's The Worst That Could Happen?
#2

You doctor is a wrong and you have been quacked, elevated estrogen can cause a lot of problems in men, soft erections, mood swings and low libido is common. An endocrinologist, this may be your problem as doctors in state healthcare systems or insurance based doctors treat everyone the same and cannot comprehend that everyone is biochemically unique, what works for one guy will cause another guy misery.

It never ceases to amaze me the lack of testing the free portion of testosterone, the free stuff circulating in the blood. SHBG should be tested and if SHBG is on the lower end, you would have a high free testosterone so targeting high total testosterone is a mistake and a reason for high estrogen.

Nebido isn’t very effective, it’s the least popular form of TRT do to the long half life not ideal for those who metabolize testosterone more quickly.

You need to seek private care because the western medicine and/or socialized medicine is filled with doctors who have no formal education or training treating men with testosterone deficiencies.

It’s not much different here in the US, here if you want to be working with a knowledgeable doctor, it will be done privately outside of mainstream medicine where TRT has existed for seven decades.

You obviously either need an AI which your endo is unable to prescribe do to narrow guidelines which do not allow for it or dosage needs to be decreased. If SHBG is low, simple solution is lower the dosage.

You need to prepare yourself for the fact you may never recover your HPTA, once men start having problems from steroid abuse, the HPTA is done.

#3

I would not beat myself up if I were you. What you did wasn’t crazy and a lot who did worse are doing fine. You did not stay on excessively, did some post cycle stuff, etc., hindsight is always 20/20.

No point rehashing the past, going forward, what now? I would look into TRT and include hCG in the protocol. Many have no trouble with E2 that high, but you may, and you may need to keep it down.

It sounds as though you may have trouble finding a doctor that can help you, which means you’ll need to learn as much as possible on your own. You will likely need underground sources as well. Good luck.

By the way, I would not have guessed that English is a second language.

#4

Thanks for your responses guys. You know, I actually took my latest labs to my doc and he said that my total testosterone was perfectly normal and, regarding my free testosterone, that there was no problem with it because my bioavailable was on range. He also said that, because I get morning erections and can get erected by physical stimulation, my problem was psychological. I have read a few articles stating that the testosterone threshold for having nocturnal erections is about 200 ng/dl and that the brain could have a higher threshold.

So I think that even if I get nocturnal erections, my testosterone isn´t above the threshold to exert it’s effects in the brain. This is just a hypothesis so I would like to know what you guys think about it.

#5

Hahahaha thanks. English is my second language but I began learning it since I was about 10 years old

#6

The cardiovascular risk is seen anything below 440 ng/dL, hard to get an erection when you have cardiovascular disease and/or metabolic syndrome. My erections start to become a problem for me when dipping below 500 and I cannot get an erection below 400. Any doctor that basis his entire decision on reference ranges is ignoring symptoms is an idiot.

Look at how many times the TSH reference ranges have been changed, it used to go all the way up to 10.0 before doctors would treat hypothyroidism. Now the ranges are .45-4.5 and now studies are showing these ranges need to be narrow yet again.

Medicine is always evolving and sadly doctors aren’t, correct information today is simply wrong needing a correction tomorrow. The reference ranges for thyroid and testosterone is still under debate, no one can agree on normal levels.

At the end of the day everyone is different and will experience symptoms at different ranges which is do to CAG repeat lengths ~ receptor sensitivity. Everyone processes androgens differently, the medical system brainwashes doctors and it’s almost as if these reference ranges are the word of god and symptoms are almost never considered because doctors are trained to ignore symptoms.

The internet can kill you because there is a ton of information out there that is simply wrong, someone could be in error, perhaps they are interpreting the data incorrectly which happens more often than not.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men. Poor sexual performance, decreased morning erection, and loss of libido had an impact on the testosterone threshold for CVD risk. The threshold level was higher in men with sexual dysfunction.

Testosterone and the Heart

However, there is no specific value that reliably distinguishes men who experience signs and symptoms of TD from those who do not nor those who will likely respond to treatment. Interpretation of total T concentrations is confounded by variation between individuals, variation in serum SHBG, and variation in androgen sensitivity.

1 Like
#7

I’ll take that for my signature.

#8

Thanks for that answer @systemlord, I know that not everyone feels fine at the same testosterone level. That’s why I am thinking on getting on TRT but this time controlling estrogen and using a better delivery method (gels/test e/test c) instead of nebido.

The reason why I am hesitant about getting on TRT is what if I increase my testosterone levels to lets say 800-900 with estrogen under control, and I keep getting the same symptoms, maybe proving that this is not organic but psychogenic. I would suppress my endogenous Testosterone again risking that I may not come back after, only to discover that testosterone was not the problem.

Also, do you think steroid use can increase the CAG repeat length? I have been researching this for a few days no, but I seem to find no answer.

#9

Just found some old labs I did two years before touching steroids. I was 18 years old when I did this tests

Free Testosterone: 5.5 pg/mL Range: 4.5 - 42.0 pg/mL
Testosterone Total: 357 ng/dl Range: 241 - 827ng/dl

And this is interesting because at that time I wasn’t experiencing any of the problems I am dealing with right now. So I would like to know if you guys have an idea about what happened. Did I become “resistant” to androgens from the use of test and tren and now my own low-normal natty levels aren´t enough?

Or maybe, at a younger age I could feel normal with a low-normal testosterone but after a few years of growing up, the low-normal testosterone is not enough to keep me functioning normal?

A little bit about my stats:
5ft 8
160 lb
11% bf
Sleep about 8 hours a day

#10

Steroid usage can decrease receptor sensitivity through down regulation, sometime the body in an attempt to protect itself and down regulate. Steroid use or AAS can fry you limbic system, alzheimer’s disease affects a portion of the limbic system and I often hear of similarities between AAS users and alzheimer’s disease patients symptoms match up. If you tipped your limbic system enough to far in one direction, you natural T production is never coming back.

Young men have an immature HPTA that isn’t fully developed and are more susceptible to permanent damage using steroids at a younger age than say a mature HPTA of someone over 40. The young men often do not recover like older men starting out optimising using very high T levels after a natural decline.

#11

Thanks @systemlord, I will be looking around for another Dr to consult with and try to get on TRT

Also, I made a mistake on my last lab tests, my free t3 is 2.01 pg/ml and the range is 2-4 pg/ml

So I think there maybe a problem with a subclinical hypothyroidsm, but I want to know what you think

#12

You don’t know the difference if you’ve always had low T. You did not become resistant. You did experience having plenty of test by running a cycle so now you know that your baseline sucked. If you only drive a Model T, you don’t know what it’s like to drive a Ferrari.

#13

That’s a good comment @hardartery, how do you know if you are optimal or suboptimal if you don’t have any point for comparison. If you don’t have anything to compare with, then you would think that you are alright.

Maaaybe if you are born with a very very low testosterone, you could feel something is wrong, but being in the low normal range all your life could go without unnoticed

Thanks for the input

#14

Those levels are not subclinical, you are full blown hypothyroid.

#15

Hahahahaha alright, my dr knows shit. I need to find a better one. Thanks, i will keep you updated guys

#16

What your doctor is doing is playing the numbers game, so he believes once you drop .2 points (1.99) for Free T3, all of a sudden symptoms of hypothyroid occur and this notion is absurd in the extreme.

You’re not a car with an idiot light that goes off when dipping out of range, you are biochemically unique individual that has his own biological setpoint where symptoms start to occur, symptoms together with labs are two tools doctors use to determine health status, but most doctors have no critical thought and only go by the numbers.

#17

I know, the last time he basically told me that everything was alright and that I should think that this is a psychological problem and not a hormonal one, and I was very doubtful about what he said not only about the thyroid but also about the free testosterone and total testosterone.

I often find myself fighting very hard to get out of bed every morning and can’t go through the day without caffeine. Also my hair is veeeery thin and if I remember correctly, a few year ago my hair was thick.

My nails are alright, not the typical hypothyroid nails but I always aaalways have dark circles under my eyes even after sleeping for 9-10 hours

#18

These doctors are the worst type, a very high percentage of men on SSRI’s suffering from depression and anxiety disorders have one or more hormones out of balance (testosterone & thyroid) do to prolonged stress levels from western civilianization, working late hours getting less than optimal sleep, poor diet and chemicals in the environment.

Your doctor just passes it off as psychological problem, this doctor is doing his patients any favors and I question why he became a doctor at all. He must feel completely worthless, what a loser!

He must feel powerless in his own life to live by such low standards, what a nobody and I doubt anyone will remember him when he is no longer here with us.

#19

I Completely agree, it is so frustrating to look at my values and everything is either low or low normal, and have a dr say that there is nothing wrong and that the problem is not from a hormonal cause.

I will be looking for another Dr and hope that he will not only look at the numbers but also at my symptoms

#20

Most sick care doctors only go by the numbers, it’s easy, lazy and gets them through 8 hours of non-stop patient visits. If you look at the population at large, most adults are lazy always looking for the shortcut in life.

The path of least resistance.

A private practice doctor can affect greater change in his patients since he only operates on a cash basis, no insurance companies looking for ways to refuse payment for services or wondering if insurance will cover treatment.

If you doctor believes insurance company will refuse treatment, he will tell you it’s a psychological problem just to get rid of you.