T Nation

24 Y/O Pre-TRT Levels w/ ED & Depression. Thinking of Going Off


#1

Hey guys, im 24 and have ED for about 5-6 years where i’ve been unable to have proper enjoyable sex with a women. It’s been brutal and i kind of adopted a defeateist attitude to it and and my life.
Did some tests and saw i had low T so i’ve been on TRT now for 9 months and while my body composition and strength has gotten alot better, i still have ED where i can get like 60-70% hard and can barely maintain it for long.

I I went to a sports medicine clinic and got TRT through there (under the table kinda deal) and had one initial blood test done to check my levels where i did have low T.

Apart from the low T, is there anything else that stands out that could be the factor for my ED and ill health?

IGF-1 30.7 (15.2-46.9)
Test 9.5nmol/l (8.0 - 30.0)
PSA 0.49ug/l (<2.51)
DHEA-S 6.1umol/l (4.8 - 13.9)
LH 8iu/l (2-8)

Unfortunately these are the only results the sports medicine person had taken. In addition, i have a general haematology of whole blood results

I haven’t had any extra blood work in the 9 months ive been on TRT (i know :/) which is a dose of 250mg of cyp with 1mg of armidex the day of injection.

The first few months i had strong morning wood (first time since i was a teenager) but it subsided and now my erections are as weak as they used to be pre TRT. I’ve also been having hairloss issues with a thinning crown and receding temple as well at the moment and after 9 months, i’m yet to have a positive considerable change in my life to warrant to keep going with it.

i’m sorry that this is all over the place and i know i’m an idiot for not being more stringent in testing my own levels and being more aware, i really am an idiot! i wish i was on top of my testing and knew what was happening inside my body! Sorry about the long post!

tldr; Strong ED and mild depression and low T made me want to get on TRT. Are there any indicators on my pre TRT to levels to indicate any reason for the bad ED? or was more testing needed?

thank you so much


#2

Without post TRT labs, there’s no way for anyone to offer advice.

Estradiol, SHBG, Free/Total test, TSH, FT3, and RT3 all need testing. Until then, no telling where there problem might lie.

Based on the minimal testing your doc administered pre-TRT, and the fact that he hasn’t even tested you post TRT, I’d advise finding a new doc.


#3

Low T and high LH indicates that your testes stopped working. Nothing can be done about that unless there are surgically correctable vascular abnormalities. Did doc examine your testes?

Current TRT:
250mg T cyp one injection per week
1mg anastrozole at time of injections

For most guys, ~1mg anastrozole is needed for each 100mg T ester. So you can expect to now have high E2 and that would explain your current issues.

250mg is way to high for TRT, but you have done it. You now have high T–>DHT driving hair loss.

Suggest:

  • Self inject 75mg twice a week, subq with #29 1/2" 0.5ml insulin syringe, over upper leg.
  • .75mg anastrozole at time of injections or 0.5mg three times per week
  • 250iu hCG subq EOD to recover testes and try to recover fertility

How much have testes shrunk?
Do they have a dull 24x7 ache?

Labs: - after 4 weeks on above
TT
FT
E2 - needs to be able to resolve low E2 levels, depends on lab company
CBC
hematocrit - might be high now
FSH - only one time to screen for testicular caner, FSH should ~=zero
AST/ALT

Do not ignore the last paragraph.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.


#4

Something i found looking through some previous blood tests. I had a blood test done at the start of 2015 where i had prolactin levels of 396 mIU/L (45-375)… converted to ng/dl that’s 18.612 which is higher than the 6-9 range KSSman indicates in the stick. However, some studies i read indicate 20 to be the upper range…

Would this be something important to look into? either way i’m going to research this further.

edit: i responded to KSSman, but i did it through the reply option under his post so its waiting for moderator approval. Sorry about that!


#5

Need more labs like ksman suggested. Does your ED persist if watching porn or are you able to get an erection if watching porn?


#6

@Hostile
Yeah man it does. .I can only ever go upto 50-60% erect even with porn


#7

And is functionality close to 0% with a real woman?


#8

@Hostile
Nope, its about the same at 60% but dies down in a few minutes while im getting a blow job or am midst intercourse. Sometimes my erection during sex does go to 75% but only for brief time before losing it


#9

That’s good to know. I agree with ksman post. Also like he mentioned keep an eye on HCT/hematocrit.


#10

Hey KSman, thanks for the response. The first endo i went to who rejected me for TRT, and just said to use some viagra for my ED (which did not work), did check my testes and said they were fine

I do have serious shirnkage of my testes, very snug. However, i have had no pain or soreness from them. It’s been fine throughout.

I’m going to get blood tests done this week and hopefully i can post an update.

One problem though, my arimidex is in capsule so unfortunately i can’t split it. The sports medicine doctor only has caps i think.

I’m thinking of doing some PCT and going off it completely, restarting my system and kind of starting from scratch again. Maybe try clomid and or/ hcg to see how i respond before i start TRT again.

The main priority for me is my erection, or lack thereof, which has been really bad for my mental health and confidence. Ive had this issue since my late teens and has never gotten better. Has really prevented me from having consistent sexual relations due to lack of confidence. It’s brutal…

I am optimistic it can be fixed because early stage of TRT i was having great erections and i was over the moon! Wish i was more on top of my blood tests and took a more active interest in it… but i shall from now on!

thank you so much


#11

sorry about the new thread, my apologies

T 79.6nmol/l (12.0 - 31.9)
FT 3050pmol/l (260-740)
oestradiol 104pmol/l (<160)
SHBG 15 nmol/l (17-56)
prolactin 333 mIU/L (90-400)

TSH 3 mIU/L (0.5-5.5)
FSH 0.2 IU/L (1.5-9.7)
LH 0.1 iu/l (1.8-9.2)
cortisol 427 nmol/L (172-497)

Had my blood test yesterday in the morning in a fasted state.
Is my low SHBG something to worry about?

i’m going to do as you said KSSMAN and split my test dose to 75mg x2 weekly to reduce my DHT… i’m not getting the desired benefits from these levels in terms of my ED and muscle gain hasn’t ever been my priority anyways

i haven’t been able to get any hcG as of yet, but once i do i’ll start dosing that too. It might be a little expensive though, but i’ll try my best


#12

Low SHBG is often seen with diabetes. But some guys just are that way. High FT pushes SHBG down.

TSH=3.0 is a big problem. Not using iodized salt can be a reason.
Where are you located? Different countries supply iodine differently.

You need to post those oral body temperatures. Low thyroid function can create most of the same side effects as low-T. >>>>ED?<<<<

Are your outer eyebrows sparse?
Do you get cold easily?


#13

Your free testosterone levels are ridiculously high. 3050 is over three times the top end of the range. Dopamine plays a major role in libido. With a testosterone level that high, you are likely desensitizing the dopamine receptors in your brain. You ought to consider lowering your TRT dose. No good reason to keep your test that high. The body seeks homestasis for all hormones. When you raise one hormone(in this case, testosterone) to supra-physiological levels this will have negative effects on other hormones/neurotransmitters including cortisol, thyroid, and dopamine(all of which are necessary for libido).

Dr Romeo B. Mariano discusses the effects of testosterone and dopamine as well as the initial TRT benefits you experienced here:


#14

The biggest factor is elevated estrogens that can wipe out many of the perceived gains of TRT. Most men need an AI to manage E2. Many doctors are not aware. Guy feels great, month later it is gone. Reduce E2 and they feel great.

Thyroid function issues are extremely common with guys who come here. The articles focus on subtle changes seems minor in comparison. But in any case, almost all such problems are withing thyroid lab normal ranges and almost all doctors are clueless. The biggest single cause of impaired thyroid function is a lack of iodine and the fad to use natural salts is really a public health issue about lack of awareness in the general population.


#15

Agreed on the thyroid/estrogen. His testosterone levels, however, are similar to that of a small cycle. Continued elevation at supra-physiological levels will likely have negative effects on every other hormone in the body including thyroid, not to mention elevated hematocrit.


#16

@dabah2014 @KSman

Thanks alot for the responses! I really appreciate it!

The FT is unusually high relative to my TT, is there any correlation between this or no? I haven’t seen FT being this high at my doseages (250mg/ml per week) for other people. The desensitization of dopamine regulators makes sense…

I kept my doseages the same as i was before just for this blood test, but i am reducing my TRT from 250mg to 150mg as per KSmans advice. I just picked up my 29g insulin needles today… i shall do another blood test in a month to re-evaluate my levels

In terms of thyroid, i live in Australia and am unsure of my idoine levels. I should’ve got my idoine, T3 and T4 levels checked with this test but it slipped my mind! I’ll do the idoine patch test to check for now and buy some idioine supplements.

My outer eyebrows are actually sparse, and whilst i dont get cold easily, my feet get unusually cold as opposed to the rest of my body. Should i test my T3 and T4 and iodine as well? are there any additional tests i can do?

Thanks guys