T Nation

26 y/o, Help for SSRI Guy

Hi, I am 26 years old guy from Europe.
I failed to regain my true self after Anitdepressants therapy - both emotional and sexual side.
I am now 3 years without taking any AD or psych drug.
Missing my old self desperately. Below are my lab results, more detailed story below them. PLEASE HELP

ESTRADIOL 36,64 pg/ml (n:7,63 – 42,6)
FSH 2,5 mIU/ml (n:1,5 – 12,4)
PROGESTERONE 0,3 ng/ml (n:0,2 – 1,4)
PROLACTIN 9,4 ng/ml (n: 4,0 – 15,2)
TESTOSTERONE 3,21 ng/ml (n: 2,490 – 8,360)
SHBG 17,5 nmol/l (n: 17,3 – 65,8)

I am still waiting for lab results of Free Testosterone and DHEA

I was always super horny since childhood. Anxiety symptoms started since 13 Y/O, never had depression till changing environment to college life (19 Y/O) - doctor prescribed Prozac when I was 21 Y/O - he didn’t mentioned about Sexual Side effects and possible remaining PSSD.
Prozac helped with benzo use ocasionally in stressful situations (once per 1-2 month). I also tried some psychodelics in the meantime with SSRIs (not wise).
After 2 years I felt completely dead dick so I tapered off for 2 weeks and quit. Then tried to battle depression from diferrent angles – here is my drug history.

Prozac (09.2011-12.2013) - almost 2.5 years
Wellbutrin (01.2014-07.2014)- 6 months
Moclobemid (07.2014) - completely healed PSSD for 2 days, give me terrible nausea, had to quit
Nothing - 2 months/ Depression relapse
Brintellix/Wellbutrin (09.2014 - 04.2015) - almost 1 year of this combo to battle depression without sexual sides with no success
Brintellix (10.2015 – 01.2016) – Last contact with AD
FREE (01.2016 – TODAY)

My sexual dysfunction is not as awful as can be in some people after AD – I am still consider myself a sexual person. However it is like 30% of what it use to be. Main symptoms – premature ejaculation, super weak erections, weak orgasms, weak sensitivity (i can’t feel the tip of my penis). Also almost no sense of connection with other people especially females (no lust/spark). No Chance for long term relationship or normal sex life. My intimate relationships are no longer than one night stands. Of course problems with motivation and focus/memory. Something like other person living in my body. Problem get better with time for maybe like 5-10% (super super slow),I got one good window of symptoms free (60%) for one day, by that was all.

I am desperate to find a relief. My Tesotosterone is super low, so maybe that is a reason? Any feedback, advices, what I can do to help myself? I am tired of waiting, I want to love, have kids, be normal.

Good news: your testosterone level sucks. Use this to calculate free: http://www.issam.ch/freetesto.htm

Hint: it is low.

Also good news: trt will propably cure all your symptoms.

Bad news: there is lots to learn.

  1. research about E2 control (yours is pretty high to start)
  2. research testosterone injections
  3. research short intervall injection
  4. research about bloodwork
  5. find good doctor

Good luck!

Your testosterone is very low considering your age, you’re scoring is on par with elderly men and below 72 year old president Trump. It may be difficult to get treatment under state healthcare since they set the bar for TRT very low, then you would need to seek private care, balance my hormones in Dorset is a private clinic that has experience hormone doctors that do not exists in the state healthcare system.

Sexual arousal is dependant on many factors, one of which sex hormones are required, the penis requires adequate sex hormones otherwise it becomes soft and lifeless.

Testosterone injections is best, a lot of men fail to absorb enough T-Gel. Injection frequency is linked to your SHBG level, low SHBG men do much better on frequent dosing. My SHBG is 22 and I do better on injections EOD or everyday. I feel nothing from TRT on injections twice weekly.

I got my free testosterone results.

FREE TESTOSTERONE - 12,20 pg/ml (n: 4,5 - 42 pg/ml)

What you guys think?
Thanks for your help.
I am reading as much as I can. Already knew about different protocol with low SHBG

Also couple of questions:
Can you give me some info about estrogen control?
How dangerous is taking stuff like AI (arimidex) for the rest of my life?
How dangerous is HCG and can I build tolerance?
Optimal will be stay just on the Testosterone I guess.
Anything about fertility, that I should worry about?

It’s almost impossible that I will get TRT from the doctor, here in my country.
Anyway, Thanks for the good news, I hope everything will resolve.

There are a lot of unanswered questions about your health. Based on what you told us, though, it seems that all of the medications you’ve taken over the years ofucked up your hormones (low normal FSH, fT, and tT), but we cannot know that for sure.

I think you need more extensive testing, such as LH and a full thyroid panel, just to be sure, before going on TRT, especially if fertility is a concern
Of course, I would not know anything about treatment options in Europe.

A lot of people come on T-Nation asking other people whether they should do TRT. That’s a decision only you can make.

My suggestion would be to make sure your diet, sleep, and lifestyle are optimal before rushing into a TRT protocol.

Whatever you do, don’t rush it. Carefully research your options, possible side effects of TRT (including fertility), and costs. TRT is a lifelong therapy.

You’re only 26 years old. Yes, TRT may make you feel great again, but what if you come off it, you will feel like shit. Unless you’re absolutely not able to raise T levels naturally, I would hold off on TRT.

Hopefully someone else chimes in about the low FSH issue. I don’t know if this is something that could be remedied with HCG alone.

Thanks for your help. I will do thyroid panel and LH as soon as possible.
My diet is average, sleep is good and never had problems with sleep however I am partying quite a bit (mostly weekends) and I am staying late. But my results are far from optimal even with poor diet.

Also worth to mention that I have another results from 2 years ago, when I was strict PALEO diet, no partying, super healthy (no even 1 cheat meal) for 6 months and my results was similar (slighly higher TEST, PROLACTIN was above norm.)

Regarding feeling like shit - I am feeling like that past 4-5 years. And when I mean shit, I mean SHIT. So when I came off the TRT, I will be just as I am feeling now I guess. Some things in my life are almost unbearable and I can imagine someone commiting suicide in that state. Thankfully I am non-suicidal, taking care of my shit, have strong enough mental health. But it is far from my potential and what things used to be.

Of course I am making my own decision, no doubt. Just wanted to ask more advanced guys.
For example I would never knew (for sure will not get this knowledge from doctor) about low SHBG protocol If I was not be asking and reading.
So here is my another question - why it is not possible to come off from TRT to baseline levels?
Normal level people are doing cycles and they are coming off with no problems - on and on.
Where is a difference with TRT?

Possible to come back from trt, just unlikely symptom free. I do not believe that people can do cycles without symptoms.

And as time goes on one gets older --> T production will diminish slowly but inevitably.

Where do you live?

I am from Poland.

You mean that there will be another withdrawal effects when you come off?
Similar to SSRI’s?

Well, if we imagine that trt negates these symptoms you are now suffering from… When you stop trt those symptoms will most likely come back. And they might be or atleast feel worse if one has felt good some time.

Anyways if one starts taking exogenous hormones ones endogenous production will diminish. And it will take some time to restart, even with tamoxifen or other SERM.

Normal people don’t have low T to begin with though. They also use PCT to start their systems back up, and even then it’s a gamble.

Thanks for all contribution and help, best for all.

Today I got my DHEA results:

DHEA - 4,013 ng/mol (n:1,33-7,78)

I will go for Thyroid Panel this week.

And I have some more questions - summing up my current results it seems, that my hormone are not so bad despite super low testosterone and quite high estradiol. I’am obvoiusly an low SHBG guy. So it is possible that chronic SSRI treatment shut down my hormones production.

I’ve heard some testimonials about guy after PSSD, who did TRT cycle for 3 months and then PCT and his sexual function was restored to before SSRI state with no longer need for TRT, but he was high SHBG guy.
Maybe it is worth to try? In worst case scenario I will be back on TRT.
Is this kind of RESTART possible?

Also regarding the fertilty issues on TRT - what You people suggest:

TRT + HCG from the beginning?
or
TRT from the beginning and add HCG when I will be trying for kids?
or
TRT from the beginning and then off for couple of weeks with just HCG or PCT when I will be trying for kids?

I think it depends on the details. Back in the old days, weightlifters typically ran cycles of 6-12 weeks, some longer, but that was generally done and it would coincide with a competition cycle of 8-12 weeks. Guys would go off for 4-6 weeks between cycles, but sometimes up to 3-4 months “off season” or when there were no major competitions ahead.

I knew some who did 6 weeks on, 4 off, year round regardless of meet schedules, and some who would stay on for 8-9 months out of the year. All these guys were in their 20s and 30s. About the only “symptom” when off was being weaker than when on, that and some weight/size loss. Libido would be higher when on, but not crazy different than otherwise.

A cycle would usually start with anabolic steroids and testosterone would be added about a third of the way in. Of course, no one was checking labs, other than the occasional liver function tests.

I think a major difference is we are talking about guys with presumably normal to high normal testosterone levels. We felt good off steroids, we just felt better on. For lower test guys, they don’t. Normal for them is not good. So, when on test they feel good, only to fall back to where they were if discontinuing.

I think you should start with trt only. Example Sustanon 250 0.1 ml every other day. Go with that for 6 weeks. Then lab --> if problems with E2 get AI or lower trt dose. When everything dialed in and you are feeling good go for Hcg. That way is safer. I have done sustanon 1ml e2weeks + Ai + Hcg --> disaster. I also have very low shbg.