T Nation

26 Y/O Need Advice


#1

-age 26
-height 6ft
-weight 150 lb
-I can grow a full beard slightly less thick on the cheeks. it grows pretty fast. i dont have a lot of hair on my body, just a patch in the middle of my chest.

-I was always skinny. at 22 i took ssris and gained 30 pounds. i lost them at 24 when i stopped the meds but i still retain fat on my belly and chest. I had a physical job so i was active all day but that fat still didnt go away. im skinny now with almost no ass but with belly and tits.

-health conditions, symptoms [history]
I havent been diagnosed with any health problems except depression, which I believe was misdiagnosed. I never felt any better on the drugs, in fact they made it worse.
When I was 19 I had no physical problems but had some social anxiety so I was isolating a bit after high school. I had no problems talking on and on with people i was comfortable with but avoided new social situations. I was prescribed Sertraline and Solian for depression supposedly but I didnt feel any different. I was however getting a lot of erections at night that wouldn’t let me sleep and it was taking forever to ejaculate.

After 3 months I stopped taking them cold turkey. That’s when all my problems started:
loss of spontaneous and morning erections, weak erection when i did get one, premature ejaculation in 20 seconds with no pleasure.
I rarely feel physical attraction and barely feel any emotions at all really. even my anxiety, I used to feel it as an emotion but now i dont feel it at all and just notice its physical symptoms. I don’t feel like a person anymore.
General weakness and fatigue, brain fog, extremely bad coordination and balance, can’t focus on anything.
I sweat excessively if I do anything: walk/laugh/get nervous/get hot/get cold/ sometimes even sitting doing nothing, and looking back it appears to get worse through the years.
I have a full head of hair but its about 30% gray and getting grayer.

I went back to the psychiatrist and visited 2 more since then each giving me more antidepressants but I havent had a single thing change over the years.

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
Sertraline
Solian
Venlaxafine
Tritticon
Depakine

–lab results with ranges
TT - 480 ng/dl 286-800 ng/dl
FT - 14.09 pg/dl 1-28.8 pg/dl
e2 - 26.9 pg/ml 26-61 pg/ml
prolactin - 303 µUI/mL 98 -456
progesterone - 85 ng/dl 22-140 ng/dl
acth -12.5 pg/ml 7.2-63.3 pg/ml
erythrocyte sedimentation rate 9 <15 (general doc told me to get this to find infection)
fsh 1.83 mUI/ml
lh 2.69 mUI/ml -they didn’t gave me references for males on these two. I’ll ask tommorow or order new tests from another lab if it’s necessary.

morning temp 98.06
afternoon temp 98.78

-describe diet.
I have a balanced diet, meat, rice, beans, potatoes, cereal, smoothies from a bunch of vegetables every day. not many sweets. I had gluten and dairy free diet for 4 months hoping it would stop my sweating but nothing changed.

-describe training
I never train. I used to have a physically active job but it wasn’t exhausting. last 3 months ive been sedentary.

-testes ache, ever, with a fever?
testes never ache but they are quite small. i once did a hand stand and noticed they went back into my body

-how have morning wood and nocturnal erections changed
I used to have morning wood every day and it would persist for a while not allowing me to pee. after ssris all erections faded for like 3 years when i started getting some half boners in the morning and theyd be gone as soon as id wake up. At the moment i get 70% erections like once every 3 days.

I really need help interpreting these results. I just want to at least know whats wrong with me.


#2

SSRI’s suck

Also see the things that damage your hormones sticky.

Oddly high oral body temperatures. Do we trust the thermometer? See of someone else scores 98.6 mid-afternoon.

You always use iodized salt?
Outer eyebrows sparse or full?

Odd to have ATCH and not AM cortisol - done at 8AM
Some adrenal imbalances can create unsteady body temperatures.
DHEA-S lab test and AM cortisol should be done.
Also test TSH, fT3, fT4 Please not T3, T4


Hyperprolactinaemia (which can lead to galactorrhoea, breast enlargement and tenderness, sexual dysfunction, etc.)

Please check all of those meds VS Wikipedia to look at adverse effects.
Could not find anything for Tritticon

Where are you located?

Is your thyroid gland enlarged, lumpy or sore?

You have secondary hypogonadism compounded with adversely high E2.
LH and FSH are low. FSH is a better measure of LH itself.

E2 can be high from liver issues, test AST/ALT or drugs that interfere with E2 metabolization in the liver by making demands on the same enzyme pathways that clear estrogens. Elevated E2 makes symptoms of low T worse and can create significant mood/depression issues.


#3

Hi, thanks for the reply. I’ve done more tests.

cortizol 552.3 nmol/L 133 - 537. done at 8 am
dhea-s 414.1 µg/dL 160 - 449
tsh 2.25 µIU/ml 0.35 - 4.94
ft3 5.4 pmol/L 3.4 - 6.8
ft4 18.5 pmol/L 10.6 - 22.7
ast 19 U/L <50
alt 21 U/L <50

I took my temp with 2 thermometers at the same every day since my last post. They both gave the same result. all taken at 7 am and 15:30, no drinking/eating etc before.

day 1 : 97.8 98.48
day 2 : 97.7 98.24
day 3 : 97.7 98.4
day 4 : 97.7 98.4
day 5 : 97.7 98.24
day 6 : 97.8 98.65 this was the day i took the blood test
day 7 : 98.06 98.9 today

so pretty unstable temp.

my eyebrows seem normal. not as thick on the outer edge but not non-existent either. my thyroid never hurt or gave me any sort of discomfort. its not enlarger or sore.
All my salt is iodized. Should I still give iodine replacement a try?

I live in eastern europe. I’m not sure how endos are since i’ve never seen one but medical care in general is sub par.I’ll schedule an appointment anyway to see about that high cortizol(he’ll probably dismiss the rest)
I asked my general doctor about my previous tests and symptoms and she said everything is in range and that I’m young and should stop worrying, even though i can barely function.

Thanks again for taking time to respond.


#4

Thyroid: TSH is too high, but perfect if you are a doctor. fT3 and fT4 are very good and body temps are looking good too. So why is TSH elevated implying that the thyroid is struggling a bit to get the job done. Possible issue if not getting enough selenium. Do you use vitamins that list iodine+selenium? Selenium is essential for proper thyroid function. Selenium deficiency can lead to inflammation then auto-immune conditions.

Your lack of energy does not seem to be from thyroid, there is good fT3 and body temperatures are decent. So while you could add a little iodine+selenium, I do not thing that it would resolve your problems.

Both DHEA -S and cortisol point to perhaps unusual adrenal activity.
Please explain if any of these apply to you:
everyday stress
acute illnesses
chronic illnesses
inflammation
allergies
blows to the head
accidents
surgeries
loss of employment
relationship problems
deaths in family or associates
etc

Stress is hard on the adrenals. Cortisol increases, but later on, the adrenals get worn done and cortisol levels can go down and rT3 can increase.

So thyroid is not an obvious source of fatigue and cortisol levels are not low. So I do not see a clear reason for what wrong. DHEA-S and cortisol do suggest an adrenal connection where perhaps the adrenal gland many not be the problem, but perhaps a victim of stress.

Any weight gain/loss lately?
Describe body shape and how it has been changing?

Drug side effects do linger as a concern.

Please read this and explore some of the links concerning high cortisol levels.
https://en.wikipedia.org/wiki/Cortisol#Disorders_of_cortisol_production


#5

I do have everyday stress but it is because of these issues. My problems started before my stress. I have loss of employment and relationship problems but these are recent where as my issues are almost 7 years. I quit my physical job and isolated myself because I had trouble performing basic tasks and felt ashamed. I would get some bursts of energy when I would work but after I would be very fatigued. maybe its a reinforcing cycle i dont know. I do not feel worse or better than when I was working.

I match some symptoms of Cushings specifically the sweating and Cognitive conditions, including memory and attention dysfunctions. I have some fat under my chin but no moon face. I also got a few stretchmarks when I got fat from SSRIs 4 years ago. Fat went away 2 years ago when i stopped the meds and my weight has been stable ever since.

My body is thin, skinny with fat only on belly, chest and a bit under chin.

My biggest fear is that its just SSRI side effect because I dont know what I can do about that.