28 Y/O Male, Secondary Hypogonadism, HELP

Pharma / TRT Testosterone Replacement
1

I am 28 years old, and have been bodybuilding training consistently since the age of 18. In Summer 2011, I was diagnosed with Secondary Hypogonadism, which is still inexplicable to me because I have never taken any anabolic steroids or prohormones of any kind throughout my training career.

Age: 28
Height: 67"
Waist: 31"
Weight: 159lbs (current) (Normally) 165-170lbs

Body/Facial Hair: Endo/Mesomorphic body type, was chubby as a kid, I still cannot grow a full mustache or beard, I shave about every 36-48 hours

Body Fat: Normally I carry a small amount of fat in the lower abdomen and low back - since my hormones have been out of balance, I have lost about 8 lbs of LBM and body fat has increased in low abs, low back, buttocks, and outer pectoral areas.

Diet: My diet has always been very good since the age of 18. Plenty of lean proteins, healthy fats, and wholesome sources of carbs. I have done several bulking and cutting cycles over the past 10 years or so, and I have never had massive caloric deficits or anything that my body cannot naturally bounce back from. I have always taken the “slow and steady” approach.

My training has never been more than four days per week. I am currently performing basic full body training 3 days per week. I have used several programs over the years: Lyle Mcdonald, EDT, Will Brink programs, and various basic bodybuilding splits. My cardio training is usually pretty consistent at three 20 minute sessions per week. No more than 5 sessions per week when cutting.

Testes ache? No, Fever= No

Morning Wood/Erections: I used to always have morning wood and regular erections for all of my adult life until my diagnosis in mid 2011. When I was on TRT, morning erections and sex drive in general came back within a few weeks. Currently, I never get erections period and sex drive is low. Also, I seem to have to urinate more frequently, especially during the night.

I went on TRT (Axiron) in Summer 2011 and remained on until I joined the Navy in March of 2012. Before leaving for boot camp, I had the doctor give me 10 pellets of Testopel, which lasted about four months, enough to get me through boot camp and then begin to see the Navy’s doctors.

I went from June 2012 to September 2012 without any form of TRT and felt absolutely terrible on a daily basis, with testosterone bottoming out around 114ng/dL. LH and FSH were less than 1. One endo that I was seeing before I transferred stations prescribed me Androgel for 6 weeks, but then I saw another endo at my new duty station who took me off of it! I finally began to see an endocrinologist in October, who prescribed me 25mg of Clomid daily for 12 weeks. This was done to try and restore normal function of the HTPA.

Fast forward to the present. I have just finished exactly 12 weeks of Clomid at 25mg daily. This particular doctor that I am seeing never tested anything other than total testosterone, as other tests were conducted in the months prior. I will post all lab results that I have:

Testosterone (total) June 2012 = 221ng/dL
July 2012 (early) 140ng/dL
July 2012 (late) 114ng/dL
OCt 2012 (after being on Androgel for 6 weeks)
543ng/dL
Nov 15, 2012 233ng/dL
Jan 24, 2013 573ng/dL (after 10 weeks of Clomid

Free t4 Aug 2012 0.65 (.59-1.61 range)

Cortisol Aug 2012 13.9 (AM)

Prolactin Aug 2012 2

MRIs of the brain and pituitary were also performed - the results were normal with no sign of tumor

Iron/Ferritin labs were also performed to look for indication of hemochromatosis, the results were in the normal range.

Fast forward to the present-

I have just finished 12 weeks of clomid at 25mg daily with my latest testosterone lab reading 573ng/dL. MY MAIN PROBLEM IS THAT I CERTAINLY DO NOT LOOK OR FEEL LIKE WHAT THE TEST SAYS.

As of jan 24, 2013, The doctor states that my HPTA has restored and I will be fine, but I have yet to regain my sex drive, morning erections, lean body mass, and that unmistakable feeling of â??Alpha Maleâ??. I feel that I look â??softâ?? with noticeable increases in body fat in the low abs, low back, and pectoral area. My strength is not where it should be as well.

Also what I do not understand is how come when I was on TRT, my testosterone levels were right about what they are now, but I almost immediately began to regain my sex drive and lean body mass. Now after 12 weeks of clomid and my T at 573, I do not look like it or feel like it!!!

I asked the doctor about E2 levels, and he didnâ??t feel the need to test them. I have taken it under my wing to pay for it myself and will post those results as soon as I have them!
Any help and advice would be very greatly appreciated from anyone with experience similar to mine and/or knowledge of my case. Thank you.

2

For one your AM cortisol is low. You’ll want to also get your ACTH tested to give a better picture of what is (or isn’t) going on with your adrenals.

We’ll have to see where your E2 levels land as high or low E2 can cause the problems you are having. It also wouldn’t hurt to have your DHT tested as low DHT can cause low sex drive. There’s a good chance that your DHT was higher when you were on TRT and that was helping the sex drive along. Also, did you have your LH and FSH tested since getting off the androgel? It would be good to see if those numbers are better than before you started taking clomid.

Of course, getting the thyroid panel outlined in the “Labs” sticky would be good to see if anything is going on there.

3

Thank you for your input Catastrophe. I am going this week to have an E2 and thyroid panel performed. I will post results as soon as I have them and go from there. thanks again.

4

E2 while on a SERM [clomid, nolvadex] will not be the same when off.

Recovery is determined weeks after, not during.

A HPTA restart with a SERM requires that the SERM not be stopped suddenly, but tapered off.

Please read stickies:

  • advice for new guys
    – come back with more data
5

Thank you KSman and ctastrophe. I’ve got my lab results back on E2 and Thyroid Markers. Also I updated my opening thread with more info. Please take a look when you get a chance.

Feb. 7, 2013

Estradiol 19.5 pg/mL (7.6-42.6)

TSH 1.020 uIU/mL (0.450 − 4.500)

Thyroxine (T4) 5.8 ug/dL (4.5 − 12.0)
T3 Uptake 34% (24 − 39)
Free Thyroxine Index 2.0 (1.2 − 4.9)
Triiodothyronine (T3) 56 Low ng/dL (71 − 180)

Also I have begun to monitor morning and afternoon body temperatures. This morning I awoke with 97.2 temp. I will continue to monitor and post these as well. What do you guys think about the low T3? Could it be corrected with an iodine supplement? thanks

6

Read sticky ‘thyroid basics’

  • describe history of use of iodized salt and iodine in vitamins.

TSH looks good, but T4 and T3 should be mid range. We are more interested in fT3 and fT4 because T4&T3 bound to binding proteins is not active. Given the data so far, you appear to be subclinical.

Also need mid afternoon temperatures, oral, no talking, drinking eating, etc before hand.

7

I had always used iodized salt up until a couple of years ago. Then I switched to sea salt because I was under the impression it was a healthier option because it was “natural”. The past 12 months I’ve been in the Navy, so I pretty much use the salt at the dining hall. I have no idea if its iodized or not.

I have been taking NOW ADAM multivitamin every day for years. It contains 45mg of Kelp and 225mcg of Iodine from Kelp.

Temperature recordings over the weekend:
02/08/13 97.2(AM)
02/09/13 96.8 (AM)
02/10/13 96.8 (AM) 97.7 (early evening)

Also I am going to have some more labs done when I get paid this week. What labs would be the most beneficial other than fT4 and fT3 and RT3?

8

Try to get a mid afternoon temperatures as well.

Sounds like any iodine deficiency should not be too deep.

9

here are some more temperature readings:

02/11 AM 95.9? afternoon 96.8
02/12 AM 96.5

My body temp is definitely consistently low and I get cold very easily. Being that I now know that my total T3 is low, is it really necessary to perform a fT3 and RT3 test?

Also, I ordered some Lugol’s iodine solution and plan to dose the 12.5mg daily for a few weeks and see if anything improves.

Is it possible that legitimate hypothyroidsism can actually cause hypogonadism, which is what I was being treated for over the last year and a half?

10

Also, I have been off Clomid for one week now, at what point should I retest my testosterone levels? The doctor never tested my free testosterone, only total testosterone. I am wondering why have not yet begun to re-gain any of my sex drive, erections, or lean body mass, and it is becoming very frustrating at this point.

Please tell me what courses of action i need to take.

11

Lab work for LH/FSH while on SERM?
Tapered off of SERM?
Test in one month, body needs to find an end point in its balance.

Confirm that someone else can get 98.6 on the thermo used the same way.

12

Doctor never tested LH/FSH while on the SERM

I finished the SERM as instructed by the doctor - 25mg daily for twelve weeks, which was the exact amount that was given to me, so no, I wasn’t able to taper off.

I will re-test total and free Testosterone on my own in 3 weeks then. Thank you KSman. Also, i had fT3 and RT3 labs taken this morning, and I will post those results as soon as I have them. Thank you again sir.

13

Somethings are just too complicated for docs to understand.

14

I have just received my lab results on my Free T3 and Reverse T3 from February 13, 2013. Please take a look and any further thoughts and comments are appreciated.

T3, Free 2.0 (2.0-4.4 pg/mL)

Reverse T3 15.2 (9.2-24.1 ng/dL)

Ft3/Rt3 ratio = 13.2

According to STTM.com, a “healthy” ratio should be 20 or higher. What does this mean, obviously my free T3 is at the very bottom of the range…

Thanks

15

What are your iodine plans?

You are not making enough thyroid hormones and your temperatures are low. Do not know why your TSH is not higher.

16

I have been dosing 12.5mg daily of Lugols 5% solution for the past 4 days. I will continue to monitor temperatures and see if I get any rise in the averages. I have another medical appointment scheduled for the 5th of March, as that is the earliest they can see me. So I will present everything I have to the doc at that time.

Is there any other tests or research I can be looking into during the mean time which might give me any more information to present to the doc?

17

How is it going? Temps improve? Did the restart work?

19

Hi there,

This was several years ago that I commented on this thread, but to answer
your question, no a Clomid restart never worked for me after 3 separate
attempts of about 10-12 weeks each. My T. level would rise to around
500ng/dL while I was taking Clomid, but my SHBG and E2 would also rise,
which pretty much cancels out any benefits. Ultimately, I got on TRT,
injections twice per week along with HCG.

But if your working with Dr. Crisler you are in good hands, I just don’t
recommend Clomid personally because I never felt well on it and it never
worked for me, but some people do have success with it. Hope this helps,
take care.