T Nation

29 YO, Low Libido and ED During TRT [Low SHBG, High E2, High Fluctuating PRL]


#43

fortunately, acne slowly dissapears after (A.) reducing CC to 25 mg ED, and (B.) adding 2 x 0.5 mg anastrozole per week.
However, I didn’t do any new bloodwork after treatment changes made 2.5 weeks ago.
I need to check my current numbers and continue to lower CC dosage (to 25 mg EOD).


#44

update 02/06/2018 - after 4 weeks of the reduced CC dosage (25 mg ED) together with 3 weeks after adding anastrozole (2x0.5 mg weekly)
LH @ 9.93 IU/l [1.7-8.6]
FSH @ 4.19 mIU/ml [1.5-12.4]
TT @ 846 ng/dl [280-800]
E2 @ 27.91 pg/ml [27.1-52.2]
PRL @ 20.66 ng/ml [4.04-15.2]


#45

And how do you feel


#46

I feel goood, however I will continue to reduce clomid dosage to 25 mg EOD.


#47

update 30/06/2018
nearly 4 weeks on 25 mg clomid EOD + 1 mg anastrazole weekly (nearly 4 months of restart in total).
I feel good overall, however lasty libido decreased toegether with worsen erection quality - PRL and TSH could be lower.

LH @ 5.11 IU/l [1.7-8.6]
FSH @ 3.08 mIU/ml [1.5-12.4]
TT @ 752 ng/dl [280-800]
E2 @ 20.99 pg/ml [27.1-52.2]
PRL @ 26.18 ng/ml [4.04-15.2]
TSH @ 3.16 mIU/ml [0.27 - 4.2]


#48

27/07/2018
about 8 weeks on 25 mg clomid EOD + 1 mg anastrazole weekly (acne worsened lastly therefore I took about 1 and 1/3 mg in week before current labs; moreover, I have skipped one CC dose by accident). I have also increased levothyroxine from 50 to 75 mcg.

LH @ 4.14 IU/l [1.7-8.6]
FSH @ 2.95 mIU/ml [1.5-12.4]
TT @ 608 ng/dl [280-800]
E2 @ 7.81 pg/ml [27.1-52.2]
PRL @ 17.29 ng/ml [4.04-15.2]
TSH @ 2.13 mIU/ml [0.27 - 4.2]
vit.D @ 22.99 ng/ml [30-100]
glucose @ 82 mg/dl [70-99]
fT3 @ 2.25 pg/ml [2.02-4.43]
SHBG - 43.17 nmol/L [18.30-54.10]


#49

Your keeping your e2 to low.


#51

yep, I am coming back to 1 mg anastrazole weekly. It used to give e2 levels around 20 pg/ml.
I have updated previous post, my SHBG level significantly increased (from 18 to 43 nmol/L). could it be connected with clomid treatment? or rather due to improving thyroid status?


#52

discontinuation of the clomid therapy is the only chance to regain libido?


#53

Plenty of members on this board have libido issues when E2 goes too low. Yours is/was crashed. Are you taking a vitamin D supplement? Low D can cause problems as well.


#54

I had stable e2 @ 20 pg/ml for months and still libido was next to zero. I have recently added vitamin D supplement (4000 IU)


#55

Estradiol @20 is still pretty low for a lot of members here. Maybe try getting it into the 30s and see how you feel.

I take 10k iu of D3 a day to keep it in the 60s. I work inside and only really see the sun on the weekends though.


#56

prolactin increased again to 25.51 ng/ml [4.04-15.2]. obviously my libido is disrupted not only by clomid, but also due to damned high PRL.

I have tried 300 mg vitamin B6 daily + vitamin E supplementation. I’m running out of ideas how to get out of it.

E2 increased to 26.31 pg/ml [27.1-52.2].


#57

LH @ 6.97 IU/l [1.7-8.6]
FSH @ 4.78 mIU/ml [1.5-12.4]
TT @ 774 ng/dl [280-800]
E2 @ 21.08 pg/ml [27.1-52.2]
PRL @ 15.57 ng/ml [4.04-15.2]
TSH @ 1.95 mIU/ml [0.27 - 4.2]
fT3 @ 3.70 pg/ml [2.02-4.43]
fT4 @ 1.47 mg/dl [0.93-1.70]

it seems I have finally found good treatment scheme:

  1. 25 mg clomid ED
  2. 100 mcg levothyroxine
  3. 0.5 mg anastrozole - monday & thursday

I am also using
kelp 225 mcg + 220 mcg selenium
vitamin D 4000 IU
vitamin A 5000 IU
vitamin E 400 mg
sildenafil 25-50 mg

I feel pretty good and will follow this protocol until my wife gets pregnant.


#58

Every day?


#59

I take it irregularly. however, I have also seen papers in PubMed considering benefis of daily 25-100 mg sildenafil in man with ED.


#60

I heard of low dose tadalafil (Cialis), typically 5mg a day but not sildenafil. Interesting…


#61

Get a script for 20mg sildenafil. It’s much cheaper. It’s the tabs they use for pulmonary hypertension. Same ingredient. Even if insurance dont cover. It’s like a dollar a pill .

And since it has a short half live and to prevent sides maybe take it 2x a day.
That was my plan but I get Cialis from compound pharmacy.


#62

06/10/2018

LH @ 9.71 IU/l [1.7-8.6]
TT @ 770 ng/dl [280-800]
E2 @ 25.46 pg/ml [27.1-52.2]
PRL @ 19.19 ng/ml [4.04-15.2]
TSH @ 2.87 mIU/ml [0.27 - 4.2]
fT3 @ 3.23 pg/ml [2.02-4.43]
fT4 @ 1.55 mg/dl [0.93-1.70]


#63

14/12/2018

LH @ 5.33 IU/l [1.7-8.6]
FSH @ 3.74 mIU/ml [1.5-12.4]
TT @ 839 ng/dl [280-800]
E2 @ 16.24 pg/ml [27.1-52.2]
PRL @ 10.55 ng/ml [4.04-15.2]
TSH @ 1.64 mIU/ml [0.27 - 4.2]
fT3 @ 3.17 pg/ml [2.02-4.43]
fT4 @ 1.58 mg/dl [0.93-1.70]