T Nation

33 y/o, Libido/ED Problems

T Replacement
#1

-age 33
-height 179 cm
-waist 79 cm
-weight 62 kg
-describe body and facial hair - hair on legs and arms are normal, no chest or back hair, facial hair is very sparse, not a full beard at all
-describe where you carry fat and how changed - mid section, chest
-health conditions, symptoms [history] - anxiety since 17 yo, currently depression (taking Mirtazapine 30 mg), problems with sleeping for a past few months, blood pressure is normal around 120/80, didn´t have any major health problems
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever - mirtazapine 30 mg for depression (I asked for meds without sexual/prolactin rising side effects), no hair loss or prostate drugs ever

ZMA regularly, starting Lugols for iodine, vit E, selenium, B6, D3 right now

-describe diet [some create substantial damage with starvation diets] - standard diet right now, I eat meat and eggs daily, bread, milk, vegetables, fruit, rice, potatoes
-describe training [some ruin their hormones by over training] - just regular walks right now
-testes ache, ever, with a fever? - no
-how have morning wood and nocturnal erections changed - I have irregular night erections but not full, no morning wood unfortunately
My labs are:

S-LH 2,4 U/l (1,5 - 9,2)
S-FSH 1,88 U/l (1 - 14)
S-Prolactin 223 mlU/l (20 - 400)
S-Estradiol 35,6 pmol/l (99,4 - 192)
S-Testosterone 12,15 nmol/l (12 - 30)
S-SBHG 24,2 nmol/l (12,5 - 68,59)
S-DHEA-S 19,2 μmol/l (4,1 - 14,3)
S-Cortizo 392 nmol/l (177 - 578)
TSH 1,4 (no lab ranges)
fT4 15,7 (no lab ranges)

basicaly my problem is low libido, ED, bad sleep and anxiety/depression

I am currently taking Mirtazapine 30 mg daily for depression.

Besides this no other medical problems or medication

Went thourhg tests at endocrinologist and urologist, without any result - they say I´m in normal ranges so I decided to self medicate. Please I´m looking for any advice.

Thanks

#2

You need to include lab ranges otherwise we have no idea your levels end up on the scale, not all labs have similar ranges. T levels are indeed quite low, doctors in your country are morons and inexperienced in diagnosing low T. You will start to experience symptoms below 15 nmol/L, most good doctors understand this, you need to find another doctor. Knowledgeable doctors in your country are hard to come by, most are robotic and only pay attention to lab ranges and ignore a patient’s symptoms. These doctors don’t have critical thinking or reasoning, this is why they fixate on labs ranges which is do to a lack of knowledge.

#3

thanks a lot, lab ranges added. I´m planning to self medicate

#4

Is my prolactin considered high in context of my libido / ED / depression problems? I´m thinking about getting cabergoline - any idea of dosing?

Thanks a lot guys in advance

#5

Most antidepressants have the side effect of low libido. However that being said you shouldn’t stop that medication for anything. Try exercise, foods rich in fatty acids, an over the counter supplement to boost libido.

#6

While the range is 0-200, <91.8 is the reporting floor and could be anything less that 91.8, there may be a different E2 lab to use that is more sensitive and better suited for use in males.

fT4, post units please

fT3 is the only active thyroid hormone, there is not receptor for T4, fT3 is often not tested and may not be available ?wherever? you are.

TSH should be closer to 1.0, there may be a minor problem. Often TSH is elevated by iodine deficiency. Are you using iodized salt?

We often see guys put on brain meds when the cause is low hormones [T and/or thyroid].

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.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

You can get a better evaluation of your thyroid status via oral body temperatures - see below.

You do not have a prolactin problem. LH/FSH are low and E2 and prolactin are not the cause of low LH/FSH. Blows to the head can damage the pituitary or a different kind of adinoma not producing prolactin.

#8

@KSman

Thanks a LOT, KSman! You are my hope to get well.

I ordered sensitive test for estradiol and it is:

S-Estradiol 9,8 pg/ml (26,9 - 52,3) so it is low

fT4 15,7 pmol/L
my temperatures are indeed low - 97,52 this morning, later in afternoon 98,78 - will continue to measure.
In Czech republic, we have iodized salt as a standard. I ordered Lugols solution and will start using today - how much should I start taking? 12 mg iodine a day or more?

-age 33
-height 179 cm
-waist 79 cm
-weight 62 kg
-describe body and facial hair - hair on legs and arms are normal, no chest or back hair, facial hair is very sparse, not a full beard at all
-describe where you carry fat and how changed - mid section, chest
-health conditions, symptoms [history] - anxiety since 17 yo, currently depression (taking Mirtazapine 30 mg), problems with sleeping for a past few months, blood pressure is normal around 120/80, didn´t have any major health problems
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever - mirtazapine 30 mg for depression (I asked for meds without sexual/prolactin rising side effects), no hair loss or prostate drugs ever

ZMA regularly, starting Lugols for iodine, vit E, selenium, B6, D3 right now

-describe diet [some create substantial damage with starvation diets] - standard diet right now, I eat meat and eggs daily, bread, milk, vegetables, fruit, rice, potatoes
-describe training [some ruin their hormones by over training] - just regular walks right now
-testes ache, ever, with a fever? - no
-how have morning wood and nocturnal erections changed - I have irregular night erections but not full, no morning wood

#9

Thanks a lot for your input! Much appreciated. I´d like to go off meds as soon as possible while consulting with my doc.

#10

Your temperature is supposed to be lower in the morning and mid afternoon your temperatures are supposed to rise, this is normal thyroid function.

#11

@systemlord Thanks for your reply, I´ve started Lugols solution for iodine, I´m trying 12 mg a day divided into two doses and will continue to check temperatures.

Any idea what to do according to my updated labs? I´m worried …

Thanks a lot in advance.