*7-22-2013 UPDATE: B WS6 Case*

I would run additional tests on your thyroid and cortisol levels since fixing your estradiol and testosterone haven’t helped.

Update:

I had performed a sleep study last night to rule out sleep apnea. The technician said she is not able to get into full detail about my results but did say that I stopped breathing a few times during the night. Hopefully if I get this straightened out, I’ll start to feel better.

To tie in my other threads I will link and post pertinent info in chronological order:

6-19-2011: “Well as some of you know, I decided to give to try the AI solo to increase my testosterone based on a few studies I read. Well, after 6 weeks my Testosterone came in at 638ng/dL, Free Testosterone at 94.9ng/dL and Estradiol from 62pg/dL to 24pg/dL. I was stunned because I did not feel any better!”

8-20-2011: "I’m back! I’ve been taking a break from this whole ordeal and enjoying the rest of my summer but it’s hard to when I’m in and out of doctor’s offices. Anyway, long story short: Noticed decreased libido January 2010, diagnosed with low testosterone June 2010 and have been researching since then. I didn’t like some of the doctors/endocrinologists I’ve seen before and finally decided to see this endocrinologist as referred to me by a family friend who is a doctor. I have been supplying him with my previous labs that confirm hypogonadotropic hypogonadism along with his own lab testing, an MRI of my pituitary that shows no abnormalities from my previous doctor.

My first visit we drew blood to establish some baseline numbers. He tested a lot of other stuff too like Vitamin B and Dopamine levels through a 24-hour urine test (happy to report that my Dopamine levels came back at the upper third of the range. I was always worried I was in a state of SSRI-induced down-regulation of dopamine levels from extra serotonin.) Anyways, he called me to come in and try a GnRH stimulation test. Fine. Tests came back today that my FSH and LH increased. Now he wants to try a Clomid test.

Really? Doesn’t that seem redundant? Either way, if the Clomid does or doesn’t work, in the end, I would be placed on TRT the way I see it. I’m getting really aggravated as weeks are passing by, I’m eager to feel better and instead of talking about a TRT plan he wants to perform another test. The nurse said he wants me to schedule a bone density scan and an ultra-sound of my kidneys later as well.

Opinions? Thoughts? "

http://tnation.T-Nation.com/hu… WS6#myForums/thread/4611974/

11-23-2011: "Well, after 6 weeks of jus’ Testosterone Cypionate (50 mg’s every 4 days), I went from a 300ish level to 1055ng/dL. I am in the process of obtaining some insurance because I had ran out so they only tested total testosterone to keep the costs to a minimum.

My jaw hit the floor when I heard my results. I was SO SURE my Testosterone was still in the tank because I was feeling exactly the same. I was guessing that the 50mg’s shut down my natural production and it wasn’t enough to compensate for my natural production of 300 more supplemental T.

I wanted them to retest my Estradiol numbers but that test alone was 230 bucks so I decided to wait on that. Isn’t there a place I can order an E2 test online and walk into a lab to have my blood drawn without a doctor’s referral? I’m hoping it would be significantly cheaper. I’m beginning to think my E2 level is in check because at 1055ng/dL, it seems like none of my 50mg’s are going to waste!

I don’t know what to do. I am in a state of shock still. I plan on going back on an AI once I establish a baseline of TT, FT and E2 on 50mg of T Cyp alone. What else should I look into? As stated before, my TSH was below 2.00, T4, and T3 were in the upper range. The only thing I wonder about is my FT3 levels but at this point, I’m feeling hopeless that’ll change a damn thing. "

http://tnation.T-Nation.com/hu… WS6#myForums/thread/4930532/

2-09-2012: "I began TRT (50mg’s of Test Cyp - Every four days) in the beginning of October. About 2 months in I got tested for total testosterone only jus’ to see if that dose was adequate. So:

2nd day after shot:
Total T = 1055ng/dL (Range 250-1100)

I was quite surprised as I didn’t feel any better. Then I decided to get my Estradiol checked up a few weeks later as maybe a possible culprit.

Don’t remember the timing of shot:
E2 = 62pg (Range 7-42)

My doctor stated that it was high and wrote me a prescription for Anastrozole. He wanted me to take 1mg/day but I had success with 0.25mg/day before so that’s what my protocol is currently: 50mg’s of Test Cyp Every four days + 0.25mg’s/day of Anastrozole. When I went back in to discuss my labs for my estradiol and to pick up the prescription for the Anastrozole we checked my Total and Free Testosterone as well.

Day 4 of cycle (so I injected after the appointment):
Total T = 540ish (Range 250-1100)
Free T = 155 (Range 35-155)

Now before going on T, I had extensive blood work done before and everything seems to check out OK accept for Vitamin B and D insufficiencies in which I am supplementing daily for:

July 7, 2011
Total T: 249 (Range 250-1100)
Free T: 44 (Range 35-155)
FSH 0.8 (Range 1.6-8.0)
LH: 0.2 (Range 1.5-9.3)
Prolactin: 4.9 (Range 2-18)
IGF 194 (Range 155-432)
DHEA 290 (Range 61-1636)

March 10, 2011
T Test: 321 (Range 241-827)
Free T: 1.05 (Range .95-4.30)
TSH: 1.29 (Range 0.35-5.50)
Total T3: 118 (Range 60-181)
Free T4: 1.0 (Range 0.7-1.7)

August 18, 2010
T Test: 170 (Range 250-1100)
Free T: 24 (Range 46-224)
SHBG 27 (Range 7-49)
Prolactin 7.5 (Range 2-18)

Now it’s only been about 1 week since I introduced the Anastrozole into my protocol and I’m hoping it’ll alleviate my symptoms - mostly low libido - but where do I go from here? I want to point out that I am also on 10mg’s of Lexapro for anxiety and wondering if it’s playing a role.

Please help guys! If you could provide any insight that would be much appreciated as I’m looking to restore my libido!

At this point, I was highly curious about DHT:

5-07-2012:

"I’ve been on TRT (Testosterone Cypionate 40-50mg’s E4D and jus’ recently added an AI @ 0.25mg daily) since October. Initiatally, the dose was jus’ right putting me at the very top of the range. I decided to scale back down to 40mg’s E4D (from 50mg’s E4D) because I’ve read of a few guys on here that felt better on lower dosages.

Here is my results (taken on 2nd day of E4D schedule):

Testosterone: 523 (Range: 348-1197)
Free Testosterone: 16.9 (Range: 9.3-26.5)
Pregnenolone: 28 (Range: <151)
DHT: 20 (Range: 30-85)
DHEA-S: 385 (Range: 160-449)
Estradiol: 6.9 (Range: 7.6-42.6)
Vitamin D: 69.9 (Range: 30-100)

My thoughts are to increase my testosterone dosage to 50mg’s E4D, decrease my AI to 0.25mg EOD and to increase my daily supplementation of 6,000IU’s of Vitamin D to 8,000IU’s. I want to change my dosages not simply because I want to have optimal numbers but because I’ve felt no increase in the libido department: the primary reason I went on TRT.

Any thoughts concerning my low DHT numbers and possibly my low Pregnenolone numbers?"

Currently, this is where I’m at:

7-22-2013:

Update: Sometime in the fall I began to lose interest in TRT. I was strict with my regimen and it slowly crumbled away to where I stopped everything because I felt nothing from it. No increased energy, weight loss and the primary reason I sought treatment - low libido. So since then, I have not been on any TRT.

Just the past week, I had an routine appointment with my primary care doctor and mentioned that I was no longer on TRT (prescribed by my endocrinologist) and I told her I was interested in some topical forms of TRT but that I was unable to afford it because I have no insurance. She gave me four boxes of Axiron to try out. I tried it for 5 days and thought about it - I really want to establish some baseline numbers again partly because I have been feeling better, mood-wise, this year. I am attributing this to the decrease in my Lexapro dosage (from 10mg's to 7.5mg's in the winter to 5mg's this month). 

Maybe your DHT level was low enough to cause all of your symptoms. I’m looking your thread and I hope you get well by fixing your DHT.

My DHT is a little bit low and I feel the same as you even with good others hormone levels.

DHT: 27 (from 25 until 100)

Hi B_WS6,
I seam to have the same symptome on hcg. After 3 injection I started to have a bad rash, first on my back, then on my chest. On my fourth injection I notice the rash on my privat parts. The rash on the back and chest are going away and hoping that it will not be come back. I also loos all energy for 2 to 3 days after my shots (250iu). I have read that some people on the hcg diet have the same symptome.