T Nation

8 yrs. AAS Use, Trying to Recover


#1

Guys, first I want to say thanks for sharing the wealth of info. that is on here. I, like so many others have been guided in circles by doc's that do not have a clue on how to treat us. First off, I'd like to give my stats, then symptoms, then most recent blood work. Any input you guys can give on personal experiences and recommendations based off of that and research you guys have done is greatly appreaciated, so thanks in advance.

Age: 27
Height: 5'11"
Weight: 180lbs. 10-11% bf
Waist: 32 jean size (around the hips) most fat concentrated around lower abs and slightly thru the sides. can still see abs.
Hair: Pretty good coat of chest/stomach hair (not quite gorilla-like though), full facial hair/beard growth Full arm/leg hair. Starting to notice gray hairs through sides (started at 24ish) and hair is starting to thin on top and recede at corners creating widows peak illusion.

-Health: took lexapro for 1 yr from june 07 thru july 08 for anxiety issues that manifested while dieting down for 1st bbing show and and taking ug gear (tren200mg e4d and eq 300mg e4d). could only do 3 shots before having to quit d/t anxiety attacks immediately after shots.

Drugs:AAS use starting at 19 and stretching the next 8 years with starting and stopping my systems.Typically took as much time off as on AAS. Otherwise None outside of marijuana brownies which illicited severe anxiety attack a few months back.

Supps: Vit D3 (4,000-5,000IU/d, Vit C 500- 1,000mg/d, Fish Oil 6g/d, zma at bedtime, 2.4g tribulus, 50mg dhea, liquid multi-vitamin iron free.
--conditions existed before I took any of that

Diet: Currently maintaining at around 3,500 calories/day.
Training: 4 days a week strength training 60-75 min./day. Bicycle outdoors once/wk for 45-60mins. very moderate intensity for recreation. Symptoms exist even when no exercise is involved and in fact are sometimes worse with regards to energy levels, concentration, etc.
-testes do not ache and are full/firm with a stage 2 varicocele on left testicle.

Symptoms
-Constant fatigue. Need 8-9 hrs. minimum or completely worthless. Find myself yawning at work sometimes, and in social settings. Occasionally yawn during working out, feel it's hard to get my adrenaline going to get geared up for an intense set.
-Brain fog. Never feel like I'm "in the moment". Always thinking of something unrelated to what I'm doing or talking about.
-No Motivation to be goal oriented. Lack future goal setting. Not really depressed though, more just going thru the motions.
-Sex drive: the desire is pretty strong as I always check out girls and think man i'd love to bang her, but my erections are not always rock hard and sometimes soften up while masturbating, but not so much during sex. can still perform during sex and orgasm normally.

-morning wood occurs maybe 2-3x/wk if lucky. likewise with nocturnal erections.
-Body Temp: rising temp seems to avg 97.6. but sometimes is as low as 97.2. feet get cold easy and sometimes hands.
-Some joints do feel achy from time to time as well as my body in general.
-Digestive issues: Typically take a crap in the am and stool is usually on the thinner/ loose side, but not diarrhea by any means.

How do I react to stress? -- I find myself easily set off and then as time goes on I'm able to settle down, stressful days really cause things to go into hiatus with focus, energy levels, etc.
Mood swings: I do find myself shifting moods throughout the day. One second everything's great and i'm communicative, 5 hours later i'm pissed and shut off.

Strongest symptoms are definitely inability to focus/mental clarity, fatigue, and lack of motivation.
I don't THINK I'm forgetting anything but the bloodwork results - sorry if anyhting important is missing but I'll check this thread consistently.
Blood was drawn at 9:30am after 12 hours of fasting and no dhea for 3 days prior.

total test: 418ng/dl (249-836)
free t4: 1.16ng/dl (.81-1.54)
ferritin: 469ng/ml (30-400)
Dhea-s: 300.1ug/dl (age 25-34yrs. old: 160-449ug/dl)
estradiol: 28.8pg/ml (7.6-42.6)
lh: 3.8miu/ml (1.5-9.3)
alt: 23u/l (17-63)
alk phosph: 46u/l (20-125)
bilirubin: 1.3mg/dl (.1-1.0)
cholesterol: 165mg/dl
triglyceride: 120mg/dl
hdl: 42mg/dl
Ldl:99mg/dl
glucose,fasting:93mg/dl (70-99)
creatinine:1.0mg/dl (.7-1.3)
tsh:1.41uiu/ml (.35-4.0)
free t3: 218pg/dl (210-440)
total t3: 103ng/dl (76-181)
cortisol:19.3 (7-10am: 6.2-19.4ug/dl)
vitamin d,25 oh: 46ng/ml (30-100)
rbc:5.33
platelets:177
wbc:6.5


#2

One thing that sticks out with your blood work is your high ferritin, definitely something to look into!

I am not sure if this could also be related to your symptoms as I don't know much about IRON overload issues.


#3

Some of your symptoms reminded me of myself so much that I thought you were copy/pasting my thread for a second.

Was this a typically stressful day for you? That cortisol number is very out-of-whack with your thyroid numbers.

Your Free T3 is very low, which SHOULD drive up your TSH - except your TSH is perfectly fine. Normally I would think that this means your adrenals can't handle any more FT3. Backing this up is the fact that your FT3 is to the left of FT4 in their relative lab ranges (typically your body downregulats FT4->FT3 production if your adrenals are fatigued).

However.... your cortisol appears fine. Additionally, your cold intolerance, creaky joints, low body temps and fatigue/brain fog are all classic hypothyroid symptoms. You have basically every symptom except for high TSH (which is frequently the only one docs care about).

I think a 4-point saliva test for cortisol could be warranted because that number just doesn't make sense.

Obviously, DHEAs is low, and Total T is to the left of where you should be at age 27, though not as bad as some.

Questions for OP:
What was the lab range for CHOL?
How much fat do you eat?
Do you use iodized salt, or eat much sea food? Possible iodine deficiency causing poor thyroid numbers (though I'd think TSH would be elevated).
Have problems gaining/losing weight?

Disclaimer: I am not a doctor, nor am I knowledgeable about AAS use (hence me staying quiet on TT,DHEA-S and LH numbers).


#4

I agree, it has been elevated in the past and I will be getting another blood test in a few weeks to test for hereditary hemochromatosis dna mutation, iron and tibc, as well as another liver function panel.


#5

Yes, it's funny that you mention the stress because I had to battle with nurses for over an hour to get the tests that I wanted. Doc was being stubborn and only wanting to order the basic cbc, tsh, glucose, etc. tests and nothing pertaining to hormones.
I will look into doing the 4 point saliva test again. I had it done about 6 mos. ago while on hcg and can post results if beneficial. I'd like to have total testosterone in the 600-700 range.

Choloesterol range was (<200)
Fat consumption, I would guess probably around 60g/day
I do salt foods, only sea food to speak of is a can of tuna/day.
I tend to struggle in gaining size/weight, hence the previous aas use, and typically find my natural body weight settling between 180 and 185 if training and nutrition is on point.


#6

It would be beneficial

But is it IODIZED salt? Not all salt is iodized, which is one of the things that leads to iodine deficiency. You want iodized.


#7

Sounds good, I'll make sure I'm getting supplemental iodine. saliva results are as follows: 1-5-11

Cortisol Morning 10am (saliva) 7.9 ng/ml (3.7-9.5)
Cortisol Noon 2pm(saliva) 1.4 ng/ml (1.2-3.0)
Cortisol Evening 8pm(saliva) 0.8 ng/ml (0.6-1.9)
Cortisol Night 12am(saliva) 0.4 ng/ml (0.4-1.0)


#8

I'm sort of at a loss here.... your pituitary should be screaming for more t4 but it isn't, yet your adrenals appear fine. Maybe something is wrong with your pituitary, but I'm out of my league with that.

I will say that the more tests you get, the more complete of a picture it paints. Couldn't hurt to test RT3 and Thyroid Antibodies (TPO/ATA). I wouldn't expect RT3 to be elevated given your normal cortisol levels, but you never know. My best guess is is that something is up with your pituitary, hopefully someone with more knowledge of that can chime in.


#9

Yes, I agree I am at a bit of a loss here as well, and i'm hoping to see an endo soon but just yesterday met with my primary physician for the 1st time since switching insurance and he basically said that all my numbers looked pretty good to him because they were in range lol.
Not sure if this will help any, but here are some blood results from 1-10-11 at 10am while on 150iu hcg/d and .5mg arimidex e5d. draw was prior to hcg shot for the day.

cortisol: 14ug/dl (5-25)
free t4:1.00ng/dl (.76-1.8)
tsh: 1.68uiu/ml (.258-3.74)
estradiol: <20pg/ml
bilirubin: 1.4 (.2-1.0)
dht:226pg/ml (106-719)
ferritin:363ng/ml (26-388)
dhea s:251ug/dl (280-640)
free t3: 3.6pg/ml (2.4-4.2)
free testosterone:97pg/ml (47-244)
total testosterone: 517ng/dl(300-1080)
alt: 30u/l (12-78)
vitd25oh: 32ng/ml (30-80)


#10

I see that your DHEA-S is below range, I have the same issue but mine is a lot further down range than yours. I feel like crap.

I was reading about DHEA-S and it seems that the more you have it the better off you are. Live longer, more immune to disease, less risks of heart disease etc...

Have not started taking it yet so can't comment on the effectiveness. But you might also get some benefit from a little supplementation. Theoretically it should also raise testosterone levels if everything works like it should.

But being in the 400 - 500's should have some benefits from what I have read!

Looks like in your 1st blood test your DHEA is higher but you were supplementing. Chronic Fatigue issues are common with IRON overload. But in post 1 you are out of range and then the test from 1.10.11 in range.

Although I have never done any cycles I have heard people say they feel awesome on them. Strong full of energy etc... It might just be hard for you getting used to being normal now :slight_smile: if you know what I mean.

Your blood test results you posted in post 1 is that the latest?


#11

When I was reading your post, I was thinking cortisol and estrogen. Was very surprised to see both of these in a good range.

Your saliva cortisol results bring up an interesting issue as you seem to be perfectly fine in the morning, but drop off sharply throughout the rest of the day and evening (not so bad for 12 am, but could be an issue at other times). Do you feel better in the mornings and start getting sluggish/pissy as the day wears on?

I have no idea what would be behind that, but it looks like it may be related to cortisol if so.


#12

I have been supplementing with 50mg dhea/d for the past 3-4months based upon my low levels 1.10.11, and discontinued supplementation a few days prior to the test to make sure blood draw gave as accurate of picture as possible.
My most recent blood work was done on 7.13.11. Those are the numbers included in the first post.
I do agree to a certain extent that you feel like a million bucks while on but if you're able to get your systems back on track while off one should not have the degree of symptoms to which i do. HIndsight is 20/20 but if I could go back in time I would have A.) waited longer to start using aas, and B.) taken more time off between cycles to ensure proper recovery, and C.)Never used underground gear. Hopefully guys in that 18-22 y/o age bracket can learn from my mistakes.


#13

Quite honestly, some days are better than others. Generally speaking, yes, in the am after I've gotten a good 9 hours of sleep I feel pretty decent, but intermittently throughout the day my energy levels peak and plummet. I do always feel better after a workout, the catch is getting going to workout and when there getting my adrenaline going to stay aggressive in the gym.


#14

High ferritin can be iron overload which would explain fatigue... it can also be raised during periods of infection (another possible cause of fatigue), which would in turn be an explanation for your high cortisol as well.

Apparently ferritin can be raised during acute periods of malnourishment... I don't know if "acute" means a 12hour fast, 36hour fast, or one week of a bad diet... it's just listed as a minor point on the Ferritin wikipedia page.

All that is off the Ferritin wikipedia page, so take it with a grian of salt, but given that your lab results are so confusing I figured it couldn't hurt to give you an idea or two to do some more research on your own.


#15

Thank you! I appreciate your insight and suggestions. What finally set things in motion to try and get treatment and improve my symptoms was my initial blood work up done 2.22.10. Where once again ferritin was elevated. This was done 2 months after aas had cleared body and no real serious pct was utilized. 10am blood draw. Check it out:

cortisol:6ug/dl (5-25)
free t4: 1.2ng/dl (.9-1.8)
tsh: 1.37uiu/ml (.4-4)
lh: 3.0 (.8-7.6miu/ml)
ferritin: 466 (26-388ng/ml)
free t3:3.0pg/ml (2.4-4.2)
vitd 25 oh:30ng/ml (30-80)
free testosterone: 69pg/ml (47-244)
total testosterone: 381ng/dl (300-1080)
alt: 51u/l (10-65)
bilirubin total: .7mg/dl (0-1.0)


#16

^^^^ Your cortisol is VERY low there. That is much more in line with your symptoms...however not in line with your most recent bloodwork.

Also I forgot to mention this but inflammation can cause high ferritin as well. Might be useful to have some serum iron labs done, they are useful to get the full iron picture when ferritin values are alarming.

The bottom line is your symptoms point to hypothyroid and adrenal fatigue, which is backed up by your most recent post. The problem is your cortisol was fine in your OP and inconsistent in your saliva test, so it's hard to know which measurement is "right". Did you make any supplement/diet/lifestyle changes between your 2/22 test and your 7/13 test? Something that would increase cortisol? A more stressful job?


#17

Well, the tests were performed 17months apart so sure, some changes in various aspects of my life have occurred. Pertaining to diet/supplement/lifestyle changes, I suppose I'm more on top of supplementing deficient areas that I never thought of before, I still exercise in a similar capacity, and have relocated but am in a similar line of work, so by no means a complete 180. Perhaps it could be that my systems are in the process of getting back on track and correcting themselves?..that may be wishful thinking on my part lol. thanks again!


#18

Guys, I've got some recent lab results that I'd like to share. The lab work was done on 8-12, about one month after the previous lab work. In the initial lab work, you can see that liver enzymes were a bit suspect and ferritin was high. According to the results below, it doesn't appear either is much of a concern. Appreciate your thoughts.

total bilirubin-.9mg/dl (.1-1.0)
alt-21u/l (17-63)
alk phosphatase-40u/l (20-125
iron-116mcg/dl (59-158)
total iron binding capacity-286mcg/dl (250-420)
iron saturation-41% (20-50)
direct bilirubin-<.1mg/dl (0-.25)


#19

Well it doesn't look like you are overdosing on iron... high ferritin may just be inflammation?


#20

ya my thoughts exactly..never thought or realized high ferritin was linked to inflammation..could be..sex drive is pretty normal and bodyfat is staying around 10% at 180 but i'm still tired quite often and have issue with mental focus and mild anxiety from time to time..