I am seeking your advice. 2.5 years ago, I did a course of accutane, which left me with persistant sexual sides, including low libido, erectile dysfunction, and loss of fullness of the testicles. Since then, I have done several hormonal panels of which the latest is the following:
Testosterone - 19 nmol/l ref: 8-29
LH - 3.46 IU/L ref: 1.20-7.80
FSH - 4.37 IU/L ref: 1.40-15.4
Prolactin - 278 mU/L ref: 11-424
Progesteron - 2.29 nmol/L ref: 0-6.26
Estradiol - 122 pmol/L ref: 37-184
SHBG - 30.2 nmol/L ref: 18.3-54.1
albumin - 51.4 g/l ref: 35.0-52.0
Free Test - 0.394 nmol/L
DHT - 0.59 nmol/L ref: 0.32-2.16
DHEA-s - 9.1 umol/L ref: 3.4-16.7
TSH - 2.6 mU/L ref: 0.40-4.0
Free T4 - 14.3 pmol/L ref: 10.0-22.0
T3 total - 1.71 nmol/L ref: 1.23-3.08
Reverse T3 - 236.4 pmol/L ref: 138.6-331.1
IGF-1 - 24.4 nmol/L 15.2-38.8
IGF-1 SD - -0.27
In my opinion, my (free) T levels are too low for a 24 year old. At the same time, my DHT also is low. It has to be said that my T levels and DHT levels were even lower in previous tests. DHT even below reference range. Furthermore, my estrogen has also been tested above reference range before (210 pmol/L to be exact). This has left me with puffy nipples (gyno) which has not been resolved.
According to some studies, accutane messes with androgen receptors, so I am now looking for something to fix these receptors. I have considered the following:
Doing 500 mg Test-E a week and 300iu HCG for three months, after which I do a 1 month PCT with enclomiphene or nolvadex
Do a PCT with nolvadex of 1 month, evaluate, and do again after a month’s rest if improvements do not stick.
These protocols are inspired by people who suffered from the same or a similar condition.
I have two concerns in this however. First, my energy levels are fine and my mental condition is also okayish. Although I desperately want to regain my sexual function, I can function well in my work, and this brings me to the concern. I recently started a new job which I really like. I cannot afford becoming mentally or physically unable to work, so I want to rule out potential risks as much as possible, if that is even possible.
The second concern is the fact that I already have puffy nipples (gyno). It’s not really visible in the right clothes, but obviously, I don’t want to make this worse. I know that test-E and especially HCG tends to raise E2. Is that also the case in the dosage I am considering?
In the end, my question to you is, what do you advice if you look at my hormonal panel and to my concerns? What do you think could give me improvements? The funny thing is that I still have morning wood regularly, but I lose it quickly once waking up and/or getting up.
I hope you guys can enlighten me about some safe options and provide me with your advice!