T Nation

Ask Physiolojik Thread


#587

@decatest hey man I don’t know if you’ve mentioned - what are your stats? That is a gargantuan amount of gear! Drastically more than I’ve ever used haha and I stay between 255-270.


#588

@physioLojik

Hi Doctor,

After natural bodybuilding for 2-3 years and putting on good muscle I decided it was time to get into the shape of my life for soccer as I was aspiring to make it professional and felt like being in excellent shape would really set my mind to achieve my goals. I returned to Canada to make money working construction so I could buy a car and travel around europe trying out for teams and getting to practice. Around May 2016 the diet and hardcore cardio I started. I basically ate nothing but vegetables with the odd piece of meat everyonce in a while, and just ate salad and drank black coffee and water.

After working 9 hours construction I went straight to practice with my friend for a good 2 hours followed by running around a track for an hour as fast as I could / HIIT training. I went from 176lbs at 5’9’’’ to 139lbs in about 1-1.5 months. I was getting lean for the first time and really started to put value into hardwork etc. This reflected onto my job where my coworkers told me repeatedly to take it easy or im going to wear myself out. One day I sat on the toilet and noticed I wasnt getting morning erections anymore. It did not bother me because I thought it was because of the diet and getting older. Eventually I quit my job after 2-3 months and returned to Europe. Anyways the next 3 months wear a blur up to december 2017, when I noticed I could not get an erection for masturbating, and one I eventually got one very little sperm came out. I even felt like my testicles shrunk.

After this 6 months I knew something was wrong and I needed to change. I immediately started eating again and gained the weight back however I noticed some more symptoms. I noticed I haven’t even had spontaneous erections in the last 2 years. Semen volume and force is still low, and there is no sensation in orgasm (good feeling) Testicles and Penis feel numb like rubber and and penis tip is cold/wet. I also developed stress incontinence. My eyes are dry, and I do not preduce precum nor armpit sweat, nor genital sweat! One time at work I even noticed some discharge from my nipples this only happened once or twice 1 year ago.

The doctors here don’t seem to believe me, please help as I dont know what to do anymore.
I have never taken any steroids or anything like that , just protein powder and occasional creatine. I am also not on TRT.

shbg 19 (18-54)
fsh 3.7 (1.5-12.4)
lh 5.0 (1.7-8.6)
e2 13 (11.5-43.2)
progesterone 0.12 (0-0.13)
total t 654
free test 2.56% (1.53-.2.88)
cortisol 481 (171-536)
acth 29.2 (0-46)
TSH 2.565 (0.35-4.94)
ft3 4.6 (2.9-4.9)
ft4 11.9 (9-19)
prolactin 301 (73-407)
DHT 220 (300-850)
DHEA-S 12,51 (4.34-12.2)
24 Hour Urine Cortisol: 77 (12-486)

Serum AM Cortisol came back elevated first time i tested it at 748 (171-536) second time it was in the high 400’s


#589

Was this post workout?

Probable culprit, do you take 5a reductase inhibitors


#590

Not that i Know of. This all started after an extreme crash diet with overtraining. Since I was 10 I had a fungal rash on my thighs/buttocks and inner biceps and was prescribed hydrocortisone cream for it. Other than that no medication/drugs…


#591

@joeviv10 you need to have a pituitary mri run to rule out a prolactinoma


#592

Just curious, wouldn’t his prolactin be elevated if he had a prolactinoma? Wouldn’t his T also probs be a good deal lower? And his LH and FSH crushed


#593

Pituitary MRI came back clean… I do have a l1-l2 minor herniation with severe loss of motor neurons confirmed by leg emg. Never had any back pain tho…


#594

@unreal24278 haha wow I totally missed the labs that were posted hahaha.


#596

any thoughts @physioLojik


#597

Luuuucccccckkkkyyyyy


#598

I’m not physiolojik nor am I nearly as knowledgeable as he is however you’re problem potentially stems from a lack of DHT.

You say these problems are recent right, they haven’t been around you’re whole life (thus you probably don’t have 5-ARD (fairly uncommon recessive condition), however as DHT stimulates growth of the prostate and seminal vesicles it would make sense (you say you have reduced ejaculatory flow and force) (and ej ducts + bulburethral glands but these aren’t dependent on DHT I don’t think).

Would you say, in comparison to normal guys, you went through normal puberty, have a normal amt of body hair and whatnot. I mean I can’t diagnose you with anything but a few possibilities come to mind when I think of what could be wrong.


#599

yes all was normal until my diet. I was low average in terms of devlopment , facial hair, etc. Felt a huge surge of testosterone at 19 to 21 before this crash…


#600

@physioLojik Hey brother ! I have a question for you. My brother in law is diabetic and had a heart attack about 10 years ago. He’s pretty overweight but is definitely interested in TRT. Does his previous health history preclude him from treatment? Would TRT help his diabetes?


#601

Ight, coming off of TRT after almost four years. I’ve been at 140mg per week for the last year, administered as 100mg E5D subq. T levels are typically 650 five days post injection.

No ancillaries.

I’m 55 years old, 6’1", 182 pounds, about 15% BF (Omron BIA has me at 13.5).

Prior to TRT commencement, T was 170. Bad diet, poor sleep, poor body composition, but no diagnosis of the cause.

Atrophy is now a concern as I am single for about a year and looking to start dating again. And, I have Central Serous Retinopathy which can be caused by Testosterone.

Last shot was 14 days ago. I have UGL Nolva, and 5000iu of HCG.

Plan?


#602

Questions

  1. I cant find any real guide or great information about Clem or Ephidrene on the site. Can you give a general rule of thumb or guideline to us who may or may not use them?

  2. I have often wondered should a newbie start bulking or cutting if they are more than 20% bf? I typically tell tgem to cut first but I have read a ton of contradictory information with arguementa to both sides… So i bring it to you, the guru.


#603

Does trt affect ATP, mitochondria, or the body’s energy transportation in any way? In my case it has been negatively affected. I have been on trt for 5 weeks or so (80mgs T cyp, 500ius hcg, 0.125mg Adex twice per week).

You dont seem to be a fan of hcg or AIs, but I dont want any shrinkage. Even on hcg I have experienced shrinkage. It seems like my only other option is serms.

I realize many of the benefits of trt take longer to kick in but I havent experienced any noticeable positive effects so far. If anything, trt is causing me to perform less optimally (memory, cognition, libido, the gym) than before I started.

I read something explaining that trt doesnt improve memory or cognition which is a bummer.

Defy wanted me to supplement dhea but it gives me side effects (insomnia, trouble staying asleep, feeling weird mildly hallucinogenic).

I realize a lot of information is lacking. I appreciate it if you can offer any wisdom
assuming e2 and thyroid are optimal.


#604

You’re on arimidex on 80mg of test/wk? Do you weigh like 700lbs or is you’re liver completely destroyed? Do you have aromatise excess syndrome lol


#605

@physioLojik any clues for me? Please help Im at my witts end!


#606

@physioLojik — Absolutely, that’s why I sought out your perspective. It’s certainly not standard or anything I plan to continue cycling long-term. See my first and second posts for stats and explanation.

In brief, I was informed that my batch was seriously underdosed, and upped intake accordingly. Bloodwork to help time my PCT surprised me when all indicators showed otherwise. This left me wondering why I hadn’t experienced any real sides at doses as high as 4 g/wk despite the absence of any and all ancillaries or aromatase inhibitors. From there I was curious about Dan Duchaine’s high-dose enhanced growth protocols, so thought I’d run high until either (a) any sides manifested or (b) blood levels reached steady state and I had a chance to conduct another round of bloodwork.

Now in week six with levels approaching steady state, I’m ordering another round of bloodwork to see how things look while dropping back down to a more conventional dosing protocol for the remainder of the cycle. Any insight or suggestions would be appreciated.


#607

Hi physiolojik, asked the following further up but I think it got lost in the other posts:

I had a question regarding my protocol and a bit of history regarding my current state.

I was put on TRT last year, routine urology protocol of 200mg every two weeks. As horrible as this dosing schedule was I felt on top of the world for 7 months. Then I started having massive panic attacks when I’d never had any before. My E2 was 47 but my urologist said that wasn’t the issue and took me off T cold turkey due to my symptoms. That was in January of this year and it’s been hell ever since. Anxiety, intrusive thoughts, severe fatigue, depression.

I got the courage up to try TRT again in September and, after doing some research, went with a knowledgeable TRT clinic. They put me on eod shots of 30mg which made me have panic attacks again and then I was on 20mg EOD which made them stop. Things were looking up until I started having panic symptoms again 9 weeks into things. I’m now on 10mg ED injections. It’s only been two weeks and I’m on the rollercoaster of trying to get stable right now. I’m experiencing depression on and off, this is not my history and it’s concerning to me. The clinic I’m with says 10mg ED is not enough and that I’m bound to feel hypogonadal at that dosage. They want me at 20mg ED.

My questions are: given that my SHBG is 16.5 on my most recent labwork. Would it be advisable to start a 20mg ED protocol as is being suggested? Or would I just end up with high E2 due to the low SHBG? Also, could the TRT withdrawal have permanently disrupted my endocrine system and this is why I’m not feeling as good as before on this new protocol?

Thanks for taking time out of your schedule to answer!