T Nation

Ask Physiolojik Thread



Could you please expand on the dopamine insuffeciency…

All specialists I have been to seem to have something to say but no diagnosis

neurologist: minor herniation l1-l2 , spina bifida l5-s1. Loss of motor neurons on left and right leg confirmed by emg.

Urologist: prescribed me PRostamol Uno ( saw palmetto)

Endocrinolgists: cant find anything, but crisler told me to check DHT for the numbness. DHT was 220 (300-850)


I’m in a similar boat broski. Did you check DHT levels before or after you started taking Saw Palmetto? Saw Palmetto reduces DHT.
Are these the only bloods you have taken?


i never took saw palmetto, propecia , fin , ssri before… I just went on an extreme diet and training regimen for 6 months. Never took steroids trt and still dont either. Loss of libido i attributed to the diet , but 2 years later its still gone, and i have no erection , morning or spontaneous in 2+ years. Genitals also went numb , tip feels cold, and the right testicle, tract also feels cold/clogged?

Scrotum is also supper tight and high. Also feels like rubber. Eyes are dry too

DHT I checked after asking Dr. Chrisler what could cause this…


DHT is important for libido. Not sure abut those symptoms. If I were you I would get more blood tests, a lot more.


recent labs

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)


I’m a little out of my depth here I think, I’ll wait for someone else to help. Maybe research DHT and look for a root cause. Thyroid doesn’t look fantastic either.


what would cause Testosterone to be normal, but DHT to be low!?


I did not take DHT inhibitor?!?


For a start your test is in range but not particularly high. Also there are other hormones involved in the pathway but as I say, I’m out of my depth here. You have a lot of reading to do.


well testosterone of 650 shouldnt cause issues with 0 LIBIDO, and NUMB GENITALS, low semen volume… maybe a bit lowered libido but not this…


@physioLojik, anything to say to help me interpret my experiences and/or understand the SERM idea?


well your low libido is definitely low DHT related plus you’ve got low range e2 which is sub optimal. Your TSH is too high, anything above 1.5 is a red flag that ALWAYS goes undiagnosed because medicine tolerates a TSH up to 3, if not 4.5, which is even worse than low-ish Testosterone. TRT is definitely useful but Thyroid experts are so much more valuable IMO. Prolactin is not low either. Your free t4 and SHBG are borderline low as well.

Your DHEA-S being high and free T being rather high point towards some weird enzyme subnormal activity. You’d be one of the only guys out there who would want more 5ar AND aromatase activity.

You’re saying you went on an extreme diet+training regimen 2+ years ago, but my guess is that you’re probably still rather OCDing and your hormones suffer from that. You could be slightly overtrained, slightly underfed or a combination of both. You could be eating too few fruits and sugar, too many proteins and grains or dairy, have a mineral imbalance, the list goes on.


i have just tried to live normal and eat like before. I weight the same as before when I felt great, even I added an extra 3-4 kgs. I do not know what would cause this mess?

Should I do a mineral test?


@tontongg - Would you mind expanding on this statement? I’ve been in trt for over a year. Had some periods where I’ve felt great libido/arousal, but it’s been a problem lately.

Finally got TSH tested and it was 3.53 (0-4.5). Going in Monday for more thyroid tests.

Do you think elevated TSH could be a contributing factor to my libido/arousal issues?


WHAT, this isn’t true, a TSH of 1.5 in absence of symptoms of hypothyroidism means absolutely nothing. A high or low TSH is merely an indicator that an individual may have hypo/hyperthyroidism. A TSH of 1.5 is perfectly normal, feel free to correct me, however I’d like to see literature stating a TSH of 1.5 is an issue, hell you can have a TSH of 2.5 and have normal thyroid status. My TSH is consistently around 1.5-2.5, I do not have hypothyroidism.


What do you think of these this profile. Only symptom is cold hands during a time mostly everyday.
BTW unreal I agree with you. Tsh can fluctuate during the day.

My research tells me that Good free t3 but low end total t3 and total t4 can indicate hypothyroidism or at least sun clinical.


Cold extremities can be a symptom of underlying thyroid pathology. How’s you’re energy levels, do you feel particularly fatigued throughout the day, what about BF %, do you feel it’s difficult to lose weight?

Look, my free T4 is lower than yours, I believe it’s 81, I have no symptoms of hypothyroidism and therefore simply don’t worry about it, everyone’s body has a different natural setpoint as to when they feel symptoms of a particular condition. Look, a TSH of 3.4, a boarder line low free T4 + symptoms of hypothyroidism a trial of levothyroxine could be justified. Are you on any kind of treatment?

Edit: I’m no expert, thus I’m not really qualified to aid in advice on potential medical conditions. Dr Sir would probably be the best one to ask for this kind of advice. (Dr Sir is physiolojik)


Physio has eyed my chart above previously and said I could Def use treatment.

I tried levothyroxine for a couple of weeks. It helped my body temperature but gave me sides. I stopped for 2 days and shoulder pain went away. And currently my joints are clicking much less.

I started NP thyroid 15mg a few days ago. Much better so far. Afternoon Temps finally close to 98.6. Prior to treatment my body Temps were erratic. Some days I would get to 98.0, some 98.3, 97.8 etc. Temps lower than 98.3 gave me cold feeling hands which is very uncomfortable for me.

If I wanted a dose that would completely suppress my production I would need bet 60-120 MG of NP thyroid. The 15mg so far is giving me a little boost.


Yeetfloop, so firstly, I apologize if this comes out as dickish, however oral body temps aren’t a good way to gauge thyroid status, it really means jack shit in the big picture of things, a basal axillary body temp test is slightly more accurate (in my opinion) however it still isn’t as important as bloods

Secondly, using hormone replacement for a little boost while preserving endogenous hormone production is like an average individual with hypogonadism adding 25mg of test Cyp to their regiment (which consists of no T). You’re endogenous T production is partially supressed however you’re TT/FT doesn’t decrease and/or marginally decreases because you’re partially replacing what you already would’ve been producing, you don’t see guys with hypogonadism replacing half of what little they’re producing, the replacement is because you aren’t producing enough, therefore you need more than what you’d otherwise be producing in order for adequate replacement to take places thus full shutdown of whatever hormone being replaced is almost a certainty (unless you’re using like T+HCG… Which unless you’re trying to get you’re ms preggo… Don’t.

Malva… Pudding



malva pudding


I’ll try to get to all these questions over the weekend. Oral body temps are NOT a gauge of thyroid function. For instance, the acceptable range of temps in humans is 97-99. Body temp is regulated by serotonin. I don’t know where the entire idea that shooting for 98.6 etc was a way to gauge thyroid. Also, whoever said the tsh under 1.5 was necessary for ideal thyroid function is absolutely not right. Much like a SHBG level, tsh changes based on feedback loops. It isn’t a static number. I can’t undestand why people get locked into the idea that a simple snapshot of one moment in time is indicative of the overall picture.


@physioLojik if you have a minute. Please verify if taking a small dose of thyroid will suppress my own production? How does this work

Ami causing more harm taking a small dose for a slight sluggish thyroid?

I gather it does not work like trt