T Nation

Bloodwork to Check Source of Low Libido?

Hey @KSman

Just wondering. My only symptom that hasn’t resolved since starting TRT is my low sex drive. I’ve managed to get myself to a point where I can achieve erections and have sex until completion with the help of Proviron and Cialis, however my actual desire for sex is nowhere near what it used to be. Used to feel strong arousal just looking at women, now it takes some decent physical stimulation just to feel aroused. Throughout the day, I rarely get spontaneous erections, and penis is always shrunken as if it were cold outside (used to hang and at least have a little blood in there, little chubs, you know?). Testicles usually up tight. This wouldn’t bother me, except for the fact that it was not really an issue before I started TRT. I’ll spare you the details of my whole situation on this thread, and it can be found on my profile. My sex drive responded really well to L-Tyrosine once (leading me to believe that it could be an issue with neurotransmitters), but that was only for one day and I haven’t achieved that with Tyrosine since. My question for you is: What is every blood lab you recommend I order to see what could be causing my low libido? Have tested Thyroid and Test/E2 in the past and am dialed in with Test/E2 and have corrected my slightly elevated TSH. I want to get every level tested at the same time to get a clear snapshot of my hormones at one time.

Currently, I plan on testing:
SHBG
DHT
RT3
FT3
Thyroid Antibodies
Pregnenolone
CMP
Cortisol AM/PM
Total/Free T
Estradiol

What values am I missing that could show signs for the reason for my low libido?

Thanks for sharing all your knowledge throughout the forum, I’ve learned a lot.

Add prolactin as well

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My testicles pull up tight when E2 is high, when E2 is optimal testiocles drop. I’m almost certain your protocol is to blame for low libido.

I suggested that to my doc, given that I’ve heard high Prolactin can be a libido and dopamine killer. On top of that, I’m aware that I’m having issues with Dopamine and have started wellbutrin. Two questions:

  1. Doc said prolactin tests are really only necessary when seeing enlargement of the breasts or lactation symptoms. Is this the case? Never had any problems with gyno or lactation. Regardless, if it is a possible cause, I will add it to the list.

  2. I’m not sure, but I believe prolactin and dopamine downregulate each other, correct? So having added Wellbutrin 300mg daily to my protocol, should I expect the increase in catecholimines to result in a decrease in prolactin?

Yes, I figured I would include E2 in my testing, even though I think I’ve got it dialed in. So far, increasing AI in the past has only made me feel better. Similarly, switching to E3.5D injections, and then to ED injections (higher frequency=less conversion to E2), I’ve felt better both times. The only adjustment I could imagine would continue to further lower my E2 would be to lower my Test dosage. Could it make sense, though, to see an increase in libido by lowering my testosterone dosage? Currently on 200mg weekly split into ED SubQ inj, 0.25mg AI, 350iu HCG EOD.

The FIRST thing your Dr should’ve tested when you’ve said low libido is prolactin.

High prolactin means low dopamine. If your prolactin is too high, he may order an MRI to rule out pituitary tumor. Regardless, insist it be tested.

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I’m not completely rejecting the possibility that I have a pituitary tumor, but I should not my libido was much stronger when I used to cycle LGD. Do you think LGD’s cognitive effects, like creating a “sense of well being” or “alpha”, could’ve led to an increase in prolactin off cycle?

What’s LGD?

lol @ your doc only willing to test for prolactin if you start lactating.

All it takes is a little check-mark with his pen on the lab sheet.

That’s like having a mechanic that won’t check your oil unless he hears your valves clacking.

“Hey Mechanic Bob, why not just check the oil? The dipstick is like, right there.”

“Nah, no point in that. I don’t hear any noise.”

“Yeah but…it’s…right there…”

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LGD-433. It’s a SARM