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Chronic Depression, Fatigue, No Libido All of My Life

Hello !

I’m 33 years old. I’ve chronic fatigue, depression and no libido (and no morning erections. Erections are good if I get horny.) all of my life. I often feel nervous too much and experience anxiety (including social. I’m an introvert). I have apathy which progresses with time.
Also I sweat too much (even in cold place). Also I’ve sleep problems.

My height is 183 cm and my weight is 77 kg.
I consider myself skinny fat. I’ve a layer of fat on my belly.
I’m allergic. I’ve a bit elevated eosinophiles

I hate that I gain weight easily eating almost nothing. By 2013 I found out that it may be due to low testosterone.
In 2013 I went to endocrinologist. I did scrotum ultrasound which showed no problems. I did blood tests which showed
3.5 TSH. For my endo you’re hypothyroid if your TSH >= 2 and free T3, free T4 suck. So she decided I’m subclinical hypothyroid
and prescribed me Eutirox 25 mcg. Also she told me I’ve low normal testosterone. My T is usually in range 3.50-4.20 ng/ml.
So she prescribed me HCG 1500 ME injections every 4th day. Also she told me I’m close to obesity and I have insulin resistance.
Totally she prescribed me omega3, vitamin D, HCG, eutirox, Glucophage Long (Metformin).

The next day after first injection of HCG I felt euphoric ! I was a superman ! I had energy, concentration, creativity, motivation, etc - all things
I’m missing all of my life. I became assertive. Also I got to know what a libido is. I have no libido all of my life. I thought that my problems are solved and I’ll feel
like this forever. But the next day its gone. My T got a bit higher than my baseline. It was a big disappointment. I kept doing my prescriptions for 3 years till 2017. In 2016 my endo
increased my eutirox dose to 75 mcg. In 2017 I noticed that I’m balding near forehead and my hair became weak and thin. I was very angry about it and decided
to stop using prescribed meds. It didn’t help to regrow my hair. I kept trying to find solutions for my problems.

I went to neurologist. She told me to do MRI and ultrasound. Found no problems. Then she prescribed me tranquilazers: strezam and grandaxin. I felt nothing.
I went to psychiatrist and she immediately prescribed me antidepressant Cipralex. I asked my endo about it and she forbid me to use it. She said that
testosterone is the best anti-depressant and prescribed me Omnadren 250 (clone of Sustanon 250) every 2 weeks. I injected it and after that I noticed
that I have better stamina and I had the best sleep ever in my life for a week. After I week I thought I’m dying. I became weak, very anxient, felt pain in my chest.
I decided not to inject it anymore. When I went to my endo again she told me I just need to inject more often. But I didn’t try it anymore.

My depression progresses. I have less & less interests in my life. As docs know nothing I became to do research on my own.
I took vitamin C, A, B (1,2,3,6,9, 12). I found books about amino-acids against depression. I tried l-tryptophan, l-tyrosine, l-phenylalanine, DLPA. I got very painful headache from L-tryptophan. I started to think that my depression is due to lack of dopamine and endorphines, not serotonin. Because sometimes after taking 1-3 DLPA pills my mood really improves
and libido increases.
After a month of gliatilin I got very painful headache.
I took A and E vitamins and overdosed it after a month. After this I discovered that since that time my DHT is 12 times higher than maximum value. And my total T is still in the same
low normal range.

Also I felt much better when I discovered Magnesium citrate.

Tried L-arginine. Makes erection better.

With L-tyrosine my TSH became 1.5 and free T3, T4 are better than ever. I have some anti-TPO. So maybe I’ve Hashimoto.

So most time I hate how I feel. I felt the best after first injection of HCG.
But sometimes I’ve ‘good mood attacks’.

One day I was nervous before sleep. So I took glycine and ate whole blister of it. I failed to sleep and in the morning I became euphoric and horny for a day.
I was in Bali and got a massage there. Felt euphoric and horny for a day.
Immunologist prescribed me Decaris against parasites to take it at night (preventively. its not confirmed that I’ve parasites). Slept great and felt good in the morning.
This year I had a scrotum ultrasound and urologist massaged it hard. After that I woke up in the night full of energy, motivation and very strong erection which lasted till
the morning. This time urologist told me I’ve varicocele.

After my experiments in 2018 frequency of good mood attacks increased a bit. I took DLPA, reduced glutathione, magnesium citrate, cashew nuts (a lot !!
best antidepressive nut!).

I think I’ve chronic fatigue due to problems with mitochondrias.

I continued my research and did simple genetic testing. I discovered that I’ve MTHFR heterozygous mutation, COMT, DRD2 homogeneous genetic mutations.
COMT and DRD2 directly affect dopamine. I’ve G/G variation of COMT which means my COMT enzyme is too active and my dopamine gets destroyed.
DRD2 means that I’ve low density of dopamine receptors.

I had a saliva cortisol test. Its elevated.

My blood estradiol, prolactin are normal. Last year progesterone is below normal or low normal.

In july one of my docs told me he found hidden iron deficiency. He told me to have 4 injections of iron. I did 2. But after that I got a serious arm injury.
So at this moment I only take care about my arm. In hospital I was injected with narcotic painkillers. I had more energy, motivation, mood and libido ! It
worked better than injected testosterone !

So I think my problem is lack of dopamine. I want to try wellbutrin, but I can’t buy it in Russia. I need to go abroad for it. And I can’t because my arm is injured now.

Why I feel bad and what can help me ?

Do you have current bloodwork with rages?

We need to see the following at the minimum

Total T
Free T
SHBG
E2
FSH
LH
TSH
FT3
FT3
CBC

Testosterone injections take weeks to work. So if you go the trt route, you need to be more patient.

This seems a bit contradictory to me.

Can you elaborate?

Need current bloodwork

HCG can only do so much. It will make you produce as much as you CAN naturally, but if you aren’t able to make enough T naturally then you’ll need to get it another way.

If I get horny (from porn) my erections are strong. But normally I’m not interested in sex and have no random erections. My dick and scrotum are often cold

HCG didnt help me much. Maximum T on it is 520

Serum Iron - 9.1 mkmol/l (5.8-34.5)
Latent iron binding ability -45.6 mkmol/l (22.3-61.7)
Total Iron Biding Capacity - 54.7 mkmol/l (54-72)
Ferritin - 77.0 ng/ml (30-400)
Transferrin - 2.6 g/l (2.2-3.7)
Transferrin saturation coefficient - 14 % (15-55)

Total T
Free T
SHBG
E2
FSH
LH
TSH
FT3
FT3
CBC

Total T 4.27 ng/ml (2.49-8.36)
SHBG 32 nmol/l (13-71)
Estradiol - 31.6 pg/ml (7.6-42.6)
LH - 4.18 mME/ml
TSH 1.19 mkME/ml (0.27-4.2)
fT3 - 2.65 pg/ml (2.84-4.39)
fT4 - 1.12 ng/dl (0.80 - 2.1)

Hemoglobin - 153 g/l (132-173)
Red blood cells - 5.02 10^12/l (4.3-5.7)
Hematocrit - 46.7 % (39-49)
MCV - 93 fl (80-100)
MCH - 30.5 pg 27-34
MCHC - 328 g/l (300-380)
Color parameter - 0.91 (0.85-1)
Platelets - 257 *10^9/l (180-320)
White blood cells - 10 * 10^9/l (4.5-11.3)
Immature granulocytes - 0.3 %
Segmented neutrophils - 4.78 * 10^9/l (1.6-7.9(
Segmented neutrophils - 47.8 % (47-72)
Eosinophils - 0.59 *10^9/l (0.02-0.3)
Eosinophils - 5.9 % (1-5)
Basophils - 0.10 *10^9/l (0-0.07)
Monocytes - 0.74 (0.09-0.6)
Lymphocytes - 3.79 *10^9/l (1.2-3)

The reason why you felt great at first and then all the symptoms that followed is because your doctor got your protocol horribly wrong. Your problem is your baseline estrogen and SHBG are likely being ignored with regard to protocol decisions and that’s why you are lost.

Your estrogen is on the higher end of the range pre-TRT and your doctor thought it was a good ideal to inject one massive dosage which would see estrogen in the stratosphere which is what caused all those symptoms, it’s no wonder you quit TRT. No wonder your TRT protocol failed, 250mg sustanon, this is way too much given your pre-TRT estrogen numbers! You can’t just inject testosterone every two weeks and expect everything to workout without considering your other biomarkers, you need to optimise your TRT protocol.

You may do better injecting 125mg once or split it up twice weekly. Some guys don’t tolerate moderate and/or large infrequent injections, your 250mg injection was massive. While sustanon isn’t bad, enanthate is a better choice as it’s a single ester rather than having multiple esters short, mid and long acting esters which all have different half lives.

It took me almost 2 years to figure out the dosage and injection frequency that works best for me. It doesn’t seem like any of your doctors even attempted to optimize your protocol, they thought inject T every 2 weeks and everything will be alright, they thought wrong.

HCG suppress the top half of the testicles and therefore doesn’t activate all hormonal pathways and is one reason why HCG isn’t always ideal for everyone.

You should have listened to your doctor, most guys would thank God daily for one that good. Omnadren is mix of esters. You felt good because the short esters kick in immediately and get you up, but one shot doesn’t allow the long esters to build up and carry you, so you went up and came back down. Sticking with it would have had you in good shape after about 8 weeks. You need some patience. If the doc is willing to prescribe it more often, go to every ten days and give it some time. Do not split the dose though, that really doesn’t work as well on a blend like that. You need all of the short esters up front, not some piddly dribble of them every day. ride it out.
And go back on the thyroid meds. Hair loss is hereditary, get used to it.

I believe I need dopamine, not testosterone. You can see that many people still have no libido on TRT

You need testosterone to make dopamine, free T in particular, which you lack. You felt great on the HCG shot because it gave you a blast of test production that lasts about two days, then it’s time for another shot if that’s the route you are taking. Libido is dependent on more than just dopamine, all of the catecholamines play some part, and they are all down-chain from free test utilization. Your problem is not testicular, it would appear to be secondary hypogonadism and pituitary related. Take the test for at least 8 weeks and be consistent and be patient. You will be happy in the end if you do.

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Testosterone directly affects dopamine, high testosterone can give you a boost in dopamine.

These levels are low, especially consider your SHBG levels, you FT levels must be sub-optimal which wasn’t even tested. The only instance this TT value would be acceptable is in someone will really low SHBG.

If you want TRT to work and improve dopamine you’ll have to give it more time than a couple of weeks and you also needed to make some adjustments to your TRT protocol.

free t - 107.8 pg/ml (2.5-64.8)
DHT 10780++ pg/ml (250 - 990)

Free T ?

free t - 107.8 pg/ml (2.5-64.8)
DHT 10780++ pg/ml (250 - 990)

You need to post your total, free number together because I’m thinking these numbers were achieved with the TT of 429 and SHBG of 32 which seem impossible.

This free T number could easily explain why you felt great initially and then encountered negative symptoms, but we need to know how long you were on this said protocol before drawing labs because if this was just a couple of weeks, it would mean you needed a dosage reduction.

This happens because of other problems TRT didn’t fix, like poor sleep habits, working nights which disrupt sleep patterns. Other times the person is on SSRI’s and omitting this fact because it will be used as a scapegoat or are in denial anxiety exists or their protocol are not ideal. High blood pressure will kill erections and libido.

Things that effect libido:

  • Obesity
  • High blood pressure
  • Diabetes
  • Poor sleep
  • Medications
  • Stress/depression
  • Low testosterone
  • Infections
  • High prolactin
  • Low thyroid hormones
  • Alcohol & drugs
  • Surgery
  • Heart disease
  • High cholesterol

free t - 107.8 pg/ml (2.5-64.8)
total t - 12.30 nmol/l (9.90 - 52.40)
unfortunately i didn’t measure shbg in that results group

These levels indicate SHBG is now low, it’s the only way FT could be so high and TT low. Your TT is 345 and FT is over the ranges, SHBG calls for a different type of protocol, very frequent injections daily. My SHBG is low and I need only 400-500 to have sufficient FT levels, but to keep levels in these ranges I need very frequent injections, TT levels above this cause symptoms and can’t keep levels from getting out of hand on infrequent dosing.

TRT decreases SHBG is just about everyone.

Last time my SHBG is usually
31-32 nmol/l (13 - 71)

@ineedenergy

Many people have increased libido from TRT. Mine went from low libido to that of an 18 yr old. I took wellbutrin for dopamine before TRT and it helped for a little while but eventually stopped. When I got on TRT I was able to get off wellbutrin no problem and TRT was much more effective. You are looking for an instant fix and that just isn’t how it works. Especially with TRT it takes months and then finding the optimal dose for you.