Dramatic Loss of Sex Drive and Sleep Issues

[Man_on_a_Mission]

Test Results

Over the last month, I have been getting erections with help of Tadalafil (Cialis) 10 mg. But during sex I have been losing erections, gaining it back and losing it again. Last couple days my sex drive has also tanked. Last night I got about 3-4 hours sleep and overall my sleep has been erratic at best. If I take Melatonin it has helped but yesterday I started DHEA and could not fall a sleep last night, maybe 3-4 hours.

Been on TRT for 4 years now. My program has been getting tweaked because I was losing sex drive and feeling low energy all the time. Age 48. Tests above were from 3 weeks ago. Diagnosed with Fatty liver 15 years ago and diverticulosis 3 years ago. Low D vitamin. Non smoker. Donating blood every 30 days right now, will go to 45 days based on tests.

Current:
-DHEA 25 mg 2 times per day breakfast and dinner (50 mg total). Started for first time yesterday. Only got 3-5 hours sleep.. not sure if related or not. (added this based on test results)
-Test Cyp injections: Monday and Thursday .35 each time= 120 mg per week (went up from .3 to .35)
-Anastrazol: 1/2 mg M,W,F (1.5 each week)
-HCG 10ml per day in morning
-10 mg Tadalafil (generic Cialis)

500 mg Vitamin C (low Ferritin levels, trying to build iron stores back up) per day
29 mg Ferrous Fumarate (1 per day... I cant take a lot of iron due to constipation) per day
4000 iu D3 includes 200 mg calcium. (diagnosed with low D vitamin) per day
2400 mg Fish Oil + 720 Omega 3 (to help if Hematocrit got too high)
81 mg Low Dose Aspirin (same as above)
2 Mens Vitamins
1 Fiber pill 2 grams fiber

I am open to suggestions that you guys have seen out there with my overall situation and also loss of sex drive suddenly.

[Hostile]

Sex drive may gone because you're not sleeping and tired. Even when my TT/FT & E2 are optimal, if I over train or become sleep deprived by libido suffers. You're injecting 10ML of hCG PER DAY?! <-Mistake? Please give all your doses in mg's and iu's.

Why are you taking DHEA? On a whim? Get your bloodwork done and post the labs with ranges; there isn't enough information here to formulate an educated guess.

-total t
-free t
-estradiol/e2
-dhea (will be high due to supplementation <- was DHEA previously shown as low through tests?)
-tsh
-ft4
-ft3
-rt3
-cortisol (may be elevated at night preventing sleep)
-cbc

[Man_on_a_Mission]

Thanks for reviewing! The link at the top has any and all Tests that have been done this last time.
You should be able to see 2 pages..do you?
Everything on the med list is doctor prescribed.

Corrections:
I am doing 140 mg Testosterone Cypionate per week (2 injections of 70 each)
HCG is .10 ML per day
DHEA was low

[blshaw]

Hmm according to those labs in the link you are dialed in pretty well outside of the CBC. I don't see your DHT levels. DHT is not all evil and considered your libido driver. Any change you have that?

[Man_on_a_Mission]

Nope on the DHT. And I looked back on my tests for the past 3 years and no one has run a DHT.

[Man_on_a_Mission]

My previous labs were at 64 (high) for Ultrasensitive Estradiol. So he put me on Anastrazole 1/2 mg twice per week and it dropped it to 22.
Now he has upped the dosage to 1/2 mg every other day but for convenience I am doing M-W-F starting last week. So my estrogen could be tanking? Is this increase a mistake? What is a good range to be in?

Weight wise I am 6'1 230 lbs. I am guessing body fat is at 20%. I dont lift weights on a regular basis and do 1 hour cardio per day. on elliptical.

[Nashtide]

22 is the magic number. It's not universal, but it's where most guys feel the best.

[Hostile]

I don't understand why your Dr would see that 1/2 mg of adex twice per week dropped your e2 from 64 to 22 and then decided to increase the adex dose by 33%.

There's a chance that the 1 mg/week dose may have eventually crashed your e2 (speculation) and the 1.5 achieved this effect more quickly. It sounds like you may have crashed your e2. Only blood work can tell for sure. I would get labs done if you can. We can use simple math to dial in adex dose with those numbers.

If you cannot, you can drop the adex for a week and see if you feel better. Then I would reintroduce 1/4 mg of adex twice per week the same day as injection. I also do not sleep well when my e2 is low or high. Figuring out e2 can be a real challenge through observation because low and high e2 can mimic each other in some ways.

Im a little surprised that your total t and free t aren't higher as well on 140 mg test cyp. Because your T isn't sky high, this will somewhat mitigate high e2 unless you have very high body fat (I see you said 20% which if accurate isn't that high, but 15% would be better).

Stop with the elliptical, start resistance training and get your diet in order.

[Man_on_a_Mission]

I do my T shots on Monday and Thursday. I did my test on Weds morning. Would this be a reason why my Testosterone is lower?

I skipped my Adex last week and started this week with .5mg. Going to change to .25 mg 2 times per week. (.50 mg per week) going forward til tests are done in 3 weeks

[squashbuckler]

I used to have fatty liver as well...
Ended up I was hypothyroid and had prolactinoma... I would rule that out Brother.