T Nation

Feeling Horrible. Your Thoughts on Lab Results

M/28

Hi guys, I kindly ask you to help me with your advice.

My current symptoms: depression, anxiety, obsessive thoughts (Pure OCD), brain fog-feeling like living detached from the world, tiredness, no energy, no motivation, no desire to do anything, no will to live, do not enjoy in anything, not feeling any emotions (living like a zombie), cannot connect with anyone, zero libido, even during puberty so no urge to masturbate or have sex, no sexual or romantic attraction for anyone (never even had-I think I am asexual and aromantic, but not sure), can get erection but do not feel any urge to have sex or masturbate.

My psychiatrist has prescribed me two antidepressants luvox (200 mg) and cymbalta (60 mg) but to no avail. Before those I was taking zoloft and serpentil and neither one of them helped me.

My endo does not want to prescribe me TRT because I am in range levels. What should I do ?

Thnx in advance.

My lab tests

E2-49 pmol/l
FSH-6,1 iu/L
LH-4,2 iu/L
Progesterone-0,6 nmol/L
Prolactin-432-mIU/L
DHEA-S-17,95 umol/L
Testosterone(total)-13,0 nmol/L
SHBG-26,6 nmol/L
Free Testosterone-0,271 nmol/L
Cortisol-649 nmol/L
TSH-1.56 mIU/L
fT4-17,3 pmol/L
Vitamin D (25-OH D)-26,4 nmol/L

It would be helpful if you provided reference ranges for all lab values.

Your estrogen levels are out of range for an adult male, but not for a pre-pubertal boy.

Your testosterone levels may be in the normal ranges, but for a man in his 70’s, few doctors truly understand sex hormones.

Young men are supposed to have higher testosterone and as men age testosterone decreases.

This is why the reference ranges are so broad. Your estrogen is low enough to eventually cause osteoporosis and the reason it’s low is because your Free T is low, the Total T is inert and the Free T is what truly matters.

I don’t know your location but if in UK or Europe you can go to the Men’s Health Clinic or Balance My Hormones and pay out of pocket for treatment because the NHS is notoriously bad for TRT.

If you want a sex drive, you need to get off of anti-depressants. They are notorious for killing it, even with high levels of sex hormones.

I’ve been on several antidepressants and they all made things worse for me. The only one I’ve heard of that had any success was Wellbutrin.

How long have you been on antidepressants?

P.S. your testosterone is literally low.
Free Testosterone-0,271 nmol/L (0,31-1,04).

By the way, If someone has a source chronic antidepressant use crashing serum testosterone levels I would be interested to see. I would bet there is a connection. I’ve seen this a lot.

did you always have many of those symptoms even before the first round of zoloft and serpentil?

are/were you trying anything else like supplements or specific eating habits?

w/ those symptoms, personally, I’d be testing many other things.

Thank you for your detailed answer. That is all I have regarding lab values. Yes, and I am sure that I would feel 100 times better with higher tesosterone but those doctors are fucking morons. When I get better with TRT I will go to their offices and have a nice conversation with them. I live in Croatia and we do not have Mens Health Clinic here but I have looked at Balance my hormones and they say on their site that is not necessary to come in UK for examination so that seems like a good option. What is your opinion about private clinic Balance my hormones, do they provide quality service, do you know maybe someone who went there to balance their hormones and is it a good decision to do that kind of treatment on distance ?

Thnx for your response. I have had zero libido and zero interest in sex and masturbation even before taking antidepressants. I have never had an urge to masturbate or to have sex. Like I said I do not feel any sexual or romantic attraction for anyone. But strange thing is that I can get erection for example when I kiss with the girls or touch them and I can have sex with them but there is no desire or urge, like some emotional component is missing, if I do have it I just do it for the sake of it, I do not enjoy in it. Strange.

I have been on cymbalta since last year but I am withdrawing slowly from it. On luvox I have been since december 2020. Previous ones were zoloft in 2017 for four months and serpentil in 2015 for three months.

Thnx for your response. Yes, I have had many of those symptoms even before taking those ssris.

I was on keto diet for six months combined with working out. Also I eliminated gluten, diary, sweets, alcohol and many other things which when I consume them make things worse, but not much has changed.

Could you tell me please, which other things would you be testing ?

Stop dieting and get good food in you. Exercise by lifting steel, cardio wont get you where you need to be. Also Im not sure what your T levels are with no range. But nevertheless, go to a TRT clinic and get retested, and get on TRT in order to get some mental wellness going, so that you can chuck the AntiDepressants into the trash. Take action or keep depending on your dumb doctor for more pills that continue to kill your sex game. Your choice.

I know jack shit about all those ssris and issues they can cause, so that’s out of my league.

As others have noted, your T is indeed low. It’s also tough to tell w/o the ranges. Is cortisol low? Might be beneficial to get your vitamin d up to 35-50, see if you notice anything. Might happen anyway w/ the summer coming up.

Speaking more generally, you can use the cronometer.com app to track your nutrient intake. See if you notice any patterns.

I’d also test anything related to neurotransmitters: folate, b12, copper, zinc, vitamin c, b6 (plp), vitamin A

other testing ideas: blood sugar markers (fasting glucose, fasting insulin, c peptide, a1c), iron panel (w/ ferritin), liver/kidney/pancreas markers, full blood panel

best of luck

Thnx for your response. I have started lifting weights again but I am so fucking tired and low energy during and after trainings. And when I get some gains it goes more to stomach, ass and legs than upper body even with strict calorie counting. Ranges for total test are from 8.26 to 29 nmol/L and mine is 13.0 while ranges for free test are from 0.091 to 0.579 nmol/L and mine is 0.271. What do you think about private clinic balance my hormones in UK because I live in Croatia and here as I know we do not have mens health clinic or anti ageing clinic at which they could give you TRT ?

Im sure you can get Turkish or German test. You’re low on T