T Nation

Feeling Stuck Between a Rock and a Semi-Hard Place


#1

I went off HRT and tried a restart that I ended on 11/17. During the restart the clomid seemed to work better for me than T/AI/HCG ever did. Which makes me think I was secondary. My T levels on T/AI/HCG never got very high and fluctuated month to month. It seemed like I always over responded to the AI and was bottoming out. Not to mention my HCT was always (and still is) near or over 50%. The dilemma I am faced with is 5 months post restart, T levels keep trending down. I have considered going on clomid but there are no studies on long term use plus the likely increase in E2 which can’t be managed if it is occuring in the testes. I also have a history of floaters which doesn’t help. I could go back on T/AI/HCG and do frequent blood donation/therapeutic blood letting and hopefully the second go around have more success and even keel. Or stay as is and live with what my 46 year old body is telling me. If anyone has done long term clomid, I would love to hear the ups and downs with it and any sides experienced. Also what dose. I was planning 12.5 or 25 mg EOD to try and keep E2 in respectable range. KS man if you can look at my labs for past 4 months and affirm my assessment is correct. I will also post a history of my TSH and T3/T4 as it has fluctuated. Also to be noted is my prolactin was elevated and cortisol near upper limits but have had ALOT of stress lately which could be a factor all around. Thanks.

                        12/4/17	1/4/18	3/6/18	4/11/18	

Testosterone
193 - 824 ng/d 461 272 272 255
Testosterone Free
41.7 - 180.2 pg/mL 153.4 103.0 108.3 84.6
Prolactin
4.0 - 15.2 ng/mL 26.8 H
Estradiol 17B
<38 pg/mL 33 <25 <25 28
Hematocrit
39-51% 51.1 50.9 49.9 49.6


Below is history of TSH/T3/T4
2/17/14 4/20/15 4/25/17 4/11/18
TSH 4.100 1.040 1.320 2.030
0.400 - 5.500 uU/ml

Free T3 2.7 2.8 2.9
2.3-4.1pg/ml

T4 Free
0.9 - 1.7 ng/dL 1.3 1.2 1.2


Misc lab history DHEA-s Cortisol

                                            4/25/17	4/11/18	

DHEA-S
44.3 - 331.0 ug/dL 94.1 96.8

cortisol
ug/dL 16.3 20.4
Cortisol Reference Range: AM = 5.3-22.5

                            7/24/17	  10/23/17	1/4/18	4/11/18	

Vitamin D 25 Hydroxy
31.0 - 80.0 ng/mL 30.5 31.1 31.2 21.6 L
I am on prescription Vitamin D (I was not taking it past 2 months though)


#2

UGH. The formatting got messed up when I posted. Let me know if it is too difficult to decipher and I will try to amend.


#3

bump


#4

@KSman any thoughts on this if you have time. Mentally I am feeling good and sexual function is pretty much normal just the s/s low T or (hypothyroidism? Temps normal range and eyebrows not sparse but hands constantly cold). Fatigue, no gains from workouts, accumulating belly fat without much fluctuations in diet. I am trying to pull the trigger to restart TRT in some form but keep telling myself 1 more month of labs. Next set is due 6/1 any benefit of adding SGBH and another set of thyroid labs to my standard labs? Thanks.


#5

You definetely need SHBG, that is what puts this all together. Get that VitB fixed too, 31 is way too low. 8000IU is good for me to stay around 60. By the way what was your TRT protocol?

Need full thyroid panel with reverse t3, antibodies. Your free t3 is a little on the low end. I was close to where you are and once I started armour the weight gain stopped. I had problems where I couldn’t stop gaining weight regardless of my diet or level of exercise, all stopped after a few weeks in 60mg of armour. I am not obese or anything but notice I was slowly packing on extra weight even though I work out and don’t eat terribly bad. My body temps were always normal so those aren’t always best to go by either.


#6

Hey thanks for reply. I am on 50000 iu for my vit D deficiency but just started back on it. As for my protocol in the past, it was what was recommended on here except I over respond to arimidex so I was taking 0.5mg weekly. My testosterone cypionate was the 100mg/week over 2 doses and hcg 250IU EOD. Got dialed in for about 3 months but T levels were never outstanding but symptoms were managable minus when my E2 bottomed out. Tried a HPTA restart using Clomid. My T levels came up nicely during that time so maybe I was a combination of primary and secondary hypogonadism. I will add the SHVG and reverse t3. Will look into the armour too.