After a battery of tests, both blood and urinalysis, I was diagnosed with secondary hypogonadism as well as a varicocele. Original reason for doctors visit were conditions symptomatic of low T, ongoing the last three years or so. I’m still in conference with my doc as to whether the varicocele is the cause of my low T and whether or not I need to worry about it. There seems to be a lot of literature out there that would indicate a varicocele is positively correlated with low T and testicular atrophy.
Before the varicocele diagnoses was made, my doc was unsure (still unsure) of the reason for the hypogonadism, but felt it warranted treatment regardless, and so we started HCG mono. Dosing was started at .7 ml every fourth day ( i.e. three days in between shot days)and was later reduced to .5 ml every fourth day after encouraging total testosterone numbers after my second blood lab. I welcomed this dose because it is roughly in line with numbers represented on here for hcg mono to avoid Leydig cell desensitization.
Discouraging was my FT numbers. I know from the stickies that TT = FT + weakly bound T + SHBG-T.
Given my numbers below, I’m curious whether I should try putting arimidex into the mix in order to increase FT and lowering SHBG (I’ve heard that E2 manipulation can lower SHBG. However others have stated there is no efficient way to manipulate SHBG at all (confused on this)). If I were to do that, at what dose should I start the arimidex? 22 is the sweet spot for E2; how much would I need to drop it from 31.5? Any other suggestions? I’ve increased iodine intake (iodized salt) as per suggestion by KSman.
Generally speaking my symptoms associated with E2 are not cause for huge concern. I can get an erection, I have nocturnal erections some nights. However, it is sometimes difficult to keep it up without constant stimulation. So things aren’t horrible, but could be better.
My symptoms have gotten better (more energy, better libido, ect.) but not as good as they could be, in my opinion.
Estradiol 2.2 ug/24hrs (normal 0.8-4.6)
Total testosterone 29.4 ug/24hrs (normal 20-200 ug/24hrs)
FT 7.2 pg/mL (8.7-25.1)
DHEA-S 300.3 ug/dL (88.9-427.0)
SHBG 43.2 nmol/L (16.5-55.9)
Insulin 11.3 uIU/mL (2.6-24.9)
Cortisol 12.7 ug/dL (2.3-19.4 (AM 6.2 -19.4, PM 2.3 - 11.9) Test taken at 5:00 p.m.)
4 weeks AFTER HCG:
DHEA-S â?? 278 ug/dl (normal 80-560 ug/dl)
Estradiol â?? 31.5 pg/mL (normal 11-80 pg/mL)
SHBG â?? 55.1 nmol/L (normal 11-80 nmol/L)
FT â?? 1.62 ng/dL (normal 0.95 â?? 4.30 ng/dL)
Total Testosterone - 722 ng/dL (normal 241-827 ng/dL).
Thank you very much for taking the time! Look forward to responses.