T Nation

High T, FSH, SHBG, Low E2 No Libido. My Lab Results (pellets)

A hundred years ago, I was measuring excess Nitric Oxide and it showed depleted (no excess indicating low nitric oxide).

Months later, after all the supplements including Nitric Oxide boosters, I tested “about normal” but wasn’t feeling any better.

Today, over a year later, I used another test strip and I am so depleted that I don’t register on the strip.

I continue to read that there is a well known connection between sleep apnea and decreased nitric oxide levels.

One of the doctors on here (Ruterbusch) told patients to drastically increase l-arginine to boost NO.

This is coming full circle for me.

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I took it for a while but really just needed to quit booze to eradicate erection issues.

It has been 4 weeks since I made an adjustment to supplements and I needed to run Estradiol tests; so I threw in a few other tests that I was curious about. Iodine was one.

In September, I had low iodine (39). I experimented for two months with armour thyroid medication and felt no different. When that was finished, I began Iodine supplements – 225mcg per day (in additional to the 150mcg in my daily vitamin).

The test this week indicates that I am back in the “normal” range, but it is interesting to me that it is a very low normal.

I have no low iodine symptoms that I am aware of other than “feeling cold” all the time; but that is not something new.

I wonder if 4-6 weeks is long enough supplementing with iodine in order to fully replenish. Unfortunately most of the iodine sites are kind of quacky.

On iodine supplementation from mid November until this test in Mid February … 3 months (12 weeks).

The point of my recent blood work was to see what Ultra sensitive Estradiol was doing.

I had stopped taking DIM for months.
My September 2019 and early Jan 2020 were at 38.
I started back on DIM and Feb was 35 – i expected it to go lower.

.
I have never been as concerned with Estradiol because when I started this journey, I had almost undetectable levels; so I didn’t mind experimenting with some free flow.

I meet with the doctor soon and will see what he thinks. If I was a betting man, I would have bet that the Indolplex DIM would have had a greater effect than a 3 point reduction.

Last night marks the second night I have used a CPAP machine. The first night, I took a sleeping pill to make sure I would sleep with the octopus on my face. Last night, I was able to sleep without any assistance.

It is a weird feeling for those who have never tried it. Imagine lying in bed and your partner is blowing into your nose all night.

But in all honesty, it IS NOT as bad as I imagined.

I am still waking up throughout the night, but the intensity has changed as I don’t wake up choking or needing water. Two nights is too early to see any changes though. The app that is connected to my CPAP displays how many times I stopped breathing, as well as how many times I was breathing shallow and the machine pushed air at volume.

I already knew that when I lie down, I get slightly stopped up in the nose. This is still happening, but the machine pushes air through and I can still breathe but the stopped up nose is “uncomfortable”. Next week, I will receive a chin strap to stop my mouth from opening – just what I need: more things on my face at night.

Most people say that it will take 2-4 weeks to get used to the device and notice changes in sleeping.

On another note – I posted good things about Isleephst where I originally had my sleep test. I withdraw everything good I said about them and the way they do business.

This was from March 2018 – two years ago last month and the reason I have no respect for Systemlord’s suggestions.

PELLET TREATMENT WORKS for me. It has been excellent. Contrary to the above advice, I have had NO trouble.

If the original insertion wasn’t enough, Doctors will give a booster to determine where the level needs to be. You CAN optimize dose on pellets.

It was the BEST move I could take. I would NEVER tell someone that injections or gels were the “wrong move” because every person and situation is different.

Take what you read on these forums (from ME and from everyone else) with a grain of salt and determine what is best for you.

Ha. I use and eye mask and a dental snoring device and on some nights even ear plugs.

Glad you are seeing promising initial results dude.

I’m so glad pellets work for you, really I’m glad you found something that works, but you seem hell bent on dredging up an old argument even after I stated pellets have their places and works great for some people, yet hear you are still ranting in caps and bold letters which seems over the top for even you.

I mean you come across as if in a constant agitated state, give it a rest, it’s post after post after post and is not normal. You don’t respect my opinions and suggestions, I’ll get over it.

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For me, I also have retainers. The most uncomfortable thing I have found is ear plugs. I’ll wear them on the plane, but under normal circumstance I can’t wear them. As strange as this sounds, I feel that the ear plugs amplify the noises in my head. Oh, that is not a joke - I’m not hearing things in my head! hahahah

I do hope this works also – for me to actually have an entire night of uninterrupted sleep is something I can’t imagine.

Yeah I get this. Its ALL amplified. Breathing, mouth noises, etc.

I used one at first. Didn’t work. My pressure was just too high for one thing. However, a little piece of surgical tape worked great. It has stopped being an issue unless I have a cold now, but the tape was significantly more comfortable and worked better.

Surgical tape on your mouth? That is interesting.

This is my report from last night. Normally those 6 “obstructive apneas” would have awakened me and I would have coughed or drank water. I didn’t sleep though the night however, but that is my dream.

At a high level, what has TRT fixed for you and what is still an issue?

Ey, I read you have troubles whit anorgasmia. Did you use ssris or other psychiatry medication before?

Serotonin is very blunting to orgasms and sexual pleasure. One option you have is buspirone that might help whit the anorgasmia. Reduces serotonin by activating the presynaptic autoreceptor (autoreceptor reduces monoamine release) but I have not tried my self and there are potential uncomfortable side effects of course.
And is usually given an hour before sex because of his short half life to make an effect

No, never. Unfortunately the cause isn’t that easy.

Just as a curiosity, rasaligine (MAO B inhibitor) might increase orgasm pleasure too.
Reboxetine might help also despite is known to cause erectile dysfunction
Even Ayahuasca being a MAOi I ve heard it fucking helps lol

QUICK ANSWER:
In Dec 19, I wrote again that in comparison to where I started more than 2 years ago, I was in much better shape – happier, more energy, feeling more alive - functioning like a human. I believe that is mostly from the Testosterone (and the effect of the Testosterone with lowered SHBG from Danazol).

DETAILED ANSWER:
Hi. Thanks for the question. Unfortunately I can’t give you a 25 word summary as a a complete answer. So pull up a chair…

I started documenting my problems online 2.5 years ago, but I had been documenting the irregularities in my semi-annual blood work for 5+ years prior to that. The results showed hormone anomalies that I didn’t understand enough to correlate to the way I felt.

My hormones were out of balance, and the doctors couldn’t correlate it to anything I was feeling. My estradiol was either undetectable or low. I only knew about my SHBG levels because the test marker was free with the package. My free T hovered around 1% give or take. My natural T was over 1000.

I began taking tests with the sole purpose of eliminating disorders. Brain MRI, penile doppler, urinary stress, kidney ultrasound, heart testing Some symptoms pointed to Thyroid so thyroid markers in blood were tested repeatedly.

I have had a dozen additional test and spent thousands and thousands of dollars with the attempt to either isolate what is causing my problems or eliminate more unknowns. I utilized blood, saliva and urine testing to compare results across the different methodology.

From the first day I began seeing doctors, I talked about my sleeping problems – the need for ambien some nights, and the inability to have a continuous uninterrupted night of sleep. All of the doctors blamed it on the stress of the “other” symptoms I was having. Because of my size and medical history, NO doctor every considered Sleep Apnea.

Another reason no one considered apnea was because apnea was known to causes issues with “libido” – which looking back, should have been taken to include both libido and arousal – or ED in general. I wasn’t having any problems with libido.

By now, I had already seen a dozen or more doctors in varying specialties. The Endocrinologist and the Urologist threw their hands up and gave me the name of a teaching hospital.

Dr Crissler reviewed years of lab results and gave his famous treatment recommendation - “throw lots of T at it; the SHBG will go down”. When I asked about all the other out-of-balance hormonal issues I was having, he said that getting T and SHBG in line will cause the others to follow.

I decided to move forward with TRT, but I did NOT believe it was going to be the answer to all my problems. I felt that my circumstances involved multiple problems that had not been diagnosed yet.

I researched pellet doctors and found my current doctor. I set up a regular office visit to talk with him and explain to him that I was going to be a problem patient and to ask if he wanted the challenge. After reviewing all the data, he said that he didn’t know if he could help me, but he was willing to try.

After the first pellet insertion, I didn’t feel better for the first 30 days, so I returned and had a booster insertion. I started feeling better. The brain fog had faded; I had energy and was no longer feeling lethargic.

My T levels tested “over 1500” (as Labcorp didn’t provide higher numbers). My SHBG increased. This dispelled the theory that throwing more T at it will cause it to decrease in all cases.

I added a test of danazol to treat the SHBG. I started and stopped twice and ran blood results each time. At the end of my cycle, with the starting and stopping Danazol, and my SHBG going up and down (and finally increasing back to where I had started) I felt like I wanted to die. High SHBG causes my body to dissolve the T pellets like candy. At the end of 3 months, I needed more pellets.

After my next insertion, I began to feel like a human again. I told the doctor that the world felt vibrant and in color again. It sounds stupid to write this – but the world had “warmth” again. I had energy and drive. With the SHBG still on a roller coaster ride, I found that I felt the best above 1400. My doctor opined that I likely had super high levels as a kid which is why I felt better with supra-physiologic doses of T.

The lower my SHBG, the longer my pellets last. I understand the theory behind it, but it was interesting to see empirically.

As I continued my T pellet cycles, I wrote that “I have felt really good. Energetic, happy, clear, and with chubbies here and there”. I wrote that I felt more “balanced” even though I had not solved all my problems.

I actually started sleeping better for a while when my T levels were super high. Sleeping problems returned gradually. I was able to extend my pellet insertions from 3 months to 6 months once my SHBG was reduced.

I continued testing and determined various vitamin and mineral problems that I have tried to correct.

Sexual arousal was on-again-off-again. Some times it was good, other times not. I needed viagra to perform. In hindsight, the more Viagra I took, the worse I slept. I later learned that is an apnea correlation.

Libido was still as strong as ever – arousal was not up to the challenge. In September of 2019, I again commented about how good I felt – other than always tired. I bought a fitbit watch and started thinking more and more that my sleeping problems were more important than I realized.

I experimented with utilizing telemedicine with a few doctors. Sent my labs and a synopsis. The results were the same – the arousal issues were “mental” – in my head. I disagreed. Being the ass that I am, I asked if the anorgasmia was in my head also – and they said yes. Next.

In Dec 19, I wrote again that in comparison to where I started more than 2 years ago, I was in much better shape – happier, more energy, feeling more alive - functioning like a human. I believe that is mostly from the Testosterone (and the effect of the Testosterone with lowered SHBG from Danazol).

My future:
I need a few weeks on the CPAP machine to see how it effects libido and erections (ie: nitric oxide production) as well as sleep and daytime exhaustion.

I received a super-strong batch of L’arginine tablets and pycnogenol and intend to follow Dr Ruterbusch’s suggestions on attacking nitric oxide production. I was on L’arginine and Citrulline back and looking at notes, I was performing better so there may be something to it. When I test Nitric Oxide, it always shows as “depleted” which may be an important factor in my arousal problems.

I will be testing a medication to treat the anorgasmia on a trial basis (off-label since my anorgasmia was not caused by medicine).

I still believe that some of my problems are catecholamine and serotonin related and I hope to take a 24-hour urine test this year.

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Wich medication can i know?