Well I did test my levels in two different places, one was at the doctor and the other was from a testing service (or whatever you call it). I got a 370 ng/dl reading at the doctor, but that was around 1pm while the 400 reading from the testing service was a fasting test in the morning. I will say that I accidentally put the reference range from the test at the doctor’s in my original post. The range from the second test where I got a 400 ng/dl reading was 248 - 836 ng/dl. I will also add that I think, if I am remembering correctly, that my libido was fluctuating low when I got a 490 ng/dl reading way back. Meaning it was low during that day but would fluctuate from high to low from week to week during those days.
Regardless, I am in no rush, so I will try some natural stuff and see if I can get levels up within the next few months. I will also try to get a doctor to do an MRI of the brain and testicles just in case, but that is gonna be difficult to get them to do.
But I am also wondering, if my LH and FSH continue to decline along with testosterone, that indicates secondary hypogonadism and would it not be appropriate to treat with HCG and FSH injections? That is actually something that is available in my country and likely easy enough to get prescribed. From what I understand, long term injections with HCG at least is well tolerated and safe. Is that correct? And could that alone increase testosterone to decent levels, in cases of secondary hypogonadism? And what about SERMs like Nolvadex and Clomid? I hear men get mixed results with those but if you control E2, maybe with an AI, and T, FSH and LH levels rise, should I not theoretically feel better? And are SERMs safe long term? Being able to stay fertile is what makes these options more appealing to me.
I’m glad that you’re still around Johann
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I still don’t think that especially the libido is directly linked to the small decline in T and the lowish T levels for your age. But if you had T measured twice recently at different labs than it might be worth to try to raise T.
I guess your best option at the moment is low dose clomiphene (1/4 of a 50mg pill = 12.5 mg every other day). Especially regarding fertility it’s the least invasive option. If at all it will improve your sperm count/mobility and you can always just stop treatment without having to care about HTP axis shutdown and the potentially associated issues that injectable T or hCG bring along.
hCG monotherapy or injectable T along with hCG are other options to keep fertile but at your age I would just not hop on that train yet.
Its difficult to predict how you will respond to the clomi, but worth a try. Reassess your situation then in 2 - 4 months. Getting the MRI scan in the meantime is a good idea although prolactin seems ok.
The articles below shows that clomi is safe and effective over a period of 3 years. Anyway I would recommend to maybe stop clomi every 12 months or so for a month. Typically dose is 25 mg eod but you may experience some side effects already at this dose. I had very good experience with 12.5 eod which raised my T from about 350 to 550; but everybody responds differently.
Maybe the articles below are helpful for the discussion with your physician
https://www.ncbi.nlm.nih.gov/pubmed/31216250
http://www.menshealthmelbourne.com.au/pdf/safe-and-effective-for-long-term-management-of-hypogonadism.pdf
https://www.ncbi.nlm.nih.gov/pubmed/30522888
I also suspect that it isn’t the T, or at least not the T alone that is causing my low libido. But the fact that it has declined and is borderline hypogonadal (if only mildly so), makes it difficult to ignore.
I will try to raise it naturally, like mentioned, but if unsuccessful, I will try to get a prescription for a SERM. Like you said, it seems like the safest and least invasive option. The problem is, it seems difficult to get a script for it here (thanks for the links though, hopefully they help). I do think it is easier to get a script for Nolvadex here than Clomid so I am wondering if you think that Nolva can be equally appropriate in my case? From what I understand, it has very similar effects to Clomid.
Thanks
Hey again,
I just measured my progesterone and got the following results:
Progesterone: 3.8 nmol/l (range <3.0) which is the equivalent to 1.096 ng/ml.
So this question is specifically about my progesterone. So as you can see, my progesterone levels are well outside range. I have even seen ranges of <02 ng/ml and I’m at 1.096! So what can be the cause of this elevated progesterone? And is there something I can do to lower it? And is it possible that these levels of progesterone are causing low libido for me? There doesn’t seem to be much info on progesterone and its effect on men online. I did see that it reduces DHT. Is that true? I will also mention that this test was not specifically designed for men, rather it was just a generic test designed for women. Could this cause elevated results? I also want to make it clear that I am still not on TRT or any medication. I take a multivitamin, a modest dose of vitamin D, C, K, B12, Citrulline, Sunflower Lecithin, Fish oil, a probiotic and magnesium.
@username2323 Its important to hear the mentality of @cigpk to keep this forum from being an echo chamber. Im on TRT and Im having great results. But it was a long road. If I were in my 20’s and know what I know now, I would really be looking at exhausting all possibilities before jumping into the commitment of TRT. Looking at your numbers, they are not bad. They arent great but not bad. I’d look everywhere else and keep TRT last. We get a little snap shot of a story from people on these boards and most of the time the immediate answer is…TRT! shocker this is a website called T-nation. Take note too that this forum is littered with stories of people on TRT with libido and erection problems. Libido is more than just testosterone so Id follow the mental health/life style change/Thyroid/…route until and if you end up on TRT.
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And yes elevated progesterone can cause some of your symptoms. Progesterone can be increased from stress. So start there. Its produced in the adrenal glands. Try some topical DHEA cream…which might increase E2 and DHT which compete with progesterone and it might relieve some adrenal stress as DHEA also comes from adrenals.
Reference ranges are method specific, so you shouldnt compare your test result to the reference range of another assay. You are only slightly outside the range.
It can be an incidental finding or it could point towards a problem with your adrenals, specifically a conversion issue from the progestans to the mineralcorticoids.
If you want to exclude the latter then you need more diagnostics. Basal levels of ACTH, aldosterone and cortisol. Idealy a low dose ACTH stimulation test.
@cigpk I can give you another point of view.
I struggled with low t symptoms for two years. Year and a half ago I discovered my t was suboptimal, around 350 and I started trying to fix it.
Initially by supplements, then optimizing vitamin d and stuff. No success. Then I contacted Defy and we started cabergoline. Thanks to that I managed to raise it to 560 but my SHBG also rose from 30 to 50. Now I have 560 total t and 9ng/dl free T. In the last 8 months I also cleaned my diet very much, eating 90 percent only whole foods, I lost 10kg body weight and exercise a lot, I increased my strength in the gym and people tell me I look much better.
But my low t symptoms are still there and Im sick of that. I’m going to start TRT next month and I think I explored all my options. To be honest I’ve not read many success stories, not to say even a single one about what you want to achieve and what I wanted to achieve as well. Even if you raise your T somehow most probably it will not be enough. For example I’m in the 500s now and I suspect I need to double it to start feeling really well. And there is only one way this can happen.
And I want to feel well and live my life fully. If I have to pin myself for life to achieve that- so be it.
Why are you still on the fence then? I see you posting about starting TRT everywhere.
@meisterxx97 I’ve been wondering that for months.
I’ve been considering it and I decided it firmly 10 days ago.
I may be a pussy but it needed a lot of time for me to take this decision.
And I cannot start tomorrow, need to organize some things. Hopefully until 10 of December everything will be ready
No one said anything about being a pussy, but the earlier you start the better. You could feel like a different man in December already. Who knows, you certainly won’t know without trying.
@meisterxx97 Hopefully.
Consult with an experienced TRT progressive doctor in Thursday. He will go through all my conditions, results and symptoms and hopefully does not find some real reason not to start(we are not talking about the clueless endo who sees that you are in the normal range). After that I’ve scheduled sperm freezing, hopefully there are enough boys.
But yes the remark is right, I started considering TRT in the spring when I found this awesome forum that played a big role in educating myself and I took the decision just recently.
Wanted to share my experience with @cigpk because it may give him additional perspective.