T Nation

Low Libido and ED w/ Labs


#1

E2: 39 PG/ML

TT: 529 (RANGE 249-836)

FT: 11.03 PG/ML (RANGE 8.90-42.50)

PROLACTIN: 9.5 NG/ML

LH: 2.23 MIU/ML

FSH: 2.60 MIU/ML

WBC count: 5.63 10^3/UL

RBC count: 5.01 10^6/UL

Hemoglobin: 15.5 g/DL

Hct 45.8

Mcv: 91.4

MCH: 30.9

MCHC: 33.8

RDW: 12.3

PDW(fl) 10.9

MPV: 10.0

PLT count: 201

Neutrophil (%): 44.6 (RANGE39-74

Lymphocyte(%): 39.6 (RANGE 19-51)

Monocyte(%): 10.3 (RANGE 3.3-10.8)

Eosinophil(%): 4.4 (RANGE 0-7)

BAsophil(%): 1.1 (RANGE 0.0-1.5)

Neutrophil(#): 2.51 10^3/UL (RANGE 2-7)

Lymphocyte (#): 2.23 10^3/UL (RANGE 19-51)

Monocyte(#): 0.58 10^3/UL (RANGE 0.2-0.8)

Eosinophil(#): 0.25 10^3/UL (RANGE 0-0.5)

Basophil(#): 0.06 10^3/UL (RANGE 0-0.2)

age 33 5’9" 163lbs waist is about 32 inches. i look slim. decent muslces from gym but hard to get.

Sparse chest hair, tons of leg hair and pubic hair, typical armpit hair,
fast growing slightly patchy beard

I carry fat in belly and buttocks. I think when I was younger less fat went
to buttocks.

I had a variocele repaired. My testes are normal in regards to blood flow and size according to DopplerUltrasound imaging.

Rx drugs: I take 1mg finasteride for hair loss. I used to abuse adderall in university heavily for a few years. I dont use it anymore (over 5 years but it's when my ED started).

My diet is high protein and low carbs to keep fat down. I get fat too easy.

Intense long training for a while but I recently started to take a break.

Testes do not ache.

I have no erections. My junk is always dead unless I undergo direct tactile
stimulation from my wife or masturbation. Even then I cannot maintain full
erections more often than not. Its terrible and is the reason im here.


#2

Based on the labs you supplied your e2 may be the culprit as it's relatively high. Most feel best in the low to mid 20's. Your FT is on the low end which would likely increase by decreasing your e2. You may want to look at your gut health before adding in pharmaceuticals like arimidex/anastrazole.

I added in a massive amount of fermented foods which nearly eliminated my need for an aromatase inhibitor in anastrazole although I'm injecting 50 mg test cyp EOD. Estrogen is metabolized initially in the liver and then second in the gut. If either aren't optimal, e2 won't be cleared and will be elevated.

Other blood work like CBC, thyroid and cortisol would be helpful to see as well.

Start researching topics of gut health, leaky gut, intestinal permeability. If you don't want to see if that could be a contributor, get an ai like anastrazole and dissolve in vodka for micro dosing.


#3

Do you have E2 labs before and after the intake of fermented foods?

What kind of fermented foods do you eat? And in what quantities? Thanks.


#4

My e2 before fermented foods was around 22-30 pg/ml taking 50 mg test cyp EOD and 1/4 adex EOD. Once I started eating around 1/2 cups of sauerkraut every day (what I prefer, I think Kimchi is gross. I've had some fermented carrot blends that aren't bad as well and plan to begin fermenting my own veggies soon. I also used to drink Kefir, but dairy and I don't mix all that well, so I dropped it. I also get around 6 tablespoons of nutritional yeast every day, along with 1 cup of raw uncooked buckwheat) and loads of other prebiotic veggies, without making any other changes, my e2 dropped to around 10 pg/ml. My need for adex has drastically reduced the "healthier" I've become. By "healthier" I mean reduction of stressors, increasing fermented and prebiotic foods, eliminating toxins and inflammatory foods and reducing body fat.


Other Options to Pharma AI's for TRT (Zinc, DIM, Arimistane)?
#5

I added other blood work that i already had done. I do not eat much if any fermented foods. It was not something I had considered. Any other advice given the new lab results I added to my original posting? Thanks @Hostile


#6

I dont eat many fermented foods if any, do you have any recommendations? Would a probiotic supplement help? Thanks @Igs


#7

Sounds amazing you were able to lower estrogen that much with diet. I was assuming estrogen was the bane of all my problems when i saw that 39 score. Thanks @Hostile


#8

When we see low FT and high E2 we suspect that the problem is impaired liver clearance and AST/ALT labs are of interest. See the highlighted sticky below re effects of some medications.

Please read the stickies found here: https://forums.t-nation.com/t/about-the-t-replacement-category/38/2?u=ksman

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

I do not think that a HPTA restart can work if this is damage from 5-alpha-reductase inhibitor.
But odd to have that and this high E2, so there are two problems.
With TRT you will still need to beat that E2 problem.

Thyroid labs?
Do you use iodized salt to support thyroid hormone production?
Starvation diets can be damaging and can stress the adrenals and elevated rT3.
Note references to thyroid in the stickies.


#9

I did read the sticky regarding damaging hormones. I was having ED problems before propecia though. I am assuming something else is going on. I think my iodized salt intake is low. My cortisol maybe jacked up given im a coffee fiend and dont always sleep well yet exercise a lot. Thyroid maybe messed up? Can you delineate the specific labs needed? Tell me what to do and I will listen. Thank you @KSman


#10

I agree with you, however there's a reason your e2 is high and I would suggest depleting those potential causes before pharmaceuticals.


#11

Probiotics have been shown to be ineffective as they rarely make it past the stomach to the intestines. One serving of fermented veggies has the same # of organisms as an entire bottle of probiotics plus they make it all the way to the large intestine.


#12

I agree about attempting to avoid pharmceuticals. I could probably see a 600 total T score naturally if optimized some things and im relatively young (well under 40) so lifelong commitment to TRT is probably overkill and I have never used any steroids or TRT in the past. Is yogurt a good source of fermented food for the gut? and what about Liver Health? Do you think it weighs in as heavily as gut health? Thanks @Hostile


#13

Please measure oral body temperatures to eval overall thyroid function as per the thyroid basics sticky. This is often more useful that thyroid labs. If temperatures are good, labs may not be needed.


#14

I measured body temperature with an oral thermometer. My temp. was 36.1C (97F) immediately upon waking up.

3pm body temperature was higher. i boned my wife with my half limp 39-E2 junk before taking a nap, then woke up 2 hours later and re-measured oral body temperature at 36.4C (97.5F).

There was a good 3 hours between activity and taking temperature, but i mentioned it because it's in the stickies about taking temp.
Thanks @KSman


#15

Do I need Thyroid Labs?

I picked up some Morton's Iodized Salt and intend to put it on most of my meals.

Going to eat more fermented foods. Ordered a Probiotics supplement and Multivitamin.

Thanks for any input on this @KSman @Hostile @Igs


#16

What about Liver clearance? Isn't that a separate issue requiring separate labs to be ruled out as the cause?
Thanks @KSman


#17

No ones mentioned the Finasteride?

I've seen that drug causing problems in men all over the place. It works by blocking the conversion from testosterone to dihydrotestosterone.

Maybe look into that side of things too.

I will also guess your SHBG is high since your free test is a little low.


#18

I had ED problems before Finasteride though. Also Finasteride (as far as i know) wouldnt elevate e2 up to 39, which is bound to cause libido problems since my T is all locked up (hence the low free T to total T ratio).


#19

bump. Should i get thyroid, liver, or other labs? If i can only get one set of labs the week what should it be? Liver?

Thanks @KSman @Igs @Hostile @Nashtide @equalo212 @gonadthebarbarian @verne @jimgainz


#20

Disclaimer: I just have read the stickies.

If KSMan says to get the liver tests, that's what I would do. Looking at your numbers, E2 is what I would be concerned about. If KSman thinks it's possibly due to a liver issue, I'd research that before going straight to arimidex.