T Nation

Low Libido, Depression. Bloodwork

T Replacement
#1

Hello,

For a long time I have been tired, I have lack of energy, the results in the gym are staying at the same level or even worse - stagnation, despite the onpoint diet, supplementation and training / deloads, etc …

I have been testing my hormones for about 3 years and always testosterone is low/mediocre - lh and fsh levels probably explain that, but the doctors keeps telling me that everything is normal.

Now I’m falling into some depression, because the libido has been way worse than it was and erections are not what it used to be, sometimes so weak that my girl thinks I am cheating on her and/or I am not anymore attracted with her body (that’s totally not the point as she is a sex bomb…) - it’s probably the worst thing that can happen for a guy who loves sex.

I have already tried to cooperate with the best dietitians here in Poland, thinking that I will be able to naturally grasp the situation - of course I have tried nearly all of the Ayurvedic herbs, zinc, shilajit etc etc…

In general, I have spent a lot of money, nerves and time, but the improvement was only delicate…

It seems to me that TRT is the only right way out, and I would like to start as soon as possible. Below are the latest blood results: after blood tests I also had a magnetic resonance of my brain - not specifically the pituitary, but apparently you can see the pituitary gland on such a scan and everything there is probably okay.

Please advice…

AST: 33 U/I [10-37]
ALT: 20 U/I [10 - 41] before: 30 U/i
GGTP: 16 U/I [<73] before: 15 U/i
LDH: 169 IU/I [120 - 246]
Cholesterol total: 128 mg/dl [115 - 190] before: 119 mg/dl
Cholesterol HDL: 50 mg/dl [>40] before: 54 mg/dl
Glukoza: 81 mg/dl [70-99] before: 86 mg/dl
PSA: 1,43 ng/ml [<4,00]

TSH: 1,386 uIU/ml [0,550 - 4,780] before: 1,601 uIU/ml
FT3: 3,65 pg/ml [2,30 - 4,20] before: 4,32 pg/ml
FT4: 1,55 ng/dl [0,89 - 1,76] before: 1,55 ng/ml
ATG: <15,0 U/ml [<60]
ATPO: < 28,0 [<60]

Estradiol (E2): 29,40 pg/ml [11,80 - 39,80] before: 31,20 pg/ml
FSH: 2,71 mIU/ml [1,40 - 18,10] before: 2,43 mIU/ml
LH: 7,77 mIU/ml [1,50 - 9,30] before: 4,08 miU/ml -sometimes even lower than that
Progesteron: 0,588 ng/ml [0,05 - 0,149] before: 0,474 ng/ml
PRL: 7,4 ng/ml [2,1 - 17,7]
Kortyzol: 28,62 ug/dl [5,27 - 22,45] before: 12,97 ug/dl
Witamina 25(OH)D: 39,80 ng/ml before: 32,00 ng/ml
SHGB: 48,9 nmol/l [17,3 - 65,8] before: 26,6 nmol/l
Testosteron total: 523 ng/dl [241 - 827] before: 426 ng/dl
Testosteron free: 15,06 pg/ml [ 4,5 - 42] before: 16,18 pg/ml
DHEA-S: 339,3 ug/dl [34,5 - 568,9] before: 363,3 ug/dl

*before = before the last tests, which were performed relatively not long ago, the oldest have a maximum of 2 years.

In general, there are no major changes in results in the past 3 years. The only thing that changes is sometimes LH sometimes higher, sometimes lower, but it’s also possible that it has a relationship with ashwagandha herbs, I’ve also had a slightly higher level of FT3 (as shown above)

#2

Certainly looks like an option. Doubling your free test would help. How old are you?

1 Like
#3

I am 26

here another one testosterone bloodwork from 2018:

Testosterone: 14,42 nmol/l [9,9 - 27,9]
Free testosterone: 10,34 pg/ml [4,25 - 30,37]

As you can see I have posted 3 different bloodworks for my free testosterone and all of them are on a bad level. .

#4

Are you experiencing low libido in general or only in regards to your gf(s)?

#5

In general. I mean, I still want sex and all, but I am not as crazy about it as I always was, I love woman’s body. I mean my gril, she turns me on, even when I think about her, she really is super sexy… but when it comes to things I tend to loose my boner from time to time, which makes me furious.

Also I have an idea that my testicles have shrinked.

#6

Does this only happen when you are with her or also during masturbating? The reasons may go beyond testosterone. From what I learned libido is very complex and so many factors are affecting it.

2 Likes
#7

These doctors that keep telling you you’re normal probably have no idea one way or the other where on average 26 year olds are scoring testosterone wise (800 ng/dL) and they probably don’t care. The problem is insurance companies restrict prescribing doctors from taking action until your levels reach that of elderly men to save on healthcare costs.

There is a stigmata of TRT in the medical community and most doctors refuse to even prescribe it to men who are truly deficient. Your SHBG is the reason why your Free T is sub-optimal, sick doesn’t optimize health, they treat disease and according to your levels, they have determine you don’t have a disease.

LH is high and testosterone should be higher, Free T isn’t even midrange. I don’t think there’s a sick care doctor that would treat you, a private doctor may be your only hope.

1 Like
#8

Partly true, the insurance companies restrict TRT to those diagnosed as having hypogonadism. To render that dx the patient has to be out of range, which is 250-1100 with Quest.

So, 249? You have hypogonadism. With 251, you are in the normal range, low normal, but normal.

If the doctor diagnoses hypogonadism with 230, or hypothyroidism with a TSH of 3.88, and submits an insurance claim with prescribed treatment, it is fraud. If the insurance company catches it, the claim is denied as not medically necessary. Do it often enough, and they will turn you over to the state medical board.

There needs to be research evidencing the need to redefine these conditions, and new parameters set for treatment qualification. As you often mention, follow the green. Who is paying for this? Pharmaceutical companies? Not much profit for generic testosterone or bioidentical T3/T4.

#9

I was thinking about that it may be caused by stress or something related with my girl, but I have the same issues when masturbating… Sometimes it works fine, but sometimes I hardly get a boner, even watching some videos with hot girls that I normally would adore to see fcking.

#10

thanks for your reply.

I know, right, my levels are of a old man, which is why I feel so bad…
What I’m really concerned about is that I have the idea that my balls shrinking and they are feeling like ‘squeezed’ I don’t know how to describe that correctly.

TRT is not popular at all in Poland, all the doctors here have no clue about it, there is also hard to find a private one that does it good… even in the capital city - Warsaw.

My SHGB tended to be out of scale, like very high sometimes… so that may the issue indeed.

What do you suggest? TRT? or something else?

#11

Something to try that helped me, stop watching porn and stop masturbating, give it a rest. I felt much more arousal and functionality getting away from it. I either have sex or do nothing and it seems to improve all around well being. Its free and worth a try.

#12

I am not masturbating a lot, and sometimes not even once a week, so I think it’s not that. I only do that from time to time when my girlfriend is not around (she lives in other country).
Also my mind is ready for sex and all, when I see her I’d like to have sex till I die, but penis is just not always working…

1 Like
#13

I am actually surprised at how much determination it takes to accomplish this. As you said though, it’s free and I would imagine would give you some more overall energy during the day. The energy drain you take when masturbating has to give an increase in energy and desire to have sex since you keep your sperm locked and loaded. I know I have gone a few days without it just as a test. I noticed that I was hornier and able to bang my wife better. Boner was more rewarding for sure.

1 Like
#14

Do you have spontaneous night or morning erections?

#15

@mindphaser
no… I don’t :frowning:

#16

I am wondering how your symptoms would improve with higher free T.

#17

Did you ever experiment with Boron? Supposedly it may lower SHBG and therefore raise free T.

#18

No I didn’t.
Does it need to be an extract or what? Also what amounts should I try?

I mean, my total test is also not best, so if when it will rise I think it would help me.
I have been on TRT for a couple months and felt a lot better back then, only my E2 did rise, which was the only side effect.

I did stop however, because the endo told me there is no reason to proceed and I shouldn’t do the TRT at all, as my levels were good and back then when he said that, they were even worse than the labs above, so I don’t think he was right about it…

#19

It usually comes in pill form. There are several studies that indicate potential benefits. One study showed an increase of free T by 28.3% after seven days and a daily intake of 10 mg.

1 Like
#20

It’s not just that there’s no profit in bioidentical hormones, it eliminate future men and women from needing profitable prescription drugs and treatments which hurts big pharma on the tail end. Now all of a sudden a large percentage of people are disease free where the wouldn’t have been if it wasn’t for bioidentical hormones.