T Nation

Low T a Year After Steroids. Hypogonadism, ED, Low Libido

hello lads hoping some of u might be able to help about 2 months a go I felt like I was suffering from low test I had all the side effects and no surprise it came back low 6.7 nmol which i think is equal to about 170 in what ever system the americans use for anyone who’s American… that was low considering the minimum border is set at 7.6n/mol… I then after had a full hormone check a couple of weeks later, the results are below…

D.H.E.A. SULPHATE 10.420 umol/L 0.44 - 13.40
FOLLICLE STIM. HORMONE 4.98 IU/L 1.50 - 12.40
TESTOSTERONE 7.11 nmol/L 7.60 - 31.40
FREE-TESTOSTERONE(CALCULATED) 0.219 nmol/L 0.30 - 1.00
SEX HORMONE BINDING GLOB 11.12 nmol/L 16.00 - 55.00
FREE ANDROGEN INDEX 63.94 Ratio 24.00 - 104.00
17-BETA OESTRADIOL 33.4 pmol/L 0.00 - 191.99

as u can see test is still low as is my free test (I did jab 1ml of sust straight after my last test results out of desperation but no more since) and also the SHBG is low. Follow those results I decided to go on HCG as a kind of HPTA restart and have been doing around 2500iu a week now about a month down the line I had a full test replacement blood test done the results are shown below… you’d expect my test to be higher than just over the minimum with all that hcg right? And still a low SHBG and high red blood cells… can anyone make sense of this? Any help is appreciated… Ive known been advised to follow Dr Scallys Power PCT which im about 6 days into:

Day 1-16 : 2500iu HCG every other day.

Day 1-30 : Nolva 20mg/day; Clomid 100mg/day (50mg was taken twice per day)

Day 31-45 : Nolva 20mg/day

However its a wierd one because ive already been doing hcg for about 5 weeks so maybe i should just discontinue that and stick to chlomid and nolva… thoughts??

Really dont know what to make of low SHGB either, thyroid estraidol and prolactin levels are all fine as wel

I’d also add before that 1ml of sust I hadn’t used Steds in at least 12 months more likely longer.

Final most recent test

Red Blood Cells
HAEMOGLOBIN (G/L) *178 g/L 130.00 - 170.00
HCT *0.524 L/L 0.37 - 0.50
RED CELL COUNT 5.63 x10^12/L 4.40 - 5.80
MCV 93 fl 80.00 - 99.00
MCH 31.6 pg 26.00 - 33.50
MCHC (G/L) 339 g/L 300.00 - 350.00
RDW 12.1 % 11.50 - 15.00

White Blood Cells
WHITE CELL COUNT 8.1 x10^9/L 3.00 - 10.00
NEUTROPHILS 4.22 x10^9/L 2.00 - 7.50
LYMPHOCYTES 2.96 x10^9/L 1.20 - 3.65
MONOCYTES 0.73 x10^9/L 0.20 - 1.00
EOSINOPHILS 0.10 x10^9/L 0.00 - 0.40
BASOPHILS 0.06 x10^9/L 0.00 - 0.10

Clotting Status
PLATELET COUNT 232 x10^9/L 150.00 - 400.00
MPV 9.9 fl 7.00 - 13.00

Kidney Function
CREATININE *121 umol/L 66.00 - 112.00

Liver Function
ALANINE TRANSFERASE 35.7 IU/L 10.00 - 50.00
CK 119 IU/L 38.00 - 204.00
GAMMA GT 39 IU/L 10.00 - 71.00

TOTAL PROTEIN 76.4 g/L 63.00 - 83.00
ALBUMIN 44 g/L 34.00 - 50.00
GLOBULIN 32.4 g/L 19.00 - 35.00

Iron Status
FERRITIN 234 ug/L 30.00 - 400.00

Cholesterol Status
TRIGLYCERIDES 1.7 mmol/L 0.00 - 2.30
CHOLESTEROL 3.96 mmol/L 0.00 - 4.99
HDL CHOLESTEROL 1.31 mmol/L 0.90 - 1.50
LDL CHOLESTEROL 1.88 mmol/L 0.00 - 3.00
NON-HDL CHOLESTEROL 2.65 mmol/L 0.00 - 3.89
Heart Disease RiskHDL % OF TOTAL 33.08 % 20.00 - 100.00

Thyroid Function
FREE T3 5.99 pmol/L 3.10 - 6.80
FREE THYROXINE 17.2 pmol/L 12.00 - 22.00


TESTOSTERONE 7.79 nmol/L 7.60 - 31.40
FREE-TESTOSTERONE(CALCULATED)*0.218 nmol/L 0.30 - 1.00
17-BETA OESTRADIOL 55 pmol/L 0.00 - 191.99
SEX HORMONE BINDING GLOB *14.4 nmol/L 16.00 - 55.00
PROLACTIN 121 mIU/L 86.00 - 324.00

Prostate Screen
PROSTATE SPECIFIC AG(TOTAL) 0.553 ug/L 0.00 - 1.40

You’re going to require injections EOD or ED if you choose to go on TRT for it to be effective. Your high red blood cells production will become a problem if you should start TRT. Some people just have genetically low SHBG which is made in the liver.

I wish i knew my bloodwork before steroids, but im sure these test levels are even too low for someone with naturally low test?

That PCT is simply wrong bro-science and bat shit stupid.

See HPTA restart sticky.

When you create high LH receptor stimulation with high SERM induced LH [and FSH] or high dose hCG and then transition to having the testes work on their own, there is a huge drop in LH receptor stimulation, which signals the testes to do less right when you want them to do the opposite. Meanwhile this LH receptor over-stimulation typically leads to high T–>E2 inside the testes and very high serum E2 levels. The lingering E2 shuts down the HPTA when the SERM is gone and E2 is unmasked. Note that anastrozole does not work against T–>E2 inside the testes.

Do not stack SERMs or SERM+hCG!

Some guys simply have high or low SHBG. Your past use of gear could have done that. There will be less non-bioavailable SHBG+T and then TT underestimates your T status.

Your blood is too thick and will be a major problem with higher T levels.
Avoid iron fortified vitamins, breads, cereals, rice, pasta etc. Read labels.
Do not get dehydrated.
Use mini aspirin and fish oil.
Donate blood if you are able to.

You have secondary hypogonadism. The top end of your HPTA works, testes do not. Testes may have been damaged by use of gear without hCG and/or bad PCT practices and outcome. If testes are going to recover, may take time for tissue changes to occur. But TRT might be your only option.

Low SHBG is often associated with diabetes. You have not shown fasting serum glucose.

Liver looks good.

TSH better nearer to 1.0
fT3 is the active hormone and well above mid-range, which should depress TSH. Suspect that rT3 may be blocking some fT3 action.
Oral body temperatures may be depressed, see below and check.

Many in UK are not getting enough in UK. Iodized salt is not in most shops and you are expected to get iodine in sea food and from dairy food.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • HPTA restart
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

"The PCT program outlined below represents what I consider to be an ideal and effective post-cycle program. It was developed by the doctors at the Program for Wellness Restoration (PoWeR), who have a formidable history helping patients recover normal hormonal functioning following steroid therapy. One of the key doctors on this program, Dr. Michael Scally, claims to have successfully treated more than 100 cases of hypogonadism/hypogonadotrophic hypogonadism, and is very well known in the field of androgen replacement therapy. PoWeR published this program as part of a recent clinical study, which involved 19 healthy male subjects who were taking supraphysiological (highly suppressive) doses of testosterone cypionate and nandrolone decanoate for 12 weeks. Their HPGA Normalization Protocol focuses on the combined use of HCG, Nolvadex’ and Clomid, and is perhaps the only clinically documented post-cycle therapy program to be found in the medical literature (it is amazing how little attention has been paid to hormone normalization in clinical medicine). The most notable variation from a classic PCT stack, such that I have( been a longtime supporter of, is the combined use of two anti-estrogens. In this case I cannot say that there is disadvantage to such use; perhaps it is indeed the better option.

Examining the program closely, we note that the teste are hit hard with HCG at the onset of therapy. Its intake however, is limited to only 16 days. The doctor, undoubtedly recognize that when HCG is taken for too long or at too high a dosage, it can desensitize the LH receptor. This would only further exacerbate the post cycle problem, not help it. Anti-estrogens are used during and after HCG, with a dosage of 10 mg of Nolvadex and 100 mg of Clomid per day rounding out this compliment of drugs. Clomid is used for a shorter period of time than Nolvadex, likely because of the desensitizing effect it too’ can have (on the pituitary gland) with continued use. Among other things, these two anti-estrogens will continue to foster LH release as testosterone levels start to go back up, as well as combat any potential estrogenic side effects that may be caused by HCG’s up-regulation and testicular aromatase activity. Although in the first couple of weeks the anti-estrogens probably do very Iittlle as they should be much more helpful towards the middle and end of the program. During this clinical investigation: normal hormonal function was restored in all subjects,I within 45 days of drug cessation. This is a definite success far more favorable than the protracted recovery window noted in studies without post-cycle therapy, such as the 250 mg/week testosterone enanthate investigation, highlighted in Figure I. For me, I believe such a detailed recovery program should follow any serious steroid cycle It is the best way to maintain your gains at their maximun and that is, after all, what we are after.

About Dr. Michael Scally

Dr. Scally***8217;s education includes a double degree major in Chemistry (1975) and Life Sciences (1975) from the Massachusetts Institute of Technology (M.I.T.) Cambridge, MA. Following, from 1975-1980, in the M.I.T. Division of Brain Sciences & Neuroendocrinology Dr. Scally researched and published investigations on neurotransmitter relationships.1 Dr. Scally’s research included involvement and participation in the earliest studies detailing the role of tryptophan, serotonin, and depression. During this time, he entered the prestigious Health Sciences & Technology Program, a collaboration of M.I.T. and Harvard Medical School. In June 1980, Dr. Scally was awarded by Harvard Medical School a Doctorate of Medicine, M.D. Continuing his education, Dr. Scally trained at Parkland Memorial Hospital, Southwestern Medical School. Scally completed the first year of postgraduate medical residency in general surgery followed by postgraduate medical residency in anesthesiology."

Its not bro science mate

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Thanks for the reply KSman I have done months and months of research and i was also read to do hcg then chlomid, not together, and i planned to do 4 weeks on hcg then 3 months on low chlomid dose however i was then advised to use the poWer PCT as it is know to be documenated extremely succesful in reverse hpta shutdown

Those high doses are harmful and the fact that many have nevertheless survived does not make it right. Please review the HPTA restart sticky.

Yes, you can find hordes of similar high dose PCT approaches on BB and steroid forums.

Not survived but sucessful and it was made by what seems a very highly reptuable Doctor with numerous certifications.

Ive had similar arguments with guys on other forums and this most recently about hcg:

Well 2500 IU every QOD is not unheard of. The whole desensitization thing is a myth that started with studies on rat balls. The problem is they gave the rats an equivalent of 10,000 IU per dose, and that showed SOME desensitization. So yea that may be too much.

Don’t get me wrong I think you guys are correct thats not a good starting point, I am just saying if someone was ASIH (Anabolic Steroid Induced Hypogonadism) they may require large doses, especially initially, to get the testes back up and running at their maximum capacity.

In what way are they harmful in only a 45 day peroid where it seems i have hypogonadism.
I have read that HPTA restart before but got influenced on to this poWer PCT and there seems to be a lot of documentation backing up its success

its hard theres so much contraversy on the internet

We absolutely know that high dose hCG and/or SERMs lead to high E2 levels. With SERMs, the S is Selective as in selected tissues. Other tissues see the E2 and react. Increases SHBG is expected from the E2 levels.

The transition from high LH receptor stimulation from high to low is not conducive to a restart transition. A long taper of SERMs has long been advocated.

Looks like you are leaning towards low-dose methods, please consider. Note that in the HPTA restart sticky there are milestones and labs in the process. But again in your case, it seems like only the testes need to be restarted. Because your LH/FSH levels are good and T levels are not. I really do not see what can be accomplished, but not much to loose either.

If you come hear asking for advice and knowledge and dismiss what is offered … what is the point?
We see guys with messed up E2 levels from 25mg Clomid ED or 20mg Nolvadex ED. In the TRT forums we have lab work showing what is going on. BB and steroid forums lack this information and insight.

Sorry if i seemed to dismissive im just diggin into what you’re saying i didnt mean it to sound that way, I really appreciate you taking the time to explain what you’re saying. This isnt something ive briefly looked into but something ive been overwhelmed with by information and struggled with the contraversy against with everyone sayin something different. Literally seems like a reason why its the worst decision ever to do one thing and then theres someone else sayin theres proof that its correct and that it was only once thought of a wrong decision because of… bla bla.

Like i said and i planned to do 4 weeks on hcg then 3 months on low chlomid dose after reading similar information to the one uve given, i read that hcg should never be used together with serms etc. and high doses can desensitise leydig cells, i also read a reason why to use chlomid only yet i cant remember completely.

In the end after a big discussion on a broad bodybuilding group i was showed the poWer PCT and from reading up about its success and the reasoning behind it, it seems hard to not agree with it? Did you read the kinda testamonial quote i put up?

You say about LH receptor over-stimulation how long do you think it take for this to cause and issue do you believe 45 days enough to do damage?

Lol ive just read into the sticky “Please do not ask about methods that you read about elsewhere that have high doses of SERMs, stacked SERMs or SERMS+hCG. There is a lot of bad bro-science that is really bad advice. The idea that more is better is totally stupid.”

Im now 12 days into the poWer PCT ive stopped hcg after about 4-5 weeks of use… im doing 100mg of chlomid ed with 20mg of nolva, do you think i should continue and see how it pans out. Im stuck on what else to do really… stop that and start this forums recommended restart or lower dosages :confused: help lol

“A long taper of serms has long been advocated” by this do you mean something like 3 months on say 12.5mg chlomid ed?

And what you say about youre not sure what can be accomplished is what leans me more to poWer PCT maybe a short high dose blast will fire things back up

i also have very low shbg

Taper allows SERM induced high E2 to settle down so E2 levels are not horrible when you stop the SERM. Also allows transition to “normal” to not involve a huge drop in LH. Taper should be onto 10mg Nolvadex ED or similar for Clomid. For many guys, it is important to be using anastrozole during and past PCT, see the sticky.

There are two issues with high SERM doses. One is high E2 levels and the other is potential desensitization of LH receptors. So maybe there is only rat data. What else do we have? How do we do a study on humans to see what LH receptor damage can occur? Do you feel happy stating that very high LH levels cannot do any harm to the testes?

Are there any studies proving LH receptor damage?

Do you feel happy stating that very high LH levels cannot do any harm to the testes?
I dont believe that any harm would be irreversible or permenant, and would be a lot less harm than high levels of exogenerous testosterone. In a situation where Im at my wits end, taking viagra every day sometimes twice suffereing from ED low libido and the rest. And with what seems very likely to be Primary Hypogonadism Im feelin like maybe a high dose blast may be a good way to get things moving again. Like you said what do i have to lose

Also KSman so im takin chlomid and nolva now… are you saying i should be takin arimidex as well?

Ive done about 4 weeks on hcg then started the poWer pct, which im now 15 days into, however i stopped the hcg after week 1 (after
already doing 4 weeks, probably around 25-30,000iu over the peroid) so im now on 100mg of chlomid 20mg of nolva every day, 15 more days ill drop chlomid and then the nolva. I havent had a blood test in about 2-3 weeks so i dont know if i havent i guess, but 2 weeks ago i hadnt, id move up from 6.7nmol to 7.7 which is like from 193 to 220 (american) and i still dont feel great and im still using jellies every day its a shit situation id love to be back on juice but i just dont wanna make things worse :frowning: