T Nation

My Low T Journey So Far


#1

Hi there

It has been a very hard year for me. I have been experiencing low T symptoms since February 2016. I have now been on Tamoxifen for only 2.5 weeks and already it has already helped with most of my symptoms. The only big thing that remains are sudden anxiety attacks that appear out of nowhere and are uncontrollable. I still also suffer from social anxiety, but it too has gotten a little better.

I sleep better, can have sex again, although libido is still very low. Fatigue and nausea seem to have disappeared almost completely.

I have been in the labs 7 times this year. Result from my first six labs were:
Total T 9.3-12.9 nmol/l (268-317 ng/dl)
SHBG 42-55
Free T 121-162 pmol/l (9.4-12.6 ng/dl)

LH was 2.86-3.42 (1.5-9.3) (LH has been rising all year) FSH was only 1.5 (1.4-18.1)

After an almost year in torment, it drove a few hundred km to see a doctor, who is very experienced with TRT. I was diagnosed with Hypopituitarism (pituitary gland prolem) 2.5 weeks ago.

He put me on Tamoxifen. First week 10mg and then 20mg.

He said, we will start with the most convinient way first and see what happens.

Tamoxifen doubled my Total T in just 2 weeks, but it also almost doubled SHBG.

Total T is now 21,8 nmol/l (629 ng/dl). SHBG is 92, which is very high. Free T is better, but still only 207 pmol/l (16,08 ng/dl). The interesting thing is that my LH only rose from 3.42 => 3.82

My thyroid values have been tested 3 times this year and they are ok.

Prolactin levels have all been taken 3 times this year, and they have been ok 85-145 (53-360)

No CT scan has been done on my head

I have not been on the gym in 2 weeks, since before treatment, working out would always make me feel even worse. In november, i took a month of the gym, but the result was my T levels dropped even more and i felt even worse. I decided i will not go to the gym again until my T levels are ok.

Accoring to some studies, Tamoxifen will raise T levels for 2 months. But what is the use of this med if SHBG raises so much? I will call the doctor next week and see what he thinks. As my testicles seem to be working, would HCG be a good thing to try next?


#2

I’m glad you’re getting better. I went down the SERM route (clomid) for about 7 months this year - way too long. My numbers went way up - total T up to just shy of 1200. Free T as a percentage of total T was lower than starting, though the number was higher. SHBG and Estrogen through the roof, and you’re right. What’s the use if SHBG increases so much that it binds the T up. Symptomatically, I wasn’t any better off, so I stopped, switched clinics, and 4 weeks ago started TRT. I’m only in the beginning of feeling better, and still learning a lot, but symptoms are already going away and I think that at least for me, TRT is the way to go rather than SERMs.

My libido is coming back. I now waking up with morning wood every day, and I also usually wake up in the middle of the night with a rock hard baseball bat between my legs - kind of annoying, actually. Mentally I feel much better.

If I were you:

  • monitor estradiol levels (E2) - I bet you they are elevated as mine were
  • track your symptoms every day and look for improvement - that’s the only thing that really matters. My doc was so stoked that my total T was almost 1200, but doesn’t mean anything if my symptoms aren’t better
  • don’t waste too much time on SERMs
  • read KSman’s stickies on TRT protocols for injections
  • read KSman’s sticky on Thyroid basics

So my advice is to give the SERMs a try, but don’t waste too much time on them. Make sure you monitor E2 and your symptoms. If they work, that’s great, but if not, move on to TRT.

Read up on TRT injection protocols and be aware that if you choose to go that route, many doctors are idiots and may start your dosage too high and give you a stupid protocol - like injecting every two weeks. You need to be prepared to not do what the doc prescribes, and to do your own program. This was hard for me to wrap my head around at first…In my case this meant cutting my weekly dose from 210mg of T to 105mg, taking anastrazole twice a week, and injecting T twice a week instead of once, so nothing crazy.

Get started right away with monitoring your body temperature and determine thyroid health.

Here’s to a much better 2017 for the both of us!


#3

I was going to post more details, but since the post was moderated, i could not until now.

Here is some more info:

After starting tamoxifen, I have had morning wood every single time I wake up. And seems like it’s getting more hard every night.

Also I don’t have to wake up in the night to go to the toilet anymore. After just a few days of treatment i could sleep the whole night without having to go to the toilet.

Before treatment, i used to suddenly have one day when libido was high. But there was maybe only 6 of those days in the whole year. After the good day, it was always back to low or zero libido for weeks. I also had a few days on the gym when i broke records in bench press and deadlift. But many times i suffered from fatigue and nausea and was unable to train at all.

My cortisol levels are high. A day after suffering anxiety attack a few days ago December 26, I went to the labs and my morning cortisol from blood was 720 (138-690 nmol/l). 3 weeks ago it was 513.

E2 levels have been ok. Before starting treatment E2 was 0,11 nmol/l and after 2 weeks of Tamo it was 0,17 nmol/l

My main question: is it normal for SHBG to double on SERM? If not, i wonder what i wrong with me. Can SHBG decrease later when the body adjusts to the new doubled Testosterone?