T Nation

My numbers and journey - TRT/SSRI use/addiction/sleep apnea


#1


Do the attached results show any promise of getting levels normal or optimal naturally?

UPDATE:
Long time SSRI user (12+ years). Currently off all psych meds
Battling depression/anxiety since 19. 34 now.
2 years sober from pain killer and alcohol abuse on 4/15/2015.
Been on test cyp shots for about 5 months now. 3/9/15

-age - 34
-height - 6'1
-waist - 36
-weight - 237
-describe body and facial hair - very hairy armpits, chest and legs.
-describe where you carry fat and how changed - I carry fat in my thighs, stomach and face
-health conditions, symptoms [history] - Depression, anxiety - run very nervous and constantly over-analyzing, cant turn the brain off usually
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever- on and off ssri's, snri's, benzo's since 18. Many supplements see below. Off psych meds. Have not had a drink or drug in 23 months.
-lab results with ranges - Given above and below
-describe diet [some create substantial damage with starvation diets] - Diet getting better as I am taking in 3 meals a day with some decent balance of protein and carbs. I do get weak and have a few cheat meals and sugar but not like it was a few months ago
-describe training [some ruin there hormones by over training]- I am athletic and played ball in high school and college. Was in shape until I had back surgery in September. Just started working out this week for the first time in about a year. UPDATE: Too tired to work out.
-testes ache, ever, with a fever? - Not that I can ever remember
-how have morning wood and nocturnal erections changed - Rarely if ever have morning wood. Sleep is bad as I am sort of up and dreaming at the same time. It is strange.


#2

fT3 still a bit low, are body temperatures low, might be on your previous post. Please do not create multiple posts where we do not have context.
fT4 is low, TSH is high, what changed? Looks like you quit the dedicated thyroid.

With that amount of time on hCG, with low T numbers, it looks like a degree of primary hypogonadism. So it looks like TRT for life.


#3

fT3 still a bit low, are body temperatures low, might be on your previous post. Please do not create multiple posts where we do not have context.
fT4 is low, TSH is high, what changed? Looks like you quit the dedicated thyroid.

With that amount of time on hCG, with low T numbers, it looks like a degree of primary hypogonadism. So it looks like TRT for life.


#4

Why do your free T numbers look so good and your total T seems low ?


#5

Because SHBG was low.

Also odd that LH/FSH was showing nicely while on hCG. Suggests that hCG was not good. Given that, I need to retract my comment about primary above as the potency of the hCG is in doubt.

If hCG was from a pharmacy, we have seen the hCG damages from shipping after reconstitution. hCG can be tested with a pregnancy test.

So this case is back to unknown. [The labs would however be consistent with a SERM.]


#6

Here are my updated results. Is it worth a shot to try a HPTA restart with nolvadex?


#7

Yes, but it is more complex than “nolvadex”.

Not enough info here about you.


#8

I tried to make this chart to help tell me story. I have been on and off ssri’s for 15 years and had an addiction issue to pain killers years ago. I have read about the possibility of that being the cause of my testosterone/hormone issues. Why else would I need to provide to get more feedback? What are some viable options to do a restart without feeling like shit? I’m willing and open minded. Any help is appreciated.


#9

I need more info about you as per the advice for new guys sticky.

Are you iodine deficient? Thyroid basics sticky. TSH is too high, check body temperatures.


#10

I am going to gather the information eluded to in the stickies.

My last TSH is .04 and being treated with 1/2 dessicated thyroid a day. It now became to low as per the ranges no?


#11

-age - 34
-height - 6’1
-waist - 38
-weight - 245
-describe body and facial hair - very hairy armpits, chest and legs.
-describe where you carry fat and how changed - I carry fat in my thighs, stomach and face
-health conditions, symptoms [history] - Depression, anxiety - run very nervous and constantly over-analyzing, cant turn the brain off usually
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever- on and off ssri’s, snri’s, benzo’s since 18. Many supplements. Currently on Prozac 20mg and buspar 10 mg. Have not had a drink or drug in 22 months.
– real dangers! see this http://propeciahelp.com/overvi
-lab results with ranges - Given above
-describe diet [some create substantial damage with starvation diets] - Always been one to want carbs (3 bowls of cereal at night). currently very bad diet.
-describe training [some ruin there hormones by over training]- I am athletic and played ball in high school and college. Was in shape until I had back surgery in September. Just started working out this week for the first time in about a year
-testes ache, ever, with a fever? - Not that I can ever remember
-how have morning wood and nocturnal erections changed - Rarely if ever have morning wood. Sleep is bad as I am sort of up and dreaming at the same time. It is strange.


#12

Here are my temps…

7 am - 96.8
1 pm - 97.0
4 pm - 98.5

Reading the thyroid sticky…again…tons of info


#13

98.1 today at 12…

I started taking Kelp and Selenium…


#14

If you have not been using using iodized salt, long term, kelp will not dig you out of the hole.

Would be good to check temps across more than one day.

Because SHBG was low.

“”“SHBG levels are decreased by androgens, administration of anabolic steroids,[19] polycystic ovary syndrome, hypothyroidism, obesity, Cushing’s syndrome, and acromegaly. Low SHBG levels increase the probability of Type 2 Diabetes.”""

Given your weight and eating habits: You are at risk for diabetes. Have you tested?:
-fasting glucose
-A1C

How do you feel since the back surgery? Feel recovered mentally?


#15

Since this last test (attached) 2 weeks ago. I totally changed my diet for the better. I have also included iodized salt each day. My daily afternoon temperature has average 98.3 in the past week.

Another important thing to note is that I am about 10 days off of all psychiatric medicines and feel a lot better. I have researched functional medicine doctors and found specific protocols to assist with withdrawals and it seems to be working (See below for my current regimen).

I have slowly gotten back into the gym and the back does inflame but I am taking it easy. Mentally I feel better then I have in a while but do have moments of ruminating thoughts and anxiety with a bit of low energy. The supps below have helped with energy and overall well being.

Morning
Candibactin-BR (Metagenics)
Probiotic ultra-flora plus DF ½ teaspoon (Metagenics ultra flora plus df)
Zinc 50 mg (Endomet)
Selenium 100mg (Endomet)
Pregnenolone 10 mg (Douglas Labs)
Magnesium Citrate 400 mg (Solgar)
Co-Q10 200 mg (NutriONN)
Acetyl-L-Carnitine 1,000 mg (Source Naturals)
N-acetyl-Lcysteine 600 mg (Solgar)
L-glutamine 4 grams (Bulk Nutrition)
L-Carnitine 500 mg (Bulk Nutrition)
Omega 3 - 1 gram (Naturenetics)

Afternoon
Caprylic Acid 600 mg (Now)
Alpha Lipoic Acid 300 mg ( Dr. Danielleâ??s)
L-Tyrosine 500 mg (Swanson)
Vitamin D3 10,000 IU (Solgar)
Flaxseed oil 1 gram (Naturewise)
Omega 3 - 1 gram (Naturenetics)
Candibactin-BR (Metagenics)
Multi nutrient vitamin (Solgar) transitioning to (orthomolecular solutions caps) when it arrives
Kelp 600 mg (Natures Way)
Olive Leaf Extract 250 mg (Natures Way)
L-Theanine (Source Naturals)
Vitamin C 1,000 mg (Vitamin Shoppe)
Turmeric Curcumin (Dr. Danielleâ??s)
Folate 800mcg (Solgar)
B-Complex 50
Resveratrol 1200mg Proprietary blend (BriNutrition)

Night
Magnesium Citrate (Solgar)
Candibactin-BR (Metagenics)
L-glutamine 4 grams (Bulk Nutrition)
Probiotic ultra-flora plus DF ¼ teaspoon (Metagenics ultra flora plus df)
L-Tryptophan 1.5 g (Source Naturals)
L-Carnitine 500 mg (Bulk Nutrition)
Zinc 50 mg (Endomet)
Selenium 100 mg (Endomet)
Gaba 500 mg (Solgar)
Holy Basil Leaf (Gaia)
Milk Thistle (Nurforma Naturals)

Pharmaceutical grade
Testosterone Cypionate 140 mg 1 x a week
HCG 250 mg 3x a week
Desiccated Thyroid ½ grain (morning)
DHEA 50 mg (morning)
Melatonin 3 mg (nightly)


#16

Ksman…

10/15/2014 See this concerning iodine and related issues:
http://drlwilson.com/...cles/IODINE.htm

Coincidentally, I tried following Dr. Wilson’s nutritional plan for correcting how terrible I was feeling (hair mineral analysis testing) but I think I was dumping metals too fast and felt worse…not to mention the diet to stick to is so limited and tough to deal with. Here were my results.


#17

That link doesn’t appear to be working.


#18

http://drlwilson.com/Articles/IODINE.htm

Here are my temperatures from yesterday…

97.0 - 8:30 am
98.6 - 1:00 pm
98.3 - 7:30 pm

Reminder…1/2 grain dessicated thyroid but my TSH level is:
O.017 - uIU/mL 0.450 - 4.500. Should I be concerned that it i now too low. (pre-treatment is about 2.0 - 2.5)

UPDATE on treatment: Saw an Endocrinologist in NJ who is rated “Top endocrinologists in NJ” and showed him my numbers in the beginning of the thread. He said:

“I do not see any diagnostic criteria the you have any type of hypogonadism. The 200-300 levels at 11 am and 4 pm that you are showing me is because you did not get it drawn earlier so these numbers do not mean you need TRT”

“Having 250-400 level is normal and does not mean you need treatment”

“The only way I can help you is if you get off all trt treatment including thyroid and come back to see me in 3 months so we can see what your raw numbers are at 9 am with two tests on two different days. Then we might order a pituitary mri.”

“I think you are too young to be on this and did not explore all areas before starting TRT. You are at risk for blood thickening, osteoporosis and heart issues if you keep it up.”

I told him that I tried to come off twice and felt so bad I could not get out of bed or leave the house as my depression/anxiety was so severe.

My questions ultimately is…Am I in a typical catch 22 as in order to find out what is truly causing low t, I would have to go through hell finding out? What if he is right and I dont really need trt? Any help would be great.

MY SLEEP STUDY RESULTS:

  1. Obstructive sleep apnea, severe in general with apnea+hypopnea index (AHI) of 34.6/hour in general and worse in supine sleep with AHI of 85.9/hr in supine sleep. O2 sat nadir of 89%, and O2 sat <90% for 0.8 mins or 0.2% of the total sleep time.

#19

Many need to drive TSH to zero to feel right.

Selenium is important for thyroid function and thyroid hormone processing in peripheral tissues.

You can try a HPTA restart. Should be attempted at your age.

Did you ever have prolactin tested?

I could not get out of bed or leave the house
AM cortisol would be interesting.

Have we discussed stress and stress reactions before?

Body temps say that you need more thyroid meds. Hopefully rT3 is not holding you back.


#20

Ksman…your feedback and promptness is appreciated…you teach selflessness and kindness…

I take this selenium 2x a day and have been for months…

I will read up on the HPTA restart and talk to my new functional medicine doc as she seems very open minded and is testing me with a plethora of tests. What do you recommend for a HPTA restart in my case?

Waiting on the prolactin levels to come back from her test that I just went to labcorp for.

Just submitted my 4 tube saliva test am,noon,pm bedtime (see attached). Probably 1-2 weeks for results.

Temps for 3/10/15
96.8
97.7
98.8

Temps for 3/12/15
96.3
98.0
98.6

We have not discussed stress and stress reactions before. (note that I am out of work on medical leave, but am a district administrator in charge of 27 buildings and 150 teachers in the area of special education. Considering going back to teach as I cant handle the stress(brain does not shut off).

I am going to go back to the thyroid sticky and read more about rT3 as I a do not fully understand it yet.

I just ordered the iodine attached.

Your thoughts on the sleep study, pain of stopping testosterone and withdrawing, dosage of selenium?