T Nation

PFS Case, What Else Can I Check/Try?

I don’t know if I’m posting in the right section, I tried to choose the most appropriate one, but whatever… The reason why I’m posting is because I am in deep trouble from using a supplement “saw palmetto”. I’m sure a lot of you know about it and that it decreases dht. Basically, I took it for roughly 5 months, and haven’t been taking it for almost a year. I am a 20 year old guy, never took steroids and was always passionate about bodybuilding.

As soon as I stopped taking it, I immediately got ED, complete lack of morning wood and significantly reduced tolerability to exercise(2-3 sets in and I already feel completely annihilated with dyspnea and elevated heartbeat that lasts up to an hour post exercise). Coincidentally, I have been taking methylphenidate (prescribed) around the same time at 15mgs a day for the same duration and the same time of discontinuation. I haven’t taken it since then.

However, I don’t think it’s because of ritalin since I couldn’t find anyone with the same problems from it. I checked my bloods immediately afterwards and after 6 months since there wasn’t much improvement. Im gonna list all of the things i have checked:

Shortly after discontinuation:
(Sex hormone-binding globulin) 52.1 ▲ 9.7 — 49.6 nmol/l
(Cortisol) 498.9 101.2 — 535.7 nmol/l
(LH) 3.35 0.57 — 12.07 MU/l
(Progesterone) 1.28 ▲ 0.32 — 0.65 nmol/l
(Prolactin) 367.0 73.0 — 407.0 mMU/l
(FT3) 4.8 2.63 — 5.70 pmol/l
(FT4) 15.4 9.00 — 19.10 pmol/l
(Testosterone) 20.74 8.33 — 30.19 nmol/l
(TSH) 3.4 0.40 — 4.00 mMU/l
(FSH) 1.6 0.95 — 11.95 MU/l
(Estradiol) 100 40 — 162 pmol/l

Glucose: 4.23 3.89-5.83

6 months afterwards:
E2 102 40 - 161 pmol/l
Progesterone 1.0 0.3 - 2.2 nmol/l
Testosterone 18.32 8.9 - 42.0 nmol/l
SHBG 44.9 16.2 - 68.5 nmol/l
Prolactin 440 73 - 407 mIU/l
Free testosterone 10.7 pg/ml 1.00 - 28.28 pg/ml
DHT 479 250 - 990 pg/ml

Is there anything in my bloodtests that could cause my current state and is there anything that I should test as well? I’ve been to numerous doctors and they just laugh at me and say that it is a psychological issue, though I never even expected these sides to appear from sp (can’t be a nocebo). I would appreciate any help from you guys!

P.S For the slightly elevated prolactin i took cabergoline 0.25 once every 10 days for a month and it made no difference.


Until now, ritalin gave me incredible super human strength at the cost of stamina and higher heart rates for prolonged periods. It also deprived me of sleep and lost 31 pounds in 28 days which forced me to stop it.

The ritalin can cause a hyperthyroid state as well. TSH is kind of elevated, I wonder what your Reverse T3 looks like.

A Total T at 527 and SHBG at 44.9, your Free T isn’t expected to be ideal. In fact your Free T percentage is 1.75% below the 2-3 percent that is normal.

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Yeah, I’m considering clomid at 25 mg every day for a month to see if there’s any improvement.
As far as ritalin, it also lowered my stamina significantly, but the next day without it I was alright. It’s only after i stopped the sp when things went really south.
Thanks for replying

So i tried clomid 25 mgs…
My test level increased from 18-20 nmol/l to 26 nmol/l and I felt infinitely worse. Idk if this is due to the mechanism of action of clomid or not, but I guess I’m just fucked forever.
I recovered to my previous “baseline” though

Not a lot of people feel better on clomid, no matter what the results of blood work are from taking it.

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I believe clomid also rayse shbg.
You progesterone seems high after discontinuation, Wich I believe is because is not being further metabolize into 5ar progesterone metabolites

Hi ncsugrad2002

Would PT-141 work?

Clomid can’t work on the long run, simply because it’s a SERM, so it block estradiol receptors in some tissues of the body where you need them. It’s not because you are messed up.

Taper off it and work with a good doctor to heal. You will do it, I’ve been there.
If nothing will work to restore your original androgens levels, a good TRT protocol will fix you.


Work for what?

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PFS and ED?

Doubtful, not sure it’s really been tried though. It made me feel like I had taken an antidepressant (which isn’t a good thing)

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My progesterone is only high for this range. In fact, it’s been like this even before I took saw palmetto. My bloodwork from 2017 shows this, and that is the time when I was in perfect health.

Yeah, that’s what I thought as well. Im off of it now and returned to my previous “PFS” baseline. I would try trt, but my test levels are pretty much the same as they were 3 years ago, even before I took this stuff. This leads me to believe that it is not a test issue, but rather something else. Planning to try proviron in the near future.

Right now I’m gonna try to talk to doctors mainly about my bad dyspnea during workouts that just keeps getting worse(not corona) Gonna check heart and lungs, as well as do any other tests that they will refer me to. Also planning to test my reverse t3 tomorrow like systemlord suggested.

Alright, so here are my recent thyroid and PRL labs:

Reverse t3: 149pg/mL reference range 92,00 - 241,00
TSH: 5.031mIU/mL reference range 0.380-4
T3 Total: 1.7 nmol/l reference range 1,34 - 2,73
T3 Free: 5.23pmol/l reference range 3,80 - 6,00
T4 Free 12.71pmol/l reference range 7,86 - 14,41
Prolactin: 271 mIU/L reference range 53 - 360

Clearly my TSH is very high, but my free t3 and free t4 are fine I would guess given that they are in the upper half of the normal range. That’s why I don’t understand why my TSH is so damn high. I didn’t do any exercise the day before the test was done, so it couldn’t be that.
My reverse t3 level is also alright I’d guess.

That’s subclinical hypothyroidism. Also full blown hypothyroidism can start out with high TSH and normal thyroid hormones which can increase with time and then thyroid hormones plummet later down the road.

When the thyroid gland is starting down the path of disease you can see a lot of dysfunction. In less common cases there is what’s referred to as thyroid resistance, but there is no lab test for thyroid resistance.

TRT increased my TSH (0.6-> 1.01), as it does a lot of other men and sometimes it’s just temporary.

yeah, I know, I would try triiodothyronine at a low dose to decrease my tsh to around 1, but I don’t know if there is much sense in doing so when my t3 and t4 are fine. I tried t4 before that for 8 weeks at 120mcg due to the tsh issue and it didn’t do anything. I might try t3 for a month and see what happens. Though, I would understand why it would cause my low exercise tolerance, can it cause ED as well even at that point when t3 and t4 are good? If it won’t help, I guess I’ll go the proviron and testosterone propionate route.

Yeah, but how can high TSH influence your wellbeing if the only hormones which perform the function of the thyroid itself are t3 and t4? TSH is just a pituitary hormone, which stimulates t3 and t4, isn’t it?

The TSH hormone is indicating a problem. You’re not seeing half of what’s really going on with lab testing, it’s a static number, a snapshot in time. Again its sometimes difficult to detect thyroid dysfunction with lab testing.

Alright, once i will try t3, i will post my experiences here. I will start at 12.5 mcgs. And of course, I will do more research about it.
Thanks for your input systemlord