T Nation

Please Help Me Save My Marriage

…I nor my Dr know what to do next

41 years old
6-3 245 lbs
38 to 40 waist, I was a 42 but I lost 30 lbs in last 2 years without any explanation. I currently found out that I have low Cortisol and I have found that this can cause weight change. This is my best guess on my weight loss. Before weight loss I was 42.

Have a full beard and full head of hair. Body hair was low until I started Androgel 9 years ago. I noticed after TRT I got more body hair. No arm pit hair until I was 16 even then it was very little. Got a few more arm pit hairs after starting TRT.

Carry all my weight around my stomach and I have chicken legs. I�¢??ve always been overweight.

Off and on depression for last 15 years. Type 2 Diabetic for last 5 years. Noticeable ED issues for last 15 years. Progressively worsened to the point that we have sex 2 to 3 times a month with very little fun for me except for the ending of course. Serve neuropathy in my feet for last 10 years. Serve low back pains for last 3 years. Diagnosed with low Cortisol 30 days ago. I get extremely fatigued by mid afternoon. If I drink alcohol it makes me very tired within an hour. I like everything about my life except for my health. I am successful with my job and between work and my hobbies I stay very busy with little to no time for exercise or relax time.

Long list of Rx and OTC. Never taken any hair loss drugs.
Daily meds:
Metformin 850mg 3 times per day
Gaberpentin 600mg 3 times per day
Lovastatin 20mg 1 time per day
Enalapril 5mg 1 time per day
Bupropion SR (Wellbutrin) 150mg 2 times per day
Pregnenolone/DHEA 100/25MG 1 time per day (Started 4/18/2014)
60mg Testosterone Cypionate 2 times per week / 120mg total per week (Started 4/18/2014, recently increased from 50mg)
.5mg Anastrozole �¢?? on days that I get TRT shot (Started 4/18/2014, never changed dose)

Rx Meds when needed:
Vicodin - Hydrocodone / Acetminophen 5-325 as needed (currently 0 to 3 a day 10 per week for back pain)

Herbal
Raw Adrenal Glandular 700mg (Swanson brand) 350mg in the morning & 350mg early afternoon. Started this when I found out I had Cortisol issues. Has helped the brain fog but no help with ED or fatigue issues.

Blood test results

Haven’t done any TRT in over 60 days as of 3/15/2014 (All blood tests by Quest Diagnostics)

3/15/2014
FSH 3 range 1.6 - 8.0
LH 3.8 range 1.5 - 9.3
Prolactin 6.7 range 2.0 - 18.0
Sex Hormone Binding Globulin 34 range 10.0 - 50.0
TSH w/Reflex to FT4 1.22 range .40 - 4.50
Testosterone, Total, LC/MS/MS 435 range 250-1100
Free Testosterone 66.8 range 35.0 - 155.0

3/21/2014
Estradiol (not ultrasensitive) 12 range < OR = 29
Estradiol, Free 0.26 range < OR = 0.45
Estrogen, Total, Serum 161 range 130 or less
PSA, Total 0.5 range < OR = 4.0
A1c 6.6 <5.7 % of total Hgb
Dihydrostestosterone, LC/MS/MS 16 range 16-79
Testosterone, Total 365 range 250-1100
Testosterone, Free 58.9 range 35.0-155.0

3/28/2014
Testosterone, Total 432 range 250-1100
Testosterone, Free 72.5 range 35.0-155.0

Last lab work right before starting TRT (Quest Diagnostics)
4/9/2014
Cholesterol, Tolat 144 range 125-200
HDL Cholesterol 53 range > or = 40
Triglycerides 72 range <150
LDL Cholesterol 77 range <130
Pregnenolone, LC/MS/MS 87 range 13-208
Whiteblood cell count 5.1 range 3.8 - 10.8
DHEA Sulfate 261 range 45-345

Cortisol Test �¢?? 5/1/2014 BioHealth Laboratory
Morning (6 to 8 am) 4.7 range 13.0-24.0
Noon (12 to 1 pm) 4.6 range 5.0-8.0
Afternoon (4 �¢?? 5 pm) 2.3 range 4.0-7.0
Nighttime (10 �¢?? 12 pm) 1.8 range 1.0-3.0
Cortisol Sum 23.4 range 23.0-42.0
DHEA-S Average 11.76 range 2.0-10.0
Corisol/DHEA-S Ratio 2.0 Ratio 5.0-6.0

First lab since starting TRT on 4/18/2014
5/19/2014
Cholesterol, Total 138 range 125-200
HDL Cholesterol 42 range > or = 40
Triglycerides 156 range <150
LDL Cholesterol 65 range <130
T4, Free 1.1 range 0.8 1.8
T3, Free 2.7 range 2.3 - 4.2
Estradiol, Ultrasensitive 23 pg/ml < or = 29
Estradiol <15 range < or = 39
IGF I LC/MS 211 range 52-328
Z score (male) 0.9 range -2 to +2
LC/MS/MS 15 range 16-79
Whiteblood cell count 13.4 range 3.8 - 10.8
DHEA Sulfate 438 range 45-345
Prolactin 7.4 range 2.0 - 18.0
PSA, Total 0.4 range < or = 4.0
Testosterone, total 543 range 250-1100
Testosterone, Free 122.6 range 35.0 - 155.0

M-F I eat Honey Nut Cherrios w/ 2% milk for breakfast. For lunch I eat fast food 50% of the time mainly burger and fries. Subway and chicken the other days. I drink 1 to 3 sugary drinks per week. I manly drink water and beer Friday night to Sunday morning. No illegal drugs of any kind. When dinners are at home they are traditional. Meat and vegetables. Never fried food. .

Zero training

Right nut hurts / feels sensitive 50% time. Not screaming pain but I definitely feel something is going on. Not so much the nut as it is to the piping leading to the nut.

Since starting this new type of TRT 52 days ago I get morning wood 30% of the time. Before 52 days ago I never got morning wood.

After 15 years of being together with my wife she is on the verge of leaving me and this would destroy my life. I can�¢??t bare to think of how things would be if she did. Since Ive been together I�¢??ve never ever been able to satisfy her in the sack. Ive tried Androgel and many doctors and theyve all told me that Im in range but I feel 100% like crap and I have a zero appetite for sex and when we do have sex I do a horrible job. Stumbling onto the T Nation website I feel is my last chance at keeping her and me avoiding a complete meltdown. Using the advise I found on this site I found a very good hormone / weight loss doctor in Corona Calif and she has donea lot but with zero success. I feel she is the right dr because what she tells me is pretty much identical to what Ive read on this site. All the recommended tests and needed numbers that she recommends are exactly the same. I asked about HGH and she told me no way, she does not offer that.

Her goal is to get me to 800 total testosterone and 22 on E2. After my first blood test results since starting TRT came back she has increased my dose of Testosterone to 120mg per week and 1mg of Anastrozole per week total divided into twice per week. Anything you can do to help will be highly appreciated.

Nothing that Ive tried has given me the desire to have sex. In case you wondering I have a hot wife, at least that’s what everyone tells me.

How long have you been on statins? Cholesterol is required for cortisol and testosterone/pregnenalo

Other than low cholesterol as a possibility there are several possibilities for causes. Also, combinations of these things. Opioids will do all kinds of things to your pleasure centers and mood. The mood stabilizers are quite a high dose. The fast food, pop , and beer are a vice of many but a disaster for diabetics.

To mask the issue with a hormone I think might be either foolish or impossible. I think there are many lifestyle changes worth investigating before more medication.

Sounds like you have a good doctor, although your testicle pain may be atrophy starting in. You need hcg in the mix to keep your boys full.

My first recommendation would be to clean your diet/lifestyle up. You don’t need to be eating all that garbage, especially as a diabetic. Find a gym too. The pain meds are likely causing some of your problems.

I would recommend taking daily (5mg) Cialis for 3 months to kick start your system, and try to get your E2 around 20. T around 800 would be good. You’ll start having morning wood every day on the Cialis once your T/E ratio is dialed in, and it will tell your brain to wake up and start feeling sexual again. The sense of well-being a guy gets from having daily MW + the occasionally spontaneous erection is something that is very important to all of your other feelings.

My doc says that you can also take a little Viagra while you are on the daily Cialis if you want to really lay the pipe some nights. He says the 5mg daily base makes it work so much better. I haven’t needed to do that yet myself, but glad to know I always have it in the back pocket.

Hey guys thanks for the feed back. Census says I need to eat better and I agree 100% and it is now my main goal in life. I think if I get that under control everything else will follow suit. Even though my A1C was were it should be as a diabetic I havent been eating as good as I should, not even close. Damn food is the devil (beer too). I was hoping that with others looking at my case something would come to mind that we are missing and I guess something did, diet and vitamins. Thanks again.

[quote]C27 H40 O3 wrote:
How long have you been on statins? Cholesterol is required for cortisol and testosterone/pregnenalo

Other than low cholesterol as a possibility there are several possibilities for causes. Also, combinations of these things. Opioids will do all kinds of things to your pleasure centers and mood. The mood stabilizers are quite a high dose. The fast food, pop , and beer are a vice of many but a disaster for diabetics.

To mask the issue with a hormone I think might be either foolish or impossible. I think there are many lifestyle changes worth investigating before more medication. [/quote]

I’ve been on Lovastatin for about a year. My cholestrol was borderline high for a diabetic, as a non-diabetic it was fine. Both the Lovastatin and Vicodins have been within the last year or two. The issues I’m having in my life have been around LONG before I started taking Vicodin and Lovastatin, but I’m sure they are not helping any. In fact they are most certainly part of the reason things have gotten worse over the last couple years.

[quote]hakrjak wrote:
I would recommend taking daily (5mg) Cialis for 3 months to kick start your system, and try to get your E2 around 20. T around 800 would be good. You’ll start having morning wood every day on the Cialis once your T/E ratio is dialed in, and it will tell your brain to wake up and start feeling sexual again. The sense of well-being a guy gets from having daily MW + the occasionally spontaneous erection is something that is very important to all of your other feelings.

My doc says that you can also take a little Viagra while you are on the daily Cialis if you want to really lay the pipe some nights. He says the 5mg daily base makes it work so much better. I haven’t needed to do that yet myself, but glad to know I always have it in the back pocket.[/quote]

One important thing I have failed to mention is since starting TRT once I have wood I can hammer a nail into a 2x4. Its the libido I have none. Very little desire to have sex. I have stayed away from Viagra and Cialis because I have been told that it doesn’t help libido only ED. Do you agree?

Libido is more mental, but, with increased MW/erections, it can lead to “wanting” it more, if that makes sense. It’s sort of a chicken or the egg kind of deal. I certainly want it more if I’ve had some cialis, that’s for sure.

redrider,

Has your wife said she is unsatisfied with sex or led you to believe that? Guys put more emphasis on sex than women do. You do have a concoction of drugs you’re on and that may not be helping.

Here’s my take on this. Sex happens between the ears and not the sheets. This is going to be hard for you but reboot your thinking. You may have just developed a case of performance anxiety; it may be that simple and that complex.

If you think I may be on to something, let me know. There are some things you can do to get out of this funk you are in and none involve more drugs.

You need to trick your mind into getting more into the swing. By taking daily Cialis, you will be a walking hard-on for a few months, and it should help you restore your libido…

Libido is a strange thing, and isn’t controlled by T or E, or anything else alone… Studies show that couples have 80% more sex while on vacation, for example… Lack of stress… a hotel room… Who knows what works for each person, because we’re all different – but I’d try that + a PDE5! :slight_smile:

[quote]hakrjak wrote:
You need to trick your mind into getting more into the swing. By taking daily Cialis, you will be a walking hard-on for a few months, and it should help you restore your libido…

Libido is a strange thing, and isn’t controlled by T or E, or anything else alone… Studies show that couples have 80% more sex while on vacation…[/quote]
Ya, the other 20% have the kids in tow. Gosh-darn little cockblockers I say!