Just got my blood tests back and would appreciate any input from you guys â?? I value it far more than my urologistâ??s opinion who is not up to date on HRT.
31 yearâ??s old, male, 180cm and 80kg. Have taken citalopram and fluoxetine (both SSRIs) on and off for almost 5 years due to anxiety that occasionally triggers a depressive episode when under stress. Now I have low stress and have been on fluoxetine 40mg for a year and now am tapering off it completely (down to 10mg at the moment).
Symptoms in order of importance:
Fatigue during the day
Almost zero libido (no erectile dysfunction)
Lack of muscle strength in gym
Fat accumulation abdomen
Apathy and lack of ambition
Felt they were textbook low testosterone symptoms â?? had levels checked and especially the bio/free level came in at the bottom of the range. I am aware that a number of these symptoms will be caused by down regulation of dopamine function due to the SSRI ( would selegiline help with this â?? I have heard some men have used it to improve test levels as well when their dopaminergic functioning has been down regulated as mine probably has)
Urologist put me down for a trial of Nebido - Hardasnails and various other informed forumites recommended I check thyroid and cortisol levels as well as various vitamins before embarking on HRT. Would welcome opinions on the blood tests (particularly cortisol and thyroid) but to me apart from the low test, only the low Vit D stood out (will be supplementing this as well as the whole Vit B complex)
As I see it I have three options:
1) Taper off fluoxetine ASAP. Optimise sleep/diet/weight lifting for several months and see if symptoms have improved/ testosterone gone to better levels.
2) Start the Nebido HRT to see if low testosterone is causing these problems. Try to convince the doc in a month to add HCG and more or less follow Crisler HRT protocol.
3) Attempt a restart of system with clomid and HCG, see how it goes there.
Any advice on which course of action to take would be greatly appreciated.