T Nation

Starting Back on TRT with PBS - Advice Appreciated


#1

Hi guys,

My story....(test results at bottom)

Your wondering what the PBS is? Well it's Prune Belly Syndrome or Eagle Barret Syndrome, a cognitive abnormality with the abdomen and quite rare. Also undecended testicles. Only known what it was since i got online back in 2005 or so and every doctor or consultant I see has never come across it. http://en.m.wikipedia.org/wiki/Prune_belly_syndrome Albiet a mild case and led a fairly normal, functioning life. Up until recently.

I'm 33 years, 5.5ft and 9 stone (12.5st in 2007) and over the past 6 or 7 years have lost considerable muscle mass and i'm now at the point where lifes pretty tough.

Symptoms....

Fatigue
Reduced Muscle mass
Weight gain around belly
Brain Fog
Leg & knee weakness
Lower back pain & sciatica
Lack motivation
Isolate myself from others
Feel bloated after meals which exaggerates back pain

Diet is fairly decent, no rubbish. Maybe don't eat as much as I should.

I'm not to sure about the direction my treatment is taking as i've not redcieved much feedback from my endocrinologist, who after 1 consultation has simply put my back on Sustanon 250 at 3 weekly cycles (1st was 18/12). The two blood test I had, GP then endo, don't really clarify their position.

The test are as follows,

03/10/2014

LH - 23.6 > U/L (1.0-9.0)
FSH - 46.2 > U/L (1.0-9.0)
Prolactin - 664 > mU/L (0-350)
Testosterone - 27.0 > nmol/L (8.4-28.7)
Cortisol - 649 nmol/L (275-690)
TSH - 3.13 mU/L (0.4-4.0)

25/11/2014

LH - 17.9 > U/L (1.0-9.0)
FSH - 42.0 > U/L (1.0-9.0)
Prolactin - 150 > mU/L (0-350)
Testosterone - 20.6 > nmol/L (8.4-28.7)
SHBG - 120.4 > nmol/L (17.3-65.8 )
Free Androgen - 17.11 > (23.3-103)

Quite unusual results I think.

I feel mabye they want to just try me back on the Sustanon to see what happens. The high SHBG surely isn't good. To me, with my limited knowledge as only been researching since september, surely it's an indication of high estrogen conversion from what appears decent initial T levels. The endo only wrote in his letter that my testicles aren't working properly. Maybe using trt will replace these bad functions and give a more stabilised, manageable distribution of testosterone. I'm not sure. They have referred me to a Urologist in which i'm still waiting for a date.

Cheers guys, great forum!

P.S - Didn't relise there was new member protocols to follow but will rectify this soon in the thread.


#2

Your high LH is probably creating high rates of T-->E2 inside your testes. You need to have E2 tested. TT levels are quite good, but most likely exaggerated by high levels of T+SHBG; which might also result from poor clearance of T+SHBG by the liver and whatever that might be it would reduce E2 clearance as well.

If E2 is elevated, LH and FSH should not be high, so your hypothalamus+pituitary may not be normal. If E2 is low, then high SHBG is caused by something else. SHBG is created in the liver in response to estrogen levels.

Need E2 to complete the picture.

TSH=3.13 indicates a thyroid problem. Have you not been steadily using iodized salt. Check your overall thyroid function by checking your body temperatures at times suggested in the thyroid basics sticky.

Your low free androgen is from high SHBG.

TRT would increase FT and should also repress LH/FSH.

Please also read the advice for new guys sticky. [there are 7 stickies]