I was the same way. I have had all the symtoms of low testosterone. My doctors allways blew me off and said I was too young to be tested. I just tested today and awaiting the results. High cholesterol levels have an effect. I have been taking some pills to clean out my arteries. I can tell you what it is when I get home. Yohimbine works well with Powerfull. Just like thyroid you could be within normal but on the bottom of the scale.
Forgot to mention that my free test was:
14.3 pg/mL (9.3-26.5)
Doubt if this makes much of a difference. Currently working on finding a new doctor. I found a male GP with a background in endocrinology. Hopefully he can help. If not, I may return to my current GP who is willing to script testosterone (but has no idea about hcg and estrogen) and provide him with ksman’s protocol.
Alright I had to stop the adex because it definitely tanked my estrogen WAY too low. What a nightmare. It sucked really bad. It’s been about 6 days since I stopped. Am I going to have an estrogen rebound? I feel mentally foggy and off right now. Is this still low estrogen or have I reached a rebound?
[quote]chemman wrote:
Alright I had to stop the adex because it definitely tanked my estrogen WAY too low. What a nightmare. It sucked really bad. It’s been about 6 days since I stopped. Am I going to have an estrogen rebound? I feel mentally foggy and off right now. Is this still low estrogen or have I reached a rebound? [/quote]
You started adex on July 29. When did you start to feel poorly? Anastrozole over responders often feel bad in days, not weeks.
Hard to tell where you are now, but your serum adex should be gone at 6 days and T–>E conversion should be back at work. If I was in your shoes I would resume adex at 1/2 the dose that you were taking. You were taking 2 drops per day 7 days per week which should have been the suggested 0.5mg per week. You can do 1 drop per day [0.25 mg/week]. Two drops EOD might be less of a bother. Note gains and losses. If you feel better then worse later, then your dose is still too high. Adex over responders typically need 1/4th of the expected dose. You may need to go there. Alternatively you could restart there at 1/8th mg/week and see how that goes then try to bump higher later.
After you get somewhere on the target, you can later refine the dose with an E2 lab.
Started adex on July 23. Started to feel adverse (clicking and cracking joints)probably as early as the 4th or 5th of August. Didn’t realize what was going on until the 9th. Got real bad when the extreme anxiety set in and had to quit the adex on the 11th. Joints are still cracking and I keep getting waves of brain fog.
I’ll have a few hours of peace and then in comes the fog. Based on these observations, I have yet to clear the adex from my system, or I am having a hard time resuming E production, which is a bit scary. Based on the nature of adex as a drug, I am assuming that my E will come back, and maybe higher than before if it rebounds.
Note that I have been losing some body fat recently which could be lowering e2 by virtue of less aromitase. Down from 222 in May to 206 a few days ago. I’m 6’5".
Any ideas why my joints are still clicking? Not as bad as on adex but still noticeable.
It’s been 1.5 months and I still don’t think I have recovered from the adex. My joints are still cracking and my mental health is so fragile. Any ideas guys? What can I do to get my e2 going again? I’m seriously about to go nuts. I have an appointment with an endocrinologist in 4 weeks. I’m so scared that I might have done permanent damage.
So here’s my latest lab results. They’re a bit spotty and without reference ranges because they were read to me over the phone. All labs were done by labcorp.
TSH: 1.81
DHEAS: 242 (242-640)
Total T: 476
Free T: 9.1 (9.3-26.5) LOW!!
ACTH: 14
Free T4: 0.74
Estradiol: 18.7
Estriol: 0.3
Cortisol: 14.44
LH: 3.87 (1.24 - 8.62)
Prolactin: 10.33
Somatometin(sp?): 221
GH: 0.1
Any ideas? Clearly the free T is low. Total T is less than ideal. Estradiol appears to be recovering, although my joints are still snap crackle pop. Mental health is doing a bit better day by day. ED is the worst it has ever been. I have another appointment 12/3 (Wednesday). Where to go from here? Should I go for clomid and try to kickstart endogenous production or just get on trt? I’m 22, by the way.
I’m no expert, but I think at your age I would at least try some nolva or clomid before going the trt route. My thoughts are if you can kick start your system with out adding exo test, then you will be better off.
FT indicates that very little of your TT is not SHBG bound. So SHBG must be high. E2=18.7 does not explain why SHBG is high, so it is high for some other reason. It is known that high levels of FT or bio-T can push down SHBG and increase FT, the FT then keeps SHBG down in a self reenforcing manner… in theory. To address that you would need 150-200mg/wk testosterone cypionate/ethanate per week while using 1.0mg/week Anastrozole per 100mg testosterone. Your low FT may be locking in a pattern of high SHBG. One might wonder if your liver is not clearing out SHBG T and E very fast. Later after your FT is high, you can taper down T to more reasonable FT levels and should seem to keep FT at high range, disregarding if TT is over range.
You will need hCG.
Your E2 levels are totally consistent with your low FT/bio_T levels. SHBG bound T cannot undergo T–>E2 aromatization. Your free E2 will be very low because of high SHBG, and may explain your symptoms.
In this situation, the TT number is meaningless and should be disregarded as noise.
fT4 [0.82-1.77 -Labcorp]. You should be near midrange: 1.295. You lab indicates that you have hypothyroidism. Your TSH does not indicate that, but that can simply mean that your pituitary gland is not releasing enough TSH to force a weak thyroid gland to produce enough T4. So you have low TSH output and weakly responsive thyroid gland. You have to first look at the possibility that your thyroid gland is suffering from low iodine levels. Do you use iodized salt. Sea salt is not going to work unless it is labeled as iodized. You can get iodine rich supplements or stronger… in better nutrition shops. Do you eat sea food or seaweed? Look at your iodine intake and get some followup labs done to check thyroid and antibodies to auto immune issues. Low thyroid status can create most of the symptoms of hypogonadism, as well as lower T levels.
Your SHBG levels or structure may be different from others, just as some have different structures presenting aromatase enzymes that make then Adex/anastrozole over-responders.
You will not feel right until your T and thyroid levels are fixed. Do not let a doc tell you that he needs to fix one at a time before doing the other. Hit them both at once.
Cortisol: Reference Interval:
PM: 2.3-11.9 μg/dL
AM: 6.2-19.4 μg/dL
When was the blood draw done?
Blood was taken fasting at 8 AM. My hypothesis during the past few months of pain was that my T production was so low that my E2 production could not resume after the adex trial, hence my problems. The blood results do confirm these thoughts.
So I’m wondering how to approach this appointment on 12/3. The doctor is an older endocrinologist, so he might not be too up to speed with HCG, Adex, frequent shots, etc. But he was pretty thorough with the lab order, which is promising. He also conceded at the last appointment that “even a level in the 500’s (my initial TT number) might not be enough for you,” which is also promising. I was up front about my self-prescribed arimidex use and he didn’t seem spooked at all and said that it shouldn’t have caused such severe problems after the drug had cleared my system. He talked about how he thought androgel was a decent product and how the shots had problems with very high levels then fading to near nothing.
I’m going to stress that I want shots, and at least 150mg/week. Anybody advocates for androgel instead? I can float the anastrazole concept, but I still have my own stash of adex if he does not agree. I also want the HCG because I want kids and I want to keep my balls! What I really need for the HCG is the JCEM article that a few guys here have used to convince their doctors to prescribe HCG. I need that ammunition real bad!
Finally, KSman and others, should I maybe hold out for clomid and try to get endogenous levels back up? TRT is my last choice. Or would I just be wasting time at this point?
“”“He talked about how he thought androgel was a decent product and how the shots had problems with very high levels then fading to near nothing.”“”
Can you manage the costs of androgel? Insurance becomes a factor.
Many?most who have hypothyroidism do not absorb transdermal T or do initially then it stops. Non response to transdermal T actually can be a diagnostic factor for hypothyroidism. So this may be a waste of time and money.
For those who train/sweat/shower during the day, transdermals may be the wrong choice.
You need to tell your doc that guys are injecting T into their vastus lateralis with #29 50iu 0.5" insulin syringes with EOD doses. With 200mg/ml test cyp/eth, .145ml [14.5iu] EOD is the typical 100mg/week. This provided very steady levels and addresses all of the doctors negative aspects of injections. The result is the overlapping T release curves of a different injection “depots” in different stages if adsorption.
As long as one is injecting hCG, the value of transdermals to avoid injecting is completely insane. So no merit there at all.
The clinical data to support T-gels shows that the levels are steadier than injecting every two weeks. Compared to EOD injections such claims are empty.
EOD self injections can be the best and least cost delivery system.
Insulin needles for T delivery is easy, comfortable and causes very little damage.
In your case:
Summary:
Good chance that you cannot absorb T-gels [mild hypothyroidism].
Injections are least cost.
EOD injections provide very steady T levels.
Insulin needle T delivery causes very little tissue damage.
Non injection value of transdermals is gone when one injects hCG.
If doc says he does not believe it, then tell him that it cannot do any harm and he can see the results for himself.
T-gels are very costly, if not for you, for your health plan.
And you should increase your DHEA levels. Try 50mg ED then test DHEA-S again later. Low LH/FSH can lower pregnenolone production in the testes that can lower production of DHEA in the adrenals.
http://www.questdiagnostics.com/hcp/files/03summer_newsletter.pdf
Your E2 level is not low now. Actually, given your TT you are estrogen dominant. Given your FT, you are very estrogen dominant.
Any thoughts on clomid?.. still trying to avoid TRT if I can get my body to do the job. Relevant JCEM article about HCG in men? I still can’t find it. Yes my E2 is high in terms of ratio. However, in terms of total E2 it must be too low for me because my joints are MESSED UP! Fish oil is helping a bit, though. If I go for TRT, I’m worried about tanking E2 again with the Adex.
[quote]chemman wrote:
Any thoughts on clomid?.. still trying to avoid TRT if I can get my body to do the job. Relevant JCEM article about HCG in men? I still can’t find it. Yes my E2 is high in terms of ratio. However, in terms of total E2 it must be too low for me because my joints are MESSED UP! Fish oil is helping a bit, though. If I go for TRT, I’m worried about tanking E2 again with the Adex. [/quote]
Clomid, HCG, Nolva - whatever? Why - because in my opinion TRT is a great option when its your only option - what can it hurt to try something else.
[quote]chemman wrote:
Maybe this is my article?
http://jcem.endojournals.org/cgi/content/full/90/5/2595?maxtoshow=[/quote]
I have directed many to that article. Save a copy, print and read, supply to docs.
So what is the deal with Clomid and SERMS? How do they work? Is it possible that they could permanently boost my T levels to the point of resolving my problems? I’m really just trying to get more opinions and info for my appointment tomorrow morning…
SERMS are Selective Estrogen Receptor Modifiers. Not the word selective. They are really estrogen drugs that block and do not activate estrogen receptors in Selected tissues. The flip side is that they are active estrogens in some other tissues. Clomid can really mess up some guys. SERMs are for short term use and are very unsuitable for TRT. Yes it is done. Nolvadex is less of a problem than clomid.
The SERMs interfere with the hypothalamus sensing serum estrogen levels, which causes it to stimulate the pituitary to create more LH and FSH. The testes can be over stimulated and estrogen levels increase. So tissues in the body that the SERM does not protect are exposed to increased estrogen levels.
AIs, aromatase inhibitors reduce E levels.
You sound like you have an expectation that you could take a SERM for a while then be fixed.
Personally, I don’t think a SERM is the answer, but I was just looking for other opinions.
My reasoning is as follows:
My Total Testosterone output is not exceptionally poor, overall. I tested once at 590 around lunchtime (but had no data regarding Free testosterone, E2, etc). My current output is around 500, which is not really hypogonadal. So I’m guessing that a SERM would probably not be helpful. For some reason my free testosterone is really low. I don’t know if it is possible for my body to make enough testosterone right now to bring that free level up to a functional level.
With those thoughts in mind, I think I’m going to opt for TRT. It’s really a quality of life issue right now. Life is too short to have these problems. We’ll see what the doc has to say
Many?most who have hypothyroidism do not absorb transdermal T or do initially then it stops. Non response to transdermal T actually can be a diagnostic factor for hypothyroidism. So this may be a waste of time and money.
would this still apply if hypothyroidism (hashimotos) has being treated and thyroid levels are within range