T Nation

What Would You Do?


#1

26 years old /12 months with low t symptoms also penile/scrotum/testicle shrinkage no libido or morning erections. lack of penis sensitivity.
never took aas, dont do drugs, cleaned up diet , exercised but still gained lots of fat on midsection. the last 12 months did everything natural to optimize hormones yet no improvements. ultrasound on testicles , mri for pituitary gland both came back clean.

(aug-nov 2010 all natty levels)
Aug 2010
Total Testosterone
410 Range 300-1080
SHBG
20 Range 11-80
Testosterone Free
96 Range 47-244
Testosterone % Free
2.3 Range 1.6-2.9
TSH
0.63 Range 0.36-43.9

Sept 2010
Estradiol 55pg (13-54)
FSH 3.5 (1.6-8.0)
LH 6.3 (1.5-9.3)
Free T3 1.27 (0.93-1.70)
TSH 0.67 (0.27-4.20)
Prolactin 5.2 (2.0-18.0)
Free Testosterone 117.2 pg (35.0-155.0)
% Free Testosterone 2.47 % (1.5-2.2)
total test 475 (250 - 1100)

Nov 2010
Estradiol 67 (13-54)
FSH 3.4 (1.6-8.0)
LH 6.6 (1.5-9.3)
Free Testosterone 106.8 (35. - 155.0)
% Free Testosterone 2.15% (1.5-2.2)
total Testosterone 497 (250-1100)
Vitamin D 25h 33 (30-100)
magnesium 1.96 (1.6-2.2)
Cortisol am 20.11 (6.2-19.4)
DHEA Sulfate 293 (110-510)

started bioidentical testosterone cream in Jan 2011 stopped after 3 weeks made shrinkage of penis/scrotum/and testicles worser.
FEb 2011
Testosterone total 322 (241-827)
Free Test 9.0 (6.0-27.0)
SHBG 16 ( 13-71)
Gonadortropin 5.0 (4.0-8.0)
PSA 0.5
Cortisol 5 (2-25)
FSH 6.9 (1.3-11.4)
Progesterone 0.5 (.15-1.15)
Prolactin 2.5 (3.0-30.0)
Free t4 1.26 (.73-1.95)
TSH 0.8 (.3-5.1)
Free t3 3.3 (2.3-4.2)
estradiol 22.1 (10 - 42)
estrone 10.7 (9-36)
total estrogens 32.8 (19-69)

March 2011 Saliva Test
progesterone 89 (5-95pg/ml)
androstenedione 480 (151-350 pg /ml)
testosterone >200 (60-110 pg/ml)
dht >125 (22-72 pg/ml)
estrone 88 (30-58 pg/ml)
estradiol 7 (1-3pg/ml)
FSH >750 (<125 uiu/ml)
LH >250 (10-25 uiu/ml)
cortisol
6-8 am 10 (13-24)
11-1pm 11(5-10)
4-5pm 6 (3-8 )
10- midnight 3 (1-4)
dhea >25 (3-10 ng/nil)

March 2011 bloodwork 300iu shot, then 200iu of hcg daily for about a week, 2 weeks later
total test 584

April 2011 one 400mg shot of Test E
total t 1490 (250-1100)
free t 410 (35.0-155)
tsh 0.400 (0.340-4.820)

May 2011
free t4 1.46 (0.73-1.95)
TSH 1.3 (0.3-5.1)
Estradiol 38 (<63)
FSH 6.2 (1.3-11.4)
LH 8.0 (1.2-7.8 )
prolactin 5.7 (3.0-30.0)
testoosterone 511 (241-827)
shbg 23 (13-71)
free t 13.0 (6.0- 27.0)
IGF-I 333 (116-358)
dhea 288 (240-549)
vitamin d3 93 (30-100)
psa 0.6 (<4.0)

here are some out of range items
cholesterol 214 (<200)
LdL chol 153 (<100)
ratio LDL/HDL 3.72 (<3.55)

blood count
rbc 6.52 (4.10-11.0)
hematocrit 51.8 (37-49)
MCV 79.4 (80--100)
MCH 25.9 (27-34)
neutrophils 38 (40-74)
lymphocytes 49 (19-48 )

in over a year my flaccid penis has shrunk , my testicles are retracted and small as shit, I never put much thought into my penis had life to worry about (school,music career, work, friends, family). my only other option is to look into pelvic pain . my life went from skys the limit to hell on earth.

my current doctor just prescribed clomid 50mgs daily for 2months.


#2

Some thoughts:

-You are leaving out some sort of info here. I doubt your Vit D improved on its own from bottom range in November to top of range in May. Same with E2 (55 September -> 22 February). You need to list all your supplements and meds for us to get a clearer picture.

-You need to start using the same lab for your bloodwork. Your ranges and tests are all over the place, making it very hard to compare. Your E2 labs are usually correct ranges, but one wasn't (<63 range)

-Saliva tests are useless for anything except cortisol

-Why did your cortisol go from being high (good) to being dangerously low (bad)?

-Are you self-treating or is this doctor controlled? A 400 mg test shot represents your doctor does not know waht they are doing if doctor prescribed. If self prescribed, it represents taht you do not know what you are doing. Both are bad.

-How far after your 400 mg shot was your April bloodwork taken? This is important info (timing of labs).

-You need to get your DHT checked. I imagine this is low and will shrink your dick and cause libido issues. Any prior history of using medication for hair loss?

-Has your doctor explained the treatment philosophy to you? It seems that you are just bouncing around. What is the end goal with these meds? Most don't prescribe clomid for long term. Does he want to pull you off after 2 months? Then what?

-TSH looks good

-Your DHEA is low--you could supplement with DHEA, which is available over the counter in the US. 50 mg day is a good starting dose.


#3

Forgot to mention that it looks like your testes are capable of producing on their own. My initial impression from your first couple of blood works was that you had high E2, and I was right when it was confirmed in September. From that, it would appear that you were a good candidate for Arimidex monotherapy. This would have lowered your E2 and boost your T by proxy (at least the free T levels).

Since your E2 seems to bounce all over the place, and you have bounced to other treatments, I'm no longer convinced it is the right option since your baseline could have shifted.

Try to find out why your body is not clearing E2. Are you fat? Liver issues?


#4

I did monotheraphy with arimidex sept to nov 2010 which really didn't do much and my penis was shrinking still. made the mistake to go to an anti aging doctor in dec-jan which put me on low dose bio t cream. same with the doctor who prescribed 400mg shot.

the 400mg shot was in april a month later from the may bloodwork. before the may bloodwork I was taking arimidex and vitamin d3. no more testosterone

would 50mg clomid help are hurt the situation. bring testicles back into size.


#5

monotheraphy with arimidex: what dose and frequency?

read the stickies, everything is there