Done Research, but still have a couple of questions

[PersuAsian]

Hello All. This is my first post and I apologize if I am touching on an overly-discussed question. I have been on this forum for hours and hours over the past few weeks and just joined today in order to post a question. I just turned 35 in December. I weight train 4 times per week. I am 6'0" tall and 215 lbs. Had been having issues with low libido and maintaining erections in the past few months. Quite embarrassing for me and I know that it was making my wife feel horrible. Also my sleep has been horrible for several months, and my mood is all over the place. I want to fall asleep all of the time. I did do a cycle of Andro in the summer and I guess this may have started the issue. I honesty never noticed any positive effects from using it, and the timing of this other stuff seemed to coincide with the cycle. Anyway, Here is my blood work and ranges. I hope it is enough to get a little more insight on my next steps.

DHEA--299 ug/dl Range 89-427 for 35-44 years
Estradiol--16.7 pg/ml Range <12-42.6
SHBG--32 nmol/L Range 10-80
Testosterone --331 ng/dL Range 280-800
Free Test--7.35 ng/dL Range 4.7-24.4
PSA--.6 Reference Interval 0.1-3.9

I had another test done for LH, FSH, TSH and a few other things. That was a separate test that my doctor failed to give me a copy of but is mailing and I should have it today.

Anyway, when I went to discuss the results with my doctor I took a few charts showing Test levels in case it did show that I was low. When it did and I brought it up he said he will not do anything for me since it is in the normal range.

I did come across several articles and forum threads talking about using Clomid and Nolva for boosting testosterone production. I ordered both from ar-r this week. I read Dr. Scally's protocol and so many threads regarding proper dosing, and I know it is different for everyone.

So anyway, to make a long story short... Does anyone think that a cycle of andro could slow/shut me down to the level that I am at? I would like to ultimately figure out why my test is so low if I can. Also, does anyone who has maybe had similar levels and situation found a good dosage that worked for them. I have some low dosing in mind, but any insight is much appreciated. Thanks in advance for any help, and again sorry if this is too much of a Deja Vu post.

[64509chvl]

You're low if you have symptoms at those levels. Who knows why...the other bloods will be good to see. The vets can tell ya if the andro shut ya down or didn't. Don't know anything about that. Try to eliminate everything else once you get the other bloods.

Before I started I had an MRI to rule out pituitary tumor & also did a sleep apnea test. I had my diet in check & lifted/exercised for 2 years before I discovered my low levels so that wasn't an issue. I have a stress free life aswell...for the most part, lol! All my other bloods were good. I had similar levels as you, a bit lower. Started with LowT at 100mg's a week, 250iu's of HCG twice a week almost 5 months ago. Feeling better, but still gettin dialed in...I'm close though!

[PersuAsian]

You're low if you have symptoms at those levels. Who knows why...the other bloods will be good to see. The vets can tell ya if the andro shut ya down or didn't. Don't know anything about that. Try to eliminate everything else once you get the other bloods.

Before I started I had an MRI to rule out pituitary tumor & also did a sleep apnea test. I had my diet in check & lifted/exercised for 2 years before I discovered my low levels so that wasn't an issue. I have a stress free life aswell...for the most part, lol! All my other bloods were good. I had similar levels as you, a bit lower. Started with LowT at 100mg's a week, 250iu's of HCG twice a week almost 5 months ago. Feeling better, but still gettin dialed in...I'm close though!

Thanks for the response. I'm glad you found something that seems to be working for you. I have an appointment with an Endo next week, so we'll see what he says. I have thought about doing a sleep study as well.

[64509chvl]

For sure man! Try everything you & your doc can think of...it's worth it. I initially started with LowT about a year ago...didn't quite rule everything out, did one injection & got cold feet, lol! So I discontinued treatment & got as much done as I could think of & about 6 months later I still felt the same...generally crappy, but I felt a whole lot better starting treatment this time & a lot less of a guess. Something to think about!

[PersuAsian]

True. After reading more on PH usage I think this may have been the cause. It came with a "PCT" which was just some herbs packed in a capsule, so no true PCT was done. I got the rest of my panel back, but it didn't include FSH or LH. Here are the rest of the numbers and ranges if it gives any more help. As much as I hope seeing an Endo or Uro will help, it just seems like there is such a wealth of knowledge in these forums. I have a call into a HBRT for an appointment, haven't heard back yet. I also have an appointment with an Endo this week.

[PersuAsian]

UPDATE:

Alright guys, after a frustrating group of appointments with 2 gp's and an Endo I decided to do try a Clomid restart on my own. Here are the results of 3 months, 15mg every day. Let me know if you have any input. I realize that the E2 is high, but this was also not a sensitive assay. I found a new doctor that I am hopeful might give me some insight. He was recommended by a compounding pharmacy near me. My first appointment with him is next Tuesday, but he had me do some blood work beforehand. I will request other tests at my appointment if he doesn't already.

DHEA-----------283 Range 89-427
Estradiol-------71.6 Range <12-42.6
SHBG-----------45 Range 10-80
Testosterone --991 Range 348-1197
Free Test------19.79 Range 4.7-24.4
PSA------------.8 Range 0.1-3.9
TSH-------------1.35 Range .27 - 4.2
DHT-- ----------67 Range 30-85
IGF-1 - -------- 148 Range 102-308

[PersuAsian]

Any advice on this before I go in to the Doc tomorrow guys? I of course like seeing the higher test numbers with the clomid experiment as it means that I am not primary. Unfortunately as we all know those numbers do not always translate to how one feels. My symptoms have had no significant improvement. Still low libido and lack of energy.

[kelkel]

Well, testosterone is not always the answer for libido issues. It's more complicated than that.
What is your definition of low libido? Define it a bit more specific to you.
Your numbers look good other than estradiol, which as you know is not the correct test and reads higher than it should in men.
The key here will be can you maintain better numbers if / when you come off the serms. What is your goal?
What are your prior LH / FSH numbers pre therapy?

[PersuAsian]

Fsh-4.1. Range 1.6-8.0
LH -5.0. Range 1.5 -9.3

Before I started feeling bad I would easily want sex at least once a day. Now and for the last couple of years really I honestly can take it or leave it. I never really have the desire to do it. I can perform, but never feel like I have to have it. Really kind of numb to it I guess. Normally even seeing pictures in magazines or whatever would get me thinking about it, but now.....nothing.

[kelkel]

Those readings were good pre-clomid. Remember, testosterone is not an aphrodisiac and as we age things change. Main thing is that it works when you need it to! I'm curious whether your current estrogen level is a bit high for you, thus causing libido issues.

[PersuAsian]

Thanks for all of the input kelkel. I know that it isn't an aphrodisiac. If it didn't take such a noticeable drop in such a short period of time I would have probably just chalked it up to getting older. Here was my estrogen level from the first set of bloodwork that I had done about a year and a half ago:

Estradiol--16.7 pg/ml Range <12-42.6-------------------again not a sensitive test

I still felt the same at this level. I honestly was a lot more interested in my numbers when I first started researching my issues and the possibility of low t, but I just want to feel normal at this point. I understand everyone's frustration with finding the right doctor after having the experiences that I have had. I just want someone to give me some insight on everything. I'm not claiming to know a lot, but the doctors I have seen so far have seemed ignorant to hormone issues in men, and the endo was the worst. He pulled my Total T, LH, FSH and Uric Acid on my only blood draw in his office. He said all were normal, but that he would write me one prescription of T-Gel if I wanted it. I asked him what he thought that was going to do for me long term, and he mumbled a bunch of stuff that made no sense. I told him I didn't want to do that without knowing why my numbers were where they were at and why I was feeling so bad. Then he told me there was nothing else he could do except send me to a sex therapist. Extremely frustrating! I have mixed emotions about trying another doctor, but I think I am more optimistic than not. We will see how it goes today I guess.

[kelkel]

That estradiol reading is low. Remember, standard estradiol reads higher in men therefore your estrogen is actually lower.
I'm curious if you know what your prolactin level is?
I also think you're doing the right thing sticking with serms and not shutting yourself down until you get a handle on this.
When it comes to doctors, most do not know hormones unfortunately. They are not trained in them in med school. Consider searching for an A4M Certified Doc (google A4M Doctor Finder) but in reality, just a doc who understands hormones. Title is irrelevant.

Have you considered asking your doc for low dose Cialis? 5 mgs once or twice daily is a great asset and a very healthy thing for males to take in many ways beyond the obvious. Also do some research on PT-141 which is an effective aphrodisiac (AR-R has it.)

[PersuAsian]

Kel - I actually have been using low dose Cialis for almost a year now initially because of ED issues, but continued for the reasons you were alluding too. The doc visit went pretty well. I was very transparent with him as far as what I took with the pro hormone and then my Clomid experiment. He was very understanding and I could tell he was actually listening and empathizing with me. He said that he loved the response that I was getting with Clomid and that he may want to continue the same protocol later with a few adjustments. For now he did another blood draw for sensitive E2 and prolactin and will follow up with a phone consult once the results are in. Then I have follow up bloods and an appointment setup for three months from now to see where I am settling in with my numbers.

[kelkel]

Great to hear your doc is listening to you! Also glad he wanted to check prolactin. Or did you influence him there?
What "adjustments" did he speak about?

[PersuAsian]

I was inquiring about the prolactin levels, so he said we could simply just pull the blood while I was there. As far as adjustments he was just saying that my higher e level this time was due to the clomid also, so we may have to add something to keep that more in range. He suggested that I take DIM if this blood work comes back high again.

[kelkel]

Yes it can be. It's an antagonist in the hypothalamus but an agonist in the liver.
Dim, zinc and copper is a good combo to help. You can buy zinc and copper combined.

[PersuAsian]

Thanks for your time and the insight Kelkel. I appreciate it. I'll post any new findings from the blood work when it is available.

[PersuAsian]

Well got the Prolactin and sensitive E2 results back.

Prolactin 6.60 RANGE 4.04 - 15.20

Estrogen Male Ultrasensitive 56.1 RANGE ≤29

I guess Prolactin is at a good level. E2 is definitely lower than the last draw, but again is the not the same same test as last time. Maybe it is just settling down to a more normal level. I started taking DIM at 100mg ED today. Hopefully this will help out with that.