Cancer Survivor - Late complications of treatment

[CSI007]

Hello,
I have a pretty long story here. I just turned 45. I have been married to a beautiful and wonderful wife for 18 years.

16 years ago I was diagnosed with Hodgkins Lymphoma. I went through 6 cycles of ABVD (6 months, twice per month). Remission soon after treatments began. I had bleomycin toxicity mid way through treatments and it was stopped. Also have some peripheral neurapathy from the vinblastine.

I dealt with panic attacks shortly after my treatment ended. They were quite severe at times and I was placed on Paxil which helped...for a time. Then I started to have sexual side effects and after about 6 to 8 months on Paxil I weened myself off and started taking a natural alternative which worked well for years until I also got myself off of it.

Had been fine for a couple years but as time has gone on I could feel my sexdrive reducing. I figured this was the stress of life. Recently lost many family members including my Dad who died suddenly. Each major event seemed to have a little more impact on the sexual department.

About two years ago. I started to occasionally have issues with erections. They would be softer. I have never really had issues with endurance etc. Not every time and it seemed to be only occasionally. My ejaculate (the sperm) seems much thicker and gelatinous. My climaxes have changed too. Some times they just don't feel right. Not a powerful, and some times it's near impossible to climax. This past year it seems to be getting worse though so I decided it was time to see a doctor about it. I suspected low-t. I went to a urologist and discussed with him the above. I had blood work done and it came back 328 (300 to ... normal) The pituitary tests all came back normal so he doesn't suspect issues with that end of things. He now wants
me to use natesto 3 times per day for about a month and then have another check up.


Also, Last year I had a check up and my blood glucose was slightly elevated and my A1C was also slightly elevated. I decided I should cut back on the carbs (I ate about 400 to 500 per day - mostly juice) I went on low carb February of last year and within a few months lost over 40lbs. To this day I continue low carb ( I typically eat about 20 to 30 carbs per day or even less) but I have hit a brick wall and pretty much nothing I do can break through it. I wanted to lose another 15 to 20lbs before I was satisfied with my weight loss. My A1C has not budged and my fasting BG, while it has not returned to normal has lowered some. I check my blood on a regular basis and I do not believe that I am a full blown diabetic. Most readings after eating quickly fall to normal levels.


So, the reason why I am posting this. I talked with the Doc last night about this. I am not sure that I want to do the testosterone replacement route just yet. Maybe some more testing since I have only had a single test and it was low (tested at 8:45am) Also, while I am pretty sure that my condition with regards to low-t is from the chemotherapy...Perhaps there is another reason?


Also, I believe my main issues are with ED, penis sensitivity and maintaining erections. But lately I have been having lots of short term memory problems etc. And for years I have not been as sharp as I used to be mentally. I feel like I am in a fog mentally. But I figured this was because of the chemo. But maybe it isn't maybe it's been the test slowly decreasing and getting worse? Or perhaps all of the above is also because of the use of the Paxil. I have heard that long term effects are similar to what I am experiencing sexually.


Quite frankly, I have never been one to take medicine. I rarely drink. And reading the side effects of the test replacement scare the hell out of me. LOL I figure once you get on this train you are on it for the long haul. Certainly not something to take lightly and should be thought about carefully.


In my mind, it sounds like test replacement would be wonderful. Perhaps taking care of all of my problems in one fell swoop. But part of me is telling me I need to EXERCISE and perhaps some supplements like zinc and vitamin d and EXERCISE some more and perhaps I can get my t levels back up to at least near average. Maybe this is just a pipe dream. I dunno.

I probably missed some things here and can add them later. Thanks for taking the time to read.

[CSI007]

Any thoughts or comments? Seems like some of you have been down a similar path. At least regarding the low-T.

I was wondering if I would be able to get off the Natesto if I only took it for a few weeks to see if I see some improvement in mood, fatigue and ED.

[kelkel]

Welcome to the forum CSI. Some bullet points:

Lifestyle will impact testosterone levels , as can medications and simply age. Some need TRT much earlier than your age.
Do you have full BW you can post? To include LH, FSH, TT, FT, Full Thyroid Panel, Cortisol and Prolactin? These are mentioned as they all can impact T levels.
So many things can cause ED that it's hard to pinpoint. Yes, testosterone can but it's not always the culprit.
TRT is a wonderful thing, if and when needed. Just make sure you go into it with a clear conscience knowing that it's necessary, hence the full BW...

Natasto is test, just a newer delivery system. It will eventually shut down your endogenous production the same as any other form of test would. It does not add to what you currently have. Doing it for a short period is fruitless. When you stop you'll only drop back to your prior poor levels, or worse.

Fire back with questions if you have them.

[CSI007]

Thank you. I don't have any recent complete blood work ups. I have one that is about a year old but it didn't include a lot of what you were asking about. I will try to dig it up and post it though.

My lifestyle is somewhat sedentary. I work in front of computers all day long. I don't get a whole lot of exercise...And when I say exercise I mean walking, doing yard work etc. I don't lift weights any more (been years) but even then it was nothing serious just occasional curls and bench pressing etc. My weight before low carb was 270lbs and now I am down to 230-240 range...It's been up and down for close to a year at that range now.

I take no medications except a daily vitamin and occasionally an allergy pill but as I have gotten older those have become less and less needed.

My Total Testosterone has 328. LH, FSH were also tested as was the PSA Those three were all within normal ranges according to the Doctor's office. I wanted to get the values but was at a place in time that I could not ask and they only offered the TT value so thats what is stuck in my head. LOL

Your comment about clear conscience is exactly where I am at right now. I am sure this Doctor means well but I am really think perhaps I should cover all bases to be sure that this is the right path to take. I feel like it is, but feeling and actual are not always the same thing. I never thought I would need to be dependent on a "drug" to keep my health. But then again, I never thought I would get cancer either.

Looking back, the doctor asked me if I have been fatigued...I didn't think so, but I have been falling a sleep more after work and again, the almost drunken feeling when working or driving etc. My head feels like it's floating. Weird.

I was reading somewhere on the web that during the natesto trial he did very well and it did not increase his E2 levels like the gels he is now currently taking. I am wondering if these is any possible difference simply because of the differently delivery method that it could keep the home grown T working little more then injections or other gels etc. Seems impossible but who knows...?

Trying the Natesto for a few weeks...If I saw no improvement, I realize that I would be back to square one but I was curious is it even possible to get off these things once your start.

[kelkel]

Congrats on the weight loss! The prior weight gain and sedentary life style makes me wonder even more about your thyroid. Hypothyroidism can and will cause hypogonadism. All the BW items I mentioned are important when it comes to a diagnosis or at least a direction to pursue. Unfortunately when a doctor says your in the normal range it could mean the "bottom" or normal. Who wants that?

Many doctors specifically seem to struggle with hormones and thyroid. They get very little training in them in med school. When it comes to thyroid many base their assessment on the TSH value which is a weak indicator of thyroid health by itself. On top of that most labs still use an older scale that goes up to about 5. A newer, more modern range is .3 - 3.0. Why don't you stop by your doctors office and pick up your labs when you can?

I haven't done much reading on Natesto but it's still a form of testosterone and testosterone turns to estrogen, regardless. Can't really avoid it. Also know that the more body fat that you carry increases the turnover rate of T to E. Testosterone may be a drug but in essence, it's the exact same thing that your body makes. No different, so don't worry about that. We all get older and TRT gives us the opportunity to live much healthier into our older years. Our parents did not have that opportunity and had to simply suffer the debilitating consequences of low testosterone .

Trying Natesto for a few weeks is a bad idea. It can take much longer for the full effects of TRT to set in and be effective based on how you feel and blood work. Step one is to get your BW and see if there's a root cause for the low T. If it's simply age related or idiopathic then you need to accept that it's time for replacement and that you'll be just fine.

[CSI007]

Thanks for all the great info! I will pursue additional blood work and see if we can nail this down. I am tired of feeling crappy so I have got to do something. I guess a thyroid problem would be better to deal with then administering testosterone . I guess that could be dealt with with a pill correct?

I may have access to my most recent lab work here in a bit if I can get access to my patient portal. I will post it if I can.

[CSI007]

I managed to get the results from the BW I had done last week. Not much here though but what do you think? The LH and FSH tests are a bit on the lower side of scale it seems.


Adult male reference interval is based on a population of lean males up to 40 years old.

testosterone , serum 328 348-1197 ng/dL

luteinizing hormone(lh), s


Test Low Normal High Reference Range Units
lh 2.4 1.7-8.6 mIU/mL

fsh, serum

Test Low Normal High Reference Range Units
fsh 2.6 1.5-12.4 mIU/mL

prostate-specific ag, serum

Test Low Normal High Reference Range Units
prostate specific ag, serum 0.5 0.0-4.0 ng/mL

Happy Thanksgiving!

[kelkel]

Yes, meds for thyroid issues.

Well, based on your LH value you're near the bottom. What this can indicate is secondary hypogonadism. LH is low, thus low testosterone . Basically it's not enough of a signal to your testies to produce sufficient amounts of testosterone . If LH was elevated yet T was low it would be indicative of a testicular issue or "primary" hypogonadism.

That said, you need to find what's causing this. Thyroid, cortisol, prolactin, pathologies, even head trauma. In the Finding A Doc sticky at the top of this forum is a solid list of BW to get. I'd recommend that as a good start.

[CSI007]

Thanks again for the info. I will report back with more results when I can get them.

Have not had any head trauma that I know of. I hope we don't go there with the pathologies...been there done that. Don't want to do it again for sure.

[CSI007]

One more quick question for now...If it turns out to be the thyroid, would thyroid medication raise these levels to normal and therefor have the testes create the proper amount of -t again?

[johnhenry]

Re cancer: google 'thetruthaboutcancer.com Google Dr Leonard Coldwell youtube - watch everything you can find there - top notch. Google 'apricot kernels, B17, G Edward Griffin, laetrile, amygdalin, - and after that, if you want more let me know. You will find there are so many ways to completely overcome cancer. The cancer industry would have us believe that the only answer is poison in the form of chemo and radiation. Read up on this - you will be excited and inspired. JH.

[CSI007]

Thank you John,
I actually hope that is way past me. I have been cancer free for over 15 years now. But I will have a look at the info you provided.

[johnhenry]

The thing is how to say cancer free - we are continually producing some 'off-type cells' which are by products of eating/ metabolic processes/ living - that have to be dealt with by the immune system. In my opinion, this info is gold....
file:///C:/Users/Owner/Downloads/introduction-to-natural-allopathic-medicine.pdf JH.

[kelkel]

One more quick question for now...If it turns out to be the thyroid, would thyroid medication raise these levels to normal and therefor have the testes create the proper amount of -t again?

As long as your HPTA is functioning properly, yes. Thyroid meds would normalize its function thus eliminating the suppression of your LH. As your LH rises so will your testosterone assuming everything downstream is functioning like normal.

[CSI007]

I had blood drawn today for Prolactin and Estradiol
I am probably going to have to go on my own to get the other tests as of now. My doctor is really leaning towards primary hypogonadism. The more I read about the limited blood tests I have gotten sure makes me think this problem started elsewhere. Maybe even sleep apnea? My wife says that I do seem to stop breathing from time to time during my sleep. Might have to go in this direction if the blood work does not pan out. I have not started the TRT yet.

[kelkel]

Primary hypogonadism would be indicated by elevated LH & FSH values, which you don't have. The elevated values are your HPTA trying to get signals downstream to make things work as they should. Your BW does not indicate elevated values.

[CSI007]

I had blood drawn today for Prolactin and Estradiol
I am probably going to have to go on my own to get the other tests as of now. My doctor is really leaning towards primary hypogonadism. The more I read about the limited blood tests I have gotten sure makes me think this problem started elsewhere. Maybe even sleep apnea? My wife says that I do seem to stop breathing from time to time during my sleep. Might have to go in this direction if the blood work does not pan out. I have not started the TRT yet.

Ok, got my results back today.

The doctor says they are normal BUT here are the results.

The Prolacin is 15.2 The range is 4 to 15.2 - I am right on the edge of normal!
The Estradiol was 9.1 The normal range is 7.6-42.6

Based on what I have read - To me this is a signal that lower normal FSH and LH and higher normal Prolactin indicates something is a miss with the pituitary/thyroid area.

[kelkel]

Correct. Elevated prolactin, like thyroid, can suppress pituitary function. Some people may be fine at 15.2, others may not. It may be prudent to request a pituitary MRI to rule in / out pathologies (adenoma's.) Your estrogen is very low. It's also the wrong test for men. You should be getting a Sensitive Estrogen Assay. Standard estradiol is geared to women and men fall to low on the scale for accurate readings. Normally estradiol reads higher (sometimes a lot) than a sensitive assay. Low E can impact many things, like your libido / erections for one.

[CSI007]

Seems like a tumor would indicate much higher Prolactin? Like in the hundreds? I am sure there are exceptions of course but generally speaking from what I read, it typically would not warrant a scan. I have no other symptoms (eye problems, sinus issues etc)

Interesting about the Estrogen. I asked for that specifically because it was in the pinned thread at the top of the forum.

So what generally causes lower estrogen? Simply because my T is lower? Don't you need the T to create the estrogen?

[CSI007]

Finally got in to see an endo this week. I got my blood drawn today for complete thyroid function panel and some other things. Having a real tough time convincing these docs of what I believe which is that this is a secondary hypogonadism. Seems to me based on the countless thing that I have read including quite a bit of medical research papers I should be attacking this problem with Clomid or HCG to try to kick start my pituitary into generating higher levels of LH.

Does any one have suggestions for doctors in this area (Baltimore, MD suburbs) that would be more receptive to taking this approach instead of just throwing T into my body?

Upon further reading I am convinced that either my elevated blood sugar (per-diatbetes) is causing the low T in some fashion or vs versa too. Which means if I ever get this hormone things straightened out the blood glucose and A1C will resolve itself.

My ED is getting worse too. Going from normal to issues rarely to issues almost all of the time now. The one drug I have tried made me very ill for 2 days after (Stendra) Bad headache, hangover feeling etc. I won't take it any more either. Didn't really do to much for me either. :/

[CSI007]

Some of my latest tests are trickling in.

Thyroid Function.

triiodothyronine, free, serum

2.9 pg/mL 2.0-4.4 completed Not applicable 01/10/2016
thyroxine, serum, free

1.19 ng/dL 0.82-1.77 completed Not applicable 01/10/2016
thyroid stimulating hormone, serum

4.470 u[iU]/mL 0.450-4.500 completed Not applicable

Looks like I may be Hypothyroid with that value of TSH. Seems most guidelines say under 3.0 now. Problem is, is it a primary Hypothyroid issue or is it just like the T issue. Secondary to something else?

I am feeling terrible. It seems like it comes in cycles, I can identify my bad couple of weeks at the beginning of each month. Last month I felt terrible around the same days of the month.

Anyone have anything to add?

[2Sox]

You're in the right place, and you will get the answers you need. This forum is a gold mine of information.

My advice: First, listen closely to what Kel already told you and take the suggested steps he lays out. Second, it would be wise to stop thinking of testosterone as a "drug" - as by now you should be very aware that it is not. Also, be very aware that T is not something you can start and stop like taking a Tylenol when you get a headache. This you should also know. All of us here know that the only time someone with low T stops is when they leave this world. So if it becomes necessary for you to begin TRT - and it seems from the information you provide, it will - just enjoy the new life you will be getting.

[kelkel]

Seems like a tumor would indicate much higher Prolactin? Like in the hundreds? I am sure there are exceptions of course but generally speaking from what I read, it typically would not warrant a scan. I have no other symptoms (eye problems, sinus issues etc)

Not all tumors are prolactinomas. Mine isn't yet it shut my T down to a 59 level and dropping. I'll get back to your other updates shortly.

[CSI007]

Well,
I have made an appointment with a naturalpath MD that also provides bio-indentical hormone replacement as well. In my emails with him he also supports the use of clomid and HCL where indicated.

I also am ordering some all natural (iodine, selenium etc) supplements for Thyroid support. And may start taking them before I see him to see if I see any improvement in my well being/mood hot flashes etc.

kelkel, Neither of the first two Doctors that I have visited wanted to do an MRI. So at this point, until I can get a Doctor to look at that avenue will have to wait. I realize there are other types of tumors that don't produce prolactin etc. My head is spinning from reading so much stuff about all of this. Ugh.

As I have said above, I want to make sure we are treating the right thing. Since the whole hormonal system is so intertwined no telling where the issue might be. But I want to save the T as a last resort. Certainly check all of the other things out first.

2sox - Understood. On the low t. I want to make sure that TRT is what I need for sure. There are other conditions that may be suppressing it all.

All I know is, I am really feeling like crap right now. Starting to feel like a repeat of my search to find out why I was sick years ago when I had cancer. Each passing month I feel a little worse.

[CSI007]

JFYI, in case this is indeed my problem.

Thyroid hormone deficiency affects all tissues of the body, including multiple endocrine changes that alter growth hormone , corticotrophin, glucocorticoids, and gonadal function. Primary hypothyroidism is associated with hypogonadotropic hypogonadism, which is reversible with thyroid hormone replacement therapy. In male children follicle-stimulating hormone (FSH) is elevated and associated with testicular enlargement without virilization. Men with primary hypothyroidism have subnormal responses of luteinizing hormone (LH) to gonadotropin-releasing hormone (GnRH) administration and normal response to human chorionic gonadotropin (hCG). Free testosterone concentrations are reduced in men with primary hypothyroidism and thyroid hormone replacement normalizes free testosterone concentrations. In men with primary hypothyroidism, prolactin is not consistently elevated (except in men and children with longstanding severe primary hypothyroidism), but prolactin declines following thyroid hormone replacement therapy. Thyroid hormone is known to affect sex hormone-binding hormonal globulin (SHBG) concentrations.

[BallSak]

In regard to your thyroid, it is important to get reverse t3 labs as well since just looking at your free t3 can give you a false reading. Your brain is sensing that your thyroid hormone is low, hence the elevated TSH.

The most identifiable symptom of hypothyroidism for me is severe brain fog.

Your body temperature should be at 98.0 in the morning and around 99.0 in the evening. Mid afternoon should be 98.6. Any temperature less will indicate hypothyroidism.

Many of your body functions require your body to be the proper temp in order for the enzymes to fire to carry out the function. When you are hypothyroid, your body temp is low and many important functions are not able to be carried out because the enzymes can't fire....that's why you feel like crap.

So, get in the habit of taking your temperature. It is a dependable way to monitor your thyroid.

[CSI007]

Ballsak,
Up until getting cancer, I was not in the habit of taking my temperature. But I do remember a a child having a normal temperature. When I got cancer I had a low grade (99f) fever for months on end. Spiked around 3:30pm and would stay there until the next morning...repeat. That is until my first chemo session and then it went away.

I take my temperature FREQUENTLY since then and my temps almost always read 97.0 to 97.4 And rarely go up from there unless I have a bug. Today at waking it was 97.4 (took it three times) This afternoon it was 97.5 and 97.0 I just took it again and it's 97.8 but I have been sitting next to a blazing fire and my wife was dying because it was so hot in family room. LOL Once I cool off I know it will be down around 97.3 or .4 again.

With all of the reading I have been doing the past month, I am right there with you. I think this is my thyroid doing this or at least contributing. Not sure if it's an iodine deficiency or something else that's why I am going to try these supplements that contain *some* iodine. Though I am not sure it has enough but I will start here.

As you can see from my TSH I am almost out of the normal range on the high side..and now days it seems that many docs think that anything above 3.0 indicates hypothyroidism.

I certainly have all of the symptoms that is for sure. The brain fog is terrible. Dizziness, hot flashes (getting much worse) etc. Not sure but maybe all these years I have been dealing with this but the low carb, high fat diet has pushed me over the hormonal edge and leaves me were I am now.

Thank you for the additional insight and I certainly agree with you regardless of the rT3 test.

[CSI007]

Oh and one more thing. Anyone here ever resolve their low T with just thyroid issue resolution (supplements or otherwise?)

[Far from massive]

CSI Just saw your thread.

Were you given Interferon during your treatments for cancer? I was placed on Interferon for HCV about 9 yrs ago and along with some visual issues it has left me in a permanent fog with the hot flashes and a nervous personality. Just thought I would mention it since your symptoms are so similar.

As to the Low T and other issues (sexual) I would also explore good nutrition as well as heavy resistance training (particularly the lower body as the glutes and legs on a sedentary male of your age are the only muscles large enough to bring about large metabolic change) this while it may not be the root cause of your issues will almost without a doubt prove beneficial to them. I worked the same job computers for 8hrs a day from 35-45 and at 240 at my worst could barely keep an erection...however after getting in shape my sex life improved dramatically.

As to the TRT subject Kelkel is the resident expert and I have nothing to add to what he has said other than its all good info.

Best of luck FFM

[CSI007]

Thank you!

No interferon. I had ABVD for lymphoma. Adriamycin, bleomycyn, vinblastine and DTOC. I spoke with my oncologist about this (great guy!) over the phone a few weeks ago and he also agreed that this is likely secondary hypogonadism but he didn't think that the chemo would have caused thyroid issues. I cannot find any concrete studies regarding my drug regime and thyroid issues either. Now, had I gotten radiation it would be a different story.

I wish I could get more exercise. My big problem is no energy, muscle aches and pain etc. Plus I have a bulging disc in my back L5S1 that kicks my butt if I do too much (Inversion table saved me from jumping off a cliff because of the hip and leg pain) If I can get this other stuff under control I will definitely put more into exercise!

It's wonderful that you are doing better. Has your brain fog lifted?

[CSI007]

Got some more test results today.

testosterone , serum, free 0.58 ng/dL <----VERY low? I can't find the reference range for this Labcorp.
testosterone, total 289 ng/dL 348-1197 <----Down from 328 about 2 months ago.
prolactin, serum 10.6 ng/mL 4.0-15.2 <----Down from 15.2
LH 4.2 mIU/mL 1.7-8.6 <---- Up from 2.4 (Too high to be Secondary now???)

[CSI007]

Oh and I woke up to a body temperature of 97.0 When I went to bed late last night it was 96.8

[2Sox]

There are many causes for ED - all of which I'm sure you have already researched. I have personally found that BPH is a contributory factor to this condition so if you have any of the symptoms you may want to investigate this further - along with the other things you're looking into. I suffered from BPH for many year and recently had TURP - a surgical procedure to alleviate the symptoms. The difference in the quality of my erections is dramatic. I feel like I'm in the best years of my youth.

[CSI007]

Thank you. After googling BPH I don't think that I have that issue. It's awesome that you were able to correct your situation!

Woke up this morning with a temperature of 96.8.

I started taking those supplements that I found yesterday for the thyroid. Two hours after taking them I felt different. I was rather nervous and a bit edgy. As the day wore on I didn't seem to feel as light headed and foggy. About 8 hours after taking them I could feel that they appeared to be wearing off and I started to have hot flashes and I got a headache. I am pretty certain that this was not a placebo effect (at least the nervousness feeling because it was pretty dramatic) It felt almost like I had gotten a huge dose of caffeine (I have not drank caffeinated drinks in many years)

Here is the supplement that I purchased and started using yesterday.

1 body brand thyroid support

[CSI007]

Hey kelkel,
What do you think about those thyroid values? And my low body temps? Seems I am definitely hypothyroid but is it enough to knock down my T to those low values?

[CSI007]

On day 4 now of those thyroid support supplements and I gotta tell you. My mental clarity and brain fogginess seem to be improving some what. I can tell when the pill may be wearing off later in the evening too, the symptoms seem to be coming back. Still no differences in the ED department as of yet. However, my body temperature remains low and my hot flashes and getting worse and more regular now. I woke up this morning just on fire with a temperature of 97.0.

Overall though I am not sure if this "improvement" is me just getting through the bad part of the month though since it seems that early month is worse and later month is a bit better.

[CSI007]

Wanted to give a quick update, it's been a while.

After meeting with my new Doctor he prescribed 25mg clomid every 3 days and ordered a ton more blood work to be completed after a month on clomid. I am continuing the thyroid supplements.

Within about 3 days of taking my first dose of clomid I started getting some missing "feeling" down south (LOL) It was great to feel like that again. Had much improved erection that following week but still loss of sensation. I managed to get 2 pills complete (4 doses) and I started with pretty bad eye pain in one eye and my vision began to get somewhat blurrier than it already is. Called the Dr and he said to stop taking it immediately. So I did.

We both agreed it might be a good idea to get the blood work done 2 weeks early so the next day I went and had blood drawn. Last week I got the labs back and some interesting points.

Total T was up to where it was in November around 327, but my free T nearly doubled. LH and FSH were still about the same though.

Both of my thyroid antibodies came back positive so I have Hashimotos disease but it's not terribly elevated values.

Also had slightly low vitamin D and iodine. I am supplementing both (vit d 10000ul per day, iodine through the thyroid supplements)

My iron was good but my ferratin was elevated at 480 (normal high is 400)

Everything else looked good. He says that my adrenal function overall is pretty spot on.

Oh, my platelets continue to be low (just outside of normal low) so we need to keep and eye on this. It might be another auto-immune thing going on.

The doctor prescribed cytomel 5mg twice a day to try to get my t3 and reverse t3 in a better ratio. Hoping that this will help with the low T but he wants me to also try HCG mono therapy to help boost the T more. He is thinking that the T3 alone will not get me high enough. What do you guys think about this approach?

I have been on the cytomel for about a week now and I certainly feel like my spirits are lifted but still having occasional hot flashes and my body temp is still low.

Sexually - still loss of sensation down there. It's not what it used to be like but I am willing to give it more time for sure.

[kelkel]

Sorry I missed some of these updates:

Yes, it does seem as if you're hypothyroid or at least sub-clinical. Anything over 2 should be checked, not 3. Yes, it can and will suppress you, it doesn't just shut you down totally. Are there more values somewhere else or just from Jan 12th? Remember as well, hypogonadism is not always primary or secondary. It can be a bit of both.

When it comes to clomid what time of day were you taking it? At bedtime is best. It would have been nice to see what effect it had on your LH values.
Your total T being up to 327 and FT doubling is probably indicative of a low SHBG value, which is fine barring other negative indicators.
Make sure you check your D levels and be sure to take it with food for best absorption. Don't go over range as if over-elevated for too long it can be toxic.
Exactly how much Iodine and Selenium?

I think HCG Mono is a bad idea when you're trying to elevate LH values. HCG over time is suppressive to LH function. Think negative feedback loop. Your body senses is doesn't need LH anymore due to the exogenous HCG (LH mimic.) Make sense?

[CSI007]

Yes,
That all makes sense. The reason for the HCG was to try to boost the T up since my LH is low (and I guess prove that I am secondary hypogonadism). All of the reading that I have done with regards to all of this..I realize that it will turn off the LH/FSH production. I am wondering how long I should give the thyroid treatment(s) to work? I am feeling better since on the supplements and the cytomel (t3) but the ED/libido is really bad. I still get morning erections and my libido is best about 30 minutes after I wake up and then just crashes. If I can get hard it does not last long. My doctor really does not think it will get much better with thyroid alone and why he suggested we try the HCG and see if it improves the ED.

I took the clomid in the evening around 9pm or so each dose. Would love to have seen what it could do for me too. But the eye pain and blurred vision was scary for sure.

I will post my last labs as soon as I can (tomorrow night?) As far as thyroid goes, the TSH was about a point lower (3.37 I believe) the FT4 and Ft3 were about the same and the reverse T3 was not too elevated but he thought that the ratio should be better and that is why he gave me the cytomel script.

I still have not had much success with getting my body temperature up higher. Some evenings I have managed around 98.2. But that seems to be my ceiling right now. Most mornings it's around 97 or slightly above or below.

[CSI007]

Here are my most recent labs:

Here are my most recent labs:

t4,free(direct) 1.11 0.82-1.77 ng/dL
reverse t3, serum 16.0 9.2-24.1 ng/dL
triiodothyronine,free,serum 2.7 2.0-4.4 pg/mL

dhea-sulfate 180.5 71.6-375.4 ug/dL
cortisol 18.6 See Comments ug/dL
tsh 3.390 0.450-4.500 uIU/mL
insulin 11.3 2.6-24.9 uIU/mL

testosterone , serum 327 348-1197 ng/dL
testosterone,free 7.72 5.00-21.00 ng/dL
% free testosterone 2.36 1.50-4.20 %
lh 2.3 1.7-8.6 mIU/mL
fsh 3.4 1.5-12.4 mIU/mL
prolactin 7.8 4.0-15.2 ng/mL
estradiol 16.1 7.6-42.6 pg/mL
estrogens, total 110 40-115 pg/mL
pregnenolone, ms 20 ng/dL
dihydrotestosterone 28 ng/dL


iodine, serum or plasma 37.7 40.0-92.0 ug/L
vitamin d, 25-hydroxy 28.1 30.0-100.0 ng/mL
selenium, serum/plasma 116 79-326 ug/L