Feel better on some hormones, but Dr won't even give pregnenolone now! Labs inside.

[mikzsan]

Hi,
Ill try to keep it as short as I can. I HUGELY appreciate any replies.

I'm 32 . Years ago, I developed ED , lack of desire, and sense of muscle loss.

Possibly triggered by an Accutane in 08, but no real way to prove the link. This drug has been studied and proven to lower most HPA hormones at least while on it.


The only stuff over the years that reliably helped my libido:


HCG 100 IU x 3/week. Partial response.

Pregnenolone (20mg/day sublingual) did help partially sometimes.

Testogel - helped libido + noticed more hair growth. Lack of sensation in testicles and annoying to apply though.

L-DOPA - Amazing libido, but causes insomnia.

Drugs always have some harsh side Supps/herbs didn't do the trick.



My GP now wont give ANY hormones , even pregnenolone because:

1. He feels none of my issues are hormonal
2. He said any hormone you take will cause suppression of some pathway.

He acknowledges I felt a bit better, but said a healthy person would also feel a boost. That makes sense I guess.

I just want to feel better though.

I don't know whether to listen to his advice in whole, seek out another doctor open to HCG
+ Preg to treat symptoms , or even order Clomid myself.

I will avoid T.


My latest results:

If anyone can give an opinion that would be great.

The labs here in Aus apparently use a separate range for 'younger males' as well.

** Brain MRI is normal **. No history of trauma.

FSH ..... 1.7 IU/L . (1.5 - 9.7)
LH ..... 2.9 IU/L . (1.8 - 9.2)
Estradiol..... 60 pmol/L . (<160)
Test total..... 18.8 nmol/l . (12 - 31.9)
Test total (most recent)..... 17.3
SHBG..... 43 nmol/l . (17 - 56)
SHBG (most recent)..... 46 nmol/l
Free Test ..... 346 pmol/l . (260 - 740)
Free Test (most recent)..... 306 pmol/l

Progesterone ..... 1.0 nmol/l . (0.7 - 4.3)

DHEAS ..... 5.6 umol/l . (4.3 - 15.0)
Cortisol AM..... 230 nmol/L . (172 - 497)
Cortisol AM (most recent)..... 401 nmol/l
ACTH..... 4.3 pmol/l , (1.6 - 13.9)

Thyroid
Free T4 ..... 13.2 (11 - 21)
Free T3 ..... 4.6 (3.2 - 6.4)
TSH ..... 2.26 (0.5 - 5)

[hammerheart]

I will avoid T.

Why. HCG is a form of TRT. Like your GP said, it will shutdown your endogenous output, just like Test would.

If you feel fine on HCG alone, consider higher dosage, as 100IU 3x week is very low in fact even less than guys on Test use as an addiction to keep the testes running. You might not need any additional pregnenolone to feel good if going higher.

HCG is great in that it will keep all the backward pathways intact , and that includes testicular output of any hormone predating Test, including pregnenolone, progesterone, and DHEA, along with T, DHT and E2.

So duh, that's where your GP is wrong - hormonal homeostasis can be hard to achieve through exogenous substances but can be done.

Avoid testogel, like all the topicals is a very poor approach to TRT.

SHBG is high and along with fT and tT on the low side of range I predict the very need of TRT (even on HCG alone if you wish) in the near future. It depend how much you can put up with the symptoms.


Just as a curiosity, how much l-dopa do you take to feel an increase in libido? I strongly advise to use ldopa only occasionally.

[kelkel]

Like Biz said I'd advise against HCG Mono. Some do fine but the majority of subjective reports I've read indicate the sense of well-being is not there as compared to T therapy. If not ready for T then I'd consider clomid.

Re shbg other than using certain other drugs to lower it, it can be hard to deal with. Consider looking into Stinging Nettle or Avenacosides and also be sure you optimize your Vit D level based on blood work. D is a hormone and will help to lower shbg and thus allow more free T.

[mikzsan]

If you feel fine on HCG alone, consider higher dosage, as 100IU 3x week is very low in fact even less than guys on Test use as an addiction to keep the testes running. You might not need any additional pregnenolone to feel good if going higher.

Thanks! I tried diff. doses in the past and at higher, I aromatize easily and lost any benefit. I know I could take AIs, but its hard to get prescribed here, and have their own sides. 100IU x 3 can get me to 4 or 5/10 libido from 1 with no sides.

HCG is great in that it will keep all the backward pathways intact , and that includes testicular output of any hormone predating Test, including pregnenolone, progesterone, and DHEA, along with T, DHT and E2. So duh, that's where your GP is wrong - hormonal homeostasis can be hard to achieve through exogenous substances but can be done.

True, my GP though will give all that if he thinks HRT is needed. The issue now is he doesn't feel I need HRT or ANY hormones, and wont give Preg/HCG etc, and said my latest numbers are OK so I created this thread to sort of get a second opinion and if people thought I should seek out another GP.

SHBG is high and along with fT and tT on the low side of range I predict the very need of TRT (even on HCG alone if you wish) in the near future. It depend how much you can put up with the symptoms.

Thanks Would you suggest its worth trying a course of low dose Clomid first?

Just as a curiosity, how much l-dopa do you take to feel an increase in libido? I strongly advise to use ldopa only occasionally.

I took 200 mg levodopa.

[hammerheart]

Thanks! I tried diff. doses in the past and at higher, I aromatize easily and lost any benefit. I know I could take AIs, but its hard to get prescribed here, and have their own sides. 100IU x 3 can get me to 4 or 5/10 libido from 1 with no sides.

This bumped my free T from low 300s to 450-500 (scale 260-700) without raising E2. I could then try and get more benefit adding other stuff, rather than upping HCG , if that makes sense.

True, my GP though will give all that if he thinks HRT is needed. He seems very knowledgeable and is a weightlifter . The issue now is he doesn't feel I need HRT or ANY hormones, and wont give Preg/HCG etc, and said my latest numbers are OK.

I'm just wondering if he's being too conservative or if they truly look ok and my issue likely isn't hormonal even partly ?

Thanks Would you suggest its worth trying a course of low dose Clomid first?

I took 200 mg levodopa and had a sharper mind, mood and the libido of a 16 yr old. Sadly, made it harder to sleep, but Im prone to insomnia and not everyone is.

Well issue with HCG is not peripheral aromatization but E2 perfusion from the testes themselves, and it's a rather common issue. This happen because of the continuous stimulation by HCG, which differs from the pulsating secretion of LH from pituitary.

Instead of upping dose you can try the same (100IU) every day, subq for simplicity. Hypodermic pins can also prevent hormone surges to some extent and slow release, comparing to IM.

Pregnenolone I do recognize as an OTC supplement, not prescr. I got mine from Swanson's, but it's not sublingual - ingesting the molecule can in fact completely alter the way the body processes it, as it will pass through the liver and undergo conversion/metabolism there.

200mg ldopa is not much but again I do strongly advise not to take this on a daily basis; occasionally might be fine.

The clomid, it might ramp your E2 through the roof just like HCG.

Your total levels are quite average, and don't suggest any special issue, especially since free T is normal too. However, I do see a problem from bw and that is SHBG, this will bound test as well as DHT, and that might explain your issues with libido and erections.

Try a good dose (2000IU is a good starting point) of vitamin D and dose accordingly to bw, like kel suggested. Another supplement you can try is boron chelate (TRAACS or albion) , 10mg did something good for me and I had quite stubborn high SHBG.

Creatine can boost DHT if you have a problem with that.

[mikzsan]

Well issue with HCG is not peripheral aromatization but E2 perfusion from the testes themselves, and it's a rather common issue. This happen because of the continuous stimulation by HCG, which differs from the pulsating secretion of LH from pituitary.

Instead of upping dose you can try the same (100IU) every day, subq for simplicity. Hypodermic pins can also prevent hormone surges to some extent and slow release, comparing to IM.

Thanks... I always did sub q. I would try every day, but the issue now is that Doc wont even give HCG anymore (or even preg) as he feels none of my issues are hormonal and doesnt want to shut me down.

200mg ldopa is not much but again I do strongly advise not to take this on a daily basis; occasionally might be fine.

I don't take that anymore, thanks for looking out

Your total levels are quite average, and don't suggest any special issue, especially since free T is normal too. However, I do see a problem from bw and that is SHBG, this will bound test as well as DHT, and that might explain your issues with libido and erections.

Try a good dose (2000IU is a good starting point) of vitamin D and dose accordingly to bw, like kel suggested. Another supplement you can try is boron chelate (TRAACS or albion) , 10mg did something good for me and I had quite stubborn high SHBG.

Thanks. Ill look into that. I just feel so shut down (even though my bw isnt that bad) that I feel something as mild as boron isn't going to cut it for me. I feel like I need something heavy duty to get me out of this.

If I was to try clomid low dose , 12.5 EOD, for example, would you say the worst that could happen is that it didnt work, and I could wean off, or it could actually screw me up?

I just want to be careful.

[mikzsan]

Hi , just an update:


My T is now higher for some reason, and LH alot higher, BUT my cortisol is below range now.


Nothing was really changed, except I switched between nasal spray brands (done before) , was on low dose nootropic (nicergoline) but noticed no effects, and got a lot of sunshine a few days before. I'm low - normal on serum Vit D, but can't tolerate oral supps.


Regardless of any of that, I still had low libido and all usual symptoms. Also, the cortisol issue.

It seems I can't get my cortisol and T at the same time to both be mid range or higher.



What should be my best approach here?


Thanks for any insight!



OCT 4th: (this particular Doc didn't do all the parameters, so some are missing)

FSH ..... 2.6 IU/L . (1.5 - 9.7)
LH ..... 6.2 IU/L . (1.8 - 9.2)
Test total..... 23.2 nmol/l. (12 - 31.9)
Free Test ..... 438 pmol/l. (260 -740)
SHBG..... 44 nmol/l . (17 - 56)
Prolactin.... 368 (90-400)
Cortisol AM..... 101 nmol/L . (172 - 497)