My Battle with Low Libido and Low T - Lab Results Inside

[rimseb]

Hey everyone, I’m a 32 year old male that has been suffering from low libido and low T for the last 5 years.

I’ve done endless blood tests and seen many doctors but all of them brushed it off saying it’s mental, stress etc etc.

Im not going to post all the lab tests since there are way too many, but my Total T , Free T have always been on the low side ( varying from 300 to 380 ng/dl , range 300-1080 ).

Also my TSH has always been on the very low end, 0.35 iUI/mL - 0.49 iUI / ml , range 0.35 - 4.94 ).

My main symptom has been low sex drive followed in a smaller extend by fatigue , dry skin, brittle nails.
I have to add Im fairly active and fit. I workout 5 times a week , 1.76m at 76kg and my strength overall is pretty good.

Fast forward to Dec 2018, I repeat my lab tests and this time both my Total T and Free T are under the norm. My TSH is again at a lowish level at 0.49. Also a bone densitometry showed I have osteopenia ( at the very initial phases ).

Finally my doctor decides to start me on Clomid 50mg EOD. After the end of the first month, he asked me to do 50mg every three days for the second month and 50 mg every 4 days the third month.

To make things easier, I have put in a table my lab tests before , during and after the treatment.



While my Total T and Free T shot up, so did the estradiol.

As for my symptoms, nothing really changed. I feel I am progressing faster at the gym but the libido is exactly the same as before treatment.

Finally, yesterday I went to (yet) another doctor and he thinks clomid is good for fertility but not for libido. He asked me to stop clomid entirely for 2 weeks and then start TRT injecting Nebido 1000mg every 3 months.

I am really at a loss here since this has been going on for way too long and I can’t find a doctor to solve my problem.

Thoughts are greatly appreciated!

[mac34]

Welcome to to the forum!

At any point during the treatment, have you noticed an increase in libido? When you started, you had too little T, now your E is too high. I don't know what is the reference range for free T, but looks like you made a significant improvement. I'm doing TRT now, still experimenting with the doses and E == 90 is pretty much what shuts down my libido.

I would recommend to check your prolactine levels first, if you haven't done that already.

[rimseb]

Welcome to to the forum!

At any point during the treatment, have you noticed an increase in libido? When you started, you had too little T, now your E is too high. I don't know what is the reference range for free T, but looks like you made a significant improvement. I'm doing TRT now, still experimenting with the doses and E == 90 is pretty much what shuts down my libido.

I would recommend to check your prolactine levels first, if you haven't done that already.

No, libido pretty much was the same as before the treatment. If there was any tiny improvement it was around the end of the first month but it was up and down before too.

I checked my prolactine levels quite a few times and they were in the norm.

Did you notice any changes in libido after you started TRT?

[mac34]

No, libido pretty much was the same as before the treatment. If there was any tiny improvement it was around the end of the first month but it was up and down before too.

I checked my prolactine levels quite a few times and they were in the norm.

Did you notice any changes in libido after you started TRT?

I'm not an expert, and there are more experienced guys here, but I think you should research your problem in depth and make TRT your last stand. You already have T levels slightly above the high end of the range, it doesn't seem to be a problem with low T levels anymore. If you start TRT, you will likely have the same problem plus a dependency on needles for the rest of your life.

If I was you, the first thing I would do is to see if libido problems are E related. Take some aromatase inhibitor and drop your E levels to about 40-50. I think you should feel completely different. You just need to test. And be careful with the dosage if you go too far low, you don't want too low E either.

I had better libido before TRT honestly (or rather before my first cycle which screwed my hormones). I'm still figuring out how to battle the high estradiol (I have about 90 as well) on TRT. Like I said, I'm not that experienced. I'm only recommending you to use AIs for testing purposes, it's not a drug to run for life, so I cannot use it in my TRT, I'm still experimenting with dosages and so on.

[rimseb]

I'm not an expert, and there are more experienced guys here, but I think you should research your problem in depth and make TRT your last stand. You already have T levels slightly above the high end of the range, it doesn't seem to be a problem with low T levels anymore. If you start TRT, you will likely have the same problem plus a dependency on needles for the rest of your life.

If I was you, the first thing I would do is to see if libido problems are E related. Take some aromatase inhibitor and drop your E levels to about 40-50. I think you should feel completely different. You just need to test. And be careful with the dosage if you go too far low, you don't want too low E either.

I had better libido before TRT honestly (or rather before my first cycle which screwed my hormones). I'm still figuring out how to battle the high estradiol (I have about 90 as well) on TRT. Like I said, I'm not that experienced. I'm only recommending you to use AIs for testing purposes, it's not a drug to run for life, so I cannot use it in my TRT, I'm still experimenting with dosages and so on.

Yeah that's why I've avoided TRT for the lats 5 years. However I guess getting injections for a couple months to test it out shouldn't create long lasting side effects.

[mac34]

Yeah that's why I've avoided TRT for the lats 5 years. However I guess getting injections for a couple months to test it out shouldn't create long lasting side effects.

Maybe it won't, but it's not as simple. It might take you months to find the proper dosages and injection schedule, or just wait for it to fully kick in. You already have high T, and your E is too high, so the simplest thing to test now would be to bring down E levels to like 40 (but keep on taking Clomid). Then whether it works or not, it will be a valuable information to narrow down the problem.

Have a look at this thread:
https://forums.steroid.com/hormone-r...y-results.html
https://forums.steroid.com/hormone-r...bloodwork.html

Fellow member was also on a Clomid therapy, but he took Arimdex as well, to bring down E levels. It seemed to work well for him.

I would just go to the old doc and ask him to help you get your estradiol levels down (to prescribe you some aromatase inhibitor).

[rimseb]

Ok, a quick update.

The last doctor told me to stop Clomid for about 20 days and then do a first shot of Nebid 1000mg.
So here's how my numbers look like 20 days after stopping clomid:


Total T: 6.5 ng/mL
Free T: 27.81 pg/mL
Estradiol: 44 pg/mL
LH: 5.10 mIU/mL
FSH: 2.80 mIU / mL
SHBG: 63 nMol/L
DHT: 116.52 pg/ml ( range 250-990)

So apart from DHT being very under the norm, the rest looks pretty OK.

Anyone has any idea how come Clomid raised Total T / Free T / E2 and SHBG but not DHT at all?

[rimseb]

No, my DHT was elevated as well, enough so that the doc prescribed low dose finasteride to bring it down. You can find details here.

Are you using Fina or any other dht reducer?

No, actually not using any DHT blocker at all.

[rimseb]

Are you sure? Nothing OTC like Saw palmetto, etc? There is some evidence to suggest that BPH OTC supps can lower DHT. Not like Fina but some anyhow.

Also, do you by chance have DHT levels from the rest of your bloodwork? It would be beneficial to see what it was during clomid treatment.

Another also, it looks like you were responding well to clomid. Why did the doc take you off of it?

Yeah I'm pretty sure since apart from ZMA / Protein / Creatine I don't take anything else.

Unfortunately my doc didn't ask for DHT levels during the treatment so I have only before I started it and after ( and they were identical, no change at all , unlike T).

The doc took me off Clomid because I went to him for low libido and Clomid, while increasing T, didn't have any effect at all on libido.

[rimseb]

Have you considered viagra or cialis? 2.5 and 5 mg Cialis is approved for BPH now so you might be able to get the doc to write them for that.

Actually, now that I think about it a little more, might be better to find the root cause. I'm no doc though. :shrug


Edit: that said, I think liquid c is readily available and if the doc will play ball, insurance should cover the 5mg version, so it might be a cheap way of finding out if it works for you.

Also, I just realized that you are probably not in the US, so all that insurance stuff is likely not the same.

Yeah I've tried Cialis and both the 2.5mg and 5mg versions work really well.

I just wanted to find the root cause that's why I've been digging into this.

I'm sure there must be something else because I doubt ED / low libido to be normal for someone's in their late 20s.

[rimseb]

Ok another update here.
I waited two more weeks to see how things would change after stoping Clomid.

Here are the values for T and Est.

Total T: 4.96 ng / mL ( 3-10.8 )
Estradiol: 18 pg/mL ( 11-44 )

Looks like both fell but Estradiol a bit faster.
Also, during this time I had a phone consultation with Dr. Abraham Morgentaler ( author of Testosterone for Life ).
He believes also that I should be on TRT and agrees with my local urologist that Nebid is a good start.

So today I'm going in for my first injection and hopefully will help.

Will keep you updated on how things go.