Hello
STORY:
I can say everything started 18 months ago, despite the fact that I’ve always had slight puffy nips, trouble packing on muscle mass, lowish muscle strength and lowish libido compared to my friends. I also had female type fat pattern and I was always skinny-fat. I’ve been using cialis occasionally. However, 18 months ago, started to lose erection without cialis. My sex performance and libido declined. I’ve decided to go to an urologist and do some blood work. Below you can see first BW results:
LH: 5.07 mIU/mL (1.7 - 8.6)
FSH: 2.18 mIU/mL (1.5 - 12.4)
Total Testosterone: 3.94 ng/mL (2.49 - 8.36)
Prolactin: 12.89 ng/mL (4.04 - 15.2)
Doc started me on Sustanon 250 every three weeks. However, after the first injection, i didn’t want to go straightforward into TRT and went another doctor who is considered to be one of the best in the country. Explained him everything. He sent me to testicle doppler ultrasound. Result came back ok, testicles are ok despite a small varicocele which he said it shouldn’t cause any trouble. Then he put me on clomid 25mg E2D for 3 months. ED became worse. Libido went to zero. Cialis worked less. However, I put on decent muscle mass and my energy levels went high. After 2.5 months on clomid, my doc wanted a bloodwork:
LH: 8.1 mIU/mL (1.7 - 8.6)
FSH: 2.83 mIU/mL (1.5 - 12.4)
Total Testosterone: 826 ng/dL (249 - 836)
Prolactin: 10.23 ng/mL (4.04 - 15.2)
Estradiol: 63.76 (27.1 - 52.2) → NOT SENSITIVE
He told me that my testicles respond well and I have no problems. I asked him about my high estradiol value and low FSH despite clomid therapy, he said no need to worry about those values, everything is fine. And advised me to stop clomid cold turkey, in order to let my body do its work and balance all hormones.
I stopped clomid cold turkey as my doc advised and I totally lost my libido and ability to get an erection as well as all muscle mass gained while on clomid. Also clomid left me a slight gyno mass on my right nipple. 2 months after stopping clomid, I went to a private lab and done BW:
Total Testosterone: 472 ng/dL (295 - 869)
Estradiol: 41 pg/mL (20.1 - 42.5) <— NOT SENSITIVE
I started to think my problem is and was about estrogen since my testosterone is decent (not very high but seems ok). I started to use letrozole (self medicate) 2.5mg tabs 1/4 tab E2D. On the second day, I had brutal high libido, strong in the gym and etc. After 10 days, I went to same private lab again to see what’s going on.
Total Testosterone: 934 ng/dL (295 - 869)
Estradiol: 23 pg/mL(20.1 - 42.5) <— NOT SENSITIVE
However, dream didnt last long. I started to have massive headaches and started to feel like shit. Tried to play with the dose for a while, but failed. In addition, my cholestrol values skyrocketed therefore I had to stop using letro. All symptoms came back, gyno came back. I was natural for a while, then I read ksman’s restart protocol on t-nation forum and tried that protocol, tried AI monotherapy, tried nolva + arimidex, tried arimidex only, aromasin, raloxifene, etc… my estradiol always crashed or skyrocketed, impossible to control it (i didn’t do BW to find out crashing estradiol, but I knew what it feels like to have crashed estradiol or excess estradiol). Sometimes i could control E2 and feel good, but other times fluctuations killed me. Here is my detailed labs on low dose arimidex monotherapy (arimidex 1/8 tab every day):
LH: 7.13 mIU/mL (1.24 - 8.62)
FSH: 3.31 mIU/mL (1.27 - 19.26)
Total Testosterone: 5.07 ng/mL (2.49 - 8.36)
Prolactin: 11.31 ng/mL (2.64 - 13.13)
Estradiol: 24.67 pg/mL (11.3 - 43.2) <— NOT SENSITIVE
PSA: 1.23 ng/mL (<2.5)
SHBG: 31.6 nmol/L (18.3 - 54.1)
Labs looked decent but I felt like shit, achy joints, ED, libido issues. I started to think maybe it’s a thyroid problem, got a detailed Thyroid panel:
TSH: 0.78 µIU/mL (0.41 - 5.18)
Free T4: 1.33 ng/dL (0.61 - 1.12)
Free T3: 4.1 pg/mL (2.5 - 4.37)
Thyroid came fine. After all those failed self-medicated protocols, I decided to come clean and go natural route (used zinc, magnesium, vitamin D, weightlifting, resveratrol etc…). Puffy nips came with a vengeance. Libido went to zero again. ED came back. Developed CPPS (or prostatitis). Urine flow became weaker. I went and got tested again in an hospital:
LH: 5.29 mIU/mL (1.24 - 8.62)
FSH: 2.34 mIU/mL (1.27 - 19.26)
Total Testosterone: 3.79 ng/mL (1.75 - 7.81)
Prolactin: 11.89 ng/mL (2.64 - 13.13)
Estradiol: 49 pg/mL (20 - 47) <— NOT SENSITIVE
My estradiol was high, but I decided to give my body more time to reach homeostatis. Meanwhile I developed severe pelvic pain and severe ED. Cialis stopped working, it was only working like %40. I went to ANOTHER urologist mainly for prostatitis symptoms but also general hormone issues. He tested my prostate culture and diagnosed me with chronic bacterial prostatitis, gave me antibiotics. But he also tested my hormones (except estradiol):
LH: 2.12 mIU/mL (2 - 10)
FSH: 1.5 mIU/mL (1 - 15)
Total Testosterone: 22.3 nmol/L (10,4 - 34,7)
Prolactin: 10.45 ng/mL (3.50 - 20)
I am totally lost.
QUESTIONS:
- Why my estradiol is always high? What can I do to solve this problem other than using AI’s? Since sensitive estradiol test is not available in my country, is there any possibility those results are showing false high?
- If my estradiol is really high (not false high because of standard test), isn’t going TRT route going to create more E2 problems since even clomid e2d made my estradiol 63 pg/ml?
- If I decide to try TRT, only testosterone injections available are sustanon and nebido. How can I create a good protocol made of one of those?
- Why my FSH always low, even on clomid? Is this a problem even with decent total T?
- My prolactin level is always on the higher side. Could it be prolactin causing libido problems?
- I have a theory about an accident which I hit my head 3 years ago. Wasn’t a severe hit, but I read that even moderate strokes to head can cause pituitary failure. Since TSH, FSH, LH all are pituitary hormones and all of them are low on my bloodworks, maybe I have hypopituitarism? What do you think? How to diagnose hypopituitarism? What route to go if my pituitary is damaged from that stroke?
TL/DR:
Sorry for long post and my english (english is not my native language), but I desperately need your help. If you don’t want to read the whole post, please read questions only. However, I would be really happy if someone with a lot of knowledge about those topics read my whole story and help me. I even think about suicide, I don’t think I can commit suicide nor I want to do it, but i think about it.
Any help appreciated.