27, High Libido, Low SHBG and Low T

Pharma / TRT Testosterone Replacement
1

Hi all. Thanks for your help. I’ll get right to it.

Age: 27M, Height: 6’5”, Weight: 290lbs.

Physique: Estrogen-dominant, gain weight on hips/thighs easily. Minor pseudogyno (confirmed by breast surgeon to be fat lobules, not breast tissue). Weight fluctuates from 275lbs-290lbs.

Iodine history: Iodized salt my whole life regularly.

Medical history: Used Celexa for a few years, then Wellbutrin, then Adderall. Off of all of them now. On Day 9 of Clomid HPTA restart attempt. Clomid is only med I’m using.

Supps: 500mg magnesium, 50mg Zinc, 3mg Boron, 6000 iU daily of vitamin D. (only started this very recently)

Erections: Can get extremely hard from oral sex but must be sitting upright. Firmness at 65-70%. Size allows for lady to orgasm regularly despite sub-optimal bloodflow. Cannot get hard at all while laying down, almost positive it’s weight related. Get out of breath super easily and regularly lose erections. I don’t masturbate, normally have sex 1-2 times daily.

Exercise: Inconsistent. Inflammation caused a lot of pain during Starting Strength cycle. Will try again soon.

Moods: Stabilized since Clomid some, but VERY up and down day to day before that. I’ve worked hard on being self-aware and not letting it show to others.

Sleep: HORRIBLE. I can only sleep through the night 1-2 times a year, and if I can, the sleep quality is very, very poor. I have no problem falling asleep, but I always have to wake up to pee or just no reason at all at least once a night. This is driving me crazy.

HRT Physician: Michael Rotman, MD (NYC - posts on ExcelMale regularly, big advocate of TRT+HCG therapy)

Labs: (Have August 2017 and September 2017 Labs if needed) See screenshots.

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Please let me know what else I can do to give you relevant info.

Thank you again!

2

What protocol r u on now? And what does Rotman think?

3

So far, he says that there’s no reason to believe my testicles are failing, so he started me on a Clomid HPTA restart to see how that goes. If it fails completely, he wants to start HRT, probably through testcyp or prop paired with HCG injections.

He’s made no mention of an AI, but with my weight it’s possible I’ll need it.

I’ve responded okay to Clomid so far - hasn’t positively or negatively affected erections, but has definitely stabilized my moods and given me a decent sense of well-being.

4

I see Rotman to. That’s good to try the restart. Your 27. Am 41.
Am sure he will give you ai if labs come up high on e2. You just need to give it a few weeks to see what your numbers stabilize at.
Then the key is what happens to your numbers after you stop clomid.

I tried clomid. I remember massive cum shots. Lol. Clomid got me to 500 total t. On 25 mg EOD. I just went to Injections right after without seeing what happens if I stop clomid for a while. I still always think about trying another restart to see if my numbers maintain. I should have waited before I started injections.

Chances are that at my age I would have ended on injections anyway. I never knew what my t levels were when younger. Just that they were 430 when I started with symptoms and went down quickly to 200 within a couple weeks after the symptoms started. Wierd how acute my case was and maybe something else caused the crash. IDK.
I basically went through hell for 3 weeks as my T and e2 crashed together.

5

You look to be primary, LH is midrange and testosterone is low. Your numbers are very similar to my own pre-TRT labs except I had low LH and low testosterone which points to secondary for me.

TSH only, that simply will not do and it shows me the level of care you’re receiving is poor! TSH shows the thyroid gland is being stimulated, if you want to know the end result you must check Free T3, Free T4, Reverse T3 and antibodies. Low SHBG can be from low thyroid hormones, some just have genetically low SHBG.

Low SHBG is an indicator of inflammation, see thyroid sticky.

6

Here’s a snippet from my November labs. Let me know what you think. @KSman, I’m looping you in here because it looks like my labs are a little atypical thyroid-wise. I’ll keep you posted on temperatures. I’ll also request thyroid labs for my next bloodwork with Dr. Rotman.

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7

Bump with substance.

Took last 3 days’ worth of temps. Upon waking up, all were exactly 97.7 and then all 98.6 at 3pm.

8

Those temperatures are excellent and I see those who have been using iodized salt on a regular basis show perfect body temperatures, the longer you test body temperatures the more clear the bigger picture. Sometimes thyroid problems are intermittent, labs are a snapshot of a constantly moving target.

You clearly have venous leakage and the cause may be do to not having enough testosterone, the penis requires blood rich with nitric oxide and as you sleep your penile tissue regenerates to maintain a healthy organ. There’s another type of venous leakage that isn’t related to not having enough nitric oxide and is genetic. You have low testosterone which is a known cause of venous leakage, I would bet this is your problem.

Your poor sleep is linked to your venous leakage, if you fail to hit REM sleep the penis doesn’t get rejuvenated and ED is a guaranteed outcome. Venous leakage is also the first sign of cardiovascular problems to come so you need to take care of this sooner rather than later.

If I were you I would target 550 to 600 Total T and no more, otherwise estrogen will be a problem since low SHBG men have so many free hormones.

9

Very nervous I have a venous leak. Happy I can please the lady, but she always has to be on top and I regularly lose hardness.

If I do, let’s hope prolonged normalized T levels fix it… surgery options look horrible at best.

10

Use Cialis or Viagra while you try to figure this out. No reason to have ED if these medicines work.

11

Thankfully, there’s a research chemical form of Cialis/Viagra I use that works pretty well. I build up a tolerance pretty quick to it though, but it’s cheap.

12

Any guy scoring these number would have erectile problems, likely not even be able to get an erection.

13

I consider myself really lucky that I’m able to satisfy a woman at all, honestly.