We need to know more than statements that other things were in range. Please [edit] above and provide data and ranges for:
hematocrit
hemoglobin
RBC
prolactin
pregnenolone
T4 and T3 are below mid range. Hopefully iodine will deal with that.
Blood pressure still where it was?
IGF-1: What will a MRI cost? If there is an adinoma, that would probably be linked to your low LH/FSH.
I think that a restart would be a good idea. But that will fail if E2 remains high. An AI to reduce E2 will be essential or you will shutdown after the restart attempt. Why is E2 high? -suspect a liver issue, and low cholesterol is also liver function related.
Note that many take 50mg iodine [elemental] per day for two weeks for iodine replenishment.
I added some scores above and also modified the options.
I spoke with an anti-aging MD today. He’s not concerned at all about the IGF-1. I’ll update the options post, but he open to combinations of natural t3/t4 meds, TRT, HCG, or AI. He’s cool w/a SERM too just not experienced with them.
Acupuncturist is also pursuing a liver issue, she’s got a list of “detox” foods and supplements.
The MDs I’ve spoke to are not in favor of Iodine loading (sadly KSMan your point about a lack of Iodine-toting drug reps may ring true), but I am planning to continue to gradually increase my supplementation up to 50mgs
So I am working on thyroid w/increasing iodine doses and T3/T4.
I am starting to design a reset protocol. Maybe I am over complicating things:
try the AI for 2 weeks; something small like 0.25mg anastrozole EOD
try hCG for 2-6 weeks, 250-500IU 3x/week
take blood test to baseline pre-clomid
try 12.5mg of clomid every day for 3 weeks
retest and adjust
Some questions:
1 - Is it ok to start the AI first? My thinking is that it seems like it might help overall feel and also get me used to the AI so I know what effects I’m looking for if add in hCG/clomid. I think I’ve got enough high E2 symptoms now to feel them go away.
2 - What’s the timeframe/max dose on the hCG for this pre-SERM usage? 250-500IU 3x/week? Is there any harm to running a slightly longer hCG cycle if it feels good?
3 - How to discontinue hCG when you start the SERM? Waiting period before blood test? Overlap the two?
If your T is low, AI may push E2 too low and that can feel bad. Its the E2 levels that matter and AI dose, if any is used to modulate E2.
If you feel OK on hCG, you can use for a longer period of time. The objective is to restore the form and function of the testes.
Just switch one day, do not overlap
Which SERM? Suggest 1/2 of what is typically prescribed, then test LH, FSH, TT, FT, E2 later on. You do not want high LH as E2 may be too high and T–>E2 inside the testes cannot be controlled with a competitive AI.
Then you slowly taper off the SERM cruising on 1/2 mg/week anastrozole.
I can pick any SERM/dosage but I’m leaning towards Clomid first and then switching if I felt any visual effects.
Do you think this hCG/SERM/AI combo is going to cause an increased fertility risk that would justify donating to a sperm bank now?
I already tested with a pretty E2 and feel like I have E2 symptoms so I’m inclined to start the AI first, but I could certainly wait. Perhaps it’s safer to wait because the risks of low E2 are worse than the feeling of high E2.
Summary: I took an adrenal health saliva test last week. Test indicates that my cortisol rhythm has improved but cortisol is still depressed. Also of note is that my Progesterone is low and I scored positive for Gliadin antibodies which when combined with my GI symptoms likely confirms my gluten intolerance.
Upped my iodine dose to 50mg 4 days ago to start a 2 week load.
Still deciding whether or not to take the HCG/AI that I was prescribed by non-insurance MD. I have an Endo appointment on Thursday. Called the Endo today and confirmed that they use HCG, they use AIs, and they allow self-injection.
Met with Endo today. He actually seemed pretty good. He was not convinced that my low T is a problem.
Said he would treat as long as bioavailable T was in the bottom 25% of the normal range.
Said he would treat with HCG or Clomid, but generally doesn’t do either.
Said he would allow self-injections after T was dialed in.
Said T would likely not cause infertility even if maintained for 5+ years. Fertility would return w/introduction of HCG after T usage. Would allow HCG use alongside T but cannot get insurance to pay for HCG.
Going to go ahead with an HCG test/restart starting whenever it gets here. Will run that for 4-8 weeks and retest.
I also started ~30mg topical pregnenolone (life-flo) per day based on the above ASI test showing low progesterone. This is day 4 and I’ve already noticed that I seem to be a bit more aggressive at work. Could be due to other factors. Have not really seen any other changes.
First, a test showed T recovered to 500 on it’s own prior to starting HCG.
I started out HCG at 350ius EOD and it was doing nothing. Adding the arimidex made a huge difference in my sexual interest. Boosting HCG from 350iu to 700iu also made an impact.
After a few weeks of 700ius HCG EOD, HCG raised Test to 600 (tested 24 hrs after injection).
E2 dropped from 38 to 30 with the .25mg arimidex EOD.
Generally feeling better, but not excellent. Might try a short cycle of T just to see how it feels.
Doc was not impressed by my response to HCG. He recommended a 8-12 week cycle.
100mg-200mg test per week.
1.5mg anastrazole per week in divided doses
PCT optional if I take the T more than 12 weeks.
I plan to ask for an HCG script for week 5 or sooner, forgot to do that at the office.
First two weeks since I started the T have been really awesome.
Feeling the energy to make it to the gym and hit my eating goals for the first time in a long time.
Just got labs back, probably taken a little too close (2 days) to an injection to really be trusted.
Test >1500 (348-1197)
FT >52 (8.7-25)
DHEA-S 244.9 (160-449)
Estradiol 25.7 (7.6-42.6)
PSA 0.5 (0-4.0)
In the middle of my 10th week now: 200mg test/week , 1.5mg anastrazole , 250IU HCG 2/x week
At 30 I don’t really want to deal with the time and money expenses of these injections all the time though. So, starting a SERM restart in next few weeks.
I’m thinking Clomid because it seems more proven and I think it’s cheaper, but doing some research on that now.
After a 3-month T cycle, I took 5 weeks of clomid 12.5mg 3x/week.
Also taking anastrazole 0.5 mg 3x/week to counter emotioanal estrogen sides from the clomid.
I’m still in the PCT…feels like testosterone is way low but estrogen sides seem to be under control
Blood work from after 5 weeks of clomid just came in:
LH 9.8 (high, way up from previous testing)
FSH 5.4(in range but up from previous testing)
Test 484 (384-1197)
Free Test 15.1 (8.7-25.1)
DHEA-S 238.9 (138-475)
Estradiol 22.6 (7.6-42.6) [I know this test is worthless on clomid]
PSA 0.6 (0-4)
SHBG 22.7 (16.5-55.9)
Seems like my body is not yet producing even a baseline testosterone 5 weeks into the PCT.
Maybe even more specifically, I suspect my testes not properly responding to the increased LH/FSH?