Do I Need TRT at 22?

Pharma / TRT Testosterone Replacement
1

Hello anyone and everyone reading this post! I’m in serious need of some crucial advice as to whether I should even attempt to pursue TRT, as I exhibit classic symptoms, which I will list in no particular order

-Almost complete loss/lack of libido/sex drive

-NO spontaneous erections, and I mean NO erections, I don’t even get morning wood

-SERIOUS sleep issues: trouble falling asleep, staying asleep, and not feeling refreshed even after 7-8 hours (I rarely even get 7-8 hours because of my sleep issues, it used to be so bad that I would sometimes get 2 or 3 hours of sleep in 2 days and sleeping pills did little to help)

-Mood and anxiety issues that have not been helped or resolved with prescription drugs;
I’ve had some pretty severe issues with poor mood/depression and very high general anxiety. Medication was not effective and they were found to be unnecessary by my shrink*.

*I’d been thoroughly examined by a psychotherapist from Johns Hopkins who was finishing her residency at a local, highly reputed state university (University of CA, Davis). After around a dozen visits spread over a couple months, she said I was completely normal, just suffering from stress + sleep deprivation, and that I was wasting my time and money seeing her.

-Patchy hair in general (facial, body, and pubic) that I also note as being thinner compared to even just a year ago. I’ve had bald patches on my legs, arms, and face for as long as I can remember.

-Urinary incontinence (?) I have trouble emptying my bladder and sometimes urine leaks out minutes after I had just gone to the bathroom. This is involuntary and highly worries me.

-Hot flashes and sensitivity to cold/heat: This is very common and very noticeable, I sweat ridiculously easily and have trouble dealing with extremes or sudden fluctuations in temperature.

I am suspecting that this is due to either low T or a general hormone imbalance…

Here are my vital stats:

Age: 22 yrs

Height: 5’10" and some change

Weight: Fluctuates around 180-185 lbs

Waist: ~30 or 32, I’ve always been husky but I hold most of my fat around my abdomen

Describe body and facial hair: Patchy and thinning

Grow fast or slow/steady as a teen? I had growth spurts, those stopped, then I grew slowly

Testes ache or hurt? Ever? Currently no tenderness or pain. I think they may have in my mid or late teens

Mood: I experience mood swings and frequent low mood, lack of motivation, etc

Depression: YES, that’s all I have to say (I’ve tried 3 prescription AD meds and NONE worked)

Libido: Non-existent…no spontaneous boners, no morning wood, no physical desire, NOTHING.

Get cold easily? Yes, I am very susceptible to sudden fluctuations in temperature, but more-so, I experience frequent hot flashes and bouts of sweating, besides sweating ridiculously easily.

Dry skin/brittle nails? Yes, I have overly dry skin and have really messed up hands (I almost always have screwed up cuticles and frequent hang-nails)

Use iodized salt? Yes, I also take a once daily iodoral supplement at 12.5 mg per dose

Eat much sea food? I work in a Japanese restaurant so I have easy access, but I eat only very moderate amounts if anything, and I actively do my best to steer clear of soy and mercury-rich fish.

Exposure to chemicals? I was exposed to a bunch as a kid, I suppose. I huffed a lot of fumes but not by choice (I lived in an industrial city in Central California), but I also had a few incidences of my dumbass young self trying to do woodwork. I had a few guitars that my parents bought me, and in a stroke of what I thought was genius, I sanded off the paint and primer “so I could paint them a nicer color myself”. I ended up inhaling the chems in the paint and whatnot for a good while (I “worked” on them for months).

Ever used hair loss drugs? No, maybe I used my dad’s “hair-thickening” shampoo once or twice when I was young and we ran out of normal shampoo, but that’s about it.

Rx and OTC drugs: Not taking any Rx at the moment, in the past though, I’ve taken a few. As far as OTC stuff, I do take a bunch of supplements. I’ll list all below:

Rx: NOT CURRENTLY TAKING ANY RX, HAVE NOT FOR MANY MONTHS
Taken in the past:
SSRI’s Fluoxetine (Prozac) and Sertraline (Zoloft)
Trazodone
Lunesta *(only used around 15-20 times when sleep was almost impossible)
Bupropion
Lorazepam *(only took for like a week on a handful of occasions)

OTC:
CURRENTLY TAKING:
Men’s multivitamin
Vitamin C
B Complex
Zinc
Magnesium
Iodoral (mixed form iodine)
Fish Oil
Garum Armoricum (another type of fish supplement, but different from fish oil)
CoQ-10
Forskolin
Bacopa Monnieri
L-Theanine
Creatine Monohydrate
Myo-Inositol
Ashwagandha
Melatonin
Turmeric Curcumin
Vitamin D3
Rhodiola Rosea

Medical history:

Teens:
Spinal injury (Thoracic spine, bulged discs)
Torn/injured Tommy John Ligament
Possible concussions

Recent/Current:
Spinal injury (same from teen years, it’s been an annoying, lingering injury that causes physical pain to some extent on most days)

Insomnia/Sleep issues that were not resolved with pharmaceuticals (sleeping pills, benzos, melatonin, anti-histamines, anti-depressants did NOTHING to help)

Anxiety/Depression/Fatigue: Again, no pharmaceutical relief. No improvement from any of the meds those pill-pushers gave me. My psychiatrist did a behavioral analysis and found me to be very stressed out but more or less completely normal. Any problems I had were due to sleep deprivation or gross exacerbation of anxiety that I had since I was a kid.

Weakness/Inability to put on muscle mass/Joint pain/Inability to adequately lose weight: Despite my best efforts, I get sort of big and then plateau no matter what I do. More rest, more food, trying harder/doing my best, more weight/more reps…less of these things doesn’t exactly help either. On top of that, I get sick very easily now.

Severe stabbing headaches that are typically unresponsive to even prescription migraine medication. I’m worried this may be a sign of a prolactinoma or other brain tumescent growth. I recently went on a camping trip, suffered a crippling tension headache and actually blacked out. The pain was unbearable and it seems they’re getting more frequent and more severe. I’ve always suffered from them but never assumed they meant anything medically serious.

These “usual suspects” have been ruled out:
-No Lyme
-No active mono (apparently I do in fact carry the virus, but had no idea of this)
-No OBVIOUS or SEVERE thyroid symptoms, i.e. no obvious goiter, no bulging eyes
-No distinct memories of me having head or testicular trauma severe enough for me to factor
them in
-No autoimmune disease markers in my blood stream
-No markers of elevated general inflammation in my blood stream
-No family history of MS, cancer, mental illness
-No severe/limiting food allergies with obvious symptoms

PAST TEST RESULTS (DURING SUPPLEMENTATION OF LONGJACK, TRIB, MACA, DIM, RESVERATROL, FENUGREEK, FORSKOLIN)

Component Your Value Standard Range

Testosterone, Total 575 ng/dL 240 - 871 ng/dL

FREE TESTOSTERONE 0.413 nmol/L 0.091 - 0.579 nmol/L

LH 6.7 mIU/mL 1.5 - 9.3 mIU/mL

FSH 5.1 mIU/mL 1.4 - 18.1 mIU/mL

Cortisol, AM Level 17.7 ug/dL 5.0 - 25.0 ug/dL

RECENT TEST RESULTS (TAKEN AT A DIFFERENT HOSPITAL THAN PREVIOUS TEST, I HAD ALSO CYCLED OFF OF ANY “ENHANCEMENT” PRODUCTS FOR ALMOST 30 DAYS):

Component Your Value Standard Range

TESTOSTERONE, TOTAL 397 ng/dL 160 - 726 ng/dL

SEX HORMONE BINDING GLOB 32 nmol/L 10 - 57 nmol/L

TESTOSTERONE, FREE CALCULATED 82 pg/mL 20 - 135 pg/mL

TESTOSTERONE, FREE PERCENT 2.1% 1.5 - 3.2 %

The fact that my total testosterone dropped so sharply made me so worried. My dad has a serum level of 899 ng/dL at 55 years of age and I get to sit here wondering why I’m feeling so crappy and dejected all the time…

Any insight or help would be greatly appreciated. If any of you would have suggestions, tips, or help with finding a family doctor/doctor who accepts insurance in the greater Sacramento, CA area (or in Central/Northern California in general) who is receptive to requests for TRT, I would be indebted to you. If you’re reading this, thanks for taking the time and for hearing me out.

Edit: I should also add that I talked over my most recent tests with my doctor. He did not test E2 nor a thyroid panel. He DID however refer me to an endo and a neurologist. I’m hoping to ask for MRI testing to rule out chronic fatigue, fibromyalgia, and any tumescent growth (be it a pituitary adenoma or anything else), as well as insisting on having a thyroid panel done as well as re-testing the essentials along with adding tests for prolactin, E2, and DHEA (as well as any others you guys can suggest)

And please excuse the poor formatting, thanks again guys.

2

Please include labs ranges for free testosterone, different labs have different ranges and the ranges mean a lot if one is to interpret labs.

You have a lot of the symptoms I had before I start TRT, I had horrible headaches later in the day that medication had zero affect on. I’d like to see full thyroid labs as thing might explain your somewhat low numbers, your numbers for a 22 year old on average are on the low end. I’m betting the reason for your feeling cold has more to do with low estrogen, I spent almost a whole year with my estrogen in the single digits, it’s hell on cartilage, joints and will make you feel cold. Just 6 months ago I’d be wearing a sweatshirt in the house when it was 80+ degrees outside, ankles were so cold it hurt. I would wake up at night for no reason, sleep was horrible without medicine.

You shouldn’t have numbers this low quite this soon in life, younger guys like yourself feel the effects of low T much sooner than a 40 year old. Even still I think it’s strange you’re experiencing all of these symptoms at these numbers. I strongly believe you got more going on than just low testosterone, it might be that all the supplements you were taking were compensating for whatever is causing your symptoms. One thing I know about testosterone is it improves your skin especially if it’s frail and dry.

I also had trouble emptying my bladder and would wake up after a nights sleep and find my pillow soaking wet, when estrogen is low your body doesn’t hold on to water very well, however when your estrogen is high you hold onto a lot of water to the point of being bloated. You’ve got way too many side effects for this to be just a testosterone problem, you’re going to require more labs. You need to educated yourself and read these sticky threads because most doctors are providing substandard care and you need to know more than you doctors if you’re to figure this all out.

What time of day were both of these labs taken? If the first set of labs were earlier in the day than the second set of labs then that might explain why your numbers dropped.

3

I’m currently waiting for the rest of my replies to pass thru the mods, but replying to systemlord’s last question, the tests were both taken at optimal times around 9 AM within hours of waking with reasonably good/decent sleep the night before, and having done my best to make sure nothing skewed the results (besides me taking those supplements the first time)… But absolutely no masturbating, no attempt to induce sleep deprivation, no drinking/smoking tobacco, no overtraining, not trying to stress out, etc. before the tests were done.

4

Hey systemlord, thanks a ton for the reply. How are you doing now that you’re on TRT, if you don’t mind me asking, and how did you convince your doc(s) to put you on a dosing regimen/protocol? (Again, sorry if I’m prying at sensitive info).

I’m definitely going to try my best to convince the endo to get the thyroid panel with the T3, T4, reflex and free for each as well as maybe parathyroid hormones checked. Along with that, I’ll get try to get the male hormone panel of total T, free T/bio-avail. T, SHBG, LH, FSH, Prolactin, E2, DHEA. I might get cortisol tested as well, maybe try to get them to look at my adrenals.

About the aching and cracking joints, yeah man I totally understand. My knees especially just pop whenever I twist them or do any sort of torsion. Not just that, but most of my joints do this as well and I get dull aches from time to time. It’s good to know that what’s most likely causing it is low estrogen though, thanks for the heads up.

Any other ideas or hunches? Maybe talking points I can go over with my doc or the specialists? Maybe even if I could just have some good, legit info or suggestions/points/facts etc to just print on a piece of paper that way I don’t feel like I’m arguing a legal battle in court haha.

I’ll definitely pour over the stickies (I did my best to interpret them, but I also tend to gloss over whatever I’m reading and fixate on the points that concern me or what I think concerns me, plus it’s a decent amount of info to digest). I’ll do my best to go over the stickies (especially KSman’s) and do it carefully and thoroughly this time.

You said you strongly believe I have more going on, would you be able to further elaborate? Sorry if I’m putting you on the spot, I’m just pretty scared about the whole prospect and I’ve been feeling like this going on 3 years now with no relief. I legitimately have no idea what it could be, but I’d like to think it’s something fixable (fingers crossed).

Anything else that I may have missed or any other suggestions? Thanks again for the reply systemlord, hopefully some others give my post a read as well.

5

Oh, I should also say that my first symptoms, if they were indicative of what is currently happening, started when I was 18/19. I had problems getting erections on occasion and my libido dropped a good amount in my senior year of high school. I started feeling rundown and crappy around when I graduated and chalked it up to poor sleep or not enough of it.

My first inklings of me having a problem were the pain/fatigue plus brain fog and then I started getting “tingles” in my brain when I would try to fall asleep (if any of you have heard of or tried ASMR, it’s sort of like the “ASMR tingles”, sort of like a pleasant but somewhat strange “buzzing” that you feel deep in your head).

After that, I had my first obvious issue manifest itself in sleep problems, specifically insomnia (sleep latency, where I found it almost impossible to go to sleep). I started having panic attacks and I wasn’t responding to medication. My dad chalked it up to me using too much caffeine/stims/pre-workout.

I’m actually pretty worried the supplements I took during that period messed me up…I was using MusclePharm’s Arnold series of Iron Cuts, Iron Dream, JYM Preworkout and some original formula Bettancourt Bullnox (tried my best not to use it near bedtime but only ever experienced sleep problems maybe once or twice if I used either one of them later than I should have). Afterwards, the docs pushed me them there pills and the rest is history. Now I’m here, looking for some answers and some damn relief. Thanks again to those who read my post and contribute.

6

Ill give you the heads up on this now since you are young. Lorazepam will WRECK your SHBG as you get older and decrease your free testosterone try and either take sparingly or stop all together. Ive taken trazadone before AND lorazepam, and I think that you are having some of your libido symptoms because of those meds.

7

Hey alphagunner, thanks for the reply. I’m not currently taking nor have I recently taken any of those garbage medications. Lorazepam I took like maybe twice, three times total in my life, period. This was during the initial “acute” stage of my sleep problems as they thought I was having a nervous breakdown. That started the cascade of meds and the psych evaluation. I know how harmful that class of drugs was, and psych meds in general but I thought my doctors had my best interests at heart, but I guess I was dead wrong.

The meds were deemed unnecessary and they found me to be 100% fine in the head. I have not actually been diagnosed with any disorder besides “acute panic disorder” (which has long since resolved) during my initial bout of getting 2 hours of sleep a day. I think it’s obvious that would be equally as stressful for most people, and that sleep deprivation gnaws away at your sanity if you have little or no sleep for extended periods of time.

SSRIs didn’t alleviate any of the symptoms, but instead usually exacerbated them. I haven’t taken any meds that alter any sort of hormone, neurotransmitter, etc in more than half a year, so if I was suffering any side effects (or if I actually had a mental disorder), it would have obviously shown by now.

About the meds; I’d like to make it clear I’m not some pill popper, I actually hate medicating myself and hate the idea of having to take prescription pills for someone to feel normal (I even hate the idea of being at the mercy of TRT or replacing thyroid hormone, but I’ll do what I must to live a good life). It felt demeaning and almost hateful to be told by people that I either required them or that they would help, only for them to harm me and actually have adverse effects because my mental health was and is A-OK. So believe me when I say I do my best to not take crap I don’t need, especially any of those God-forsaken Rx pills that I listed.

Thanks again for the reply, anymore suggestions, tips, etc. would be greatly welcome.

8

You are definitely missing the Estradiol lab, which his crucial. If its too high, it can cause a lot of those symptoms you were stating you had.

9

I completely missed all the medication you used to be on, all of those medications except Trazodone can cause low T symptoms a mess with your libido and erections. I’ve taken all of those medication in the past to treat my Tourette Syndrome and the Prozac and Zoloft caused huge issues with fatigue, low libido and shriveled up erections.

I’ve been on TRT for 5 months now and it’s taken at least this long to start feeling consistently good. It wasn’t difficult to get my doctor onboard for TRT, my neurologist performed a Electromyography which measures muscle response or electrical activity in response to a nerve’s stimulation of the muscle and found my muscles to be wasting.

He already knew before my labs that my testosterone must have been extremely low, once we got the labs he referred my to an endocrinologist. A good doctor is going to consider your symptoms and labs to determine if you’re a good candidate for TRT, a doctor that has no clue what they’re doing will ignore your symptoms and fixate on just your labs or put you on a protocol with injections (200mg testosterone) every 2-3 weeks. My joints are still popping and aching with the slightest twist, but are improving.

My first endo was clueless and put me on a terrible protocol and by the middle of the second week I felt horrible, when I complained to my endo he didn’t seem interested in helping me resolve these symptoms, but looking back now I understand he just didn’t have a clue on how to administer TRT properly. Testosterone has a half life of 5-8 days, so 50% of the medicine is gone by this time. In any case your endo will likely try clomid restart first, then if it fails TRT.

You’re going to encounter resistance in getting TRT because of your age, TRT can decrease fertility. You’re really low for your age and your symptoms are probably the most severe I heard of since joining these forums. When you see an endo argue you dads testosterone levels if you meet resistance, those are excellent levels for a 55 year old!

10

Hey again, systemlord thanks for another response. I’d just like to reiterate that I haven’t taken any of those meds for a loooong time i.e. many, many months (much longer than their washout periods or half-lives) so any ill side-effects would be gone by now, even lingering ones should be gone. The SSRIs should be completely and utterly out of my system unless there’s something screwy between my body and those drugs’ method of action or how they’re metabolized/eliminated from the body. I haven’t used any of them for more than 6 months at a time (definitely long enough for them to show ANY signs of efficacy, but not long enough that I would have lingering side effects THIS severe).

I’ll bring that up with my doc and endo in case I’m an atypical responder to those meds and DO have lingering side effects, as well as discuss my past medications to see if they could be causing any of my symptoms. I was never on any of the meds for extended periods of time, maxing out at 6 months and that was only the Zoloft. All of the other meds were taken long enough for them to show efficacy but not much longer after they showed no signs of any therapeutic effects.

Trazodone and Fluoxetine were maybe only a few months, 3 or 4 at the most. Lorazepam was only two or three times, ever. Bupropion was a trial prescription to see if I would respond to it for my fatigue and mood, that experiment only lasted a month and a half. The Lunesta was only 15 uses, as needed, during my acute sleep problems. I do not and have never abused prescription or illegal drugs. I’ve used medical cannabis to induce sleep for the better part of half of a year, but have not noted any changes in severity of my symptoms once I started. I also do not partake recreationally or indulge in its use, it is strictly for sleep (and it kills me, personally from a moral and ethic standpoint to have to rely on it for sleep, as I do not enjoy having to use it).

I’ve already mentioned my past medications (albeit in passing, so I mentioned it, they considered it, but mostly it was glossed over) with my last doc and my current doc, and they too seemed worried/confused because they also believed I shouldn’t be exhibiting side effects at this point, but I’ll make sure to attempt to discuss it in detail the next chance I get. Anything else I should note?

Thanks again for you time.

EDIT: Oh yeah, the first set of results, the lab didn’t actually include or list a reference range for free testosterone on the result itself, but on an attached note that was forwarded to me. I’ll edit it into my initial post.

The reference range seemed a little too broad:
Male (17 - 65 yrs): 0.091 - 0.579 nmol/L

11

In my case medication was the cause of my low T symptoms or rather the withdraw off the medicine (Klonopin 28 years) which caused permanent damage to my endocrine system. I was perfectly fine while on the Klonopin, it all started during withdraw as my doctor explained it stressed out all my glands. It’s likely you were put on these medicines to alleviate your symptoms which failed to do so since it failed to address the real problem.

Cannabis can definitely induce low T symptoms and really mess with the brain’s chemistry, how long has it been since you stopped cannabis? I’ve heard of a few who haven’t had a relief in symptoms since stopping cannabis, some people are a lot more sensitive than others. You really need more labs to better paint a picture of what’s going on, labs and symptoms can tell a lot.

There’s no way your issues are just low testosterone, your multiply symptoms are too severe given your levels. One would expect your symptoms at the very bottom of the range which I’m not stranger to, I felt like you describe at 119 ng/dL. I’m not going to lie as it might be difficult finding a skilled endo in Sacramento, but when you get tired of running into doctors that just don’t understand male hormones you might consider Defy Medical, they don’t take insurance but the plus side is it’s not terribly expensive and most insurances will cover the labs which only leave the initial consultation and medication. You don’t even need to travel, they operate via phone or video conferencing.

This is the route some end up going simply because they get tired of waiting months to see and endo only to realize they don’t know jack nothing about male hormones or it’s next to impossible to find a knowledgeable endo in their area.

12

Thanks for another helpful reply, man I appreciate it. I 100% agree with your statement about them trying to relieve my symptoms rather than treat the root cause. I really think that I have physiological basis for feeling like this rather than a psychological/mental problem (I’ve never been diagnosed with an actual mental illness or disorder, only an acute bout of panic from the sleep deprivation which triggered heightened anxiety and OCD behavior).

Regarding the cannabis use, I still partake and use it pretty much every night to go to bed. I did read an article on the NCBI government medical database stated that “Many of the effects on the endocrine system caused by chronic treatment of animals with THC are completely reversible with time and there is reason to believe that tolerance develops to these effects with acute exposure to THC.” I wouldn’t use it if I thought it was so negatively impacting it, but adding to this, a few articles from scientific journals considering the topic:

"Effects of chronic marijuana use on testosterone, luteinizing hormone, follicle stimulating hormone, prolactin and cortisol in men and women.

Block RI, Farinpour R, Schlechte JA.

Department of Anesthesia, College of Medicine, University of Iowa, Iowa City 52242.

To investigate possible effects of chronic marijuana use on reproductive and stress hormones, we assayed testosterone, luteinizing hormone, follicle stimulating hormone, prolactin, and cortisol in 93 men and 56 women with a mean (+/- S.E.) age of 23.5 +/- 0.4 years. Hormone values were compared among groups of subjects stratified according to frequency of marijuana use (frequent, moderate and infrequent; N = 27, 18, and 30, respectively) and non-using controls (N = 74). Chronic marijuana use showed no significant effect on hormone concentrations in either men or women.

Serum testosterone concentrations in cannabis and opiate users

[Article in German]

Friedrich G, Nepita W, Andre T.

Institut fur Rechtsmedizin, Universitat Freiburg.

“The object of this study was to establish possible influences of long-term cannabis usage on plasma testosterone levels. The plasma testosterone levels of 66 male Pakistani who for years had smoked cannabis daily or drank cannabis regularly where measured after chronic and acute intake of the drug and compared with a material of 41 normal controls, i.e. persons who did not use cannabis. An evaluation of the results showed that there were no significant differences between the two groups. No influence of long-term cannabis usage on plasma testosterone levels was found. Furthermore we wished to find out whether long-term heroin abuse showed an effect on plasma testosterone levels. The concentrations of testosterone in the plasma of 102 heroin addicts assigned to a Methadone Program were measured and compared with the values of 29 male healthy students as controls. Plasma testosterone levels were found to be significantly decreased in heroin addicts as compared to controls.”

Now I’m not advocating FOR cannabis use, as I actually despise stoner culture and deeply wish that I wouldn’t even have to waste my money or brain cells using this trash to go to bed, but it’s the only thing that gives me consistent, effective relief. I know that even if it doesn’t impact T production at a great amount, I could cease using it and see an increase as it does somewhat impair male hormones.

I’m just scared of what sleeping pills can do to your glandular and mental health, although I would love nothing more than to stop using weed, but I’m afraid of the prospects of going back to 2-5 hours of sleep a night, as I think I’m just too stressed as it is to bear that load again. Maybe I should give Trazodone another shot as that actually did a pretty good job of making me have that sleepy, “sedated” feeling as well and usually helped me get to bed on a semi-consistent basis.

About my symptoms, I’m not an unreasonable man, so if the labs or factual evidence suggest I’m physically fine, I’m fine with a differential diagnosis. I’d just like to know what’s wrong with me and how to treat it, and to cover all possible solutions with sound, logical basis for me to question whether or not I’m suffering from this or that; following this train of thought is why I’m exploring the possibility of TRT or HRT in general as a disorder regarding my hormones may very well be the cause of my symptoms. So if it’s anxiety/depression, chronic fatigue, some other random disorder, then so be it; I’ll accept it and do my best to bear through it. I’m just hoping it’s actually something tangible and treatable, and that I reach a solid, legit diagnosis.

I have an appointment with an endo on the 16th of October, which is a bit of a ways away, but I’ll try to convince my doctor to test my E2 and the thyroid panel before then.

I really appreciate your time, man. I’m sorry to bug you with these wall-of-text replies. Thanks for the tip about Defy Medical, I checked them out and will do further research on them but they seem really legit, with some really positive reviews.

13

Whatever you do, DO NOT go back to pharma for sleep. Are you really that turned off by weed? I also think the stoner culture is degenerate, and disgusting. But separate the two. Its medicine, and that’s it.
Just the mention of trazadone makes me sick to my stomach.

14

Sleep: I have major problems. I use 5mg time release melatonin, must be time release, and trazodone.

Do not test DHEA, test DHEA-S

Are you taking a multi-vit that has trace elements, 150mcg iodine and 200mcg selenium? Selenium is very important and all the more with high dose iodine to avoid thyroid autoimmune …

Need thyroid numbers!
Please eval thyroid via oral body temps as suggested below…

Please get EFA’s - fish oil, nuts, flax seed oil/meal
Vit-D3 5000iu

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

15

Hey man thanks for another reply. Yeah I hear that about pharma. I’m very weary of that whole sordid industry but you’re right. If the weed is medical in its purpose, does its job, has LESS side effects than meds, than why not use it. I just wish it didn’t have to come this…oh well

I’ll definitely try not to go back on Trazodone or prescription drugs, as apparently it has extreme negative connotations in your case. I know it can speed up early-onset of dementia if used regularly, and I think most psych drugs raise prolactin, but are there any other negative effects you could bring to my attention (Just so I can use it as counterpoint if my doctor tries to get me to go back on any drugs)? Thanks again for your time.

16

Oh snap, KSman in the house! I was hoping to get some advice from you sooner or later. Thanks for the reply, I’d like to say that I actually tried iodine replenishment after reading one of your stickies back when I thought I may have had a thyroid issue. I did 50mg a day for a while (like a month and some change) to try to reach the 1500mg capacity I though I saw was mentioned somewhere. Along with that, I took 200-400 mcg of Selenium a day, and I don’t know if the experiment made me worse or if I was the same, but I didn’t note any improvements.

I did jump headfirst into trying Iodine Replenishment, instead of being smart and taking my oral temps and logging them like I should have, so I should definitely do the temp logging. I didn’t eat iodized salt or any fish as I kid so that’s the reason I jumped the gun and went straight to IR supplementation. I do try to liberally use iodized salt whenever I cook for myself nowadays.

I also do in fact take 5000 IU of D3 a day (used to be 10k but I started feeling that was too much/unnecessary or that I was too gung-ho about taking supplements). I take a bunch of EFAs in the form of high potency fish oil with 1g Omega 3 in each 1400mg capsule; I used to take 4 a day but thought I was over-doing it again and went back to 1 per day recommendation listed on the label. I do eat plenty of raw/salted almonds, walnuts, etc.

I’ll do my best to fully read, interpret, and internalize the thyroid and TRT stickes. I don’t have an appointment with the endo until the 16th of October (it was the earliest available appointment). So by then, you may likely have moved on to advising someone else; like you said I might very well fall off of your radar, which is totally understandable with how active you are.

I have an appointment with my regular doc on the 28th but he’s a real boy scout prick with a stick up his ass type of person (The whole " I’M THE DOCTOR YOU’RE NOT, I’M RIGHT YOU’RE NOT " kind of person). I’ll do my best to insist for a full, comprehensive thyroid panel before I go to the endo. I’m actually concerned I have a thyroid disorder at this point since my T levels are still at the higher end of abysmal, but I guess I’ll see conclusive test results between now and going to the endo. Thanks again for your response and for your time. Any other wisdom or suggestions you can impart besides what we went over?

EDIT: I should say I also do plan on reading Stop the Thyroid Madness before my visit with the endo to read up on the subject and try to glean any knowledge I can.

17

Your doc, like most, will probably dismiss your thyroid and iodine concerns.

Note that high dose iodine causes expected high TSH levels.

18

“I know it can speed up early-onset of dementia if used regularly” THAT SHOULD BE ENOUGH RIGHT THERE! lol And an added benefit, your other sleep choice has been proven to delay and even break up Alzheimer plaque and its neuroprotective. Pretty easy decision if you ask me.

19

Well, this is very out of the blue, but I’m back after a long, LONG period of doubt and introspection. I’m feeling a lot more level headed now, definitely less manic about my whole situation.

So I ended up going to a private doctor at a wellness clinic after finally getting fed up with the situation; I had been bouncing around from self-diagnosis to self-diagnosis (low T, neurological issues, adrenal insufficiency, HPTA disruption/dysregulation, primary depression, you name it) so I thought “what have I got to lose.”

Let’s start with the lead-in to all of this: I was still suffering from a lot of worrying symptoms, got sick after Christmas and seemingly couldn’t get well for the life of me, and ended up de-training and going back to a very lax, unregulated lifestyle (i.e. being very unproductive). During this period of (in)activity, I went ahead and got my labs done by my dad’s naturopath at that wellness center and have gotten my results back.

Honestly, I wasn’t holding my breath as I had chalked everything up to me just sucking as a human being and being doomed to live a rather crappy life, but the labs were very interesting to say the least.

E2: 59.1 pg/mL ref: ND - 56 (assuming ND refers to low value not being established)

Seems to be REALLY high despite “meh” total T with lower-end free T levels

LH: 3.1 mIU/mL ref: 0.8 - 7.6

FSH: 4.0 mIU/mL ref: 0.7 - 11.1

Progesterone: 0.4 ng/mL ref: 0.27 - 0.90

Prolactin: 10.4 ng/mL ref: 2.5 - 17.0 (seems on to be on the higher end)

NOTE : I do take Trazodone for sleep, after coming to the conclusion that it isn’t nearly as harmful as I first thought, so this may explain the heightened prolactin (at least to some extent).

TT: 492 ng/dL ref: 160 - 726 (seems pretty good despite low-T symptoms)

FT: 10.4 ng/dL ref: 9.0 - 30.0 (looks pretty low, but not clinically low?)

SHBG: 29 nmol/mL ref: 10 - 57

Androstenedione: 2.0 ng/dL ref: 0.6 - 3.1

DHEA-S: 118.7 μg/dL ref: 80 - 560

(Numerically, this just LOOKS low haha; assuming there is something afoot here? The naturopath did say that I might have an adrenal or HPTA issue due to intense stress from onset of chronic insomnia and other stress-related maladies, which kicked in about 4-5 years ago)

IGF-1: 279 ng/mL ref: 107 - 367

PSA: 0.3 ng/mL ref: <= 4.0

Thyroid labs:
I had previously loaded large quantities (50mg daily) of iodine, but stopped upon deciding it was foolish to play around with my body when I wasn’t even sure what was wrong.

I was dosing with Iodoral 12.5 mg when these blood tests were drawn, which I assume led to the spike in TSH. I just simply didn’t think it was a thyroid issue so I just let it be and dosed inconsistently.

(TSH + T4F +T3 Free):

TSH = 2.450 uIU/mL ref: 0.450 - 4.500

TSH definitely looks high, but it’s been near 1.0 in the past, but also climbed up to 3.17 during the onset of severe symptoms (about 4-5 years ago).

Triiodothyronine, Free, Serum = 3.7 pg/mL ref: 2.0 - 4.4

T4, Free (Direct) = 1.69 ng/dL ref: 0.82 - 1.77

Vitamin B-12 + Folate and Vitamin D3 tests came good (I think), so I’d like to think these are not of concern.

Vitamin B12 = 1229 pg/mL ref: 232 - 1245

Folate (Folic Acid), Serum = >20.0 ref: ng/mL >3.0

Vitamin D, 25-Hydroxy = 80.9 ng/mL ref: 30.0 - 100.0

Lipid Panel:
Cholesterol, Total = 162 mg/dL ref: 100 - 199
Triglycerides = 38 mg/dL ref: 0 - 149
HDL Cholesterol = 45 mg/dL ref: >39
VLDL Cholesterol Cal = 8 mg/dL ref: 5 - 40
LDL Cholesterol Calc = 109 mg/dL ref: 0 - 99 (Flagged as high)

Does cholesterol look adequate? LDL was flagged as high/out of range.

Other results of note:
Insulin = 3.5 uIU/mL ref: 2.6 - 24.9
Glucose, Serum = 88 mg/dL ref: 65 - 99

Insulin seems REALLY low, this was a fasted blood draw (12 hour fast) but I’m unsure of how low the result should be for a test like this? I was not on a low-carb diet during this time.

After these results came back, my dad’s naturopath promptly suggested I hop onto “HCG monotherapy at 1,000 IU twice weekly”, which I assume to mean 1,000 IU split into 500 IU two times a week, but I am unsure of this treatment given my very high E2 and middling Total T plus lower end Free T.

I am not entirely sure how to decipher and interpret my results given the big picture, any input would be very much appreciated. @KSman 's expertise in this would be greatly appreciated, in particular!

Thanks all, and have a good day to anyone who to took the time to read this.