[quote]RhunDraco wrote:
DrSkeptix wrote:
DrSkeptix wrote:
RhunDraco wrote:
DrSkeptix wrote:
How about this?
List all the meds and supplements you may have taken regularly over the last 4 weeks.
Not much. I cut down on just about everything, as money has been tight.
Consistently taking protein, ala Metabolic Drive. Couple scoops per day. Pretty much always been that way. Picked up more ZMA recently, and been taking that for about 5-7 days.
I’d say that Androgel is about it, 10g/day for the past several weeks.
At last.
OK. You have may have IHH. (A reasonable guess, given your initial posted history and no data to the contrary.)
Here you go:
[i]Complete reversal of adult-onset isolated hypogonadotropic hypogonadism with clomiphene citrate.
Ioannidou-Kadis S, Wright PJ, Neely RD, Quinton R.
Department of Endocrinology, Royal Victoria Infirmary and University of Newcastle-upon-Tyne, Newcastle-upon-Tyne, United Kingdom.
OBJECTIVE: Inhibition of pituitary gonadotropin secretion in men by T is principally mediated by aromatization to estrogen (E), which inhibits hypothalamic secretion of GnRH. We hypothesized that adult-onset isolated hypogonadotropic hypogonadism (IHH) might result from an altered central set-point for E-mediated negative feedback. DESIGN AND SETTING: Longitudinal clinical investigation unit-based evaluation of the clinical and biochemical response to E-receptor blockade. PATIENT(S): A 31-year-old man presenting with an 18-month history of sexual dysfunction resulting from severe adult-onset IHH (LH 1.7 U/L, FSH 2.0 U/L, T 3.5 nmol/L). INTERVENTION(S): Initial therapy with 50 mg of clomiphene citrate (CC) three times a day for 7 days, with overnight LH pulse profiling and 9 am T levels evaluated at baseline and on completion. A 2-month washout period, followed by low-dose maintenance therapy (25-50 mg/d) for 4 months. MAIN OUTCOME MEASURE(S): Baseline and stimulated T levels and LH pulsatility; effect on sexual function. RESULT(S): Clomiphene therapy resulted in complete normalization of pulsatile gonadotropin secretion, serum T level, and sexual function. CONCLUSION(S): Isolated hypogonadotropic hypogonadism may result from an acquired defect of enhanced hypothalamic sensitivity to E-mediated negative feedback. Whereas direct T replacement therapy can further suppress endogenous gonadotropin secretion, treating IHH men with gonadotropins can stimulate endogenous T secretion and enhance fertility potential. On theoretical grounds, reversal of gonadotropin deficiency with CC might be expected to have a similar biological effect.[/i]
Points:
- Real doctors can make real diagnoses. (Not me. I suggest you see a real doctor; some hammer that does not see every problem as a nail.)
- Real treatments can work (There are 44 more articles to back up this simple case report.)
- Not every young man needs the same therapy; not every young man is consigned to a lifetime of TRT.
Interesting. I’d like to see Dr Crisler, but I’m afraid that with my job looking like it’s going away, any further treatment may be difficult, if not impossible, to get.
They didn’t specify which T measurement, so I’m assuming serum. Mine comes out to 10.2018 nmol/L, if the formula I found is correct.
Would you agree that it’s probably a good idea to start watching thyroid function more closely, regardless? In another forum, a member suggested that I am a poor responder to transdermal T, and that this may indicate a thyroid issue, even though the last time it was checked, all my thyroid #'s were mid-range.[/quote]
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You currently have a doctor who orders test and prescribes medicine. GO to him/her with the literature (which I have just pm’ed to you). Ask if you can consider, an alternative approach, done in a responsible manner. He/she may say yes.
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Your last thyroid values are ok (missing a TSH, but that’s ok). You are not hypothyroid. There are other reasons which impede the utility of Androgel.
Best of luck.
