Feeling Horrible. Your Thoughts on Lab Results

Pharma / TRT Testosterone Replacement
1

M/28

Hi guys, I kindly ask you to help me with your advice.

My current symptoms: depression, anxiety, obsessive thoughts (Pure OCD), brain fog-feeling like living detached from the world, tiredness, no energy, no motivation, no desire to do anything, no will to live, do not enjoy in anything, not feeling any emotions (living like a zombie), cannot connect with anyone, zero libido, even during puberty so no urge to masturbate or have sex, no sexual or romantic attraction for anyone (never even had-I think I am asexual and aromantic, but not sure), can get erection but do not feel any urge to have sex or masturbate.

My psychiatrist has prescribed me two antidepressants luvox (200 mg) and cymbalta (60 mg) but to no avail. Before those I was taking zoloft and serpentil and neither one of them helped me.

My endo does not want to prescribe me TRT because I am in range levels. What should I do ?

Thnx in advance.

My lab tests

E2-49 pmol/l
FSH-6,1 iu/L
LH-4,2 iu/L
Progesterone-0,6 nmol/L
Prolactin-432-mIU/L
DHEA-S-17,95 umol/L
Testosterone(total)-13,0 nmol/L
SHBG-26,6 nmol/L
Free Testosterone-0,271 nmol/L
Cortisol-649 nmol/L
TSH-1.56 mIU/L
fT4-17,3 pmol/L
Vitamin D (25-OH D)-26,4 nmol/L

2

It would be helpful if you provided reference ranges for all lab values.

Your estrogen levels are out of range for an adult male, but not for a pre-pubertal boy.

Your testosterone levels may be in the normal ranges, but for a man in his 70’s, few doctors truly understand sex hormones.

Young men are supposed to have higher testosterone and as men age testosterone decreases.

This is why the reference ranges are so broad. Your estrogen is low enough to eventually cause osteoporosis and the reason it’s low is because your Free T is low, the Total T is inert and the Free T is what truly matters.

I don’t know your location but if in UK or Europe you can go to the Men’s Health Clinic or Balance My Hormones and pay out of pocket for treatment because the NHS is notoriously bad for TRT.

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3

If you want a sex drive, you need to get off of anti-depressants. They are notorious for killing it, even with high levels of sex hormones.

I’ve been on several antidepressants and they all made things worse for me. The only one I’ve heard of that had any success was Wellbutrin.

How long have you been on antidepressants?

P.S. your testosterone is literally low.
Free Testosterone-0,271 nmol/L (0,31-1,04).

By the way, If someone has a source chronic antidepressant use crashing serum testosterone levels I would be interested to see. I would bet there is a connection. I’ve seen this a lot.

4

did you always have many of those symptoms even before the first round of zoloft and serpentil?

are/were you trying anything else like supplements or specific eating habits?

w/ those symptoms, personally, I’d be testing many other things.

5

Thank you for your detailed answer. That is all I have regarding lab values. Yes, and I am sure that I would feel 100 times better with higher tesosterone but those doctors are fucking morons. When I get better with TRT I will go to their offices and have a nice conversation with them. I live in Croatia and we do not have Mens Health Clinic here but I have looked at Balance my hormones and they say on their site that is not necessary to come in UK for examination so that seems like a good option. What is your opinion about private clinic Balance my hormones, do they provide quality service, do you know maybe someone who went there to balance their hormones and is it a good decision to do that kind of treatment on distance ?

6

Thnx for your response. I have had zero libido and zero interest in sex and masturbation even before taking antidepressants. I have never had an urge to masturbate or to have sex. Like I said I do not feel any sexual or romantic attraction for anyone. But strange thing is that I can get erection for example when I kiss with the girls or touch them and I can have sex with them but there is no desire or urge, like some emotional component is missing, if I do have it I just do it for the sake of it, I do not enjoy in it. Strange.

I have been on cymbalta since last year but I am withdrawing slowly from it. On luvox I have been since december 2020. Previous ones were zoloft in 2017 for four months and serpentil in 2015 for three months.

7

Thnx for your response. Yes, I have had many of those symptoms even before taking those ssris.

I was on keto diet for six months combined with working out. Also I eliminated gluten, diary, sweets, alcohol and many other things which when I consume them make things worse, but not much has changed.

Could you tell me please, which other things would you be testing ?

8

Stop dieting and get good food in you. Exercise by lifting steel, cardio wont get you where you need to be. Also Im not sure what your T levels are with no range. But nevertheless, go to a TRT clinic and get retested, and get on TRT in order to get some mental wellness going, so that you can chuck the AntiDepressants into the trash. Take action or keep depending on your dumb doctor for more pills that continue to kill your sex game. Your choice.

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9

I know jack shit about all those ssris and issues they can cause, so that’s out of my league.

As others have noted, your T is indeed low. It’s also tough to tell w/o the ranges. Is cortisol low? Might be beneficial to get your vitamin d up to 35-50, see if you notice anything. Might happen anyway w/ the summer coming up.

Speaking more generally, you can use the cronometer.com app to track your nutrient intake. See if you notice any patterns.

I’d also test anything related to neurotransmitters: folate, b12, copper, zinc, vitamin c, b6 (plp), vitamin A

other testing ideas: blood sugar markers (fasting glucose, fasting insulin, c peptide, a1c), iron panel (w/ ferritin), liver/kidney/pancreas markers, full blood panel

best of luck

10

Thnx for your response. I have started lifting weights again but I am so fucking tired and low energy during and after trainings. And when I get some gains it goes more to stomach, ass and legs than upper body even with strict calorie counting. Ranges for total test are from 8.26 to 29 nmol/L and mine is 13.0 while ranges for free test are from 0.091 to 0.579 nmol/L and mine is 0.271. What do you think about private clinic balance my hormones in UK because I live in Croatia and here as I know we do not have mens health clinic or anti ageing clinic at which they could give you TRT ?

11

Im sure you can get Turkish or German test. You’re low on T

12

Guys, here are my blood tests which I did 2 weeks ago with ranges while I have been taking 45 mg of Cymbalta and 300 mg of Luvox.

Estradiol-49 pmol/l (94,8-223),

FSH-6.1 IU/L (1.5-12.4)

LH-4.2 IU/L (1.7-8.6)

Progesteron-0,6 nmol/L (0.7-4.3)

Prolactin-432 mIU/L (86-324)

DHEA-S-17.95 umol/L (4.34-12.20)

Testosterone-13.0 nmol/L (8.6-29)

SHBG-26.6 nmol/L (18.3-54.1)

Free testosterone, calculated-0,271 nmol/L (0,091-0,579)

Cortisol-649 nmol/L (171-536)

TSH-1.56 mIU/L (0.40-4.00)

fT4-17.3 pmol/L 12-22

Vitamin D-26.4 nmol/L

Below are my blood tests 3 years ago when I was not on SSRIs and was working out 4-5 times a week (hard full body workouts), and was taking care of my diet and sleep.

FT4 - 13.0 pmol/L (11.5-22.7)

TSH - 2.53 mIU/L (0.3-5.0)

LH - 4.47 IU/L (1.7-8.6)

FSH - 8.27 IU/L (1.5 - 12.4)

Prolactin - 294 mIU/L (86-324)

SHBG - 43.35 nmol/L (14.5-48.4)

E2-134.1 pmol/L (41-159)

Total T - 19.44 nmol/L (8.64-29.0)

Index free T - 44.84 % (33.8-106.0)

Cortisol - 447,5 nmol/L (171-536)

Could you give me your opinion on my blood tests regarding ranges which I wrote now ?

Thank you.

13

Your estrogen looks crashed. That can have a big effect on how you feel. Your total testosterone is also low, but your lowish SHBG is keeping your free T up.

How did you feel 3 years ago compared to now?

14

I felt the same. I do not understand why my estrogen levels were so high 3 years ago and now they are totally crashed ? Also, was my SHBG high 3 years ago because it was at the upper range ? What about my Total T, how it is possible to be that high comparing to low estrogen levels and high SHBG ? And what about index free T which was 44,84 % in the range of (33,8-106.0) ? This hormone thing is so confusing. My endo 3 years only looked at my total T and said you have a lot of testosterone, you also have a beard and muscles, no TRT for you.

15

Mistake

  • What about my Total T, how it is possible to be that high (19,44 nmol/L), comparing to higher estrogen levels (134,1 pmol/L) and high SHBG (43,35 nmol/L) ?
16

My question is still: how did you feel 3 years ago compared to now? There is no reason to get nit picky about the numbers if you felt crappy around both blood tests.

17

I felt the same, like shit, nothing better.

sub, 13. ožu 2021. 17:45 galgenstrick via Forums - T Nation <tnation@discoursemail.com> je napisao:

18

Most of your testosterone is inert. Clearly this endocrinologist doesn’t understand hormones as well as he thinks he does.

In my experience endocrinologist are a waste of time. They do seem knowledgeable in thyroid and diabetes though which is taught in medical school, sex hormones are not.

19

systemlord, I have already contacted clinic you previously reccomended to me and they are going to put me on 125 mg test ethanate every five days. Thank you from the bottom of my heart for that reccomendation. I hope everything goes well.

20

do yourself a favor and stop taking psych-pills. there is not a SINGLE person in the entire universe which got better on this stuff.

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