@krataios next step is my appointment with the doc you advised me on thursday 19/5.
i’m really nervous about my IGF-1. feeling tired after training and cannot lose weight.
My IGF is 170 and I decided to take HGH. Maybe the tiredness and the weight problem is a thyroid issue, KSman can help there. Nolva and clomid made feel like shit all the time but maybe that doesn’t apply to your case. I noticed significant fat loss when I addressed my thyroid issues
Doesn’t seem to have worked to a good extent. fT is very low, calculated out to be about 10 ng/dl, will probably come down after cessation of the SERMs. a fT of 8-9 gives me all the symptoms of hypogonadism so i don’t think its a good restart. TT is meaningless as your SHBG has gone up, inflating TT. fT(what matters only) has not gone up too much.
@krataios what your doc thinks about GH?
@equalo212 i have good libido so far, so time will tell us. i’m not happy about fT too.
Well then you don’t really need to look at numbers too much. We all want the symptoms relief rather than any arbitrary number.
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Maybe your SHGB is to blame for your low FT. My doc actually suggested the HGH but he is quiet liberal in general. He also had me on 200mg test for 5 months and had no problem with my 1400TT (300-1200) I lowered the dose by myself. I don’t know what the doc in Athens thinks about HGH but the guys tell me she 'll do whatever she can about your needs. (This sounded funny)
yeah my SHBG is elevated in the last test. but it is difficult to manage SHBG. some people say vitD3 will manage it. i started today 10000iu D3.
i’m waiting @KSman 's opinion also.
i hope your information will be true. (she’s pretty)
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@krataios you’ve got mail
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today i had my appointment with a new endo.
the first i can say, wow the girl is a rocket. she even watches american forums.
she laughed at my previous experiences with endos.
she said suspects hypoclinical hypothyroidism, hypogonadotropic hypogonadism due to pituitary malfunction.
my GH is extremly low.
she wanted to give me immediately androgel but i said i prefer injections.
so possible therapy is testo + gh + hcg injections but before we start i’m gonna have pituitary MRI and complete checking of my thyroid hormones including antiTG and antiTPO.
stay tuned for new labs
i’m glad i met her
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Well done bro, this is very promising
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@equalo212 how do you convert 17.3 pg/ml to 10 ng/dl?
Immunoassays to determine will not be used by any doctor in his right mind in order to diagnose or treat hypogonadism. It’s simply not very accurate and the accurate technology which is used to determine fT is expensive and not available conveniently. Calculations by the amount of TT and SHBG are the standard to establish approximate fT concentration. Assuming your Sr albumin is 4.3 units, your TT and SHBG values point 10ng/dl as your approx. fT, which is low.
but i’ve never test my serum albumin.
what is the reference range for albumin?
what is considered below range free testo in 10ng/dl?
Albumin in addition to SHBG are two primary androgen binding proteins. SHBG bound T is unavailable for use for the body, Albumin bound T is more bio available than SHBG bound.
Albumin is generally between 4-5 units in men. Variations within this normal range don’t have a major implication on Bio-T.
10ng/dl is not below range, it’s border line low. The range is typically 9-30 ng/dl in young males. fT is the biochemically relevant androgen in our body and determines symptomatic relief or lack thereof. Clomid can raise SHBG, this is not so say that SHBG is the reason for your low fT, That’s a different story. Your LH/FSH are very good, but not yielding particularly good T levels, some issues in the testes are possible. I also see that your gonadotrophin hormones were not low prior to clomid. And you can see how clomid did not raise your fT, rather it remained same but it just increased your SHBG and due to it your TT.
When i was relying on Immunoassays for FT measurement, my fT fluctuated from 5ng/dl to 13ng/dl despite TT and SHBG not moving. So you can see the inaccuracy of these methods. There are online calculators to estimate FT from TT, SHBG, Albumin concentrations.
A higher SHBG will inflate TT more than what would be expected with low fT. SHBG bound T is not cleared quickly by the body hence exaggerating testosterone levels in the blood.
Look at fT and bio-T measurements more than TT measurements to determine outcome. TT is not the end all be all, it’s just a measure which calculates SHBG bound T+Albumin bound T+ FT. The latter two carry value from the patient’s perspective.
thanks for the information.
as i’ve said before i’ve checked my testes and they are completely healthy.
also my new endo told me that gonadotropins before therapy were normal-low and not high.
Not high but FSH was not below 5 once. Does not suggest low gonadotropins, after SERM its high but not leading to enough T. Low testicular function, not failure is what I am suggesting.
maybe you’re right.
new labs without medication and pituitary MRI are coming.
Also, low sperm count also suggests this. The pituitary is secreting enough FSH for spermatogenesis. I am in similar situation, many cases of mixed hypogonadism.
the thing i don’t understand is that all problems including low sperm count started after seropram medication.
never had such problems.
Maybe more of a coincidence than causality. This class of drugs when abused can affect hpta. But your hpta is functional. LH and FSH are mid range or higher but even TT was low prior to clomid. Clomid raised TT and shbg, shbg being the cause of raised TT imo.
Clomid was never going to work with those LH and FSH levels. TRT is the solution you’re looking for.