SERM Restart

Pharma TRT
41

Edit - Corrected DHEA dosing.

Updated blood work.

T - 80mg x 2 weekly. SubQ
Adex - .3mg day after T. .2mg other days.
HCG - 250IU day before T.
Preg - 100mg LEF
Prog - Kal transdermal.
DHEA - 25mg LEF
Cialis - 6mg

Total T - 745 (348-1197). Was 508
Free T - 31.1 (8.7-25.1). Was 23.6
E2 - 27.8 (7.6-42). Was 36.7
Pregnenolone - 28 ng/dl (<151). Was 65 on 100mg on different brand, no micronized.
Progesterone - 1 ng/ml (.2-1.4). Using slightly less.
DHEA-S - 364 (89-427). Was 519 @ 50mg.

I feel pretty good in general. Not like a younger man, but a lot better than where I was 6 months ago. It’s not a grind just to get though normal daily activities.

Almost positive I’m still having adrenal issues, so energy isn’t consistently good. I get flushed every afternoon around 3:30pm. My ears get bright red and energy gets pretty low. I need to sort this next.

Libido is back to normal and I’m not moody. Acne on chest and shoulders comes and goes. E2 control seems to be the key here.

Strength gains seem to have tapered or stopped since starting treatment. Could be related to adrenal issues. I feel a little burnt-out in the weight room. I can’t remember the last time I was actually fired up during a workout. I just seem to get through them. I am starting to lose a bit more body fat though. Body hair seems thicker and to be growing faster.

This was on Wednesday morning, so 48hrs after my last shot. Given the way I feel, I probably shouldn’t mess with T does, but it would be nice to reduce the Adex. I’m thinking about just doing .5mg the day after my twice weekly T shot. I wouldn’t have to mess with the liquidex and could just cut my scripted pills in half. I could reduce T dose to get the desired E2 levels. Even though my total T wasn’t that high at 50mg x 2, my free T was still good.

I go back to the Endo in 2 weeks. Go in for testing on Monday before my appt. Might have them add serum cortisol just to see where it’s at. Will also be interesting to see if my thyroid panel has changed at all. My body temps are a little low again despite continued supplementation with iodoral, iodine in my multi and using iodized salt. Doc wants to sort thyroid and apparent Hashis next. I’d like to address adrenal issues first, but not sure he’s the guy to help me there. Should have probably gone back on some of the sups that helped adrenals in the past ahead of my appt. to see if that had any effect on thyroid. Just feel like I have a few too many balls in the air right now.

42

BW from the Urologist. Note that ranges are a bit different than the LEF tests I do on my own. Testing was Monday morning, so right before my Monday injection.

T - 80mg x 2 weekly. SubQ
Adex - .3mg day after T. .2mg other days.
HCG - 250IU day of T.
Preg - 100mg LEF
Prog - Kal transdermal.
DHEA - 25mg LEF
Cialis - 6mg

Total T - 870 ng/dl (300-1600)
Bio T - 268 pg/ml (250-300)
Pregnenolone - 111 ng/dl (23-173)
SHBG - 10.5 nmol/L (13-71)
E2 - 33.1 pg/ml (10-30)
Albumin - 5 g/dl (3.5-5)
Cortisol - 12.3 ug/dl (5-25)
TSH - 1.24uiU/ml (.4-2.5)
Total T4 - 6 ug/dl (4.5-12.5)
Total T3 - 103 ng/dl (84-172)
Free T4 - 1.1 ng/dl (.8-1.9)
Free T3 - 2.8 pg/ml (1.5-4.1)
TBG - 11.8 ug/ml (13-39)
Thryroglobulin - 6.4 (.8-68)
Anti-TPO - 18.9 Iu/ml (10-35)
Anti-Thryoglobulin - <20 (20-40)

Nothing extraordinary to note here. Cortisol is low, which wasn’t much of a surprise. Thyroid function is less than optimal but doc seems to think it’s not quite bad enough to start messing with things.

Also get genetic testing results back. Going have them interpreted and see if there’s anything to address there. Did a bit of research on my own and it seems there’s at least a couple methylation and detox mutations.

Not much new to report on symptoms. Still issues with body acne. Not much for energy. Strength is down a bit.

Vision issues don’t seem to bother me as frequently. Weight is still coming off. I’d no longer consider myself fat. I’d say I’m probably cruising past chubby to just soft.

43

Interesting read. Your story seems a bit familiar with my own journey. I am trying to uncover the cause of my Low-T still. I did discover my body temp is low so supping 50mg day of iodine and monitoring temps, but I’m thinking its not going to help me much with my lowT. Im experiencing low libido lately as well, and after I did a SERM restart using Nolvadex it had gone through the roof but slowly tapered down since last December until now its basically gone and my T is low again as well…

I’d check if you need glasses for your vision. Im 37 myself and just started wearing glasses on the computer because my vision was worse than I had realized. It went really fast. Now I love my glasses, so could be age related vision loss which is common if you use a computer all day long…

44

Seems like you’re fine tuning your E2, which now seems to be in the 28-33 range. How’s the ED?

45

I had my eyes checked. No obvious issues. Vision hasn’t been all that bad lately.

Not sure on ED. I take 6-9mg of cialis every day, so no way for it to be an issue. It works fantastic and it has other health benefits. Can’t see giving it up. Even if you’re not having issues, you should give it a try.

Still trying to figure out why I’m in this spot. Just got 23andMe genetic testing results. Working with two people to decipher and make some recommendations. Some interesting stuff so far. Issues with E metabolism and B vitamin absorption transport and metabolism.

46

My ED has been cured by supping Iodine,DHEA, and Pregnenolone. Its been just about 2weeks so the jury is still out but I was bad off with libido and erections leaving a lot to be desired. Taking those supplements has turned me around almost overnight. I could tell a difference after the first day.

Im going for bw in about 3 weeks and maybe my T is going to be higher. I’d never had my Thyroid, T3, Cortisol, checked so Im kinda blindly supping things that hopefully will boost all my hormones.

47

Updated blood work.

T - 30mg EOD. SubQ. (Was 80mg x 2 weekly)
Adex - .2mg ED. (was .3mg day after T. .2mg other days.)
HCG - 125IU EOD. (was 250IU day before T).
Preg - 100mg LEF
Prog - Kal transdermal.
DHEA - 25mg LEF
Cialis - 6mg twice daily.
Added some additional zinc /B and some Calcium d-glucarate since last time.

Total T - 469 (348-1197). Was 745
Free T - 19.5 (8.7-25.1). Was 31.1
E2 - 9.7 (7.6-42). Was 27.8. Would like to settle in to around 20.
DHEA-S - 526 (89-427). Was 364. Adrenals must be back online.

I’ve had pretty low SHBG and seem to metabolize T pretty fast. It was suggested that I try EOD injections and try to get E2 down a bit more to stay inline with SHBG.

I like the EOD schedule. Should be able to knock the AI down again. I hate to chase numbers, but I wouldn’t mind getting my free T a little closer to the top of the range.

Might give 40mg EOD a shot and see what happens. I’ll probably drop back down to 30mg and try increasing HCG to 250IU EOD. I’d like to compare results just for shits and giggles. Mostly interested in E2 response, so I’ll keep my current AI schedule while I experiment a bit. Will HCG increase E2 disproportionately to the increase (if any) in T when compared to increasing T dose? If not, I’d rather increase HCG. If so, I’d rather increase T. My goal is to use as little AI as I can get away with.

I’m a little puzzled by the DHEA-s results. The big increase would seem to suggest that my adrenals are producing a bit more, but I can’t say I feel any difference in energy levels. Feels like I’m still having some adrenal issues. Waiting on 4x cortisol results. Also doing another neurotransmitter test.

48

Saliva Test Results

DHEA - 648 pg/ml (137-336)

Cortisol

AM - 11.59 nmol/L (5.1-40.2) Optimal = 18-35
Noon - 3.51 nmol/L (2.1-15.7) Optimal = 6-12
Evening - 4.66 nmol/L (1.8-12) Optimal = 4-8
Night - .72 nmol/L (.9-9.2) Optimal = 2-6

I’ve been taking ashwaganda. Obviously not a solution. Might try licorice root again. I have neurotransmitter test I need to take. Will probably wait to see what that looks like first.

49

I don’t really have anything to add just wanted to say I’m sort of in the same boat as you albeit younger. I’m having some vision issues too where everything seems to be blurry- has only seem to have gotten worse in the last few weeks. I’m awaiting a 4x salivary cortisol kit to arrive so I’m kind of using your thread as a guide.

50

Good friend of mine has the same vision problem (so it seems). He says in the morning he can see perfectly but by the afternoon he can’t read a stop sign or stuff on the work board. his eye doc said his vision was perfect, he was just burned out and needed to take a break, get some sleep. His eye muscles would fatigue easily. He listened and it has cleared up.

51

I’m pretty convinced my vision problems are related to my cortisol issues. When I’m really fatigued (low cortisol) my vision is worse. When I crash in the afternoons (cortisol issues) my vision is worse.

It’s still blurry but not nearly as bad as it has been, which seems to match my test results. Cortisol is still low, but not as bad as it was. Still waiting on the neurotransmitter testing to see if there’s anything interesting there. If not, I’ll try licorice root again. Also going to do a Nutreval at some point.

52

I had the same issues and, for me, they were absolutely related to low cortisol. After noon, my eyes would start getting sleepy and I would have to physically push them completely open. At night was the worst. I have glasses, but rarely needed to wear them. I found myself wearing them almost always when driving at night because lights would cause distortion in my vision. At one point i actually thought it might not be safe to drive. I began taking hydrocortisone tablets at 15/10/10/5 mgs throughout the day and haven’t felt it since. I tried the licorice root route as well. Didn’t make much difference for me.

53

[quote]Kaynon311 wrote:
I had the same issues and, for me, they were absolutely related to low cortisol. After noon, my eyes would start getting sleepy and I would have to physically push them completely open. At night was the worst. I have glasses, but rarely needed to wear them. I found myself wearing them almost always when driving at night because lights would cause distortion in my vision. At one point i actually thought it might not be safe to drive. I began taking hydrocortisone tablets at 15/10/10/5 mgs throughout the day and haven’t felt it since. I tried the licorice root route as well. Didn’t make much difference for me. [/quote]

Yep sounds familiar. The best way to describer the vision issues is distortions due to light. The light bleeds into the darker areas. Reading this site for example, the white text will bleed into the black background and become unreadable. When closing my eyes, my eyelids are still a blob of very bright light. It would always happen when I was feeling other symptoms of low cortisol.

I’ve been trying to figure out why I’m having cortisol issues. I really haven’t had much success. It seems the hardest to get to the bottom of. plenty of info out there on treating it, but not much getting to the root cause.

Enodcrine issues - treated and fairly stable. Still small tweaking.
Thyroid - Diagnosed with Hasis, but not that bad yet. Not treating.
Genetic Testing - Few clues. Vit B issues. Gaba issues.
Neurotransmitters - waiting on results
NutrEval - ordered this weekend
Sleep Study - on the list.
immunologist - on the list.

54

[quote]dhickey wrote:

[quote]Kaynon311 wrote:
I had the same issues and, for me, they were absolutely related to low cortisol. After noon, my eyes would start getting sleepy and I would have to physically push them completely open. At night was the worst. I have glasses, but rarely needed to wear them. I found myself wearing them almost always when driving at night because lights would cause distortion in my vision. At one point i actually thought it might not be safe to drive. I began taking hydrocortisone tablets at 15/10/10/5 mgs throughout the day and haven’t felt it since. I tried the licorice root route as well. Didn’t make much difference for me. [/quote]

Yep sounds familiar. The best way to describer the vision issues is distortions due to light. The light bleeds into the darker areas. Reading this site for example, the white text will bleed into the black background and become unreadable. When closing my eyes, my eyelids are still a blob of very bright light. It would always happen when I was feeling other symptoms of low cortisol.

I’ve been trying to figure out why I’m having cortisol issues. I really haven’t had much success. It seems the hardest to get to the bottom of. plenty of info out there on treating it, but not much getting to the root cause.

Enodcrine issues - treated and fairly stable. Still small tweaking.
Thyroid - Diagnosed with Hasis, but not that bad yet. Not treating.
Genetic Testing - Few clues. Vit B issues. Gaba issues.
Neurotransmitters - waiting on results
NutrEval - ordered this weekend
Sleep Study - on the list.
immunologist - on the list.[/quote]

D, did you ever figure this out? If the picture below your name is any indication of what you do for a living, that could be your root cause. Long deployments, time away from family, stressful combat situations. I don’t know if these apply to you, but that could be your root cause.

Adrenal fatigue, unlike TRT, was “plug-and-play” for me. Fix that, and your energy levels will be much better. Several things will be better.

55

[quote]Kaynon311 wrote:

[quote]dhickey wrote:

[quote]Kaynon311 wrote:
I had the same issues and, for me, they were absolutely related to low cortisol. After noon, my eyes would start getting sleepy and I would have to physically push them completely open. At night was the worst. I have glasses, but rarely needed to wear them. I found myself wearing them almost always when driving at night because lights would cause distortion in my vision. At one point i actually thought it might not be safe to drive. I began taking hydrocortisone tablets at 15/10/10/5 mgs throughout the day and haven’t felt it since. I tried the licorice root route as well. Didn’t make much difference for me. [/quote]

Yep sounds familiar. The best way to describer the vision issues is distortions due to light. The light bleeds into the darker areas. Reading this site for example, the white text will bleed into the black background and become unreadable. When closing my eyes, my eyelids are still a blob of very bright light. It would always happen when I was feeling other symptoms of low cortisol.

I’ve been trying to figure out why I’m having cortisol issues. I really haven’t had much success. It seems the hardest to get to the bottom of. plenty of info out there on treating it, but not much getting to the root cause.

Enodcrine issues - treated and fairly stable. Still small tweaking.
Thyroid - Diagnosed with Hasis, but not that bad yet. Not treating.
Genetic Testing - Few clues. Vit B issues. Gaba issues.
Neurotransmitters - waiting on results
NutrEval - ordered this weekend
Sleep Study - on the list.
immunologist - on the list.[/quote]

D, did you ever figure this out? If the picture below your name is any indication of what you do for a living, that could be your root cause. Long deployments, time away from family, stressful combat situations. I don’t know if these apply to you, but that could be your root cause.

Adrenal fatigue, unlike TRT, was “plug-and-play” for me. Fix that, and your energy levels will be much better. Several things will be better.
[/quote]

I am not in the military but stress is absolutely an issues I’ve dealt with in the past. I burnt the candle at both ends for many years and paid the price.

TRT has been relatively easy to tweak. It’s taken some time, but I’m at the point now where everything is pretty much in check. Adrenal insufficiency seems much more complicated unless I want to just go on HC. TRT has my functional gain, but I feel strongly that adrenal issues are the key to me feeling good.

Just started taking LicoricePlus supplement to see if that helps bring levels back up. Still waiting on neuro testing results to see if there are any clues there. Ordered a popular parasite cleanse to make sure that’s not the issues. I believe I have yeast issues, so ordered a popular cleanse for that. Getting ready to order NutrEval testing to see if I can uncover any clues there. Also looking at doing a sleep study.

56

More lab work.

T - 40mg EOD. Was 30mg EOD
HCG - 125IU EOD. Same.
Adex - .2mg ED. Same.
DHEA - none. Was 25mg ED
Pregnenolone - none. Was 100mg ED.
Progesterone - small dab at night. Same.

Total Test - 536 ng/dl (348-1197). Was 469
Free Test - 25.5 pg/ml (8.7-25.1). Was 19.5
DHEA-s - 367.3 ug/dl (88.9-427). Was 526
E2 - 11.6 pg/ml (7.6-42.6). Was 9.7
Progesterone - .7 ng/ml (.2-1.4). Was 1

E2 didn’t come up that much. Seems like the EOD schedule is working much better for me. I think I’m going to try dropping adex down. Maybe .3mg on T inj days. After I get E2 levels back up a bit, I should be pretty much done tweaking TRT. Maybe up HCG a little to get the boys a bit more full.

57

A lot of guys with good T levels report what you reported, losing their libido and erections when their E2 level gets too low. If you can dial in your T dose, and get feeling good on the minimum injection of T possible – You may not even need the AI at some point. Seems really tough for many guys to dial in.

Saw you are taking Cialis low dose, which has been great for me when T is high, but E2 gets a little screwed up. Can really help get you over the humps, and one study I read even said that low dose long-term use of Cialis can help reduce estrogen levels in men.

Good luck!

58

I’m knocking my ai dose down to .3mg EOD. I’ll retest in a couple weeks.
Not sure if ill ever be able to go without an ai. Estrogen dominance has been an issue for a very long time. I was on one even before being on T. Genetic testing confirmed mutations for estrogen metabolism. We’ll see.

Daily use of cialis is great. I also take arginine and citriline. Even if guys don’t think they need it, they should try it.

59

Updated BW

40mg T EOD - Same
125IU HCG EOD - Same
.3mg Adex EOD - was .2 ED
Transdermal Progesterone - Same
15mg Transdermal Preg - Was 100mg capsules.
Added 25mg Trazadone for sleep.
Added 300mg Buproprian

Total T - 643 ng/dl (348-1197) - Was 536
Free T - 29 pg/ml (8.7-25.1) - Was 25.5
DHEA-s - 393 ug/dl (89-427) - Was 367
E2 - 20.6 pg/ml (8-43) - Was 11.6
Progesterone - .9 ng/ml (.2-1.4) - Was .7

Cholesterol Total = 209 - Not too bad.
Triglycerides = 132 - should be less than 80
HDL = 42 - should be greater than 50
VLDL = 26 (5-40)
LDL = 141 - should be less than 80
Total Chol ratio = 5 - should be less than 3.4

I like this protocol. I’m feeling better than I have in a very long time. Still having energy issues, but not bad since starting the Buproprian and Trazadone. I’m sleeping at night and have adequate (not great) energy during the day. Increased DHEA and Progesterone might suggest my adrenals are picking up a bit. I’m going to order another cortisol test to see.

I still might try knocking T back down to 30mg EOD and bumping HCG back up to 250IU EOD, just to see what numbers look like.

Because of my cholesterol results, I also did a panel for Glucose, Insulin and Hemaglobin A1 to see how my insulin resistance is doing. Feel like it’s still an issue, but that could just be my adrenal issues. Also did a c-reactive protein test. This has been high for years. Also did a CoQ10 test. Still waiting on these results.

60

More results…

Glucose - 82 mg/dl (65-99)
Insulin - 9.3 uIU/mL (2.6-24.9)
Hemoglobin A1c - 5.7% (4.8-5.6)

CoQ10 - 1.18 ug/mL (.37-2.2)

Glucose is ok. Insulin is a bit higher than I’d like to see. LEF recommends less than 5. HA1c is also a bit high.

I ordered some CoQ10 to see if I can get levels up a bit.

Nothing earth shattering here, just wanted to see where I was at. Looks like insulin resistance is still a bit of an issue despite a decent diet, plenty of exercise and improved hormone levels.