[quote]DOUBLEDD wrote:
would this still apply if hypothyroidism (hashimotos) has being treated and thyroid levels are within range
[/quote]
I have wondered about that and not seen any reports either way. Hypothyroidism can cause a number of troublesome skin conditions, varying widely perhaps from individual response. These changes are probably behind transdermal resistance. If thyroid meds resolve other skin conditions, then it would make sense if transdermal resistance cleared up.
Well the appointment was a giant waste of time. Doc was an hour late, of course. He spent most of his time measuring my height and wingspan to make sure I wasn’t still growing. Then we talked about the labs. Bottom line is I have another lab order for total t, free t, LH, and fsh to draw in 3 months to see if things sort themselves out. Great.
Have you asked compounding pharmacists for referals?
There’s a compounding pharmacy down the street from me that I asked a few months ago and they gave me a few names…one was an anti-aging doctor that does not take insurance. The other was an endocrinologist…who apparently will not treat my low T at this moment based on yesterday’s appointment. I might go back to my original GP who gave me 5g testim ,show him the new labs, and try to get him in line with shots, hcg, etc. If that doesn’t work, I might just have to give up for now! Being 22, I only have so many resources at my disposal.
I would like to direct everyone to this (somewhat older thread):
In the thread, Bill Roberts gives an interesting take on total testosterone, Bio-available testosterone, SHBG, and free testosterone. I have always been under the assumption that SHBG eats free testosterone. In the above thread, it appears that SHBG merely determines the Total testosterone reading, and that free testosterone is largely a function of HPTA output rather than an interaction between SHBG and the Testosterone produced by the HPTA.
In the past few days, I’ve really been trying to come up with a clinical (self) diagnosis for myself. Looking at the HPTA from Bill Roberts’ view it appears that I would be primary hypogonadism. I have decent LH values but my free T is low. What do you guys think of Bill Roberts’ view on free T being the real indicator of HPTA output? Is looking at total testosterone a waste of time in virtually all cases (not just mine)?
In case anybody is still following this thread, I have updates.
I had another round of bloodwork done a month ago and my TT came in at 283, 3 points from out of range low. Bioavailable testsoterone was 98 with a ref of [110-550]. Clearly my problem is secondary hypogonadism
I finally made the missing connection here. That initial TT of 590 that I had was at 1pm, so my natural testosterone is probably closer to 700 or so at 8am. The second blood that I had drawn, this time at 8am, was only 345, about half of my natural production.
The only thing that changed between the 590 and the 345 was a lot of tribulus terrestris intake. I think the tribulus shut me down. Many people claim that tribulus is benign, but for me and the brand that I used, it was not.
I will be doing a course of clomid to try to restart my HPTA. If that doesn’t work, well, we know where to go from there.
The TT/HPTA thing is a bit more complex than that. TT is around 1/2 SHBG bound T [SHBG-T]. SHBG-T is not functional and represents garbage trucks that need to go to the liver and get dumped. SHBG does not transport T to T receptors. SHBG can transport and release estrogens, but not T. The notion that SHBG transports T to where is can be used is simply wrong, but often repeated.
Some docs do not test TT during ongoing TRT treatment, only FT and E2.
Lowering E can lower TT while increasing FT. Effects of things like tribulus need to be in a broader context.
Yes, once again I understand that TT alone is a lousy indicator of testosterone status. We have established this a gazillion times. That’s why I had my BAT (Bioavailable T) checked, and it was out of range low, not even 1/5 of the upper range.
If you can propose a mechanism explaining how tribulus terrestris could shut me down for months, I will be more impressed. I was relatively fine before tribulus. I now understand what true hypogonadism feels like, and it’s hell on earth.
Hey there,
I just wanted to throw my 2 cents in as well. Yesterday I had an appt with Endo and brought my 2 tests (which were taken 3 weeks apart) 1st set of labs said that my T was at like 323. KSMAN told me it was low and I could be estrogen dominant. 3 weeks later I get more labs but this time is says my T was 428.
100 point jump threw me off so I asked the endo and he asked if I was taking anything. I listed some vitamins and then said that I was also taking Tribulus and he said “there you go. That explains it.” I asked him about it and he said that it causes a shut down and some people and on the labs will make normal T show up lower because it tricks the body into thinking its producing T.
Never knew that or never heard of it. Just wanted to say that this endo said the same thing. Even though its an herb he said it still can shut down natural T production. I will see how this goes with him because he also said some other weird stuff.
I hope this helps
The issue is that you will get FLAMED on T-Nation if you suggest that Tribulus is anything but gold. In retrospect, it was a dangerous supplement FOR ME.
I felt incredibly good for the several weeks or so that I took it. Very aggressive, confrontational, shaved my head, felt very horny (in a weird way IMO), very into lifting weights and running around to listening to heavy metal. Sounds like how some people feel on a cycle of steroids.
But then I became very depressed, moody, and brain-fogged. Started having some anxiety problems and just felt plain weird. That was probably the estrogen that had formed and might have contributed to my shutdown. I think I have a VERY sensitive HPTA.
I have actually consulted the opinion of a doctor who is extremely knowledgeable regarding the HPTA. It is actually his specialty, and he is probably one of the best in the world. He has observed several cases of T production shutdown from tribulus. He specifically recommends not using tribulus, especially if you are trying to recover testosterone production. This particular doctor is actually a former bodybuilder and is familiar with LOTS of supplements and lots of steroid (and PCT) compounds and their effects on testosterone production.
So there ya go.
Crazy info and thanks for it. I do agree though. This was my second time taking it and nothing came of it but clear blood work problems. I didnt have all that sweet stuff happen to me but I did notice more mood swings. I believe Iam in the same boat as you (whos steering this thing anyways??) and could be one of those unlucky SOBs who is just sensitive to these kinds of things. Where is your doc located and or how could I speak to him? Im also post car accident, brain trauma, and think that may be causing some of my problems too, as was also suggested by KSman.
Thank you sir
Thyroid is looking fine.
TSH: 1.97 [.4-4.5 mIU/L]
Free t4: 1.3 [0.8 - 1.8]
Free t3: 333 [ 230-420]
T3 total: 101 [76-181]
Reverse T3: 31 [11-32]
TBG: 20.3 [12.7 - 25.1]
Thyroglobulin antibodies: <20
Thyroid peroxidase antibodies: <10
Testosterone not so good:
FSH: 4.1 [1.6-8.0]
LH: 3.0 [1.5-9.3]
progesterone: 1.1 [<1.4}
Dihydrotestosterone: 27 [25-75 ng/dL]
Testosterone, total: 283 [250-1100 ng/dL]
Free Testosterone; 46.3 [46.0 - 224 pg/mL]
Bioavailable testosterone: 99.3 L [110 - 575]
SHBG: 23 [7-49 nmol/L]
Albumin: 4.7 [ 3.6 -5.1 g/dL]
I took 4 doses of clomid and then my hands and feet started to get numb, so that is not an option anymore. It did make my nuts get nice and full and gave me nighttime and morning wood, so that was nice.
So now that I have reached the one year mark since I hit truly hypogonadal status and an HPTA restart looks unlikely, should I just get on TRT? I feel like shit and am at my wits end. My only hesitation is the fact that I am 22 years old (23 in a few months).
That appears to be your only option. You could try hCG only. Your clomid attempt did seem to indicate an increase in T, seeming to confirm the suspicion that the problem is with the pituitary gland.
Did you ever start taking DHEA?
What is the standard dosing protocol for hcg only? My current E2 is 23. So with HCG it’s likely that it will shoot up, and shoot up more than T injections. DHEA was midrange on this last test (no supplementation) and 8am cortisol was just at the top of the range, so I think my adrenal glands are doing OK now.
My only other option besides TRT is a tamoxifen restart, but I am weary of the fact that it is unstudied in men and rather carcinogenic.
carcinogenic?
In any case, a SERM is used short term. Clomid can have significant side effects. Nolvadex less so.
250iu hCG EOD is close to a replacement dose for LH. As such, one would not expect intratesticular E2 production to vary much from normal men. E2 levels are also a result of liver function and alcohol or other drugs that load up the P450 enzyme pathways that also clear estrogens. You cab always use some anastrozole to manage E and an optimal level will make what T you do make more effective.
Read this. It is very clear, but you might find the style of writing difficult at first.
Yes I believe that tamoxifen has been linked to cancer, but maybe that is with longterm use. Even if I can get my HPTA back to where it was, I probably had suboptimal levels of T to start with. I never had morning wood, started having ED, energy issues, etc. I was decently strong but nothing to brag about (200 bench, etc.), especially on this site lol.
I’m working with one doctor that’s pushing tamoxifen and maybe hcg monotherapy. I’m going to try and persuade him to do t-shots with small amounts of HCG here and there.
My GP, on the other hand,is looking into antidepressants, even after seeing my latest labs.
You would not do tamoxifen and hCG together. Say no to the AD meds, most are going a step in the wrong direction. But you could try 2.5mg EOD deprenyl/seleginine and trazodone for sleep if that is an issue. These do not have negative effects. Tell doc that you need to get your hormones right, then depression can be looked at if not resolved by the hormone changes.
Tamoxifen and HCG together would be an HPTA restart protocol. HCG would be used to definitively get the balls working again (only used for 1 week or so). Tamoxifen is used to regain the pulsatile firing of the hypothalamus. My problem is most likely at the hypothalamus, not the the pituitary. Clomid would most likely be used in this protocol as well, but I cannot tolerate that drug due to parasthesias.
Ever try 5 to 10 grams of Androgel. All I ever used except a two 1-month stints on HALF A TAB of clomid.
5 to 10 g of Androgel keeps me at 700 to 1000 and feeling like a million bucks - no other drugs required.
Half a tab of clomid tripled my T - 240 to 790 in ONE fucking month!
[quote]Bricknyce wrote:
Ever try 5 to 10 grams of Androgel. All I ever used except a two 1-month stints on HALF A TAB of clomid.
5 to 10 g of Androgel keeps me at 700 to 1000 and feeling like a million bucks - no other drugs required.
Half a tab of clomid tripled my T - 240 to 790 in ONE fucking month![/quote]
Yea I did the half tabs of clomid. It definitely works. But it gave me numb hands and feet within 4 doses so I had to stop. With results like that, I’m surprised your doctor didn’t keep you on the clomid for a while longer. Longer stints of clomid can reverse secondary hypogonadism. But it sounds like your TRT is working great so I wouldn’t worry about it. What were your symptoms before TRT?
I have been prescribed a one month trial of HCG monotherapy. 250 iu every day. If that doesn’t work then I will explore shots, gels, etc.