Low Testosterone, low SHBG, low GH, high prolactin and high estradiol

Estrogosky

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Hi everybody,
I am writing here after having investigated into my libido, T problem for more than 2 years now and not having been able to fix the symptoms (endo says I am normal)
From what i have read you seem to be very knowledgeable about this issues and your opinion would be very important for me. It all started with me feeling very tired especially in the morning and realising i did not have any morning wood anymore.

Blood test first clarified I was suffering from Hashimoto hypothyroidism, I am on 75mcg of levothyroxine since 6 months now and feeling much less tired, but my libido problems are still there. I am in UK, 33yo, 168cm and 71 Kg, with 24% fat, trying to eat healthy and in normal amounts (avg 1800 calories per day) without excluding any basic nutrient (maybe low carb).Latest blood tests:
TSH 0,7 (taking levothyroxine)
FT3 3,91 pg/ml (2,7-5,7)
FT4 13,6 pg/ml (7-17)
Total T 300 ng/dl (170-800)
FSH 6,8 Mu/ml (1,8 – 17)
LH 2,8 Mu/ml (1,4 – 12,7)
SHBG 20,5 nmol/l (27-92)
Estradiol 53 pg/ml (<50)
Prolactin 12 ng/ml (2-13)
Cortisol 89 ng/ml (85-260)
ACTH 17 pg/ml (9-52)
DHEA-S 3173 ng/ml (350-4300)
IGF -1 154 ng/ml (90-492)
GH 0,04 ng/ml (0,05 – 5)
OH Vit D 26,3 ng/ml (30-100)

Prolactin has always come out at top of the range/slightly out of max limit so I have done a pituitary MRI. Everything is normal. Then I have checked prolactin curve at 15m intervals, stayed at 10 ng/ml over 1 hour, so i guess that is my “normal” level.
I have checked Insulin curve and the base was 5,3 McUI/ml, and raised to 16,7 after 90 minutes to fall back to 4,7 after 180 minutes, which was considered normal to exclude insulin resistance but i think i am used to a low carb diet and cannot exclude insulin resistance as the problem

I have checked glucose curve together with insulin and the base was 99 mg/dl, 84 mg/dl after 90 minutes and 69 mg/dl after 180m

Given low LH with low T I have done a GNRH test and pulse and amplitude of LH and FSH resulted normal and reacted normally to the injection.

My GH is also low...

I am followed by supposedly very good endocrinologist and their diagnosis is that my T is low but since shbg is low as well the Free T is enough to get the system going and since testicle normal size etc they do not suggest T replacement therapy.

Unfortunately i have the symptoms of low T.
I would not like to do T replacement myself because I am fertile and would like to stay so. Doctors just proposed me to get PDE5 but i have more a libido problem to solve first!

Never taken any illegal substance /AAs , max was creatine for maybe total 3 months in my life

Over multiple tests i have done in the last 2 years there are some constant results: T is always at 300, shbg is always at 20, prolactin always at 10>, cortisol normally high (this test is an exception i believe), DHEA-s always towards top end of range, GH always very very low, Vit D always around 25

In these two years i had small windows of well being and good libido and was waiting for the blood test to confirm that maybe my T had gone up, but was never the case. So i started to think that is not only T, but estradiol or other things which drives libido etc. Probably when i felt better wasn t for higher T, but rather for lower Estradiol.

3 years ago i was running very often and dieting (low carb) and reached a weight of 63 Kg, since then i have gained 8 Kg, most of it being fat.

The way i put on this weight is: stressful lifestyle, alcohol, eating out and especially a 3 months period at 3000 calories and weights lifting in May-June-July 2008. I had never done weight lifting before but in May 2008 i gave it a try and i went from 65 to 70Kg in just 2 months supplementing with only protein an creatine (and fat!).

After that i experienced a further deterioration of libido,my idea is that:
1) I wasn’t genetically gifted with high T, my body structure and fat % tells me that (never seen my abs)
2) I have stressed my system extremely over the last 3 years, both physically and at work (my working hours are very volatile and can go up to 100 hrs a week for as long as 2 -3 months in a row), driving up my cortisol up, also poor sleep lowered my GH
3) Hypothyroidism lowered my shbg, Free T raised (had period of incredible hair growth and libido in March 2008)
4) Total T had to decrease to keep Free T in check
5) The increase in weight + stress drove up estradiol and prolactin
6) I am now in a vicious circle where high estradiol and prolactin and low GH are keeping my T down and cannot lose weight/fat

Given this idea that i will discuss with the doctor as well, what do you think about my plan:
1) Try to lose weight (but is incredibly difficult to lose weight for me given my endo profile of low thyroid, low T! Do you have any advice?)
2) Ask doctors for some kind of aromatase inhibitor to keep estrogen down for a period so that i can lose weight (how long can i take them? It would help me to lose weight?)
3) Change my lifestyle/work? Apparently all my system is out of whack and maybe i need to rest

Thanks a lot!
 

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