25 year old bloke here, first time poster from the UK, having seen advice to come here from other forums I have posted in. Hoping someone is able to help out with some advice. I will try and summise my situation.
Christmas day last year I was drinking heavily and in a good natured play fight with friends which went wrong I ended up dislocating my shoulder. I went to A&E, they put it back in and I was sent home.
I woke up the next day with what I now know to be panic attacks. They were horrendous and having had no history of mental illness or psychological problems I thought I was losing my mind. I went back to work after the Christmas break, still battling the anxiety. I also began to get severe fatigue, RSI esque pain in my hands, dry gritty vision / sensitivity to light and difficulty reading as a result on monitors / televisions.
I was unable to cope with work and was signed off by my GP. She also persuaded me to take an SSRI, Citalopram for the anxiety. I was off work for 3 months and unable to do much of anything other than lie in bed in darkened rooms. I was told at the time I had ‘post-viral fatigue’ by my GP. I decided to discontinue the SSRI after 6 weeks as I believed it to be affecting my libido, which was causing problems with my relationship.
I successfully weaned off it and the anxiety did not return, the rest of my symptoms began to ease and I was soon back in work. The only symptom which remained was my lack of libido, which at the time I attributed to after effects of the SSRI.
Being an avid field hockey player I was desperate to regain my former high level of fitness and began exercising as I used to, at least an hour or two per day of intense running / heavy weight lifting. I had always managed with this in the past, but on top of it I decided, possibly now in my error, to start a pattern of calorie restricted dieting with intermittent fasting to lose the fat I had put on(I was drinking a lot of black coffee during the 'fast'). It was very successful in that regard and to be honest I felt better than I ever had done, other than the fact I still had no libido. This continued for a couple of months, but then July I asked my GP to check my testosterone levels and they were very low, (4.3 nmol/l )
She prescribed me Testogel and at the time, not knowing what I do now about primary / secondary hypogonadism, I took it gladly. My libido started to come back but to my horror so too did the panic attack / anxiety symptoms, so I discontinued the gel after 2 weeks and got my GP to refer me to an endocrinologist.
Soon after stopping the gel I began to crash badly and the same fatigue / visual symptoms returned. I am now having to work reduced hours and am completely unable to exercise or do any of my hobbies.
Since then I have I have had an MRI of my pituitary, an ultrasound of my testes, a GNRH stimulation test and numerous blood tests. These all came up normal and they were baffled as to why it was low.
I was also trialled on Clomiphene Citrate for 2 weeks to see if my testosterone levels would rise. They did rise to 18.3nmol/l but subjectively I felt no better at all. They have since fallen to the value in the below blood test.
It is this which has led me to believe my low testosterone may be secondary to adrenal dysfunction. My AM serum cortisol reading is low as you can see below and I have suggested this theory to my endocrinologist who I have persuaded to arrange an ACTH stimulation test which I will have this coming Monday, although he was fairly dismissive of my theory.
Would someone be able to explain to me what pathway the adrenal glands would affect the sex hormones on?
Can anyone suggest where do I go next if the NHS aren’t prepared to treat this or accept it as a condition? Self-treat with hydrocortisone at a physiological dose for a few months, can it be bought without prescription?
I am currently taking: Vitamin C, Vitamin B5, Vitamin D3, Omega 3s, Zinc, Magnesium, Celtic Salt
I have bought Nutri Adrenal Extra gladulars but am holding off trying it until after the ACTH stimulation test.
Blood test results below, please help if you can as I am getting increasingly desperate for answers or someone to take me seriously / not fob me off with CFS / Depression.
Total Testosterone 10.7nmol/l (8.5 - 29.0)
Prolactin 147 miu/l (0-350)
FSH 6.0 iu/L
LH 3.1 iu/L
Cortisol 267 nmol/l (140 - 700)
Sodium 142 nmol/l (133 - 146)
Potassium 3.9nmol/l (3.5 - 5.3)
Urea 6.7nmol/l (2.5 - 7.8)
Creatinine 95 umol/L (0-135)
Magnesium 0.87 nmol/L (0.7 - 1.0)
Free T3 5.0pmol/l (2.5 - 6.5)
Free T4 16.6 pmol/l (8.0 - 21.0)
TSH 1.44 mu/L (0.4 - 4.5)