Advice for HPTA restart/boost for non-steroid user

  1. New Member
    Mikemas's Avatar
    Stats
    6'3"  235 lbs.
    Join Date
    Dec 2012
    Posts
    7
    Rep Power
    26
    Level
    2
    Lv. Percent
    45.17%

    Question Advice for HPTA restart/boost for non-steroid user


    Hey guys,

    I have been looking at the site for a few months to get an idea of possibly what happened to me as well as any success stories for healing. To summarize, I am a 32 year old male, never used steroids, but ended up getting my HPTA and immune system destroyed by a prescription to Methylprednisolone (for some nerve pain) that I had a severe reaction to, including months of insomnia and RAPID weight loss. This happened at the end of September 2012, and, of course, every doctor said it was in my head until I got to an endo and they ran some real blood/urine tests. Here is a summary:

    November 8 2012 @ 8am:

    TSH: 0.94 (.3-5)
    FT4: 0.95 (.5-1.2)
    T3: 86 (80-200)
    Antibodies in normal range

    Testosterone: 148 ng/dL (300-1080)
    Bio Available T: 79 ng/dL (131-682)
    Free T: 26 pg/mL (47-244)
    LH: 0.6 mIU/mL
    FSH: 2.3 mIU/mL
    Prolactin: 3.3 ng/mL
    DHEA-S: 502 mcg/dL
    SHBG: 28 nmol/L (11-80)
    Cortisol: 11 mcg/dL
    ACTH: 28 pg/mL (7-51)
    Cortisol Free (urine): 35.3 ug/d (<61)

    At this point, besides my testosterone, which matched a random blood draw a couple weeks earlier at my PCP, everything was "within range" according to him but at "stress levels", so he wanted to run another check a few weeks later. He did not want to start me on Androgel yet as he warned me about the fertility issue.

    November 27, 2012 @ 8 am

    Testosterone: 304 ng/dL (300-1080)
    Bio Available T: 198 ng/dL (131-682)
    Free T: 73 pg/mL (47-244)
    LH: 1.1 mIU/mL
    FSH: 3.2 mIU/mL
    SHBG: 18 nmol/L (11-80)
    Cortisol Free (urine): 74.6 ug/d (<61)

    So he told me that since the T value "doubled" he was happy with the results. I told him that LH and FSH levels do not seem to be normal for my age and I still don't feel right. He said that these are normal stress level responses (hence the high cortisol) and I need to work on getting my stress down and come back in six months.

    I started doing acupuncture, exercises, etc. to reduce stress and started sleeping well again over the next month or so. However, I had significantly reduced libido, it seems my testes were getting smaller, my hair was falling out, and I had low sensitivity in my penis and scrotum. Obviously, this was causing me a bunch of stress anyway, and I knew that at 300 my T was pretty low. So about two weeks ago I finally found a good PCP who cares about my condition and will do pretty much any blood test, and a reproductive endo who knows male hormones and prescribes clomid and hCG, which luckily my insurance covers.

    So these are the results at 7:45am on January 9:

    TSH: 0.835 (.45-4.5)
    T4: 6.7 ug/dL (4.5-12)
    Free t4: 2.5 (1.2-4.9)
    T3 uptake: 37% (24-39)
    Reverse T3 21.5 ng/dL (9.2-24.1)
    Free t3: 2.8 pg/mL (2.0-4.4)
    Antibodies in normal range

    Testosterone: 382 ng/dL (348-1197)
    Free T (direct): 12.6 pg/mL (8.7-25.1)
    Estraidol: 12.2 pg/mL (7.6-42.6)
    LH: 3.1 mIU/mL (1.7-8.6)
    FSH: 3.0 mIU/mL (1.5-12.4)
    Prolactin: 7.2 ng/mL (4-15.2)
    DHEA Serum: 343 ng/dL (31-701)
    SHBG: 28 nmol/L (11-80)
    Cortisol: 21.6 mcg/dL (2.3-19.4)
    Vit D: 26.7 ng/mL (30-100)
    Ferritin: 104 ng/mL (30-400)
    DHT: 33 ng/dL (30-85)

    So, it seems my estrogen, test, LH, FSH, and DHT are still on the low side. I do have some options at my disposal. Do I continue to wait it out, or try a boost/restart? I was figuring that maybe I can use low dose (50mg or 25mg a day) and see how I feel, or should I try HCG first? Again, surprisingly my insurance is covering blood work, hCG and Clomid, but I don't want to cause more problems and want to be fairly conservative. I do want kids someday, and I do believe that my HPTA is suppressed but not dead. Any insight would be greatly appreciated. Sorry for the long post, but I wanted to add in as much detail as I could.

  2. New Member
    acidvoodoo's Avatar
    Stats
    6'0"  186 lbs.
    Join Date
    Jul 2012
    Posts
    66
    Rep Power
    44520
    Level
    12
    Lv. Percent
    26.23%
    Achievements Reputation Pro

    vitamin stands out as very low, start supplementing with a good quality product like NOW foods 10000iu vitamin D3, take with a vat containing meal. It should be more like 60ng/ml. IF there are days you can get out in the sun, then do that instead of the supplement that day. Retest in 2 months

    Hows the rest of your diet, are you sure you are getting and absorbing all the right nutrients to product hormones? Start taking 30mg of zinc citrate before bed also.

    your latest blood work is very similar to mine, its important to rule everything else out before trying a restart so you get the greatest benefit.

    As stress has caused this i'd for a 4 point saliva test for cortisol, to rule out adrenal fatigue
  3. Elite Member
    The Matrix's Avatar
    Join Date
    Mar 2008
    Posts
    5,033
    Rep Power
    7699
    Level
    48
    Lv. Percent
    34.52%
    Achievements Reputation ProPosting ProPosting Authority

    One needs to look.at the underlying pathology as well as detailed history of the case along with diet, supplements, lifestyle as well as possible past chemical.or environmental exposures. What was the TCM diagnosis? Blood work is just a tool. Majority of the treatment comes from.asking the proper questions getting down to.potential causes which takes time.patience and work to.evaluate and explore.
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
    •   
       

  4. New Member
    Mikemas's Avatar
    Stats
    6'3"  235 lbs.
    Join Date
    Dec 2012
    Posts
    7
    Rep Power
    26
    Level
    2
    Lv. Percent
    45.17%

    Yeah I forgot to mention the Vitamin D being low. I started taking 5000iu daily but I can bump that to 10000iu no problem. Being winter I dont get too much opportunity for sun exposure.

    Diet wise, I have started eating healthier, throw a ton of veggies and eggs into a Vitamix and I eat Mediterranean and sushi quite a bit. Being on the road alot, sometimes my options are limited but I also take a superfood supplement to make sure I don't miss any vitamins and minerals. In addition to that, I have also been taking fish oil, vitamin B complex, Vit C, and some other vitamins including chelated zinc. I will look into zinc citrate.

    I do think that stress is a huge part of it but that Medrol dose pack did something to exacerbate it (gave me some sort of anxiety disorder). I didnt sleep for nearly two months, even on high powered sleep meds, and even now I cannot stop stressing about health related things, like getting cancer from the pelvic CT scan I got in November, etc. Didn't have any medical issues before taking that medicine. I have had the urine and blood cortisol and it is always high. My endo said that adrenal fatigue is not what is concerned about, he is more worried about Cushings and still tells me to get my stress down. That is why I started acupuncture and counseling. I am sleeping well now, but I am starting to think about the chicken and the egg thing, i.e are my low T symptoms causing me stress, etc. That is why I was thinking about low dose Clomid for a month to get the T up while getting the stress down.
  5. Elite Member
    The Matrix's Avatar
    Join Date
    Mar 2008
    Posts
    5,033
    Rep Power
    7699
    Level
    48
    Lv. Percent
    34.52%
    Achievements Reputation ProPosting ProPosting Authority

    You need to identifying what is stressing you ....Easy for endo to say, but did he make an suggestions what to further evaluate? You need to stop over analyzing things. Way I look at every single case of if they where an autistic child focusing on identifying the neurological, biological, structural, environmental, lifestyle, psychological, nutritional, and genetic imbalances in the person. You have this huge onion and you just start pulling it back layer by layer which reveals hidden issues each layer at a time. Once these are all identified then you need to see how each one is connected with other. In the end of what seems to be some medical enigma, its basically common sense which is the answer but so highly over looked..
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
  6. New Member
    Mikemas's Avatar
    Stats
    6'3"  235 lbs.
    Join Date
    Dec 2012
    Posts
    7
    Rep Power
    26
    Level
    2
    Lv. Percent
    45.17%

    So I held off a bit on medications until I could dig a little deeper into this. I took a 24 hour Lupron (GnRH) stimulation test, and my LH and FSH shot through the roof, and my testosterone went from 300 to nearly 500 in 24 hours. Based on this, the endo thinks my hypothalmus is stuck in low gear (my pituitary obviously works) and is giving me the green light to move forward with Clomid and hCG. He thinks the hCG is important to stimulate the Leydig cells since I have had some atrophy and my sperm test showed very low motility / strong swimmers. However, he thinks this will probably reverse with the hCG. He is not sure, however, if the hypothalmus can be rebooted. Since my Cortisol and ACTH, as well as thyroid hormones, are back in fairly normal ranges, I am guessing this means my hypothalmus still technically works but is not releasing gonadotropins? One other thing, the hCG I have been prescribed is 10,000iu weekly, which seems really high. He is a fertility endo so that is where his background is, but he is all for backing up the dosage. Do you think 1,000iu twice a week and 25mg Clomid every day is a good place to start, then back off the hCG in about three weeks?
  7. Elite Member
    The Matrix's Avatar
    Join Date
    Mar 2008
    Posts
    5,033
    Rep Power
    7699
    Level
    48
    Lv. Percent
    34.52%
    Achievements Reputation ProPosting ProPosting Authority

    Quote Originally Posted by Mikemas View Post
    So I held off a bit on medications until I could dig a little deeper into this. I took a 24 hour Lupron (GnRH) stimulation test, and my LH and FSH shot through the roof, and my testosterone went from 300 to nearly 500 in 24 hours. Based on this, the endo thinks my hypothalmus is stuck in low gear (my pituitary obviously works) and is giving me the green light to move forward with Clomid and hCG. He thinks the hCG is important to stimulate the Leydig cells since I have had some atrophy and my sperm test showed very low motility / strong swimmers. However, he thinks this will probably reverse with the hCG. He is not sure, however, if the hypothalmus can be rebooted. Since my Cortisol and ACTH, as well as thyroid hormones, are back in fairly normal ranges, I am guessing this means my hypothalmus still technically works but is not releasing gonadotropins? One other thing, the hCG I have been prescribed is 10,000iu weekly, which seems really high. He is a fertility endo so that is where his background is, but he is all for backing up the dosage. Do you think 1,000iu twice a week and 25mg Clomid every day is a good place to start, then back off the hCG in about three weeks?
    Risking major estrogen issues.
    If you start crying at movies do complain I did not tell you so LOL
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
  8. New Member
    steam's Avatar
    Join Date
    Jan 2009
    Posts
    479
    Rep Power
    113277
    Level
    22
    Lv. Percent
    52.71%
    Achievements Reputation ProReputation Authority

    is increased estrogen the cause for men being emotional, crying in movies etc?
  9. New Member
    Mikemas's Avatar
    Stats
    6'3"  235 lbs.
    Join Date
    Dec 2012
    Posts
    7
    Rep Power
    26
    Level
    2
    Lv. Percent
    45.17%

    Well, I definitely do not want to risk estrogen issues, however based on my last lab results, my estrogen was almost out of range on the low end. I want to be careful with the HCG due to gyno possibilities, etc., so I'm not even sure I want to go that high of a dose (1000iu). Strangely enough, my endo regularly gives 10,000iu per week to men for fertility (he is a reproductive endo) over periods of three months and has not once had an issue with gyno. This is with no AI, he only prescribes HCG and Clomid to men. They did give me one dose of 1000iu when I was there after I mentioned that I was uncomfortable with 10,000iu, and to be honest I felt better than I have felt in four months that day. My libido came back out of nowhere. So to summarize my situation:

    >Started with nerve pain in the groin, given methylprednisolone dose pack and have not been the same since. Before this, maybe went to the doctor once a year and felt on top of the world.
    >Told I was suffering from "steroid psychosis" from the dose pack.
    >Cortisol always high - an endo tested me for Cushings but does not believe I have it. Thinks this is stress related. Does not believe in anything FDA off-label, therefore never prescribes something like Clomid to men.
    >Test levels in the 100's since and no LH until recently - test levels around 300 (on average) and LH between 1 and 3.
    >FSH consistently around 3.
    >Had insomnia but now sleeping pretty well.
    >Besides low T symptoms, do not really have any other overwhelming feeling of stress (getting over the CT scan worry lol), and latest cortisol, ACTH test in range, but Test still slightly below 300
    >Testicular atrophy noted by urologist. Pelvic CT shows no other abnormalities.
    >original nerve pain possibly related to bulging disk - have been getting physical therapy, traction, acupuncture with some success.

    Therefore, I am trying to be patient with the situation, but feel like I am missing an opportunity to address my low T without TRT. Not only that, the fertility endo I am seeing definitely believes that my sperm analysis and hormone levels warrant HCG/Clomid treatment even if I am not currently trying to have kids. I really do not want to do anything rash and really do appreciate your replies to my situation. Do you feel that I should NOT be doing any treatment even though I have shrinking testicles, low energy/libido, etc? I have identified this as my point of stress. When you are my age with sudden ED, small testes, and low sensitivity, my main priority would be to address this so I don't stay so stressed about it. If there is a better protocol for HCG, Clomid, or something else in regards to this situation, I would be definitely interested in that as well.
  10. New Member
    daveness's Avatar
    Stats
    6'2"  214 lbs.
    Join Date
    Mar 2013
    Posts
    2
    Rep Power
    21
    Level
    1
    Lv. Percent
    31%

    Your case is amazingly similar to mine. I was as healthy as a horse, until a 3/4 month treatment of doxycycline for rosacea that seemed to knock my HPTA out of whack a few months ago. I had a "crash" period where my numbers plummeted a couple of months ago. My T was similar to your first reading. I am on a 1 month Clomid protocol (50mg EOD) and am on the 3rd week of that. The reproductive urologist I'm seeing has also given me the option of HCG which I'm still considering. Like you, I wanted to preserve fertility. Amazingly, after 2 different semen analyses, my numbers were a lot higher than expected (1st-62 million/FSH 6, 2nd-21 million). That might be due to the fact that the sperm was produced 75 days earlier (ie. the amount of time it take for spermatogenisis). You definitely ought to pursue one of these 2 treatments (Clomid or HCG), as you will accomplish both tasks: boosting T & preserving fertility.
  11. Elite Member
    The Matrix's Avatar
    Join Date
    Mar 2008
    Posts
    5,033
    Rep Power
    7699
    Level
    48
    Lv. Percent
    34.52%
    Achievements Reputation ProPosting ProPosting Authority

    Quote Originally Posted by daveness View Post
    Your case is amazingly similar to mine. I was as healthy as a horse, until a 3/4 month treatment of doxycycline for rosacea that seemed to knock my HPTA out of whack a few months ago. I had a "crash" period where my numbers plummeted a couple of months ago. My T was similar to your first reading. I am on a 1 month Clomid protocol (50mg EOD) and am on the 3rd week of that. The reproductive urologist I'm seeing has also given me the option of HCG which I'm still considering. Like you, I wanted to preserve fertility. Amazingly, after 2 different semen analyses, my numbers were a lot higher than expected (1st-62 million/FSH 6, 2nd-21 million). That might be due to the fact that the sperm was produced 75 days earlier (ie. the amount of time it take for spermatogenisis). You definitely ought to pursue one of these 2 treatments (Clomid or HCG), as you will accomplish both tasks: boosting T & preserving fertility.
    Suggestion work on your Gi tract problem will eventually resolve it self. Probably induced a state of dysbiosis and malabsorption from the antibiotics. I see this on a daily basis from the lyme patients from Dr's I work with. There are several nutrients required for proper sperm production and motility. You may have been low then this was just the icing on the cake.
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
  12. New Member
    nomadicone's Avatar
    Stats
    5'8"  215 lbs.
    Join Date
    Dec 2012
    Posts
    10
    Rep Power
    28
    Level
    2
    Lv. Percent
    68.5%

    Quote Originally Posted by The Matrix View Post
    Risking major estrogen issues.
    If you start crying at movies do complain I did not tell you so LOL
    So why not just take an AI alongside the HCG/Clomid?
    not a doctor. talking out of my ass.
  13. Elite Member
    The Matrix's Avatar
    Join Date
    Mar 2008
    Posts
    5,033
    Rep Power
    7699
    Level
    48
    Lv. Percent
    34.52%
    Achievements Reputation ProPosting ProPosting Authority

    Quote Originally Posted by nomadicone View Post
    So why not just take an AI alongside the HCG/Clomid?
    To many variables, and one needs to see what else is out of balance. Its all about going over detailed case history, and family history. One can do that, but would you be masking other things? I see this all to often. Take a drug to counter side effect of another. The approach I like to educate people with less variables better the out come, less chance of covering something else up. You need to look at things from a birds eye view, not with tunnel vision as many medical professionals commonly do.
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
  14. New Member
    Mikemas's Avatar
    Stats
    6'3"  235 lbs.
    Join Date
    Dec 2012
    Posts
    7
    Rep Power
    26
    Level
    2
    Lv. Percent
    45.17%

    Thanks for replying with your story as well - I feel like I am not alone in this sudden loss of HPTA stability. I did try some HCG and Clomid and that seems to start to get me on the right track, although I did deal with some estrogen issues as Matrix pointed out. I am now meeting with an HRT specialist in Nashville who is getting some more bloodwork done now that I am a month off of HCG/clomid/tamoxifen so we can determine a good course of action. He mentioned his preference for tamoxifen and it sounds like that is the direction we will probably go first. I will keep you posted and update my numbers after what I took a month ago: two weeks of low dose HCG, and about a month of clomid/tamox.
  15. Elite Member
    The Matrix's Avatar
    Join Date
    Mar 2008
    Posts
    5,033
    Rep Power
    7699
    Level
    48
    Lv. Percent
    34.52%
    Achievements Reputation ProPosting ProPosting Authority

    Your trying to build a mansion on crappy foundation its going to collapse. To.get.proper response you.need.isolate hidden variables. One time a guy I ffound to have heavy.metals, another one food intolerance, nutritional deficiency, malabsorption of.fats due to.thickening.of.bile.flow. These are just the.tip.of ice berg why people fall at restart. I.have not.even touched.on.neurotransmitters.h uge over.looked. Gives you the idea of the complexity.involved in prepping a person.for a restart.
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
  16. New Member
    daveness's Avatar
    Stats
    6'2"  214 lbs.
    Join Date
    Mar 2013
    Posts
    2
    Rep Power
    21
    Level
    1
    Lv. Percent
    31%

    Quote Originally Posted by The Matrix View Post
    Suggestion work on your Gi tract problem will eventually resolve it self. Probably induced a state of dysbiosis and malabsorption from the antibiotics. I see this on a daily basis from the lyme patients from Dr's I work with. There are several nutrients required for proper sperm production and motility. You may have been low then this was just the icing on the cake.
    Can I run something by you? I need to add some information first. I was taking Cholestoff brand (plant sterols) and fish oil. Those 2 supplements and the antibiotics were all that I was taking. I'm pretty certain after further investigation that the antibiotics downregulated the P450 enzyme in the liver (that is responsible for excreting estrogen) combined with the fact that the plant sterols have an estrogenizing effect. (Foolishly, I didn't know the details about how Cholestoff worked.) I believe my HPT axis is reset with higher Estradiol and a feedback loop that has downregulated T production. Wouldn't an estrogen blocker, be it a pharmaceutical like Arimidex or a natural means (such as zinc, etc.) perhaps bring Estradiol down and re-regulate T production? I am going to see a new doc (the famous one in PA). I didn't walk into this situation with a defective axis. I am hoping there is some way to reset the "thermostat" of the negative feedback loop. Thoughts?
  

  
 

Similar Forum Threads

  1. Non Steroid for TRT
    By RichTan in forum Male Anti-Aging Medicine
    Replies: 16
    Last Post: 02-28-2011, 02:27 PM
  2. Replies: 12
    Last Post: 11-29-2007, 09:58 AM
  3. Replies: 7
    Last Post: 09-25-2006, 09:19 AM
  4. Anti-Estogens for non-androgen users.
    By OmarJackson in forum Supplements
    Replies: 6
    Last Post: 09-02-2004, 06:01 PM
  5. Former steroid user ask for info
    By bigbeef in forum Cycle Info
    Replies: 6
    Last Post: 01-27-2003, 04:54 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Log in
Log in