Kjellfh`s Journal/wailing wall - Another Low T thread

Kjellfh

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Hi everyone.

26 year old male,
height: 170cm / 5,5 ft,
weight: 67kg / 147.5 lbs.

Problems with low testosterone for nearly 3 years. I have tried to avoid making a thread like this and just let the doctor/endocrinologist do his job, but in desperation and failure to get to any solution I am now asking you guys for some advice. I don`t care so much about the numbers, I just want my life back and feel normal again. Sorry for the long posts, but you can just skip the history if it is not relevant. More history/earlier tests are in the second post. I have tried to gather as much information as possible that can be relevant. Let me know if there is anything missing.

I think bad sleep combined with overtraining and negative stress over a longer period maybe started some of this, but don't know for sure. When I had the lowest numbers, I practiced a fairly high amount of cardio and a little resistance training. Had been doing this for quite some time.

I have quit all mid-high exercise long time ago and are a more mentally robust person at this time. Diet is varied and good with no calorie counting/restriction. Stopped eating gluten and casein for half a year ago. Are doing some light exercise(walking/swimming) and get a fair amount of light physical activity in my job.
I am much out in the sun as possible in the summer and in the winter I am taking solarium once a month or more.

Background info:
No problems with puberty.
Never used steroids or similar substances.
Done MRI with contrast, pituitary was ok.
Done lumbar puncture/spinal tap, all fine except a little high in inflammatory cells.
Checked for borrelia.
Checked for sleep apnea.
Liver tests have been ok all the way.
No other disease I know of that could be related.
Full lipid panel taken mid august 2013 was fine, little low in omega 3 despite supplementation/eating fish.
Done LgG urine/and blood test, this showed intolerance to casein and some to gluten, I eat no dairy or grains.
Done a gene test at 23andme.com, results uploaded to google drive. Can also be found down in this thread.

Diet:
Varied. No calorie restriction, lots of healthy fats(olive, coconut, macadamia, avocado, ghee), all kinds of vegetables, low/med. glycemic carbs, meat ,fish, eggs and some nuts/berries and fruits. No/very little refined/processed foods. Stopped gluten and casein for half a year ago. Keep myself away from phyto and xeno-estrogens.

07.01.2014, latest test:
HEMOGLOBIN 13.7 (13.4-17.0) g/dL
PSA 0.29 (0.00-2.5) ug/L
ESTRADIOL <0.05 (0.00-0.16) nmol/L
TESTOSTERONE 11.6 (9.0-35.0) nmol/L
SHBG 40 (15-85) nmol/L
FSH 9.6 (1.0-12.0) IE/L
LH 3.1 (1.0-10.0) IE/L
PROLACTIN 159 (100-500) mlE/L

Current status:
Tried transdermal T (Tostran) and Injections(Nebido) with little effect. Finished tapering off clomid for a little under three months ago, feeling the same or worse now than I did before I went on TRT. Has some good days once in a while where better mood and feelings of well-being/energy are present, but libido is still very low. These days are typically after a better nights sleep. The following days after a good one tends to be very bad, then slowly get a little better and then back to ****t again. Almost like a pattern that I cant control. These occasional good days are the only things that have made me capable of keep things going.

Tried all kinds of sleep meds, OTC and prescription(antihistamines, melatonin, herbals and so on).
Had tiny effect from Zopiclone and Zolpidem(got approx. 4-5 hours continuous sleep) but this caused horrible daytime anxiety/panic attacks so I quit them all for about a year ago. I believe my bad sleep nowadays is due low T.

I have not posted all the blood tests that have been done, but those I think are relevant. Let me know if I shall dig up other tests.
My general doctor thinks that there is nothing somatic wrong with me other than low T.

So what should I do, and how long should I keep on trying to get my natural production/feelings back, before I give up?
Should I check for any other underlying cause?
Go back and try Nebido again over a longer period?
HCG?
Supplements? Have tried Omega 3s, B-vitamins/multiminerals, high dose Vit D, Vit C, Boron, Rhodiola and many other natural supplements with no effect.

Current symptoms/observations:
- Really bad sleep (waking up many times, waking up early and cannot get back to sleep, waking up feeling unrested/like garbage).
- Night sweats (followed me from the start, had some better periods sometimes).
- Hot flashes/feeling warm now and then during daytime.
- More body fat(especially abdominal) and minor gyno development.
- Very low libido (been with me from the start, got better when on TRT).
- Poor concentration.
- Rollercoaster mood(one day fine, next day total crap, usually coupled with the kind of sleep).
- No/very little motivation/energy (most days).
- Anxiety, come and go with no obvious reason.
- Very sore and stiff after exercise/physical activity.
- Weight before bedtime is typically 1.5-3.0 kgs (3.3-6.6 lbs) heavier than in the morning.
- Higher resting pulse than before(was between 50-60, now 60-80),
- Cannot tolerate caffeine or other stimulants(chocolate/theobromine,tobacco/nicotine, alcohol) anymore,I get headache, high pulse and BP, sometimes anxiety and generally feel bad.
- Rarely feel satiation after meals, sometimes I can eat what seems to be endlessly (this have been with me from the start).
- Had a trial with high dose phosphatidylserine and I felt really good for a couple of days, however this effect disappeared and I haven't had the same success with it later(tried both low and high doses at different times a day with no effect)..
- Nasal congestion at bedtime (lately).
- Inconsistent and rare stool frequency.
- Headaches.
- I am very rarely "real" sick (fewer, runny nose, coughing, nausea or stomach aches). Gets the flu maybe once a year.
- Melatonin worked for sleep to begin with, now I get paradoxical reaction(more awake) or no effect at all.

I have an appointment with my endo on June 30 this month to start with Nebido injections again if I fail to find another solution.

Any help/tips would be much appreciated.
 

Kjellfh

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Some history and tests done earlier:
05.10.2012, went to the doc because of issues with sleep, headaches and libido that had disappeared completely. My doc ran a number of tests and said all came back fine except for little low testosterone.

05.10.2012, first blood test:
CRP - <1.0 (0.00-5.0) mg/L
HGB - 13.2 (13.4-17.0) g/dL
TSH - 1.9 (0.30-4.2) mlE/L
FT4 - 11.5 (11.0-22.0) pmol/L
TESTOSTERONE - 4.7 (9-35) nmol/L
PROLACTIN - 134 (100-400) mlE/L

05.25.2012, was instructed to take another test:
Estradiol - <0.05 (0.00-0.16) nmol/L
TEST - 2.1 (9.0-35.0) nmol/L
SHBG - 69 (15-85) nmol/L
FSH - 6.8 (1.0-12.0) IE/L
LH - 2.6 (1.0-10.0) IE/L
PROLACTIN - 271 (100-400) mlE/L

06.19.2012, another test done(dont know if this is relevant):
HGB - 12 .8 (13.4-17.0) g/dL
FERRITIN - 34 (30-400) µg/L
B12C - 338 (150-700) pmol/L
CRP - 17 (0.00-5.0) mg/L
CORTISOL - 461 (220 - 850) nmol/L

09.11.2012, after long time waiting I was finally to see an endo. He could not explain why my T was low.
He said that steroid use could be the reason. I told him I had never used it. I was then sent to take more tests:

TESTOSTERONE- 4.0 (9.0-35.0) nmol/L
ESTRADIOL <0.05 (0.00-0.16) nmol/L
CORTISOL 536 (220 - 850) nmol/L
FT3 3.7 (3.1-6.8) pmol/L
FT4 12.2 (11.0-22) pmol/L
TSH 1.1 (0.30-4.2) mlE/L
GLUCOSE 5.3 (4.0-6.3) mmol/L
HbA1C 4.9 (4.0-6.0) %
SHBG 45 (15-85) nmol/L
FSH 7.8 (1.0-12.0) IE/L
LH 1.0 (1.0-10.0) IE/L
PROLACTIN 155 (100-400) mlE/L
17-hydroxy progesteron Normal(?)
IGF-1 41 nmol/L.

11.02.2012, endo told me to take more tests:
ACE Normal(?)
FSH 9.8 (1.0-12.0) IE/L
LH 2.6 (1.0-10.0) IE/L
TEST 10 (9.0-35.0) nmol/L
SHBG 52 (15-85) nmol/L

Endo then set me on T-Gel(Tostran 2%) in late November 2012. He instructed me to apply the gel on my chest and stomach. Was on it for about 4 months(50mg ED), after a while I got a little better sleep and some libido from time to time but nowhere near how it was before this started. Also developed some gyno. My endo said I should continue on this regime the rest of my life and that that my problems had to come from psychological reasons. He could not explain gyno though, once again he told me that steroid use would have explained it all.

02.04.2013, blood test taken after about 2 months on gel:
TESTOSTERONE - 12.3 (9.0-35.0) nmol/L
SHBG 38 (15-85) nmol/L
FSH 1.9 (1.0-12.0) IE/L
LH <0.5 (1.0-10.0) IE/L
HGB 14.4 (13.4-17.0) g/dL
PSA 0.3 (0.00-2.5) ug/L

02.22.2013, blood test taken after almost 3 months on gel:
TESTOSTERONE - 14.4 (9.0-35.0) nmol/L
SHBG 29 (15-85) nmol/L
ESTRADIOL 0.11 nmol/L
HCG <2 IE/L <3 IE/L
FSH <0.5 (1.0-12.0) IE/L
LH <0.5 (1.0-10.0) IE/L
17-hydroxy progesteron 2.7
FT4 11.8 (11.0-22) pmol/L
TSH 1.7 (0.30-4.2) mlE/L

Went to another endo early in April who set me on Nebido injections(Testosterone undecanoate 250mg) 8 weeks apart. I had a couple of weeks where I actually felt very good after the first injection. This feeling disappeared and I then experienced a rollercoaster trip downwards. The second injection I didn't feel at all. I can remember waking up having some nocturnal wood a couple of times but that was all. Had a trial of low dose Arimidex mid/late in second injection. Didn't notice anything other than losing some weight(maybe water?).

04.30.2013, blood testtaken about 3 weeks after first injection:
TESTOSTERONE 26.4 (9.0-35.0) nmol/L
SHBG 57 (15-85) nmol/L
ESTRADIOL 0.06 (0.00-0.16) nmol/L
FSH <0.5 (1.0-12.0) IE/L
LH <0.5 (1.0-10.0) IE/L

06.03.2013, blood tests taken about 8 weeks after first injection:
TESTOSTERONE 12.3 (9.0-35.0) nmol/L
SHBG 36 (15-85) nmol/L
FSH <0.5 (1.0-12.0) IE/L
LH <0.5 (1.0-10.0) IE/L
PROLACTIN 99 (100-400) mlE/L

06.05.2013, took the second shot of Nebido.

07.29.2013, blood test taken about 7 weeks after the second shot:
TESTOSTERONE 15.1 (9.0-35.0) nmol/L
SHBG 41 (15-85) nmol/L
TSH 1.4 (0.30-4.2) mlE/L
FSH <0.5 (1.0-12.0) IE/L
LH <0.5 (1.0-10.0) IE/L
FERRITIN 175 (30-400) µg/L

07.31.2013, Started with Clomid 50mg ED(about 8 weeks after the second Nebido injection). Got the vision sides after awhile, cut down dosage to 25mg ED. At the time I started Clomid, my balls had shrunk pretty much, after the use of clomid they have seem to regain some(if not all) of their size. Did not feel any better while on clomid, like before I started, maybe even worse. Gyno also got worse at the end.

08.19.2013, first blood test 20 days after starting with clomid 50mg ED:
TESTOSTERONE - 15.2 (9.0-35.0) nmol/L
SHBG - 42 (15-85) nmol/L
ESTRADIOL - <0.05 (0.00-0.16) nmol/L
FSH - <0.5 (1.0-12.0) IE/L
LH - <0.5 (1.0-10.0) IE/L
TSH - 2.3 (0.30-4.2) mlE/L
FT4 - 11.5 (11.0-22) pmol/L
PROLACTIN - 159 (100-400) mlE/L
GLUCOSE - 5.3 (4.0-6.3) mmol/L
HbA1C - 5.0 (4.0-6.0) %
PSA - 0.43 (0.00-2.5) ug/L
HGB - 15 (13.4-17.0) g/dL

12.16.2013, on clomid 25mg ED since November:
TESTOSTERONE - 12.6 (9.0-35.0) nmol/L
SHBG - 49 (15-85) nmol/L
ESTRADIOL- <0.05 (0.00-0.16) nmol/L
FSH - 6.8 (1.0-12.0) IE/L
LH - 1.9 (1.0-10.0) IE/L
TSH - 1.2 (0.30-4.2) mlE/L
FT4 - 11.2 (11.0-22) pmol/L
GLUCOSE - 4.9 (4.0-6.3) mmol/L
HbA1C - 4.7 (4.0-6.0) %
CRP - <1.0 (0.00-5.0) mg/L
PSA - 0,32 (0.00-2.5) ug/L
HGB - 13.3 (13.4-17.0) g/dL
 

Kjellfh

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01.03.2014, my new general doctor ran many tests, here are some of them:
TESTOSTERONE - 10.0 (9.0-35.0) nmol/L
SHBG - 46 (15-85) nmol/L
TSH - 2.4 (0.30-4.2) mlE/L
FT4 - 12.8 (11.0-22) pmol/L
ALBUMIN - 52 (36-48)
FOLATE - 31.7 (7.7-25)
B12 - 553 (150-700)
HGB - 14.0 (13.4-17-0)
Vitamin D - 57 (37-131) nmol/L

03.24.2014, recently quit clomid:
TESTOSTERONE - 19.0 (9.0-35.0) nmol/L
SHBG - 46 (15-85) nmol/L
ESTRADIOL- 0.05 (0.00-0.16) nmol/L
FSH - 12.9 (1.0-12.0) IE/L
LH - 4.9 (1.0-10.0) IE/L
TSH - 1.4 (0.30-4.2) mlE/L
FT4 - 11.6 (11.0-22) pmol/L
PROLACTIN - 119 (100-400) mlE/L
GLUCOSE - 5.1 (4.0-6.3) mmol/L
HGB - 13.3 (13.4-17.0) g/dL
HbA1C - 5.3 (4.0-6.0) %
HAEMATOCRIT - 0.40 (0.40-05.0)

Despite the higher readings, I didn't feel any better or different this period.
 

Mr.TT

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DHEAs, Progesterone, Pregnenolone, ?????????

Some of your symptoms sound histamine related..... Some possibly Anxiety related....
 

Kjellfh

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DHEAs, Progesterone, Pregnenolone, ?????????

Some of your symptoms sound histamine related..... Some possibly Anxiety related....
I have taken allergy tests, also when I was using antihistamines as a sleep aid I didnt felt any better.

Progesterone taken 02.22.13:
S-17-OH-PROGESTERONE 2.7 (0,6 - 2,5) nmol/L
an earlier test from 09.11.12 says Normal.

I am looking through all my papers but it seems that there have never been taken any DHEA or PREGNENOLONE test, are they crucial?

Another test from 05.19.14:
TESTOSTERONE - 8.8(6.7-31.9) nmol/L
SHBG - 41(13-71) nmol/L
ESTRADIOL- 44 (20-130) pmol/L
FSH - 7.7 (0.7-11.1) IE/L
LH - 1.2 (0.8-7.6) IE/L
ACTH 6.5 (2.0-11-6) pmol/L
CORTISOL 566 (120-600) nmol/L
GROWTHHORMONE 0.1 (<4.4) ug/L
IGF-I 30 (15-63) nmol/L

05.22.2014,
TESTOSTERONE 7.8 (9.0-35.0) nmol/L
SHBG 49 (15-85) nmol/L
ESTRADIOL 0.05 (0.00-0.16) nmol/L
FSH 8.0 (1.0-12.0) IE/L
LH 2.0 (1.0-10.0) IE/L
PROLACTIN 90(100-400) mlE/L
CHOLESTEROL 5.5 (4.0-6.0) mmol/L
HDL 2.0 (0.8-2.1) mmol/L
LDL 3.3 (1.3-4.3) mmol/L
HbA1c 5.0 (4.0-6.0) %
 

Mr.TT

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I have taken allergy tests, also when I was using antihistamines as a sleep aid I didnt felt any better.
CORTISOL 566 (120-600) nmol/L
Your test results bounce all over the place, depending on what meds you are trying.
Probably you have multiple issues. Benadryl only helps with IgE mediated mast-cell activation.
I have very low IgE (@6 (normal range 0-184)) but I have lots of allergic (mast cell) reactions.
The 23andMe DNA test's raw data, may be really helpful for you, it was for me.

http://ajcn.nutrition.org/content/85/5/1185.full
 

Kjellfh

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Your test results bounce all over the place, depending on what meds you are trying.
Probably you have multiple issues. Benadryl only helps with IgE mediated mast-cell activation.
I have very low IgE (@6 (normal range 0-184)) but I have lots of allergic (mast cell) reactions.
The 23andMe DNA test's raw data, may be really helpful for you, it
Yes it bounces alot, what makes me think that maybe there is other things that causes the low T. I will look more closely into allergy issues. I have confirmed intolerance to casein and probably gluten but maybe there is more. SHBG seems always to be high, this should be around 20 in healhty individuals, correct?

I got confirmation from 23andme today that they have received the saliva sample. Looking forward to results, should arrive in a couple of weeks.
 

Mr.TT

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Andalucia just posted an interesting SHBG hypothesis, in "YUP, SHBG 82.4, HELP!!!!", I would not worry about your SHBG right now.

As for sleep issues, Vitamin D3 levels are important, I try to keep my D3 between 60 and 80 (range 30-100).
A simple aid for excess histamine levels, is to sublingual chewable Vitamin C, 250mg 4 times a day, and avoid high histamine foods.
You will feel the results in a day or two, if histamine is the problem.

YES, knowing your DHEAs level is important if you have low T and E2 levels, and it is easy and cheap to fix.
 

Kjellfh

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Andalucia just posted an interesting SHBG hypothesis, in "YUP, SHBG 82.4, HELP!!!!", I would not worry about your SHBG right now.

As for sleep issues, Vitamin D3 levels are important, I try to keep my D3 between 60 and 80 (range 30-100).
A simple aid for excess histamine levels, is to sublingual chewable Vitamin C, 250mg 4 times a day, and avoid high histamine foods.
You will feel the results in a day or two, if histamine is the problem.

YES, knowing your DHEAs level is important if you have low T and E2 levels, and it is easy and cheap to fix.
Vitamin D3 should be ok these days(been very much out in the sun lately). I had no benefit from high dose supplementation the past.

I have tried vit C extensively in the past with no benefit. Never tried sublingually though, I will try this and look up histamine containing foods to avoid.

You say the 23andme test helped you, what kind of helpful information did you get? And what program/service did you use to decode the raw data?

I will speak to my endo about a DHEA test but I think that test is uncommon here in Norway, never seen it on the standard blood work scheme.
If he refuses I can try to get it from a private doctor.
 

Kjellfh

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So I asked my endo to take another blood test with DHEA before starting with Nebido, he told me that DHEA was not necessary(?!).
Don`t have the money right now to take it at a private clinic.

Had two nights in a row with 4-5 hours continuous sleep. Hope this lasts. Currently trying out diet low in histamine. Gonna try sublingual Vit C in the weekend.
 

sammpedd88

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So I asked my endo to take another blood test with DHEA before starting with Nebido, he told me that DHEA was not necessary(?!). Don`t have the money right now to take it at a private clinic. Had two nights in a row with 4-5 hours continuous sleep. Hope this lasts. Currently trying out diet low in histamine. Gonna try sublingual Vit C in the weekend.
When a doctor tells you something isn't necessary, you need to insist that it be done. Another words go back and tell him you want it done. Doctors work for us....not the other way around.
 

kisaj

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When a doctor tells you something isn't necessary, you need to insist that it be done. Another words go back and tell him you want it done. Doctors work for us....not the other way around.
This. They are not here to dictate anything to us, we tell them what we want and they offer guidance. It is our health, not theirs.
 

Kjellfh

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This. They are not here to dictate anything to us, we tell them what we want and they offer guidance. It is our health, not theirs.
When a doctor tells you something isn't necessary, you need to insist that it be done. Another words go back and tell him you want it done. Doctors work for us....not the other way around.
I agree with you guys.. but I don't know how to persuade him. I think I'm going to take the DHEA at a private doctor. Any other tests I should take in addition to the standard hormones?

The good night's didn't last.. back to 2 hour sleep with night sweats again tonight. Did some yoga and swimming this day, maybe I didn't tolerate this. Felt ok until evening/night. Now I just hate my life.
 

Kjellfh

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Testing DHEAs is more common than testing DHEA.
Have you tried Benzodiazepines, for sleep?
Ok, I will see if its possible to do both then. Thanks for the link.

Yes, have used Zopiclon, Zolpidem(not real Benzodiazepines) and Oxazepam. When on Zoplicone I remember I could usuallly sleep for 4-5 hours straight with nice dreams after approx. half an hour- 45 minutes. Had almost the same effect with Zolpidem but not quite as good maybe. Had to quit these meds because I always got severe anxiety attacks during the day after use with no exception. This was anxiety that I had no control over. Took some time to figure out what was causing it and it was hell weaning off. Had a little trial with a higher dose Oxazepam lately with no success. I am gonna stay away from all these kinds of GABA altering drugs from now on since they tend to have little or no effect and very prominent side effects in me.

Got the results back from 23andme:

Ran the raw data through the geneticgenie site and it gave me these results:

Methylation Profile:

VDR Bsm rs1544410 CT +/-
VDR Taq rs731236 AG +/-
MAO-A R297R rs6323 TT +/+ Maybe this has something to do with my problems (?).
ACAT1-02 rs3741049 AG +/-
MTHFR 03 P39P rs2066470 AG +/-
MTHFR A1298C rs1801131 GT +/-
MTRR A66G rs1801394 AG +/-
MTRR K350A rs162036 AG +/-
MTRR A664A rs1802059 AG +/-
CBS C699T rs234706 AG +/-
CBS A360A rs1801181 AA +/+

Detox:

CYP1A2 164A>C rs762551 AC +/-
CYP1B1 L432V rs1056836 CG +/-
CYP1B1 R48G rs10012 CG +/-
CYP2C19*17 rs12248560 CT +/-
GSTP1 I105V rs1695 AG +/-
SOD2 A16V rs4880 AG +/-
NAT2 I114T rs1801280 CT +/-
NAT2 K268R rs1208 GG +/+

I also have uploaded the PDF reports from geneticgenie:

https://drive.google.com/folderview?id=0B1PWy0jDjqzreHRwTUsxc3BYSjQ&usp=sharing


All tips/help regarding this will also be greatly appreciated.
 

Mr.TT

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You only need DHEAs, not DHEA.

Please post your 23andME GENETIC GENIE results on

http://forums.phoenixrising.me/index.php?forums/detox-methylation-b12-glutathione-chelation.6/

They can guide you.

CBS mutations will require Molybdenum, and TMG supplementations.
I have HomoZ CBS mutations. The SULFATE urine test strips are a good way to confirm how much
CBS is affecting you. CBS caused me to require higher levels of Molybdenum and depleted my ability to
recycle Homocysteine back into SAM. How is your Homocysteine?

There are people on the "PHOENIXRISING" site with terrible insomnia, maybe their threads will help.
 

Kjellfh

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You only need DHEAs, not DHEA.Please post your 23andME GENETIC GENIE results on They can guide you. CBS mutations will require Molybdenum, and TMG supplementations.I have HomoZ CBS mutations. The SULFATE urine test strips are a good way to confirm how muchCBS is affecting you. CBS caused me to require higher levels of Molybdenum and depleted my ability to recycle Homocysteine back into SAM. How is your Homocysteine?There are people on the "PHOENIXRISING" site with terrible insomnia, maybe their threads will help.
I have created a post there now. I have been taking TMG, Metylated Folate, P-5-P and B12 for a couple of weeks. Can not say I notice any change, maybe a little energy/mood boost sometimes from TMG but this could be placebo or something else.

Homocysteine blood test have been done once, and it was high/high-normal (I think it was around 11 μmol/L). I have also had high/elevated Folate on two tests. B-12 have been mid/high. I will post the numbers when I have them available.

I will take a close look at the sleep threads on phoenixrising, thank you.
 

Kjellfh

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Had a few good days last week. Had a trial with magnesium(malate and glycinate) as sleep aid. Have done this before with success but built tolerance fast, the same happened this time. Actually felt a little rested after these nights and had my first ejaculation in over a month. Worked 2-3 nights and then back to crippling normal. No effect whatsoever now.

No success with vitamin C trial, so should I assume my symptoms are not histamine related?
Have changed dosing of Methyl folate/B12 to 800mcg metafolin and 30-60 min after - 1mg of Methyl b12, quit TMG. No change here either.

Decided to postpone nebido injection a little to see if something magic could happen, I really had hoped to get natural production up and running. Took new tests Tuesday this week , got the results today:

07.01.2014:
Hemoglobin 13.7 (13.4-17.0)
PSA 0.29 (0.00-2.5)
Estradiol <0.05 (0.00-0.16)
Testosterone 11.6 (9.0-35.0)
SHBG 40 (15-85)
FSH 9.6 (1.0-12.0)
LH 3.1 (1.0-10.0)
Prolactine 159 (100-500)

I have sent a request for DHEAs, Progesterone, Pregnenolone and some other tests to a private doctor, hope he`s gonna help me with this real fast.

Does anybody know of a good Nebido protocol? In case natural production not will come back I want to be updated on the best possible way to administer this.
 

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Took a tablet of Phenergan(25 mg Promethazine) to help with sleep last night. Haven't used antihistamines in a good while now but used it much in the past. Sleep was good and I had light wood this morning. Seems like everytime I get some restorative sleep I also get some testosterone out in the bloodstream. Is this just SHBG that releases some of its storage? After all this time I had come to conclusion that my poor sleep nowadays was because of low T, not the other way round. Slept fairly well after some weeks on gels I remember. Any thoughts on this?
 

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Tried a cup of coffee today to remove some of the crappy feel. Shouldn't have done that, headache, heart palpitations, adrenaline surges and sweating was added to soreness/muscle ache, burning eyes and generally feeling bad...


Had severe night sweats/feeling warm all night. Felt kind of good yesterday until evening so had some light/medium exercise(wood chopping and walking). Seems like the severity of the nightly hot flashes/sweats always increases on nights after some physical activity on the day before.

Update: Couldn't stand the heart palpitations anymore, took a 7 minute cold shower and my pulse went from approx. 80 to 60. Helped a little on the palpitations but still feel real bad..
 

Mr.TT

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I just reread this entire thread.
SHBG has an 18 DAY half-life, it is unlikely the problem. In fact, SHBG is helping maintain your
Total Testosterone (TT) levels, even though your TT is at the bottom of range.

In a 24 hour Day, how many hours of sleep do you get??????

Do you eat SOY, FLAX, ChickPeas, or Ginseng?

When did the lack of Sleep start???? What else changed around this time???

You never have posted a Free Testosterone Lab number!!!!! Yes, they also should be really low, but I like to see them.

I have no idea which came first, the low TT, or the sleep/anxiety issue.
The MAO-A ++ could make this neuro-transmitter issue, this is not my area of expertise.
I wish MATRIX will read and interject on your thread.

SOMEHOW, you, have to get regular restful sleep. Can you speak with a therapist ??
 

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I just reread this entire thread.
SHBG has an 18 DAY half-life, it is unlikely the problem. In fact, SHBG is helping maintain your
Total Testosterone (TT) levels, even though your TT is at the bottom of range.

Again, thank you so much for input.
I have realized that SHBG is helping me to some degree.


In a 24 hour Day, how many hours of sleep do you get??????

Usually falll asleep ok then typically 1-3 hours light/non refreshing sleep, then wake up hot/sweaty and wide awake, and maybe sleep 1-3 hours more after awhile. This is very inconsistent with wake ups in between. The sleep that feels most productive/restorative tend to be the last(typically in the morning).

The recent night with 25mg promethazine I slept 7-8 hours with just one wake up(had to pee) then fell asleep again right away. This was very refreshing. Have used antihistamines a lot in the past but the effect wears off after a few days use. They don't work every time either and I get nasty side effects.

If I stay awake the whole night before I usually sleep ok the next night...

Do you eat SOY, FLAX, ChickPeas, or Ginseng?

No, have stayed away from all of them for a long time. Also try to stay away from other phyto/xeno-estrogens(like hops, rosemary, plastic containers, cosmetics chemicals and so on).

When did the lack of Sleep start???? What else changed around this time???

I have always had some minor problems with sleep from time to time, but not so much more than the average man. The crippling sleep started back in 2011 I think. I've had periods(weeks) of better sleep in between but the last year only a few nights here and there. If I remember correct I slept fairly well after some weeks on gel.

You never have posted a Free Testosterone Lab number!!!!! Yes, they also should be really low, but I like to see them.

I have looked through all my papers again. Sorry for not posting this earlier. I dont know what kind of measurement scale is used here:

11.02.2012, last test before starting with gel:
Free TT index: 1.92 (3,0 – 14,7)
02.04.2013, test taken after about 2 months on gel:
Free TT index: 3.20 (3,0 – 14,7)
02.22.2013, test taken after almost 3 months on gel:
Free TT index: 4.97 (3,0 – 14,7)
08.14.2013, after two weeks on 50mg clomid :
Free TT index: 3.70 (3,0 – 14,7)

Should I add that to the new blood work request also?.

I have no idea which came first, the low TT, or the sleep/anxiety issue.
The MAO-A ++ could make this neuro-transmitter issue, this is not my area of expertise.
I wish MATRIX will read and interject on your thread.


Always been somewhat nervous person but after my psychiatrists opinion not far from average. I Have been doing a lot of CBT(still doing) and I think this has made me more mentally strong.

SOMEHOW, you, have to get regular restful sleep. Can you speak with a therapist ??

YES that would be great!. I have been to psychiatrist and been doing CBT which helps alot with functioning day to day and with any though situations, but this has not helped anything with sleep.
 

Mr.TT

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Usually falll asleep ok then typically 1-3 hours light/non refreshing sleep, then wake up hot/sweaty and wide awake,

A few possibilities come to mind, for the sweats......and interrupted sleep
1. Estradiol spike, (bad E2 to FT ratio )
Your CLOMID challenge, proved you can make more testosterone, have you considered HcG? AND/Or AROMASIN? To see just
how much Test you can make? Nobody around here likes the idea of once every 2 month testosterone injections.
2. Histamine spike, (caused by normal low night-time Cortisol levels or low Pregnenolone leading to low Progesterone and low DHEA.
try 5mg mangananese and 200mcg molybdenum to calm mast cells.
3. LOW D3 levels (sleep problems but not the sweats)


[
 

Kjellfh

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Usually falll asleep ok then typically 1-3 hours light/non refreshing sleep, then wake up hot/sweaty and wide awake,

A few possibilities come to mind, for the sweats......and interrupted sleep
1. Estradiol spike, (bad E2 to FT ratio )
Your CLOMID challenge, proved you can make more testosterone, have you considered HcG? AND/Or AROMASIN? To see just
how much Test you can make? Nobody around here likes the idea of once every 2 month testosterone injections.
2. Histamine spike, (caused by normal low night-time Cortisol levels or low Pregnenolone leading to low Progesterone and low DHEA.
try 5mg mangananese and 200mcg molybdenum to calm mast cells.
3. LOW D3 levels (sleep problems but not the sweats)


[
Is there any side effects/possible negative outcomes with trying Hcg?
Is it possible for HCG to reboot my system or do I have to continue on it if I start?

I have some arimidex from earlier, is this similar to aromasin? If Estrogen spike is my issue will this show fast if try it? I had a trial with arimidex for about a year ago but don't remember any big benefit. I was on Nebido back then.

I have ordered both manganese and molybdenum.

My D3 levels should be fine but have added it to the blood work request. Have some 5000iu caps from earlier, maybe start to take some again just to be on the safe side.

Had another night with promethazine. Slept fairly well, woke up sweaty a couple of times but fell asleep quickly, no morning wood. Light headache, else ok.
 

Mr.TT

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You are willing to try anything, to see if it makes a difference. I'm just like you.

If you can get a 5000iu HcG bottle, you can experiment with a sublingual HcG mix. (28 days worth)(no injections)
There is no side effects to stopping HcG, Weight loss users cycle it.
You get the HcG, and I'll share with you the sublingual mixing and dosing instructions that I have used.

YOUTUBE is loaded with mixing and dosage Videos, where people sublingual HcG for weight loss.

Until your TT increases, and a blood test shows high E2, I would not take a chance on using ADEX, and clobbering your E2 levels.

Verifying that your DHEAs levels are good, is important now. Low DHEA could explain your low TT.
 

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You are willing to try anything, to see if it makes a difference. I'm just like you.

If you can get a 5000iu HcG bottle, you can experiment with a sublingual HcG mix. (28 days worth)(no injections)
There is no side effects to stopping HcG, Weight loss users cycle it.
You get the HcG, and I'll share with you the sublingual mixing and dosing instructions that I have used.

YOUTUBE is loaded with mixing and dosage Videos, where people sublingual HcG for weight loss.

Until your TT increases, and a blood test shows high E2, I would not take a chance on using ADEX, and clobbering your E2 levels.

Verifying that your DHEAs levels are good, is important now. Low DHEA could explain your low TT.
Thanks for fast answers!

Yes I am desperate and are willing to try everything. This have been going on far to long already...

I will see if I can get some HCG.

No arimidex then.

DHEA-s is on my list.
 

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So, finally got some answers from the private doctor, he said he would help me with blood tests but he is om vacation until August. Same goes for my current endo. The private doctor also told me some of his clients got higher free testosterone from low carb diets. I am staying away from "low" or "high" diets but generally eat varied, natural low/med GI foods and stay away from refined foods and sugar. So I think this is not a problem.

I have no intention of waiting until August before taking more actions as this week have been all time high in regards to some of my symptoms. Looking back I see that the "curve" of good nights/days have been declining all the way from good periods of weeks to start with and now if I am lucky, a couple of days per week. Just cannot handle it anymore.

Seems like I got punished from the few night's good sleep with antihistamine. Yesterday I got palpitations all day and hot flashes starting after work not ending until this morning. Got to sleep after taking some propranolol and slept a few hours. Today headache and feels like there is no serotonin left in my brain. The palpitations yesterday were not anxiety related.

I made an appointment with my general doctor tomorrow morning and will ask for DHEA-S test, a prescription for Pregnyl/HCG and maybe something alternative to help with sleep. Hope he will help me, the last time I asked for Cortisol tests he just laughed at me.

The last night's I have also experienced some excess thirst/urination, don't know what to think of this. Seem to start at late evening and last into early daytime. Have experienced this in the past to but been a while since last time.

I have bought body thermometer and will measure under tongue temps to se if there is something unusual going on here. Temp measured right now was 36 C.

Molybdenum and manganese should arrive tomorrow.

Sorry for messy post, sent using phone.
 

Mr.TT

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MAO-A R297R rs6323 TT +/+ Maybe this has something to do with my problems (?).
Do me a favor.... Go to the 23andMe, RAW DATA screen, and in the GENE option, enter MAOA,
? Is there one letter listed for your genotype???? or two letters???
Look at the GENE option for AR, Is there 1 or two letters???

If you have two letters, 23and Me is reporting 2 X chromosomes.

Around the top of that screen, 23andMe lists Chromosome 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 X Y Mt
?Do they show X Y or X X Y ?????
 

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Do me a favor.... Go to the 23andMe, RAW DATA screen, and in the GENE option, enter MAOA,
? Is there one letter listed for your genotype???? or two letters???
Look at the GENE option for AR, Is there 1 or two letters???

If you have two letters, 23and Me is reporting 2 X chromosomes.

Around the top of that screen, 23andMe lists Chromosome 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 X Y Mt
?Do they show X Y or X X Y ?????

Screen Shot 07-12-14 at 07.05 PM 001.PNG
Screen Shot 07-12-14 at 07.05 PM.PNG


Is this correct (see pics)?
On AR there are only one letter under genotype.
 

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Took some new blood tests yesterday, asked for Pregnenolone, Progesterone and DHEA-S. My doctor didn't have any schematics for Pregnenolone and DHEA-S but said he should request it from the bloods drawn for other tests. Asked for Pregnyl/HCG but he said I would have to ask my endo when he is back from vacation.

Tonight I had severe burning/pulsating headache with palpitations and nausea/malaise, would not go away. Got two hours sleep late in the morning. Feel like I have some kind of withdrawal/rebound from something, but cant understand what. There have been several weeks since I last used a benzodiazepine. Went to the emergency clinic today after have consulted them over the phone. They checked blood sugar (7.2 mmol), hemoglobin (14 g/dl) and CRP (below 5 mg/L) all were fine I was told except my blood pressure, it was 165/105 ! The doctor said the headache could be caused by the high BP but could not explain why it was high. Was told to check further with my general doctor. Still feeling like garbage.

Have started supplementing manganese and molybdenum today.
 

Mr.TT

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An MAOA or AR with two letters would have meant that you have Klinefelter syndrome. You don't.
But, it would have explained all of your blood tests.
Your MAOA is "T" not "TT" , it is "+" not "++".

Have you ever taken DHT suppressors??? or opiates???
 

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An MAOA or AR with two letters would have meant that you have Klinefelter syndrome. You don't.
But, it would have explained all of your blood tests.
Your MAOA is "T" not "TT" , it is "+" not "++".

Have you ever taken DHT suppressors??? or opiates???

Ok, this is good right?

About DHT suppressors, I do not now of anything... do you have any examples of suppressors?
Never used opiates other than painkillers with codeine/tramadol a few times when sick.
 

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Blood tests 07.11.2014 (morning):

CORTISOL 466 (220-850) nmol/l
TESTOSTERONE 14.4 (9.0-35.0) nmol/L
SHBG 42 (15-85) nmol/L
PROGESTERONE 1.8 (<3) nmol/L

DHEAS was not ready yet =\.

Tried promethazine again last night but seems like it have lost its effect again..
 

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Finnally got the results on DHEAs:

DHEAS 6.0 (3.4 – 17.0 µmol/L)

Status since last update:

Oral temps seems normal, have only checked sporadically but seems to range from 36-37,5 Celsius. I will try to check more consistently on specific times and keep a log.
Not had any luck with manganese and molybdenum yet.

Was at a new GP last friday since my usual one had vacation. I begged for some help and he prescribed me Tolvon/Noval (Mianserinhydrochloride 10mg) to help with sleep. He also ran some blood tests, dont know what kind but I have asked for a copy of the results.
I asked him to check my BP due the incident earlier, it was approx. 135/75.

Tolvon has given me a couple of nights with some restful sleep but the effect seems to get weaker.

Yesterday I felt ok and tried 30 mins of Yoga, this was to much I think because afterwards I started suffer from headache and significantly higher resting pulse. This lasted the rest of the day. The sweats last night was also more intense. Today I`am feeling exhausted but "wired" and stifness/soreness in the muscles used yesterday.

Update: got the 5000iu bottle of HCG today. I read that it should have been kept between 5-15 Celsius, this have not been done. Could this mean that it is spoiled?
 

Mr.TT

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Finnally got the results on DHEAs:

DHEAS 6.0 (2.0 – 10.5 µmol/L)

Status since last update:

Oral temps seems normal, have only checked sporadically but seems to range from 36-37,5 Celsius. I will try to check more consistently on specific times and keep a log.
Not had any luck with manganese and molybdenum yet.

Was at a new GP last friday since my usual one had vacation. I begged for some help and he prescribed me Tolvon/Noval (Mianserinhydrochloride 10mg) to help with sleep. He also ran some blood tests, dont know what kind but I have asked for a copy of the results.
I asked him to check my BP due the incident earlier, it was approx. 135/75.

Tolvon has given me a couple of nights with some restful sleep but the effect seems to get weaker.

Yesterday I felt ok and tried 30 mins of Yoga, this was to much I think because afterwards I started suffer from headache and significantly higher resting pulse. This lasted the rest of the day. The sweats last night was also more intense. Today I`am feeling exhausted but "wired" and stifness/soreness in the muscles used yesterday.

Update: got the 5000iu bottle of HCG today. I read that it should have been kept between 5-15 Celsius, this have not been done. Could this mean that it is spoiled?
The hCG should be fine, We all get it shipped to us through the mail, where it gets heated up, and it is OK.
( I live if Florida, how hot can it be in Norway?)

If you were having Histamine problems, I would expect the Vitamin C, Manganese, and Molybdenum to give you palpable results, in a day.
So, this does not seem like an excess histamine problem.

Your DHEAs level is fine.

Your Thyroid is fine.

So here is my non-medical opinion.
Your low testosterone is not the cause of your anxiety and insomnia, it is a symptom.

Adrenal hormones could produce most of your symptoms.

I see no harm in trying to raise your Total and Free Testosterone levels into the mid-range. It may help.
 

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The hCG should be fine, We all get it shipped to us through the mail, where it gets heated up, and it is OK.
( I live if Florida, how hot can it be in Norway?)

If you were having Histamine problems, I would expect the Vitamin C, Manganese, and Molybdenum to give you palpable results, in a day.
So, this does not seem like an excess histamine problem.

Your DHEAs level is fine.

Your Thyroid is fine.

So here is my non-medical opinion.
Your low testosterone is not the cause of your anxiety and insomnia, it is a symptom.

Adrenal hormones could produce most of your symptoms.

I see no harm in trying to raise your Total and Free Testosterone levels into the mid-range. It may help.

Florida sure is warmer than Norway I think :), but there have been some abnormally hot days here the last weeks with degrees over 86 F.

I have been afraid of your conclusion myself - that the low T is a symptom of another condition.
My GP says he have ruled out everything and that there is nothing "somatic" with me other than low T.
So the only option I see is to try TRT again and just hope that all the other issues go away after a awhile with normal/mid T levels.

I recently bought a new book by John Crisler and Robert A. Kominiarek called "The Low T Book".

In this book I read that one of the best TRT regimes can be transdermal T with daily low dose HCG injections.

So my plan now is try HCG solo with 100iu as daily dose subcutaneously and see what happens.
If this does not give any results I will slowly add inn transdermal testosterone as 2% gel.

Any input on this?
Are there anything else that should be tried/tested before joining the TRT train again?

Update: got the test results from 07.18.2014, no hormones taken here and all look good I think. The only thing outside range is Albumin - 52 (36-48 g/L). Albumin tend always to be just outside the range. Does this mean something?
Also got the DHEA-S paper, updated the reference range according to the paper.

Attached the whole bloodwork: View attachment 07.18.2014-BW.pdf
 

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Ended up taking Tolvon (Mianserine) at 30mg every night before bed. Mianserine is similiar to Mirtazapine more commonly used in the US.
It helped a lot for sleep some nights, especially to begin with. Some mornings I actually felt refreshed. After a couple of weeks I also noticed elevated mood. Even had two-three days in between with some libido. This has not been present since I was on TRT.

At first I thought all this was just my overall health balancing and restoring, but I wonder if it all somehow was related to the mianserine. Could it be that mianserine corrected some imbalances of neurotransmitters/hormones (cortisol, dopamine, serotonine, ??).

Problem is that it stopped working. Then when I tried some nights without it, ended up with intense anxiety, sweats, feeling hot/cold and heart palpitations the whole nights through. If it gave persistent effects I would just continue using it but I think I`m gonna wean off as I feel it gonna cause more trouble in the long run.

Got prescription for Pregnyl(HCG) and Gonal-F (FSH/follitropin alfa) from my endo when he was back from vacation. Started on HcG 250IU EOD subq Tuesday this week. I don`t think I have much to loose doing this?
I have no plans on trying Gonal-F yet as it is very expensive and I don't find much information about it. Any opinions?

I have ordered some Bacteriostatic water because the mixing agent that follow the Pregnyl version I have is standard NaCl water only.
Anyone know the shelf/fridge life of HcG mixed with the accompanying NaCl in a sterile vial by the way?
I have to use this until the BAC water arrives.

With help from a private doctor I took some final tests before I started HcG, these tests included cortisol saliva 2x. I asked for 4x but that is not common here and seemed difficult to get.
 

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