[JanSz]

I suggest that you keep your health record here so it can be reviewed on as need basis

Thanks, JanSz- See below for a heavily REVISED and hopefully easier to make sense of list of blood results.

I lived this for only a year or so, but it feels like forever. Sometimes I forget that others are not, quite understandably, familiar w/ my situation.

My issues started lst fall when I switched from 1 1/2 yrs of Paxil to Wellbutrin due to weight gain. Felt like a switch got turned off as all of a sudden, w/i 2 wks on WB erections were non existent, which for me is dman near worse than death. I had been on Propecia for about a month max a good 7+ yrs prior. Dropped it when erectile issues surfaced and recovered-or so I thought. On reflection I realize that erectile quality and general energy levels had been dropping over the preceeding 2-3 years, which is why the Paxil, etc was suggested. I have no proof as to what might have caused what, although I blame the Propecia and W/B.

On a hunch I had my T tested in the fall of 2006 and there it was: 200. FSH and LH were both low (2 or less). I knew next to nothing and saw a local Urologist, who suggested Androgel. I knew next to nothing so I went along w/ it. Net result after 1 & 2X/day trials: 300. Research revealed the ball-shrinking issue and dependency issues, so I visited an Endo, who was even more useless.

Time spent on these boards and a desire to get to the root cause led me to Dr. Shippen, who is trying hcg, which thus far has only given me bouts of depression, a general malaise and near constant fatigue. Intellectually I know that the diagnosis process is often trial and error, but I am tired--and even more tired of BEING tired. There are too many days I wouldn't GAS if I woke up the next day, which is no way to be with 2 beautiful and energetic young daughters who need me. I am frustrated as nearly every day is a damned struggle-I often look forward to sleeping, where I don't have to think or worry about this anymore. Not trying to be melodramatic-just the way I feel. Since I believe this is a chemical issue I am trying desperately to fix it and give my family some quality of life. I'm not the psychiatry type and don't feel it would do much unless the underlying body chemistry is fixed.

The blood tests I list are a compilation of different ones taken post Androgel over a roughly 4-6 week time this Spring. They're a mix of what the Dr. @ Mass Gen'l wanted, Dr Shippen wanted and what I read about here. I am well aware of your list and would like to have it all done, but so far not even Dr Shippen has asked for that much data. Nobody has been willing to write me a scrip for all that just yet.

The bottom line is that I am trying to educate myself so I know what to look for symptom wise (might make for more accurate diagnosis), ask better questions and be a partner in an eventual recovery. I am fully aware that my mental state stinks, which I view as part of the problem. I can detach myself, so to speak, and look at myself from a 3rd party prespective. I don't like what I see: A tired, frustrated, PO'd at the world, sometimes scared and angry once strong 43 yr old watching everything I've worked for at risk and terrified of having to live the rest of my life like this. Yeah, I know this is a but "heavy", but I need to be honest with myself in order to find a way out. Sometimes I feel like life did this to me:

I very much appreciate the extremely helpful input and help given me by you and guys like you. Wouldn't have made it this far w/o it.

Here we go in chronological order:

Total/free T (test 1: 4/10/07 Lab work for possible clinical trial which I did not do)

Total T 205
% Free T 5.7
Free T 11.6 (5-21)
E2 9.1 (0-35 pg/ml)
FSH 2 (1-15)
LH 2 (2-12)
DHT 10.28 (no range given)
Prolactin 6 (2-18)


Total/free T (test 2: 4/12/07 Lab work w/ Quest)

Total T: 185
% free T 2.0 (1-2.7)
Free T 37.3 (50-210) Noted "low"
FSH: 1.8 (1.8-8.0)
LH: 2.0 (1.5-9.3)
E2 <32 (doesn't say much)
Prolctn 8.6 (2-18)
SHBG 11 (8-46)


MISC RESULTS FROM 4/07:

Thyroid:

TSH .98 (.40-5.5)
T4 free 1.1 (.8-1.8)
T3 free 297 (230-420)

Cortisol (24 hr test)

Cortisol: 44.6
Cort Free (24hr) 66.9 (5-50) ** seems high **

Cholesterol

Cholstrl 160 (162-280)
Trigylc 257 (55-327)
HDL 23 (27-67)
LDL 86 (87-186)

This seems to be warning me about metabolic syndrome unless I fix this......

RESULTS POST CLOMID TEST W/ DR. SHIPPEN:

Test. 319 (up from avg of 200)
FSH 2.4 (up from 1.8-2)
LH 5.0 (up from 2)
DHEAS 250 (241-827)
DHT 18 (25-75)
E2 <32 (<52 Dr did NOT ask for sens. test)

Cortisol: 18.5 (4-22 Once again, cort is high)

I noted that doctors have certain obligatory routines (I am sure well reasoned) that they feel obligated to try:

clomid 2-3 months
hcg 2-3 months
transdermals year or two (with out hcg so your nuts are gone)
other experiments another year
then you graduated to T injections, HCG, Arimidex, pregnenolone cream, Armour and Cortef

as a patient you go nuts in mean time (literally, either killing your self or divorcing wife, quitting good job, loosing bussiness or else)

I do not know what to say ....................

With my personal history behind me,
history that I am not sure would apply to you,
seeing above tests I would do:

T injections, HCG, Arimidex, pregnenolone cream, Armour and Cortef
but you have to remember this is just another experiment.

With general opinion that it is better to have readings within range than being totally low, I would say that your chances are increased when you get you levels to desirable ##'s.

You need about 3grains of Armour/day (before retesting)
Your SHBG is low, usually one would try first Androgel, that is mostly because of daily applications. With your thyroid problems, Androgel is just another experiment that may not work.
Do your DepoT shots E2D or even every day, not really big deal.
Assuming E2D
hcg-250iu each shot
Dept-Testosterone, 200mg/mL
SHBG=11
goal for TT=750
need ~100mg/week=0.5cc
0.5cc/7*2=0.14cc=14units od Depo-T

Do the (T&hcg) shots as E2D or half dose every day.
Do SubQ shots with 31ga 3/10cc 5/16" long needle
around navel. Do (T&hcg) on same day the other day free.

prescription compounded pregnenolone cream
100mg/1gram, use 1gram/day

Lugol's solution 4-6 drops/day

Not sure if you will need scripts for
Cortef, Arimidex, Cialis but you should have it handy.

I suggest my usual supplements for other than E2 estrogens,
SUPER Omega 3 EPA/DHA and many other, I can post my list or I probably posted it on my thread.

Wait two to three months on this, your depression could possibly start lessening by then.
Do the blood test that I usually post, with the conditions that are also posted.

I would hope that by then you would be in better mental condition ready to tackle the harder to identify and treat your low cholesterol and anything else that hides behind low SHBG.
.
For me TT at higher level improved mental clarity and stability, (just do not ask my wife she my hold different opinion).
.
Hey, that is just another theory, Dr Shippen will come with something that fits you better.
Keep us informed of your progress.
.
.

[anyman]

Thanks for taking the time to write all this. There is much here to digest and think about. You're right about all the BS most Drs make us go through-like we can all just put our lives on hold for years while they fart around. We need more--many more--good doctors like Shippen, Crisler and Mariano.

Like I said- I'm tired of being tired and want a "normal" life back. Before my young kids are grown and only know Daddy as a crabby 'ol bastard. I need to work through mt bitterness and resentment, if possible. Getting tuned up might help quite a bit.

I suggest that you keep your health record here so it can be reviewed on as need basis



I noted that doctors have certain obligatory routines (I am sure well reasoned) that they feel obligated to try:

clomid 2-3 months
hcg 2-3 months
transdermals year or two (with out hcg so your nuts are gone)
other experiments another year
then you graduated to T injections, HCG, Arimidex, pregnenolone cream, Armour and Cortef

as a patient you go nuts in mean time (literally, either killing your self or divorcing wife, quitting good job, loosing bussiness or else)

I do not know what to say ....................

With my personal history behind me,
history that I am not sure would apply to you,
seeing above tests I would do:

T injections, HCG, Arimidex, pregnenolone cream, Armour and Cortef
but you have to remember this is just another experiment.

With general opinion that it is better to have readings within range than being totally low, I would say that your chances are increased when you get you levels to desirable ##'s.

You need about 3grains of Armour/day (before retesting)
Your SHBG is low, usually one would try first Androgel, that is mostly because of daily applications. With your thyroid problems, Androgel is just another experiment that may not work.
Do your DepoT shots E2D or even every day, not really big deal.
Assuming E2D
hcg-250iu each shot
Dept-Testosterone, 200mg/mL
SHBG=11
goal for TT=750
need ~100mg/week=0.5cc
0.5cc/7*2=0.14cc=14units od Depo-T

Do the (T&hcg) shots as E2D or half dose every day.
Do SubQ shots with 31ga 3/10cc 5/16" long needle
around navel. Do (T&hcg) on same day the other day free.

prescription compounded pregnenolone cream
100mg/1gram, use 1gram/day

Lugol's solution 4-6 drops/day

Not sure if you will need scripts for
Cortef, Arimidex, Cialis but you should have it handy.

I suggest my usual supplements for other than E2 estrogens,
SUPER Omega 3 EPA/DHA and many other, I can post my list or I probably posted it on my thread.

Wait two to three months on this, your depression could possibly start lessening by then.
Do the blood test that I usually post, with the conditions that are also posted.

I would hope that by then you would be in better mental condition ready to tackle the harder to identify and treat your low cholesterol and anything else that hides behind low SHBG.
.
For me TT at higher level improved mental clarity and stability, (just do not ask my wife she my hold different opinion).
.
Hey, that is just another theory, Dr Shippen will come with something that fits you better.
Keep us informed of your progress.
.
.