Anyman's personal journal: May it help me and others to follow

anyman · 08-07-2007, 10:03 PM

OK, here we go: As of this date, 8/7/07, I am a few months short of 44 and am apparently suffering from secondary hypogonadism. I have only been aware of the condition for less than 1 year, but now relaize it was probably years in the making. My goal is to get better and let me experiences help others similarly situated avoid much of the BS and pitfalls I've suffered.

I became aware of my problem last fall when I switched from 1 1/2 yrs of Paxil to Wellbutrin due to weight gain. Paxil has been prescribed for general irritability, anxiety and heretofor unknown instances of PE. After switching to WB it soon felt like a switch got turned off as all of a sudden, w/i 2 weeks on WB. erections were non existent, which for me is damn near worse than death.

I had been on Propecia for about a month max a good 7-8 + 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.

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.

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 the guys here. 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 June 2007 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)

Next blood work: Mid August

JanSz · 08-08-2007, 07:30 AM

Post your current routine of medicines, supplements, doses, when this routine started, what blood tests prompted this routine.

Undone · 08-09-2007, 04:37 PM

How long ago did you see Dr. Shippen? When are you scheduled to go back? Did he suggest your E2 is high?

anyman · 08-09-2007, 05:21 PM

Quote:

Originally Posted by Undone

How long ago did you see Dr. Shippen? When are you scheduled to go back? Did he suggest your E2 is high?

Just had blood drawn today. Hope to have results in a few weeks. The Dr will get his copy quicker, by the patient copy takes longer.

JanSz · 08-10-2007, 09:58 AM

Quote:

Originally Posted by anyman

Just had blood drawn today. Hope to have results in a few weeks. The Dr will get his copy quicker, by the patient copy takes longer.

Post all of the results here when you get them.
Name, number, units, range, any other description

anyman · 08-16-2007, 04:28 PM

Upon my return from a few days away I saw an envelope from Quest with my 3 week post start of hcg blood work drawn a week ago. Damn--was I ever disappointed. No change whatsoever. T still low at 224. FSH and LH still barely registering (I expected this). Estradiol is still under 32.

Here are the results:

Total T: 224 (241-827)
LH: .2 (1.5-9.3)
FSH: .7 (1.6-8.0)
Estradiol: <32 (<52)

Here are some prior blood results for comparison:

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)

RESULTS POST June 2007 CLOMID TEST:

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

Not sure what to think. I had or have all the indicia of being secondary: Low FSH, low LH and low T. How can I be truly secondary and see no change after 3 weeks on hcg? Put simply, WTF??

After opening the results I feel like I've been kicked in what's left of my balls. Is it possible for a person to be BOTH primary and secondary? How the hell could THAT have happened? Or, perhaps, all the hcg did was raise my E and nothing more. This might be a possibility as clomid DID raise my T by blocking E. Also, the depression which started shortly after starting hcg can be the result of elevated E. Either way, how could clomid show some improvement while hcg did not? I really have no idea and could use some input.

JanSz · 08-16-2007, 05:11 PM

Quote:

Originally Posted by anyman

Upon my return from a few days away I saw an envelope from Quest with my 3 week post start of hcg blood work drawn a week ago. Damn--was I ever disappointed. No change whatsoever. T still low at 224. FSH and LH still barely registering (I expected this). Estradiol is still under 32.

Here are the results:

Total T: 224 (241-827)
LH: .2 (1.5-9.3)
FSH: .7 (1.6-8.0)
Estradiol: <32 (<52)

Here are some prior blood results for comparison:

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)

RESULTS POST June 2007 CLOMID TEST:

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

Not sure what to think. I had or have all the indicia of being secondary: Low FSH, low LH and low T. How can I be truly secondary and see no change after 3 weeks on hcg? Put simply, WTF??

After opening the results I feel like I've been kicked in what's left of my balls. Is it possible for a person to be BOTH primary and secondary? How the hell could THAT have happened? Or, perhaps, all the hcg did was raise my E and nothing more. This might be a possibility as clomid DID raise my T by blocking E. Also, the depression which started shortly after starting hcg can be the result of elevated E. Either way, how could clomid show some improvement while hcg did not? I really have no idea and could use some input.

In my view you did the only valid test, you have used hcg.
Theoretically, had you had Clomid working for you all it would mean that you would have now script for HCG.
Clomid is not long term solution, even if possibly it works.
HCG is long term.

Now you know what you need to know.
Your testis when stimulated by hcg do not produce any more Testosterone.

This is good decission point to be at.
Look for your next option.

(Personally, if you want to go thru next agony, go and test how transdermals work or not work, for you).

With my past history, I would go straight for Depo-T shots plus HCG for the cosmetic part.

Your balls still may be fertile, do not assume you are not fertile.

Your DHT looks low.

Your E2 test looks low and unfamiliar.
-----------------------------------------------
T4 free 1.1 (.8-1.8)
T3 free 297 (230-420)

When are you going to start Armour,
------------------------------------------------
Lots of supplements, fish oils and what not for your low cholesterol.

I am sure prescription compounded pregnenolone cream would help you.
100mg/1gram, use 1gram/day
blood test, increase dose if not high enough

plymouth city · 08-16-2007, 05:14 PM

I posted this in your other thread but I believe it applies here as well.

Anyman - Classic case of how "More" is not "Better".

Dr John believes, and given his caseload of patients to back himself upon, I agree, that " I recommended 250IU of HCG twice per week for all TRT patients"

That is 500Iu per week. You are taking three times that dose. It is apparent that taking more hcG to make up for a lack of T will not work.

Your baseline T production is just not up to par and exogenous T must be administered.

I don't thin it is an issue of hcG conversion to estrogen. hcG in itself does not aromatize into estrogen. it is a rise in T that aromitzes into E, and that rise in T can come from hcG, but looking at your BW it is painfully aware that this is not the case. It looks to me like it is a simple matter of you not having enough T running threw your blood.

JanSz · 08-16-2007, 05:24 PM

SHBG 11 (8-46) (low)

Goal
freeT~250
Required
TotalT~750
to get there one need external 200mg/mL
DepoT=100mg/week (slightly less)

that is 0.5cc/week=50units on insuline syringe
People with low SHBG are specially sensitive to blood T level fluctuations,
use E2D, every two days schedule for both
T&hcg
use 250iu hcg each shot
use 50/7*2=14 units of testosterone

use this needle for subQ injections around navel:

http://hocks.com/Merchant2/merchant....Category_Code=
BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle--1/2 Unit Markings 100/b Price: $25.95

or this

http://hocks.com/Merchant2/merchant....Category_Code=
Easy Touch U-100 Insulin Syringe 31 Gauge 3/10cc 5/16 inch Short Needle 100/Box Sale Price: $13.99

After 2-3 months recheck you blood test, adjust T shots accordingly with a goal of
FreeT~250 reading chart post #41

Jan's BloodTest April13/2007

anyman · 08-16-2007, 05:30 PM

Quote:

Originally Posted by JanSz

In my view you did the only valid test, you have used hcg.
Theoretically, had you had Clomid working for you all it would mean that you would have now script for HCG.

Your testis when stimulated by hcg do not produce any more Testosterone.

Ok, but WHY?? Could they have they failed as well? How can this AND low FSH/LH happen? Am I am totally screwed?

(Personally, if you want to go thru next agony, go and test how transdermals work or not work, for you).

Tried this several months ago. Androgel once and twice daily only raised T 100 points to 300 total-the same as the clomid test.

With my past history, I would go straight for Depo-T shots plus HCG for the cosmetic part.

[b]You are likely right. Let's see what Dr. S says/B]

Your DHT looks low.

Yup. Could be my 8-9 yr ago 1 month use of propecia

Your E2 test looks low and unfamiliar.

It's the same one Quest has done for awhile
-----------------------------------------------
T4 free 1.1 (.8-1.8)
T3 free 297 (230-420)

When are you going to start Armour.

Once I get the OK from Dr S.
------------------------------------------------
Lots of supplements, fish oils and what not for your low cholesterol.

I take fish oil now. Holding off on much more till I get the OK

I am sure prescription compounded pregnenolone cream would help you.
100mg/1gram, use 1gram/day
blood test, increase dose if not high enough

Sounds right yet again. Gotta see what Dr S says first as I am loathe to do much w/o his advance OK or input. As always, Jan, you're insight and comments are dead on and much appreciated. Thanks. I am just trying to make sense of this and have yet to do so.

plymouth city · 08-16-2007, 05:35 PM

Quote:

Originally Posted by JanSz

SHBG 11 (8-46) (low)

Goal
freeT~250
Required
TotalT~750
to get there one need external 200mg/mL
DepoT=100mg/week (slightly less)

that is 0.5cc/week=50units on insuline syringe
People with low SHBG are specially sensitive to blood T level fluctuations,
use E2D, every two days schedule for both
T&hcg
use 250iu hcg each shot
use 50/7*2=14 units of testosterone

use this needle for subQ injections around navel:

http://hocks.com/Merchant2/merchant....Category_Code=
BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle--1/2 Unit Markings 100/b Price: $25.95

or this

http://hocks.com/Merchant2/merchant....Category_Code=
Easy Touch U-100 Insulin Syringe 31 Gauge 3/10cc 5/16 inch Short Needle 100/Box Sale Price: $13.99

After 2-3 months recheck you blood test, adjust T shots accordingly with a goal of
FreeT~250 reading chart post #41

Jan's BloodTest April13/2007

JansZ,

I wrote about this in another post but I believe it applies here as well.

"Let us not forget that SHBG itself is often VERY difficult to measure correctly, even with quest's standards.

The most accurate way to measure bio indentical hormones, the gold standard, is urines. Urines, if I remember correctly, do not measure SHBG. There is much invalidity in bloods, even by Quest standards. I think that Urines may very well be the gold standard in hormone measurement.

It is these reasons in itself why we must not use SHBG as a marker on how to treat a HRT program and adjust dosages. Get Bioavailable T and E in line and let things like SHBG fall where it may.

Besides, how do we treat SHBG with consistency? There is really little to do to raise/lower it. Chrysin cream has shown a little promise in lowering it, yet it is inconsistent."

plymouth city · 08-16-2007, 05:41 PM

"Yup. Could be my 8-9 yr ago 1 month use of propecia"

I highly, highly doubt that a one month run of propecia could have led to low DHT.

It is more likely that your overall lack of androgenic hormones that convert to DHT are to blame.

plymouth city · 08-16-2007, 05:43 PM

"Tried this several months ago. Androgel once and twice daily only raised T 100 points to 300 total-the same as the clomid test"

How much androgel were you on.

Were you using hcG as well?

It is lack of hcG, not enough androgel and not sticking with program long enough is why program did not work.

anyman · 08-16-2007, 05:43 PM

My comments are in bold

Quote:

Originally Posted by plymouth city

Anyman - Classic case of how "More" is not "Better".

Dr John believes, and given his caseload of patients to back himself upon, I agree, that " I recommended 250IU of HCG twice per week for all TRT patients"

I agree. But, this is what Dr. S started me on. I hesitate to cut back or change his routine w/o checking w/ him first. Seems like a good idea, though since I wonder if the hcg is the cause of my recent depressive episodes and more constant melancholy

That is 500Iu per week. You are taking three times that dose. It is apparent that taking more hcG to make up for a lack of T will not work.

Yup. The question is WHY doesn't it work? My testes are normal sized and I fathered 2 kids. Huh??

Your baseline T production is just not up to par and exogenous T must be administered.

Sure looks that way. Not Androgel, though. That did nothing for me several months ago. Now that I think of it, could my one month on Androgel have shut down my testes?

I don't thin it is an issue of hcG conversion to estrogen. hcG in itself does not aromatize into estrogen. it is a rise in T that aromitzes into E, and that rise in T can come from hcG, but looking at your BW it is painfully aware that this is not the case. It looks to me like it is a simple matter of you not having enough T running threw your blood.

Agree. I need T. But, why didn't the hcg work? Arrghhh! I'm about ready to scream in frustration. Certainly explains why I've felt no better. Hell, I'll bet the hcg actually worsened things, which my more recent crappy moods and depression would explain.

Thanks again. Please keep the comments and insights coming. Trying to make sense of this. Not yet there.....

plymouth city · 08-16-2007, 05:49 PM

"I agree. But, this is what Dr. S started me on. I hesitate to cut back or change his routine w/o checking w/ him first. Seems like a good idea, though since I wonder if the hcg is the cause of my recent depressive episodes and more constant melancholy"

Do not blame hcG. It is lack of T running threw your veins that is causing you problems.

"Yup. The question is WHY doesn't it work? My testes are normal sized and I fathered 2 kids. Huh??"

Again, lack of T. All the hcG in the world is not going to fix this

"Sure looks that way. Not Androgel, though. That did nothing for me several months ago. Now that I think of it, could my one month on Androgel have shut down my testes"

Again, androgel program did not work for reasons I noted in above post.

"Agree. I need T. But, why didn't the hcg work? Arrghhh! I'm about ready to scream in frustration. Certainly explains why I've felt no better. Hell, I'll bet the hcg actually worsened things, which my more recent crappy moods and depression would explain"

Think of you being a car with no transmission or engine. hcG is your brand new trans, and T is the engine. Yet your engine is still broke. You are blaming the mechanic who gave you a brand new trans for your car not running, not realizing your car still has no engine.