Penile Atrophy, Zero Libido, Ejaculatory Anhedonia, Bloodtests Back

[PainIsGrowth]

Hello Forum,
Thank you very much for providing the right direction to look for finding what is going wrong in my body. I had the recommended blood tests done from this post, done at Quest.
Penile Atrophy, Zero Libido/sensitivity, Help

Again, here are my main symptoms.
* Zero Libido/Sex Drive
* Bad Erectile Dysfunction even when using max doses of Cialis or Levitra
* Loss of Morning / Spontaneous / Nocturnal Erections
* Penile Tissue Changes (narrowing, shrinkage, curving, numbness, wrinkled)
* Penis Feels "disconnected" from head or body

****Complete loss of pleasure during Orgasm, this is new during last month. I know oxytocin is created by the pituitary, so I'm wondering is something is damaged there? I literally have no sensation during sex/masturbation, a slight sensation at approach of orgasm, and then nothing when there used to be a massive euphoric rush and tingly sensation thoughout my body. This is worrying me the most now.
Here are the results: In Range Out of Range Refererence Range
Estrogens, Fractionated, LC/MS/MS
Estrone, LC/MS/MS 23 pg/ml
Reference Range: < OR = 68

ESTRADIOL, ULTRASENSITIVE 48 H pg/mL
Reference Range: < OR = 29

Estriold, Serem <0.10 ng/mL
Reference Range:
Adults: 0.2 or LESS

Hepatic Function Panel
Only listing things out of range:
ALBUMIN 5.2 H Range : 3.6 - 5.1 g/dL
AST 88 H Range: 10-40 U/L
ALT 81 H Range: 9 -60 U/L

New Testosterone Results, FREE BIO TOTAL LC/MS/MS Range:

Testosterone Total 1081 250-1100 ng/dL
Testosterone Free 127.8 46.0 - 224.0 pg/mL
Testosterone BioAva 301.7 110.0-575.0 ng/dL
SHBG 44 7-49 nmol/L
Albumin Serum 5.2 H 3.6-5.1 g/dL


Estrogens, Total Serum 116 pg/mL Reference Range 130 or LESS

Progesterone, LC/MS/MS .3 ng/mL Reference Range .3 or LESS

PREGNENOLONE 39 ng/dL Reference Range 10-200

Dihydrotestosterone FREE Serum: PENDING, will know tomorrow
ESTRADIOL, FREE, LC/MS/MS PENDING, will know tomorrow

CBC = everything within range

ALDOSTERONE 13 ng/dL

CORTISOL, TOTAL 26.9 mcg/dL H
Reference Range for 8AM (7-9AM) 4.0 to 22.0
Reference Range for 4PM (3-5PM) 3.0-17.0
(I took this bloodtest at 11am, after a stressful situation trying to get the doctor to order these tests)
Range
DHEA Sulfate 302 110-510 mcg/dL
FSH 1.4 L 1.6-8.0 mIU/mL
LH 3.9 1.5-9.3 mIU/mL
Prolactin 8.7 2.0 - 18.0 ng/mL
T-4, Free 1.3 0.8 - 1.8 ng/dL
TSH, 3rd Gen 2.23 0.40 - 4.50 mIU/L
PSA, total 0.8 < or = 4.0 ng/mL

T3, FREE 297 230- 420 pg/dL
************************************************** ********************************************
I know its a lot to look at, but I really appreciate anyone's help. I'll post the DHT and free estradiol tomorrow when I get it, but until then, please let me know what you think the most likely cause of these symptoms are. Urologists up to this point offer nothing but cialis, which barely works. Within the last month, the ejaculatory anhedonia is really scary! Is the low FSH with the high estradiol ultrasensitive enough to warrant an MRI for a brain tumor? How can I bring the Estradiol down naturally? Is my LH really "normal", and what causes FSH to be low? My old testosterone and thyroid results were done in June, so if you reference them, thats the date. Thanks again.

[Recless]

Hmmm...Free T3 is low...Should be at least 330 pg/dL. I am surprised your TSH is not higher than that though. You need to be under the care of a good Dr Bro...This is definitely not a case you can figure out on your own.

[pmgamer18]

I had this same problem but your not on TRT anyway it is your high Estradiol levels. I had bad ED and could not reach an orgasm and if I did could not feel it. I got my Estradiol tested and it was dam high I needed to go on Arimidex .5mgs eveyday for 6 weeks to get it down. The labs you had done are a new one that just came out the range is <OR=29 at the time of my test my range was 13 to 54 pg/ml I was 90. Your at 48 so if 29 = 54 your 48 is just under 100 compared to my test.

With Estradiol this high it will mess with your Thyroid levels and your Cortisol your Aldosterone at 13 is dam low and getting your Estradiol levels down can change this. Your Free T will come back up and your SHBG should go down.

I would not worrry about your LH and FSH with a total T this high. You brain is just not asking for more.

This first thing that happened to me getting my Estradiol down was a big loss of water weight. Then come morning and night time wood. I was then able to have sex with my wife and reach an orgasm for the first time in 10 yrs.

Now you dam young to have this high Estradiol do you eat or drink a lot of SOY in your diet this will do this.

I would first get this down and then retest to see how things changed.

You still could have this problem I posted to you some days ago.
Congenital Adrenal Hyperplasia: Not Really a Zebra - March 1, 1999 - American Academy of Family Physicians
Pituitary Network Association - Disorders - Prolactinomas

[BILLYGRINGO]

have you lookied into the possibility of Diabetes ? alot of what you wrote is greek to me but, your header looks diabetic ??

good luck

gringo

[JanSz]

Originally Posted by PainIsGrowth

Hello Forum,
Thank you very much for providing the right direction to look for finding what is going wrong in my body. I had the recommended blood tests done from this post, done at Quest.
Penile Atrophy, Zero Libido/sensitivity, Help

Again, here are my main symptoms.
* Zero Libido/Sex Drive
* Bad Erectile Dysfunction even when using max doses of Cialis or Levitra
* Loss of Morning / Spontaneous / Nocturnal Erections
* Penile Tissue Changes (narrowing, shrinkage, curving, numbness, wrinkled)
* Penis Feels "disconnected" from head or body

****Complete loss of pleasure during Orgasm, this is new during last month. I know oxytocin is created by the pituitary, so I'm wondering is something is damaged there? I literally have no sensation during sex/masturbation, a slight sensation at approach of orgasm, and then nothing when there used to be a massive euphoric rush and tingly sensation thoughout my body. This is worrying me the most now.
Here are the results: In Range Out of Range Refererence Range
Estrogens, Fractionated, LC/MS/MS
Estrone, LC/MS/MS 23 pg/ml
Reference Range: < OR = 68

ESTRADIOL, ULTRASENSITIVE 48 H pg/mL
Reference Range: < OR = 29

Estriold, Serem <0.10 ng/mL
Reference Range:
Adults: 0.2 or LESS

Hepatic Function Panel
Only listing things out of range:
ALBUMIN 5.2 H Range : 3.6 - 5.1 g/dL
AST 88 H Range: 10-40 U/L
ALT 81 H Range: 9 -60 U/L

New Testosterone Results, FREE BIO TOTAL LC/MS/MS Range:

Testosterone Total 1081 250-1100 ng/dL
Testosterone Free 127.8 46.0 - 224.0 pg/mL
Testosterone BioAva 301.7 110.0-575.0 ng/dL
SHBG 44 7-49 nmol/L
Albumin Serum 5.2 H 3.6-5.1 g/dL


Estrogens, Total Serum 116 pg/mL Reference Range 130 or LESS

Progesterone, LC/MS/MS .3 ng/mL Reference Range .3 or LESS

PREGNENOLONE 39 ng/dL Reference Range 10-200

Dihydrotestosterone FREE Serum: PENDING, will know tomorrow
ESTRADIOL, FREE, LC/MS/MS PENDING, will know tomorrow

CBC = everything within range

ALDOSTERONE 13 ng/dL

CORTISOL, TOTAL 26.9 mcg/dL H
Reference Range for 8AM (7-9AM) 4.0 to 22.0
Reference Range for 4PM (3-5PM) 3.0-17.0
(I took this bloodtest at 11am, after a stressful situation trying to get the doctor to order these tests)
Range
DHEA Sulfate 302 110-510 mcg/dL
FSH 1.4 L 1.6-8.0 mIU/mL
LH 3.9 1.5-9.3 mIU/mL
Prolactin 8.7 2.0 - 18.0 ng/mL
T-4, Free 1.3 0.8 - 1.8 ng/dL
TSH, 3rd Gen 2.23 0.40 - 4.50 mIU/L
PSA, total 0.8 < or = 4.0 ng/mL

T3, FREE 297 230- 420 pg/dL
************************************************** ********************************************
I know its a lot to look at, but I really appreciate anyone's help. I'll post the DHT and free estradiol tomorrow when I get it, but until then, please let me know what you think the most likely cause of these symptoms are. Urologists up to this point offer nothing but cialis, which barely works. Within the last month, the ejaculatory anhedonia is really scary! Is the low FSH with the high estradiol ultrasensitive enough to warrant an MRI for a brain tumor? How can I bring the Estradiol down naturally? Is my LH really "normal", and what causes FSH to be low? My old testosterone and thyroid results were done in June, so if you reference them, thats the date. Thanks again.

Estradiol high ----> Liquidex 0.75cc/E3D retest in 6 weeks
-----------------------
FreeT low
with your
SHBG=44
you need
TotalT=around 1500 (off the chart
to get there you need over 200mg/week of testosterone
Do 200mg/week on E3D schedule, retest in 2-3 months
do HCG Novarel, 500iu/shot
do both T & hcg shots on same day, E3D schedule, use 30ga 1/2" needle, subq shots around navel for both T& hcg, at the same time take LiquiDex
Goal
FreeT~300 using dr Shippens chart, post #41
Jan's BloodTest April13/2007 - Page 2

Do blood testing per post #44
----------------
T3, T4, FREE very low, get up to 4grains Armour Thyroid then start blood testing.
You want both at the top of range. You may be on top of FreeT3 and still be short on FreeT4, will have to use little bit of Synthroid at that time.
Carefull ramping up on Armour, watch pulse and temperatures, do not go over 90bpm resting
-----------------
DHEA low, get 100mg/day, test and adjus dose, you want to be at 500-650
------------------
Get prescription compounded pregnenolone cream, 100mg/mL, use 2grams/day, retest, adjust dose
-----------------------

AST
ALT

[PainIsGrowth]

Thank you for the replies so far. This is definately going to require a good doctor, but looking at the results so far, what are the probable causes of the estradiol (ultrasensitive) being high, considering my bioavailable testosterone is pretty good. Is my free testosterone at 127.8 Does this sound like a possible testicle tumor (leydig) or adrenal tumor. Or does this seem more like thyroid condition with adrenal fatigue? I want to get to the bottom of the cause, and treat from there. I'm guessing im going to need to see an Endocrinologist to begin some treatment. Any recommendations for Florida/Georgia area? Also, my previous testesterone test done in June was

Free Testosterone 202.1 H 35.0-155.0 pg/mL
I was high at 202.1 H, and the range was 35.0 - 155.0 pg/mL

The new test shows
Testosterone Free 127.8 46.0 - 224.0 pg/mL.

Why is there such a different range, since both were done by Quest. The newer one includes bioavailable. Are they comparable, or did they use a more sensitive testing method this time around? If not, my testosterone free almost dropped in half within the last 2 months. Also, will the DHT and Estradiol Free levels, which should definately be in tomorrow, give any other insights into this condition? Thanks again.
phil-
I'll try to test for the CAH next time I get bloodwork, but I think the prolactinoma is ruled out with my prolactin levels, right? Thanks for the ideas.

[pmgamer18]

Jan gave you some good info but first things first you need to get your estradiol down then retest. You Free T levels can go up getting your Estradiol down your Total T can come up some 200 to 300 points and your SHBG can come down.
Medibolics
this link is about older men but still applies.
Effects of Aromatase Inhibition in Elderly Men with Low or Borderline-Low Serum Testosterone Levels -- Leder et al. 89 (3): 1174 -- Journal of Clinical Endocrinology & Metabolism
So do this first then retest Don't go on TRT or see an Endo Endo's are not good Dr.'s for low T or Adrenals and Thyroid. Read the sticky Finding a New Dr.

[PainIsGrowth]

I just called Quest and got my DHT results. They don't seem to add any more insight into this condition. The results seem in range, and I from what i've read really high DHT or LOW dht isnt good for libido. It seems like the high E2 has to be what's causing this problem! Does anyone know from bloodtest experience if 48 E2 is high enough to completely kill libido and give severe ED? Maybe its different person to person, but im just wondering. Also what are the known physical conditions that cause high E2. I don't care how obscure the reference. I want to eliminate all possibilities.

Value Range
Dihydrotestosterone 53 25- 75 ng/dL
DHT free 4.81 1.00 - 6.20 pg/mL
DHT free % .83 % .62 - 1.10%

Estradiol, Free, LC/MS/MS still pending. Its frustrating for tests to take so long.

[pmgamer18]

Some men not me can do good with a level between 30 to 40 but they have a higher SHBG level. I have a low normal SHBG levels about 20 I can not get it up if I am over 30 pg/ml I do best at 15 to 20. When I get over 30 I get a bad rash, have hard and sore nipples, look red on my upper body like a sun burn, sweat and feel hot all day, have panic attacks and bad brain fog.

[jaydee]

Phil, is that correlation between SHBG and E true for most men? Is it a good guide to go by? My E is 33 and my SHBG is about the same.

[pmgamer18]

I don't know a hole lot about it other then what Dr. John told me my SHBG is 20 at the time my E2 was 20 and Dr. John told me my E2 was not low enough so when I got down to 15 wow big difference much better libido and wood.

Originally Posted by jaydee

Phil, is that correlation between SHBG and E true for most men? Is it a good guide to go by? My E is 33 and my SHBG is about the same.

[jaydee]

Wow.....thats amazing you got such a difference with such a small change.

[pmgamer18]

Originally Posted by jaydee

Wow.....thats amazing you got such a difference with such a small change.

This is why it is so dam hard to keep leveled on estradiol the window is dam small and I find the best gauge for this is night time and moring wood when Estradiol is at the best range you get wood so strong it wakes you up. One needs to keep a log on how they are doing day to day. I went to the gym to day and was working out after about 40 mins my nipples started to get dam hard and sore this tells me my E2 is going up but after I got home it settled down.

[jaydee]

Makes ya realize just how lost these poor blokes are who's Endo's dont even moniter E at all.

[PainIsGrowth]

These are the final pending Estradiol, Free, LC/MS/MS results. I'm going to the doctor who ordered them tomorrow, so hopefully, I can use these to show that something isn't right. I highly doubt he would go for the Arimdex, but maybe I could ask for an MRI of the adrenals or pituitary to rule out an estrogen secreting tumor? Don't really know where else to go from here.


Estradiol, Free, LC/MS/MS Range
Estradiol free .91 H .3 - .9 pg/mL
Estradiol free % 1.66 % 1.66% - 2.11 %
Estradiol 55 10-50 pg/mL

I guess this was a seperate Estradiol test from the Ultrasensitive method which came back at 48H. I hope this is enough to get some help.