In Serious need of help.

[roro]

I would like to thank those who have already given me some feedback on the limited amount of info I had at the time. I am posting these now as I am utterly desperate to simply lead a normal life. I apologise in advance if I am going against protocol by posting up a detailed sob story, but I really don’t know what else to do.

Up to the age of fifteen, I was completely normal (uncontrollable erections and thoughts of sex 24/7). However I got a urinary infection, my semen changed in appearance, and all I could think was “**** me, I’m going to lose my sex drive and become impotent. I worried intensely about this for years, and surprise surpise these things manifested completely. (There’s a bit more to this, and if anyone really feels they can offer me any help, more info, as well as other blood tests can be PM’d or emailed).

I am now 33, I don’t have a libido at all. I only really masturbate to try and make sure nothing ‘shuts down’. I never get full erections, and only RARELY get soft morning erections.

I have seen urologists, sex therapists and endocrinologists (but none that have an interest in male sexual dysfunction). I have only had one proper girlfriend and that lasted a year when I was 23. When your in bed with a really good looking girl with a great body at that age, and you can’t get hard AND you don’t really feel that driven to do anything anyway, theres something very, very wrong.

I had resigned myself to ‘someday’ finding a very understanding woman with a low sex drive (mines Z_E_R_O). That was up until about 3 months ago.

I tried a testosterone booster (The old Alpha Male from Biotest) and was about to wonder why I was bothering until after the 4th day….BOOM! I felt like I had never EVER felt since I was 15. It started off lunch time, all of a sudden I felt like I needed to get in the ring for a sparring session, and then I started looking at women. It was like switching on a light bulb. I was actually looking at women who I would never give a second look and thinking “yeah, I would”. It was absolutely amazing. I simply had to go to the toilets for a “number 3” twice, and this is at work. I only felt like this for a while and almost as good the next day, but still VERY noticeable. That weekend was full of that particular sexual energy that being male is supposed to be. It was only after this experience that I realised just how bad things had been. To not have felt anywhere near half of that sexual energy in over 17 years is not good, needless to say I had actually forgotten how it felt.

Unfortunately, I havn’t been able to repeat this, and I have tried lots of things,(Maca, Tribulus, Red Kat 6 oxo etc) 6 oxo gave me a similar half hour burst once but that’s all.

I can’t see anything that seems seriously out of line. PMgamer18 thinks my E2 may be too high, and I will suggest this to the Endo. One thing that also seems strange is the SHBG. In the table, the average SHBG for my age range is 35.5. With a standard deviation of 8.8, I’m guessing that that means the highest was 44.3 and the lowest 26.7? If that’s the case, mine seems quite low.

Any feedback would be greatly appreciated.

For the record, there is nothing wrong with my secondary sexual characteristics, and 2 months working out gets back a great physique.

The serum testosterone and SHBG ended up being done twice as it took 3 visits to get all the tests done that I requested.

Serum Testosterone 18.1 nmol/L (10.0–31.0) 31/07/06
Serum Testosterone 22.7 nmol/L (10.0–31.0) 07/08/06
Bio-available Test’ 15 nmol/L unknown
DHT 2.62 nmol/L (0.9-2.9) unknown
SHBG 13.8 nmol/L (13.0-71.0) 31/07/06 (ammended report?)
SHBG 17.1 nmol/L (13.0-71.0) 07/08/06
FSH 2.9 iu/L (0.8-13.0) 31/07/06
LH 3.9 iu/L (0.5-10.0) 31/07/06
Oestradiol 128 pmol/L (0-206) 31/07/06
Prolactin 167 mIU/L (53-360) 31/07/06
Cortisol 356 nmol/L (138-690) 07/08/06 (morning sample)
TSH 3.07 mIU/L (0.3-4.1) 07/08/06
Albumin 43 g/L (35-50) 31/07/06
Triglycerides 0.7 mmol/L (0.8-1.7) 31/07/06 (only included as low)

Ten years ago, this incredibly in-depth investigation was done……………

Serum Testosterone 26.2 nmol/L (10.0–31.0) 04/06/96

I have never done any steroids.

Age Number of Subjects Total Testosterone Standard Deviation Free Testosterone Standard Deviation SHBG Standard Deviation
25-34 45 21.38 5.9 0.428 0.098 35.5 8.8
35-44 22 23.14 7.36 0.356 0.043 40.1 7.9
45-54 23 21.02 7.37 0.314 0.075 44.6 8.2
55-64 43 19.49 6.75 0.288 0.073 45.5 8.8
65-74 47 18.15 6.83 0.239 0.078 48.7 14.2
75-84 48 16.32 5.85 0.207 0.081 51 22.7
85-100 21 13.05 4.63 0.186 0.08 65.9 22.8

[pmgamer18]

The problem for most of us is your units are not the same as the labs her in the US. Your E2 is 37 in are units a little on the high side we try to keep it between 10 to 30 best at 20 and your T is 637 not to bad. But for the way you feel I say go on TRT and see how you feel. For the best TRT go to www.allthingsmale.com and read TRT: A Recipe for Success and the HCG update.
I do Depo T shots every 3 days 40 mgs and HCG the 2 days in between 400 IU's I take a .25 mg of Arimidex every 3 to 5 days.

I find it odd that your T levels are this high with your LH and FSH so low. I would look into having your Pituitary checked doing an MRI on it to see if anything is wrong. It looks like your testis work but not getting enough LH and FSH from you Pit.

TSH of 3 shows me your Thyroid is slow try getting a Free T3 and Free T4 done. As for you cortisol I can convert it into ug/dl but if you can and it's less then 15 this would also be to low.

[roro]

http://www.vin.com/scripts/labquest/converthtml.pl

LabQuest
Unit conversion
Cortisol
Chemistry SI Units ----> US Units
Cortisol 356 nmol/L converts to 12.89 µg/dl

[taser]

your estrogen is a bit high. you need to bring it below 30. also,once you had an experience with erectile dysfunction,it stays with you as it can be quite traumatic. you definitely have a case of performance anxiety coupled with an underlying problem. i would try a small dosage of arimadex and see where that leads you. however,its best to do it in conjunction with a doctor;someone who specializes in "Andrology".

[roro]

Getting nowhere fast...

Endo reckons everything is A OK (specialises in andrology)

Quick question.

With my E2 being 37, some feel this may be too high. With my SHBG being so low (13.8 and checked again at 17.1) could these two factors be combining to have a detrimental effect? Am I right in thinking that SHBG binds to E as well as T?

Any feedback greatly appreciated.

[zumper]

Search,ask.,read, make everything to fix your life ,don't quit,you will find the solution .
BTW do not be sure that the answer always is high T.

[JustOne]

Originally Posted by roro

Getting nowhere fast...

Endo reckons everything is A OK (specialises in andrology)

Quick question.

With my E2 being 37, some feel this may be too high. With my SHBG being so low (13.8 and checked again at 17.1) could these two factors be combining to have a detrimental effect? Am I right in thinking that SHBG binds to E as well as T?

Any feedback greatly appreciated.

What I found to be usefull in your situation is to call up your local phone directory and ask for an anti aging clinic, thats what worked for me.

[jbailey27]

Originally Posted by roro

I can’t see anything that seems seriously out of line. PMgamer18 thinks my E2 may be too high, and I will suggest this to the Endo. One thing that also seems strange is the SHBG. In the table, the average SHBG for my age range is 35.5. With a standard deviation of 8.8, I’m guessing that that means the highest was 44.3 and the lowest 26.7? If that’s the case, mine seems quite low.

Just to clear up your confusion on standard deviation. This is a statistical term used to describe roughly the spread of the data ie dispersion. With all the many assumptions, what this means is that 99.7% of the SHBG data collected was withing 3 standard deviations. This would imply that if you take enough data, you would see values at 35.5 +/- 3*8.8 or 9.1 to 61.9.

Quite a large range. I am not sure what data they are basing this on, but to get an idea of the range, you need to multiply by 3 on the standard deviation.

[van-man]

Originally Posted by jbailey27

Just to clear up your confusion on standard deviation. This is a statistical term used to describe roughly the spread of the data ie dispersion. With all the many assumptions, what this means is that 99.7% of the SHBG data collected was withing 3 standard deviations. This would imply that if you take enough data, you would see values at 35.5 +/- 3*8.8 or 9.1 to 61.9.

Quite a large range. I am not sure what data they are basing this on, but to get an idea of the range, you need to multiply by 3 on the standard deviation.

But roughly 90% of the samples will fall within one standard deviation. The last two deviations will only have the last 10% of the total sample population. You can disregard them in a practical application.

[Andrew Androgen]

Originally Posted by roro

Getting nowhere fast...

Endo reckons everything is A OK (specialises in andrology)

Quick question.

With my E2 being 37, some feel this may be too high. With my SHBG being so low (13.8 and checked again at 17.1) could these two factors be combining to have a detrimental effect? Am I right in thinking that SHBG binds to E as well as T?

Any feedback greatly appreciated.

Mate, the vast majority of endos will tell you that your doing ok, even when your test levels are low as hell & you have all the symptoms of hypogonadism. It seems that they only offer treatment for guys who are missing a nut or two.

[JustOne]

Originally Posted by Andrew Androgen

Mate, the vast majority of endos will tell you that your doing ok, even when your test levels are low as hell & you have all the symptoms of hypogonadism. It seems that they only offer treatment for guys who are missing a nut or two.

They gotta be missing 2, Ive heard of a lot of people being told there ok with just one, my urologist and GP thinks im ok. I just play along when they tell me I can function normally with just one.

Whats bad is on the testicular cancer forums theres a whole bunch of guys with 1 nut not doing any TRT, infact I dont think any of them with one nut are doing TRT only the bilateral guys and even some of them get taken off because there liver enzymes get alil elevated.

[marianco]

Originally Posted by roro

IUp to the age of fifteen, I was completely normal (uncontrollable erections and thoughts of sex 24/7). However I got a urinary infection, my semen changed in appearance, and all I could think was “**** me, I’m going to lose my sex drive and become impotent. I worried intensely about this for years, and surprise surpise these things manifested completely.

I am now 33, I don’t have a libido at all. I only really masturbate to try and make sure nothing ‘shuts down’. I never get full erections, and only RARELY get soft morning erections.

For the record, there is nothing wrong with my secondary sexual characteristics, and 2 months working out gets back a great physique.

The serum testosterone and SHBG ended up being done twice as it took 3 visits to get all the tests done that I requested.

Serum Testosterone 18.1 nmol/L (10.0–31.0) 31/07/06
Serum Testosterone 22.7 nmol/L (10.0–31.0) 07/08/06
Bio-available Test’ 15 nmol/L unknown
DHT 2.62 nmol/L (0.9-2.9) unknown
SHBG 13.8 nmol/L (13.0-71.0) 31/07/06 (ammended report?)
SHBG 17.1 nmol/L (13.0-71.0) 07/08/06
FSH 2.9 iu/L (0.8-13.0) 31/07/06
LH 3.9 iu/L (0.5-10.0) 31/07/06
Oestradiol 128 pmol/L (0-206) 31/07/06
Prolactin 167 mIU/L (53-360) 31/07/06
Cortisol 356 nmol/L (138-690) 07/08/06 (morning sample)
TSH 3.07 mIU/L (0.3-4.1) 07/08/06
Albumin 43 g/L (35-50) 31/07/06
Triglycerides 0.7 mmol/L (0.8-1.7) 31/07/06 (only included as low)

Ten years ago, this incredibly in-depth investigation was done……………

Serum Testosterone 26.2 nmol/L (10.0–31.0) 04/06/96

I have never done any steroids.

To help those of us in the U.S. understand the labs better, it is important to convert the units from SI to conventional units:

Total Testosterone = 22.7 nmol/L = 649 ng/dl
Dihydrotestosterone = 2.62 nmol/L = 75 ng/dl
Sex Hormone Binding Globulin = 17.1 nmol/L
FSH = 2.9 iu/L
LH = 3.9 iu/L
Estradiol = 128 pmol/L = 35 pg/ml
Cortisol = 356 nmol/L = 12.9 mcg/dl
TSH = 3.07 miu/ml
Albumin = 43 g/L = 4.3 g/dL
Triglycerides = 0.7 mmol/L = 62 mg/dL

1. When total testosterone is good, but problems remain (e.g. sexual dysfunction), then the problem lies elsewhere. This means there are other neurotransmitter/hormone/immune-cytokine problems that are present to cause the problem.

2. A total testosterone of 649 is high enough to indicate that there is no need for testosterone replacement. The problem lies elsewhere.

3. Sex Hormone Binding Globulin is increased by thyroid hormone, estrogens, and progesterone. It is lowered by androgens (e.g. testosterone, DHEA), growth hormone, and insulin.

4. Low sex hormone binding globulin can occur most commonly with insulin-resistance/diabetes type 2 (with high insulin levels), and with hypothyroidism. Low estrogen and progesterone may also contribute.

5. Clues to insulin-resistance/diabetes includes a fasting blood glucose over 102 mg/dl, a high fasting insulin, high glucose and insulin levels on a 3-hour glucose tolerance test, a triglyceride (mg/dl) to HDL cholesterol (mg/dl) ratio > 3.5.

6. High estradiol may impair sexual function. Estradiol increases the production of thyroid binding globulin, which then reduces the activity of thyroid hormone. Estradiol itself competes with thyroid hormone at the thyroid hormone receptor. This causes a relative state of hypothyroidism which reduces libido.

7. Estradiol is important for sex drive. Excessively low estradiol levels will contribute to a lack of libido. Estradiol is necessary for the production of numerous neurotransmitters - such as serotonin, dopamine. etc. Estradiol itself contributes to sexual aggression - hence sex drive.

8. It is far more important to address testosterone production, thyroid hormone activity, and adrenal hormone activity first before considering estrogen as a problem - because most often it is not estrogen that is the problem. When total testosterone is around 650 ng/dl, estradiol can be as high as 50 and a person can still have good sexual function - so long as there is adequate thyrod hormone and adrenal hormone activity.

9. Often, when sexual function improves because of the use of an aromatase inhibitor, the lowering of estradiol ends up improving thyroid function, which then improves sexual function. The thyroid dysfunction is the original problem. Once thyroid hormone is optimized, then estradiol control becomes much less of an issue.

10. A morning cortisol of around 18-20 mcg/dL is about ideal. When the morning cortisol is low, adrenal fatigue or adrenal insufficiency may be occurring - causing fatigue, anxiety, and a loss of sex drive - among other symptoms.

11. Lab clues to adrenal fatigue include: low normal fasting blood sugar (e.g. < 93 mg/dL), low sodium, low potassium, low or low normal progesterone, low albumin, low DHEA-s, low normal cortisol AM and PM, low saliva cortisol levels. Additionally, in post-menopausal women: low testosterone, low estradiol.

12. Hypothyroidism causes sexual dysfunction. It can also lead to insulin-resistance and diabetes; as well as adrenal fatigue; depending on the stresses a person experiences in their life.

13. Clues to hypothyroidism include: TSH > 2.0 mIU/mL OR a Free T3 < 3.3 pg/mL OR a low Free T4.

14. The Free T3 is the most important measure since it represents the most active thyroid hormone and the hormone measured by the brain to determine TSH. Unfortunately, for various reasons, the TSH is often wrong. For example, with age or brain injury, the brain cannot produce enough TSH, leading to hypothyroidism despite a "normal" TSH. TSH is the brain's opinion of how much T3 is available. Unfortunately, the brain can be wrong.

15. There are people who have a mitochondrial disease which causes thyroid hormone resistance. For them, they have completely normal thyroid hormone levels but they are clinically hypothyroid - having all the signs and symptoms of hypothyroidism. For them, a trial of thyroid hormone treatment is indicated - since they need higher than normal thyroid hormone levels to treat their signs and symptoms.

16. When it comes to the diagnosis of hypothyroidism, it is important to see a physician who can diagnose hypothyroidism strictly by history and physical exam - without relying on lab tests. This is a physician who has not lost his/her skills at physical diagnosis, and will most likely be able to help the person suffering from hypothyroidism.

17. If the physician has to rely on the lab test for the diagnosis, then that physician will be blind to the adequate treatment of hypothyroidism. If treated, the patient will improve but will not be fully well.

18. Unfortunately, too many endocrinologists are willing to keep a person hypothyroid than to risk getting optimum treatment out of fear of letting the person become hyperthyroid. To do this keeps the person at high risk of obesity, diabetes, heart attacks, strokes, cancer, sexual dysfunction and mental illness. Since hyperthyroidism is obvious to diagnosis, and one needs very high doses of thyroid hormone to achieve a hyperthyroid state, I think this is an unfounded fear. Also, if one uses Armour Thyroid, rather than T3 or Cytomel, to obtain T3, safety is enhanced. Unfortunately, many endocrinologists view Armour Thyroid as a primitive treatment - yet it is highly standardized in dose (30 mg of Armour thyroid has 19.5 mcg of T4 and 4.5 mcg of T3).

By the way, if you are in Europe, the best physician there for addressing hormone problems is Thierry Hertoghe, M.D., in Belgium. He is fabulous. He comes from a long line of famous endocrinologists. He is a true anti-aging physician.

[roro]

Marianco,

Thank you so very, very much.