Zero libido, low T (21, male)

[lxm]

I GUARANTEE you I did not call you a TROLL. I said you were potentially PRESENTING AS ONE. You would know had I done so....! You are more than welcome to ask that I stay out of your thread and you are more than readily obliged...

If you feel that you have anything to contribute to this thread then please do so! Im looking for others opinions and previous experiences to help with my own treatment.

Thanks

 

[lxm]

for your info....

I was on 1ml sustanon250 (250mg) every 4 weeks (28 days) I experience a bad crash every injection after 2.5-3 weeks, my doctor seems in no hurry to sort out my frequency. He told me to continue Injections at 4 week periods to see if things 'level out'. I continue at this protocol for 3 months, then doctor agrees to check a trough.

Had trough blood work done just before next injection
4 week trough
Test : 7.8nmol (8.6nmol-28.8)
E2 : 156pmol (0-150pmol)

Doctor agrees to move injection protocol to injection every 3 weeks (21 days). This is better, but 2-3 days before next injection I have a bad crash, I request that he take a trough at 3 weeks.

3 week trough
Test : 7.3nmol (8.6nmol-28.8)
E2 : 77pmol (0-150pmol)

I was surprised at this, I guess that before the 3 week period, the sustanon250 testosterone has been completely used up, and the testosterone levels of 7nmol at weeks 3 & 4 is from my own natural production (my testicles are still functioning, LH is just hanging in and no more at 1.8 (1-9) and FSH at 4.6 (1-9)

Pre TRT my LH & FSH were around the 6 (1-9)

My doctor is not happy changing the frequency of sustanon250 to every 2 weeks, he wants to change me to a different medication, either gel or nebido. Its frustrating that hes not willing to adjust the dosage for my case, as every patient is different

 

[lxm]

I'm getting a little confused with my case, my symptoms of no libido, no sexual assertiveness and drive is creeping back in.... I'd just rather not..... No horniness what so ever! When I initially started TRT all of these sexual functions came back to me.

The cognitive and normal functions are 110% better and I want to definitely stay on the TRT for this reason alone, as before I was a complete mess unable to function in day to day life (brain fog/confusion, no concentration, non assertive, anxiety, lethargic, aching muscles)

So sexual functions have slowly gone down the drain again, but the cognitive and basic functions have kept up and 110%. Does anyone know why this is?

Also I have received more blood works, a trough at 2 weeks... Again its a surprise. Each of the bloods below is for 1ml sustanon250mg.

4 week trough
Test : 7.8nmol (8.6nmol-28.8)
E2 : 156pmol (0-150pmol)


3 week trough
Test : 7.3nmol (8.6nmol-28.8)
E2 : 77pmol (0-150pmol)

2week trough
test: 11.2nmol (8.6-28.8)

The doctor doesn't understand why the testosterone is being depleted so fast in my system.

125mg per week is seeing me at 11nmol (323ng/dl) trough on the 7th day......


Is there more going on with my case than simply testosterone levels? other hormone levels ? pharmacokinetics? some other type of faulty gene or disorder?

I have been being seen by a university endocrinologist registrar (who specialists in diabetes) We have demanded that I am seen by a male androgen specialist but there are none in my country (scotland) so the best I can get is a senior consultant endocrinologist.

 

[idmd]

I started at the standard dose of 100mg per week and felt better all around but libido still lagged. Since going to 200mg per week libido has been back in full.

My libido is MUCH better at 200mg/week of just test or 150mg/week test and 500ui/week hCG....no AI.

 

[UK86]

If your levels are dropping so low so soon after the injection then it would suggest your body is dumping out the T really quickly? I'm not experienced enough to say why, but personally my instinct would be to use LESS T but more often, not just jack up the dose to 200mg weekly, especially as your estrogen appeared to already be too high.

 

[lxm]

I started at the standard dose of 100mg per week and felt better all around but libido still lagged. Since going to 200mg per week libido has been back in full.

My libido is MUCH better at 200mg/week of just test or 150mg/week test and 500ui/week hCG....no AI.

Issue is 125mg per week (250mg sustanon every 14 days) is the greatest amount of testosterone that is available to a patient on the nhs, that's it.

If your levels are dropping so low so soon after the injection then it would suggest your body is dumping out the T really quickly? I'm not experienced enough to say why, but personally my instinct would be to use LESS T but more often, not just jack up the dose to 200mg weekly, especially as your estrogen appeared to already be too high.

I guess my body is dumping it for whatever reason... Im guessing this is where a daily gel could be more effective?

My options are ;
250mg sustanon250 per 14 days (2 weeks)
1000mg nebido per 84 days (12 weeks)
10g testosterone gel (10mg) per 1 day

 

[lxm]

I'
4 week trough
Test : 7.8nmol (8.6nmol-28.8)
E2 : 156pmol (0-150pmol)


3 week trough
Test : 7.3nmol (8.6nmol-28.8)
E2 : 77pmol (0-150pmol)

.

I got the official numbers from my 2 week trough of 1ml sustanon250 (250mg every 14 days)


Test 10.5nmol (8.6-28.8)
E2 138pmol (0-156)
Lh 0.1 (1-9)
Fsh 0.3 (1-9)
SHGB 12nmol (18-35)


Looks my own production is now pretty much near shut off! and testostrone not really making an appearance....

 

[UK86]

Seems OK for a tough level @ 2 weeks. I doubt any Dr in the NHS would go any more than 2 weekly Sustanon 250 - I mean that is already more frequent than the prescribing guidelines in the BNF state and low-normal levels at the end of the 'cycle' are generally what they are aiming for anyway.

You also pushed your SHBG even lower.

You could try Nebido - they go for 12 weeks to start normally and it is very linear in the way it delivers... the thing is though you will still be approaching that kind of T level by the end of those 12 weeks. The peak and trough figures are still similar just the swing happens over a longer time frame, which might even out the symptoms I guess.

What are your hopes/expectations for TRT?

 

[lxm]

Seems OK for a tough level @ 2 weeks. I doubt any Dr in the NHS would go any more than 2 weekly Sustanon 250 - I mean that is already more frequent than the prescribing guidelines in the BNF state and low-normal levels at the end of the 'cycle' are generally what they are aiming for anyway.

You also pushed your SHBG even lower.

You could try Nebido - they go for 12 weeks to start normally and it is very linear in the way it delivers... the thing is though you will still be approaching that kind of T level by the end of those 12 weeks. The peak and trough figures are still similar just the swing happens over a longer time frame, which might even out the symptoms I guess.

What are your hopes/expectations for TRT?

Thanks for the reply - I'm not contesting wanting more frequent than 250mg E2W, I thought numbers would be a little higher considering that the BSSM guidelines state that a level of 16nmol should be aimed for at a trough to relieve patients of symptoms (at a trough level)

There has been a very noticeable return of symptoms (sexual) and on that side of things I pretty much feel like I did pre-trt. Completely uninterested in sex, zero libido or hornyness ever... I almost feel like I've been castrated.

Ive also lost that drive, get up and go that the TRT initially boosted for me, and on this front gone back to the way I was feeling pre TRT.

Ive failed to loose any body fat or notice any body composition change in the last 8 months. The only thing that the TRT is releaving is the cognitive symptoms (brain fog, bad memory, mental confusion) and muscle aches...

Should I stop TRT ? why are all of the positive effects of TRT subsiding? I've read that low SHBG can render TRT useless in some cases.

 

[James23]

Thanks for the reply - I'm not contesting wanting more frequent than 250mg E2W, I thought numbers would be a little higher considering that the BSSM guidelines state that a level of 16nmol should be aimed for at a trough to relieve patients of symptoms (at a trough level)

There has been a very noticeable return of symptoms (sexual) and on that side of things I pretty much feel like I did pre-trt. Completely uninterested in sex, zero libido or hornyness ever... I almost feel like I've been castrated.

Ive also lost that drive, get up and go that the TRT initially boosted for me, and on this front gone back to the way I was feeling pre TRT.

Ive failed to loose any body fat or notice any body composition change in the last 8 months. The only thing that the TRT is releaving is the cognitive symptoms (brain fog, bad memory, mental confusion) and muscle aches...

Should I stop TRT ? why are all of the positive effects of TRT subsiding? I've read that low SHBG can render TRT useless in some cases.

In many cases, low SHBG renders TRT useless. It depends on why SHBG is low. A high or normal SHBG that is driven down by TRT is often not a problem as long as the patient controls estrogen. A patient with existing low SHBG that tries to undergo TRT will almost never experience any symptom relief. This is true for me and many other members of this board. Interestingly, all low SHBG sufferers that I've seen on the boards are very, very young. Almost invariably; they are between 19 and 24.

 

[lxm]

In many cases, low SHBG renders TRT useless. It depends on why SHBG is low. A high or normal SHBG that is driven down by TRT is often not a problem as long as the patient controls estrogen. A patient with existing low SHBG that tries to undergo TRT will almost never experience any symptom relief. This is true for me and many other members of this board. Interestingly, all low SHBG sufferers that I've seen on the boards are very, very young. Almost invariably; they are between 19 and 24.

Im now 22, although was 20 when I started the blood tests etc.

My initial bloodwork pre-trt was : Serum T @ 10.8nmol, SHBG @ 14nmol, E2 @ 222pmol

SHBG has now been driven down to 12nmol.... and the synthetic testosterone that im injecting is metabolizing very quickly...

would the gels be a better option for me ? Initially sexual symptoms, well being & general life drive.. and cognitive symptoms were improved 110%... now everything is dwindling apart from the cognitive functions on trt, and when the T runs out the cognitive side really crashes hard.

Im being seen by a registrar diabetes endo who doesn't have a clue so there's no way hes going to know about low shbg causes TRT patients issues...

Ive not been 'horny' since I was 16...That feels pretty sh1tty... that over excited rampant devils advocate drive... I can only dream

 

[idmd]

Im now 22, although was 20 when I started the blood tests etc.

My initial bloodwork pre-trt was : Serum T @ 10.8nmol, SHBG @ 14nmol, E2 @ 222pmol

SHBG has now been driven down to 12nmol.... and the synthetic testosterone that im injecting is metabolizing very quickly...

would the gels be a better option for me ? Initially sexual symptoms, well being & general life drive.. and cognitive symptoms were improved 110%... now everything is dwindling apart from the cognitive functions on trt, and when the T runs out the cognitive side really crashes hard.

Im being seen by a registrar diabetes endo who doesn't have a clue so there's no way hes going to know about low shbg causes TRT patients issues...

Ive not been 'horny' since I was 16...That feels pretty sh1tty... that over excited rampant devils advocate drive... I can only dream

So pre-TRT you were not hypogonadal (on the low side but in range) but you had really high E2. Then you start TRT and your trough test levels are even lower than your pre-TRT levels and your E2 is still elevated....and you wonder why you still feel like shit?

I think you would've been much better off just controlling E2 with a very conservative dose of an AI...E2 would've come down and your test (which was in range already) would've gone up significantly.

 

[lxm]

So pre-TRT you were not hypogonadal (on the low side but in range) but you had really high E2. Then you start TRT and your trough test levels are even lower than your pre-TRT levels and your E2 is still elevated....and you wonder why you still feel like shit?

I think you would've been much better off just controlling E2 with a very conservative dose of an AI...E2 would've come down and your test (which was in range already) would've gone up significantly.

Initially when I first went to my doctor about how I was feeling and my test was 13.5nmol, I went away for a year and made many lifestyle changes, I went from 220lbs @ 35% BF to 155lbs @ 20% bf in this period. I was still feeling terrible and went back to him, and thats when the bloods showed 11.5nmol, 10.8 nmol & 9.6nmol with E2 @ 200 + pmol...

NHS dose not offer estrogen control.

I can completely understand where you are comming from, maybe it would have been a smart move to self medicate with an AI.... but I was unaware of that at the time and thought the doctors wast the best option.

should I come off the TRT ? and try and get estrogen down, and see if that raises my T ?

I have managed to get a appointment with the main consultant at my hospital in the mean time

 

[domino]

Why not pick up an AI on your own and then try it - have blood drawn in 6 weeks and see where you are at?

 

[lxm]

Hi Domino, thanks for chipping in!

What would you suggest ? arimidex? what dosage ? My last E2 readings at the troughs were surprisingly lower than pre-trt (70pmol, 130pmol & 150pmol)

Ive balooned massivley in weight also since starting TRT... eating no more than previously, and keeping active... Ive put on 20lbs and my belly, love handles & lower back are extremely watery and flabby"! gahh.

I guess I'll find out whats happening with my case when I see the registrar next week....Again I also have an appointment with the senior consultant for a second opinion, I think he may re-investigate my case, does anyone have any pointers I should bring up with him>

 

[domino]

If it were me I would try arimidex at 25 eod. You might need more or less. I had to play around with my dosing to find that sweet spot. If u go to low achy joints and you need some estrogen. Also going to low made my libido go down. Some people take a lot more than I do but I think you start small and increase to see what blood work looks like and also how you feel.

 

[idmd]

If it were me I would try arimidex at 25 eod. You might need more or less. I had to play around with my dosing to find that sweet spot. If u go to low achy joints and you need some estrogen. Also going to low made my libido go down. Some people take a lot more than I do but I think you start small and increase to see what blood work looks like and also how you feel.

0.25mg EOD

 

[domino]

Do u workout. You should exercise. The weight gain. This could be bloat. Arimidex will help with that. You can control some of this or a lot of it with proper nutrition and regular exercise. Put some sweat into it. Don't depend on your doc for everything. Take it into your own hands if need be. But whatever you do research it. Look on here about arimidex or google it and read and research how others use it. Come up with a game plan and do it. This is your health dude. Take control of it. Get lots of rest. Eat right. Do everything you can to control your health.

I use test cyp every 4 days. Works great for me. I also use 12.5 mgs arimidex every other day. I was taking arimidex ed and had joint issues. I found my spot and adjust as needed. I don't depend on docs to control it anymore. Hell yesterday I had a doc appointment and they told me that the test caused me to have a bundle blockage.

 

[domino]

Sorry I meant .25.

 

[zkt]

Has

[ame=http://en.wikipedia.org/wiki/Klinefelter_syndrome]Klinefelter syndrome - Wikipedia, the free encyclopedia[/ame]

Been ruled out?