Positive Outcome Of Clomiphene Citrate Treatment In Young Hypogonadal Men

[Dr JIM]

Thx

 

[arrius]

Thanks to all who are posting on these boards. I have been reading with interest ,so know that your posts are appreciated. Myself, 48 year old male started with bouts of ED about 8 years ago which. I was also battling worsening extreme fatigue and weakness. I continued working but it took all the energy I could summon up to make it through the workday. I kept telling my doc at the VA hospital that I was getting weaker. Her response was that this was normal as I was getting older. At that time I was only 45 and I said damn doc when I lift 25 pounds it feels as if I am trying to lift 100 pounds. I told her at 5'11" and a solid 190 lbs , 32" waist I shouldnt be that weak. To make a long story short I eventually fought my way in to see a VA Endocrinologist. After some blood tests he felt that my T levels were way to close to the bottom of the scale given my age. Solution, the Endocrinologist started me on T replacement therapy. Given I have an adhesive allergy and the Veterans Administration does not have the gel, they supply me with the injectable form of T and I self inject one of the small 200 mg vials one time weekly. 5 days after injection my T levels are still about 795 which is much better than before I started the therapy. The downside is the T did nothing for my ED absolutely nothing . The good news is the T did give my energy back and that is priceless in itself.
Everyone , please do keep posting here as I will keep trying to solve my ED issues. The one thing I have learned is that ED is a very complex and odd thing. I was given Viagra and it did nothing for me . I was given Cialis and it did nothing for me. Then I was given Levitra and the first time I took it was mindblowing, my ED was non existent for at least 15 or more hours from one dose of Levitra. Unfortunately the Levitra worked excellent with the very first dose but after that was very little help. I thought my doc might have an answer on why Levitra would work so unbelievably well on the first dose but then no more. The docs reply was , he had no answer for that.

 

[foreveryoung]

Thanks to all who are posting on these boards. I have been reading with interest ,so know that your posts are appreciated. Myself, 48 year old male started with bouts of ED about 8 years ago which. I was also battling worsening extreme fatigue and weakness. I continued working but it took all the energy I could summon up to make it through the workday. I kept telling my doc at the VA hospital that I was getting weaker. Her response was that this was normal as I was getting older. At that time I was only 45 and I said damn doc when I lift 25 pounds it feels as if I am trying to lift 100 pounds. I told her at 5'11" and a solid 190 lbs , 32" waist I shouldnt be that weak. To make a long story short I eventually fought my way in to see a VA Endocrinologist. After some blood tests he felt that my T levels were way to close to the bottom of the scale given my age. Solution, the Endocrinologist started me on T replacement therapy. Given I have an adhesive allergy and the Veterans Administration does not have the gel, they supply me with the injectable form of T and I self inject one of the small 200 mg vials one time weekly. 5 days after injection my T levels are still about 795 which is much better than before I started the therapy. The downside is the T did nothing for my ED absolutely nothing . The good news is the T did give my energy back and that is priceless in itself.
Everyone , please do keep posting here as I will keep trying to solve my ED issues. The one thing I have learned is that ED is a very complex and odd thing. I was given Viagra and it did nothing for me . I was given Cialis and it did nothing for me. Then I was given Levitra and the first time I took it was mindblowing, my ED was non existent for at least 15 or more hours from one dose of Levitra. Unfortunately the Levitra worked excellent with the very first dose but after that was very little help. I thought my doc might have an answer on why Levitra would work so unbelievably well on the first dose but then no more. The docs reply was , he had no answer for that.

I would think that it was a coincidence of other factors coming together for a perfect storm and the levitra was the lucky one to be involved that day, and had it been viagra that you had taken that day the results would have been the same.

libido can be like that, for whatever reason all the neurotransmitters and brain chemistry can come together briefly for a short blip of time and give a different libido situation (better or worse) than what one experiences usually, who knows why or what influenced it that day.... just my opinion

 

[arrius]

Thanks foreveryoung for sharing the thoughts. I to agree with that theory of the perfect storm. I will keep researching on my end. Its the damndest thing in that they always say cigarette smoking will kill your wood. Hell I use to smoke two packs of Marlboro a day but quit about 10 years ago. While smoking wood was always good to go unlimited times daily ,ejaculate volume was substantial and I felt good. Since having given up smoking though wood get more contrary with each passing year, ejaculate volume is only a quarter or less what it use to be and ejaculate force is very little.
As noted in my original post my VA doc found that my T level was only like 205 at 48 years old so they did put me on injectable T one shot weekly. This has been dramatic in improving my energy which had also tanked big time. Unfortunately though in my case even with a T level of 790 , 5 days post shot, this has done nothing for the sexual issues. I take other meds , Adderall for attention span, Wellbutrin for mood but the sexual issues have existed long before these meds so I will safely say it is not them. Just recently my doc added Atenolol to lower my normal BP of 165/90 and slow my normal resting pulse rate of 102. Again though can rule out that med as I have just started it a week ago.

 

[toolman]

Thanks to all who are posting on these boards. I have been reading with interest ,so know that your posts are appreciated. Myself, 48 year old male started with bouts of ED about 8 years ago which. I was also battling worsening extreme fatigue and weakness. I continued working but it took all the energy I could summon up to make it through the workday. I kept telling my doc at the VA hospital that I was getting weaker. Her response was that this was normal as I was getting older. At that time I was only 45 and I said damn doc when I lift 25 pounds it feels as if I am trying to lift 100 pounds. I told her at 5'11" and a solid 190 lbs , 32" waist I shouldnt be that weak. To make a long story short I eventually fought my way in to see a VA Endocrinologist. After some blood tests he felt that my T levels were way to close to the bottom of the scale given my age. Solution, the Endocrinologist started me on T replacement therapy. Given I have an adhesive allergy and the Veterans Administration does not have the gel, they supply me with the injectable form of T and I self inject one of the small 200 mg vials one time weekly. 5 days after injection my T levels are still about 795 which is much better than before I started the therapy. The downside is the T did nothing for my ED absolutely nothing . The good news is the T did give my energy back and that is priceless in itself.
Everyone , please do keep posting here as I will keep trying to solve my ED issues. The one thing I have learned is that ED is a very complex and odd thing. I was given Viagra and it did nothing for me . I was given Cialis and it did nothing for me. Then I was given Levitra and the first time I took it was mindblowing, my ED was non existent for at least 15 or more hours from one dose of Levitra. Unfortunately the Levitra worked excellent with the very first dose but after that was very little help. I thought my doc might have an answer on why Levitra would work so unbelievably well on the first dose but then no more. The docs reply was , he had no answer for that.

Arrius according to this post they have you on 200mgs a week from the start. That really is a high dose for TRT. I know because that is what the anti aging clinics put me on. When I satrted to notice estrogen related issues I found that it is not the normal dose to start on. After finding a good endo he started me on 100mgs weekly and so far the same benefits as before but also no ED issues (which may be the result of too much aromatization of the 200mg weekly dose), no gyno and my BP has stayed normal rather than pre hypertensive which the 200mg weekly dose put me at. If you are shooting 200mgs weekly and your numbers are just in the 700's, you are getting alot of conversion.

 

[LW64]

You've got to monitor your tT and E2 monthly so that you can make intelligent adjustments to your replacement protocol. Too much T can give you ED from the E2 conversion. Very likely you need less T. You can also try injecting smaller doses more frequently.

 

[arrius]

For those in here that have used clomid in lieu of test for TRT, how long did it take for you to feel better? I am week 3 of 25mgs daily and I feel no better. Actually I am sleeping like a zombie and it is hard to wake up. Other than that, no morning wood, no libido increase, etc. My endo wants me to go 6 weeks then run complete labs again. I felt way better on test. However the test was prescribed at an anti aging clinic and I realized by week 6 that they were clueless starting me at 200mgs a week.

I know how you feel, hopefully things will get better. I know for quiet a few years I was on a downward spiral, fatigue and chronic weakness. My docs at the VA Hospital kept telling me it was normal since I was getting older. After hearing this once to often I made it clear that I was only 45 (at the time) and not some 95 year old Geri patient which is what I literally felt like. I then demanded to see an Endocrinologist. The Endo Doc put me on Testosterone and within a very short time I realized that stuff is an absolute miracle. My strength and energy were and are back. The 200mg dose may be medical standard as that is exactly what I inject once weekly. In my case this dose is good and has me at T levels slightly below 800 even at 5 days post injection. I will note though that even with these great T levels it has not helped my ED even in the slightest. On a bright note though it was actually prescribed to boost my strength and energy back up to acceptable and normal levels. This is did extremely well and now I could not and would not want to go life without it again. As for the ED I will keep working on that one. The positive is that I had an exceptional one time only success with Levitra, only once. This though told me that it is fixable somehow, some way.

 

[arrius]

You've got to monitor your tT and E2 monthly so that you can make intelligent adjustments to your replacement protocol. Too much T can give you ED from the E2 conversion. Very likely you need less T. You can also try injecting smaller doses more frequently.

Thx LW & Toolman. This makes sense and I will definitely look into it. I had never thought of splitting the dose. My ED symptoms started long before I ever took Test, but if I lower the Test dose it may change the ED outcome. I will definitely look into this and run a trial, 100mg on my next injection rather than 200. Will post on how this turns out, might be that elusive magic key I have been looking for.

 

[LW64]

Thx LW & Toolman. This makes sense and I will definitely look into it. I had never thought of splitting the dose. My ED symptoms started long before I ever took Test, but if I lower the Test dose it may change the ED outcome. I will definitely look into this and run a trial, 100mg on my next injection rather than 200. Will post on how this turns out, might be that elusive magic key I have been looking for.

I would go to 50 mg twice a week, but you can always do that later if 100 mg once a week doesnt work.

GET LABS DONE for tT and E2 after 4 weeks on the same protocol!

Then get back to us with the results.

 

[arrius]

Many Thx LW, I can do this with no problem. Normally do my injections on Sunday nights. I will split 100 into two 50s and will post results to the board. Luckily for myself it is very easy to realize the primary effect. I say that because I have no doubts that my energy and strength will bottom out if the dose is not enough. Prior to starting on Testosterone I well beyond fatigue. I did not loose physical size but I lost an immense amount of strength.
Perhaps a reduced dose will help with the ED as well. I will say in the area of ED I guess I am one of the fortunate guys. Mine is not a total loss, if that were the case I would very likely quit work and search night and day for a fix. In my case the problem is erections are only about 65 to 70 as firm as they use to be. The other problem is it is work on my part fighting to keep that 65 to 70 percent erect for he duration of the act. It is actually work for me to stay up and that should not be. I will let you know how the T split goes. My very recent endocrine blood work looks to be fairly okay to me but I will not know until I see the VA endo doc again in 3 months. Several various hormone levels are at near the very top of acceptable and some near the bottom. I assume though as long as their in acceptable range even near the top or the bottom they would be considered good.

 

[arrius]

This post is a bit lengthy but I will put it up in case anyone should know of any helpful labs my doc may be missing. The following blood work was done 6 days post testosterone injection. The only levels not shown below are Thx

Lab Test: Hemogram V
Lab Type: Chemistry/Hematology
Specimen: Whole blood
Date/Time Collected: 27 Aug 2012 @ 0840
-----------------------------------------------------------------------------
Test Name: BASOPHILS
Result: 0.03
Units: x1000/uL
Reference Range: (0.0-0.1)
Interpretation:
Status: Final
----------------------
Test Name: BASOPHILS/100 LEUKOCYTES
Result: 0.5
Units: %
Reference Range: (0-2.0)
Interpretation: Reference range changed
08/25/99 due to change in
methodology. Previous reference
range = 0-3 %.
Status: Final
----------------------
Test Name: EOSINOPHILS
Result: 0.31
Units: x1000/uL
Reference Range: (0.0-0.8)
Interpretation:
Status: Final
----------------------
Test Name: EOSINOPHILS/100 LEUKOCYTES
Result: 4.9
Units: %
Reference Range: (0-5)
Interpretation:
Status: Final
----------------------
Test Name: ERYTHROCYTE DISTRIBUTION WIDTH
Result: 13.1
Units: %
Reference Range: (11.6-15.5)
Interpretation: Reference range changed
08/25/99 due to change in
methodology. Previous reference
range = 11.5-14.5 %.
Status: Final
----------------------
Test Name: ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN
Result: 31.2
Units: pg
Reference Range: (27.3-33.8)
Interpretation: Reference range changed
08/25/99 due to change in
methodology. Previous reference
range = 27-31 pG.
Status: Final
----------------------
Test Name: ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION
Result: 34.3
Units: g/dl
Reference Range: (32.4-35.6)
Interpretation: Reference range changed
08/25/99 due to change in
methodology. Previous reference
range = 31-36 %.
Status: Final
----------------------
Test Name: ERYTHROCYTES
Result: 5.09
Units: M/uL
Reference Range: (4.24-5.56)
Interpretation: Reference range changed
08/25/99 due to change in
methodology. Previous reference
range = Male: 4.7-6.1 x10^6 cells/mm^3
Female: 4.2-5.4 x10^6 cells/mm^3
Status: Final
----------------------
Test Name: ERYTHROCYTES.NUCLEATED/100 LEUKOCYTES
Result: 0.0
Units: /100WBC
Reference Range: (<0)
Interpretation:
Status: Final
----------------------
Test Name: GRANULOCYTES.IMMATURE/100 LEUKOCYTES
Result: 0.2
Units: %
Reference Range: (0.0-5.0)
Interpretation:
Status: Final
----------------------
Test Name: HEMATOCRIT
Result: 46.4
Units: %VOLUME
Reference Range: (39.5-50.5)
Interpretation: Reference range changed
08/25/99 due to change in
methodology. Previous reference
range = Male: 42-52 %
Female: 37-47 %
Status: Final
----------------------
Test Name: HEMOGLOBIN
Result: 15.9
Units: G/DL
Reference Range: (13.2-16.9)
Interpretation: Reference range changed
08/25/99 due to change in
methodology. Previous reference
range = Male: 14-18 g/dl
Female: 12-16 g/dl
Status: Final
----------------------
Test Name: IG #
Result: 0.01
Units: x1000/uL
Reference Range: (0.0-5.0)
Interpretation:
Status: Final
----------------------
Test Name: LEUKOCYTES
Result: 6.33
Units: K/uL
Reference Range: (4.3-9.7)
Interpretation: Reference range changed
08/25/99 due to change in
methodology. Previous reference
range = 5-10 x 10^3 cells/mm^3.
Status: Final
----------------------
Test Name: LYMPHOCYTES
Result: 1.71
Units: x1000/uL
Reference Range: (0.5-5.1)
Interpretation:
Status: Final
----------------------
Test Name: LYMPHOCYTES/100 LEUKOCYTES
Result: 27.0
Units: %
Reference Range: (9.5-44.2)
Interpretation: Reference range changed
08/25/99 due to change in
methodology. Previous reference
range = 17-37 %.
Status: Final
----------------------
Test Name: MEAN CORPUSCULAR VOLUME
Result: 91.2
Units: fL
Reference Range: (83.5-100.5)
Interpretation: Reference range changed
08/25/99 due to change in
methodology. Previous reference
range = Male: 80-94 microns^3
Female: 81-99 microns^3
Status: Final
----------------------
Test Name: MONOCYTES
Result: 0.61
Units: x1000/uL
Reference Range: (0.2-3.4)
Interpretation:
Status: Final
----------------------
Test Name: MONOCYTES/100 LEUKOCYTES
Result: 9.6
Units: %
Reference Range: (1.0-14.9)
Interpretation: Reference range changed
08/25/99 due to change in
methodology. Previous reference
range = 0-8 %.
Status: Final
----------------------
Test Name: NEUTROPHILS
Result: 3.66
Units: x1000/uL
Reference Range: (1.9-6.8)
Interpretation:
Status: Final
----------------------
Test Name: NEUTROPHILS/100 LEUKOCYTES
Result: 57.8
Units: %
Reference Range: (41.5-82.8)
Interpretation: Reference range changed
08/25/99 due to change in
methodology. Previous reference
range = 40-70 %.
Status: Final
----------------------
Test Name: PLATELET MEAN VOLUME
Result: 10.9
Units: fL
Reference Range: (6.9-14.6)
Interpretation: Reference range changed 2/26/09 due to change in
methodology. Previous range = 6.7 - 10.9 fL.
Reference range changed 08/25/99 due to change in
methodology. Previous reference range = 7.4-10.4 microns.
Status: Final
----------------------
Test Name: PLATELETS
Result: 257
Units: K/uL
Reference Range: (150-391)
Interpretation: Reference range changed 2/20/04 due to change in methodology.
Previous reference range = 130-400 K/uL.
Reference range changed 08/25/99 due to change in methodology.
Previous reference range = 140-500 K/uL.
Status: Final
===========================================================
Lab Test: Albumin
Lab Type: Chemistry/Hematology
Specimen: Serum
Date/Time Collected: 27 Aug 2012 @ 0840
-----------------------------------------------------------------------------
Test Name: ALBUMIN
Result: 4.1
Units: GM/DL
Reference Range: (3.1-4.5)
Interpretation: Reference range change 7/21/2009 due
to instrument change.
Reference range changed
11/20/96 due to methodology
change. Previous reference
range = 3.9-4.9 g/d/l.
Status: Final
===========================================================

Lab Test: Bilirubin Direct
Lab Type: Chemistry/Hematology
Specimen: Serum
Date/Time Collected: 27 Aug 2012 @ 0840
-----------------------------------------------------------------------------
Test Name: BILIRUBIN.GLUCURONIDATED+BILIRUBIN.ALBUMIN BOUND
Result: 0.2
Units: MG/DL
Reference Range: (0.0-0.4)
Interpretation: Reference range changed
11/20/96 due to change
in methodology. Previous
reference range = 0-0.2 mg/dl.
Status: Final
===========================================================

Lab Test: Bilirubin Total
Lab Type: Chemistry/Hematology
Specimen: Serum
Date/Time Collected: 27 Aug 2012 @ 0840
-----------------------------------------------------------------------------
Test Name: BILIRUBIN
Result: 1.0
Units: MG/DL
Reference Range: (0.1-1.5)
Interpretation: Reference range change 7/21/2009 due to instrument change.
Previous range 0.3-1.5 mg/dl.
Reference range changed 9/24/02 due
to change in methodology. Previous
reference range = 0.2-1.3 mg/dL.
Reference range changed 11/20/96 due
to change in methodology. Previous
reference range = 0.4-1.4 mg/dl.
Status: Final
===========================================================

Lab Test: Lactate Dehydrogenase
Lab Type: Chemistry/Hematology
Specimen: Serum
Date/Time Collected: 27 Aug 2012 @ 0840
-----------------------------------------------------------------------------
Test Name: LACTATE DEHYDROGENASE
Result: 144
Units: U/L
Reference Range: (98-225)
Interpretation: Reference range change 7/21/2009 due to
instrument change. Previous reference
range 98-195 IU/L.
Reference range changed 9/24/02 due
to change in methodology. Previous
reference range = 313-618 IU/L.
Reference range changed 11/20/96 due
to methodology change. Previous
reference range = 109-193 u/l.
Status: Final
===========================================================

Lab Test: Phosphatase Alkaline
Lab Type: Chemistry/Hematology
Specimen: Serum
Date/Time Collected: 27 Aug 2012 @ 0840
-----------------------------------------------------------------------------
Test Name: ALKALINE PHOSPHATASE
Result: 42
Units: IU/L
Reference Range: (38-126)
Interpretation: Reference range changed
11/20/96 due to methodology
change. Previous reference
range = 36-92 u/l.
Status: Final
===========================================================

Lab Test: Testosterone
Lab Type: Chemistry/Hematology
Specimen: Serum
Date/Time Collected: 27 Aug 2012 @ 0840
-----------------------------------------------------------------------------
Test Name: TESTOSTERONE
Result: 661.25
Units: ng/dl
Reference Range: (168-781)
Interpretation: Reference range changed 9/13/02
due to change in methodology.
Previous reference range:
Male: 280-1200 ng/dl
Female: 14-56 ng/dl
Reference range changed 9/13/02
Status: Final
===========================================================

Lab Test: Thyroid Stimulating Hormone
Lab Type: Chemistry/Hematology
Specimen: Serum
Date/Time Collected: 27 Aug 2012 @ 0840
-----------------------------------------------------------------------------
Test Name: THYROTROPIN
Result: 3.08
Units: uIU/ML
Reference Range: (0.34-5.60)
Interpretation: Reference range changed 9/24/02 due to change in methodology.
Previous reference range = 0.49-4.67 uIU/mL.
Status: Final
===========================================================

Lab Test: Transferase Alanine Amino SGPT
Lab Type: Chemistry/Hematology
Specimen: Serum
Date/Time Collected: 27 Aug 2012 @ 0840
-----------------------------------------------------------------------------
Test Name: ALANINE AMINOTRANSFERASE
Result: 25
Units: IU/L
Reference Range: (10-50)
Interpretation: Reference range changed 9/24/02
due to change in methodology.
Previous reference range = 21-72 IU/L.
Reference range changed 11/20/96 due
to methodology change. Previous
reference range = 8-54 U/l.
Reference range changed 6/14/05.
Previous reference range = 10-63 U/L.
Status: Final
===========================================================

Lab Test: Transferase Aspartate SGOT
Lab Type: Chemistry/Hematology
Ordering Provider: MERENDINO, JOHN
Ordering Location: MARTINSBURG VAMC
Specimen: Serum
Date/Time Collected: 27 Aug 2012 @ 0840

-----------------------------------------------------------------------------
Test Name: ASPARTATE AMINOTRANSFERASE
Result: 21
Units: IU/L
Reference Range: (15-41)
Interpretation: Reference range changed 9/24/02 due
to change in methodology. Previous
reference range = 17-59 IU/L.
Reference range changed 11/20/96 due
to methodology change. Previous
reference range = 0-37 U/L.
Status: Final
===========================================================

Lab Test: Transpeptidase Gamma Glut
Lab Type: Chemistry/Hematology
Specimen: Serum
Date/Time Collected: 27 Aug 2012 @ 0840
-----------------------------------------------------------------------------
Test Name: GAMMA GLUTAMYL TRANSFERASE
Result: 16
Units: IU/L
Reference Range: (7-56)
Interpretation: Reference range changed 9/24/02 due
to change in methodology. Previous
reference range:
Male 15-73 U/L
Female 12-43 U/L
Reference range changed 11/20/96 due
to change in methodology. Previous
reference range = 0-99 U/L.
Status: Final
-----------------------------

Lab Test: Lipid Panel
Lab Type: Chemistry/Hematology
Specimen: Serum
Date/Time Collected: 14 Aug 2012 @ 0852
-----------------------------------------------------------------------------
Test Name: CHOLESTEROL
Result: 220 High
Units: MG/DL
Reference Range: (<200)
Interpretation: <200 MG/DL = Desirable Range
200-239 MG/DL = Borderline High
>239 MG/DL = High
Status: Final
----------------------
Test Name: CHOLESTEROL.IN HDL
Result: 44
Units: MG/DL
Reference Range: (>35)
Interpretation: Reference range changed 11/20/96 due to change in methodology.
Previous reference range = 30-70 mg/dl.
Performing Location: MARTINSBURG VAMC 510 BUTLER AVENUE , MARTINSBURG, WV
25405-9990
Status: Final
----------------------
Test Name: CHOLESTEROL.IN LDL
Result: 142.7 High
Units: MG/DL
Reference Range: (<130)
Interpretation: <130 MG/DL = Desirable Range
130-159 MG/DL = Borderline High
>159 MG/DL = High
Status: Final
----------------------
Test Name: TRIGLYCERIDE
Result: 169
Units: MG/DL
Reference Range: (0-250)
Interpretation: Reference range changed
due to change in methodology.
Previous reference range
= 0-210 mg/dl.
Status: Final

 

[toolman]

I don't see any test for estrodial or any estrogens. On the dosage you are on, you should absolutely be monitering that.

 

[LW64]

Many Thx LW, I can do this with no problem. Normally do my injections on Sunday nights. I will split 100 into two 50s and will post results to the board. Luckily for myself it is very easy to realize the primary effect. I say that because I have no doubts that my energy and strength will bottom out if the dose is not enough. Prior to starting on Testosterone I well beyond fatigue. I did not loose physical size but I lost an immense amount of strength.
Perhaps a reduced dose will help with the ED as well. I will say in the area of ED I guess I am one of the fortunate guys. Mine is not a total loss, if that were the case I would very likely quit work and search night and day for a fix. In my case the problem is erections are only about 65 to 70 as firm as they use to be. The other problem is it is work on my part fighting to keep that 65 to 70 percent erect for he duration of the act. It is actually work for me to stay up and that should not be. I will let you know how the T split goes. My very recent endocrine blood work looks to be fairly okay to me but I will not know until I see the VA endo doc again in 3 months. Several various hormone levels are at near the very top of acceptable and some near the bottom. I assume though as long as their in acceptable range even near the top or the bottom they would be considered good.

Give the new dose/frequency a chance. It can take some time to get results. It took you a while to get here. It can also take a while to fix it.

I didnt see sex hormone binding globulin (SHBG) in your labs...or did I overlook it?


Some questions:

[1] Could you do with losing some weight?

[2] What medications are you presently taking?

[3] What kind of diet are you eating?


Btw, dont be shy about using whatever PDE5-I (Viagra, Cialis, or Levitra) works best for you while you get your T protocol worked out.

These posts for arrius dont belong in this thread. Moderators?

 

[arrius]

Some questions:

[1] Could you do with losing some weight?

[2] What medications are you presently taking?

[3] What kind of diet are you eating?

Btw, dont be shy about using whatever PDE5-I (Viagra, Cialis, or Levitra) works best for you while you get your T protocol worked out.

You are right on Target LW. Some weight I do need to loose because the problem is , seems the only fat cells in me happen to be right in my stomach only. Im 5' 11" tall but have now reached a weight of 197 as of today. To look at me it is not clearly visible as I comfortably wear a 33 waist in pants and even though my abs are somewhat visible the fat is there. I have gotten back into exercise this year but prior to the Testo I literally had no energy. Being a BioMed tech I drive much of the time meaning the only time I am active is when I am onsite but even that is never aerobic level stuff. My energy use to be so heavily drained that I told my doc just getting out of bed in the morning was a labor. Once out of bed and working I would literally be wiped out within two hours but would continue working ti the days end. My goal is to return to about a 170 weight range.

Current meds are :
Pravastatin 20mg once nightly

Bupropion HCI 150mg 12HR , 1 Tablet Morning, 1 Tablet Afternoon

Levothyroxine 0.075mg, 1 tablet in morning ( Doc says when I see him again we may stop this one. He initially put me on it to see if it would help with fatigue and tiredness. It did not so he then ordered the Testosterone.

Adderall 5mg 1 tablet by mouth 3 x daily

I am also suppose to take Fluoxotine but do not for fear it will worsen my ED. The VA assumes I take it but I am leery about risking that one.

Methocarbamol 750mg 1 tablet by mouth 2 x daily ( for neck and back spasms) . This stuff does not work very well but better than nothing.

Ranitidine HCL 150MG two tablets by mouth daily at bedtime.

Testosterone Injection weekly .
The above are my daily meds. I should note that my ED problems existed long before any of these meds were ever started. It has gotten no worse with any of the meds.

My diet is an on the road kind of thing meaning it is not the greatest. I would have to say lots of card and diet soda drinks. Another bad habit I have had for years is no scheduled eating times. I normally skip breakfast through the week and at times remember to stop for lunch but usually not til 2 or 3pm. I then find myself eating dinner at about 9 pm. In the past two years or so I have also oddly for no reason developed an insatiable appetite for sweets primarily donuts and snack cakes. I had never had that before and suddenly I found myself literally craving the stuff. I am making progress in getting that under control. The rest of my intake is often fast food. I cannot conquer anything the size of a BK double whopper but do the single once every couple weeks. Often KFC two piece chicken meal etc. Not near the major eater I was a few years back . This is good though as I likely do not have the metablolism to keep me at 165 like I had and was back then.

As for the ED Drugs none of them work for me. I originally tried an RX of Viagra up to the max dose and it did nothing for me over a one month trial period. I was then given Cialis for a one month trial and it did nothing. In the end they said I should try Levitra. I took the very first Levitra and it worked so well that it was literally unbelievable. Unfortunately it only worked that incredibly well on the first pill. After the first pill none of the Levitra pill that followed did anything for me. I told the uro doc about this and he said the meds are notoriously like that. I found it odd that Viagra did nothing, Cialis did nothing, finally the very first Levitra brought everything into absolute perfection yet the following Levitra did nothing.

I agree that I need to discuss the estrogen testing with my doc. So far I have been lucky I guess with no Gyno in the chest or anything like that. I had actually mentioned to my primary care doc about checking my Est levels, about 5 months ago. Her reply was I will send an email to your Endo doctor and if it is needed he will do so. Three months later when my endo appointment came up I mentioned it again. He then ordered labs which are the ones I posted here but to my surprise requested nothing on Estro levels. This is why I hate not being able to just walk into a lab anywhere , request what I want and pay for it. It would be so much easier that way.

 

[arrius]

Thx for the questions LW. I also forgot to mention that during my original trials with the ED drugs I was not yet on any of the meds listed. When the Levitra worked so well that first time and then not at all after that it had me wracking my brain. Spent a long time trying to determine what I may have done different the day I took it but could come up with nothing. My Uro doc then told me that the drugs are often that way. I asked him if he did not find it the least bit odd that a month of Viagra and a month of Cialis would fail me completely yet that very first Levitra would work so very well, yet none after that. HIs reply was no, it was not the least bid odd but very common.

 

[LW64]

[1] It's hard to explain your ED unless you've been hypogonadic for a while with maybe subclinical hypothyroid along with it. They reinforce each other when they're working right and they drive each other down when they arent. Has your hypogonadism been diagnosed - i.e., are you primary or secondary? If you dont know, then you need to get a proper diagnosis.

[2] By the looks of your lipid panel, being on a stain isnt doing a damn thing for you. It may be un-necessary anyway. Start a low-carb diet, like, as soon as possible...Gee what a surprise that I would recommend that, huh? : -) Excessive carbohydrate intake cause lipids to go out of whack. Low carb, high fat (LCHF) corrects it most of the time without the need to put a sledgehammer to your liver with a statin. LCHF just about guarantees three things: Trigs under 100, a huge increase in HDL (the 'good' cholesterol), and a shift in the size pattern of your LDL (the 'bad' cholesterol) from small and dense (danger! atherogenic!) to large and buoyant (not so much danger - 3x less atherogenic than the small stuff)

[3] Review all your prescription drugs carefully with your doctor to eliminate anything that might be an ED enabler. Do some homework yourself first on the internet - look up every one of them and look at potential sides and interactions.

[4] Be sure to have SHBG taken once a year or so. It helps you target your T level with your injection dose. It will also provide a rough idea of how insulin resistant you are. E2 gets monitored along with tT.

[5] Not only are the PDE5-I inconsistent but they are inconsistent in their inconsistency. At first Viagra worked best for me and Cialis wasnt worth a shit. Now Cialis mostly works (not always) and Viagra seems unreliable. Levitra always works but doesnt last very long. Keep trying with all three. Take them on an empty stomach (never mind what the insert says on L and C). Dont overdo it with alcohol or, better yet, avoid it. (I know that one is a Catch-22, but it has helped me more than a few times.)

You can also try a part of a full dose to get things going followed by the remainder of the full dose just before sex. For example: take a 25 mg V a couple hours before sex, then a 75 mg 30 minutes before. Chew them a bit and put them under your tongue to get some absorption for 5 or 10 minutes before swallowing.

[6] Start supplementing with fish oil. Dont bother with gelcaps, get the liquid you keep in a bottle in the fridge. Look for the ones with the higest dose of EPA and DHA you can find. I use Carlson's: 800 mg EPA, 500 mg DHA per teaspoon. Twice a day.

[7] Start supplementing with magnesium citrate: 300 to 500 mg/day. Check out the thread in the Nutrition section for details on why this is a good idea. For one, you may find you need less metho for the muscle spasms or that the metho will work better. There's lots more reasons to take it anyway. The list of benefits to taking magnesium is very long.

[8] Start supplementing with vitamin D3. Start with 5,000 IU/day - gelcaps only - and get your level checked in 90 days. When you get your serum level labs, adjust your dose to get your level into the 60s.

 

[arrius]

Excellent and well written advice LW. My immense thanks for the consideration and time in providing it. Be assured I will adhere without a doubt. Everything you have provided in the post is clearly very logical advice. I definitely also agree with the fatty foods over carbs. I am the type that actually prefers burger without the bun. As they are usually served with the bun though I just automatically devour it as well. I can discard the carb items and will start promptly.

Fortunately, I never have been a major drinker of alcohol. Once a weekend I will have one shot of good Scotch. Only one shot in a two ounce shot glass, never more. Probably safe to say that is a super lite when it comes to drinking levels . I never was a beer fan, would rather be shot in the head than to drink that any of those concoctions.

I will also follow all of your other very valid advice. This weekend I will split the test dose. Rather than 200 mg all at once I will shot 50 on Sunday and the second 50 on Wednesday. I will then of course discard the remaining 100 in the vial due to shelf life. It is no problem for me to do that because my Test is mailed to me by the Veterans Administration pharmacy system, 4 vials at a time, no charge.

I will also follow through on reading up on the other drugs. As I noted, I avoid the Fluoxotine because I have heard it is notorious for sexual side effects. This is why I talked them into adding wellbutrine. The VA believes that I take the well-b as a secondary but I actually use it as the primary, safer. The Atenolol is a new one added only about a week ago. To date it seems to be having an effect but will wait and see if that last. It was given to rope in my BP which is normally about 168/95 and my resting pulse which has always been 102 to 105. Last check BP is now 130/78 and resting pulse was 81. The adderall I use sparingly to keep focused out of all that class, add was the only one that worked. Of the muscle relaxants as I noted none of them work very well so unless the VA has a better idea I may have to give them up anyways since they do not work. They are given for low back and cervical muscle spasms. I took a rough and tumble fall in the Military, 1982, through no fault of my own. Knocked my lower back and upper cervical areas around in the process. Since that time muscle spasms in those areas have been ever present. Of course the docs at the VA all say their is no way low back and cervical spasms contribute to ED, but then again they never want to attribute any incidental conditions to existing service connected conditions. They are like right though in that my old injury to the L-5 on S-1 and the cervical base are not the cause. Had that been the case I would have likely had ED issues long before which I did not.

Again LW my many thanks for the excellent advice. It will be utilized and I will post the results

 

[LW64]

[1] Atenolol is a beta blocker and they can cause ED. Unless you have a serious heart condition (at age 48??) look for elimination or alternatives with your doctor.

[2] Dont throw the excess T away unless it cant be sealed properly. It should be good for 90 days (minimum, maybe more!) and it doesnt hurt to have some spare around.

[3] Have you had your thyroid checked? If you have not, then insist on a full thyroid panel next time you see the doctor.

[4] When you start eating more fat and less carbs your insulin level will drop, your kidneys will let go of sodium, and your BP will drop. Monitor as you go and let your doctor know you're doing this because you will very likely need to taper your BP meds.

DO NOT EAT: sugar/HFCS (sports drinks, soda, candy, etc.) wheat (bread, pasta, cake, cookies, etc.), vegetable oils (corn oil, margarine, mayo, ketchup, etc.)

EAT: meat, fish, eggs, poultry, green veggies, butter, heavy cream (not milk), coconut oil, olive oil, dark chocolate (90%), moderate nuts and berries. Water, tea, and coffee (w/heavy cream!). Use plenty of salt on your food all the time.


You're welcome.

 

[foreveryoung]

why are people willing to take a whole lot of drugs, yet not willing to do what should be the very first things for health which is perfect their diet? it's not that hard but people always seem to have excuses and yet fill themselves up with powerful drugs.... you are what you eat

 

[arrius]

why are people willing to take a whole lot of drugs, yet not willing to do what should be the very first things for health which is perfect their diet? it's not that hard but people always seem to have excuses and yet fill themselves up with powerful drugs.... you are what you eat

I agree with that ForeverYoung. I believe the problem seems to be proper education. The reason I say this , the diet that LW has laid out is pure perfection for me and one I can easily live no problem at all. The problem is if you take that same diet to many of the docs out there in the world including those at the VA I assure you 1000% those doc would say absolutely not. I know this for a fact because I have been told by numerous docs, actual MD's to , avoid salt, avoid fatty foods, avoid butter, coffee and most all else LW recommends. Not only MD's but also certified dieticians. Their advice is likely why my problems exist. I ate just what LT recommends, most of my life. Over these past few years though I have cut out salt, coffee, real butter, cream much high fat content meat or limit it to one single burger. As for me I could not be more pleased with LT's advice because I can easily sit and eat nice thick medium steaks with no problem at all
Again, thanks for the great advice LT. Im not seeking to look like a young Frank Zane (though that would be nice) but I am aiming to fix these problems. I truly believe your diet recommendations are just the ticket I need LT. Have a good one all I am out of here to work.