Untainted Results Are In - Burning through T Fast

[CubbieBlue]

There is nothing from my MRI to indicate so

Same for most people (like people with eating disorders, or stress disorders.

and if I was secondary why would my pituitary output LH and FSH and my hypothalmus output GnRH just because I took Clomiphene Citrate and Tamoxifen

Because when you are secondary your testes work fine, there is something wrong "up top". Clomid and Tamox basically cause GnRH to be released, which in turn causes spiked LH & FSH levels. Which results in higher testosterone.

So I think it is still accurate to say idiopathic but not primary or secondary (I also respond to HCG)

It is not. I would say you are an idiopathic secondary.

 

[CubbieBlue]

Scally asked me to go back on TRT for 1 year. Many people double their TT numbers - possibly due to addition ARs being created. Long term TRT does create additional ARs - at least anecdotal evidence exists for this. Dr. Scally did not tell me at the time why the TT may double after an additional year of TRT and then repeat PCT. I don't think now it would have worked. I think I have to control insulin resistance first, get my SHBG up, and then maybe try again.

Double their TT numbers? Additional ARs?

Can ou explain what you mean by ARs?

 

[james2012]

Double their TT numbers? Additional ARs?

Can ou explain what you mean by ARs?

Androgen receptors.

 

[sako]

So I think it is still accurate to say idiopathic but not primary or secondary (I also respond to HCG).

You have to be either primary or secondary, idiopathic isn't its own classification. I think there's also tertiary where lh/fsh are not stimulated by GnRH.

 

[imrj]

You have to be either primary or secondary, idiopathic isn't its own classification. I think there's also tertiary where lh/fsh are not stimulated by GnRH.

hmm..am pretty sure "idiopathic" exists for a lot of conditions, basically means they dont have a f'ing clue what it is? am i wrong?

 

[CubbieBlue]

Right, but if he is responding to hCG, he is not primary. He is secondary (meaning the cause is not from the testicles) but somewhere else. You could say he is an idiopathic secondary because that "somewhere else" is not known.

 

[imrj]

Right, but if he is responding to hCG, he is not primary. He is secondary (meaning the cause is not from the testicles) but somewhere else. You could say he is an idiopathic secondary because that "somewhere else" is not known.

right so in that case he is secondary just like me....my pituitary is barely functional due to empty sella syndrome (dam thing is totally squashed up, was barely visible on MRI....they went looking for a tumor and found another mess, and is not curable!) but in my case am secondary for literally everythng the anterior pituitary does, LH, FSH, TRH, ACTH....the whole works....real nice, am loving it!!!

 

[james2012]

right so in that case he is secondary just like me....my pituitary is barely functional due to empty sella syndrome (dam thing is totally squashed up, was barely visible on MRI....they went looking for a tumor and found another mess, and is not curable!) but in my case am secondary for literally everythng the anterior pituitary does, LH, FSH, TRH, ACTH....the whole works....real nice, am loving it!!!

Right, except my MRI of hyop and pituitary were normal. My idiopathic has nothing to do - in my opinion - with either. I have a metabolic issue - insulin resistance perhaps (most likely due to my advanced heart disease, A1C of 6.1, overweight most my life although taking it off now). Therefore, if I correct for this then MAYBE - maybe - my issue will resolve itself. That is not to say upon resolution - say normalization of SHBG - that I still do not have symptoms of low T and need TRT due to age related decline. Libido and ED are another issue. This is my theory - if the T cyp made me go nuts on libido and ED was nonexistent for three weeks then there is something that can address that. Finding out what THAT is would take real detective work. That is why I am thinking Marciano.

 

[sako]

What are the Top symptoms that you have? and what do you think were the first ones you had?

 

[james2012]

What are the Top symptoms that you have? and what do you think were the first ones you had?

Top symptoms in order of appearance over the last three years.

Exercise induced angina - now gone. This is most critical as I have 25 stents - not a typo. With no EI angina I pass stress tests. With it, I don't and it will be another stent.

Difficulty losing weight - no longer an issue

Peaking on muscle gains - making great gains now

Low energy - comes and goes as I am still playing around with TRT

Low libido - comes and goes

ED - comes and goes, mostly goes (Levitra works good to excellent with only a few failures every 20 tries)

 

[imrj]

man honestly, that doesnt sound that bad!!! just keep your head up and dont rely on meds to take care of it all...you'll be surprised how much your on mind can help you heal....keep stress of your back, make sure get good sound sleep

 

[james2012]

man honestly, that doesnt sound that bad!!! just keep your head up and dont rely on meds to take care of it all...you'll be surprised how much your on mind can help you heal....keep stress of your back, make sure get good sound sleep

I with you on that one. Dropped Crestor (will probably restart Niacin soon - I wanted to give my liver a holiday for awhile). I have dropped my Norvasc BP medication from 10mg/day to 5mg/day and soon should be able to drop that. If my SHGB increases, then there is a small chance if this has been the cause of all my issues all along (actually not the cause but a pointer to an underlying range of disorders that comes under the heading Metabolic Syndrome X), then I may be able to do a restart and it will work. If I can get my SHGB to near the middle range with a total T of around 700-1000 I think the restart will work this time but not until I address the MSX. I am getting a hydrostatic BMI done today. Everyone looks at me at tells me I'm not overweight. I do have muscle but not a ton of it. Everyone guesses my weight at 195-200, when my range right now is from about 220-225 with the goal of being around 200. I have the "preganant look" when I let my belly hang out and look at my view sideways in the mirror. This is adipose fat and is really concentrated around the lower part of the abdomen above the genital area. Lower SHBG, more aromatase.

I also have a small amount of back fat and fat over the abdominal muscles, although this does not contribute to any aromatase activity. Perhaps my liver is the culprit for aromatase and mefaformin will do the trick for me and raise my SHBG while staving of diabetes. My first and foremost goal is to try diet and exercise without any new med and then attempt to detox the liver and see if I can help it out a bit. Only if that does not work will I try another med.

December 1st is my next stress test. Two years from now is my next. If I pass both, then my docs will consider taking me off the Plavix. I am hoping to talk them into using me as a case study - a man with 25 stents (stents within stents) who did not respond to 75mg of Plavix and needed to take 150mg/day. Someone with stents from three different stent manufacturers. There is a paper here somewhere and I hope to talk them into doing a free Intra-venous ultra-sound just to make sure there is no metal left hanging out in the bloodstream. If there is, and this is an issue with all DES (they work so well they sometimes stop scarring prematurely) then stopping Plavix would be a death sentence. If I can stop the Plavix, I'll work on lowering my aspirin to 81mg/day from 325mg/day (studies show there is not that much difference).

Just think about it. I could potentially drop 3 meds, possibly 4 and only be on Tricor (which I will always be on with levels as high as 2000 in the past), Niacin, and Clonzepam (which I am slowly lowering from 1mg 5x/day to 1mg 3x/day). I'm heading in the right direction. With a nutra-eval I may even find out some other pathway to move away from the other drugs or lower the amount I need to take. I also need to become an expert on nutrition.

That's the goal - less drugs, more lifestyle changes, and a better understanding of how my body works.

Thanks for the encouragement. It always helps. I figure if I can buck the trend and "beat the Bruce" on December 1st (which means I go the full 18 minutes on the treadmill - something even a guy who trains with Lance Armstrong here in Austin could not do) then I'll be letting the doctor's know something important. Enable patients to take control of their own health with guidance instead of hammering them over the head with medical dogma. I don't know how many docs have told me I would not be around today with 25 stents. Well guys, f**k you. I'm still here and my last ejection fraction was 68 (range 50-72). My resting heart rate is 58. My BP is averaging 115-120/70-75. Heh.

Never say never and never back down. Most importantly, find doctors who have this same attitude and are not afraid to laugh in the face of "established" medicine. I have one now, but he is not really a TRT expert. However, he is willing to work with me and work with one. Next goal - find that TRT expert in Austin.

 

[CubbieBlue]

If I can get my SHGB to near the middle range with a total T of around 700-1000 I think the restart will work this time but not until I address the MSX. I

Again, what does a TT # on TRT have anything to do with you doing a restart?!?

You said yesterday you were no longer interested in a restart.

If you can go the full 18 minutes on a stress test...wow. That thing has you going full out sprint, uphill about 10 minutes into it.

Good luck!

 

[james2012]

If I can get my SHGB to near the middle range with a total T of around 700-1000 I think the restart will work this time but not until I address the MSX. I

Again, what does a TT # on TRT have anything to do with you doing a restart?!?

You said yesterday you were no longer interested in a restart.

If you can go the full 18 minutes on a stress test...wow. That thing has you going full out sprint, uphill about 10 minutes into it.

Good luck!

I reconsidered CubbieBlue. I have not quit given the uphill odds I have faced. It may be a restart is a stupid idea but by God I am going to try it if I can pinpoint SHGB and Metabolic Syndrome as the culprit of my TRT issues. If I can normalize SHBG by losing weight, then all TRT did for me was allow me to lose the weight and gain BMI faster than if I was off it (this is based on results seen since being on TRT). That is why I am TT on TRT means something. If I can get TT up with FT in the upper range and not over range, then my SHBG is under control. However, this does not explain my low levels of LH and FSH while not on TRT but after my collapse from taking Prinzide. From what I can tell from the research, IR lead to increased LH secretion so something else is suppressing my secretion. I can't trust what happened after my collapse because every system went wild - suddenly I was diabetic then not. Failed dex supression test, cortisol off the charts, etc. Six months later a spontaneous recovery. So what does my LH and FSH levels look like post PCT? I will have a copy of that lab from the past by Wednesday (hopefully). I also hope SHBG and Free-T was measured (although I do not trust Free-T measurements anymore at lest its from the same lab about 16 months apart). If LH and FSH are normal to high-normal or even high, SHBG low, and TT low with FT normal, then it is insulin resistance (which suppresses Leydig cells). This will be my cue to attempt a restart. If not, then its more detective work. Idiopathic means idiot to me. If I am not secreting tell me why. If it can be fixed, fix it. Once fixed, then I'll try a restart one last time before going on TRT/HRT for life. It's worth a shot and only costs me 3 months of my life and a few bucks out of pocket.

I have been training for six months to "beat the Bruce". I can burn 1100 calories in 1 hour on an elliptical. I blast 90% of my time on the higher resistances and spend more than 75% of my time in the upper incline ranges. Heart rate is above the cardio range about 90% of the time as well.

The only possible thing that can stop me now is shin splints. Those can get really painful during the test for me. If anyone knows of a cream or knows if a wrap on the shins that will control the pain, I will "beat the Bruce". My record is 16 minutes and I had to stop due to shin splints in one case and heart rate of 185 in another (it was above my max range for more than 1 minute so they stopped the test out of fear they would induce a cardiac arrest).

I can do this!

 

[james2012]

Hmmm. I found this interesting:

In men, estrogen (produced by aromatization of testosterone) has a negative feedback effect on hypothalamic secretion of GnRH and thus inhibits pituitary gonadotropin secretion. It has been hypothesized that some cases of IHH result from an acquired defect of enhanced hypothalamic sensitivity to estrogen-mediated negative feedback since maintenance clomiphene citrate therapy can result in complete normalization of pulsatile gonadotropin secretion, serum testosterone level, and sexual function in men with IHH.

I did respond to clomiphene citrate in the past during PCT. Along with HCG and Tamoxifen my TT was 560, FT was normal which indicates SHBG was normal. I forget, but CT or Tamoxifen raise SHBG. So my issue may be estrogen related. Arimidex only targets E2. What targets all three?

 

[CubbieBlue]

I reconsidered CubbieBlue. I have not quit given the uphill odds I have faced. It may be a restart is a stupid idea but by God I am going to try it if I can pinpoint SHGB and Metabolic Syndrome as the culprit of my TRT issues. If I can normalize SHBG by losing weight, then all TRT did for me was allow me to lose the weight and gain BMI faster than if I was off it (this is based on results seen since being on TRT). That is why I am TT on TRT means something. If I can get TT up with FT in the upper range and not over range, then my SHBG is under control. However, this does not explain my low levels of LH and FSH while not on TRT but after my collapse from taking Prinzide. From what I can tell from the research, IR lead to increased LH secretion so something else is suppressing my secretion. I can't trust what happened after my collapse because every system went wild - suddenly I was diabetic then not. Failed dex supression test, cortisol off the charts, etc. Six months later a spontaneous recovery. So what does my LH and FSH levels look like post PCT? I will have a copy of that lab from the past by Wednesday (hopefully). I also hope SHBG and Free-T was measured (although I do not trust Free-T measurements anymore at lest its from the same lab about 16 months apart). If LH and FSH are normal to high-normal or even high, SHBG low, and TT low with FT normal, then it is insulin resistance (which suppresses Leydig cells). This will be my cue to attempt a restart. If not, then its more detective work. Idiopathic means idiot to me. If I am not secreting tell me why. If it can be fixed, fix it. Once fixed, then I'll try a restart one last time before going on TRT/HRT for life. It's worth a shot and only costs me 3 months of my life and a few bucks out of pocket.

I have been training for six months to "beat the Bruce". I can burn 1100 calories in 1 hour on an elliptical. I blast 90% of my time on the higher resistances and spend more than 75% of my time in the upper incline ranges. Heart rate is above the cardio range about 90% of the time as well.

The only possible thing that can stop me now is shin splints. Those can get really painful during the test for me. If anyone knows of a cream or knows if a wrap on the shins that will control the pain, I will "beat the Bruce". My record is 16 minutes and I had to stop due to shin splints in one case and heart rate of 185 in another (it was above my max range for more than 1 minute so they stopped the test out of fear they would induce a cardiac arrest).

I can do this!

For me I get shin splints when I am not really in running shape. After a few weeks of running they usually go away. Also if my running shoes are old a new pair helps.

 

[Chris.N]

If you have low SHBG then your Free T levels would be much higher, I think you may have insulin resistance.

 

[james2012]

If you have low SHBG then your Free T levels would be much higher, I think you may have insulin resistance.

And you are the winner! Again, I don't put much faith in free-T results, but with an A1C of 6.1 and - hold on to your horses - a Bod Pod (considered to be the most accurate measurement of body fat) measurement of 28% with all but about 10lbs of it adipose (I have no leg, arm, very little back, and very little fat outside the abdominal cavity) it all points to one thing and one thing only - MSX.

Of course, I have already been told this, but today I now have the proof to take back to my doctors that I need to lose about 20-25lbs. I don't look fat because my abs are strong and I am so used to "sucking it in" that I appear to a lot thinner than I am. With no fat in other areas, it is clear how a doc can be fooled. However, if I take my shirt off, stand sideways and look in the mirror without sucking in my gut" - whoa! - it is clear I have more than just a few pounds to lose.

Losing excess weight equates to increasing SHBG - Google it. The male PCOS some people talk about - congenital low SHBG - has a prerequisite of alopecia before age 30 combined with low SHBG in the absence of other factors that could lower it. I do not fall into that category and I bet most of you with low SHBG don't either.

Once again I urge anyone with low SHBG to Google hydrostatic chamber and your city. Or Google Bod Pod (or bodpod). Find one, get your body fat % and then correlate to your SHBG. If it is low, then you know what you need to do. Does this mean don't do any TRT and attempt to lose 25-50 lbs. Nope. I think that would be crazy - the process would be so slow most would give up. If you don't do it, TRT won't work. Hence the false meme that TRT won't work for those with low SHBG in all cases.

Spread out the dose, don't worry about libido and ED, and maybe even think about pellets but be very careful. If they dose you too high you will be in a persistent state of estrogen dominance and possibly high Free-T. Actually, let me say bioavailable T. Can we all agree to quit talking about free T? Until someone can show me that Labcorp or Quest can do a reliable Free-T then I'm tired of hearing about it. BioT with Quest is good. I don't know about LabCorp (anyone?).

Get your free-T into the normal range with pellets or spreading out your dose. Some will disagree, but I would ask for a 24 hour urine testosterone test and see when you burn your bio T out too low. That will let you know when to dose again and then split your dose. Or do pellets. With the extra energy burn off the excess fat and keep measuring and tweaking until your %body fat is acceptable, your SHBG is normal and then you should benefit from T like many others. If you still have libido and ED issues, give your body a couple of months to reach homeostasis and if you still have issues, look at other hormones for backfilling. Or, if you feel lucky, attempt a restart with PCT.

The prevailing thinking around here is SHBG is impossible to treat. No way this is true. It just takes a very long time and a complete change in lifestyle for those who do not suffer from the congenital version. I agree, for now the congenital version would be difficult to treat, although you may be surprised at how well you respond to pellets and backfilling and a good nutra eval to plug the holes in your metabolic pathways.

Never say never.

 

[Chris.N]

And you are the winner! Again, I don't put much faith in free-T results, but with an A1C of 6.1 and - hold on to your horses - a Bod Pod (considered to be the most accurate measurement of body fat) measurement of 28% with all but about 10lbs of it adipose (I have no leg, arm, very little back, and very little fat outside the abdominal cavity) it all points to one thing and one thing only - MSX.

Of course, I have already been told this, but today I now have the proof to take back to my doctors that I need to lose about 20-25lbs. I don't look fat because my abs are strong and I am so used to "sucking it in" that I appear to a lot thinner than I am. With no fat in other areas, it is clear how a doc can be fooled. However, if I take my shirt off, stand sideways and look in the mirror without sucking in my gut" - whoa! - it is clear I have more than just a few pounds to lose.

Losing excess weight equates to increasing SHBG - Google it. The male PCOS some people talk about - congenital low SHBG - has a prerequisite of alopecia before age 30 combined with low SHBG in the absence of other factors that could lower it. I do not fall into that category and I bet most of you with low SHBG don't either.

Once again I urge anyone with low SHBG to Google hydrostatic chamber and your city. Or Google Bod Pod (or bodpod). Find one, get your body fat % and then correlate to your SHBG. If it is low, then you know what you need to do. Does this mean don't do any TRT and attempt to lose 25-50 lbs. Nope. I think that would be crazy - the process would be so slow most would give up. If you don't do it, TRT won't work. Hence the false meme that TRT won't work for those with low SHBG in all cases.

Spread out the dose, don't worry about libido and ED, and maybe even think about pellets but be very careful. If they dose you too high you will be in a persistent state of estrogen dominance and possibly high Free-T. Actually, let me say bioavailable T. Can we all agree to quit talking about free T? Until someone can show me that Labcorp or Quest can do a reliable Free-T then I'm tired of hearing about it. BioT with Quest is good. I don't know about LabCorp (anyone?).

Get your free-T into the normal range with pellets or spreading out your dose. Some will disagree, but I would ask for a 24 hour urine testosterone test and see when you burn your bio T out too low. That will let you know when to dose again and then split your dose. Or do pellets. With the extra energy burn off the excess fat and keep measuring and tweaking until your %body fat is acceptable, your SHBG is normal and then you should benefit from T like many others. If you still have libido and ED issues, give your body a couple of months to reach homeostasis and if you still have issues, look at other hormones for backfilling. Or, if you feel lucky, attempt a restart with PCT.

The prevailing thinking around here is SHBG is impossible to treat. No way this is true. It just takes a very long time and a complete change in lifestyle for those who do not suffer from the congenital version. I agree, for now the congenital version would be difficult to treat, although you may be surprised at how well you respond to pellets and backfilling and a good nutra eval to plug the holes in your metabolic pathways.

Never say never.

I agree. I take 100mg of Test cyp a week with HCG and my brother and I both have low SHBG and we are both having a great experience.

Saru would be a good person to have chime in on this, he has insulin resistance I believe.

 

[james2012]

I agree. I take 100mg of Test cyp a week with HCG and my brother and I both have low SHBG and we are both having a great experience.

Saru would be a good person to have chime in on this, he has insulin resistance I believe.

That is great to hear. Do you do any backfilling? For some reason that same dose of test cyp rocked for about 3 weeks and then libido and ED were dead - I mean GONE, KAPUT! It was two weeks before my anniversary cruise and I switched to Testim Gel, prayed a lot, got some Levitra and no problems. But I still need Levitra and libido is low. There must be something else going on.

What is your HCG dose and schedule?