Blood Work, life and advice needed.

[Helpout]

I`m 39 and just had one hell of a year, decided to divorce a year ago, first few months were great, met a girl was in love but we broke off, ever since I have insomnia and the last couple of months libido is gone, I get erections just fine but I have a hard time coming off, masturbating with porn seems easier something I always hated.

I still like my ex wife and we are trying to get back together, I have a daughter, who made divorce even more harder as she constantly complained about my absence during her everyday.

Long story short I went to a Psychiatrist and an Endo, both diagnosed me with depression and I´m on 5 days on AD, but I really anxious about it. You may ask why I´m here, well 3 years ago I asked a Total Test from my MD because I´m an avid cyclist and wanted to know my range, it came back 278ng/dl, but I never had issues with staying lean, gaining mass (my legs became very muscular because of sport) or libido.

Fast forward to last month, at the height of insomnia, worries about family life and daughter my libido just went away. With the old test range in my mind I went to one of those TRT clinics and they gave me a form for a battery of tests I did the tests but never had the courage to go back to the clinic, I have always been against meds

Anyway the results

Total Test 289ng/dl (at 8:00AM)
SHBG 26,30 NMOL/l
Test Free Calculated 6,42 ng/dl
Test Biodisposiable 150,43 ng/dl
Estradiol 33,3 pg/ml
FHS 2,2 mUI/ml
LH 2,6mUI
TSH 1,805 uUI/ml

Test even went up from 4 years (at the time I had a major flu when I took the test and it was a little later than 8:00AM if I remember)

I just want some input from people that have went through this before, could depression and lack of sleep for almost a year finally catch up and kill libido? Can I get my HPTA back up? Considering my number I must be secondary?

I will stick to the AD but would a SERM be a good option like clomid?

Also I was diagnosed with tuberculosis, its not active and I only found out because I have psoriasis and I had to take a huge number of tests if I wanted to take a biological med which I already gave up.

Thanks and sorry for the long post

 

[Entourage_Doc]

How your lifestyle? Numbers don't really mean anything unless you can tell me a little bit about you. Active? Ever been treated for anything other than depression? You have psoriasis?

Would you consider TRT or trying to avoid that route- you are on your way there.

Clomid monotherapy is poor but if you want to try it then do it and see how you feel.

Dr B

 

[Helpout]

Active lifestyle, no drug use, no symptons before divorce. I really dont feel depressed and I do have psoriasis since I was 16 but I dont have issues with it. But I did take a immunosupressor Metrexate 2 years ago.

I have been sleeping pretty badly for almost a year.

Im really trying to avoid TRT, if it was later in life I would not feel so worried about.

How your lifestyle? Numbers don't really mean anything unless you can tell me a little bit about you. Active? Ever been treated for anything other than depression? You have psoriasis?

Would you consider TRT or trying to avoid that route- you are on your way there.

Clomid monotherapy is poor but if you want to try it then do it and see how you feel.

Dr B

 

[scorob777]

I find it curious you would want to stay off drugs, but want to stay on the anti-depressant. Seems to me you should want to stay the fuck off anti-depressants and try anything else.

You mention cycling for fitness. Do you do any weight lifting? Could be a great way to de-stress, and get yourself exhausted so you can sleep better.

 

[Helpout]

I find it curious you would want to stay off drugs, but want to stay on the anti-depressant. Seems to me you should want to stay the fuck off anti-depressants and try anything else.

You mention cycling for fitness. Do you do any weight lifting? Could be a great way to de-stress, and get yourself exhausted so you can sleep better.

Just quit AD, you are right, only stayed for 5 days and lowest done. I started to lift weights again this month.

Before waking up in the middle if the night did not bother me, but now with no libido Im going crazy.

 

[scorob777]

That's really good news you quit the AD and started lifting weights. Just eating right and lifting weights should boost your test and let you sleep better.

I'm not very knowledgeable about FSH, LH, and test levels - but from what I can see your FSH and LH are really near the bottom of the range, so the low test might have more to do with that then the testes. I.e. more of a secondary than primary issue.

Others with more knowledge should weigh in here - but perhaps you could try a HPTA restart, similar to a steroid cycle PCT, using HCG, clomid, and nolva. Might be worth a shot, then if it doesn't work you could do more testing or think about TRT.

 

[Entourage_Doc]

I would first try the hpta re-start and see if that doesn't get you therapeutic.

So you have issues staying asleep or falling asleep?

Dr B

 

[Helpout]

I would first try the hpta re-start and see if that doesn't get you therapeutic.

So you have issues staying asleep or falling asleep?

Dr B

Thank you for the replies!

Anyone has a good hpta restart that is conservative and safe?

My sleep has been bad since divorce and I did not care because it was not affecting anything else, I would wake always in the middle of the night. (2 or 3 am) and would eventually dose off again for 1h. Today I had a hard time to sleep maybe it had to do with stoping Antidepressents, read that can take a couple of weeks to clear from the system even at low periods of use.

If somone said it was normal under a year of lack o proper sleep these symptons, lack libido, I would probably feel more at ease and focus only on getting sleep right.

 

[appleton111]

Good that you got off antidepressants, are you sleeping any better now? hows the sex life?

 

[Mprtz]

I'm confused about the use of the term restart here... from my reading the OP has not started TRT. Do you just mean lifestyle changes to attempt to raise T levels?

His lab values don't fall into the current (LabCorp) range for hypogonadism either.

 

[scorob777]

Basically saying do a PCT as if you had just come off an AAS cycle. Like 1,000 IU HCG per day for 10 days, then chlomid 50 mg/day for 4-6 weeks plus nolva 40 or 20 mg/day for 4-6 weeks.

Might kick the HPTA into a higher gear, and if it didn't work might point you toward TRT.

It would be cheap and take 8 weeks, not a bad thing to try.

 

[Entourage_Doc]

Yes, I did use the term re-start. At some point his hypothalamic pituitary axis was therapeutic, obviously. We would then essentially "re-start" it with special compounds as a avenue of fundamental treatments.

He falls into my "range" for hypogonadsim and that's what matters, and It would be considered secondary if I did indeed diagnose him.

Yes- antidepressants take at least 6 weeks to clear the system

Dr B

 

[daleb]

Labcorp recently changed their labranges. But labwork is not supposed to be definitive for diagnosis, its supposed to help guide providers.

TB is a mofo. Id try to find a doc that is NOT a mainstream doctor and NOT a member of the Infectious Disease Society of America. A provider who specializes in just TB. It sounds fishy to me that TB is in remission. I know a few things about infectious disease and from my experience with it mainstream doctors do not know the CDC guidelines for treating them. They often misinterpret the guidelines or disregard parts of them to suit their convenience. CDC guidelines are just cover for insurance companies to not have to pay for proper treatment. You might just need a few months of Rifampin and Isoniazid to knock TB completely out.