Some hormones help me, but Dr wont even give pregnenolone now. Labs inside!

[MikeZ]

Hi,
Ill try to keep it as short as I can. I HUGELY appreciate any replies.

I'm 32 . Years ago, I developed ED , lack of desire, and sense of muscle loss.

Possibly triggered by an Accutane in 08, but no real way to prove the link. This drug has been studied and proven to lower most HPA hormones at least while on it.


The only stuff over the years that reliably helped my libido ...

HCG 100 IU x 3/week. Partial response.

Pregnenolone (20mg/day sublingual) did help partially sometimes. Testogel - helped libido + noticed more hair growth. Lack of sensation in testicles and annoying to apply though.

L-DOPA - Amazing libido, but causes insomnia.

Drugs always have some harsh side Supps/herbs didn't do the trick.



... My GP now wont give ANY hormones , even pregnenolone because:

1. He feels none of my issues are hormonal
2. He said any hormone you take will cause suppression of some pathway.

He acknowledges I felt a bit better, but said a healthy person would also feel a boost. That makes sense I guess.

I just want to feel better though.

I don't know whether to listen to his advice in whole, seek out another doctor open to HCG
+ Preg to treat symptoms , or even order Clomid myself.

I will avoid T.



My latest results:

If anyone can give an opinion that would be great.

The labs here in Aus apparently use a separate range for 'younger males' as well.

** Brain MRI is normal **. No history of trauma.



FSH ..... 1.7 IU/L . (1.5 - 9.7)
LH ..... 2.9 IU/L . (1.8 - 9.2)
Estradiol..... 60 pmol/L . (<160)
Test total..... 18.8 nmol/l . (12 - 31.9)
Test total (most recent)..... 17.3
SHBG..... 43 nmol/l . (17 - 56)
SHBG (most recent)..... 46 nmol/l
Free Test ..... 346 pmol/l . (260 - 740)
Free Test (most recent)..... 306 pmol/l

Progesterone ..... 1.0 nmol/l . (0.7 - 4.3)

DHEAS ..... 5.6 umol/l . (4.3 - 15.0)
Cortisol AM..... 230 nmol/L . (172 - 497)
Cortisol AM (most recent)..... 401 nmol/l
ACTH..... 4.3 pmol/l , (1.6 - 13.9)

Thyroid
Free T4 ..... 13.2 (11 - 21)
Free T3 ..... 4.6 (3.2 - 6.4)
TSH ..... 2.26 (0.5 - 5)

 

[appleton111]

how much accutane did you take in 08?

 

[MikeZ]

how much accutane did you take in 08?

A 7 month course I believe , with 4 months at 80mg/day , and the rest , tapering up and tapering down. It did completely get rid of my acne.

 

[IMT staff]

A 7 month course I believe , with 4 months at 80mg/day , and the rest , tapering up and tapering down. It did completely get rid of my acne.

Just FYI if you ever do the accutane again you only need 10-20mg per day. Its the higher dosages that cause problems with accutane.

 

[Entourage_Doc]

I have had a few patients that have had hormonal imbalances from accutane.. Actually recently, as well

Free t levels in the 300 would qualify you for TRT treatment. You should look into that or talk with your pcp (hopefully he is progressive)

Dr B

 

[MikeZ]

I have had a few patients that have had hormonal imbalances from accutane.. Actually recently, as well

Free t levels in the 300 would qualify you for TRT treatment. You should look into that or talk with your pcp (hopefully he is progressive)

Dr B

Thanks for the reply. I wasn't sure if my level was low enough , but your reply helps me a lot.. I will go to this different doc who is more open minded.

 

[MikeZ]

Hi , just an update:


My T is now higher for some reason, and LH alot higher, BUT my cortisol is below range now.


Nothing was really changed, except I switched between nasal spray brands (done before) , was on low dose nootropic (nicergoline) but noticed no effects, and got a lot of sunshine a few days before. I'm low - normal on serum Vit D, but can't tolerate oral supps.


Regardless of any of that, I still had low libido and all usual symptoms. Also, the cortisol issue.

It seems I can't get my cortisol and T at the same time to both be mid range or higher.



What should be my best approach here?


Thanks for any insight!



OCT 4th: (this particular Doc didn't do all the parameters, so some are missing)

FSH ..... 2.6 IU/L . (1.5 - 9.7)
LH ..... 6.2 IU/L . (1.8 - 9.2)
Test total..... 23.2 nmol/l. (12 - 31.9)
Free Test ..... 438 pmol/l. (260 -740)
SHBG..... 44 nmol/l . (17 - 56)
Prolactin.... 368 (90-400)
Cortisol AM..... 101 nmol/L . (172 - 497)

 

[MikeZ]

Just an update:


I had cortisol rechecked and normal. 285 now vs 101 as above. Also ACTH was normal.

Everything looks good. Thyroid, Cort, T, etc.

BUT I still have many hypogonadal symptoms. Most of these started after Accutane (07-08).

Does this mean, I avoid all hormonal substances based on recent tests, even though some of them made me feel better in the past ?

Ie treating symptoms vs treating numbers?

For e.g. low dose HCG restored some sense of well being , testicular fullness, and a 30-40% rise in libido.

Androgel as well, (but no testicle fullness like HCG) , but Ill avoid this since my HPTA is intact and its inconvenient to apply though?

I have never tried Clomid, but never read what it does to the libido and hormones of someone with 'normal T', but with hypo symptoms.



Only read this section if you are wondering how I even tried hormones in the past

In 09 I was Dx as hypogonadal + low cortisol, by a very progressive anti ageing Dr. Whether I was truly hypo back then, the current numbers now (taking nothing) show I'm not anyhow. He also mainly used saliva testing for everything and is quite controversial in the field.

The above is only to explain how I ever got around to trying various hormones etc.

He tried everything. I found I got the best libido lifts from bio identical gel , HCG, and pregnenolone. Later on I was just using HCG and preg.

I switched to a diff anti ageing doctor in 2014. Very knowledgeable , but cheaper. He is also more conservative. He did continue to provide HCG and preg, but stopped in 2016 because he said my numbers are fine and doesn't want to cause any suppression of any kind and my issues aren't hormonal.

I agree with him on that regard, BUT this doesn't provide an actual solution to help my symptoms.

At the end of the day, the goal is to feel better.

I'm now at a loss whether I should see this new Dr who is known to provide HCG and other things, or just avoid all hormones now.

Thank you SO much for any help.

 

[IMT]

Just an update:


I had cortisol rechecked and normal. 285 now vs 101 as above. Also ACTH was normal.

Everything looks good. Thyroid, Cort, T, etc.

BUT I still have many hypogonadal symptoms. Most of these started after Accutane (07-08).

Does this mean, I avoid all hormonal substances based on recent tests, even though some of them made me feel better in the past ?

Ie treating symptoms vs treating numbers?

For e.g. low dose HCG restored some sense of well being , testicular fullness, and a 30-40% rise in libido.

Androgel as well, (but no testicle fullness like HCG) , but Ill avoid this since my HPTA is intact and its inconvenient to apply though?

I have never tried Clomid, but never read what it does to the libido and hormones of someone with 'normal T', but with hypo symptoms.



Only read this section if you are wondering how I even tried hormones in the past

In 09 I was Dx as hypogonadal + low cortisol, by a very progressive anti ageing Dr. Whether I was truly hypo back then, the current numbers now (taking nothing) show I'm not anyhow. He also mainly used saliva testing for everything and is quite controversial in the field.

The above is only to explain how I ever got around to trying various hormones etc.

He tried everything. I found I got the best libido lifts from bio identical gel , HCG, and pregnenolone. Later on I was just using HCG and preg.

I switched to a diff anti ageing doctor in 2014. Very knowledgeable , but cheaper. He is also more conservative. He did continue to provide HCG and preg, but stopped in 2016 because he said my numbers are fine and doesn't want to cause any suppression of any kind and my issues aren't hormonal.

I agree with him on that regard, BUT this doesn't provide an actual solution to help my symptoms.

At the end of the day, the goal is to feel better.

I'm now at a loss whether I should see this new Dr who is known to provide HCG and other things, or just avoid all hormones now.

Thank you SO much for any help.

Did you see your new doc? hows your freet levels now? feeling better?