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Kjellfh`s Journal - Low T and/or other problems

Discussion in 'Member Journals' started by kjellfh, Aug 23, 2014.

  1. JanSz

    JanSz Well-Known Member

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    Ask your doctor.
    I would say no to testosterone.
    ---------------
    Gonadotropin-releasing hormone (GnRH), also known as Luteinizing-hormone-releasing hormone (LHRH) and luliberin, is a trophic peptide hormone responsible for the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary.
     
  2. kjellfh

    kjellfh Member

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    Been off HCG/TRT from 11.17.2014.
    I tried HCG as monotherapy for approx. 90 days total. I can`t say I have had great success. After a couple of weeks I felt that there was a positive trend for about 1-2 weeks but this subsided. Overall I think I maybe felt a tad better than before I started.

    At first I tried 250 IU EOD for five weeks, then 150 IU ED for three weeks and 200-250 ED or 500 IU EOD the rest. I took one shoot of 2000 IU. This was the last shot before the two week break before the stimulation test.

    I am not sure of this but it seemed that for me, EOD injections was better than ED and nightly injections better than morning.

    LHRH and TRH stimulation tests were done on 12.01.2014. Results:

    LH goes from 4.5 to 9 mU/l
    TSH
    goes from 2.5 to 22 mU/l

    These are normal responses according to the doctor.

    Some of the results of tests taken before the the stimulation test:

    B-Hemoglobin 15.2 (13.5-17.0) g/100mL
    EVF 0.44 (0.40-0.50)
    SR 1 mm
    Kreatinin 81 (60-105) μmol/L
    HbA1c 5.3 %
    FT4 11 (8.0-21) pmol/L
    FSH 12.6 (1.4-12.0) mIU/L
    Prolactin 93 (<370) mIU/L
    Testosterone 7.1 (9.0-30.0) nmol/L
    SHBG 51 (8-60) nmol/L
    Cortisol 608 nmol/L
    ACTH 6.2 (<10.2) pmol/L
    Growth Hormone 6.8 (<15) mIU/L
    IGF1 30 (17-63) nmol/L

    BP 120/50, Pulse 60 Weight 70.3 kg, Height 173 cm.

    Based on the results, is it safe to say that the signaling between the pituitary and hypothalamus is ok? Can I learn anything other from these results?

    I have pretty much decided to try daily T-Gel/Tostran 2% in combination with low dose HCG weekly. Any thoughts on this?

    Will try to update this post later with some of the bloodwork/info that was lost in the server crash and so on.

    Edit: Bloodwork from 09.17.2014. 29 days with HCG 250 IU EOD.
    Working on lowering natrium a little bit, GFR is normal according to standards used here.
    I remember Picton mention this earlier.

    Still waiting for results from 05.11.2014. This was the last test taken when on HCG only.
     

    Attached Files:

    Last edited: Dec 9, 2014
  3. Picton

    Picton Super Moderator Staff Member Super Moderator

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    So is your Doctor saying you have PRIMARY Hypogonadism then?

    If that is so, it's a long time (more than 50 years!) you will need to be on testosterone Replacement, and once on exogenous testosterone, it does switch production off, some can turn that on again if they stop, but no guarantee that you will.

    I used Tostran for 4 years and liked it, some complain at how slow drying it is. I generally needed 8 pumps daily to get past 15nmol/L. Standard dose is 6 pumps (6mg).

    If you are genuinely primary, then presumably HCG won't have very much effect.
     
    kjellfh likes this.
  4. kjellfh

    kjellfh Member

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    Thanks for sharing your experiences. What TRT regime do you use now?
    I have tried Tostran over a period of 3 months before, but the endocrinologist back then told me to rub it on my breast and stomach and to use no more than 5 pumps (50mg).

    The last endocrinologists calls my condition "Hypopituitarism".
    My bloodwork from 09.22.2014 (34 days with HCG 250 IU EOD) shows that there is some response to HCG, does this mean that I am not primary?
    Still waiting for another test taken a little further into HCG mono treatment (78 days).
     
    Last edited: Dec 11, 2014
  5. kjellfh

    kjellfh Member

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    One of my biggest problem nowadays is excessive thirst and urination,
    I have experienced this before but it have gone away by itself.
    This time it have been almost consistent everyday or every other/third day for weeks. It is typically worst in the evening/night and in the morning. At worst I have to pee 6 times at night. I remember having this problem sometimes when drinking alcohol(even small amounts) couple of years ago also.

    I have no pain or trouble emptying the bladder. No special smell or color. I have checked the urine numerous times with these test strips. Also checked for creatinine, all tests have been normal/negative except for a few times with low specific gravity(diluted urine).

    The internet have told me that this could be some disturbances of the ADH/AVP hormone and that low testosterone can cause low ADH. Anyone who have had similar experiences?

    I am heading for my physician tomorrow and will ask him about it.
     
    Last edited: Dec 8, 2014
  6. Picton

    Picton Super Moderator Staff Member Super Moderator

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    This is all a bit puzzling.... If you are hypopituitary, then there is a lot more than just Testosterone needs looking at...depending on circumstances all or most of the pituitary hormones may need replacement, and even Growth Hormone. The thirst and urination could fit in there... as Diabetes Insipidus, that is more usually related to the Posterior Pituitary.

    I would imagine you need a good deal more blood testing to see what is happening.
    You are in a situation beyond my personal experience, you need to get some answers from your Endo (good luck there!) and research online.

    Tostran - the usual starting does is 6 pumps (60mg), and you would possibly need more. I used it on inner thighs, for the simple reason I have too much abdominal fat, my inner thighs are much leaner, and I want to keep it away from areas of high aromatisation.
    https://www.medicines.org.uk/emc/medicine/19702

    I am currently being moved to Testogel, (NHS problems!), it's jsut two weeks and I have not even had any new bloods yet, so not sure where I stand with that until next week.
     
  7. kjellfh

    kjellfh Member

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    I have had contact with six different endocrinologists , three different general physicians and one neurologist. Each and all have run their sets of blood tests and said that there is nothing wrong except "a little low testosterone" or even "all is fine". Two of the endocrinologists have mentioned over-training could be a factor. Others say "there is no explanation for this". I don`t think I can get them to run any more tests other than follow up hormone tests from my current general physician.

    Was on a follow up MRI scan of the head at 12.04.2014, maybe this will reveal something new.

    I was at my current physician at 12.09.2014. Asked about the urination problem, took a urine test to check for urine tract infection, which where all fine. He said I should give it some more time to see if it goes away, if not it could be diabetes insidipus (as you said) and I should try medication for this and see if it improves my symptoms.

    Finally got results from 11.05.2014, 78 days after the first HCG shot (250 IU EOD for five weeks, 150 IU ED for three weeks and 200-250 ED or 500 IU EOD the rest, this show even more response:

    HEMOGLOBIN 14.7 (13.5-17.0) g/100mL
    EVF 0.44 (0.40-0.50)
    B-MCH 29 (27-33)
    PSA 0.39 (0.00-2.5)
    ESTRADIOL 0.11 (0.00-0.16) nmol/L
    TESTOSTERONE 22.6 (9.0-35.0) nmol/L
    SHBG 46 (15-85) nmol/L
    FSH <0.5 (1.4-12.0) mIU/L
    LH <0.5 (1.0-10.0) mIU/L
    PROLACTINE 358 (100-400) mIU/L

    I started with Tostran again 12.02.2014 with 8 pumps(80mg). I apply the gel in the morning, usually on the arms and shoulders.

    Is it ok to take new blood tests after two weeks(12.16.2014)?
     
    Last edited: Dec 11, 2014
  8. Picton

    Picton Super Moderator Staff Member Super Moderator

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    In which case, I am not so sure you should be on testosterone, you seemed to be reacting fine to the HCG, which rather implies that you don't have Primary Hypogonadism!
     
  9. kjellfh

    kjellfh Member

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    Make sense.... if not either primary or secondary, best I hope for is that testosterone correct some of the imbalances and start a cascade of some sort. I don`t know what else do to.
     
  10. Dr. John Crisler

    Dr. John Crisler Lord of the Forum Staff Member Super Moderator

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    This post might be a good time to remind people that I come online to answer questions; but can't spend 15 minutes evaluating an entire case, and then trying to solve the whole thing.
     
  11. kjellfh

    kjellfh Member

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    This is perfectly understandable and I will like to thank you for running this forum. I`m going for an AOC appointment if I fail to achieve results after some time.
     
  12. kjellfh

    kjellfh Member

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    Took some tests again 12.16.2014 two-three hours after application, testosterone is most likely falsely high due application area (washed my arm before test but that didn't seem to help), a slightly high Estradiol indicate maybe a little over the top range of testosterone(?) but dont know how much value this estradiol test have anyways:

    Leukocytes 5.4 (3.5-10.0)
    Hemoglobin 15.5 (13.4-17.0)
    MCH 29 (27-33)
    HBA1C% 5.0 (4.0-6.0)
    PSA 0.44 (0.00-2.5)
    Creatinine 83 (60-105)
    Pt-GFR, estimated >90
    ALAT 14 (10-70)
    Estradiol 0.19 (0.00-0.16)
    Testosterone 218.0 (9.0-35.0)
    SHBG 47 (15-85)
    FSH <0.5 (1.0-12-0)
    LH <0.5 (1.0-10.0)
    Prolactin 116 (100-400)

    Took new tests a few days after at 12.23.2014, changed application area to inner thighs this day, not 100% sure about the reference values here yet because it was taken at another laboratory and haven't got the papers yet, but I think they are almost the same:

    Testosterone 28.6 (9.0-35.0)
    SHBG 44 (15-85)
    Hemoglobin 15.7 (13.4-17.0)
    MCH 29 (27-33)

    The excessive urination/thirst have finally almost gone away, now at worst I am up 3 times per night to pee and it does not bother me the same at daytime either.

    Other than that, days have mostly been crap since last update, a big increase in heart palpitations and headache the last week especially. Also had periods of chest pain/stiffness. Palpitations have been day and night. I upped Tolvon/mianserine dosage from 12.14.2014 in order to get some restorative sleep. Maybe this have increased this problems, going to taper completely from this med as I no longer notice much effect.

    Pulse-rate have been varying from 80-120 at rest. Was at a local doctor today(I am at my family for the holidays) and she measured BP to 140/85 pulse 86 which she say is normal, also took a EKG which was ok. Going back tomorrow to re-check BP/EKG and maybe get some answers on blood tests taken today.

    Rechecked BP/PR after some hours rest at home = still slightly high BP at 139/84 and pulse at 75.

    I am 100% off work/reported sick since 12.14.2014 (80% before) and will be until I get better, also have very low stress times at my family for christmas(no tasks/duties at all) so I don't understand this reaction at all other than it could be the mentioned Tolvon increase.
     
  13. kjellfh

    kjellfh Member

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    I quit Tolvon/mianserine cold turkey at 12.19.2014. I don`t know if that was what caused rise in heart palpitations and headaches that lasted the whole Christmas but my resting BP and pulse got back to around 120/65 and 70. Sleep and other problems has been even worse though.

    Current TRT protocol:
    Tostran 70mg + HCG 150 IU E3D.

    New tests taken 12.27.2015, 2-3 hours after gel applied to inner thighs and three days since last HCG shot:

    Hemoglobin 15.4 (13.4-17.0)
    MCH 29 (27-33)
    Creatinine 81 (60-105)
    GFR >90
    ALAT 23 (10-70)
    PSA 0.41 (0.00-2.5)
    Testosterone 33.9 (9.0-35.0)

    For some reason my doctor did not order SHBG and Estrogen. I will nag for this on the next test.
    My guess is SHBG still is kinda high (last test was 46 nmol/L).

    So, my total T numbers have been better for some time now but I still suffer greatly.

    Symptoms, same or worse:
    - Very shallow non-refreshing sleep.
    - Night sweats and/or feeling hot+heart palpitations.
    - Low libido, no night or morning wood, no spontaneous erections.
    - Bad mood, depression, low motivation/energy, poor concentration.
    - Headaches.
    - General feelings of restlessness and uneasiness.
    - Low or no feeling of satiety after meals, post meal cravings.
    - Constipation/Inconsistent stools.

    Improvements the last 2-3 weeks:
    - Less "no reason" anxiety.
    - Less nasal congestion at bedtime.
    - Less excessive thirst and urination.
    - Less nipple/breast itching.

    Sleep pattern is usually like this: fall asleep between 22:00-00:00, sleep superficially for 1-3 hours, wake up with heart palpitations, wide awake, hot and sometimes sweaty, often feeling stiff,sore and bloated. If I am really lucky I get to sleep again around 05:00-09:00 and maybe sleep 1-2 hours more. This sleep is usually more refreshing than the first.
    Some nights I have consciously not slept at all and actually felt better than after a standard night. Sometimes this also helps a little bit with sleep the next night.

    Maybe I am just being impatient but I remember the first time I went on TRT, some relief in sleep problems was felt after a month at a much lower T dose than I am using now.
    Could what I am experiencing now be withdrawal from mianserine or high histamine?
    Mianserine has pretty strong antihistamine effect and I have been on it since late summer 2014, the last period at dosages up to 150mg each night.

    I tried two nights with 15mg some days ago and slept better again, even had some loose wood the mornings after. I will not start on this medication again but was curious to see the reaction.

    Generally I do not take any supplements and haven't for a long time but in desperation I have tried some again with negative results:
    Magnesium (taurinate or glycinate or citrate), taken at nights caused big increase in palpitations and night sweat intensity.
    Pharmagaba, little to no help at night, big increase in anxiety and restlessness the next day.
    Melatonin low dose, little or no effect.
     
    Last edited: Jan 29, 2015
  14. kjellfh

    kjellfh Member

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    Last weeks has been hell, many nights without any sleep at all.
    I believe that withdrawal from mianserine/Tolvon could be the culprit.

    It`s been 45 days since I stopped taking this med cold turkey. I have taken it maybe 3-4 times after that in small doses with improvement in symptoms that last 1-3 nights every time. Could be a coincidence but I don't believe so.

    Googled a litte bit and found that many people suffer the very same kind of insomnia after quitting such meds:

    http://www.benzobuddies.org/forum/index.php?PHPSESSID=lo7tcq9vt9q3ddh5nmg60dpr83&topic=79503.0
    http://www.depressionforums.org/for...-after-quitting-remeron-mirtazapine-insomnia/
    http://www.depressionforums.org/forums/topic/82231-mirtazapine-withdrawal-insomnia
    http://survivingantidepressants.org/index.php?/topic/3757-rosalind-6-weeks-off-remeron/
    http://www.depressionforums.org/for...y-withdrawal-symptomes-came-gradually-normal/
    http://mentalhealthdaily.com/2014/07/21/remeron-mirtazapine-withdrawal-symptoms-how-long-they-last/ comments
    http://www.socialanxietysupport.com...t-read-124008/#/forumsite/20507/topics/124008

    Most anecdotes says that withdrawal last from 1 to 6 months, some shorter and some even longer.

    Any experiences/tips are greatly appreciated.
     
  15. kjellfh

    kjellfh Member

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    Another completely sleepless night again, but think I feel the same or better than when I only get those crappy 1.5-2 hours. Checked my body temperature (under the tongue) while having the usual nightly hot flashes/palpitations. Readings showed average of 36.7 which should be normal. Weird cause it feels like surges of "burning" up from inside and that the body is working really hard with something.
     
  16. kjellfh

    kjellfh Member

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    New tests taken 03.10.2015 approx. 4 hours after applicaton of gel containing 60 mg and 4 days since last HCG shoot:

    Hemoglobin 15.5 (13.4-17.0)
    MCH 29 (27-33)
    Testosterone 104 (9.0-35.0)
    SHBG 37 (15-85) nmol/L
    ESTRADIOL 0.15 (0.00-0.16) nmol/L

    I think testosterone is false high again, forgot that I was to take blood test this day and applied gel early in the morning as usual.
    After 20-30 minutes I remembered and washed and rubbed the needle area with soap and alcohol thoroughly, also did this right before the test but to no help. Seems like the gel gets absorbed and stored pretty good in my skin. Both estradiol and hemoglobin looks fine so I`m not going to worry about this.

    Finally SHBG seems to going down, I think of this as a very good sign.
    Still battling most issues as before though, insomnia/anxiety being the worst. Had a few nights where I`ve got up to an hour sleep late in the morning and this helps a little. Night sweats/flashes have been a little less intense, also morning stiff- and soreness have been better the last couple of days, hoping for some positive trends here!!. Still use low doses of mianserine intermittently/in between but consistently low dosages only.
     
    Last edited: Mar 12, 2015
  17. kjellfh

    kjellfh Member

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    Since 03.05.2015 I got a tDCS device. Been experimenting/using with it everyday since. Can`t say I notice any difference. Mood has been a little better the last days but I dont think I can attribute this to the tDCS sessions. Interesting and simple technology though. Tried various montages but kind of landed on Anode(+) on F3 and Cathode on right shoulder.
     
  18. hebsie

    hebsie Super Moderator Staff Member Super Moderator

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    ...I had to google what a 'tDCS' machine was. The first article I hit was this:

    Brain Hackers Beware: Scientist Says tDCS Has No Effect

     
  19. kjellfh

    kjellfh Member

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    Yes.. I`ll guess tDCs have little if any effect at all.
    However this site lists some montages and links to the study`s behind them.
    It think it was worth a try anyway.
     
  20. kjellfh

    kjellfh Member

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    New labs 05.12.2015, taken around 14:00:

    Albumin 56 (36-48) g/L
    Kreatinine 78 (60-105) µmol/L
    Pt-GFR, estimated >90
    TSH 3.5 (0.30-4.2) mIE/L
    Free T4 14.9 (11.0-22.0) pmol/L
    Free T3 5.5 (3.1-6.8) pmol/L
    Anti-TPO 7 (<=40)
    Calcium 2.61 (2.15-2.51) mmol/L
    Calcium albumin adjusted 2.32 (2.17-2.47)
    Calcium ionized, relevant 1.22 (1.16-1.32)
    Calcium ionized, ph 7.40 1.26 (1.16-1.32)
    PTH(parathyroid hormone) 4.3 (1.3-7.1) pmol/L

    Cortisol 605 (220-850 between 07:00-09:00) nmol/L
    Testosterone 34.6 (9-35) nmol/L
    SHBG 40 (15-85) nmol/L
    FSH <0.5 (1.0-12.0) U/L
    LH <0.5 (1.0-10.0) U/L
    Prolactin 261 (100-400) mU/L

    So I am pretty sure that the low testosterone was only a symptom now, there is little difference in how I feel now after almost a half year on TRT and with significant better T values for the last months.

    Still battling horrible insomnia, mood swings, anxiety and cravings. Also have periods with excessive urination/thirst. During a typical week, I have between 2-3 days/nights that I function as a normal human and can sleep ok. These days/nights are pretty random.

    The only thing that I know for sure helps a little for sleep is antihistamines(even zyrtec/cetirizin that is said to be non drowsy). Problem is that over time it looses its effect and stopping it creates big rebound. This rebound is in regard to restlessness, headaches, palpitations and warm skin/sweating at night. So I generally do not use it.

    Because of this I am speculating on that excess histamine is playing a role, maybe causing release of cortisol/adrenalin to counter it. The weird thing is that I have very few of the standard high histamine symptoms(rash, itching, runny nose etc.)
    I have tried various "natural" antihistamines such as grape seed extract(GSE), vitamin C, nettle, parsley and quercetin but failed to achieve satisfactory and consistent effects. Also tried following a low histamine diet.

    According to different sources, histamin H1 receptors play various roles in the CNS, for example in sleep-wake cycle, body temperature, endocrine homeostasis, appetite and mood. Cetirizin/zyrtec is a H1 antagonist.

    Also I have this homozygous mutations on the MAO-A R297R rs6323 and CBS A360A rs1801181 genes, but I dont know if there is any point doing any more research on these...

    Any input is appreciated.
     

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