29 Yo Male, Low Libido And Low Ferritine, Ed-recovery

[Arclight]

Undereating alone causes a host of issues.
Males, Anorexia, and Physical Side Effects

Yes, I am aware of that, but I havent restricted food for the last 2 years. I have been pretty gung-ho in opting for nutrient dense and adequate amounts of food.

Actually Im kind of worried about the fact that Im eating a lot without going any cardio and still not galning any lean mass at all, not that much fat either, and still feeling weak.

Malabsorption or insulin resistance could perhaps be a factor, Im not sure

 

[EIRE24]

Yes, I am aware of that, but I havent restricted food for the last 2 years. I have been pretty gung-ho in opting for nutrient dense and adequate amounts of food.

Actually Im kind of worried about the fact that Im eating a lot without going any cardio and still not galning any lean mass at all, not that much fat either, and still feeling weak.

Malabsorption or insulin resistance could perhaps be a factor, Im not sure

If you are not gaining weight then you are not eating enough. Its as simple as that

 

[Arclight]

If you are not gaining weight then you are not eating enough. Its as simple as that

Im considering if being unable to absorb ingested food and difficulties in keeping on mass could be a sign of underlying problems with insulin resistance or gut disease

 

[EIRE24]

Im considering if being unable to absorb ingested food and difficulties in keeping on mass could be a sign of underlying problems with insulin resistance or gut disease

Possible. Get it checked out dude

 

[marsaday]

SSRI's in me caused low testosterone. I was on one tablet a day for about 14 yrs. Then stumbled on the low thyroid connection. Ever since i have been on T4 and done much better than on SSRI's. My testosterone level came up from 10 to 17 nmol after stopping the SSRI's and moving onto T4.

It has taken a long time to get balanced out, but i am miles better than 10 yrs ago.

I would think you have some thyroid / adrenal issues going on. Before you start thyroid i would give the Progest-E oil a go. It is progesterone and it can have wonderful effects on lowering anxiety. Men only need to use a small amount and so the progest-E allows you to dose in 3mg amounts (1 drop). See how one drop goes for a week or two and then add in another. The most i would be happy using is 3 drops per day. We make about 20mg of progesterone a day and so you don't want to be overloading the system with it.

The progesterone also boosted my testosterone from 17 to 21.

Your FT4 at 12 is bottoms of the range. It would be interesting to see what you felt like with the FT4 around 16. This is a good level to have - not to high or low and conversion to T3 is more effective when the Ft4 is mid teens. You would need to experiment with some T4 to find out.

So things i would look at using are progesterone, T4, pregnenalone, vitamin D and then other diet changes. Try not make changes all at one time and just experiment with one area at a time. It can take time to find a good balance between the thyroid area and the adrenal side as they will both ping off each other.

 

[Arclight]

SSRI's in me caused low testosterone. I was on one tablet a day for about 14 yrs. Then stumbled on the low thyroid connection. Ever since i have been on T4 and done much better than on SSRI's. My testosterone level came up from 10 to 17 nmol after stopping the SSRI's and moving onto T4.

It has taken a long time to get balanced out, but i am miles better than 10 yrs ago.

I would think you have some thyroid / adrenal issues going on. Before you start thyroid i would give the Progest-E oil a go. It is progesterone and it can have wonderful effects on lowering anxiety. Men only need to use a small amount and so the progest-E allows you to dose in 3mg amounts (1 drop). See how one drop goes for a week or two and then add in another. The most i would be happy using is 3 drops per day. We make about 20mg of progesterone a day and so you don't want to be overloading the system with it.

The progesterone also boosted my testosterone from 17 to 21.

Your FT4 at 12 is bottoms of the range. It would be interesting to see what you felt like with the FT4 around 16. This is a good level to have - not to high or low and conversion to T3 is more effective when the Ft4 is mid teens. You would need to experiment with some T4 to find out.

So things i would look at using are progesterone, T4, pregnenalone, vitamin D and then other diet changes. Try not make changes all at one time and just experiment with one area at a time. It can take time to find a good balance between the thyroid area and the adrenal side as they will both ping off each other.

Interesting thoughts marsaday,
However, supplementing with Progest-E as a relatively young male seems kind of intimidating. Even to trying out Pregnenolone feels like experimenting with a really powerful substance, since I'm not well educated enough, and cant afford enough labwork, to properly track that kind of try-out process by myself.

Same thing goes for T4. Most of what I've read about thyroid supplements so far seems to point out that taking only T4 can be problematic and hard to monitor for a lot of people. Of course it's crucial for people who maybe had their thyroid removed surgically or is experiencing clinical hypothyroidism.
But as far as I can tell from my symptoms- cold hands and feet, fatigue, hair loss and constipation, I also think there is some kind of thyroid issues going on, at a more subclinical level. Thus, supplementing seems like something worth considering. Im unsure of the difference betweens symptoms of thyroid issues vs. adrenal problems.

How come you prefer Progest-E oil over Pregnenolone?

 

[redlight]

I really hope you solve your low T...I had similar T levels as you and i could not function at all.. TRT was a miracle for me, sorry it didnt work for you

 

[ejalrp]

Check out the writings of Dr. Romeo Mariano. He's a big advocate of ferritin levels up around 100. It's one of the first thing he tests for in patients. Unfortunately his website www.definitivemind.com is undergoing a relaunch and is down now but there's still plenty of mention of him if you google.

 

[Arclight]

I really hope you solve your low T...I had similar T levels as you and i could not function at all.. TRT was a miracle for me, sorry it didnt work for you

Thanks redlight,

TRT worked for me too as far as raising my serum testosterone levels significantly. But the only really significant benefit I experienced from the raised T-levels was a lot more muscle growth when strength training. Apart from that, there was no change in libido, maybe a bit more solid morning erections, no changes of sleep or depression/anxiety issues.
What kind of TRT are you on, how long have you been on it?

Nothing really "forced" me to stop the TRT, the headaches was not that acute etc. But since I dont belive it's caused by primary hypogonadism, I wanted to give it a go and see what happened if my hpa-axis got to work more undisturbed, without transdermal influence.

 

[Arclight]

Check out the writings of Dr. Romeo Mariano. He's a big advocate of ferritin levels up around 100. It's one of the first thing he tests for in patients. Unfortunately his website www.definitivemind.com is undergoing a relaunch and is down now but there's still plenty of mention of him if you google.

Thank you, I will look into it.
Do you agree with his writings? Have you benefited from implementing something specific?

 

[marsaday]

Interesting thoughts marsaday,
However, supplementing with Progest-E as a relatively young male seems kind of intimidating. Even to trying out Pregnenolone feels like experimenting with a really powerful substance, since I'm not well educated enough, and cant afford enough labwork, to properly track that kind of try-out process by myself.

Same thing goes for T4. Most of what I've read about thyroid supplements so far seems to point out that taking only T4 can be problematic and hard to monitor for a lot of people. Of course it's crucial for people who maybe had their thyroid removed surgically or is experiencing clinical hypothyroidism.
But as far as I can tell from my symptoms- cold hands and feet, fatigue, hair loss and constipation, I also think there is some kind of thyroid issues going on, at a more subclinical level. Thus, supplementing seems like something worth considering. Im unsure of the difference betweens symptoms of thyroid issues vs. adrenal problems.

How come you prefer Progest-E oil over Pregnenolone?

Well for me i had had 16 yrs of misery and so self experimentation was my only get out clause - i had nothing to loose.

Experimentation is safe and works well if you use small amounts of hormone. All these top athletes are now micro dosing with hormones to fine tune their systems. We can all benefit from this principal. I discovered this for myself because i was ill for many years.

I now take T4 prescribed by the doc, but i was only ever sub clinical with hypothyroidism. I think many people have this condition and it is a hidden problem. Eventually as we age the condition gets worse and we suddenly discover we have full blown hypothyroidism. This issue has now surfaced thanks to the internet. I would say experiment for yourself and if results improve go to the doctor to say what has happened. This is what i did and they agreed i needed thyroid treatment.

Initially i took thyroid hormones and my health improved a lot, then i stopped them thinking i was better. About 4 months later my health crashed back again. I was new to it all and thought it may be testosterone problem. I was very naive with regards to self treatment. Anyway i started back on the thyroid again and regained my health. This ad hoc experimentation helps prove my body needed these hormones.

Progesterone is just much better for me than pregnenalone. Preg works well, but it seems to stop working after a few weeks. Prog just keeps doing the same thing every day. So i am very happy on about 2 drops per day.

All i can say is try self experimentation. Don't fear it, and use small amounts, whichever hormone you try.

 

[Arclight]

Did your docto

Well for me i had had 16 yrs of misery and so self experimentation was my only get out clause - i had nothing to loose.

Experimentation is safe and works well if you use small amounts of hormone. All these top athletes are now micro dosing with hormones to fine tune their systems. We can all benefit from this principal. I discovered this for myself because i was ill for many years.

I now take T4 prescribed by the doc, but i was only ever sub clinical with hypothyroidism. I think many people have this condition and it is a hidden problem. Eventually as we age the condition gets worse and we suddenly discover we have full blown hypothyroidism. This issue has now surfaced thanks to the internet. I would say experiment for yourself and if results improve go to the doctor to say what has happened. This is what i did and they agreed i needed thyroid treatment.

Initially i took thyroid hormones and my health improved a lot, then i stopped them thinking i was better. About 4 months later my health crashed back again. I was new to it all and thought it may be testosterone problem. I was very naive with regards to self treatment. Anyway i started back on the thyroid again and regained my health. This ad hoc experimentation helps prove my body needed these hormones.

Progesterone is just much better for me than pregnenalone. Preg works well, but it seems to stop working after a few weeks. Prog just keeps doing the same thing every day. So i am very happy on about 2 drops per day.

All i can say is try self experimentation. Don't fear it, and use small amounts, whichever hormone you try.

What kind of health issues did you experience that got alleviated by starting the T4-supplementation?
How come you decided to take a T4-only substance instead of for example Cynomel or Novotiral, or a T3-T4 combo?

 

[marsaday]

I have tried all thyroid meds. Natural thyroid / T4 only / T4 and T3 / T3 only. When i first became unwell i tried natural. The docs only use T4 so this is what they gave me. I found little difference between natural and T4 only, but over time i was still not fully balanced, so i introduced T3 on my own.

I have used T3 along with the T4 for many years, but slowly my body has rejected the T3 and only needs the T4. This accelerated when i started to use progesterone. So i now hardly use any T3. If i do i will only use 5mcg doses. So really i just use T4 only.

T4 is excellent for many people, but i understand a smallish no of people do need T3 to get full function back. I personally have found T4 to be the best at restoring optimum metabolism and would always recommend people try this first over T3.

I do convert T4 to T3 very well, so this is not an issue for me, so understand poor converters may not do so well on T4 only. You need to get FT3 bloods taken to see where you are at.

My health issues before thyroid meds were:

tiredness
foggy head
nervousness
anger
cold hands
inability to loose weight on the stomach area
weaker muscles
lower stamina
pale skin
dryer skin
Low temperature on waking

Thyroid meds improved all these areas, but introducing the progesterone helped even more. I still have a low HR and just cannot elevate this at all. At rest in bed watching TV it can be as low as 40 bpm.

ps. I used to read Dr Mariano's info. If you have poor quality adrenals then always use T4 only. T3 will hammer them much more. I think your issue is poor quality adrenals due to lower thyroid output, so running on adrenaline more. You need to improve thyroid output and counter this with better adrenal output. Food, nutrition, good sleep, good sunlight exposure and then hormone modulation are the areas to focus on. Low thyroid people tend to have poor digestion as well as not enough hydrochloric acid is produce.

 

[Mittir]

@Mittir
I find conflicting information regarding hypocholesterolemia. How come the reference range is now lowered? Accordning to Mayo Clinic, total cholesterole below 200 mg/dL or 5.3 mmol/L is desirable. And the lower end of the reference range from labs here in Sweden is set to 2.9 mmol/L or 112 mg/dL

Wikipedia: According to the American Heart Association in 1994, only total cholesterol levels below 160 mg/dL or 4.1 mmol/l are to be classified as "hypocholesterolemia". However, this is not agreed on universally and some put the level lower.

I cant find any specific information regarding what kind of symptoms that can be induced from too low serum cholesterole. In what way do you think it coukd manifest as problematic?



Some history of iron-labs, from 2 years ago, but still:
fP-Transferrin-satuariton% (ref.15-60)
2014-07-02: 28 %
2014-06-19: 27 %
2014-04-30: 15 %
2014-01-17: 32 %

P-ferritin, ug/L (25-310)
2014-07-02: 17
2014-06-19: 12
2014-04-30: 2.9
2014-01-17: 7.7




I think my T3 is at the lower end. Latest T3 labs, little over one year ago:
2015/03/10 S-T3, Free (Dxl): 4.1 pmol/L (ref. 3.5 - 5.4)

Cholesterol is precursor to progesterone, pregnenolone, DHEA,
testosterone and other protective hormones. So, low cholesterol
can lead to low testosterone. RP recommends at least 160 total cholesterol
before starting thyroid supplements. If you raise your cholesterol to 190,
it is still within the reference range of your doctor.

You did a lot of iron tests over a short period of time.
Except for one test of 15% saturation index rests are well
within healthy range. Were you having anemia with saturation index
25+? RP mentioned that saturation index below 25
is protective against cancer. Do you know why there was this
sudden decrease in saturation index from 27 to 15 and again
rise to 32.

You can read Ray Peat's article on iron and cholesterol
to get a better idea about your problems.

I read one old studies that showed almost all the European
countries adopted new cholesterol reference range except for
France, the country with lowest heart disease death rate
in first world. It was a report from 2004 or around.
France was still using upper range of total cholesterol as 250.

 

[Arclight]

You did a lot of iron tests over a short period of time.
Except for one test of 15% saturation index rests are well
within healthy range. Were you having anemia with saturation index
25+?

2014-01-17:
Transferrrin: 32 %, Hemoglobin: 145 g/L

2014-04-30:
Transferrin: 15 % Hemoglobin: 139 g/L

2014-07-02:
Transferrin: 28 % Hemoglobin: 132 g/L

Hard to determine if the transferrin affects the Hemoglobin-levels. My Hemoglobin seems to drop when my S-Testosterone drops low.
I did some supplementing with iron one motnh prior to the first test, that may have caused the elevated levels at the beginning

 

[tara]

I'd think the very first thing you want to do is bump your caloric intake up to about 3,000 calories a day. Maybe try to get the extra cals from whole milk, that's a favorite among body builders. Yeah, you might have some extra fat gain, but that almost always accompanies an anabolic environment. Honestly, if you're only 145 pounds at six feet, you probably need both extra fat and muscle. You may even need to go higher than 3,000 cals a day.

+1

I have read a lot about the Minnesota starvation study. It's great information. What puzzles me though is the seemingly spontaneous regain of muscles that the participants experienced, even without excercising during refeeding. That is not something I have experienced since upping calories.

They had to eat a lot more than 2500 to recover - that's not enough calories to sustain metabolism and structure in a healthy man of your age and height, let alone recover. IIRC, the The Minnestota starvation subjects did better with ~4200 cals. I'm not sure that all the muscle gain was quick, easy and spontaneous, though.

So I'm beginning to wonder if other things need to be adressed other than pure calories.

Maybe, but the calories are probably essential anyway. Once you've tried eating enough for a year or two, you can see if there is still more to do.

I have a lot of friends who have twice the musclemass I have, and they never seem to need a lot of calories to maintain strength. I eat more food/ more nutrientdense than most people I know.

Are you sure you are seeing everything they eat (and drink)? I used to think I was eating more than the people around me, and figured there was something wrong with me feeling hungry a lot. I also used to assume that because my weight was often reasonable stable around the middle of the so-called 'ideal/normal' BMI range, that I was eating enough. I now believe this was incorrect. Since I've got serious about reliably eating enough, I've had improvements in fatigue, sleep, cold hands and feet, brain fog, feeling tense/stressed, a couple of slow healing injuries recovered. I did other things too, and I don't think it's all down to just calories, but I do credit this as an essential part of the solution for me.

Eventual hypothyroid symptoms, hormonal imbalances etc.

Reduced thyroid hormones and reduced reproductive hormones are a normal adaptation to chronic undereating. Attempting to drive up metabolism by supplementation in the absence of adequate nutrition runs a significant risk of causing more stress and catabolism.

So maybe some kind of malabsorption, poor use of nutrients is in play here,

Possibly - that period of even more intense undereating may have cause some (probably repairable) damage to the digestive system. But even if that's the case, you still need to get the nutrition in, even if that means eating more than some people.

I could definitely give it a try and increase my intake a bit, but previous attempts has always resulted in feeling wired, some fat gain around the waist, and quite poor increases in bodytemp & pulse.

Did you manage to get your calories up to at least 3000 every day for a while? How long for? Did you get any increase in temps and pulse at all? Are you monitoring temps from time to time? What sort of numbers?

Normal recovery from undereating often includes some fat gain. There are people here who think this is avoidable. I don't know if it always is (maybe it sometimes is). An increased propensity to store fat is a normal (pro-survival) adaptation to undereating. Gaining some fat round the belly (and from the numbers you've posted, I'm guessing it is a small amount so far) is not a good reason to keep starving. Continuing to undereat in order to avoid fat gain can become a downward spiral - with the body getting better and better at storing fat, at the cost of more energy-expensive lean tissues and organs (muscles, skin, thymus, eventually lungs, heart, ...) and lowering metabolism.

As I understand it, recovery from semi-starvation happens in phases if reliably adequate nutrition is happening every day. If the energy deficit has been severe, other things normally happen before an increase in metabolism, and some of them may not be comfortable. Bloating is a common first response, and fat gain after that. To anthropomorphise, the body needs to trust that the food/energy supply will be reliable before it will take the risk of raising energy expenditure on metabolism and building/rebuilding of lean tissue. Until then it's more likely to take any excess and store it in an energy efficient way to prepare for the next famine.

I think your problem is calories. Plain and simple. Eat lots of delicious food and engage in some form of weight training. I think a lot of stuff will fall into place. Don't get caught up with the small details. I wish someone had given me this advice from the start ...

:)

Waking up in the middle of the night every night and a major lack of libido could perhaps be brought on by complete starvation. But I have been eating at least 2500 kcal/day for the last 2 years. Upping them a lot more from there could maybe make me heavier and a little warmer, but the other health issues seems tied to other things than just some lingering semi-starvation.

All the things you've described could be linked to reduced metabolism from semi-starvation that you have not yet recovered from.

If some of your health issues predate your period of more extreme restrictive dieting, I'm wondering whether you ever ate enough. Did you ever, as a young growing man - eg before 25 - have extended periods of eating at least 3500 cals to support full growth and physical maturity?

Is that total cholesterol? 3.9 mmol/l = 151 mg/dL. In older reference ( 160 to 200+age)
range that is considered as Hypocholesterolomia . I think low cholesterol is a major
source of problems for you. Fructose can easily raise your total cholesterol level.
Fruit juices can be useful here. I would shoot for at least 200.

+1
You can't create steroid hormones, including testosterone, without the cholesterol substrate.

I find conflicting information regarding hypocholesterolemia. How come the reference range is now lowered? Accordning to Mayo Clinic, total cholesterole below 200 mg/dL or 5.3 mmol/L is desirable. And the lower end of the reference range from labs here in Sweden is set to 2.9 mmol/L or 112 mg/dL

Cholesterol is a necessary molecule for many of the hormones, including the protective ones.
There are apparently some studies showing reduced risk of repeated cardiovascular incidents for middle aged or older men who have already experienced one, if they can lower their cholesterol. Very high cholesterol levels can indicate an increased need for the protective hormones, and/or a decreased ability to produce them from cholesterol. So it's not surprising that there would be a correlation between high cholesterol and some kinds of problems. As far as I can tell, these are amongst the justifications for recommending lowering cholesterol.

However, if you look at overall mortality graphs, they tend to show that for most other groups, mortality is worse at the lower part of these ranges, and better at the top end.

Yes, I am aware of that, but I havent restricted food for the last 2 years.

If you've only been eating 2500 calories, then you have not given yourself a chance to recover yet.

Actually Im kind of worried about the fact that Im eating a lot without going any cardio and still not galning any lean mass at all, not that much fat either, and still feeling weak.

You are not eating a lot.
I recommend not starting to do more than gentle movement/exercise until you've been eating well and are getting your energy and strength back. 3200 would be approximate maintenance for an average active mature male of your height - more would likely be needed to support higher levels of physical work and anabolism. And your body probably has some other priorities for repair before it gets heavily into building a lot of muscle.

Im considering if being unable to absorb ingested food and difficulties in keeping on mass could be a sign of underlying problems with insulin resistance or gut disease

There is not much evidence of this yet. If you eat more than 3200 cals every day for a few months and are not gaining, it would be an interesting question to consider then.

However, supplementing with Progest-E as a relatively young male seems kind of intimidating.

This may turn out to be relevant, but if I were you I would not start experimenting with supplemental hormones at this stage - consider these later, when you've addressed the energy deficit. (Though small quantities of pregnenlolone or progesterone are unlikely to be dangerous if you decide to try them out.)

France was still using upper range of total cholesterol as 250.

:)

Some of these ideas come from Gwyneth Olwyn ant youreatopia.com, rather than from Peat, though some of them seem consistent to me. There is more discussion here:
Recovery From Undereating - Youreatopia

How are you going with reading/listening to Peat's articles and interviews?
Ray Peat
Cholesterol, longevity, intelligence, and health.
Ray Peat Resources & Quotes | Ray Peat Forum

I guess you've come across the idea of minimising PUFA intake because of it's multiple anti-metabolic effects.
Make the most of what sunlight you can get before it disappears. Consider getting some kind of red light set up to supplement it in the winter.

Lycka till

 

[Healthia]

Hi there ran across your thread and I think my thread may be of some help to you. https://raypeatforum.com/community/threads/lost-libido.13595/

 

[Cymatic]

SSRIs are hormonal disruptors. It's perfectly reasonable to suspect this is influencing or causing your low hormone levels and libido.

Selective serotonin reuptake inhibitors directly alter activity of neurosteroidogenic enzymes
Selective serotonin reuptake inhibitors and neuroendocrine function. - PubMed - NCBI
https://www.researchgate.net/public...exual_Side_Effects_after_SSRI_Discontinuation