Fatigue/Depression/Low Libido And Pseudo Gyno - Full Blood Panel Inside [25 Y/o Male]

Discussion in 'Blood Work, Labs' started by tizout, Apr 16, 2018.

  1. tizout

    tizout Member

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    Hi, I'm a 25 year old male and I've been having issues with fatigue, libido and general depression/anxiety for the last few months. My background is fully natural up to November 2017 when I quit competing in drug tested powerlifting, so I thought I'd try a low dose aromasin/exemestane by itself for physique improvements (I was using 3.125mg ED for one month and then bumped it to 6.25mg ED for another month). I realized my stupidity in using an AI on its own without prior use of hormones/steroids so I stopped (and I was also getting side effects such as poor sleep and fatigue, basically everything associated with crashed estrogen). I did look good visually but that was only due to the transient water shedding.

    I felt really good prior to taking aromasin like an idiot. My blood work before taking anything (exemestane is the only hormonal thing I have ever taken and it was for two months at the above dose) was:

    Total Testosterone: 28.9 nmol/L [ref 8-29]

    Estradiol: 99 pmol/L [ref 0-160]

    TSH: 1.4 mIU/L [ref 0.2-4]

    Free T3: 4.1 pmol/L [ref 3.5-6.5]


    My blood work from last week (3 months after full cessation of aromasin/anything hormonal):

    Total Testosterone: 32.8 nmol/L [ref 8-29]

    Free Testosterone: 573 pmol/L [ref 175-700]

    Estradiol: 80 pmol/L [0-160]

    Prolactin: 8 ug/L ref [0-15]

    SHBG: 54 nmol/L [ref 10-55]

    FSH: 4 IU/L [ref 1-18]

    LH: 8 IU/L [ref 1-9]

    Albumin: 42 g/L [ref 33-48]

    IGF-1: 203 ug/L [ref 105-316]

    eGFR: 65 mL/min/1.7 [ref >=60]

    TSH: 0.12 mIU/L [ref 0.2-4]

    Free T3: 4.7 pmol/L [ ref 3.5-6.5]

    Free T4: 16.6 pmol/L [ref 10.0-25.0]

    Creatinine: 131 umol/L [ref 50-120]



    1. I've bolded what I think might be an issue. All other basic blood work came back fine. I am suspecting that my bout of aromasin will take longer for my HPG/HPA/HPT axes to recover (not to mention time for my poor aromatase enzyme to regenerate itself), but it looks like I have low total E2 for my age and possibly low free E2? Since my total E2 is low-moderate and my SHBG is high, in theory my free E2 would be really low right according to this statement:
    "High SHBG Men (not on HRT): High SHBG will naturally push down free estradiol levels. So a man with low medium estradiol could end up with overly low free estradiol levels due to so much of his estradiol pool being bound up."

    2. Do you see any other possible issues? I also think that my prolactin could benefit from being lowered a tad so I would like to give cabergoline a try. I have legit Dostinex on its way, I'm thinking of trying it at 0.125mg twice a week to start and see how it goes. I've used mucuna pruriens (from Inhibit P, contains 180mg l-dopa) and based on that I feel like I'd benefit from a dopamine agonist at very low - low doses for off-label depression treatment. I also realize that my I'm borderline hyperthyroid based on my TSH but my free T4/T3 are in range so my endo wasn't concerned but he did reduce my dosage of thyroid meds to 100mcg levothyroxine + 10mcg lioothyronine.

    3. Also, I seem to have perpetual pseudo gyno in that I have fatty tissue/a visually large amount of fat in my chest despite having my E2 and prolactin in check. Would a SERM help at all or cause more damage than worth?

    4. One last thing, I wasn't able to get my DHT or DHEA-S measured for some reason. Do you think taking a T boosting supplement like cordyceps and shilajit would be beneficial in bringing my e2 back up?

    Thank you for your generous time!
     
  2. Constatine

    Constatine Member

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    Have you ever gotten your vitamin D levels checked? I would recommend trying some topically. It works closely with androgens and estrogen and modulates the function of the androgen receptors. Minor gyno symptoms while having your hormones in check sort of hints towards the fat solubles.
     
  3. OP
    tizout

    tizout Member

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    Yeah my vitamin D status is find, I got blood work for that a while back. I average about 6000 iu/day.
     
  4. Luckytype

    Luckytype Member

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    This is actually really surprising to see.

    Upon reading the title I came in expecting some really low values.

    What else do you have going on in life currently that could possibly be a stressor, even minor of sorts
     
  5. unexamined_whimsy

    unexamined_whimsy Member

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    You are exhibiting classic hyperthyroid symptoms which are associated with elevated estrogen (supranormal total-T + high-normal SHBG, for confirmation also probe estrone sulphate which ought to be high) despite normal estradiol. The aromasin pushed your LH levels to the upper end of normal, which is both an estrogen agonist, and greatly increases the substrate for estrogen --testosterone. This led to a surge of estrogen beyond which your body can handle. I would simply lower your thyroid meds, to get your TSH around the 1.0-1.5 range. In the meantime consider supplementing zinc, as it's depleted quickly when estrogen is high, and avoid any gut irritants.
     
  6. OP
    tizout

    tizout Member

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    Thanks for the advice, I'm doing just that. Hopefully that fixes everything otherwise I might have to give cabergoline and/or raloxifene a shot.
     
  7. Luckytype

    Luckytype Member

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    What kind of body composition are you at roughly that would pique your interest in an ai for improvement?
     
  8. OP
    tizout

    tizout Member

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    I was around 14% bodyfat pre-AI and quite muscular, but I wanted to get leaner. I thought an AI would lower body fat because estrogen reduction was a good thing for males, boy was I misinformed. I didn't know that inhibiting aromatase/lowering estrogen in men worsens body composition.

    I immediately looked better when taking aromasin but that was due to transient water shedding. Is there anything that compares to an AI's water shedding effects that's not full of side effects?
     
  9. Luckytype

    Luckytype Member

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    When you ask this are you thinking along the lines of improving your composition?
     
  10. Lokzo

    Lokzo Member

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    Your interest in giving Cabergoline a try seems risky man. Have you thought about trying other natty dopamine boosters?
     
  11. LukeL

    LukeL Member

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    What specifically is risky?
     
  12. Lokzo

    Lokzo Member

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    I''d be really curious what you would say about my hormonal profile.
    21 Y.O - Full Hormonal Results. Thoughts?
     
  13. OP
    tizout

    tizout Member

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    Well, I'm doing the best I can to improve body composition. Good training, dieting, sleep and stress reduction. I would love to have something handy that sheds water acutely like an AI though for certain events, you just look so much better. It doesn't seem like there's anything safe for that though, diuretics are full of side effects and natural stuff like dandelion and caffeine are mild at best.

    I assume the risk lies with DAWS (dopamine agonist withdrawal syndrome)?
     
  14. Lokzo

    Lokzo Member

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    Precisely. And downregulation of the receptors.
     
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