Blood work, can someone take a look at it please

[dova]

Not doing so well for the moment.
I still was taking 50mg of seroquel (quetiapine) before bed.
Thursday i decided to drop it.
It's sunday now and i feel like shit.
Can't sleep, 30' to 1 hour and than i'm awake very anxious. A couple of hours later i sleep again for 30' to 1 hour..... No dreams also.
Also a very tight back. I feel nauseous, don't have hungry.
I take gaba, valerian, melatonin, but nothing seems to help for this moment.
I give it another week. If it's not better, i start the seroquel again.

But what i experience during the nights is that i'm extreme horny and have rock hard erections. Why, i don't know.

[Jelisej]

Keep taking seroquel for time being, first you need to fine tune hormones and some other stuff before moving into this area, there are still lot of unresolved issues (ferritin levels, adrenals etc), and I'm afraid that it will take time to get to that point, and also its questionable wheter us from this forum will be able to help you with that, as that area of science is not researched well enough, but as I said there are lot of things to be done beforehand,
and please dont experiment too much and dont stop taking meds "cold turkey" as these things rarely work well, and sometimes can be dangerous.

[dova]

Thx,
I was planning to start seroquel again this evening. It is not bearable for the moment. Last night i slept 3h and then get up to go to work.
It was not a cold turkey stop, i was coming from 200mg and dropped 50mg at a time.

Maybe hormones can't solve this problem and it is a short circuit in my brain.
it's very strange, during the day i'm pretty relaxed, in the evening i get tired. Once in my bed, my heart start racing, my head works like crazy. Why? i don't know and i can't stop it.
But if i'm good with my trt and only 50mg of seroquel to get a good night, why not take it.
It's better than 4 meds of antidepressants and still feel like shit.

Before i started trt i was taking 4 antidepressants and i still was very nervous, headaches, anxious, suicidal, depressions,lack of libido, my whole body felt tight and no sleep.
now, with trt and 50mg seroquel, i still am nervous, but i have more resistance to it, no more depressions, no more suicidal, no more headaches, my body is more relaxed and libido is good. nights are pretty good. When i stopped the seroquel, the anxiousness came back and my body felt tight again. Once at noon i felt better and i tought, ok it's over. But once in bed, it all started over. Strange. next month, i talk to my psychiatrist about it and also begin next month, bloodwork again.

I also have a little fever for the last days. Don't know why. is it because i stopped the seroquel? Because i have a little cold? (the cold is so little that i don't think this is what gives me fever). But i eat, work and train. Hopefully, it doesn't mess with my bloodwork.

[Jelisej]

Well, hormones do have a very strong influence on neurotransmitters which (neurotransmitters) I think is underlying cause of your nervousness and mental issues. There is some influence from way you thinking/feeling- when you get some unwanted toughts of any kind try to tackle them- basically you need to question your toughts, evaluate, where are they coming from and what is bringing them? Slowly it will change thinking pattern which should help somewhat with your general situation, as for completely sorting problem- one needs to sort out chemical imbalances in brain which again is very complex thing but eventually you'll get to that point- sorting out all other issues will lead to big improvement and reduction in anxieties and other symptoms.

[dova]

Back on track. Now 2 days that i take my seroquel and i'm ok. The fever is also gone.
Changing the thinking process : easier said then done. That's the problem with generalized anxiety disorder. i saw different psychologist and none of them where able to help me. Just one was honest with me. She asked me : you must stop your unwanted toughts, how you gonna do it? I say, i don't know, that's why i'm here. She : We learn to say in school that you must stop thinking about negative toughts. She asked her professor how? She is still waiting for his answer. There is a problem with neurotransmitters, for sure. I took cymbalta (ssri). It worked, but i had too many sides of it. A normal dose of cymbalta is 60mg even up to 120mg. I couldn't handle more than 20mg and i still had problems with ejaculations. And with the low test levels it was a complete disaster. with the test and pregnenolone now, the depressions and suicidal toughts are gone. Erections and ejaculations are good. The anxiety is still present. Not so severe as it was but it's bearable. I have more resistance to it. Could i cure completely? i don't think so. But if i can hold it like it is now, it would be great.

[dova]

So, what's up,
Yesterday have some blood drawn. In a week i have the results.
For the moment still feeling good, but what is changed the last months.
Pregnenolone is back to 50mg/day. 100mg/day (2x50) gives me a headache. Don't know why. Tried several times to go back to 100mg, but the headache still comes back. And the 50mg, i take them before bed. This seems to be working best for me.
I also take no AI for the moment. Even the smallest amount of adex or aromasin crashes my libido. Let's see how my E2 is.
So, i take sustanon 30mg, 3x/week. HCG 250IU 3x/week and pregnenolone 50mg/day.
The last time blood was drawn, i had some problems with my cholesterol. The forum told me, it could be the problem of the high fats, high prots and the low carbs i ate. I changed my macro's to 50/35/15 (C/P/F). The feeling is not that good with it. Gained some fat. No big deal. But, i have more acid burns, gas bloating, bad taste in my mouth and a bad breath. The poo is not as solide as before. I'm also more prone to hypo's. I'm now reading 'the metabolic diet' from dr. Mauro Dipasquale and i think i will give this a try. It's a cyclic keto diet.
Today i still have no depressions, no suicidal toughts and a good libido. The anxiety disorder i still around, but bearable. The anxiety disorder will probably not be solved with hrt, but i have my life back after 8 years of suffering.

[dova]

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Finally results are in. Something went wrong. Did not receive the full test. DHT is missing. Not much of a problem i think, because all male hormones are low.

Protocol before blood drawing was : sustanon 3x30mg/week, HCG 3x250iu/week, AI by feeling, pregnenolone 1x50mg/day (2x50mg gives me a headache).
Because of the low value of testoterone, i upped the dosis sustanon to 3x35mg/week.
I did AI by feeling and it worked very well. But i did not felt that my E2 was too high, but i probably felt that the T/E ratio decreased with gave me the feeling of high E2. E2 was way too low, but i did not felt it.

RBC : 5810000 + (4000000 - 5800000)
WBC : 4200 (4000 - 9000)
Iron : 147 (59 - 158)
Ferritine : 37 (30 - 400)
Glucose : 104 + (60 - 100)
BUN : 37 (10 - 50)
Cholesterol : 146 (140 - 190)
HDL : 48 (>40)
No HDL : 98 (<138)
LDL : 88 (<115)
Free T4 : 19,4 (12 - 22)
TSH : 1,37 (0,27 - 4,20)
Cortisol : 9,3 (5 - 23)
Prolactine : 7,33 (4,04 - 15,20)
E2 : 6,1 - (7,6 - 42,6)
Testosterone : 356 (200 - 700)
Free testosterone : 9,1 (4 - 15)
DHT : not available
SHBG : 0,6 (0,5 - 1,5)
DHEA : 186 (120 - 380)

Cholesterol and iron are back in range. Cholesterol was on the lower end this time.
One thing that worries me a bit is blood sugar (glucose) that is a little too high.......

[Jelisej]

Your glucose was never that good, and is connected to insufficient glucocorticoid levels- which was your main issue.
Overall, I think this bloodworks show a lot of improvement, altough I'm pretty sure that you will not agree with me, anyway- I can agree with little increase in testosterone dose, but bear in mind that because your low SHBG testosterone levels dont need to be high, also higher levels would again deplete your body of nutritiens, you would probably get anxieties etc...
Also, altough at the moment your androgen levels seems very low, its not quite that bad- they are low but not as it seems as they are being used up a lot better and lot of more efficient- so yes you need a bit of increase, I can agree with 3X35 but dont go over that, for time being.

I hope that now you learned that you cant always predict things how you feel.

[dova]

Yes, i agree with you. Bloodwork is much better than last time. Thyroid seems to be working fine. But, here we go, i ask alot of questions, because i want to know how it works what i do.
And, i always did what you told me. Some times it is not always possible to do that. Doc won't prescribe it, or it is illegal in my country. Or, like pregnenolone that i have to drop to 1x50mg because of the headache.

So, still the adrenals. These should be the reason that i have higher glucose levels. What can we do about it to decrease glucose levels?

Ok, i agree that i don't need sky high levels of testosterone, but 356 is a bit low i think. Like i learned, low shbg, high E2 and very hard to control for me. I don't need to be a horny bull.

What i think, please correct me if i'm wrong : low test (356) and very low E2 (6) felt not bad. High T/E ratio. I took a low dose AI if i felt that my libido decreased. Probably E2 increased, T/E ratio decreased. E2, needs to be between 20 - 30. But if i have lower levels of test. Let's say 400-500. Will my libido not be gone because of the lower T/E ratio?

I agree that you not always can predict things. Some times you have to go by feelings. It's not possible everytime i feel good or bad, to go by the doctor to draw some blood. I'm happy that he did bloodwork every 2-3 months.

Thanks for your help, i really appreciate it!!

[Jelisej]

Yes, 356 ng/dl is low, but as you noticed your thyroid is working fine meaning that your metabolic rate has increased- your adrenal hormones cortisol is also low but on positive note body is still coping and overall even if numbers dont seems to be changed- in reality output has increased, and your hormones are being used up efficiently- and trick is to find dose that your body will able to sustain without problems like ferritin depletion or adrenal crash/depletion as I think its best to avoid synthetic cortisol as it is quite nasty thing IMO, it has to be dosed often, it has sides especially if given too much, and one feels as zombie if insufficient.

Libido itself is a strange animal, there are lot of factors involved in that, including mental side- E2 has a definitive effect on it, testosterone (mostly free testosterone), DHT and number of other hormones. Usually if E2 is in range and free testosterone is good libido is fine- I think that free testosterone is one to watch, rather that tot. testosterone or T:E ratio.

In yur case as SHBG is low your free testosterone will be high even with moderate tot. testosterone levels, whilst someone with high SHBG will need higher levels- I've seen people with very high SHBG some og them had a tot. test over 800 ng/dl but libido was still low- as free test. was low.

Eventually, glucose should settle itself down, I think you doing everything that you can anyway, so just carry on.