General Health:

Mild unstable mood disorder controlled by 1mg clonazepam 5x/day.
43 year old male
heart disease – 25 stents (not a typo). Details at http://www.lumponablog.com under My Story
Very low cholesterol – need to raise it, but still controlled to what I believe to be sub-optimal levels for hormones. May neeed to one day backfill with preg, progresterone, or DHEA.

So here is my regimen: 1.5tubes/day of Testim, .25mg Arimidex every third day along with 250IU HCG every third day. I am insulin resistant and have seen low SHBG even when TT was low and %freeT was high and free T was low normal.

LDL: 23 (0-99 range) LOW (cardiologist wants it between 50 and 70)
Total: 92 (range 100-199) LOW but per cardiologist it would be high (he wants < 100)
HDL: 45 (>39 range)

Now here are my eye popping results:

TT: 1481ng/dL (range 280-800) HIGH
Free T (Direct) 52.1 ng/dL (range: 6.8-21.5) HIGH
SHBG: 15.9 nmol/L range (14.5-48.4): LOW NORMAL
Estradiol, Sensitive: 17pg/mL range (3-70) NORMAL

T4 Free, Direct: 1.63 nl/dL (range .82-1.77) HIGH NORMAL

NO MEASUREMENT for T3 which bothers me because!!!!!!: Reverse T3: 481 pl/mL (range 90-350): HIGH (Doc is checking my iron levels and does not seem to be too worried)

TSH: 1.35 uIU/ML (range .450-4.5) NORMAL

Prolactin: 5.4 ng/mL (range: 4.0-15.2) LOW NORMAL

Triiodothyronine: 3.3 pg/mL (range: 2.0-4.4) NORMAL (not sure what the heck this is)

Cortisol: 16.3 ug/dL (range: 2.3-19.4) NORMAL (blood gathered at 9:00am for all tests)

A1C: 6.0

So a couple of questions from a very nervous man that still has ED and Libido issues:

Does SHBG typically lower with TRT? If so, then if my TT lowers my SHBG should raise?

What is the significance of the Prolactin being low normal to libido and ED? What can be done to increase this level?

I am losing weight but not body mass like crazy. Doc thinks my weight loss should equate to lower A1C (it has not moved). His thinking is that A1C is being negatively impacted by high free-T. If free-T were normal then I should see a benefit to insulin resistance and SHBG should increase.

Now for this reverse T3. Doc is not worried because T3 is normal and RT3 is probably due to overly high T and fast weight loss combined with diet and heavy exercise.

Moving forward: going down to one tube testim, armidex .25 mg every five days. Dropping HCG to 150mg every three days and retest in 1 month.

Continuing diet and exercise with goal of 200lbs. For me this would be very thin with little adipose fat if my muscle mass remains the same. I am 22 lbs away from this. Before TRT I was 245 lbs.

My goal is to get to the upper end of the TT range and mid to upper FT range. Right now I have NO exercise induced angina where before T treatement when T was very low I did have exercise induced angina. T is helping here big time. Even when levels on depo were 600ng/dL angina disappeared. Stopped depo due to issue with libido and ED.

Still have issues with libido and ED and the above levels but I am not surprised.

Hematocrit levels are normal and RBC is normal.

Any advice would be greatly appreciated.