[skywalker45]

So I just spoke with my doc. She says that sometimes it’s safer to leave people on low dose benzodiazepines indefinitely than it is to take them off especially if they’ve taken them for years. She did say though this is not true of high doses or people with a history of abuse or who develop a tolerance. Thankfully I don’t fall into either one of those categories. So it looks like I will be on 1 to 1.5mg of Klonopin as needed indefinitely unless something else happens. She said that exercise and a good diet can help to curb the unwanted side effects of tiredness and said that such a low dose should not interfere with my REM sleep.

[skywalker45]

@wapf fan 2497 wrote:

What about getting off the other meds first and see if maybe you can keep the klonopin since that is the one that works for you? I know some people just need to stay on that one.

Well I think my doc wants me off of it because of unwanted side effects. Unlike a lot of other people I never really developed a tolerance to the medication. In other words I’ve never had to escalate the dose to reap the anti-anxiety benefits, however it has begun to cause unwanted sexual problems, I’m tired most of the time, lack of motivation, etc. This has been attributed to my testosterone deficiency however that problem has been addressed and I’m doing MUCH better in that department. I’m just tired of relying on it. I do understand though that there is a small chance I will always have to take it. Currently I take it and propranolol 40mg a day also for anxiety. The combination of those two is a real problem in the sexual and general energy department. I really don’t know what to do. I go for a testosterone injection tomorrow so I’m going to speak to the nurse about these problems. Thank you for your input.

[skywalker45]

@canthavetoomanytoys 1459 wrote:

I could use some guidance and suggestions…

I am a 50yo male with several hypogonadism symptoms. My PCP ordered a CBC, CMP, and LP along with a T test which I requested. This has led me to research and seek care for LOH. My essential questions are what nutritional supplements or meds I should D/C before getting a hormone workup and what testing should I see being ordered by an Endocrinologist?

Some background and detail:

The blood testing for the PCP revealed a relatively low testosterone level, an elevated TSH, and lipids above desired levels.
Testosterone, total 382 ng/dL LabCorp range 241-827 [10:30 AM]
Test, free (direct) 9.9 pg/mL range 20-29 years: 9.3-26.5 pg/mL
TSH 2.34 uIU/mL
Chol, tot 247 mg/dL
HDL 37 mg/dL
Trig 160 mg/dL
My primary physician flagged the lipid problems but either missed or overlooked the T levels (reported within normal range by LabCorp) Although a statin drug was recommended I suggested high-dose Niacin and diet modification. So far I have lost 20 lbs from just over 200 in about two-months. Nearly all external fat is around the mid-section.

I sought care regarding TRT with my Urologist. He has seen me for many years for recurring kidney stones and for several years with ED. He prescribed Testim Gel [5 gms] as a trial for one month.
Testosterone, total is now 999 ng/dL [9:00 AM, 2 hours after application]
It would seem that there may be an error with the lab result or somehow I am WELL absorbing. Nonetheless, my symptoms have not markedly improved, particularly not feeling refreshed after sleep, fatigue in the late afternoon, falling asleep after 7P, and libido/ED. Apparently I have more going on then just reduced T.
The Urologist referred me to an Endocrinologist and is leaving me on the Testim until the Endocrinologist workup.

Rx Meds:
Niaspan 2000 mg
Testim 5 g

Supplements (none before first labs, ** only started after second lab):
DHEA** 50 mg
Zinc Monomethionate** 60 mg + 4 mg CU
Tri-Iodine** (Iodine/Iodide) 25 mg
Fish Oil 7 gms
L-Arginine 3000 mg
Selenium 200 mg
Folic Acid 800 mcg
Vit D 5000 IU
Vit C 1000 mg
Vit E 800 IU
Vit A 10000 IU
B complex (50 mg based)
Magnesium 500 mg
Centrum multi
Baby Asprin

Regarding above in bold. I’m no expert but have learned much from various forums and you need the thyroid workup HAN spoke about but it’s not a good idea to have a testosterone test 2 hours after applying Testim. I’m on Testim as well and the general “name of the game” (according to my doctor) was to apply the gel the day before the test, then the morning of the test take a shower and wash the applied area, have the blood drawn, then apply the gel again. This worked with me. On one of my tests my testosterone was 617ng/dl and a good free test reading and that was applying the above procedures. Transdermal gels can raise total test into the supraphysiologic range for quite some time before the levels come down several hours later. I’m in your boat as well. Now I have abysmal test numbers regardless of being on Testim and I apply two tubes per day, once in the morning and once in the evening. Get the thyroid workup but watch it when you apply the gel with the timing of your blood draw. Those numbers really don’t mean much unless they stay in a certain area and don’t wildly fluctuate. My libido is in the toilet too as well as having moderate to severe ED at times.

I have also found a new Endo (referred) who is a specialist in male/female sex hormone issues. My urologist gave up on me telling me I was just too hard a case. My new Endo has told me to stop all HRT 2 weeks prior to seeing him as no one ever bothered to try to find out why my test was low to begin with and he wants to see my numbers as closely as possible to what they were before beginning HRT.

[skywalker45]

@skywalker45 1442 wrote:

Since prostate tissue and uterine tissue arise from the same embryonic tissue I find it interesting that docs would say testosterone (DHT actually) is the cause of prostate enlargement and ultimately the cause and proliferative agents of prostate cancers. There does seem to be a link but I find it all very confusing since uterine cancers generally proliferate in the presence of estrogens but I’ve never heard mainstream docs say the same about prostate cancers. They always say in the presence of androgens and estrogens are seldom if ever discussed unless you read about it on forums such as these. Where am I going wrong?

Just as an anecdote to my statement and questions above —- Is there any relation or division exactly between a uterus being essentially saturated with estrogen receptors and a prostate being essentially saturated with androgen receptors? Common sense would say this is true from the difference in sexes but yet the argument of estradiol causing prostate enlargement and cell proliferation is intriguing.

[skywalker45]

Thanks for the welcome HAN as well as the other information. Eastern medicine is fascinating and I couldn’t agree with you more. Unfortunately no one bothered to find out why I was hypogonadal so I’m in that boat now but I have found a new doctor who appears to be top notch. My first appointment with him is Sept. 4 so hopefully we can get this stuff in order.

[skywalker45]

@DrMariano 1423 wrote:

Benzodiazepines, such as Clonazepam, increase GABA signaling. The increase in GABA signaling can reduce norepinephrine signaling (the signal that causes anxiety and irritability and insomnia, etc.)

Norepinephrine is necessary (though not in excess) for libido, erectile function (providing the excitement of sex), and ejaculation (it triggers ejaculation).

Excessively reducing norepinephrine can cause problems with the above functions.

Wow then I’ve really been playing with fire. To top off all that I also take propranolol 40mg/day and have for about 17 years. Not for HBP though. It was given to me for tachycardia potentiated by severe panic attacks. No one ever took me off the medication because they all said at such a low dose it wouldn’t matter and it’s heart protective, but it blocks adrenergic receptors and in my line of thinking since I’ve aged some this drug could also be causing many of my problems now. I should note that I never had a problem with ED, ejaculation or sexual desire before age 36 (I’m 40 now). I would have been on propranolol for 13 years before any sexual problems (I believe related to hypogonadism) began to occur.

[skywalker45]

That’s good to hear doctor and thank you for the reply and the other information. I do believe however, and please correct me if I’m wrong, that Clonazepam and other benzos can and do cause loss of interest in sex, ED and ejaculation problems. I thought the connections there were a little more clear or am I wrong there?

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