Bloods done - let's discuss some of the results
My stats are on my profile except bf which is around 15-16%.
History: skinny type till 2.5 years ago when I decided i was going to take gymming and the lifestyle seriously so i grafted my ass off and went from 71kg to a respectable 92.5kg purely through food, so much food and tracking macros and adjusting as and when needed and gymming - a lot of gymming (also always tracking and trying to make progress). I don't smoke, I don't drink, I sleep at least 8-9 hours a night, I don't take drugs, I eat my meat and fruits and veg so I would classify myself as pretty healthy on paper.
Up till now I have been planning on a " 10 - 12 week beginner cycle" of test e 250mg 2/week and the standard pct of clomid and nolva with an AI on hand as recommended through the many posts on here i have read.... That was till i did the responsible thing and got my pre-cycle bloods done and these are some of the results.
My results VS what's acceptable
follicle stimulating hormone 4.26 IU/L (1.500 - 12.400)
testosterone 13.55 nmol/L (7.600-31.400)
free-testosterone *0.177 nmol/L (0.300 - 1.000)
SHBG *60.3 nmol/L (16.000 - 55.000)
my blood count profile is all great and so is my thyroid function, kidneys, liver and vitamin and mineral profile and my cortisol and 17-beta oestradiol.
my concern is around the low free test and the high SHBG and i've come to 3 possible outcomes which i would like to discuss
1) go see a doctor/doctors and potentially go on trt
2) do a cycle and my pct, starting an AI on cycle to free up my test knowing my body has the tendency to bind my free test. I'll monitor my test and SHBG throughout, as recommended and also because it's responsible thing to do and then post pct see where i am wth regards to free test and potentially go on trt
3) start taking an AI now, pre-cycle to start the process of stoping the free test binding and then start my cycle
honestly i have felt like i have had low test for a long time, i mean years, but i have never done anything about it thinking it was normal to have the lack of sex drive, depression, lack of motivation (some days are great and then some days are not so great but i have pushed through to get to where i am today because i just hated being skinny), anxiety, irritability, fatigue and fogginess.. the list goes on.
I would also like to add these two questions to the discussion
1) What do you make of those numbers?
2) What advice would you give, and do you think trt is the inevitable outcome?
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update...
Doc said I should redo the same blood test but in the morning in a fasted state as testosterone drops as the day goes on. I did as told and these are the new blood test results
Hormones
follicle stimulating hormone 4.17 IU/L 1.500 - 12.400
testosterone 30.65 nmol/L 7.600 - 31.400
free-testosterone 0.438 nmol/L 0.300 - 1.000
SHBG *65.78 nmol/L 16.000 - 55.00
17-beta oestradiol 114.4 pmol/L 44.000 - 156.000
I was also told to take a prolactin test and Hep C test
Prolactin 216.6 mIU/L 86.000 - 324.000
Hep C negative
My doc is away till the 18th so will have a chat when he gets back
Off to the doctor this afternoon - it's the right thing to do. I'll keep everyone updated
Your test level is normal.. Therefore likely not a candidate for TRT. Your free test is low likely due to your elevated shbg. SHBG increases as we age. I know you're only 35 based on your stats but when this starts to happen is variable for everyone and depends on genetics.
Venlafaxine and other SSRI/SNRI can commonly cause decreased libido and anorgasmia. The mechanism behind this I'm not sure.. But I've never heard of these medications causing hormonal imbalances. And I prescribe these medications often. That being said neurotransmitters and sexhormones have variable and complicated roles in depression and overall homeostasis of mood. If I've learned anything in medicine it's that there's very rarely a solid answer for things like this. But this is because many, many factors come into play. Sleep, for example. Extremely vital in mood, recovery, regeneration of cells, hpta balance. Etc.
35 is when "some" people see a drop... Go to the doc.
Id go with the doctor now. Trying to get on TRT after cycling is a nightmare.
Any pro hormone use or test boosters? Most people don't take them seriously, but they can fuck some things up. Prior to ever cycling, I had some estro issues over a gnc product. I don't convert much with test, but had conversion issues with this product. They do have effects, they're just highly unpredictable.
I'm just asking because most people will venture that route before entertaining steroids, and they can be suppressive.
I'd recommend taking some time and figuring out why things are out of whack before you dive in. It'll be good practice for when you're trying to stabilize things after a cycle.
No prohormones. I took tribulus and tongkat ali but those were both many years ago between, I guess about the ages of, 26 and 32.
At the moment I take my ZMA at night and ALA and L-Carnatine during the day and 1 post workout protien shake. The rest is food. I don't even drink milk any more because of the estrogen/prolactin horror stories
What was your estrogen at? Are you taking any prescription drugs? There are natural ways to lower shbg, I don't think trt is inevitable for you.
What are your goals and reasons for wanting to run a cycle? I wouldn't do it just to raise your free test, it might seem like a solution now but could potentially complicate things down the road.
Do you have a doctor you can sit down with and discuss all of this? I think that should be your first step.
17-BETA OESTRADIOL 70.47 pmol/L (44.000 -156.0). I'm on venlaflaxine 125mg a day but that's it and no OTC medication either.
My ultimate goal is to be a bigger better version of myself. Healthy but still big. I imagine walking down the street and instead of being bumped into, I want people to be intimidated and just politely get out my way.
Yeah I do have a very open minded doctor I can speak to which is instinctively what I thought of doing.
Any problems with sexual dysfunction? Effexor is in the SNRI family if I'm not mistaken and antidepressants like that can raise shbg and lower free test.
If not waking up with morning wood and actually just never having sex because I'm not interested in it, could be classified as sexual dysfunction then yeah. My erections are not as hard as they should be and the last time I had sexual contact was in March.
I brushed off the lack of sexual interest over the past couple of years due to the intense focus on gym.
Effexor and antidepressants degrade the amount of REM cycles you have during sleep and REM sleep is when nocturnal tamusents or rigid erection occur in males and therefor over time of use will drive your sex drive down for some users.
Hey bro if you can find the data supporting that I'd be really interested in reading it. I'm gonna look it up once I get back to work on Tuesday.
Sure bro ill get back to ya
Edit: Here's what I have pulled up so far, there isn't a ton of research on it but I think I have more at home. Out of town at the moment, but I'm curious to hear your thoughts on this
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321007/
http://www.mental-health-today.com/rx/testos.htm
http://www.ncbi.nlm.nih.gov/m/pubmed/10984008/
Another quick one that discusses ssri, which technically venlafaxine still is except it touches norepinephrine as well as serotonin:
http://www.bmj.com/rapid-response/2011/10/30/ssris-why-are-we-surprised
No worries bro. I checked out these links. #2 is certainly the most credible study, unfortunately 1&3 were case reports and can never be extrapolated to the general population. I also couldn't get full access to them at home to read them thoroughly. I'll check them out when I get to work tomorrow. The problem I have with #2 though is that it does not report statistical significance.. which if there is none really means diddly in the world of science/medicine :-( Regardless, it's interesting to see!
Yeah, perhaps I shouldn't have sounded so absolute in my statements earlier lol. It's too bad there isn't more about this but I will keep digging. Let me know if you find anything else, appreciate you looking the links over and giving feedback