22 years old, erectile dysfunction.

[SHBG]

Hey everyone.
I decided to post on this forum since a lot of you here are extremely knowledgeable on this stuff.
Im 22 years old and I’ve been experiencing erectile dysfunction for the past 3 years. Ive visited countless doctors, but none of them were really helpful.
I’ve done a lot of blood tests over the years.
Testosterone: 18-25 nmol/l on different occasions
Free testosterone(Direct): 10.7 pg/ml Range(1-28pg/ml) I know, this 1 pg where it starts doesn’t make any sense. It should be more like 9-32 pg like in labcorp direct test.
SHBG: hovering around 47-55 nmol/l on different blood tests
LH: 3.5 mMIU/l
FSH: 1.65 mMIU/l
TSH: 2.6-3.5 on different occasions
Prolactin: 367-420
Estradiol: 100pmol/l

More info:
I stopped waking up with morning wood when I became 19 years old. Usually, if I can get an erection it just lasts just 2-3 minutes without touch(even on cialis) After that I need constant tactile stimulation to keep it up, otherwise it falls within seconds, which is very inconvenient and frustrating in sexual encounters with women. Before that I could have sex 5-10 times in one day and i would still be hard, now i can barely have 1 in 3 days.
Please help.

 

[SHBG]

Forgot to add that i was following the test guidelines very strictly. Early in the morning on an empty stomach with no training the day before.
I had a history of very mild steroid abuse at 17 years old. I used 4-Andro prohormones for 1 month only though. The issues started 2 years later. Everything started after I discontinued saw palmetto supplement. Dont know if it has any relevance.

 

[Systemlord]

Free testosterone(Direct): 10.7 pg/ml Range(1-28pg/ml)

The direct free testosterone measurement is known to be inaccurate and should not be relied upon.

So retest using the more accurate LC/MS assay and report back.

 

[SHBG]

The direct free testosterone measurement is known to be inaccurate and should not be relied upon.

So retest using the more accurate LC/MS assay and report back.

I live in eastern europe and I couldn’t find any of these fancy tests(ultra filtration, dialysis etc) in my country. I did an lc/ms total though and it showed 550 ng/dl, which is consistent with my normal imunoassays. If i was in the USA i would do them already haha.

 

[Systemlord]

I did an lc/ms total though and it showed 550 ng/dl,

These values together with your SHBG levels, Free T can't be optimal. Your LH isn't spectacular either.

 

[SHBG]

These values together with your SHBG levels, Free T can't be optimal. Your LH isn't spectacular either.

What about lh, is it too low, too high?

 

[SHBG]

I recently bought a 6 month supply of androgel. Planning to use 2 packets of it per day. I will adjust the dosage depending on bloodwork. Im young so my skin will absorb it easily. I read this forum and it seems like a lot of people with high shbg have the same problems as I do.

 

[Systemlord]

What about lh, is it too low, too high?

LH is pulsatile, it can be high and 30 minutes later on the lower end.

To give you a little bit of context my LH was 3.6 when diagnosed with low-T, 91 ng/dL to be exact.

This is considered low normal for LH.

 

[Systemlord]

recently bought a 6 month supply of androgel.

Androgel has a bad reputation around these forums and with good reason. The concentration percentage of Test is too low at 1.62%.

Compounding pharmacies in the US have concentrations at 20%, but even then I didn't absorb hardly any of it.

 

[Cataceous]

... I read this forum and it seems like a lot of people with high shbg have the same problems as I do.

Newer thinking is that SHBG has little to do with it. Your body is regulating for its desired level of free testosterone. The question is: Is that level is high enough? The free testosterone calculators are putting your free testosterone at the low end of the healthy normal ranges. Most guys would be functional at these levels. However, I see that your prolactin is a little on the high side. This may be a contributing factor. Dr. Saya has said:

... Prolactin > 15 [ng/mL or 319 mIU/mL] is generally my low-end threshold for even considering a trial of cabergoline (in cases of severe sexual symptoms with other more common causes ruled out sometimes >10 [ng/mL or 213 mIU/mL]). Symptoms always help to guide and a short trial is all that is needed to determine if prolactin is the culprit.​

[R]

 

[SHBG]

Newer thinking is that SHBG has little to do with it. Your body is regulating for its desired level of free testosterone. The question is: Is that level is high enough? The free testosterone calculators are putting your free testosterone at the low end of the healthy normal ranges. Most guys would be functional at these levels. However, I see that your prolactin is a little on the high side. This may be a contributing factor. Dr. Saya has said:

... Prolactin > 15 [ng/mL or 319 mIU/mL] is generally my low-end threshold for even considering a trial of cabergoline (in cases of severe sexual symptoms with other more common causes ruled out sometimes >10 [ng/mL or 213 mIU/mL]). Symptoms always help to guide and a short trial is all that is needed to determine if prolactin is the culprit.​

[R]

I tried caber to no avail

 

[bixt]

Everything started after I discontinued saw palmetto supplement.

So my unqualified diagnosis is that you have PFS. Saw palmetto is a 5-AR inhibitor same as finasteride. Your symptoms appear to be the same as well.

I may be wrong (and I sincerely hope I am) but I suspect normalising your free T may not resolve your ED in this case.

In that event, throw away the gel and get that 20% T cream that was mentioned, apply it to your nuts. It will convert to massive amounts of DHT and hopefully reverse the PFS.

 

[SHBG]

So my unqualified diagnosis is that you have PFS. Saw palmetto is a 5-AR inhibitor same as finasteride. Your symptoms appear to be the same as well.

I may be wrong (and I sincerely hope I am) but I suspect normalising your free T may not resolve your ED in this case.

In that event, throw away the gel and get that 20% T cream that was mentioned, apply it to your nuts. It will convert to massive amounts of DHT and hopefully reverse the PFS.

I dont have access to that 20% gel cuz im not in the united states. I will use the normal formulation, just 2-3 sachets a day depending on how the levels go. The pharmacokinetics of 2 sachets a day gave a mean of 30-40nmol/l. I can purchase it here without a script.
PFS from tree leaves that millions of men use around the globe? Come on. I only have ed. No brain fog, insomnia or depression or panic attacks.

 

[Systemlord]

Everything started after I discontinued saw palmetto supplement.

PFS from tree leaves that millions of men use around the globe? Come on. I

There's nothing that says you'll get every symptom of PFS, in some cases PFS doesn't occur until after discontinuation 5-AR inhibitors.

You may have gotten a milder form of PFS.

 

[SHBG]

There's nothing that says you'll get every symptom of PFS, in some cases PFS doesn't occur until after discontinuation 5-AR inhibitors.

You may have gotten a milder form of PFS.

Zinc is also a 5 alpha reductase inhibitor, does it mean that you should avoid all foods that have zinc in them because you might get pfs from zinc? People on pfs boards get pfs from all kinds of stuff.

 

[bixt]

Zinc is also a 5 alpha reductase inhibitor

Zinc increased DHT in this paper across both groups. There are many others.

Effect of zinc administration on plasma testosterone, dihydrotestosterone, and sperm count - PubMed

The effects of zinc therapy on plasma testosterone (T), dihydrotestosterone (DHT), and sperm count were studied in 37 patients with idiopathic infertility of more than five years duration. In the first group (T less than 4.8 ng/ml; 22 patients), T and DHT rose significantly after oral...

pubmed.ncbi.nlm.nih.gov

 

[SHBG]

Zinc increased DHT in this paper across both groups. There are many others.

Effect of zinc administration on plasma testosterone, dihydrotestosterone, and sperm count - PubMed

The effects of zinc therapy on plasma testosterone (T), dihydrotestosterone (DHT), and sperm count were studied in 37 patients with idiopathic infertility of more than five years duration. In the first group (T less than 4.8 ng/ml; 22 patients), T and DHT rose significantly after oral...

pubmed.ncbi.nlm.nih.gov

Blood has nothing to do with it since dht is a paracrine hormone.

Inhibition of 5 alpha-reductase activity in human skin by zinc and azelaic acid - PubMed

The effects of zinc sulphate and azelaic acid on 5 alpha-reductase activity in human skin were studied using an in vitro assay with 1,2[3H]-testosterone as substrate. When added at concentrations of 3 or 9 mmol/l, zinc was a potent inhibitor of 5 alpha-reductase activity. At high concentrations...

pubmed.ncbi.nlm.nih.gov

Lycopene that can be found in tomatoes is also a 5 alpha reductase inhibitor apparently. So now tomatoes are dangerous as well? Btw this is what propeciahelp people advocate. Thats why i left these forums a long time ago. Dont eat tomatoes dont eat a lot of zinc cuz you may crash etc. I do believe that there are some people who got their life ruined by finasteride/dutasteride, but the majority of pfshelp is filled with crazy people who will tell you that they crashed from eating salmon or something like that. How is that a surprise that people there get pfs from these berry extracts when they apparently crash from eating every day foods? Saw palmetto is not even proven to have any therapeutic effects for people with prostate problems or AGA.

 

[Vince]

Hey everyone.
I decided to post on this forum since a lot of you here are extremely knowledgeable on this stuff.
Im 22 years old and I’ve been experiencing erectile dysfunction for the past 3 years. Ive visited countless doctors, but none of them were really helpful.
I’ve done a lot of blood tests over the years.
Testosterone: 18-25 nmol/l on different occasions
Free testosterone(Direct): 10.7 pg/ml Range(1-28pg/ml) I know, this 1 pg where it starts doesn’t make any sense. It should be more like 9-32 pg like in labcorp direct test.
SHBG: hovering around 47-55 nmol/l on different blood tests
LH: 3.5 mMIU/l
FSH: 1.65 mMIU/l
TSH: 2.6-3.5 on different occasions
Prolactin: 367-420
Estradiol: 100pmol/l

More info:
I stopped waking up with morning wood when I became 19 years old. Usually, if I can get an erection it just lasts just 2-3 minutes without touch(even on cialis) After that I need constant tactile stimulation to keep it up, otherwise it falls within seconds, which is very inconvenient and frustrating in sexual encounters with women. Before that I could have sex 5-10 times in one day and i would still be hard, now i can barely have 1 in 3 days.
Please help.

I thought someone would have mentioned this. That's why I haven't read this thread. Any chance you have Venous leak?

 

[SHBG]

I thought someone would have mentioned this. That's why I haven't read this thread. Any chance you have Venous leak?

I had CT cavernosography which says that i have insignificant(said in conclusion) venous leak. Doctor just told me to take cialis which helps only somewhat and then proposed a varicocele surgery, which doesn’t improve erection.

 

[Vince]

I had CT cavernosography which says that i have insignificant(said in conclusion) venous leak. Doctor just told me to take cialis which helps only somewhat and then proposed a varicocele surgery, which doesn’t improve erection.

I already know one person that had varicocele surgery. It did take him a long time to heal but it cured his ED issues.