29 y/o male blood work- huge surge in T, low iodine?

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goofy24

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Hi all. 29 year old male here. Never used any anabolics or such, whatsoever. Have adrenal insufficiency and take supplementary hydrocortisone (20mg/day) and 100mg/day of DHEA. Got my labs today and saw a large surge in total and free T, shockingly after 10 years of basically being 550ng/dl with free T rarely in the upper portion of the range. I was basically bedbound a decade ago for a few years due to severe chronic fatigue, things are much, much better now. I cannot, however, work out without getting dizzy and crashing afterward. I presume due to the adrenal insufficiency. So I limit my physical activity and do as much as I can tolerate.

I have had chronically severely low iodine via my urine testing. I have been taking 2.5mg iodine per day for the last few months, and it is still almost zero on my testing. I am not sure what is going on here, if I have some sort of iodine issue or if the urine testing is simply flawed? Or I am over hydrated and that is leading to dilution? I am not sure. I don't want to take much more iodine because it can be toxic, and my ft3 is perfect in the upper end of the range, and I don't want to push myself to by hyperthyroid if unnecessary. But it seems I cannot get my iodine up.

I suffer from chronic depression, and low libido. I had a many year porn addiction that I stopped last year and began to turn my life around, with moderate success. I always assumed that my libido issues were inadequate T, but it seems that there must be more going on, especially since it is still very low even with these T levels. I suspect dopaminergic dysfunction.

The only change in the last year has been that I added in 10mg boron glycinate every day or two, and the addition of 2.5mg iodine most days. I have attached my blood work that I believe is relevant. Any idea what cause the surge in test? I occasionally take the herb cistanche, but never noticed anything from it, and it is sporadically used. Maybe once every few days.

I am constantly thirsty, and I do think I may have a form of diabetes insipidus(excessive thirst and lack of water conservation by the kidneys). Or it could be my adrenal insufficiency leading to lack of electrolyte retention. I drink a lot of water, and lots of electrolytes. I am just speculating here.

Any comments on my labs and suggestions would be great. I trialed bupropion(wellbutrin) with success but the side effects made me stop. Dopamine boosting supplements don't seem to do much either. I can get a full erection, and perform once sex starts, but the anticipation and leading up to it, I feel "dead". I.e. if a hot woman is grinding against me, I will not get hard generally. But if I pull my pants down and she starts playing with it, I will get hard quickly. The anticipation aspect is just dead. I occasionally use sildenafil or tadalafil as an insurance policy. My dick works, it just doesn't seem to get excited unless things are really getting hot and heavy. I don't think this is normal, and I am starting to think this is not testosterone related at all.

I also feel awful after orgasm and crash physically and mentally for a few days every time.

Any input from lab pros would be appreciated. Thank you all. Attached are relevant labs. Have a great day everyone.
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I would like to add, that the only time I ever have a significant libido is when I am high on THC. If that makes any difference. I know THC acts on dopamine, so that may lend some credence to the dopamine theory.
 
So I have experimented with various meds, none of which made much of a difference, but pramipexole I started a few days ago. By far the most libido enhancing substance I have ever used. Extremely rock hard erections that won't go away, an urge to go down on thick women and fuck them hard. Depression seems slightly improved. Either way, does this confirm my issue is dopamine or could theoretically it be prolactin related still?

Edit: I am on .25mg. I am having dry mouth and sleep interruptions. But I feel the stuff kick in about 2-3 hours after dosing, so I wonder if it could safely be used sporadically vs daily? I am taking it before bed and it for sure interrupts my sleep. Maybe earlier in the day dosing is worth trying as well.
 
It could still be a high prolactin issue since prolactin and dopamine are inversely related, so check your prolactin levels.

Otherwise, probably your libido problem is related to the nervous system, not to testosterone. It is either a neurotransmitter issue, or a nerve/brain damage somewhere in the circuits, that you compensate with the dopamine agonist pramipexole. Whatever damaged your adrenal glands (most often infection) could have damaged the nervous circuit too.

Your thirst, could be a side effect of too much hydrocortisone:
Hydrocortisone (Oral Route) Side Effects - Mayo Clinic
Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems (eg, Cushing's syndrome). Talk to your doctor right away if you have blurred vision, dizziness or fainting, a fast, irregular, or pounding heartbeat, increased thirst or urination, irritability, or unusual tiredness or weakness.

The low iodine in urine may be due to drinking too much water.
 
It could still be a high prolactin issue since prolactin and dopamine are inversely related, so check your prolactin levels.

Otherwise, probably your libido problem is related to the nervous system, not to testosterone. It is either a neurotransmitter issue, or a nerve/brain damage somewhere in the circuits, that you compensate with the dopamine agonist pramipexole. Whatever damaged your adrenal glands (most often infection) could have damaged the nervous circuit too.

Your thirst, could be a side effect of too much hydrocortisone:
Hydrocortisone (Oral Route) Side Effects - Mayo Clinic


The low iodine in urine may be due to drinking too much water.
OK. Should I check the prolactin levels specifically after a long period of abstinence, or right after, or does it not matter?

I had the thirst issues prior to the hydrocortisone. I wonder if I actually should consider fludrocortisone to see if that helps. My doc had mentioned it, it's common in addisons patients to need it, but the potential side effects pushed me away. And my sodium levels have always been fine on serum.. i do eat salt like a horse though. Literally sucking on salt tablets all day.
 
Prolactin should be checked when you don't use dopamine agonists or anything that affects dopamine because that indirectly affects prolactin.

Cabergoline is a dopamine D2 agonist that is used to lower prolactin.
 
Prolactin should be checked when you don't use dopamine agonists or anything that affects dopamine because that indirectly affects prolactin.

Cabergoline is a dopamine D2 agonist that is used to lower prolactin.
Sorry, by abstinence I meant ejaculation. Since I feel so crappy after ejaculating I presume it may affect the blood results if I am doing it right after or many weeks after.
 
Unlikely prolactin to be influenced by ejaculation but since it makes you feel bad, it shouldn't be a problem to wait a week after the last one to do the test. During that time you should not use dopamine agonists, THC or any other recreational supplements/drugs/herbs except your regular drugs and supplements.

The goal is to measure prolactin in your typical current state, not when using occasional experimental or new drugs or treatments.
 
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low libido/depression can have about a million causes. I too learned that THC will boost my libido, but i think this has to do with distraction/relaxation from daily stress. work stress is an absolute libido killer.
what works for me consistently is a low carb/heavy red meat diet + organs plus a good workout routine, weight lifting+ a bit of cardio (not too much)
porn will definitely fry your dopamine system and add to depression.
I also experimented with modafinil for dopamine boost, and that worked pretty good, but doesn't work long-term, can be used sporadic only, since like all drugs it will cause your brain to work against it and cause dependence/brain changes.
IMHO diet is the key. western diet is designed to make you depressed. you need to cut all processed shit, especially ALL seed oils and processed sugars/starches. search youtube for guys like carnivoremd/dr ken berry.
 
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