Only joined the site this week but it has been inspirational reading the posts with so many questions and great, clear and supportive answers from those knowledgeable on the forum. If it's OK I'd like to share my journey too, and perhaps attract some feedback from anyone interested in adding their experience and commenting on my plans.
In July 2015, I suffered a heart attack, two stents were fitted to my heart immediately and I had another 3 fitted some 8 weeks later. Seems my arteries were 98 and 99% blocked respectively – I was 59 years old, at that point, I had already been being treated for Type 2 diabetes for 7 years. Medication for the diabetes consisted of Metformin for the most part – at 2500mg, and for the last year Gliclazide. In early 2015, I was working hard to lower my Blood Glucose, since the GP had told me if I continued as I was (with high fasting BG) I was destined for Insulin shots sometime very soon.
I worked so hard in fact, that by my HbA1c dropped to 6.1%. The practice Nurse decided that at that level I should take a break from medication completely for a while???? Felt wrong to me at the time, but it fooled me into thinking I was making progress, and I desperately wanted it to be true! A month later the heart attack!
Of course, it was a rude awakening for me and I knew I needed to make some drastic changes to my life and health. There was a rehabilitation programme to get me mobile again which worked fantastically, to the point where I started independently working out at the gym.
For clarity, I was now 59, 5'8”,74kg (162lb), and really unfit. In September that year I set a target to get off the diabetic medication, and through exercise, diet and help from a local Professor who was pioneering Type 2 reversal research at Newcastle University, I did exactly that in January of 2016. It was a challenge, eating at 600 to 800 kcals a day for 10 weeks, but worth the effort. The downside of the process was that I had reduced my body weight to 61 kg (134lb) and 12% body fat, but it seemed like it was mostly muscle that had gone along with a bit of belly fat! I was skinny as hell and though I felt great, I looked like I was seriously ill!
As a kid and into my twenties (28 at least) I was always an Ectomorph. Seemed like at 30 I started to gain weight and it kept on coming, I guess I became more of a Mesomorph. The Type 2 reversal process, with the very low-calorie diet probably slowed my metabolism even further and contributed to the ease of adding body fat.
So, I hit the gym, and between then and now, managed to get back some of the lost muscle, up to 72.5 kg (159lb) now but with a creeping bodyfat at 19%. I track everything nowadays, macros, training, blood glucose, blood pressure etc and it's been very apparent over the last year that my metabolism is incredibly slow. I can eat as low as 1000 calories, with sub 20g carbs and still put on fat. I should be looking at >2000kcals BMR at my size yet working hard in the gym 4 times a week with weights seems to have negligible impact.
When I was diagnosed with Type 2 I realised I had been suffering with ED probably for a couple of years, it kind of crept up on me, but after the heart attack it became a full-on challenge. At first Viagra worked, then it was not so effective and more recently is not working at all (Cialis, Avanafil either).
The post heart attack meds list I now consume is very likely contributing to my ongoing ED issues. They include:
I know Bisoprolol and Ramipril have been shown to effect ED, though I don't note any of them compromising Libido to the extent I suffer it currently.
The helpful GP (NOT), when I asked if low T might be contributing to the ED just suggested I should try the Penis Injections and stop reading stuff on the internet about testosterone. I pushed him and he eventually agreed to give me a T blood test last December. The result, (relayed to me by the practice receptionist over the phone) was ‘7' (UK numbers I'm afraid), the GP had noted on my file that that result was satisfactory.
I only later discovered that the range the lab was applied was 9 to 42 so 7 was off the scale, but in any case, I now know the reading on my record actually said <7? Of course, with that positive feedback I let the question about low T hang – I assumed he was correct and my levels were perfectly OK. My symptoms persisted and I'll admit to a degree of despair.
In the last 3 months or so I came across Nelson Vergel's great videos on YouTube and it inspired me to investigate things further for myself. I was already advised by the GP's Practice Nurse that a referral to an Endocrinologist would take 6 months, and that would lead to a, possibly, year-long process of tests, trials of treatments, reduction of treatments and then more trials. At my age, I need to get some quality of life back as soon as possible, looks like the only way forward is to do it myself.
Therefore, here I am! I had some private lab work done this week with very surprising results:
D.H.E.A. SULPHATE 2.280 umol/L 0.44 - 13.40
FOLLICLE STIM. HORMONE 4.44 IU/L 1.50 - 12.40
LUTEINISING HORMONE 3.33 IU/L 1.70 - 8.60
TESTOSTERONE *1.48 nmol/L 7.60 - 31.40
FREE-TESTOSTERONE(CALC) *0.0333 nmol/L 0.30 - 1.00
SEX HORMONE BINDING GLOB 21.7 nmol/L 19.00 - 83.00
FREE ANDROGEN INDEX *6.82 Ratio 24.00 - 104.00
17-BETA OESTRADIOL 18.4 pmol/L 0.00 - 191.99
PROLACTIN 57.4 mIU/L 86.00 - 324.00
So, my Testosterone readings were all low in the extreme, just as I had anticipated, everything else seems in range (Prolactin is low but I can't find any discussion on low Prolactin in Men).
I feel my SHBG and Oestradiol are both a little low, but since Prolactin is also low (so unlikely to be affecting the ED situation) I suspect both the former are depressed because of the low Testosterone in my system.
I have a sense that everything points to ‘simply' Low Testosterone. From my research it seems probable that adjusting my T will support my SHBG and Estradiol in achieving a with-in-range level???
So, I have embarked on a protocol of my own design to test the waters. I have started Testogel application, 2* 5mg sachets applied once per day. I'm going to run this for another two weeks (so 3 weeks in total on the gel) and re-do my TRT blood test to see if it has any effect at all. I know the gel is less effective than injectable but its a 'toe in the water'.
Next plan is to:
My Targets:
I know I'm an older guy now and can't expect miracles but I'd really like to add some decent muscle to my body as well as correct the issues I have with Libido and ED. If I could lower my body fat too I'd be very pleased. I eat clean anyway but would really love to speed up my metabolism so that I could add some carbs and more calories to my diet without worrying about body-fat quite so much.
I don't think that is too much to hope for or outside of the realms of possibility, I am hoping the Testosterone adjustments will make most of this possible?
Apologies for the length of this post, I hope at least some will have made it this far. I'd appreciate any feedback + or -.
If there is any interest I will update this post with future logs of Labs and modifications to my programme and how things work out, I guess I'm in for the long-haul now anyway!
Very best regards to all.
In July 2015, I suffered a heart attack, two stents were fitted to my heart immediately and I had another 3 fitted some 8 weeks later. Seems my arteries were 98 and 99% blocked respectively – I was 59 years old, at that point, I had already been being treated for Type 2 diabetes for 7 years. Medication for the diabetes consisted of Metformin for the most part – at 2500mg, and for the last year Gliclazide. In early 2015, I was working hard to lower my Blood Glucose, since the GP had told me if I continued as I was (with high fasting BG) I was destined for Insulin shots sometime very soon.
I worked so hard in fact, that by my HbA1c dropped to 6.1%. The practice Nurse decided that at that level I should take a break from medication completely for a while???? Felt wrong to me at the time, but it fooled me into thinking I was making progress, and I desperately wanted it to be true! A month later the heart attack!
Of course, it was a rude awakening for me and I knew I needed to make some drastic changes to my life and health. There was a rehabilitation programme to get me mobile again which worked fantastically, to the point where I started independently working out at the gym.
For clarity, I was now 59, 5'8”,74kg (162lb), and really unfit. In September that year I set a target to get off the diabetic medication, and through exercise, diet and help from a local Professor who was pioneering Type 2 reversal research at Newcastle University, I did exactly that in January of 2016. It was a challenge, eating at 600 to 800 kcals a day for 10 weeks, but worth the effort. The downside of the process was that I had reduced my body weight to 61 kg (134lb) and 12% body fat, but it seemed like it was mostly muscle that had gone along with a bit of belly fat! I was skinny as hell and though I felt great, I looked like I was seriously ill!
As a kid and into my twenties (28 at least) I was always an Ectomorph. Seemed like at 30 I started to gain weight and it kept on coming, I guess I became more of a Mesomorph. The Type 2 reversal process, with the very low-calorie diet probably slowed my metabolism even further and contributed to the ease of adding body fat.
So, I hit the gym, and between then and now, managed to get back some of the lost muscle, up to 72.5 kg (159lb) now but with a creeping bodyfat at 19%. I track everything nowadays, macros, training, blood glucose, blood pressure etc and it's been very apparent over the last year that my metabolism is incredibly slow. I can eat as low as 1000 calories, with sub 20g carbs and still put on fat. I should be looking at >2000kcals BMR at my size yet working hard in the gym 4 times a week with weights seems to have negligible impact.
When I was diagnosed with Type 2 I realised I had been suffering with ED probably for a couple of years, it kind of crept up on me, but after the heart attack it became a full-on challenge. At first Viagra worked, then it was not so effective and more recently is not working at all (Cialis, Avanafil either).
The post heart attack meds list I now consume is very likely contributing to my ongoing ED issues. They include:
Amlodipine, Bisoprolol, Clopidogrel, Ramipril, Pramipexole.
I know Bisoprolol and Ramipril have been shown to effect ED, though I don't note any of them compromising Libido to the extent I suffer it currently.
The helpful GP (NOT), when I asked if low T might be contributing to the ED just suggested I should try the Penis Injections and stop reading stuff on the internet about testosterone. I pushed him and he eventually agreed to give me a T blood test last December. The result, (relayed to me by the practice receptionist over the phone) was ‘7' (UK numbers I'm afraid), the GP had noted on my file that that result was satisfactory.
I only later discovered that the range the lab was applied was 9 to 42 so 7 was off the scale, but in any case, I now know the reading on my record actually said <7? Of course, with that positive feedback I let the question about low T hang – I assumed he was correct and my levels were perfectly OK. My symptoms persisted and I'll admit to a degree of despair.
In the last 3 months or so I came across Nelson Vergel's great videos on YouTube and it inspired me to investigate things further for myself. I was already advised by the GP's Practice Nurse that a referral to an Endocrinologist would take 6 months, and that would lead to a, possibly, year-long process of tests, trials of treatments, reduction of treatments and then more trials. At my age, I need to get some quality of life back as soon as possible, looks like the only way forward is to do it myself.
Therefore, here I am! I had some private lab work done this week with very surprising results:
D.H.E.A. SULPHATE 2.280 umol/L 0.44 - 13.40
FOLLICLE STIM. HORMONE 4.44 IU/L 1.50 - 12.40
LUTEINISING HORMONE 3.33 IU/L 1.70 - 8.60
TESTOSTERONE *1.48 nmol/L 7.60 - 31.40
FREE-TESTOSTERONE(CALC) *0.0333 nmol/L 0.30 - 1.00
SEX HORMONE BINDING GLOB 21.7 nmol/L 19.00 - 83.00
FREE ANDROGEN INDEX *6.82 Ratio 24.00 - 104.00
17-BETA OESTRADIOL 18.4 pmol/L 0.00 - 191.99
PROLACTIN 57.4 mIU/L 86.00 - 324.00
So, my Testosterone readings were all low in the extreme, just as I had anticipated, everything else seems in range (Prolactin is low but I can't find any discussion on low Prolactin in Men).
I feel my SHBG and Oestradiol are both a little low, but since Prolactin is also low (so unlikely to be affecting the ED situation) I suspect both the former are depressed because of the low Testosterone in my system.
I have a sense that everything points to ‘simply' Low Testosterone. From my research it seems probable that adjusting my T will support my SHBG and Estradiol in achieving a with-in-range level???
So, I have embarked on a protocol of my own design to test the waters. I have started Testogel application, 2* 5mg sachets applied once per day. I'm going to run this for another two weeks (so 3 weeks in total on the gel) and re-do my TRT blood test to see if it has any effect at all. I know the gel is less effective than injectable but its a 'toe in the water'.
Next plan is to:
- Discuss with my Dr the possibility of coming off the Bisoprolol or Ramipril as an experiment, to see how I react and if it helps the ED (I monitor BP daily).
- Move to Testosterone Enanthate at 100mg 2 times per week SubQ
- Add hCG 250iu 2 times per week SubQ
- Monitor my SHBG and adjust with Proviron if it begins to stray into the higher numbers, which will I hope also support my Libido to some degree.
- Possibly adjust Oestradiol with Tamoxifen should it stray outside of a comfortable range.
My Targets:
I know I'm an older guy now and can't expect miracles but I'd really like to add some decent muscle to my body as well as correct the issues I have with Libido and ED. If I could lower my body fat too I'd be very pleased. I eat clean anyway but would really love to speed up my metabolism so that I could add some carbs and more calories to my diet without worrying about body-fat quite so much.
I don't think that is too much to hope for or outside of the realms of possibility, I am hoping the Testosterone adjustments will make most of this possible?
Apologies for the length of this post, I hope at least some will have made it this far. I'd appreciate any feedback + or -.
If there is any interest I will update this post with future logs of Labs and modifications to my programme and how things work out, I guess I'm in for the long-haul now anyway!
Very best regards to all.
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