My journey so far with low testosterone.

[CSI007]

I guess until I drop dead or it stops working. LOL

I felt so bad a little over a year ago, I can't even begin to think about going back to the way I felt. I just wish my ED was resolved more. It's certainly better but....I wish it to be closer to 100% Really tough wanted to go at it every day and be apprehensive about it because the plumbing isn't working.

 

[CSI007]

Just a quick update on the blood glucose front. Last night I took my third metformin pill. 500mg about 8pm each night with a little snack. Next Tuesday starts low carb diet week 3. The past two days I have begun to notice what I believe to be some significant differences in BG.

As was with the testosterone I am reacting very quickly to the drug. This seems to be a common theme with my body. I react very quickly to drugs introduced in to my system.

Fasting numbers are still about where they have been although they appear to be coming down but who knows. What interests me the post already is the random numbers I am taking. Yesterday I went about 8 hours during the day without food and came home to a BG of 87. Never had a number that low. Other random tests through out the past couple of days have all been below 100. Regardless of what I did I could never get consistent numbers below 100. Occasionally one would slip in there after I did some serious exercise (for me).

I have some stomach wierdness right now but nothing I would say terrible. My appetite is turning to crap though. Some foods are not tasting too great right now.

Oh and my libido is really ticking up a few notches the past couple of days. Not sure if it's related or if its the 10k iu of D3 I have been taking for the past month.

 

[JPB]

The metformin messes with the gastrointestinal microbiota so it may take some getting used to

 

[CSI007]

The metformin messes with the gastrointestinal microbiota so it may take some getting used to

Suggest taking some Probiotics?

 

[dnfuss]

Just a quick update on the blood glucose front. Last night I took my third metformin pill. 500mg about 8pm each night with a little snack. Next Tuesday starts low carb diet week 3. The past two days I have begun to notice what I believe to be some significant differences in BG.

As was with the testosterone I am reacting very quickly to the drug. This seems to be a common theme with my body. I react very quickly to drugs introduced in to my system.

Fasting numbers are still about where they have been although they appear to be coming down but who knows. What interests me the post already is the random numbers I am taking. Yesterday I went about 8 hours during the day without food and came home to a BG of 87. Never had a number that low. Other random tests through out the past couple of days have all been below 100. Regardless of what I did I could never get consistent numbers below 100. Occasionally one would slip in there after I did some serious exercise (for me).

I have some stomach wierdness right now but nothing I would say terrible. My appetite is turning to crap though. Some foods are not tasting too great right now.

Oh and my libido is really ticking up a few notches the past couple of days. Not sure if it's related or if its the 10k iu of D3 I have been taking for the past month.

The lack of appetite at first is common. I had it, along with a metallic taste in my mouth. It eventually went away. Be patient. I also found switching to the extended-release form very helpful with those symptoms.

And just as libido/ED often takes longer than other symptoms to respond to TRT, fasting blood sugar upon awakening often doesn't reduce significantly on metformin until post-meal glucose has been under control for some time. Once you no longer have any gastrointestinal issues (diarrhea, bad gas, sour stomach or low apetite) and you've been on your dose for at least three weeks, you can consider increasing your dose if fasting blood sugar still isn't where you want it to be.

 

[CSI007]

OK guys,
Something crazy going on. So about a week or so into the metformin I noticed that I really started to break out again like I did when my E2 was in the up 60s. Was having some hot flashes etc. Did not change anything with my T protocol. Libido has steadily increased each and every day since I started metformin. The end of beginning of last week I decided to try my last Stendra pill for the heck of it because I as out of cialis. That night I had the best erection I have had in years! Lasted over an hour. The next day the same thing! The Stendra did nothing for me 2 years ago. I thought maybe it as because the hormones had improved things and that the stendra would just work better for me then the cialis. Anyway several days without ED drugs and the ED is basically gone. Still not 100% sensitivity but MUCH improved. The only other thing besides the metformin that I have done is that I have started doing kegals multiple times a day. I then tried 14mg of cialis which was basically doing nothing for me 3 weeks ago and again, major improvements - as a matter of fact I may have had a harder erection then I have had since i was in my teens with the cialis. Before it was a fight to keep things up.

I am at a complete loss as to what has happened. I plan to get blood work done this week so I can have a snap shot of my hormones in this state. I am at a complete loss as to what has changed. Hopefully blood work will shed some light? Anyone have any ideas I am open to comments.

So either the kegals have helped me, or the metforim has drastically changed my entire hormonal balance in some way. Increase in nitric oxide?

After a week on metforim the FBG numbers rose significantly without a change in routine or diet, the past 3 days they have started to slowly come down again.

 

[CSI007]

Have I stumped everyone? Was hoping to get some comments. I am getting more blood work tomorrow. Starting to wonder if this might be HCG related. I am using a very old batch that likely weakened over the months. Should be able to confirm with the labs.

 

[CSI007]

I'm actually beginning to think that perhaps the metformin could also be playing a role. Looks like it can significantly reduce testosterone for people who take it.

 

[Vince Carter]

People seem to like Metformin for all kinds of reasons. Your experience could be one-off and unique to you.

 

[CSI007]

People seem to like Metformin for all kinds of reasons. Your experience could be one-off and unique to you.

Possibly, I cannot imagine what is going on at this point. Just got blood drawn today to see if anything has changed with hormones. If T and E2 has not changed then the metforim must be what is doing it. I have a hard time believing that jsut a few weeks of kegels could have this kind of impact. Virtually no ED issues as of today. Went over an hour today before things started to slacken off. This was unheard of just two weeks ago were I would major struggles with 21mg of Cialis.

 

[Nelson Vergel]

Metformin may improve insulin sensitivity that may improve endogenous testosterone and MAY even add onto the improved expression of androgen and estrogen receptors caused by TRT (my hypothesis which may be right or wrong).

This study shows what happens in diabetes to receptors before and after TRT:


Eur J Endocrinol. 2018 Jan 16. pii: EJE-17-0673. doi: 10.1530/EJE-17-0673. [Epub ahead of print]

Diminished Androgen and Estrogen Receptors and Aromatase Levels in Hypogonadal Diabetic Men: Reversal with Testosterone.
Ghanim H1, Dhindsa S2, Abuaysheh S3, Batra M4, Kuhadiya N5, Makdissi A6, Chaudhuri A7, Dandona P8.

Abstract
AIMS:
One third of males with type 2 diabetes have hypogonadism, characterized by low total and free testosterone concentrations. We hypothesized that this condition is associated with a compensatory increase in the expression of androgen receptors (AR) and that testosterone replacement reverses these changes. We also measured estrogen receptor and aromatase expression.

MATERIALS AND METHODS:
This is a randomized double-blind placebo controlled trial. 32 hypogonadal and 32 eugonadal men with type 2 diabetes were recruited. Hypogonadal men were randomized to receive intramuscular testosterone or saline every 2 weeks for 22 weeks. We measured AR, ERα and aromatase expression in peripheral blood mononuclear cells (MNC) and adipose tissue in hypogonadal and eugonadal males with type 2 diabetes at baseline and after 22 weeks of treatment in those with hypogonadism.

RESULTS:
The mRNA expression of AR, ERα and aromatase in adipose tissue from hypogonadal men was significantly lower as compared to eugonadal men and it increased significantly to levels comparable to those in eugonadal patients with type 2 diabetes following testosterone treatment. AR mRNA expression was also significantly lower in MNC from hypogonadal patients compared to eugonadal T2DM patients. Testosterone administration in hypogonadal patients also restored AR mRNA and nuclear extract protein levels from MNC to that in eugonadal patients.

CONCLUSIONS:
We conclude that, contrary to our hypothesis, the expression of AR, ERα and aromatase is significantly diminished in hypogonadal men as compared to eugonadal men with type 2 diabetes. Following testosterone replacement, there is a reversal of these deficits.

 

[CSI007]

Thanks for the additional info Nelson,

I have read that metforim can lower serum testosterone but no that it can raise. So maybe its acting as an aromatase inhibitor (unless I am reading this wrong?) which lowered my E2 all the while raising my T. I have been reading that it seems to also lower hematicrit in some people on TRT.


The interesting thing is. The past 3 days I feel like my levels of T and E2 have crashed. I am sweating, joint and muscle aches, I feeel weak. I have felt all of these things before (when I started the T cream and my levels crashed), but with the flu going around among other things I am hesitant to point the finger at TRT failure (because of metformin?) Not pressing the panic button yet since I also have had some pretty bad nausea and diarrhea. If I don't get full blown illness in the next day or two but continue to feel this way I will REALLY be interested to see my blood work when it comes in. I guess I will be a good case study for metformin and TRT!

Metformin may improve insulin sensitivity that may improve endogenous testosterone and MAY even add onto the improved expression of androgen and estrogen receptors caused by TRT (my hypothesis which may be right or wrong).

This study shows what happens in diabetes to receptors before and after TRT:


Eur J Endocrinol. 2018 Jan 16. pii: EJE-17-0673. doi: 10.1530/EJE-17-0673. [Epub ahead of print]

Diminished Androgen and Estrogen Receptors and Aromatase Levels in Hypogonadal Diabetic Men: Reversal with Testosterone.
Ghanim H1, Dhindsa S2, Abuaysheh S3, Batra M4, Kuhadiya N5, Makdissi A6, Chaudhuri A7, Dandona P8.

Abstract
AIMS:
One third of males with type 2 diabetes have hypogonadism, characterized by low total and free testosterone concentrations. We hypothesized that this condition is associated with a compensatory increase in the expression of androgen receptors (AR) and that testosterone replacement reverses these changes. We also measured estrogen receptor and aromatase expression.

MATERIALS AND METHODS:
This is a randomized double-blind placebo controlled trial. 32 hypogonadal and 32 eugonadal men with type 2 diabetes were recruited. Hypogonadal men were randomized to receive intramuscular testosterone or saline every 2 weeks for 22 weeks. We measured AR, ERα and aromatase expression in peripheral blood mononuclear cells (MNC) and adipose tissue in hypogonadal and eugonadal males with type 2 diabetes at baseline and after 22 weeks of treatment in those with hypogonadism.

RESULTS:
The mRNA expression of AR, ERα and aromatase in adipose tissue from hypogonadal men was significantly lower as compared to eugonadal men and it increased significantly to levels comparable to those in eugonadal patients with type 2 diabetes following testosterone treatment. AR mRNA expression was also significantly lower in MNC from hypogonadal patients compared to eugonadal T2DM patients. Testosterone administration in hypogonadal patients also restored AR mRNA and nuclear extract protein levels from MNC to that in eugonadal patients.

CONCLUSIONS:
We conclude that, contrary to our hypothesis, the expression of AR, ERα and aromatase is significantly diminished in hypogonadal men as compared to eugonadal men with type 2 diabetes. Following testosterone replacement, there is a reversal of these deficits.

 

[CSI007]

Well, I think I have my answer. I had about a week of really super strong libido and virtually no ED issues and sadly it faded late last week - feeling anxious and crappy also been in a crappy mood too.. I think that either the HCG is now too weak (been months and months on the same bottle) or the Metformin has knocked down my T and thus the E2.

Here are my latest lab results that I had drawn last Wednesday. T is 100 points lower then it's been for 6 or 8 months. E2 is about 10 points lower then last time. Good news is A1C is holding steady at 5.7!!!







Where the heck do I go from here? I feel like I was in the zone a week ago. Now, Kaput. Use a new bottle (unmixxed HCG but the bottle is also months old but not kept in fridge) Increase my injection T? I am at a total loss where to go and how to get fined tuned.

 

[Vince Carter]

You really can over analyze everything to the point that it's all in your head. Honestly.

 

[CSI007]

You really can over analyze everything to the point that it's all in your head. Honestly.

I wish that were the case. I don't think it is though. I was just going about my days and I felt a clear change about a week after I started the Metformin. I "know" when I am feeling right. A week and half ago I felt the best that I ever have since I started with the low T issues. Something has clearly changed. My wife even commented on it because I have been very moody the past several day. I am too busy with other things to be dwelling on how I feel. But I know when I am not feeling well.

I think I can even prove this with the above labs. Now the question is, is this enough of a change to throw me off? I feel like I blew right past my ideal levels last week.

 

[Systemlord]

I wish that were the case. I don't think it is though. I was just going about my days and I felt a clear change about a week after I started the Metformin. I "know" when I am feeling right. A week and half ago I felt the best that I ever have since I started with the low T issues. Something has clearly changed. My wife even commented on it because I have been very moody the past several day. I am too busy with other things to be dwelling on how I feel. But I know when I am not feeling well.

I think I can even prove this with the above labs. Now the question is, is this enough of a change to throw me off? I feel like I blew right past my ideal levels last week.

How long has it been since starting Metformin?

 

[CSI007]

How long has it been since starting Metformin?

I started on 1/8/2018 so today is the start of week 4 of 500mg once per day.

 

[dnfuss]

I wish that were the case. I don't think it is though. I was just going about my days and I felt a clear change about a week after I started the Metformin. I "know" when I am feeling right. A week and half ago I felt the best that I ever have since I started with the low T issues. Something has clearly changed. My wife even commented on it because I have been very moody the past several day. I am too busy with other things to be dwelling on how I feel. But I know when I am not feeling well.

I think I can even prove this with the above labs. Now the question is, is this enough of a change to throw me off? I feel like I blew right past my ideal levels last week.

It took three or four weeks before I felt stabilized on Metformin. During that time I occasionally experienced ED and libido issues. My guess is that it wasn't due to changes in hormone levels, but was simply a result of the gastric distress and and other physical unease from the Metformin. Same effect as when I get a minor cold or infection. When I'm a little unwell I just don't feel much sexual desire and find it difficult to perform.

Once I had completely adapted to Metformin, libido and erections went back to where they'd been before I started. I found that gastric distress and other physical symptoms were helped by taking the extended-release formulation at night. Some also find it helpful to take with meals, some the opposite. YMMV. Lots of good information on Metformin on this page.

Good luck!

 

[dnfuss]

I started on 1/8/2018 so today is the start of week 4 of 500mg once per day.

Have you seen material changes in your blood glucose levels since going on Metformin, either fasting or post-meal?

 

[CSI007]

It took three or four weeks before I felt stabilized on Metformin. During that time I occasionally experienced ED and libido issues. My guess is that it wasn't due to changes in hormone levels, but was simply a result of the gastric distress and and other physical unease from the Metformin. Same effect as when I get a minor cold or infection. When I'm a little unwell I just don't feel much sexual desire and find it difficult to perform.

Once I had completely adapted to Metformin, libido and erections went back to where they'd been before I started. I found that gastric distress and other physical symptoms were helped by taking the extended-release formulation at night. Some also find it helpful to take with meals, some the opposite. YMMV. Lots of good information on Metformin on this page.

Good luck!

I don't think that is it. I had the worst of it with regards to the gastric stuff the first week and right after that I felt the best I have since starting TRT. Overall all today I feel fine with regards to that.