Tamoxifen Monotherapy w/ High Cortisol and Remaining Classic Low T Symptoms

[Nielske]

Hi, these are the last blood test results taken on the 23rd of may this year. At the time I nearly completed my fourth week of Tamoxifen at 20 mg a day.

Before the Tamoxifen my last TT was 371 ng/dl and Free T was -0,650 ng/dl. I will be doing another blood test in about 4 weeks to see where my T stays after stopping Tamoxifen.

Symptoms of low T that I have had for sometime now
-Erectile Dysfuction
-Fatigue
-Low motivation
-Difficulty concentrating
-Grumpy
-compared to a few years ago, barely any morning wood
-bad sleep

TT: 533 ng/dl  (250-836)
Free T: 0,970 ng/dl (0,90-2,90)
SBHG: 21 nmol/l (8,4-49)
Oestradiol: 29 ng/l  (14-60)
LH: 5,2 u/l (1,7-8,6)
FSH: 4,5 u/l  (1,5-12,4)
Prolactin: 316 mlU/l  (86-324)
Progesteron: 0,51 ūg/l (0,20-1,40)
Cortisol: 37,2 ug/dl (6,2-19,4)
DHEA: 223  mcg/dl  (80-560)
Androsteendion 240 ng/dl   (134-429)

Thyroid panel and vitamin D have been tested before and were in range. Diet, lifestyle and weight training are consistent and good.

If you have any questions please ask.
Thank you!

[Kierkegaard]

From what I know (not a whole lot on this subject), high cortisol can share many of the symptoms of low T.  Has your doc talked of any medications for lowering C?

[PeakT]

Okay, you're our first Tamoxifen Monotherapy guy.  You got me curious:  what made you decide on this protocol?  Were you having some gyno?  Or trying to preserve fertility?

Obviously, the high cortisol is a concern for many reasons:

http://www.peaktestosterone.com/Hdr_Cortisol

High cortisol can result from stress, of course, and also can be the intermediate stage in adrenal fatigue:

http://www.peaktestosterone.com/Adrenal_Fatigue_Testing

And let me tell you my experience.  I was always in the low 300's and, back in the day, my urologist put me on compounded testosterone.  It only took me up to the upper 400's and occasionally lower 500's.  This helped me a little bit, but no quantum improvement.  Basically, it helped me somewhat with erectile function (coupled in my case with a Low Fat Diet) and maybe a third with fuzzy thinking and sleep and fatigue and depression, etc.  But it didn't really "get me out of the woods" nor did it give me morning erections or help to heal my venous leakage. 

So this may be your situation as well?  I certainly can't promise it but am just sharing my experience.

[Nielske]

Concerning the Tamox instead of the Clomiphene treatment. It is mainly because of the side effects of Clomid, mostly the eye issues it may induce.

As for the cortisol, on my previous test it was 19,4 ug/dl  (6,2-19,4).

Quick questions, is my prolactin high as in I might have prolactinoma? Does Tamox raise prolactin because I've heard conflicting results from this.

Thanks again!

[PeakT]

Concerning the Tamox instead of the Clomiphene treatment. It is mainly because of the side effects of Clomid, mostly the eye issues it may induce.

As for the cortisol, on my previous test it was 19,4 ug/dl  (6,2-19,4).

Quick questions, is my prolactin high as in I might have prolactinoma? Does Tamox raise prolactin because I've heard conflicting results from this.

Thanks again!

If I did my calculations correctly, you are a little high at 14.6 ug/l.  You can see average values here:

http://en.wikipedia.org/wiki/Prolactin

Hope there's no prolactinoma:  let us know how it goes.

[Nielske]

Will do, thanks btw

When I get my next blood work in a month I'll post it here.

Sleep study has been planned for next month as well.

As for adrenal fatigue, would an endo be my best bet for helping me determine if its adrenal fatigue or not?

[PeakT]

As for adrenal fatigue, would an endo be my best bet for helping me determine if its adrenal fatigue or not?

Adrenal fatigue is not a legitimate diagnosis for most endos.  You'd have to find an alternative practitioner to help you out.

[PeakT]

Btw, I did a post on tamoxifen and prolactin here:

http://www.peaktestosterone.com/Tamoxifen_Prolactin

Let me know if you have any comments

[Nielske]

Besides the sleep study I'll be looking into getting checked for adrenal fatigue.

As for the prolactin, see the following page/studies for its realtion to acne. I am currently on my third high dosage course of Accutane and if nothing gets beter I'll be on it for a long while or have to deal with cystic acne.

http://www.ncbi.nlm.nih.gov/pubmed?cmd=Retrieve&db=PubMed&list_uids=2764750&dopt=AbstractPlus

http://www.ncbi.nlm.nih.gov/pubmed?cmd=Retrieve&db=PubMed&list_uids=2449020&dopt=AbstractPlus

http://www.acne.org/messageboard/topic/323678-why-prolactin-may-cause-acne/

Now I am really curious about my blood work results next month to see where my prolactin (and other hormones) is at without the Tamoxifen in my blood.

Thanks

[PeakT]

Besides the sleep study I'll be looking into getting checked for adrenal fatigue.

As for the prolactin, see the following page/studies for its realtion to acne. I am currently on my third high dosage course of Accutane and if nothing gets beter I'll be on it for a long while or have to deal with cystic acne.

http://www.ncbi.nlm.nih.gov/pubmed?cmd=Retrieve&db=PubMed&list_uids=2764750&dopt=AbstractPlus

http://www.ncbi.nlm.nih.gov/pubmed?cmd=Retrieve&db=PubMed&list_uids=2449020&dopt=AbstractPlus

http://www.acne.org/messageboard/topic/323678-why-prolactin-may-cause-acne/

Now I am really curious about my blood work results next month to see where my prolactin (and other hormones) is at without the Tamoxifen in my blood.

Thanks

Did you read the other thread on Accutane?

[Nielske]

I have read a thread on Accutane and the effect it has on our whole endocrine system but would mind linking me to it again? All information/help is appreciated

[PeakT]

I have read a thread on Accutane and the effect it has on our whole endocrine system but would mind linking me to it again? All information/help is appreciated

https://www.peaktestosterone.com/forum/index.php?topic=4301.msg35807#msg35807