- 09-23-2009, 07:21 PM
I am a 42 yr old male.I have been on hrt for 12 years 100-200 per week with no hcg.I have a zero sperm count.Dr want me to drop the test and do 12.5 clomid per day for 3 months then recheck.I asked if I could keep doing the test and add hcg at 250-350iu eod for three months.He said no that I had to stop the test.I asked what i could do about zero sex drive and all the other problems it would cause and he I said I would just have to tough it out and he may have to increase the dose and it may take over a year.There has to be a better way.Any help.
- 09-23-2009, 07:38 PM
but ask for modification.
Forget about Clomid.
Keep using testosterone.
Add 400iu-HCG EOD(EveryOtherDay)
After about two months increase to 600iu.
Give another two months time.
Check your sperm (at about 4-6 months) from start.
If you see some sperm but not much
for about 3 months
This is modified protocol that draws some similarity to:
Jan's BloodTest April13/2007
but keep using testosterone.
- 09-23-2009, 08:16 PM
Thanks man.May have to go to my endo for this because the Dr I saw is stuck on using clomid and said the only way would be to stop the test injections.I dont understand that.Am I wrong in thinking I will feel like hell going on the clomid and stoping the test.Dr said my test levels will go down but will come back up on the clomid alone.From what I have read I dont find many guys that do very well with clomid alone.Could you give me any advice on that so I can talk to the dr about it.Thanks
09-23-2009, 11:32 PM
#2, as is you need patch up job.
Clomid would have some (very little) sense if you were not using testosterone at the present time.
Clomid is not going to rebuild your testicles.
Since you are using testosterone (without HCG) you either do not have any testicles at all or they are shriveled, in any case it will take long time, at least a month to bring your testicles to physical size, probably another month or two to start them fully.
Look at the link I posted in previous post, chart there.
That chart advises to use HCG if Clomid does not work.
Another words, it says that HCG works better than Clomid.
Since you are going to be on HCG at that time, you are already on next step.
When you add HCG, your testicles at certain time will start making some testosterone.
It would be a good idea to monitor that process and withdraw some of your injected testosterone.
Your overall goal should be
Using tests from Quest Diagnostics
Estradiol, Ultrasensitive, LC/MS/MS (30289X)
Testosterone, Free, Bio/Total (LC/MS/MS) Code: 14966X
To be fertile assumes that you have produced some testosterone before you went on TRT.
If you are Primary, then that would also apply to sperm.
09-24-2009, 06:42 AM
My test levels at age 30 were 185 total and below normal free levels.At that time I had never taken any test.I also had thyroid problems at the same time and still cant get my meds right for that but thats a another story.Thanks for all the help man!
09-24-2009, 12:14 PM
Thyroid is one of the basics, if you can get it straighten up, good chance that it will help in other areas.
Browse thru my thread here, all five pages, may give you some idea.
From what I see, most people do not have enough TT3.
Have to be TT3>165ng/dL
And end up with high RT3
RT3 must be
To get there one must give up (some) on TT4
But doctors push T4 on them hell or high water (even if it is hidden as Armour)
Jan's BloodTest April13/2007
Post your test results if you want.
09-24-2009, 01:47 PM
The labs I have from 2005-2209 I only had t3 free and tsh done.Tsh levels the lowest was 4.13 in 2005,5.25 2006,4.51 2007,4.73 2007,8.75 2008,most recent 10.506 last month.Only t3 free was last month and it was 2.4 range is2.0-4.9.I have been on 150mcg synthroid the whole time.I have tried cytomel at 10mcg with 150mcg synthroid and could not tolerate ie nervous,heart palp etc.Droped the synthroid and tried 25 mcg cytomel samething as above.I did not stay on this very long ,a week just did not feel right.All the test from 2005-2009 I was only on 150mcg synthroid.As for old test I have one from 1995 tsh 3.15,t4 8.3(4.5-12.0),t3 uptake 37(27-41) I was on no meds at this time.1997 t4 7.2,t3 uptake 38.9,t7 flex 2.8 no meds.2000 t4 total 5.7 ,t3 uptake 34.7,t4 free 2.0 also was on test at this time 270 total test and 1.54 % free and 41.6 free both low.From 1997 to 2004 I used 60mg up to 150mg armour.I had panic disorder started in 1986 and used the whole run of drugs MOAI,kolnpin,prozac.No real problems anymore but I do take 150mg welbutrin per day,just feel better on it more engery,less trigger points,muscle joint stuff.I will say that the cytomel made me feel some panic like along time ago and it sucks.Also BP is high 160/90 has been higher in the past when on armour.I have just switched back to 60mg armour and will get blood work in 2 months.Long post sorry hope you can get something from it.Thanks for all your help.
09-24-2009, 02:07 PM
Also I do take 100mg DHEA but I need to cut back I was at 15.5 and range is 1.9-7.6 that was in 2007 .I now take 50mg but need to get retested.
09-24-2009, 06:45 PM
analyte name, value, units, range, name of laboratory.
Very limited thyroid tests, obviously you have a big thyroid problem as we speak.
You are not able to take CytomelT3 because you must have also bad adrenals.
Adrenals would have to be taken care of first.
Better working adrenals would possibly help with your high bp.
It would be a good idea if you could do my long list of tests, post #44, page #2 between blue lines, here:
Jan's BloodTest April13/2007
There would be some other tests need also, but that latter.
09-24-2009, 07:43 PM
Sorry about the tests.Should I drop the Dhea?I am looking over the tests and will get what I need and then post.Thanks for all the help.
09-24-2009, 08:54 PM
10-06-2009, 03:00 PM
Went to another another urologist and went through the whole thing again.He said it was outside his area being a fertility problem and was not comfortable.A few things that came up.He thought hcg and clomid were the same,I told him and he also looked it up WTF!He does not use test or hrt on anyone and does not like it and feels it will cause cancer which is way over blown.He thinks I should stop everything for 3 months and then test FSH and LH and test levels and get a baseline.I see his point but I have been on hrt for 12 plus years and I was low at the start its not going to get any better,I am 42 years old.He said it does not matter if i feel like crap if I want to get my wife pregnet thats what I should do.I still have to be able to function and what about my sex drive going to hell.I want to go the hcg way and I am going to see my endo on Wed.If I could go back in time I would have checked my LH and FSH levels at the start and would have used hcg the whole time.You go to a urologist all they care about is prostate.Go to a endo and you get a numbers person.SUCKS!
10-06-2009, 10:19 PM
10-07-2009, 06:39 AM
10-07-2009, 11:39 AM
HCG got me from 880k to just over 15 million on my count, ,y wife works for an eye doc, don't know all the details but I would watch clomid. They see people with issues from it all the time.
10-07-2009, 04:45 PM
Would there be a difference with creams, gels, or injections or does it all make you sterile? I thought the gel was worse, but don't know why?
10-07-2009, 07:34 PM
Went back to my reg endo and talked to him about what you said JanSz he is on board 100%.Man my endo is very up to date and willing to work with me.Will start 400iu hcg eod like you said and follow your advice.I will stay on 100mg test cyp per week.I got my E2 and total and free test levels done today before I start.Talked to him about the estrogen levels and will add meds when I need to.I know I need to stay in the 20-29 range on the E2 blood work so when should I retest that level and what else should I look at.I know I have a long road ahead but man I feel good.At the very least I will get my nuts back.Thanks for the help man.
10-07-2009, 08:42 PM
A question on the hcg JanSz.I am getting 10000iu costing around 50 bucks with insurance.Is that a good price?And I want to have a concentration of 400iu per ml so I would need 25ml bac water for 10000iu hcg powder to make 400iu per ml concentration.Thanks
10-07-2009, 09:37 PM
Your future child needs all around healthy father not just a sperm donor.
H stands for Hormones
that is many more than just Testosterone and HCG
you will need
T3 & T4
and (likely) Hydrocortisone (Cortef) or Medrol (methylprednisolone)
Other than low testosterone you have known thyroid problem.
If you can arrange, now is good time to do my long list of tests and make necessary adjustments.
We already know that that is going to be
may be more.
Speaking of 50 bucks
you probably should buy it in the intrest of time.
Keep also scripts with refills, just in case.
one vial will last you 50 days
there are some doubts if after 30 days reconstituted HCG is any good.
You may have to throw away whatewer is left after 30 days.
At ************* you can get 5000iu for $15 or 2000iu for 11.50
5000iu is probably better choice, but buy 6-9 months worth at one time to save shipping cost.
There is a possibility that you may need AI.
Arimidex(pills)(expensive)=Liq uidex(liqud)=Anastrozol(liquid )(even less $)
I do not have good info, lets start with something, make adjustments latter when you come back with blood tests.
assume EOD schedule,
assume (Test and HCG) shots on one day next day free of shots.
assume 200mg/mL testosterone enanthate or cypionate
use only these needles
BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle--1/2 Unit Markings 100/b
For first HCG, assume 10000iu powder diluted with 5mL diluetant that came with powder.
You will need one 3-5-10mL syringe with needle
10000iu/5mL=2000iu/mL HCG solution
0.2cc=20units=400iu-----(fits into 3/10cc syringe, that have 30 units capacity)
If, eventually you buy 5000iu, you will need syringe for mixing
When I was using 2000iu, I would not buy separate syringe.
I would use my 3/10cc syringes and make 3 trips.
I like 2000iu/mL density
Do all above for three months then do testing.
By then you should be about stabilized and your testis will be back in place.
Here I am thinking
TT, BAT, SHBG, E2 and DHT
and adjustments after ward.
Adrenal and thyroid testing you can do right away.
Why do not you tell what you think of this plan, we will flesh it up some more, latter.
10-07-2009, 09:57 PM
Thats sounds good.I do think of myself as a normal man who needs hrt and other things fixed to.I am trying to put myself in the best place I can to take care of myself so I can take care of my future child.It has been tough to find a good Dr but I have one now.I am on armour 60mg now and Dr wants to test blood in 2months.I do feel better on the armour than synthroid and or t3.Should I use bac water ,I have heard the hcg will last longer.Will get testing done for adrenal now and will get thyroid done in about 6 more weeks. Thanks for all the help.
10-07-2009, 10:23 PM
Powder and liquid.
Whatewer you call that liquid. You are not buying any separate liquid or separate vials, do not go that way.
Make sure that the powder comes in vial.
Unused portion of liquid you will discard, so it does not matter how it is packaged.
Some liquid come in vial, some come in ampoule.
Using syringe, you will transfer (measured part) of the liquid to vial with powder. Do not shake it violently because it foams easily.
Stirr gently, so all powder is diluted.
Store in refrigirator.
Buying from *************,
do not buy 10000iu
if you buy 5000iu, make sure that picture shows vial.
From what I see now, the liquid part comes in ampolues.
Smaller, 2000iu, 1500iu or 1000iu
you do not worry if there is a vial or not.
If both are in ampoules, you will transfer all to syringes at the time of mixing.
You should do at least some adrenal/thyroid testing.
If you could do my long list, it contains about all that you will need for good start.
If you are feeling better on Armour than on Synthroid,
it would be a good idea to know that
you have good amounts of
there is more.
10-07-2009, 10:50 PM
My ferritin on 9/15/09 was 197 range 20-300.A question off subject my GFR is always on the low side 4 readings in 3 years 60,67,74,67 Is this from low thyroid,I have read that it can cause this because of vascular resistance and that will also raise BP.Any ideas?
10-07-2009, 11:09 PM
Not really sure how to help in this.
Possibly someone will chime in.
Glomerular Filtration Rate, Estimated (eGFR)
Table 2. Classification of Chronic Kidney Disease and Clinical Action Plans
eGFR (mL/min/1.73m2) 60-89
stage 2 Kidney damage
with mild ↓ eGFR
Clinical Action Plan-->Estimating progression
10-08-2009, 06:39 AM
Thanks.I have seen studies where they found people with low thyroid had lower than normal GFR.Also it is fig on body mass and I am 5'10 230 and pretty low BF so I dont know it that might mess up the result.Dr has never said anything about it.
10-08-2009, 11:30 AM
hopefully your eGFR will get better too.
What is your HDL?
However, there was a significant interaction between eGFR and BMI (P < 0.001). In separate models stratified by eGFR category (>or=60, 45 to 59, and 30 to 44 mL/min/1.73 m(2)), greater BMI was associated with a graded increased adjusted odds of low HDL level in each eGFR category
It may be a good idea to read
NKF KDOQI GUIDELINES
Part 5. Evaluation of laboratory measurements for clinical assessment of kidney disease
Guideline 4. Estimation of GFR
Guideline 5. Assessment of Proteinuria
Guideline 6. Markers of Chronic Kidney Disease Other Than Proteinuria
Part 6. Association of level of GFR with complications in adults
Guideline 7. Association of Level of GFR With Hypertension
Guideline 8. Association of Level of GFR With Anemia
Guideline 9. Association of Level of GFR With Nutritional Status
Guideline 10. Association of Level of GFR With Bone Disease and Disorders of Calcium and Phosphorus Metabolism
Guideline 11. Association of Level of GFR With Neuropathy
Guideline 12. Association of Level of GFR With Indices of Functioning and Well-Being
10-08-2009, 01:06 PM
Just checking to see if I am invisible to people on this board, quote me if you can see this. Thanks
10-08-2009, 02:30 PM
Thanks for the info.Ouestion on hcg brands.My pharm got in 10000iu novarel and it is 77 bucks higher than they said.Allday chem has hucog 2000 and ferigyn 5000 both good prices which one should I go with.My hdl has always been between 38-48.My ldl has been high at times 126-167 and my trig have always been high 200-300 range.I follow your thinking and I also feel when I get my thyroid sorted out my GFR will go up.I dont think I have kidney problems,Dr has never been concerned.I do have high BP 160/80 to 165/90 I have always wanted to get it down by fixing the problem not just doing the meds.I have used Benicar 20mg the plain one not with hct.It has helped by do get some sides.What do you think.Thanks
10-08-2009, 03:01 PM
17181X - ALDOSTERONE,LC/MS/MS
11316X - POTASSIUM W/OCREAT 24HR U
10537T - RENIN ACTIVITY,PLASMA
11317X - SODIUM W/O CREAT,24-HR UR
Post results here.
10-08-2009, 03:11 PM
10-08-2009, 03:26 PM
Injectable tends to raise E2, specially when used infrequently.
Transdermal tends to raise DHT
Transdermal tends to not work in people with thyroid problems.
Either way, after a time testicles get shutdown if they are not supported by HCG.
Testosterone should always be used with HCG.
Actually HCG should be introduced first.
In healthy testicles when (LH/FSH) signal is blocked
it can be replaced by 306iu/EOD HCG (per research)
By some sources, testicle can be induced to produce up to about 140% of their nominal capacity at the time.
That translate to a usefull range
(250 - 750)iu
HCG shots on EOD schedule
I derived that value based on available research, it is in one of my posts on:
Testicles are induced to their production by LH & FSH
HCG replaces only LH
When attempting fertilization, HCG may not be sufficient, usually HMG is then added.
Use HMG 75iu/EOD for at least 3 months before expecting results.
When using testosterone supplementation
try to maximize natural production first
add missing testosterone.
Observe BAT and aim at upper 1/4 range or just a top range.
Quest Diagnostics test
Testosterone, Free, Bio/Total (LC/MS/MS) Code: 14966X
is relatively reliable way of finding BAT
Per that test aim at BAT~575
If that test is not available, I prefer to abandon testing for BAT.
Instead find TT & SHBG using any laboratory,
use dr Vermulen's chart
Using that chart "acceptable" values are
aim at 300-375
10-08-2009, 03:35 PM
10-09-2009, 07:55 AM
The neddles you told me to use were right on the money.I have know guys that would back fill the BD neddles but they were using a full cc.Started this morning 400iu hcg eod and test cyp 200mg ml taking .2 eod.Everything was perfect.I have been injectind for a long time but you can always learn something new.Thanks
10-09-2009, 08:27 PM
10-10-2009, 10:18 PM
might want to find a male fertility specialist.
I recently had the same problem. I had used Test with HCG and Arimidex briefly 4 months or so. When we decided to get pregnant i quit that protocol, but contimued using HGH every day.
After 6 months or so, still no baby. Went and had a semen analysis, and i was low. Went to a male fertility specialist. These are not very common. I live in a city of over 1 million and there is only 1 in my area. Anyway, i went to see him, and he told me to stop the GH, and any vitamins which had herbals in them. Said only to use vitamins without any of the herbals. Something like a Centrum. I also have a varicocele which he said i would have to have fixed before he would recommend In Vitro or other lab assisted fertilization. He told me to think about. I chose to quit the GH and vitamins and give it a few months. 4 months ago i went back for another semen analysis (fun huh). got my results and waited to hear from the Dr. I didnt understand the results the lab sent, since it was different measurements than my first test. A day or two later i walked in the door, and my wife was crying saying she was pregnant! The same day, i called the Dr. to ask for my results and told the secretary, to tell him we were pregnant. He called that afternoon and told me Congrats and that my numbers were mucch better. Said i had a few slow swimmers, but overall, not bad.
We are at 14 weeks now, and the baby is doing great and ive resumed my TRT. Anyway, it may behoove you to find an expert. Someone who has actually done a fellowship in male fertility. Not just a urologist who dabbles in it. Ask to see his CV.
Im not sure what the deal was and even if there was a culprit. I could have just had a bad day on my 1st test, which the doc said was possible.
I agree your baby needs a healthy father, but, you have to get the baby 1st. I dont think any Dr., Anti-aging, or otherwise is going to recommend you stay on Test. You can always resume treatment when your wife gets pregnant. I havent felt great and had low libido the past year, but im gettting back on the program now. I dont think its wise to piecemeal advise from various doctors and people on internet message boards and hope it works.
Anyway, good luck.
10-11-2009, 05:47 AM
Thanks for the info.I did see the fertility clinic with my wife and the urologist in that group is a male fertility specialist.I went back to my endo who does work with this problem and has had very good outcomes using the treatment I am using.This is one of the things my endo is a specialist in.Thanks for the help.
10-14-2009, 07:20 PM
Got some labs back.Was on 100mg test cyp per week 1 shot.Total test 648,Free 118,E2 44.I have started the hcg 400iueod and test cyp 200mg per ml strength at .2 eod.Would taking .5 arimedex 2x per week help the e levels.
10-14-2009, 11:16 PM
unless your current E2 bothers you, it may be a good idea to wait with Arimidex.
Next time when you do testing, do it at Quest Diagnostics, these tests:
43 --------- Estradiol, Ultrasensitive, LC/MS/MS (30289X)
44 --------- Estrogens, Fractionated, LC/MS/MS (36742X)
45 --------- Testosterone, Free, Bio/Total (LC/MS/MS) Code: 14966X
46 --------- Dihydrotestosterone
47 --------- 3a-Androstanediol Glucuronide
10-15-2009, 02:34 AM
Will the hcg raise my e levels?I do feel some problems at this e level,mostly sex drive.Would .5mg 2x per week arimidex push my levels to low?
10-15-2009, 02:16 PM
Having long term steady schedule helps immensly but you still are left with big problem.
It is very important to have EOD schedule, or even ED, that will make measurements (blood tests) more reliable.
Symptoms are similar when your E2 is to high or too low.
So it is very hard to go by obserwations, it is 10x harder to make correct bets about E2 status when on new procedure.
New procedure requires at least ~6 weeks to stabilize.
If you go and take a blood test now, by the time you get the results your levels will be different any how.
Personally, I would try to tough out sex problems, possibly 20mg Cialis pill EOD or (better) split in half and take evey day.
I would only consider Arimidex if you see/feel developing breast problems.
If you would go to fertility doctor, they would refuse to discuss your E2 or ability to have natural erections.
Will give you penis ring or CaverJet injection and they would think that they did their job.
10-19-2009, 09:11 PM
JanSz I am going to get 4 sample saliva test done for adrenals.Is there anything I should not take or do on the day I do the test?I take 50mg DHEA a day.Should I not take that on the day I test?Thanks
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