36, TT 274, ~400 2 years ago, started TRT 4 weeks ago
03-23-2011 02:08 AM
36, TT 274, ~400 2 years ago, started TRT 4 weeks ago
I know there has probably been numerous threads posted like this... and I just found this forum tonight and have been reading voraciously. However, I figured it couldn't hurt to tell my story and see what people think. I'm not asking for everyone to answer all my questions... but I have just started my trip down the rabbit hole and have much to learn... so I'll learn while I communicate with folks. So much to read, so little time to second guess possibly bad decisions a month ago... *sigh*
My primary care physician says I have hypogonadism. He's probably right, but it is not a satisfying answer in and of itself. I want to know the hows & whys. I want to know if it is primary, secondary, what are my alternatives to TRT, etc.
Some history... I'm 36, no steroid history, been healthy, etc. I've seen mention of low cholesterol levels on here, so I'll throw that out... 2/2011 - HDL 34, LDL 84. 2/2010 HDL 23, LDL 83
Around December of '08 I was in a relationship where I had some very mild symptoms of erectile dysfunction. Basically, with a condom I had no problem getting there, but couldn't really sustain. So, I complained to my doc. He ordered a blood test to check for total testosterone. At that time, my testosterone level was around 370. Erections never really were like they used to be after that.
Fast forward to Oct 2010, and I was yet again in a relationship where there were some issues. Before entering into this relationship I had basically decided I was happy being single after the last train wreck and the amount of stress I was dealing with at work. So... I guess I thought my mind said I was happy being alone, but perhaps it was really my low drive due to below average testosterone for a 36 year old. Anyway, in Dec 2010, I again complained to my doctor about ED issues in this relationship. He scheduled another testosterone blood test in addition to the standard stuff... 2/2011 it came back TT 274. On the followup visit about 6 weeks ago, he informed me he thought I had hypogonadism. He recommended several options.
The options were: Testosterone cipionate (sp?) injections, the usual patches/creams, told me about a local compounding pharmacy, etc.
So, I started doing some reading. For the last two years I was extremely stressed at work, my memory was failing, was lethargic/fatigued all the time, etc. Mild cases of depression, and I think I would call a nervous breakdown around March of 09 due to stress at work. After reading that low testosterone could cause or make worse all of those things, I was eager to get started.... so on 2/18/2011 I went for my first injection. It was weekly for the next four weeks...
I freaking felt great! I felt I was on top of my game again... My memory, concentration, energy, focus, and enthusiasm about life was back again. Now I am 10 days into my last injection, and I can feel it wearing off again. Next injection due in two days. For a week after the injection, erections are like I'm 18 again... which is great. Morning wood, etc.
Now... after the amount of reading I have been doing, I am questioning whether I acted too fast. I am feeling like I am now trapped into this whether I like it or not... I like the return to normalcy, but feel trapped now.
My concerns are:
a) he didn't tell me about the sterility problem... I'm not in a relationship now, but that doesn't mean I won't want kids someday. Convenient not to tell me about the risks... How reversible is this? Is 60 days of TRT difficult to reverse? I think my boys are already shrinking away... which he didn't tell me about either.
b) Should we have done more testing before making a decision?
c) once I'm on this stuff, I hear it is VERY difficult to get off due to the testes/pituitary shutting down, possibly permanently.
If anyone has any insight on my three concerns above, I'd appreciate it. I know the information is here, and I am reading steadily, but it's a bit much to take in all at once...
The worst part is knowing that I need more than just food, water, and oxygen now to survive... I've always been a bit of a loner/survivalist type and it is difficult knowing that I am a vial of testosterone away from a thriving life.
Thanks all for any advice you can offer.
03-23-2011 02:42 AM
First of all welcome :-).
Now onto the fun stuff. Tons of things can affect ur hypogondal axis. But I'm not one who really cares if its primary or secondary. Here is why I say that. Eventually most all of us are going to be candidates for TRT. So I say bring on the test lol.. Some will disagree but again I could care less.
I'm not a fan on injections for trt unless u can do them weekly with HCG alongside it. To me that is the best way to run test cyp for trt..
I personally prefer transdermals like androgel or testim. U apply the gel daily after a shower and keep ur test levels at the top of the normal range forever. Plus androgel is DHT based so it helps greatly with sexual dysfunction.
Low test is not the end of the world and not something I would get excited about if u have options for trt as u do.
Embrace having test levels of an 18-21 yr old for the rest of ur life. If u can't get weekly injections u may wish to look at something like the transdermals unless ur insurance doesn't cover very well. Then injections may be the better route. Strive to get HCG alongside ur test. Ur nutz will stay full and u should have less ups and Downs..
Hope this helps a little. I'm sure many more guys will chime in..
For what its worth. I'm an old school juicer who now is on trt using androgel daily at 10 grams and keeping overall test levels 900-1500. With my bioavailable and free above the top of the normal range. I feel better than ever at 36 hormonally that is.
Originally Posted by Arnold Schwarzenegger
03-23-2011 03:00 AM
i will only say if you need trt, which you prolly do so i wont go into life style etc to see if thats the cause, embrace it brother. do you want to go back to feeling like you did 6 weeks ago? you will feel much better doing more frequent injections. i inj 2x weekly others do weekly or every 5-6 days. you and your dr will get it nailed down in time so be patient. some people like the creams/gels as pump does above and others injections. i prefer inj. my t levels are similar to pumps and at 42 i feel freakin awesome
03-23-2011 03:12 AM
Don't get me wrong... I felt great for the four weeks I was getting weekly injections. I'm not so worried about the lag right now, as I think my doctor would work with me on lower dosage but more frequent injections...
What bothers me is the thinking that I may have rushed into this, and the fact that there is no turning back. I'll talk to my primary and the urologist I am going to see in a couple weeks about the HCG. As many have seem to have mentioned before, I'm not sure they'll go for it, but I'll try.
Also, I failed to mention above, there is a fourth concern. He didn't seem too hot on the idea of me self injecting. If I'm going to be stuck on this forever, I don't want to have to schedule a doctor appointment in a far off town just because I want to take a 2 week road trip... Or drive the 90 minutes roundtrip to the doctor's office every week (I live in the sticks). I'm willing to go in and learn, and demonstrate ability to inject myself... but they didn't seem hot on the idea.
03-23-2011 03:18 AM
i assume you are referring to your pcp. you may want to look into an endo or uro if they are unwilling to work with you.
if you feel you rushed into this then you probably did because its your mind that has to be made up. look if it makes you feel any better you can always come off with a proper pct especially since you have just started. so if you think you need to step back and do some more research have your dr give you a months worth of clomid and grab some other pct products and run a pct.
03-23-2011 04:01 AM
Sorry.... not familiar with the abreviation... PCT?
yes, it's my PCP, primary care physician that started me on this path. You're right, I knew something was wrong... and when I correlated my last two years with the list of symptoms, I was eager to get my life back on track. But, I'm worried about things like sterility, etc. I've heard that it is pretty much permanent, and then I've heard about guys on here after years of HRT fathering... so I just don't know what to believe right now. I'm not stopping immediately... I will continue through the next 7 weeks or so, then more blood work. I'm just stressed about learning as much as I can as quick as I can so that I feel comfortable that I am doing the right thing... down the rabbit hole I go!
Anyway, I have an appointment with a urologist in a couple weeks, and then a endo in May. With all the bad reports of experiences with doctors on here though, I think it will be a long search to find the right one.
03-23-2011 04:05 AM
Nevermind... just googled around for PCT - Post Cycle Therapy.
Thanks for the advice. I may think about it. Wish my primary would have told me about the sterility side of things... I mean, a 36 year old with no kids? Did he not think that may be a consideration?
03-23-2011 04:24 AM
good luck with whatever you decide to do. but honestly i wouldnt get too stressed about it.
although if you feel that you are likely to come off id get some hcg in the mix. in the mean time relax and enjoy feeling young again
03-23-2011 07:21 AM
I would try to isolate the cause to as to why your levels are low them seeing if fixing the root cause of the problem would correct your symptoms. Many guys venture into trt will out looking at the simple things first. If imbalances are found and corrected then levels can increase with in a month or so. So many guys are on trt and have either new symptoms or original ones never resolved. As I tell patients some time taking the short path ends up being the longest one. Again there are several variables to deal with and long case history would be needed to even know where to begin. Moral is to many guys jump the gun and end up on trt thinking it's testoerone is the root cauE but in the end they shot them self in the foot
04-13-2011 11:33 PM
Well, saw a urologist who claims to have ~500 patients in the area on TRT. I wasn't too impressed with him, but I did find some useful information from him and some directions to go... I told him I was simply fact finding now... and would continue to see my primary doc for TRT while I learn.
My primary doc had laid out this plan:
200mg/wk for 4 weeks
200mg every other week for 8 weeks
Then... get this... 200mg/month then on.
The urologist rightly said that was crazy, and he thought too low a dosage. So, I had him send his recommendations to my primary doc. Had an appt with my primary today, and was very pleased on leaving. He is no expert on this, which he readily admitted, and I seem to have information he wasn't aware of... however, he is very open to reading journal papers, etc. that I bring to him and is receptive to getting consults from other docs that I consult. For right now, I think having a primary doc who is intrigued by the information I present to him is half the battle. When you're fighting to get more than a 15 minute meeting with your doc, and he is actually interested and spends 45 minutes while people are waiting, that is to me a good sign even if he is not an expert. I have piqued his interest in this and I think he's onboard with anything relevant I bring him. In the meantime, I need to find someone in the area who is an expert... gonna be tough to get good info though.
So, here is the 8 wk plan...
150/wk test cyp injections, with a semen analysis in the meantime.
When I insisted on lab work last week, I asked them to test testosterone levels and estrodiol. My numbers came in at 204 (at the end of a 200mg 2 week cycle) and estrodiol was around 25. I didn't write down the exact number. With test this low, should estradiol be in that range?
Anyway... it's a short term plan. Also the urologist suggested getting off test cyp after 3-6 months and see what happens. He said he's had some rebound and stay off for up to 4 years. This is the first i've heard of this... and he warned me that I would crash and burn for a while, but especially with the sterility concern he said probably closer to the 3 month mark...
So, my questions are I guess:
1) Is anyone surprised that my test level was 204 after a 2 wk 200 mg shot?
2) Would anyone be concerned about that estradiol level with a test level of 204?
3) Has anyone else heard of this strategy to quit TRT to see if there is a rebound effect? He said there is a possibility of clomid during the withdraw, and also he has people take DHEA during.
4) I think my primary doc will be open to clomid also when test is withdrawn. What do folks think about this? Is my thinking correct that this should be tried when test is withdrawn?
So much to learn...
04-13-2011 11:45 PM
Also, has anyone here discussed the effect of low zinc on testosterone and sperm production? I have a reference study if it hasn't been discussed here before. Sorry, it's all I can do to read what I have. I'll search in a bit...
Anyone try taking zinc? Did it improve things?
04-13-2011 11:46 PM
And another question... I read that flax seed can have a lowering effect on estrodiol. Anyone else look into that?
04-14-2011 06:20 AM
dude you need a new dr.
as for the test levels. when you say 200mg for 2 weeks do you mean 200 each week or 200 on one inj then tested 14 days later. that would make a huge difference. generally speaking a 200mg inj should spike blood levels to ~1800ng the following day and fall from there
04-14-2011 07:34 AM
good call. For those of you who do large injections on a once every 2 week period, isnt it a pretty big rollercoaster ride for those 2 weeks?
Originally Posted by ambulldog
04-14-2011 08:16 AM
You need a new dr other wise you are going to cause other things to go out of balance (adrenal and thyroid). I have seen this happen in many dr's patients i have worked with from incompetent drs. It can take months to get them back to feeling well and other imbalances corrected
Originally Posted by MakaveliThaDon
04-14-2011 08:26 AM
Originally Posted by Fletcher
100 mg per week dude, can you inject yourself? just split the injects
200 mg and then a measurement at the end of 2 weeks may give a level of 200 yes, that's when it has worn out
estradiol 25 may be what you had at the time of the t level measurement of 200? you need to retest after 4 weeks on 100 mg per week and test on thursday morning if you take shot on monday, and do e2 with it
zinc is good but not strong enough for TRT, but helps with immune system and sperm production
flax seed forget it
indolplex dim is a good option for lowering e2, start with 100 mg a week and take 2 indolplex dim tabs a day and see how you improve
adrenals: cortisol 4x saliva and if possible 24 hours urine test
additional: shbg, free/bio available t, vitamin d, iodine
vitamins: you probably lacking, get dr schulze's superfood plus or energy revitalization system from enzymatic therapy
good luck dude
04-14-2011 04:33 PM
Three months to get in to an endo around here... for now, I'm just doing what I can.
Originally Posted by ambulldog
Originally Posted by ambulldog
I mean 200 injection... then 14 days later blood was drawn. I was getting 200 every two weeks and it wasn't cutting it. I hear a lot of guys are happy with 150/wk which is the current plan.
04-14-2011 04:37 PM
Haven't found a doc that will go along with the self injection route... If I could, I would have already.
Originally Posted by cumkwakka
yes... estradiol was taken at the same time as the results for test which came in at 204.
Thanks for the other suggestions. Anyone have a recommendation on how to find a good doc? Doesn't seem to be any around me... I'm willing to drive/fly and pay.
04-14-2011 05:04 PM
Originally Posted by Fletcher
none would you let you self inject? That would seemingly pretty inconvenient to try and make a bi weekly doctors appt for the rest of your life. Was he responsive in a weekly dosage protocol?
I only ask because I'm talking to my doc atm, and he thinks once a week is the most anyone should inject, never mulitple injects a week. But I don't want to schedule a dr appt every week for the rest of my life, I'd like it to be something I can do on my own.
04-14-2011 05:26 PM
Im on 200mg every 2 weeks and its hell! Have apointment next month and if he wont change it im gonna quit and tell him thanks for nothing. Week 2 is sleepy, no energy, no libido etc. I would rather feel like sh*t all the time then feel good one week and crap the next.
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