Looks like pituitary is primary - Trt or hcg/clomid?

[oliverduke]

Background
Male, 22yo, train 5 days a week 1-2 hours.

Low test symptoms
-low labido, tiredness, brain fog.

Underlying possible causes
- traumatic brain injury at 13, but since then I have gone through puberty (which suggests post head injury I was okay)
- one PH cycle two years ago, felt like I recovered fine and did have symptoms before but could of made issue worse.

As bloods show, my pituatory isn't functioning for what ever reason, I also seem to have an under active thyroid although TSH is normal, t3/t4 are low. My diet contains no iodine salt but I do take a multi vit that contains 250mcg.

Iv seen one endo says Trt is the only option, and another that said maybe low Trt to boost T and hcg to remain fertile.
It should be noted my sgbh is on the lower side and estrogen seems middle range?

Thanks for any help

 

[oliverduke]

 

[oliverduke]

noone?

 

[edmassa]

If I were you I would try taking some clomid for your testosterone levels. Maybe 50mg a day for a few months and see where that gets you. You can also try some high dose iodine supplements like iodoral see if that affects your numbers. I would avoid trt it's a hassle and a last resort

 

[oliverduke]

yeh thats my plan, what about hcg pre clomid?

 

[edmassa]

You know I was just thinking about that. Someone with more knowledge will add in. I know hcg by itself is suppressive. A typical restart protocol would be
500iu hcg eod for a few weeks followed by 50mg clomid and 20mg nolvadex ed for a few more weeks. At least that's what I have gathered in my research about coming off trt

 

[oliverduke]

thanks, will see what others have to say

 

[oliverduke]

Just saw my endo today...

Hes said that its probably due to training and that because i look healthy the tiredness/labido is due to that even though my test is rock bottom, he said that would be from training but then went on to say dont worry about training less...

so confused and deflated

 

[SF1025]

If I were you I would exhaust all other avenues before I jumped on trt for life here is a protocol i used for coming off a 3 1/2 year blast and cruise so take it for what it's worth..... I pin 1000iu of hcg for 10days then I start 250iu of hcg for 2weeks the day after discontinuing the hcg I take a 100mcg shot of triptorelin I wait 3 days and take 100mcg triptorelin once more (from the start of my hcg until I begin toremifene I take .5mg anastrozole 5 days a week) I then begin 25mg clomid and 60mg torem a day for 6 weeks....before blasting and cruising my test levels were in the mid 200's and when I did this protocol it went to 740ish immediately following the pct and I tested 4 months post pct and my levels were 820ish....if I were you I'd also get a thyroid complex supplement and something for your adrenals

 

[oliverduke]

Tempted to run clomid and get re tested...

Worried about doing it without supervision thought incase estro rises high :/

 

[RecompMan]

Tempted to run clomid and get re tested... Worried about doing it without supervision thought incase estro rises high :/

HCG monotherapy then clomid is what I've seen people do

 

[oliverduke]

HCG monotherapy then clomid is what I've seen people do

I think my testes are fine to output the test, there just not getting any signal to...

 

[oliverduke]

HCG monotherapy then clomid is what I've seen people do

I think my testes are fine to output the test, there just not getting any signal to...

 

[oliverduke]

any other opinions?

2 years of feeling tired/not quite right with low labido... GP does bloods, low T > Refers to endo

First endo, talks through head injury + past PH cycle. Decides its head related and suggests TRT solo gel's + MRI to rule out tumour etc...

Second opinion (higher up in terms of qualifications) - Conducts more bloods to rule out other issues, but bloods come back the same, poor pituitary output etc but decides not to treat and to leave it and says the following :- I can maintain erection, my sperm count is good - therefore he doesn't think my low T is worth treating (Even though its 4-9nmol).


So now I'm stuck between two opinions.
Endo 1 - My T is too low and its causing my tiredness/labido issues and that TRT is best option, and that its probably from my head injury.
Endo 2 - My T is low, but I'm functioning fine so leave it - Because my tissues are working (sperm count + muscle mass) TRT probably isn't worth it and I should carry on as normal and that overtraining may be causing my issues/symptoms not the low T.


My own perspective.
I believe the head injury is most likely the sole cause, my tiredness/labido issues have been since i can remember, but I'm not denying training would possibly make me more tired, but i don't think thats lowering my T that much.
Although i could carry on with life as is, my sleep is often lacking in quality even though i take all the steps i can to make it good (no caffeine, bed by 10pm etc etc) it still does not improve.
The lack of labido effects my current relationship. (Although yes i can maintain erection, but no morning wood)


Maybe i am just chasing numbers? but I don't think my numbers are even close to borderline acceptable that Im in a position to just leave it?