VARICOCELE...can it effect testosterone?

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    Quote Originally Posted by Megazoid
    Strangely i had my varicocele for about 6 months too and it caused all manner of problems, in a sentence, my nut's went nut's!

    When i went on Androgel i felt pretty good. I had a strange reaction though with my skin (Rash) and not to mention my HPTA still kicking about. I didn't get any shutdown and my total T went back up to 25.1 and my LH/FSH still remained in a very normal (if not 'highish') range. I was getting good benefits from TRT but i didn't like the fact that i was flushing alot and the skin reactions. Otherwise i did notice erection improvements and morning wood more often. My penis also plumped back out to it's normal size and wasn't shrunk up (not sure if you are experiencing this also?).

    The problem with TRT is that your nut sack get's like ultra tight all the time and if you have a varicocele it can hurt like hell.

    If i am doing TRT again i will be using HCG to promote testicular size and health improvements and to prevent the tight sack thing.

    In general are your testicles normal size (2+ inches)? Do they feel different at all (weight, size, density, etc)?

    How large is the varicocele (roughly)?

    Was your LH around 3/4 (this is considered the "normal level", 2 or below isn't normal)?

    I am considering running either Test E + HCG (2/3 times a week) or Testim/Androgel + HCG (3 times a week or more).

    Like you i want my natural levels back but this might not be fully possible unless given time so i need to compensate.
    Ok, I found my blood work...my LH was 2.8 and FSH 3.2 and I even got prolactin which was 9.5 (normal)
    The varicocele is pretty big and it seems like its getting bigger all the time. The right side was good before but within the last week, I noticed some dilation there too. I hopt im not getting one on the right side. To be honest I think my varicocele was caused by pro hormone use. The reason I think this is because when my body started to recover after the last cycle, it did it really fast and the valves in my nuts didnt have time to open. I dont know if this is the case but its just a theory. Another thing that I think could have caused it is ROS (reactive oxygen species) and that is a toxic by product of nitric oxide. I was using No2 type products for about a year straight without taking anything to fight the free radical build up. I did some research and found that ROS is one of the causes of Varicoceles! To answer your question do you mean Is each nut 2-2 1/2 inches? For the week that I was on TRT I felt like crap (even worse than before) I think that only 5g of andro gel is only going to get you to the 300 range, which I was already in, so i think that i actually need more like 10g of andro gel. Im going back to the urologist this morning and I pray to God that he can do something for me because I have never been this depressed in my whole life.

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    I can relate 110% with you Hyde, this is an absolute nightmare and i wish it would stop too. Depression is the right word to use, my body is in a shambles because of 6 months of suffering from this low t (or "low normal" t). Did you run HCG/Clomid end of cycle?

    I can assure you when i find the answers i will let you know but i have been researching like hell for the past 5/6 months trying to find suitable ways of treating this and coming up with very little except that many guy's with varicoceles (fixed or not) still have low t later on in life. You didn't tell me your age or your previous results before the varicocele did damage?

    My problem is that my right testicle was already atrophied and dysfunctional from being undescended so i was relying on the one and when that atrophied too i knew i would be stumped and in for trouble.

    Your LH is rather low to be honest. 3.9 is the "normal" level that most guy's have. However the low LH might be a good sign for you as no damage has been done to the leydig cells most likely.

    How is your E2? Low E2 can cause problems like high E2 and more to the point cause "more" problems for guy's like us because low e2 causes blood flow issue as well as sperm production issues.

    Being honest with you i don't think the varicocele is your only worry, i feel your piturity hasn't been restarted properly because your LH/FSH should be higher. This might explain the atrophy too. Have you tried running HCG/Clomid to restart fully and recover from the atrophy?

    Alot of guy's can have varicoceles for literally years (even bi-laterial) and have no problems, so i have really started to question why this happened to me. I believe a domino effect occurs in some cases (like mine) and i praying that HCG is the answer (and hopefully for you too).

    Varicoceles cannot start large, they always start really small, mine was undetectable to start with. When i got the operation for mine i seen it on the monitor and it looked like a tentacle coming down from my kidney! It messess the veins up high up so in turn your theory could be right about ROS.

    I have an appointment with a urologist to check that this operation has worked because i am not 100% convinced. I am getting new blood work done next week to check my current levels. I think they are about the same as before.

    The fact you have noticed problems on the right side is pointing more towards my own theory. Low T and low E2 in turn effect blood flow around the body (slow it down somewhat) when the ratio is effected this might explain why i got atrophy and why you might be getting another varicocele. I actually noticed my nut's felt alot better when on androgel and i wasn't getting atrophy that i could notice. Maybe it helped blood flow by raising my total up to 25nmol (about 650/700)?

    Maybe we can deal with this together? I am sure the both of us can figure this out. I am seriously thinking about either running HCG daily (250iu daily) alongside Testim at either 5 or 10mg to see how i get on for a few months. I want to try and get back nut size and reap the benefits of TRT until my nut's come back to normal size. I considered running HCG alone but my fear is that it will cause shutdown and 250 might be enough to keep my t up throughout the day. I might try this for a few months till my nut's recover.

    Part of me think's my right nut is still working somewhat but i had a very small varicocele on it about 2 year's ago and it went away on it's own. I am going to get this checked and my other testicle to make sure the operation has worked. I don't mind if i need another one but would prefer not to of course.

    In the mean time stack up on vit e and c to help the veins and cut out all caffeine based drinks and alcholol, these will aggrevate the small veins in the testicle and lead to problems. I take Vit e at 800iu daily to prevent leydig cell fibrosis occuring and even put on some Vit E cream onto my scrotum to help.
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    Cool. Thanks for all your help and advice. I got back from the urologist and he gave me 3 options to fix my varicocele. one was a cut to the sack another was to the groin and the last one (the one that sounds the best) was the embolization. He said that I would have to come back and talk to his partner for the embolization because he usually does not do the embolizations but he does the groin cut. He went on to tell me that going in through the groin is a good idea, but you run the risk of getting the artery to the testicle severed and that would ruin that testicle forever. So, I am going to try to get the embolization done because that seems like it has the best reviews. Which procedure did you have done? which one do you recommend? I am 28 years old and I really do not want to have low T for the rest of my life. After my last cycle I made the mistake of only using ATD so it messed up my HPTA. I did use Toremifine for a while and that helped really well for about a week and then it stopped working. If this keeps up im going to get some Proviron. At least I will have a sex drive. I dont think that I suffer from low E2. I think my E2 is high because I am really starting to gain some fat around my lower abs and sides and I feel bloated. Im taking Rebound Reloaded and Dim right now, but neither of those are doing anything. I would be careful if I were you with the HCG because it is not your natural LH and at high doses over long periods of time it can kill the leydig cells and it can convert to estrogen just like androgel. Tormifene seems to be the best thing out there right now and it has been the only thing that has at least worked for a little while with me.
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    This is so strange this came up. I was diagnosed with a varicocele when I was 15. I'm almost 50, so I've had it most of my life.
    But, when the doctor told me it was like, no big deal, it just a varicocele. I ended up going on HRT when I was only 38. I suspect due to my inability to build muscle for the 20 years I had been working out at that time I have always had low test levels.
    No one ever treated it like it was a big deal during any of the hundreds of physicals I have had over the years and no one ever suggested surgery to repair it.
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    Quote Originally Posted by DragonRider
    This is so strange this came up. I was diagnosed with a varicocele when I was 15. I'm almost 50, so I've had it most of my life.
    But, when the doctor told me it was like, no big deal, it just a varicocele. I ended up going on HRT when I was only 38. I suspect due to my inability to build muscle for the 20 years I had been working out at that time I have always had low test levels.
    No one ever treated it like it was a big deal during any of the hundreds of physicals I have had over the years and no one ever suggested surgery to repair it.
    I have been laughed at by doctors too for suggesting that a varicocele will cause low testosterone. I dont understand how they can think otherwise because a varicocele will degrade the testicle and most of your testosterone is produced in the testes so obviously they wont put out the same test as a healthy testicle. The key to getting it fixed is to make sure you tell the doc that it hurts really bad. Mine really does hurt bad. Do you have a large varicocele that can be felt by hand? Those are the worst ones and that is like the one that I have.
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    Sorry for the late reply Hyde, i have been snowed under with house work and decorating (of all things!).

    Basically the veins from the testicle run down from your left kidney/adrenal to your testicle which put's it at risk from toxic by products (hence why the blood supply needs to be functional and your T optimized for best effect).

    You might notice some guy's who are secondary experience increases in testicular size without HCG this could be todo with the improved cardiovascular function as well as the fact that estridol and T/E ratio is very important for sperm production and in turn testicular function (i have low E2 which could cause sperm production problems in itself). HCG might be the answer but i want to get the blood flow evaluated on ultrasound to fully rule out any testicular problems.

    The problem is that when a varicocele occurs on the left testicle it tends to work it's way up towards the kidney so you end up with a tentacle size vein strangulated and wirey all the way up to your kidney (hence why the varicocele get's bigger and bigger). Varicocele embolization tends to mean "plugging" the vein at kidney level to stop blood going down that way and being redirected to healthy veins. For me this removed the varicocele in my sack and the vein seemed to die off, however i am not 100% convinced the operation has worked and going back to see my urologist to find out if it might be worth entering the scrotum and tying the vein off to be sure NOTHING can be flowing around in there and giving the testicle a chance at least to work well. Maybe he can put in more coils or something. I will keep you posted on my progress.

    I recommend the varicocele embolization for relief of varicocele pain and discomfort but i cannot confirm if i have noticed an increase in testosterone or sperm production since the operation (nor testicular size). My nut's for lack of a better explination are going nut's! My left one is changing size and shape throughout the day and it's causing all manner of problems for me i think. They are basically going from full to atrophied for some reason due to bad blood flow. I believe T/DHT/E have a huge role to play in this too though. Only time we will tell when i run HCG + TRT to see how thing's work out (or try to restart). I am going to get fresh blood work done next week and i will post up before and after blood work.

    The best options to go for regarding varicocele operations are probably in this order:

    Varicocele Embolization
    Microsurgical Varicocelectomy
    Varicocele Ligitation (Scotal)

    Realistcally you are suffering from similar symptoms to a secondary hypogonadism sufferer. Because you LH is low (should be at 3+ to be normal) in theory if you get this back up to 3.9/4 (Which mine is at and i have never done steriods or anything) then you could double you T (roughly) up to about 600. The varicocele WILL cause some degree of leydig cell dysfunction but after this is fixed i am sure you will go back up to 700+ if your HPTA is back and functional (i.e. LH at 4).

    Let me know how you get on and if you have any more questions.
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    Quote Originally Posted by Hyde12
    I have been laughed at by doctors too for suggesting that a varicocele will cause low testosterone. I dont understand how they can think otherwise because a varicocele will degrade the testicle and most of your testosterone is produced in the testes so obviously they wont put out the same test as a healthy testicle. The key to getting it fixed is to make sure you tell the doc that it hurts really bad. Mine really does hurt bad. Do you have a large varicocele that can be felt by hand? Those are the worst ones and that is like the one that I have.
    Very large and obvious, but never hurt.

    Doctors don't have to live with it, so they don't care.
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    Quote Originally Posted by Megazoid
    Sorry for the late reply Hyde, i have been snowed under with house work and decorating (of all things!).

    Basically the veins from the testicle run down from your left kidney/adrenal to your testicle which put's it at risk from toxic by products (hence why the blood supply needs to be functional and your T optimized for best effect).

    You might notice some guy's who are secondary experience increases in testicular size without HCG this could be todo with the improved cardiovascular function as well as the fact that estridol and T/E ratio is very important for sperm production and in turn testicular function (i have low E2 which could cause sperm production problems in itself). HCG might be the answer but i want to get the blood flow evaluated on ultrasound to fully rule out any testicular problems.

    The problem is that when a varicocele occurs on the left testicle it tends to work it's way up towards the kidney so you end up with a tentacle size vein strangulated and wirey all the way up to your kidney (hence why the varicocele get's bigger and bigger). Varicocele embolization tends to mean "plugging" the vein at kidney level to stop blood going down that way and being redirected to healthy veins. For me this removed the varicocele in my sack and the vein seemed to die off, however i am not 100% convinced the operation has worked and going back to see my urologist to find out if it might be worth entering the scrotum and tying the vein off to be sure NOTHING can be flowing around in there and giving the testicle a chance at least to work well. Maybe he can put in more coils or something. I will keep you posted on my progress.

    I recommend the varicocele embolization for relief of varicocele pain and discomfort but i cannot confirm if i have noticed an increase in testosterone or sperm production since the operation (nor testicular size). My nut's for lack of a better explination are going nut's! My left one is changing size and shape throughout the day and it's causing all manner of problems for me i think. They are basically going from full to atrophied for some reason due to bad blood flow. I believe T/DHT/E have a huge role to play in this too though. Only time we will tell when i run HCG + TRT to see how thing's work out (or try to restart). I am going to get fresh blood work done next week and i will post up before and after blood work.

    The best options to go for regarding varicocele operations are probably in this order:

    Varicocele Embolization
    Microsurgical Varicocelectomy
    Varicocele Ligitation (Scotal)

    Realistcally you are suffering from similar symptoms to a secondary hypogonadism sufferer. Because you LH is low (should be at 3+ to be normal) in theory if you get this back up to 3.9/4 (Which mine is at and i have never done steriods or anything) then you could double you T (roughly) up to about 600. The varicocele WILL cause some degree of leydig cell dysfunction but after this is fixed i am sure you will go back up to 700+ if your HPTA is back and functional (i.e. LH at 4).

    Let me know how you get on and if you have any more questions.
    ====================
    Newer done steroid or T supplementation at that time.
    Now I am on Androgel.

    I complained about ED, sore testicles when not using tight panties.
    First test ordered by local doctor, done at LabCorp (7/10/03)
    Testosterone, serum=255 (241-827) ng/dL
    I then went to university hospital,
    there the director of sex health told me that I have varicocele.
    He ordered tests and I done them at local hospital's lab (Jan8/04)
    E2=24 (0-52) pg/mL
    LU=5.7 (1.5-9.3) miu/mL
    Prolactin=7.2 (2.1-17.7) ng/mL
    Testosterone=311 (241-827) ng/dL
    and at Quest Diagnostics
    Free Testosterone (EIA)=6.0(2.6-64.8) pg/mL
    ---------------------------------------------------
    What should have been my best line of action if I could start it from scratch again?
    ---------------------------------
    At this time 7.5gram of Androgel and two pills of DIM+I3C,
    DIM-vise equal to one pill of Indolplex with DIM
    keeps me operating semi-ok.
    My testicles are shrunk and scrotum is tight, but no pain.
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    Quote Originally Posted by JanSz
    ====================
    Newer done steroid or T supplementation at that time.
    Now I am on Androgel.

    I complained about ED, sore testicles when not using tight panties.
    First test ordered by local doctor, done at LabCorp (7/10/03)
    Testosterone, serum=255 (241-827) ng/dL
    I then went to university hospital,
    there the director of sex health told me that I have varicocele.
    He ordered tests and I done them at local hospital's lab (Jan8/04)
    E2=24 (0-52) pg/mL
    LU=5.7 (1.5-9.3) miu/mL
    Prolactin=7.2 (2.1-17.7) ng/mL
    Testosterone=311 (241-827) ng/dL
    and at Quest Diagnostics
    Free Testosterone (EIA)=6.0(2.6-64.8) pg/mL
    ---------------------------------------------------
    What should have been my best line of action if I could start it from scratch again?
    ---------------------------------
    At this time 7.5gram of Androgel and two pills of DIM+I3C,
    DIM-vise equal to one pill of Indolplex with DIM
    keeps me operating semi-ok.
    My testicles are shrunk and scrotum is tight, but no pain.
    I would have gotten the varicocele fixed first and then see how you felt. I dont understand the logic of the Urologists when they say that varicoceles do not affect Testosterone.
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    I am going to be setting up a website highlighting the dangers and being a one-stop-source for varicocele sufferers. Hopefully we can get the message across with time.

    JazSz, it sound's like the varicocele might have been the cause of your low t. However you are an older dude too so it might be a combination of factors. Did you suffer any atrophy at all or were your nut's normal size before you started TRT? How long did you go "suffering" (with the ED/Libido and general Low t) before you went onto TRT?

    In a realistic world i would have got the varicoceles fixed and see how you got on. Even now it might be worth fixing them then trying HCG if your LH/FSH aren't elevated due to testicular failure.

    Why do you say you function "semi-ok" JazSz? I thought you were feeling really good on your TRT plan and were getting erections when you wanted them (is the libido still there?).

    Hyde, would you be up for helping me with the site (moderating the forum, helping out, etc)?
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    Quote Originally Posted by Megazoid
    I am going to be setting up a website highlighting the dangers and being a one-stop-source for varicocele sufferers. Hopefully we can get the message across with time.

    JazSz, it sound's like the varicocele might have been the cause of your low t. However you are an older dude too so it might be a combination of factors. Did you suffer any atrophy at all or were your nut's normal size before you started TRT? How long did you go "suffering" (with the ED/Libido and general Low t) before you went onto TRT?

    In a realistic world i would have got the varicoceles fixed and see how you got on. Even now it might be worth fixing them then trying HCG if your LH/FSH aren't elevated due to testicular failure.

    Why do you say you function "semi-ok" JazSz? I thought you were feeling really good on your TRT plan and were getting erections when you wanted them (is the libido still there?).

    Hyde, would you be up for helping me with the site (moderating the forum, helping out, etc)?
    Yes, most likely the varicocele is a reason for my low T.
    I think my nuts were about the same size as usual, up until I started on Androgel, now small and soft.
    I think my nuts were about right throughout my life.
    One possible exception from normal was, and still is, that my right nut travels up the sack, right before orgasm.
    It is uncomfortable enough that when it happens I have to stop and push it back, so it drops back into sack.
    I had erection problems for about 3 years.
    Now on Androgel it mostly works, underline mostly, not always, and that is with Cialis.
    I never had libido problem, looking at pretty girl works me up, mentally.
    It is quite confusing now, to get erection I need mechanical friction and there is time delay, even when everything works.
    My wife is accustomed to the routine by now, still I have to concentrate a lot on the business at hand,
    any distraction and erection may be gone.
    I guess if I tried with somebody else it may not work unless she was really patient.
    Few minutes ago I made appointment to see my new doctor (osteopath), next Tuesday.
    That will be my second visit with him. His nurse, my dancing friend, said that he want to learn TRT.
    So there is my big chance. I am hoping for change for better when I start HCG.
    My ejaculate is almost non-existing,
    I should probably do the other hormone, FSH, forgot its name, do not know brand names, dose, frequency, details. Somebody fill me in, please.
    I will also ask him for script for Armour Thyroid and Cortef.
    Actually I already ordered Armour over internet an already have Isocort,
    but with the script my prescription plan will get a chance at footing my bills.
    ---------------------------------------------------------
    Wish there was some detailed discussion on GH here.
    Last time I checked my (IGF-1)=120 (75-212) (Sep2/05)
    ------
    01-22-2007, 05:07 PM , Dr John said
    1.35 Mg of GH per day & Igf-1 levels still sub optimal

    Any doctor with much experience will tell you not to chase IGF-1 levels.
    Once you have passed 2IU, what's the use?
    You have to treat the patient, not a laboratory printout.
    We normally produce about 0.5IU of GH per day.
    ---------
    That may be a good starter.
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    HCG is known to improve ejaculate volume but it will result in that thin, watery like ejaculate which isn't too great.

    I am only 23 year's old and also have to really work to get erections. I am not sure if thryoid/adrenals have a role to play int his too though. My thyroid is in the shape with no problems (if anything, i am a little underweight).

    What were your latest labs like JazSz?
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    Quote Originally Posted by Megazoid
    HCG is known to improve ejaculate volume but it will result in that thin, watery like ejaculate which isn't too great.

    I am only 23 year's old and also have to really work to get erections. I am not sure if thryoid/adrenals have a role to play int his too though. My thyroid is in the shape with no problems (if anything, i am a little underweight).

    What were your latest labs like JazSz?
    HCG basicaly replaces missing LH.
    I was taking about Follicle stimulating hormone (FSH).
    Supposedly it works better than HCG, and increases ejaculate volume, something I could use.
    In wikipedia I was able to find:
    Follicle-stimulating hormone - Wikipedia, the free encyclopedia
    "FSH is available mixed with LH in the form of Pergonal, and other more purified forms of urinary gonadotropins as well as in a pure forms as recombinant FSH (Gonal F, Follistim). "
    ------
    If there was discussion on this, FSH, topic, please point me to it.
    I would like to know dose, frequency, product names any other particulars.
    ============================== =============

    I did my last test in Oct/06, at LabCorp, it was a short test.
    As you see I got that useless FreeT, and they skipped SHBG, just so I was not able to do my own calculations. I was on 10grams of Androgel. I have since reduced to 7.5mg, I think it works better. I also take one extra, for the total of two pills of
    LEF version of DIM+I3C. They have two of them, I use this one:
    Dual-Action Cruciferous Vegetable Extract With Resveratrol & Cat's Claw, 60 Vegetarian Capsules
    .
    Total Estrogens------------------------------ ---260 pg/mL (40-115) LEs Optimal Range: 4077 pg/mL
    estrone, serum------------------------------- ----78 pg/mL (12-72)
    Estradiol, sensitive--------------------------- ----27 pg/mL (3-70) LEs Optimal Range: 1030 pg/mL
    Progesterone---------------------------------- ----1.4 ng/dL (0.3-1.2)
    Pregnenolone---------------------------------- ----23 ng/dL (10200) LEs Optimal Range: 100170 ng/dL
    Total Testosterone-------------------------- ---932 ng/dL (241-827) LEs Optimal Range 500827 ng/dL
    Free Testosterone--------------------------- --36.5 pg/mL (6.6-18.1) LEs Optimal Range: 1826.5 pg/mL
    DHT (dihydrotestosterone)--------------- ---226 ng/dL (30-85) LEs Optimal Range: 3050 ng/dL
    prolactin, serum----------------------------- ----4.2 ng/dL (2.1-17.7) LEs Optimal Range: 2.15 ng/mL
    sex hormonebinding globulin (SHBG), serum nmol/L 1371 LEs Optimal Range: Lower part of normal range is desirable
    (TSH)-------------------------- --1.89 uIU/mL (0.350-5.5) LEs Optimal Range: 0.35 to 2.1 mIU/mL TSH good if below 1.5(Gary Field) 1.425
    Free (T3)----------------- --2.9 pg/mL (2.3-4.2) (3.67-4.2)per Crisgj2 =4.3-(4.2-2.3)/3=3.67 3.825 <--FT3 start of upper 25%
    Total T3---------- ---104 ng/dL (85-205) MESO-Rx - View Single Post - For those of you on thyroid medication 3.667 <--FT3 start of upper 33%
    Free T4(direct)--------------- --1.37 ng/dL (0.61-1.76) Top of the FT4 and upper third for FT3 is what I look for 3.350 <--FT3 start of upper 50%
    DHEA Sulfate------------------------------------- ---369 ng/dL (42-290) LEs Optimal Range: 500-640 ug/dL
    Cortisol (7:20)AM --24.2 g/dL (4.3-22.4)
    Cortisol (3:20)PM ----6.9 g/dL (3.1-16.7)
    Hematocrit---------------------------------------- --45.6 % (36-50)
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    Ok, Im getting my varicocele surgery next Thursday. They are going to be doing the one in which they go through the groin. I will keep everyone posted of the outcome. Megazoid, I think the website is a great idea and I would love to help with it. People need to get the truth about these things and not put off the repair because they do effect Testosterone levels.
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    I wish you the best luck with your surgery Hyde and hope get a fast and effective recovery. Because your T is low this will effect your "recovery" time and i would strongly advise topping yourself on some TRT to get into a good 500/700 range so you recover faster. This operation will involve cutting muscle and this will generate at roughly 70% rate in normal t level men. While this will supress your HPTA further, in the long run i feel running TRT + HCG might be the answer after your surgery, this way you can reap the benfits of TRT while helping your balls to heal and grow back. The atrophy IS for the most part

    Your HPTA is not firing out enough signals and you're balls won't be responding well so you should probably do TRT for a few months alongside HCG to get them back working again. After this you can try coming off everything using a post cycle therapy style cycle and restarting properly.
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    Thanks for the reply Dr John.

    The main reason i have had to resort to self-treatment is because doctors are failing to help me in my country and i have spent thosands trying to get proper treatment. I have spent the past 6 months researching the subject of varicoceles and the effects on steriod secreation and testicular dysfunction caused by the varicocele. I am trying to raise awareness of the information i have gained regarding this subject and help others.

    However you are right, i am not in a position to give out information regarding TRT so i will stay out of this one.
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    Dr John, i have a few questions for you which i hope you don't mind me asking.

    1) Have you ever been presented with a patient that has varicocele induced testicular atrophy and normal LH/FSH levels but low T?

    2) Have you ever used HCG on a varicocele sufferer and had good results with regards to improvements in testicular health and size (getting back "normal" testicular size for example)?

    3) Have you ever been able to recover a varicocele suffer into gaining high T levels without TRT, using HCG + PCT style recovery (clomid/nolva)?

    Special thanks for your help and input on this matter.
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    Quote Originally Posted by Dr. John
    As I do sometimes, I'll just insert my responses IN CAPS. Please ignore usual Internet etiquette, as this is not meant as shouting.
    We need more doctors out there like yourself. The Urologists that I've seen told me Varicoceles wont effect T Even though the testicle on the side with the varicocele is Atrophied.
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    Quote Originally Posted by Dr. John
    Can somoene do a seach and look for a proven connection?

    I just know I have seen the association enough times to ignore it. You know, when I hear the same story over and over, I have to take it seriously.

    But even if an association is not proven, the result is the same: repair the variocele, see what happens, and administer TRT if necessary.
    I would say it does effect testosterone level, even the studies against, still say it does raise testosterone after surgery although insignificantly.

    For
    Entrez PubMed
    Entrez PubMed


    Against
    Entrez PubMed
    Entrez PubMed
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    Quote Originally Posted by ItsHectic
    I would say it does effect testosterone level, even the studies against, still say it does raise testosterone after surgery although insignificantly.

    For
    Entrez PubMed
    Entrez PubMed
    Against
    Entrez PubMed
    Entrez PubMed
    43% raise seems like a pretty significant amount to me.
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    Defenetly, but its weird how 2 studies have diffrent views on what should be simple.
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    Quote Originally Posted by ItsHectic View Post
    Defenetly, but its weird how 2 studies have diffrent views on what should be simple.
    I bet the second studies were done using men with minor Varicoceles. I have a level 3 one (the biggest possible)
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    I think in most cases varicoceles cause multi-factorial issues which in turn cause testicular dysfunction. Testosterone and DHT have a role in determining blood flow through the penis and testes, affecting nitric oxide production. Which links back to what Hyde said, so this in turn could explain why my nut's are for lack of a better word, going nut's. Low T in itself effects blood flow around the body and in turn could be the the cause of the atrophy. Low estridol can effect sperm production and 'technically' cause atrophy due to this. I believe high E2 can cause epididyml abnormalities and blockages when E2 is high.

    Androgel (50mg) reduces my LH to 2.2 but brings my total t up to 25/6nmol. Within a few hour's my penis and testicles feel allot more healthy and fuller (for lack of a better word). Which again might back up this theory.

    Some men can go through life having bi-lateral varicoceles and never have atrophy or low testosterone until allot later in life (JazSz being a good example). However the sluggish blood flow caused by the varicocele can cause over-heating and tissue damage to the testicle in the long-term.

    It's important to remember that varicoceles cause, in most cases, permanent damage to the testicle, tissues and cells (leydig included - though they are alot 'tougher' than sperm production tubules). I believe when the testicles atrophy a degree of compression and a tighter area of leydig cells occur which in turn can cause some degree of dysfunction and reduced binding of the LH signals. I guess a kind of 'domino' effect occurs with varicoceles.

    While there is no "average" testosterone level and everyone is different it's assumed that an inter-testicular testosterone level of 23+nmol is required for proper sperm production and transportation, so i guess when your T goes low this might explain the atrophy too. Low E2 can contribute to sperm production problems (which i have myself).

    Dr John, the best research paper i have found is here:

    Elevation of serum testosterone and free testosterone after embolization of the internal spermatic vein for the treatment of varicocele in infertile men -- Gat et al. 19 (10): 2303 -- Human Reproduction

    I have to agree fully with you on this one, get the surgery, see how thing's go but don't expect miracles (i need to honest here, having spoken with alot of varicocele sufferers). I am pretty confident i haven't seen any improvements what so ever with the exception of reduced pain and no more swelling in the scrotum. However using TRT + HCG i am hoping i can restore thing's as i don't have full primary testicular failure. My LH/FSH are both in the normal if not 'perfect' range. Elevated LH would mean leydig cell dysfunction/atrophy.

    If you come across any old patient records on the subject Dr John, i would love to hear more about your own personal experiences treating varicocele patients and how they respond to HCG. My other testicle was already atrophied due to being undescended as a child and ironically also suffered from a varicocele in my early teenage years.
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    A long thread.

    When a varicocele or other injury reduces the ability of the teste(s) to produce T, if the upper end of the HPTA is working right, then the levels of LH will be high. So in that case, taking HCG will probably not be of value as the LH levels are probably above normal range already. If this is the case and the varicocele is restored and the teste recovers circulation and is has not suffered permanent damage, then there should be enough LH on hand. But perhaps a short shock treatment of HCG might have some value (but I am not saying that that is the case).

    When would HCG be of benefit with a repaired varicocele? If the top end of the HTPA is not making LH, then for HCG to be of benefit more than the testes and T, it would have to increase T levels that that might wake up the top end of the HTPA. If the HTPA is not doing the right thing, then it might be from too much E. That is where a SERM might get things going.

    I have seen a few guys with this problem on another board who are now happy to be on TRT.
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    Thanks for your reply KSMan, i think i sent you a message a little while back on t-nation?

    I believe it's more based on "dysfunction" rather than full blown damage. It's difficult to really understand what happens with varicoceles and how they effect the testicle, i believe a lack of nutrients alongside sluggish blood flow are the prime causes.

    My actual problems comes from having low E2/DHT. When i apply androgel (even 50mg) i go up to 25/6nmol and my ball's feel alot better. Erections aren't perfect but a good bit better than before.

    KSMan, do you know of any varicocele sufferers that are using HCG alongside TRT? I want to use Testim (50mg - or more) daily alongside HCG at least 3 times a week.
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    Megazoid, Im not sure that testosterone plays a huge part in Nitric Oxide. I have been doing more research and from what I read, most men recover from Varicoceles after the surgery. Im getting the operation in the morning. Wish me luck.
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    You'll be cool Hyde, it's pretty straightforward and you'll be back on the forum tomorrow night i am sure (if limping a little).

    Best of luck with the operation tomorrow! Let me know how it goes.
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    Quote Originally Posted by Megazoid View Post
    Thanks for your reply KSMan, i think i sent you a message a little while back on t-nation?

    I believe it's more based on "dysfunction" rather than full blown damage. It's difficult to really understand what happens with varicoceles and how they effect the testicle, i believe a lack of nutrients alongside sluggish blood flow are the prime causes.

    My actual problems comes from having low E2/DHT. When i apply androgel (even 50mg) i go up to 25/6nmol and my ball's feel alot better. Erections aren't perfect but a good bit better than before.

    KSMan, do you know of any varicocele sufferers that are using HCG alongside TRT? I want to use Testim (50mg - or more) daily alongside HCG at least 3 times a week.
    That is me on t-nation.

    If you do TRT, you will be fully LH repressed if it is effective [which for some can be problematic for some on transdermals]. Then you can/must use HCG to keep your testes from shutting down. But if not on TRT, as I stated before, the LH levels might be above normal range already as the HPTA tried to get higher T+E levels.

    So there were two answers there. If not on TRT, adding HCG might take levels higher than needed, but the HPTA would probably simply reduce LH to get you back to where you were in terms of T+E status.

    If you need a boost in your T levels and there is little prospect of you recovering to higher T levels on your own, then TRT+HCG seems to make a lot of sense. E will also recover and you might need AI to maintain libido and mood later. If costs are an issue, injections are certainly the least cost if you can self-inject.

    If surgery and recovery make the teste(s) ready to go from a blood flow point if view, the(y) might be profit from HCG and/or SERM as would be used in PCT to kick things into gear, get the testes developed and responsive and get the HP part of the HPTA going again. When we see guys that have botched cycles and PCT who can't get their HPTA to self-recover over time, then it seems that this system can be stuck or trapped. Use if PCT methods to get things running again can work, and in some cases of varicoceles, if blood flow is normalized, then HCG could take care of physical recovery of the testes and create some T to help wake things up. A SERM would encourage resumption of LH. But for some varicoceles after surgery with good blood flow circulation, LH may be ready and willing and HCG might help, but may not be necessary.

    I think that for the HPTA to be stuck, bilateral varicoceles might be needed. If one is bad, the HPTA may be working ok and a PCT approach does not seem to have any obvious benefit. The amount of time that a teste was shutdown or starved also speaks to the issue of permanent damage vs recovery. If TRT is required after all is said and done, so be it. We have seen guys [not gear users] in their 20's with very low T. These things happen.
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    Very special thanks for the feedback guy's. Dr John, your advice is also appreciated, as is yours KSman. The sad but true fact is i am getting zero support from doctors across here and have to self-medicate which is terrible. I have found a good blood testing lab though and know enough to self-medicate myself (sometimes i think just going by "how you feel" is worthwhile - libido, morning wood, mood, etc) and doing lab's every few months to monitor progress.

    Throughout all of this my LH/FSH are totally normal, even when the varicocele induced atrophy. LH has remained at 3.9 and down-regulates to 2.1 when doing androgel at 50mg daily (1 packet). My total T goes to 25nmol and E2 remains low (which i think is maybe my problem - too low E2?). I am getting fresh blood work soon to get a baseline with no TRT and then another a month or two latter with testim at 50mg daily.

    Usually guy's with varicoceles (or some form of testicular failure) have elevated LH which is strange as mine is normal. My only theory is that both ball's are still somewhat responding even though they are both atrophied, i was however told they were in the "normal size limits" by a urologist. But they aren't normal size for me (they were normal, adult size before). Not to mention the fact i have ED, low libido and i am suffering all the side effects of low t.

    Basically if i do HCG alone i am shooting myself in the foot but it might be worthwhile in restoring testicular size/function. I don't want to cause complete HPTA shutdown (LH = Zero) by doing HCG if it dosen't get me high enough or improve testicular health (size/function). Blood work is very expensive too and i can't afford to keep getting constant tests. A few week's back i was thinking about doing 250iu HCG daily for 3/6 weeks then running Nolvadex for 4 week's afterwards but because my HPTA seem's somewhat normal this wouldn't make sense and maybe PCT isn't the answer if my piturity is working fine. I really feel Dr John is right about this, the less stuff you take the better (plus nolvadex has IGF-1 effects which i don't want).

    I was hoping to see improvements after the surgery but haven't yet (though it's still only been about 2/3 months). No size increases and no T improvements (my original level was around 25/30nmol). I am visiting the urologist again for another ultrasound and to check if thing's are working or not. While the varicocele has cleared i am still getting some pain and feel the blood is still polling around in the whole area.

    In general i feel allot better on androgel but i don't like the tight scrotum effect i am getting and the reduced ejaculate volume. Is it possible for a guy to use 50mg androgel daily (or testim) and NOT get complete shutdown?

    It's almost ironic Dr John because say that HCG will down regulate the leydig cells but at the same time you think TRT + HCG is a good choice I agree with this however, but i really want to try everything before giving into TRT (not saying it's a bad thing - just very expensive for me right now) assuming i have no E2 problems (i am very lean, very little body fat, good build, etc) would you recommend running your own protocol of Testim + HCG? And how much HCG a week? I was considering using Testim (50mg daily - maybe moving up to 75mg if needed) as this should get me into the 500/650 range even with HPTA shutdown and then maybe using HCG at 500iu 3 times a week (mon-wed-fri). In fact maybe lowering this to 250iu HCG would work better 3/4 times a week (mon-wed-fri-sun)?

    While you can only offer your opinion (as i am not your patient - but would like to be if my doctor would work with you and not be a **** about this!) it would be appreciated as always.
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    Quote Originally Posted by Megazoid View Post

    It's almost ironic Dr John because say that HCG will down regulate the leydig cells but at the same time you think TRT + HCG is a good choice
    The point is that too much HCG will DR the receptors. 250iu EOD or less will not do that.
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    Hi everyone. Just got done with my surgery and yes im limping around a low, it hurts like hell to stand all the way up. On a positive note, the surgery went well and they gave me about 30 percocets for pain
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    Very pleased to hear it went well Hyde. What technique did they use and how is the scar?

    Did they tie off the veins at kidney/abdominal level or scrotal level?

    After you have healed, what will your plan of action be?
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    Quote Originally Posted by Megazoid View Post
    Very pleased to hear it went well Hyde. What technique did they use and how is the scar?

    Did they tie off the veins at kidney/abdominal level or scrotal level?

    After you have healed, what will your plan of action be?
    They cut me at the groin level, and its hurts like crazy. I can already feel some libido returning (believe it or not)
    and its only been one day!
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    Good to hear Hyde, you might be on the road to recovery. When are you going to get blood work done?
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    I am seeing the urologist this Tuesday, i really do need luck when dealing with this guy. He can be a nightmare at times and doesn't always want to listen.

    My right testicle has always been smaller and dysfunctional since having it injured as a teenager. I think it had a varicocele that magically (?) went away on it's own after a year or two. The spermatic cord has a noticable blockage though (not a varicocele) which i want fixed to see if it will restore more testicular function than present and more importantly reduce the pain. The urologist mentioned it was like a vascotemy had happened.

    Regarding left side varicocele i want to get this confirmed that the operation has worked 100%. My nut's are still going nut's and i am not sure if hormones are to blame or bad blood flow. Maybe even more factors? What i am confused with even more is the fact that my LH/FSH are normal and not registering anything "abnormal". I am going to get more test's ran.

    At present i am on TRT and feeling a "bit" better using one tube of testim a day. Only been 3 day's since starting Testim. It stinks though so i am going to change back to TestoGel (100mg daily) alongside HCG once everything is fixed and confirmed in the testicular department. I have a girlfriend now that i really love and i have had to refrain from sex because of these problems and because wood isn't too good (nor libido) so i am holding back.

    God i hate varicoceles...
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    Quote Originally Posted by Megazoid View Post
    I am seeing the urologist this Tuesday, i really do need luck when dealing with this guy. He can be a nightmare at times and doesn't always want to listen.

    My right testicle has always been smaller and dysfunctional since having it injured as a teenager. I think it had a varicocele that magically (?) went away on it's own after a year or two. The spermatic cord has a noticable blockage though (not a varicocele) which i want fixed to see if it will restore more testicular function than present and more importantly reduce the pain. The urologist mentioned it was like a vascotemy had happened.

    Regarding left side varicocele i want to get this confirmed that the operation has worked 100%. My nut's are still going nut's and i am not sure if hormones are to blame or bad blood flow. Maybe even more factors? What i am confused with even more is the fact that my LH/FSH are normal and not registering anything "abnormal". I am going to get more test's ran.

    At present i am on TRT and feeling a "bit" better using one tube of testim a day. Only been 3 day's since starting Testim. It stinks though so i am going to change back to TestoGel (100mg daily) alongside HCG once everything is fixed and confirmed in the testicular department. I have a girlfriend now that i really love and i have had to refrain from sex because of these problems and because wood isn't too good (nor libido) so i am holding back.

    God i hate varicoceles...
    I am convinced that Varicoceles somehow tie in to blood flow to the penis because I swear my penis seems like it is re inflating and I am getting random erections for the first time in months I don't know that much on anatomy, but maybe Dr. John can chime in, but Varicoceles somehow effect blood flow to the penis.
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    Varicoceles/testicles don't share the same vascular system as the penis, but they do effect hormones which effect blood flow to the penis. Maybe your T is going back up which is a good sign Hyde?

    One thing i should mention is that allot of guy's that adding HCG to there TRT regiem makes everything "hang" and look better in general. Maybe Dr John can comment on this? HCG has potent effects on the whole area i think.
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    Hyde, How are thing's progressing for you? I hope you have made some good progress over the past few days.

    I am going to visit the urologist tonight and really need a good bit off luck while dealing with this guy, hopefully i can get this right side spermatic cord blockage repaired and also he can evaluate the varicocele operation i had.

    What is your plan of action now?
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    Just a quick update. I'm healing pretty quickly. I did not take any of the percocet they gave me because they contain aspirin and aspirin slows down healing. The past 4 days I have had a pretty good libido and no ED issues. For some reason today, I don't have a good libido, maybe I just need more recovery time?
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    Quote Originally Posted by Hyde12 View Post
    Just a quick update. I'm healing pretty quickly. I did not take any of the percocet they gave me because they contain aspirin and aspirin slows down healing.
    Your exactly right about that. Its amazing how few people know that.

    Personally, I avoid painkillers and pretty much any and all perscription drugs unless absolutely necessary. I get sick? Big deal. I tuff it out.
  

  
 

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