20 yr old considering TRT

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    Exclamation 20 yr old considering TRT


    Hi,

    I'm very concerned about my current state of health. Before I get into my history i'll keep your interest by letting you know that my Total and Free test levels are 61 L and 12 L respectively. Both are Extremely low. I'll be 21 in october and have come a long way on my journey to this point. I'll give you guys a little history.

    The summer before i turned 19 i took a 3 week cycle of M1t (methyl -1 testosterone). Stupid, i know, but it's in the past. I researched it before i did it and followed it up with the standard post cycle therapy of nolvadex for 4 weeks. I did not have bloodwork pre or post cycle (again, stupid, i know). I weighed about 193 coming off the cycle and looked pretty good muscle-wise. The following year i put on over 20 pounds while traveling on a gap year that i attributed to drinking and eating fatty foods that most kids gain in college. I started getting weird stretch marks all over and then continued gaining weight at a rapid pace. I am now 232 pounds, have had symptoms of extreme lethargy and brain fog that doctors have called everything from mono to lymes-disease. I finally was directed to an Endo and thats when we discovered my low test.

    He has done a lot of testing and is currently thinking that i might have cushings (yes i know its rare) and i will be going for MRI' and CT scan soon to check the Pituitary for benign tumor.

    My questions are these (many): 1. Is it likely the M1t was the culprit here? 2. is it possible that i never recovered from the shutdown from the prohormones even though it's been over 2 years? 3. could taking prohormones at that age have shut me down for ever?

    I havnt discussed the past prohormone use with him yet as i honestly didn't even consider them to have been a possibility until recently and i will inform him during my next appointment.

    Maybe someone can see something he's missed in this bloodwork:

    Testosterone, Total: 61 L <250-1100 ng/dl >

    Free Testosterone: 12 L <35.0 - 155.0 pg/ml >

    Cortisol, Free (24 hour urine): 149.6 H <4.0-50.0 mcg/24h)

    Creatinine, urine: 2.56 H <0.63-2.50 g/24hr>

    FSH: 1.0 L <1.6-8.0 mIU/mL>

    LH: 0.7 L <1.5-9.3 mIU/mL>

    ACTH, PLASMA: 15 <7-50 pg/ml>


    Those are the tests he has done so far and i have yet to do the MRI's or CAT scan if he continues to think it points towards cushings. Is it possible i have that and its unrelated to the m1t? Sorry for all the questions but i am tired of being exhausted all the time and foggy all the time and he seems to be willing to go the TRT route if necessary he says but i'm equally apprehensive about starting at such a young age.

    Thanks for listening,

    TL

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    Wholy crap your LH and FSH are crap. Your testicals are basically not working.

    The thing is, I think honestly the M1T thing is purely coincidence and has no effect whatsoever on your condition.

    Lets be realy here - Comparing M1T to a real dose of 500mg to 1g of T is like comparing a firecracker to a bomb. And PLENTY of guys do cycles like that with no lingering or lasting side effects.

    I just cannot see how a little 3 week cycle did anything like that. Your nutts are practically destroyed. No way no how.
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    I was also wondering if it could be just a freakish coincidence about the m1t. That's why i didnt think to mention it to the endo at first. Because it was a short cycle, and the fact that i didn;t over abuse the substance like some did and i followed reccomended dosage, and i did a post cycle with nolvadex, i figure I shouldnt be as shut down as I am. But i DID use a steroid at a young age which might have screwed me up. I really need help here guys. I feel like crap all the time and my energy level is so low i honestly feel as though i've entered my 60's already. As far as the pituitary thing goes, now that i think of it i DO remember getting in a fight around that same time and taking a punch to the side of my head around the ear. I've read that car accidents and head injuries can cause problems like mine. Is that a possibility worth mentioning to my doc?
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    Yea, it smuch more likely to be a pitutiary issue. The M1T thing is small fries man. That is nothing. That shouldn't even put a dent in anyone. Were talking a miniscule amount compared to a real cycle. And it was 3 weeks long.

    You were 19 as well. Its not like you were 12 and still developing. Not that Im an advocate or anything, just saying.
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    Well m1t is a very potent steroid. It is known to cause complete testicular shutdown in as little as 4 days. It's one of the most suppressives substances out there in terms of the HPTA. So in that sense it's not really "small fries" because even a 3 week cycle could easily have shut me down. The fact that i never recovered even a little or slowely is what makes me agree with you that it might not absolutely be related. Im confused as what to do from here though because there's another guy telling me it's almost for sure the m1t and i need to get on clomid/torimefine/AI immediately to get my lh and fsh back up to normal. Im not sure i wanna do that without consulting with my doc but im sure he has little to no experience in using SERMS to treat hypogonadism.
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    Quote Originally Posted by SilkPhantom View Post
    Well m1t is a very potent steroid. It is known to cause complete testicular shutdown in as little as 4 days. It's one of the most suppressives substances out there in terms of the HPTA. So in that sense it's not really "small fries" because even a 3 week cycle could easily have shut me down. The fact that i never recovered even a little or slowely is what makes me agree with you that it might not absolutely be related. Im confused as what to do from here though because there's another guy telling me it's almost for sure the m1t and i need to get on clomid/torimefine/AI immediately to get my lh and fsh back up to normal. Im not sure i wanna do that without consulting with my doc but im sure he has little to no experience in using SERMS to treat hypogonadism.
    For the next three months do daily subQ
    hcg-100iu
    HMG-75iu

    After 3 months check your TotalT and FreeT
    if low your nuts are fried, proceed accordingly.
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    Quote Originally Posted by JanSz View Post
    For the next three months do daily subQ
    hcg-100iu
    HMG-75iu

    After 3 months check your TotalT and FreeT
    if low your nuts are fried, proceed accordingly.
    Good plan, let me adjust slightly.

    E3D IM, yes, thats IM injects of

    hcG - 100IU
    hmG - 100IU

    Resveratrol - 300mg per day
    Vit E - 400mg per day

    arimidex E3D - .25mg
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    Quote Originally Posted by plymouth city View Post
    Good plan, let me adjust slightly.

    E3D IM, yes, thats IM injects of

    hcG - 100IU
    hmG - 100IU

    Resveratrol - 300mg per day
    Vit E - 400mg per day

    arimidex E3D - .25mg
    Not sure but I think HMG come in multiples of 75iu, at least the one I came across while searching internet.

    Post info on HMG that you are familiar with.

    Post good prices and where.

    My best info:

    Anabolic Steroids and Bodybuilding - View Single Post - Need testers for Dermacrine -- A topical testosterone booster

    Anabolic Steroids and Bodybuilding

    Pharmacy Online .ca - Canadian Online Pharmacy | Canada Discount Prescription Drugs

    When looking for HMG

    Humegon (75iu) $81.97 ($81.97 every day for 3 months, good luck)
    Pergonal (2mg) $75.97
    Repronex
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    Quote Originally Posted by plymouth city View Post
    Good plan, let me adjust slightly.

    E3D IM, yes, thats IM injects of

    hcG - 100IU
    hmG - 100IU

    Resveratrol - 300mg per day
    Vit E - 400mg per day

    arimidex E3D - .25mg
    What is reasoning for armidex plymouth with no e2 labs done?

    Did we over look this kids cortisol level as well?
    some adrenal support is needed
    1000 mgs vitamin C 3-5 times a day
    300 mgs of phosphodylserasine before bed
    magnesium glycinate or plain old ZMA before bed time..
    1 tsp fish oils a day morning and night.

    increasing testosterone will lower cortisol, but lowering cortisol could increase testosterone...
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    Guys, thanks so much for all the advice. I'm a little confused about how to try and get treatment with hcg or hmg though. Should i discuss this with my endo? Another board poster reccomended i not tell my doctor i took the steroids because he won't know how to treat me anyway with stuff like hcg or clomid or anything the bodybuilding community accepts as successful and he may refuse to treat me at all. What do you guys think?
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    Quote Originally Posted by SilkPhantom View Post
    Guys, thanks so much for all the advice. I'm a little confused about how to try and get treatment with hcg or hmg though. Should i discuss this with my endo? Another board poster reccomended i not tell my doctor i took the steroids because he won't know how to treat me anyway with stuff like hcg or clomid or anything the bodybuilding community accepts as successful and he may refuse to treat me at all. What do you guys think?
    With elevated cortisol like that expect inuslin imbalnces either now or down the road. Glucose tolerance test 2 hours would be a nice test to run to verify this. Cortisol and insulin usually balance each other. When one rises so does the other one
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    Yeah...the cortisol problem is the one part of this whole thing i can't figure out. Is that a normal side from the m1t? I feel like i might have two seperate situations going on in my body.

    1) Coincidental Cushings from a pituitary disorder

    2) suppressed hpta axis
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    To get a better perspective on the possibility of cushings, you can ask your endo about administering the dexamethasone test.

    It is a simple test were you take one tab of dexamethasone before going to sleep and then get blood work the next morning to see how your cortisol responds.

    Good Luck!
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    Update:

    Went to see my endo again. Told him about the prohormone use and he said that he seriously doubts that my problem is coming from a cycle of steroids i did 2 years ago. He told me that he's treated body builders coming off of seriously long cycles of sostonol 250 and strong androgens that rebound and my issue is more likely a pituitary. He's still thinking the Cushings route has an MRI scheduled for me in addition to a 3rd urinary cortisol check and a midnight salivary test for cortisal as well.

    He's a pretty young doc in his very early 40's if he's that old so i trust that he is in touch with the modern suppliment world to some degree. I also think he sincerely cares about helping me and has even called me back a couple of times and talked to me for a solid 5-10 mins on the phone to answer ALL my questions outside of our regular appoinments.

    He says since the cushings diagnoses is soooo difficult to make it could take some time but if it turns out my MRI is negative and the cortisal levels are more normal it'll pretty much throw his theory out the window.

    What i do know right now is that i am seriously HYPO-gonadal and still feeling like **** and can't shake the feeling that i just want to start TRT and deal with it so i feel better, even if its for life. If it IS cushings though my doc says when they remove the pituitary tumor the body's testosterone levels return to normal and i won't need TRT.

    What do you guys think?
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    I don't know of anyone who has more experience in this type of thing than Dr. Crisler. I know yo're young so money may be an issue, but saves a lot of time (YOUR YOUTH !!) and in the long run you may end up there anyways.

    just a thought.



    Quote Originally Posted by SilkPhantom View Post
    Update:

    Went to see my endo again. Told him about the prohormone use and he said that he seriously doubts that my problem is coming from a cycle of steroids i did 2 years ago. He told me that he's treated body builders coming off of seriously long cycles of sostonol 250 and strong androgens that rebound and my issue is more likely a pituitary. He's still thinking the Cushings route has an MRI scheduled for me in addition to a 3rd urinary cortisol check and a midnight salivary test for cortisal as well.

    He's a pretty young doc in his very early 40's if he's that old so i trust that he is in touch with the modern suppliment world to some degree. I also think he sincerely cares about helping me and has even called me back a couple of times and talked to me for a solid 5-10 mins on the phone to answer ALL my questions outside of our regular appoinments.

    He says since the cushings diagnoses is soooo difficult to make it could take some time but if it turns out my MRI is negative and the cortisal levels are more normal it'll pretty much throw his theory out the window.

    What i do know right now is that i am seriously HYPO-gonadal and still feeling like **** and can't shake the feeling that i just want to start TRT and deal with it so i feel better, even if its for life. If it IS cushings though my doc says when they remove the pituitary tumor the body's testosterone levels return to normal and i won't need TRT.

    What do you guys think?
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    "Went to see my endo again. Told him about the prohormone use and he said that he seriously doubts that my problem is coming from a cycle of steroids i did 2 years ago. He told me that he's treated body builders coming off of seriously long cycles of sostonol 250 and strong androgens that rebound and my issue is more likely a pituitary. He's still thinking the Cushings route has an MRI scheduled for me in addition to a 3rd urinary cortisol check and a midnight salivary test for cortisal as well"

    Yep, just as I noted above. Your little cycle/prohormone use is small potatoes.

    Good luck and update us.
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    Quote Originally Posted by SilkPhantom View Post
    What i do know right now is that i am seriously HYPO-gonadal and still feeling like **** and can't shake the feeling that i just want to start TRT and deal with it so i feel better, even if its for life. If it IS cushings though my doc says when they remove the pituitary tumor the body's testosterone levels return to normal and i won't need TRT.

    What do you guys think?
    I know exactly how you feel. I want so badly for them to find out the root cause of my problem and treat it, and if I still need TRT after that then get on it. But at this point, I've been feeling the symptoms of hypogonadism for about 7 months and I've been clinically diagnosed as secondary hypogonadism for 2 months but no treatment yet. Still trying to figure the cause out. But I do sympathize with you because I'm about ready to say screw the root problem I need to start feeling at least a little better now, it's been long enough. One thing that makes me feel better about it all is researchng and coming up with theories about what may be wrong. If I didnt have this forum with these guys helping me try to figure things out, I'd probably go crazy .
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    The root cause: What many search for, few find and most doctors don't GAS about.


    Quote Originally Posted by CF10 View Post
    I know exactly how you feel. I want so badly for them to find out the root cause of my problem and treat it, and if I still need TRT after that then get on it. But at this point, I've been feeling the symptoms of hypogonadism for about 7 months and I've been clinically diagnosed as secondary hypogonadism for 2 months but no treatment yet. Still trying to figure the cause out. But I do sympathize with you because I'm about ready to say screw the root problem I need to start feeling at least a little better now, it's been long enough. One thing that makes me feel better about it all is researchng and coming up with theories about what may be wrong. If I didnt have this forum with these guys helping me try to figure things out, I'd probably go crazy .

    At your age try hard to find the root cause. Try as hard as you can and then some. Being here will help quite a bit as you're already many times ahead of guys struggling with their local GP who only knows Androgel and no more.
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    Quote Originally Posted by anyman View Post
    At your age try hard to find the root cause. Try as hard as you can and then some..
    X2 on this one. The novelty of TRT wears off fast, at least it did for me.
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    Update:

    Had my MRI done yesterday...that was a strange experience. As I posted in another thread, I don't know if you guys have ever been in one of those machines but it's kinda cramped for anyone larger than a schoolgirl and the experience is something like listening to a cd skip at max volume for 30 minutes.

    I don't know whether i want them to find a pituitary adenoma so i know what the cause of this mess is or not because surgery scares me. Brain surgery is a very freaky thought.



    -TL
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    Quote Originally Posted by SilkPhantom View Post
    Update:

    Had my MRI done yesterday...that was a strange experience. As I posted in another thread, I don't know if you guys have ever been in one of those machines but it's kinda cramped for anyone larger than a schoolgirl and the experience is something like listening to a cd skip at max volume for 30 minutes.

    I don't know whether i want them to find a pituitary adenoma so i know what the cause of this mess is or not because surgery scares me. Brain surgery is a very freaky thought.



    -TL

    X2 on everything you said. I've had an MRI, of my knee not my head, and it's kinda weird but I found it to be soothing after a while and I just daydreamed.

    As far as wanting them to find something or not, I know how you feel. Everytime my labs come back negative for all kinds of different things Im happy that I dont have those things, but at the same time Im wondering what I DO have that is still hidden. I guess my #1 hope is that it's idiopathic and there is no underlying danger and to this point it looks that way.
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    CF10,
    Have you ever entertained the idea that your HTPA is partially shudown/depressed due to all of the extreme dieting and exercise one needs to do to get to look like you?

    Ive seen some labs from some athletes and alot of them, suprisingly, looked pretty bad.
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    Quote Originally Posted by plymouth city View Post
    CF10,
    Have you ever entertained the idea that your HTPA is partially shudown/depressed due to all of the extreme dieting and exercise one needs to do to get to look like you?

    Ive seen some labs from some athletes and alot of them, suprisingly, looked pretty bad.
    Yeah I have though about that but my dieting phase has been well over for a long time now. I eat a very well balanced diet with plenty of protein, conmplex carbs, and healthy fats. I take my multi and fish oils every day. I dont over exercise, just 45 min in the gym 5x a week and cardio 2-3x a week for 20 min light jogging. I know it probably looks in that picture like I am dieting extreme and doing hours on hours of exercise but to be honest I have always been very lean even before I touched weights or a treadmill. Im just a naturally very skinny person so being lean isnt a problem it's gaining muscle that is.

    But anyway, my labs arent even bad it's just low T from secondary hypogonadism. There were some minor elevations of other things but they cant find a damn thing wrong and they are talking about enzyme deficiencies or maybe genetic disorders now. Like I said in another thread, I had health problems during puberty invloving my stomach to the point where I couldnt eat much at all, so maybe something didnt develop correctly at the time. I also had a concussion as a yound child. So these could be explanations, or like everything else so far, they could not.
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    Quote Originally Posted by CF10 View Post
    Yeah I have though about that but my dieting phase has been well over for a long time now. I eat a very well balanced diet with plenty of protein, conmplex carbs, and healthy fats. I take my multi and fish oils every day. I dont over exercise, just 45 min in the gym 5x a week and cardio 2-3x a week for 20 min light jogging. I know it probably looks in that picture like I am dieting extreme and doing hours on hours of exercise but to be honest I have always been very lean even before I touched weights or a treadmill. Im just a naturally very skinny person so being lean isnt a problem it's gaining muscle that is.

    But anyway, my labs arent even bad it's just low T from secondary hypogonadism. There were some minor elevations of other things but they cant find a damn thing wrong and they are talking about enzyme deficiencies or maybe genetic disorders now. Like I said in another thread, I had health problems during puberty invloving my stomach to the point where I couldnt eat much at all, so maybe something didnt develop correctly at the time. I also had a concussion as a yound child. So these could be explanations, or like everything else so far, they could not.
    Those could all be issues as well.

    Funny how things from childhood carry over to adulthood.

    I have very low IGF-1 levels 130(126-350)

    I would be willing to bet I have had this my whole life.
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    Update: Doctor response

    Results from the MRI came back negative. No tumors or lesions in the pituitary.

    I e-mailed him and asked:

    At this point the following questions still remain:

    What is the result of the MRI?
    What is the result of the Sleep Study?
    What can we address while still awaiting a diagnosis?

    Hypogonadism: Does it make sense to treat this issue to eliminate the lethargy, brain-fog, obesity, and other resulting problems? *It is extremely difficult to continue to function (or rather not function) with these problems day to day. Can we address this issue in the meantime while awaiting the Cushings diagnoses? You had mentioned testosterone replacement therapy as an option.

    Obesity? Should there be any programs for exercise (with PT?) put into place or special eating? should additional lab tests for Insulin levels be run?

    The last 24-Hour urine test was submitted Monday, August 6th, and the Midnight salivary test for Cortisol will be submitted Tuesday August 14th.
    ==============================
    This was the response i got in the e-mail:

    "I understand your sense of urgency to come to a diagnosis and ameliorate your complaints. As I explained to you last visit, the most appropriate and efficacious therapeutic intervention depends on making the correct diagnosis. For example, if you have confirmed cushings syndrome from whatever etiology, treatment of this condition will help rectify the hypogonadism, weight gain, mental fog, etc. Treating hypogonadism with testosterone is not necessarily efficacious in this setting. The treatment of choice is to remove the source of excess cortisol production (if it indeed exists).

    As far as diet and exercise, I agree that lifestyle intervention as described in your email can be very beneficial for a multitude of reasons. You could follow a 1600 kcal diet and start to exercise if you feel up to it.

    There is absolutely no role in assaying insulin levels.


    As far as an update;

    The MRI was negative - no pituitary lesons or infiltrative processes were seen.

    I don't have the results of the urinary studies at this time.

    The salivary studies may take a couple of weeks to return.

    I don't have the results of the sleep study.

    warm regards,

    Dr. F"
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