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Hypo since 20 y/o - now 30. Thoughts on this bloodwork?
There are pros and cons to either. Enclomiphene blocks the negative feedback from estradiol, which stimulates the HPTA. The higher LH/FSH then lead to increased testosterone, at least if the testicles are functioning well. Enclomiphene has the advantage of stimulating the entire HPTA. Clinical...- Cataceous
- Post #12
- Forum: Blood Test Discussion
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Hypo since 20 y/o - now 30. Thoughts on this bloodwork?
Ok, that confirms the previous number and an unusual pattern. You seem to have bounced back from the first episode in 2016 after dabbling with Clomid and hCG. Possibly you could again. As mentioned above, enclomiphene is usually preferred over Clomid. If you don't get acceptable results with...- Cataceous
- Post #10
- Forum: Blood Test Discussion
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Hypo since 20 y/o - now 30. Thoughts on this bloodwork?
You really needed a testosterone measurement to go with that LH/FSH. With the huge variability in your readings I wouldn't trust that it remained at the 91 ng/dL from August, even if that value was correct. There is still uncertainty. No, this combination points to secondary, where the brain...- Cataceous
- Post #7
- Forum: Blood Test Discussion
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Thoughts / Advice on bloodwork
I was curious what AI would say about cabergoline vs P5P: Effectiveness Cabergoline is generally more effective for lowering prolactin levels, particularly in cases of hyperprolactinemia in men, such as those caused by prolactinomas. Multiple studies show it can normalize prolactin levels and...- Cataceous
- Post #5
- Forum: Blood Test Discussion
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Thinking about TRT and could use some guidance
There are better options than conventional TRT. First, strongly consider switching to topical finasteride. The side effects profile is considerably improved, reducing your risks in the long run. If you still feel as though there's a lot of room for improvement then try a fast-acting testosterone...- Cataceous
- Post #4
- Forum: Testosterone Basics & Questions
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Thoughts / Advice on bloodwork
With the caveat that your results are hard to read due to low resolution, it appears that Vermeulen calculated free testosterone is about 11 ng/dL. This is not really into hypogonadal territory. On the other hand, having prolactin near top-of-range can be problematic. If your health and...- Cataceous
- Post #2
- Forum: Blood Test Discussion
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DHT Cream Plus Testosterone Propionate = Major Libido Boost
It's still a small enough molecule that you might have reasonable absorption—but "reasonable" is only about 10%, so it's not very efficient. Possibly better if applied to the scrotum. If there is such a thing then you'd want to think about possible side effects; 5ar does more than convert T to...- Cataceous
- Post #447
- Forum: When TRT Is Not Enough (ED, Libido, & More)
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Hypo since 20 y/o - now 30. Thoughts on this bloodwork?
Your 2016 and 2021 results are contradictory. It seems unusual to move from secondary hypogonadism to the edge of primary and back. Another interpretation is that you've always had borderline testicular insufficiency, but it is masked by secondary hypogonadism. If you're willing, report your new...- Cataceous
- Post #4
- Forum: Blood Test Discussion
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Pharmacokinetic Profile of Testosterone Suspension: A Case Study
A problem with having limited data is that you can come up with various hypotheses that are consistent with the results yet are vastly different. So here's an update on the examination of testosterone suspension: For a period I switched to an aqueous testosterone solution, as described above. I...- Cataceous
- Post #17
- Forum: Testosterone Basics & Questions
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Hypo since 20 y/o - now 30. Thoughts on this bloodwork?
I think you have the right idea: Retest testosterone, and also LH and FSH. Make sure it's done not too long after waking. Throw in SHBG if you're not also testing free testosterone via equilibrium dialysis. Estradiol should probably be in there too. Your 2021 results do hint at testicular...- Cataceous
- Post #2
- Forum: Blood Test Discussion
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Inject hCG IM for better results?
The point is that if you open the door to anecdotal evidence then there are examples suggesting faster SC absorption in some cases. However, I have much more confidence in the controlled studies measuring AUCs. No, it takes >40° C to invoke non-negligible degradation. That's not happening...- Cataceous
- Post #30
- Forum: When TRT Is Not Enough (ED, Libido, & More)
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Inject hCG IM for better results?
It may be far-fetched, but less so than some mysterious and unelucidated mechanism of testosterone destruction.- Cataceous
- Post #28
- Forum: When TRT Is Not Enough (ED, Libido, & More)
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Inject hCG IM for better results?
If with both SC and IM you ensured you had no injection site leakage and you measured free testosterone at enough time points in an injection cycle to accurately estimate AUC then you'd have some grounds to claim reduced bioavailability. What I've been saying is that measuring testosterone at...- Cataceous
- Post #25
- Forum: When TRT Is Not Enough (ED, Libido, & More)
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Inject hCG IM for better results?
Fair enough, since there's little, if any, hard data. Anecdotal reports appear to favor it. Grok says this: Injection site leakage, where a small amount of the oil-based medication (such as testosterone enanthate or cypionate) seeps out from the puncture wound after needle withdrawal, appears...- Cataceous
- Post #21
- Forum: When TRT Is Not Enough (ED, Libido, & More)
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Inject hCG IM for better results?
Occam's razor. There's injection site leakage, a known phenomenon that's almost certainly going to be more prevalent with SC injections. Then there's some mysterious, never directly observed, testosterone-destroying interaction that disappears under controlled conditions—and worse, is assumed to...- Cataceous
- Post #19
- Forum: When TRT Is Not Enough (ED, Libido, & More)
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Inject hCG IM for better results?
Somehow you forgot about the Xyosted study. Meanwhile there are no controlled studies pointing to dissimilar bioavailability for SC and IM. I presume if I were trying to support an argument with anecdotes that did not even measure the parameter in question then you would jump on that. But now...- Cataceous
- Post #16
- Forum: When TRT Is Not Enough (ED, Libido, & More)
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Inject hCG IM for better results?
As long as we're fantasizing that someone's going to fund such a study then of course it should include enough samples to generate accurate AUCs. But first, if you're rejecting the explanation involving injection site leakage then you should come up with a remotely plausible alternative...- Cataceous
- Post #13
- Forum: When TRT Is Not Enough (ED, Libido, & More)
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Inject hCG IM for better results?
Have to re-emphasize: "Clinical data consistently shows that SC administration of testosterone esters achieves comparable bioavailability to IM." Under controlled conditions the bioavailability is the same. What you're left with are basically three things: • Localized side effects. Ok, some...- Cataceous
- Post #8
- Forum: When TRT Is Not Enough (ED, Libido, & More)
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Inject hCG IM for better results?
Query to Grok: Someone asserts that testosterone esters have less bioavailability when delivered subcutaneously (SC) versus intra-muscularly (IM). I disagree, pointing to Xyosted clinical trials that show similar areas-under-the-curves. He then points to a study showing that hCG does have less...- Cataceous
- Post #5
- Forum: When TRT Is Not Enough (ED, Libido, & More)
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TRT in Canada if borderline Testosterone and Prolactin?
If you stop there one might think that elevated prolactin equals more dopamine activity. Nope. Modestly high levels of prolactin can reduce dopamine activity in men. Prolactin and dopamine have an inverse relationship in the brain, primarily regulated through the hypothalamic-pituitary axis...- Cataceous
- Post #8
- Forum: Blood Test Discussion
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7.5mgs daily labs
Let's keep this in perspective: The lab measurement error is probably around the same size as or greater than the daily variation you see in levels. It's not something to even think about unless you shift to less frequent injections.- Cataceous
- Post #21
- Forum: Blood Test Discussion
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7.5mgs daily labs
Your lack of understanding suggests either a problem with reading comprehension or else deliberate trolling. I've never said anything like that and yet here you are with a third admonishment in a two week period. The point is that with the long half-life of cypionate—actually more like five...- Cataceous
- Post #18
- Forum: Blood Test Discussion
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7.5mgs daily labs
This is unnecessary. Men on daily cypionate will usually not see much variation.- Cataceous
- Post #10
- Forum: Blood Test Discussion
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TRT in Canada if borderline Testosterone and Prolactin?
Prolactin works against dopamine, so it can contribute to the symptoms you describe. According to Dr. Saya, and also in my experience, in some men even prolactin over 10 ng/mL can cause issues. Perhaps it depends on the level that's appropriate for the individual's physiology. There's a simple...- Cataceous
- Post #5
- Forum: Blood Test Discussion
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Subcutaneous vs. Intramuscular Testosterone: Do Delivery Methods Affect Blood Health and Hematocrit Risk?
Interesting that we used almost identical numbers to test this. I had SHBG of 40 and 27 nMol/L, FT of 13.6 and 13.1 respectively, the latter well within margins of error. Of course I also searched for the full text, but so far even the abstract only shows up on this page. It would be...- Cataceous
- Post #4
- Forum: Testosterone Side Effect Management
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Starting Fertility Journey After Long-Term TRT – Seeking Insights
That doctor is way too pessimistic. The studies suggest that a significant majority of men can regain fertility. It can take as long as one or two years, however. If you're wanting to hang onto the cypionate as long as possible then you might be interested in this speculative treatment...- Cataceous
- Post #2
- Forum: hCG, Clomid & Others for Fertility, PCT or Low T
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Subcutaneous vs. Intramuscular Testosterone: Do Delivery Methods Affect Blood Health and Hematocrit Risk?
This study should not be used to suggest that subcutaneous administration is less effective than intramuscular. First, free testosterone would be the more definitive measurement, and that was not used. Second, there's no mention of dosing. Then there's the hint of bias in the total testosterone...- Cataceous
- Post #2
- Forum: Testosterone Side Effect Management
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7.5mgs daily labs
To further elaborate on the low-and-slow philosophy: The key thing is to establish a solid reference point at reasonable levels, which is where you are now. Later on, if you think improvements are possible then you will have a point of comparison as you gradually raise the dose. It's common to...- Cataceous
- Post #6
- Forum: Blood Test Discussion
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7.5mgs daily labs
I agree with @Seagal: Those are stellar numbers for just starting out, right in the midrange for healthy young men. Do give it some more time. If you haven't already, skim through this article to get a sense of the time frames for various improvements. Remember that TRT is not a cure-all, and...- Cataceous
- Post #4
- Forum: Blood Test Discussion
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New to TRT. Received first labs. Concerned and need help.
I will continue to advise newcomers coming to this site with problems that a low-and-slow approach is preferred, backed up by scientific and anecdotal evidence. If you're going to keep butting in with contrary and harmful advice that is unsupported by any serious evidence then you can expect...- Cataceous
- Post #62
- Forum: Blood Test Discussion
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New to TRT. Received first labs. Concerned and need help.
You can repeat this misinformation forever, but the study does not compare physiological to non-physiological doses, and therefore does not support your claim. The fact that a particular dose is tolerated in a short-term dose-response study does not indicate that it is suitable for long-term...- Cataceous
- Post #58
- Forum: Blood Test Discussion
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