26 y/o 374 tt, trt?

[bayraider510]

Hey guys, got my hormones tested after a lack of energy and sex drive for years. I exercise regularly along with lifting and I'm in shape for my age 5'7" 140lbs 12-13% BF. Here are my lab results, any reply or help would be appreciated.

Testosterone, Serum 376 ng/dL 348-1197
Free Testosterone(Direct) 7.3 Flag Low pg/mL 9.3-26.5 BN
LH 2.3 mIU/mL 1.7-8.6
FSH 2.0 mIU/mL 1.5-12.4
DHEA-Sulfate 196.0 ug/dL 138.5-475.2
Estradiol 7.3 Flag Low pg/mL 7.6-42.6
TSH 1.20 uIU/mL 0.10 - 5.50
Prostate Specific Ag, Serum 0.5 ng/mL 0.0-4.0


Complete Blood Count


WBC COUNT 3.5 - 12.5 K/uL 5.2
Red blood cells count 4.10 - 5.70 M/uL 4.79
Hgb 13.0 - 17.0 g/dL 15.5
Hematocrit 39.0 - 51.0 % 44.1
MCV 80 - 100 fL 92
RDW, RBC 12.0 - 16.5 % 12.1
Platelets count 140 - 400 K/uL 267


Fasting Lipid Panel


Cholesterol <=239 mg/dL 150
Triglyceride <=499 mg/dL 36
HDL >=40 mg/dL 51
Low density lipoprotein calculated <=159 mg/dL 92


Hemoglobin A1C


ESTIMATED AVERAGE GLUCOSE 85 - 126 mg/dL 94
Hgb A1c % 4.6 - 6.0 % 4.9


Didn't get T3/T4/fT3 done but I can find the results from six months ago or so where it was completely in range.

I was also told I should get a prolactin test to rule out a pituitary adenoma?

Anyone know what might be causing my low T? Should I go ahead and bite the bullet and do TRT even though I'm only 26? Thanks.

 

[thatoneguy]

Your LH hormone is pretty low as well, you may be a good candidate for clomid.

 

[CoastWatcher]

Welcome to Excelmale. A quick question - was your estradiol test the sensitive (LC, MS/MS)? It is the only one of use to measure E2 in men. What about a psa? That is a crticial baseline of you are considering exogenous testosterone as part of your protocol. You are young to be committing to TRT for life. Given your age a Clomid restart would be worth investigating. What did your doctor say about that?

 

[ERO]

At your age, I would check everything and then try a Clomid re-start with a knowledgeable Doc and consider TRT as your last option. Clomid can be tricky and not many Doctors are well versed in it. I would at least get a consult with Defy Medical before doing anything else.

 

[bayraider510]

Your LH hormone is pretty low as well, you may be a good candidate for clomid.

Do you know why my LH might be low and how to go about a clomid restart? Any other solutions to raise LH? Thank you.

Welcome to Excelmale. A quick question - was your estradiol test the sensitive (LC, MS/MS)? It is the only one of use to measure E2 in men. What about a psa? That is a crticial baseline of you are considering exogenous testosterone as part of your protocol. You are young to be committing to TRT for life. Given your age a Clomid restart would be worth investigating. What did your doctor say about that?

I am not positive about Estradiol. It was the male hormone test on Life Extension's website. PSA I forgot to add but the result has been added to the first post. How would I go about a clomid restart? I don't have a doctor and am uninsured, paid for these tests out of pocket. I've seen a couple doctors for it before but they dismiss 350-375 as being "in range" highly frustrating.

At your age, I would check everything and then try a Clomid re-start with a knowledgeable Doc and consider TRT as your last option. Clomid can be tricky and not many Doctors are well versed in it. I would at least get a consult with Defy Medical before doing anything else.

Will definitely look into Clomid as well as Defy. Would HCG be another option and just as effective as clomid? Thank you.

Also do you guys recommend me going to get prolactin and cortisol levels checked? And is saliva or blood test better for cortisol?

 

[ERO]

The best Cortisol test is the 4-tube saliva test. It gets readings when you get up, around noon, around dinner and around 11:00 pm so you can see where your levels are at various times as that is more critical by far than the absolute level of just one reading. For example, your cortisol should be at the top of the range in the AM, so if you were to get a blood draw at, say 8:00am the test may say your cortisol is borderline high - when it fact it is supposed to be high at that time. The problems typically come when it is high at night causing insomnia. Poor sleep can cause Low T.

How is your sleep? Any history of chronic pain medication or drug use? Not judging - those can also cause Low T that sometimes persists after the drug use stops.

 

[bayraider510]

The best Cortisol test is the 4-tube saliva test. It gets readings when you get up, around noon, around dinner and around 11:00 pm so you can see where your levels are at various times as that is more critical by far than the absolute level of just one reading. For example, your cortisol should be at the top of the range in the AM, so if you were to get a blood draw at, say 8:00am the test may say your cortisol is borderline high - when it fact it is supposed to be high at that time. The problems typically come when it is high at night causing insomnia. Poor sleep can cause Low T.

How is your sleep? Any history of chronic pain medication or drug use? Not judging - those can also cause Low T that sometimes persists after the drug use stops.

I usually get seven hours but I wake up to go to the bathroom quite a bit. Never done drugs or pain killers or anything like that. No roid history either. Haven't even drank alcohol for a year. Might need to cut back on caffiene? Two cups of coffee a day is about my standard.

 

[socks]

Do you know why my LH might be low and how to go about a clomid restart? Any other solutions to raise LH? Thank you.

In this thread a user documents an amazing recovery of total-t on 12.5mg Clomid EOD for 2-weeks followed by 1.5-weeks of 5mg Nolva EOD. These are VERY low dosages and the two SERMs were not run concurrently so that makes the rise even more impressive for 3.5-weeks of treatment.

On just the quarter tab of clomid/nolva EOD for a few weeks, my total test went from 300-725. My estrogen stayed the same, but it was tested non-sensitive.

 

[bayraider510]

Thank you for that information! Do you know where I can do a clomid restart, doea Defy offer this?

 

[CoastWatcher]

Thank you for that information! Do you know where I can do a clomid restart, doea Defy offer this?

Yes, Defy does. Here is a thread from Defy's medical director, Dr. Justin Saya. Good thoughts on Clomid.

https://www.excelmale.com/forum/sho...or-do-they-really-exist&highlight=clomid+saya

 

[bayraider510]

Also,

I might have some type of auto immune condition but my former doctor when I had insurance tested for everything major like Lupus, Rheumatoid, Allergies, etc. All negative. After certain foods like dairy, soy, anything fermented, and/or artificial light exposure for to long, my hands develop rashes that burn like crazy and I get a migraine right where my sinus is.

Could this have anything to do with my Low T?

 

[PAUL-E]

Also,

I might have some type of auto immune condition but my former doctor when I had insurance tested for everything major like Lupus, Rheumatoid, Allergies, etc. All negative. After certain foods like dairy, soy, anything fermented, and/or artificial light exposure for to long, my hands develop rashes that burn like crazy and I get a migraine right where my sinus is.

Could this have anything to do with my Low T?

I would look into gluten intolerance.

more info

 

[bayraider510]

I react badly to gluten as well and have been off of it for 5-6 months now. I stay away from gluten, soy, and dairy which is extremely difficult. Cook all my meals and all of it is whole foods.

Also, another bit of information for you guys:

Whenever I consume more than about 15g a fat a day which isn't much at all, my testicles literally ache. Pressure + very bad ache sometimes. Not painful, just very uncomfortable.

Has anyone ever heard of anything like this? I don't eat any bad fat. My diet is mostly chicken, turkey, almonds, lots of vegetables, rice/quinoa, potatoes, and every once in a while a steak.

 

[PAUL-E]

That's good maybe more time away from gluten give your body time to repair. Have your been checked for celiac disease?
not sure about the balls but I believe people with celiac disease are recommended to eat a lower amount of fat?

 

[bayraider510]

That's good maybe more time away from gluten give your body time to repair. Have your been checked for celiac disease?
not sure about the balls but I believe people with celiac disease are recommended to eat a lower amount of fat?

I tested negative for cealic, to my surprise. Definitely some kind of intolerance to it though. Although I react way worse to dairy, soy, fermented anything, alcohol, chocolate, etc.

 

[PAUL-E]

I tested negative for cealic, to my surprise. Definitely some kind of intolerance to it though. Although I react way worse to dairy, soy, fermented anything, alcohol, chocolate, etc.

IMHO I would try the restart program with defy if it fails and you start TRT being as you seem to be sensitive to things be aware that the testosterone with injections are suspended in oil usually cotton seed or grape seed oil and (BA)benzyl alcohol (BB)benzyl benzoate .

 

[thatoneguy]

I tested negative for cealic, to my surprise. Definitely some kind of intolerance to it though. Although I react way worse to dairy, soy, fermented anything, alcohol, chocolate, etc.

I know someone who tested negative to celiac using the blood test, but had a biopsy and was confirmed to have celiac disease. If gluten is really bothering you might be worth considering, or just avoid gluten.

 

[bayraider510]

IMHO I would try the restart program with defy if it fails and you start TRT being as you seem to be sensitive to things be aware that the testosterone with injections are suspended in oil usually cotton seed or grape seed oil and (BA)benzyl alcohol (BB)benzyl benzoate .

Good to know! I think the only oil I react badly too is soybean oil and I do react quite badly to it.

The thing that scares me about TRT is it's for life, huge committment.. mentally and financially. Question.. if I did quit TRT at some point, would my levels just go back to my 375 range or would they crash completely to something scary like sub 200?

Also is there any negative effects to doing a HPTA restart? No crash?

Is clomid a pill or injected? I react quite badly to most pills as well. If it's a pill, an ingredient list somewhere would be awesome.

 

[CoastWatcher]

Good to know! I think the only oil I react badly too is soybean oil and I do react quite badly to it.

The thing that scares me about TRT is it's for life, huge committment.. mentally and financially. Question.. if I did quit TRT at some point, would my levels just go back to my 375 range or would they crash completely to something scary like sub 200?

Also is there any negative effects to doing a HPTA restart? No crash?

Is clomid a pill or injected? I react quite badly to most pills as well. If it's a pill, an ingredient list somewhere would be awesome.

TRT is typically a lifetime commitment. That is why, at your age, there have been so many responses, along with links, suggesting you take a good, hard look at a restart protocol. Exogenous testosterone - topicals, injections, pellets - shut down your body's natural production of testosterone. You quit producing it. One never abandons TRT cold-turkey - that's where an experienced doctor comes in to manage the effort to restart your axis. That said, it's never certain what a post-TRT effort will achieve.

Clomid is taken orally. Clomiphene is the generic name. There is plenty of information here on the Forum, via the search function, or on the web, about it

 

[bayraider510]

Are there any alternatives to clomid? I see one of the ingredients in it is lactose. I've had pills with lactose before and they also give me a migraine/burning rashes on my hands.