Need TRT changes.

Hello, i am from Poland so at first, sry if my english is bad. I was diagnosed with hypogonadism, was having few tests in hospital, GNrH and test with HCG. It seems that my testicles are ok and there are problems with pituitary. After hcg test, my teststosterone levels went up to the upper limit of norm. Doctor from hospital prescribed for me hcg 300 ui two times a week. First 1-2 days after my first injection i was feeling much more better but then every next day that feeling was worse and worse and finally i was feeling worse than before starting my treatment so decided to stop it. At the end when i stoped it, decided to make blood work for testosterone and estradiol as after about 7 days my nipples started to itch and was feeling also some strange button close to my nipple. Also my frame of mind was terrible, zero libido, zero erectile, my pennis shrunked and diminished . My bloodwork was: testosterone 8.44 ng/ml and estradiol 90 pg/ml. I showed the results for my doctor and he sad that is it normal that testostorone aromatize to estradiol and there is nothing strange with this. Even when i asked him that its maybe estradiol too high and causes the problem and maybe we should lower it he answered to me that there is no way to lower my estradiol and he change treatment from hcg to testosterone in gel, called TestimGel. He told me to use 1 tube per day. And i experienced similar situation to hcg treatment with a little bit difference in time affect and benefits were small and improving very slowly comparing to hcg where in the next day after hcg injection i felt amazing to be honest but i went to bad things also faster comparing to teststosrone. First 5-6 days i was feeling slightly better and better, it was a small improvement but still.. And after 5-6 days i was going again worse and worse and my nipples started to itch again but this time i didnt do any bloodwork. I just listened to my body and knew it that my estradiol is going up again. Also nipples didnt itch that hard as it was on hcg but still. Decided to stop the treatment few days ago because was scared about gyno. It was shocking for me that my estradiol after 1 week of hcg treatment went so high and my nipples started to itch so fast... Now in few days i am going to him again to tell him how i am feeling and whats going on with me, probably he will do some changes but to be honest i dont believe that it will be a miracle and he will presrcibed for me IA for example. If he will not do this then i will start treatment by my self but i need to know how to start it as i am very inexperinced. Its something totally new for me. Here, in Poland methods of treatment for low testosterone are very bad. Most of polish doctors never prescribed something for lower estradiol for example and even they are giving injections once per 2 weeks and thinking that its totally fine. Any help will be greatly appreciated.

I would probably try to switch to injections, some on this site lower there estradiol by going to daily injections of T. I would also look for a better TRT doctor.

Thanks for answer. I dont have good feelings about injecting my self everyday. What could be the problem with my treatment? For now i am using Testosterone gel everyday, 1 tube per day but i am feeling like trash so decided to stop it for a little bit. Also looking for a better doctor for trt in my country is hard if not almost impossible.

Anybody got some ideas what should i add or change?

There's just too much speculation with what's causing this? It sounds like your total serum levels are/at about a decent level, but there's no discussion of free or bio-available testosterone (Or SHBG for that matter, which would help us on the free/bio part). E2 "might" very well be an issue, but not seeing the results on a Sensitive assay platform makes it hard to assess, and of course to treat.

Without speculating too much, we need a litany of labs, including all thyroid, CBC's, lipids, metabolic, AST, ALT, etc. What is your blood pressure like? What are your stats? Diabetes? Smoke? Drink? Without clearly describing your profile, we're just making this a straw man discussion. I don't mean this as sarcastic, I promise, I just mean this as a request to give us more so we can provide you with some ideas.

Hey, thanks a lot for answer in my thread. I will give some more information then:

Thyroid - was having many blood tests for it and always in normal range + ultrasound examination fine too.
Diabetes - glucose was always in normal range
Lipids - i dont know what is it, if cholesterol then i only did blood test for it once and it was too low, 114.9 mg/dl, normal range was between [140.0 - 200.0]
ASL, ALT - was fine
SHBG - was always too low 12.0 - normal range [16.5 - 55.9 nmol/l] and second time 15.8. Both times tested when i was in hospital

No smoking, no drinking at all. Few years ago it was but that was school time fun etc. and it was for not that long. Since like 6 years, nothing.

I guess thats all for now.

Maybe its a good idea to try 100 iu hcg everyday injection if i was feeling bad at 300 iu every third day? And maybe it will lower my estradiol levels?

I tried hcg 100 iu everyday and i felt very bad. For maybe 2-3 days, felt very, very bad but my testicles were bigger and my muscles more "fuller" but thats all, i felt very weak and my frame of mind was very bad too. After that i was desperate to feel better so decided to try something new, again. Clomid, 12,5mg first two days and 25 mg third day and i immediately stopped it because it caused gynocomastia and it was growing so fast, faster than on my hcg protocol 300 iu e3d. And that happened from clomid... Strange? Glad that i stopped immediately but my nipples steel are feeling pain and gyno is progressing even tho i stopped clomid 3 days ago, probably because of long term of clomid in my body.

What to do now? Maybe will try to jump on testosterone, small amounts, twice a weak? Only testosterone i tried was TestimGel and i felt better but after 5-6 days of treatment again, started to feel worse and worse, nipples started to itch, etc.

With hcg the same situation as with TestimGel. First 2-3 days were better and then i started to feel weaker and weaker and even after longer break hcg didnt work for me anymore.

Hello again. I have few more questions.

Could very low vitamin D be responsible for low SHBG in my body?

And is using hcg making my SHBG droping down or not?

Maybe the T-gel is not providing your with enough T and your levels have crashed. I was on T-cream and it crashed my levels once my natural production shut down.

I think that my problems are connected with low SHBG, around 12 to 16 when i was doing blood work and also with my estradiol. Is going up when starting hcg/trt. With both hcg/test i was having problems with my nipples and erectile dysfunction and more and more...

I am looking now for something to rise my SHBG levels...

Verdilo said:

I think that my problems are connected with low SHBG, around 12 to 16 when i was doing blood work and also with my estradiol. Is going up when starting hcg/trt. With both hcg/test i was having problems with my nipples and erectile dysfunction and more and more...

I am looking now for something to rise my SHBG levels...

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People with diabetes or pre-diabetes tend to have low SHBG. Have you checked your A1c?

Its not low SHBG that is causing your problems it's pretty clear to me it's Estrogen and you should be looking for the drug Arimidex or Anastrozole. You can rule out low SHBG as a "problem" when he was on daily gelm, and the brief HCG mono experiment had nothing to do with SHBG either.

It's Estrogen and that's fact.

Thanks a lot for answers! I know that estradiol is ONE of my problems but i dont think its the only one here. Why? Because there is something strange in my first trt treatments.

When i was tested with hcg in hospital to check if my testosterone will rise from it i was feeling very good affter few days from injecting it. After hospital, doctor prescribed for me hcg and frist injection was some time after my hospital stay, around 2-3 weeks probably. First inection - was feeling great in the next day but slowly starting to getting worse and worse so then it could be stradiol, thats correct but why after longer break of hcg (like 1 month) and starting it again i didnt feel that good as on the beginning as before? Maybe hcg droped my SHBG levels too and hcg stoped working for me?

This is what i am wondering about. Estradiol is one thing but why i dont respond to hcg as good as on the beginnig of the treatment?

I am not diabetic, was tested several times for it. One time i did it for my self the day after a very bad eating diet with a lof of unhealthy food and my glucose was still in the middle of range.

Everyone has some kind of honeymoon period in the first 2-3 weeks. You can't let that portion of it dominate, and, again, it's not SHBG. Added that HCG monotherapy is a pretty fleeting endeavour, most no one can sustain it, for whatever reason, and even larger are the number of guys that experience no substantive benefit with HCG use at all.

You're wrapped up in some things that don't matter and/or cannot control.

Even if you weren't having elevated estrogen, lot's of guys report feeling fantastic for the first couple of weeks followed by feeling run down, it's perfectly normal. Most of the time it will all workout in the coming months if your doctor is properly managing you and checking your labs at least every 3 month in the beginning. Being in Poland is a huge disadvantage.

I didnt got even weeks of honeymoon. My good time with hcg lasted 2 days and with testosterone gel 3-4 days. So You are thinking that estradiol is my main problem? I got a new doctor and he asked me to do blood work for free testosterone levels. I dont know why but well i am gonna trust him. Maybe i will tell him about my estradiol things and see how hes gonna respond to that. For now i didnt tell him about my estrogen yet because we are only in contact by the phone because of big distance between us.

Can gynecomastia appear if i take for example clomid and my estradiol levels are good because of anastrazole?

I want to know if this is possible. Something else than high estradiol could make gyno starting?

In few days i am starting a new protocol, got new doctor and i am little bit afraid of gyno because of my past treatments. He prescribed for my clomid 1 tablet every second day and 1 anastrazole every fourth day (anatrazole only if i am gonna feel my nipples or see on blood work that estradiol is too high), This protocol is not final, he only wants to see if my pituitary will respond for clomid. After 21 days i am going to him again to show results of testosterone, fsh, lf, estradiol and prolactin.

Hello again. I am starting trt and got curious. I used last tablet of clomid yesterday and my T level is around 800 because of clo. Should i wait few days when clomid will stop working and my T levels will go down and then start injecting testosterone after that or it doesnt matter and i can start it even today with my 800 ng T level?