29 y/o considering TRT

Hello guys,

I have been battling a serious frequent urination problem which I thought was starting to heal up recently. It all started when I was experimenting with anabolic steroids in large quantities and eventually it caught up with me. I stoped everything in April 2017, and realized my PCT failed due to wrong information. At that time my TT was 86, very low. Last year I have been through numerous doctors and procedures trying to resolve my urination. I am negative for UTI, STD's, Diabetes, Diabetes Insipidus, Prostatitis, Epididymitis, BPH, Hepatitis, and MRI/Abdominal ultra sound is clean with no abnormalities in the bladder,kidneys, and prostate. Originally it was thought my crashed estrogen was the issue. I started a Clomid 3 month mono therapy 50mg ED to resolve my crashed estrogen which brought my levels up to almost ~400. I have had some good weeks with no issues when later to realize I had a serve anal fissure which was near the scrotal area. I went to a Colon Rectal Specialist, underwent a Lateral Internal Sphincterotomy, which seems to be successful. The CRS explained that the cause of my frequent urination was due to the fissure since there were a lot of nerves in that area. So possible nerve damage could be causing my frequent urge to urinate, which I am reading could take up to 8 months for nerves to heal?

So I invested in a year so far trying to find some answers and the only thing I can really refer to is lab reports. It is almost been a year, and also using Clomid to start my Endocrine system again, my Testosterone is still low. I am starting to believe my low Testosterone is causing my an anxiety towards my OAB. So with starting TRT for life I wanted to get some opinions before I go down that road. My doctor still believe because I am young I should hold off another year.

Is TRT Healthy if regulated correctly? What are some of the things I should expect besides infertility, possible prostate issues, cardiovascular?...etc. Anything I should be aware of before going down this road?

I am attaching my recent lab reports... Remember I have been off everything since April 2017.

If the restart fails, I believe trt would be the best option. The number one issues I see is when using TRT, doctors over-prescribing AI and high HCT levels.

Welcome to Excelmale. Yes, you are certainly hypogonadal. In answer to your primary question, TRT is certainly healthy, in fact it can impact one's health in a remarkably positive way. The single most important element in succeeding with a TRT protocol is the relationship you develop with a skilled doctor. - a physician who is experienced in managing the health of men on androgen therapy makes all the difference.

In in regard to your lab work, you are missing some essential tests. SHBG, DHT, prolactin, DHEA, and all the thyroid tests (TSH, ft3, ft4, rt3, a and both antibody panels).

Low E2 can cause excessive urination, as well as excessive thirst.

When my E2 was low, I had to urinate every hour almost, and it'd feel like an emergency every time. The thirst was probably the worst part, I would wake up so damned thirsty every morning, drink about 32oz of water, run to the bathroom and still be thirsty. There was no satisfying it.

I don't know much about anal fissures, but did clomid help the urination issue? Did you have any labs taken while on it?

TRT is not a bad option for levels like yours, although you'll need a few more labs prior to starting it.

CoastWatcher said:

Welcome to Excelmale. Yes, you are certainly hypogonadal. In answer to your primary question, TRT is certainly healthy, in fact it can impact one's health in a remarkably positive way. The single most important element in succeeding with a TRT protocol is the relationship you develop with a skilled doctor. - a physician who is experienced in managing the health of men on androgen therapy makes all the difference.

In in regard to your lab work, you are missing some essential tests. SHBG, DHT, prolactin, DHEA, and all the thyroid tests (TSH, ft3, ft4, rt3, a and both antibody panels).

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The Clomid was helping for a few weeks, then I fell right back in over active bladder scenario. Here are my labs when I was on Clomid for those 3 months.

One thing I am concerned about is my ALT. I do not drink alcohol, and have a healthy diet. Since 7-8 months of blood tests, an MRI, and ultra sound nothing has shown to be a red flag for my liver. Smooth liver not enlarged. My ALT ranges aroun 66-78. I had one test where it was at 44 and I was happy. No clue what this could be?

Checkdis said:

One thing I am concerned about is my ALT. I do not drink alcohol, and have a healthy diet. Since 7-8 months of blood tests, an MRI, and ultra sound nothing has shown to be a red flag for my liver. Smooth liver not enlarged. My ALT ranges aroun 66-78. I had one test where it was at 44 and I was happy. No clue what this could be?

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Are you working out? Rigorous resistance training increases both AST and ALT, but more so AST (1). After a 3 hour leg day, I pulled a 107 ALT, doctor was very concerned so I retested a week later and took a week off from the gym and everything was in normal range.

1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2291230/

nurselyfe said:

Are you working out? Rigorous resistance training increases both AST and ALT, but more so AST (1). After a 3 hour leg day, I pulled a 107 ALT, doctor was very concerned so I retested a week later and took a week off from the gym and everything was in normal range.

1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2291230/

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I am actually not weight lifting as I used to. Or doing any sort of exercising to that matter. I probably should but I just have been feeling like crap. Some random moments I have panic/anxiety attacks where I feel very worried for no reason. Then my bladder issue adds to it or vise versa. It’s like a fight or flight issue which makes me urinate a lot. I hate it, it sucks

its still less than a year from when you stopped so you could try to wait for improvement if not going on TRT is really important to you. consider your total testosterone level has risen from 86 to 262, thats a significant increase. but the problem is if you end up in the 300's-400's that may not be enough and now have wasted that time with low t. me personally i would just start trt, your around 30, the time when testosterone starts dipping anyway for most men.

at15 said:

its still less than a year from when you stopped so you could try to wait for improvement if not going on TRT is really important to you. consider your total testosterone level has risen from 86 to 262, thats a significant increase. but the problem is if you end up in the 300's-400's that may not be enough and now have wasted that time with low t. me personally i would just start trt, your around 30, the time when testosterone starts dipping anyway for most men.

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Agreed, I might just start it. Last night I woke up at 4:30am and urinated just about 7-8 times. I just want to figure out this urination thing. It’s driving me nuts. It’s like it flares up if it were autoimmune. And I hope it’s not nerve damage. I have exhausted all possibilities? Can bacteria not show up in a urine analysis? I feel like I should just try crypo for 2 weeks if the doctor would allow it.

I eat healthy, stay away from foods and drinks that cause irritation in the bladder. Also I stay away from natural diuretics.

Checkdis said:

Agreed, I might just start it. Last night I woke up at 4:30am and urinated just about 7-8 times. I just want to figure out this urination thing. It's driving me nuts. It's like it flares up if it were autoimmune. And I hope it's not nerve damage. I have exhausted all possibilities? Can bacteria not show up in a urine analysis? I feel like I should just try crypo for 2 weeks if the doctor would allow it.

I eat healthy, stay away from foods and drinks that cause irritation in the bladder. Also I stay away from natural diuretics.

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Have you considered at 29 years of age you could live another 50-60 years? Are you really prepared to start something for life involving needles and injections? I'm 58 and didn't want to do it lol.

Before you "load that needle" as you stated, really think this thru from a 50-60 year commitment perspective. If I was you I would do anything or everything else first.

I guess you could always quit it, seems like 85% of people do.

Lee Panelas said:

Have you considered at 29 years of age you could live another 50-60 years? Are you really prepared to start something for life involving needles and injections? I'm 58 and didn't want to do it lol.

Before you "load that needle" as you stated, really think this thru from a 50-60 year commitment perspective. If I was you I would do anything or everything else first.

I guess you could always quit it, seems like 85% of people do.

But good luck with whatever decision you make. ​

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I am going to try again and restart my system with HCG and then Clomid 50mg twice a week. I am just not sure about the HCG? When I first started my doctors protocol he gave me Clomid 25mg everyday for 3 months. But I spoke with a new doctor and he said he would try again and jump start my system using HCG first and then Clomid 50mg twice a week.

What would be the best protocol to run first before committing to TRT for life?

Checkdis said:

Agreed, I might just start it. Last night I woke up at 4:30am and urinated just about 7-8 times. I just want to figure out this urination thing. It's driving me nuts. It's like it flares up if it were autoimmune. And I hope it's not nerve damage. I have exhausted all possibilities? Can bacteria not show up in a urine analysis? I feel like I should just try crypo for 2 weeks if the doctor would allow it.

I eat healthy, stay away from foods and drinks that cause irritation in the bladder. Also I stay away from natural diuretics.

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Lots of reasons peeps can get that urge to pee.

So you have ruled out urinary tract or bladder infections?
What is your A1C? could you be pre or diabetic?
You said you stay away from diuretics.

You are way to young to have BPH and all that old man crap I have, but who knows you may have accelerated that with the steroid abuse.
TRT can cause urination issues especially if you had it before TRT.

I wish I had an answer for you. I am root for you and hope you can find some relief. Please keep us posted on how things are going.

FeelingLost said:

Lots of reasons peeps can get that urge to pee.

So you have ruled out urinary tract or bladder infections?
What is your A1C? could you be pre or diabetic?
You said you stay away from diuretics.

You are way to young to have BPH and all that old man crap I have, but who knows you may have accelerated that with the steroid abuse.
TRT can cause urination issues especially if you had it before TRT.

I wish I had an answer for you. I am root for you and hope you can find some relief. Please keep us posted on how things are going.

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Your account name is spot on and thank you I greatly appreciate it!

Correct no UTI, and my MRI on the pelvis only found free fluid a small amount. No remarks on the bladder and prostate. Ultra sound found no abnormalities either

But I have never been tested for lymes. My joints have been achy and it would explain the elevated ALT since I have been very healthy. And from doing some quick googling Lymes likes to live in the bladder. I have a freaking husky which always has ticks on him and I would be damned if I wasted almost a year over lymes. To be honest I hope it's positive.

I am going to get retested correctly for diabetes, since my doctor just kind of brushed it off when there wasn't Glucose in my urine and my blood test was below 99. I have had high 90's but it has been going back down to 80's.

If anyone would help me suggest a good HCG dosage and protocol to start with, I would greatly appreciate it. I will relay this info to my doctor, thanks for all the feedback and help guys.

Hey guys, so my endocrinologist appointment is on the 02/06.

Should I try HCG? Then Clomid? Originally my other doctor put me on Clomid for a few months saying this will work, and avoided HCG altogether. I’m not sure what to suggest to my new doctor but from my labs I posted earlier I really want to try my best to jump start my system before resulting in TRT.

I'd strongly advise trying something more conservative such as Clomid, given your age. You might need to get some more bloodwork and other tests to rule out any other problems as well. HCG is suppressive to the HPTA system just the same as TRT, so my thought would be Clomid only. You just have to have a discussion with your doctor.

Might want to also have a look at your liver. That ALT is pretty high. Liver regulates a lot of stuff in our bodies including sex hormones.

CSI007 said:

Might want to also have a look at your liver. That ALT is pretty high. Liver regulates a lot of stuff in our bodies including sex hormones.

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Yeah and my ALT has been that level for nearly 9 months.

Alright I’ll keep exploring my options to the correct treatment.

Checkdis said:

Yeah and my ALT has been that level for nearly 9 months.

Alright I'll keep exploring my options to the correct treatment.

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Not trying to alarm you about it because I certainly am not expert. But my father had cirrhosis of the liver and had ALT levels far lower then yours. Do you drink a lot? Or perhaps took Tylenol before the test?

Checkdis said:

Hey guys, so my endocrinologist appointment is on the 02/06.

Should I try HCG? Then Clomid? Originally my other doctor put me on Clomid for a few months saying this will work, and avoided HCG altogether. I’m not sure what to suggest to my new doctor but from my labs I posted earlier I really want to try my best to jump start my system before resulting in TRT.

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If you deside to go with Clomid talk to the doc about an AI. I have (no experience) but have read many who take Clomid mono and even HCG mono your E2 will rise and maybe go out of range. If you start crying a lot for no dam good reason that's your first clue E2 is too high.

Here's hoping you have a good endo we read so many bad stories around here.