Hi all,
I posted here earlier in the year describing my symptoms and shared some blood results demonstrating low free T.
After two further blood tests confirming I have low free T I finally made the move and went to see a men's health specialist privately.
I am still awaiting an appointment on our national health service but given the horror stories and my previous expose with endocrinologists following procedure I figured it is highly unlikely that I will be prescribed replacement therapy so have taken a different route.
My most recent bloods were
Total test 15.7 (9-30)
Free T 22 (45-220)***low
SHBG 72 ***(20-55)high ...(have been in a calorie deficit since march which may have bumped this up slightly, it's usually between mid forties and early fifties)
Estradiol - can't find result page but was also low(unsurprisingly)
So I am faced with two options
Testosterone enanthate and hcg or clomid 25mg/d
i have to now weigh up wether to risk TRT at the cost of my adrenal function as test has previously lowered my cortisol down to a level I cannot function at or hope that my body is In a better state to deal with TRT and this may not happen.Previous history and science tells me I will get a drop in cortisol but I think that from a numbers perspective TRT would be a better route for me given my SHBG.
Second option is Clomid, I haven't used clomid since my bodybuilding days for pct which was around 10 years ago so I have no idea what impact this will have on cortisol.from what I have read it will raise the testosterone via increased Lh signalling and should keep the adrenal pathways in tact..like anything the "on paper" result tends to be quite different from the real life so I am still apprehensive about this.I am also concerned about the side effects such as blurred vision and the estrogenic effect of the clomid itself(basically don't want to feel even less masculine than I do already)
Things I do know:
Testosterone did lower my cortisol
ACTH on blood test a week after last shot of T was in upper quartile of range so it may be more of a conversion /cascade issue
My SHBG is high so I will likely need quite a high dose of T to get the free levels up
Things I don't know:
Wether HCG will sufficiently backfill the hormonal cascade
Wether the ACTH will also drop with the increase in test or if it will remain high normal
Wether Clomid will cause same/similar issues with test
Wether there is a link between estrpgen and lower cortisol rather than Testosterone (would then an AI from the start be less disruptive to the adrenal system)
No idea what my pregnenolone ,DHEA and progresterone levels are
Wether my body will somehow "adapt" after a short period of time on testosterone
Wether I could have another negative reaction to TRT which could render me unfit to work or worse ,clinically dangerously low levels of adrenal hormones and requiring emergency intervention.
When I run through the above the most logical/ risk averse option would be to try clomid and see what happens, should anything go wrong it will not leave my HPTA in a worse state and my adrenal hormones should experience the least amount of disruption.
Most of the doctors I have encountered in the UK have a very standard approach and even the more liberal "specialists" don't tend to know much about the link between TRT and adrenals.
At this junction I felt it would be a good time to post up my situation to see if anybody has walked a similar path or perhaps some input from the Drs here could prove really valuable.
Thanks for reading, if you have time I would appreciate any responses, help and support.
I posted here earlier in the year describing my symptoms and shared some blood results demonstrating low free T.
After two further blood tests confirming I have low free T I finally made the move and went to see a men's health specialist privately.
I am still awaiting an appointment on our national health service but given the horror stories and my previous expose with endocrinologists following procedure I figured it is highly unlikely that I will be prescribed replacement therapy so have taken a different route.
My most recent bloods were
Total test 15.7 (9-30)
Free T 22 (45-220)***low
SHBG 72 ***(20-55)high ...(have been in a calorie deficit since march which may have bumped this up slightly, it's usually between mid forties and early fifties)
Estradiol - can't find result page but was also low(unsurprisingly)
So I am faced with two options
Testosterone enanthate and hcg or clomid 25mg/d
i have to now weigh up wether to risk TRT at the cost of my adrenal function as test has previously lowered my cortisol down to a level I cannot function at or hope that my body is In a better state to deal with TRT and this may not happen.Previous history and science tells me I will get a drop in cortisol but I think that from a numbers perspective TRT would be a better route for me given my SHBG.
Second option is Clomid, I haven't used clomid since my bodybuilding days for pct which was around 10 years ago so I have no idea what impact this will have on cortisol.from what I have read it will raise the testosterone via increased Lh signalling and should keep the adrenal pathways in tact..like anything the "on paper" result tends to be quite different from the real life so I am still apprehensive about this.I am also concerned about the side effects such as blurred vision and the estrogenic effect of the clomid itself(basically don't want to feel even less masculine than I do already)
Things I do know:
Testosterone did lower my cortisol
ACTH on blood test a week after last shot of T was in upper quartile of range so it may be more of a conversion /cascade issue
My SHBG is high so I will likely need quite a high dose of T to get the free levels up
Things I don't know:
Wether HCG will sufficiently backfill the hormonal cascade
Wether the ACTH will also drop with the increase in test or if it will remain high normal
Wether Clomid will cause same/similar issues with test
Wether there is a link between estrpgen and lower cortisol rather than Testosterone (would then an AI from the start be less disruptive to the adrenal system)
No idea what my pregnenolone ,DHEA and progresterone levels are
Wether my body will somehow "adapt" after a short period of time on testosterone
Wether I could have another negative reaction to TRT which could render me unfit to work or worse ,clinically dangerously low levels of adrenal hormones and requiring emergency intervention.
When I run through the above the most logical/ risk averse option would be to try clomid and see what happens, should anything go wrong it will not leave my HPTA in a worse state and my adrenal hormones should experience the least amount of disruption.
Most of the doctors I have encountered in the UK have a very standard approach and even the more liberal "specialists" don't tend to know much about the link between TRT and adrenals.
At this junction I felt it would be a good time to post up my situation to see if anybody has walked a similar path or perhaps some input from the Drs here could prove really valuable.
Thanks for reading, if you have time I would appreciate any responses, help and support.