John in Raleigh

Hello everyone! I'm John, age 51 in Raleigh, NC. While my regular blood work, doctors exams, etc show my health to be optimal I am just unsatisfied with my well-being, vigor, strength, appearance, etc. In other words, I am unhappy about aging and loss of those youthful attributes. I was in the gym a while back and a VERY muscular older man (he was muscular FAR beyond what I'd like to achieve) was willing to tell me he was using testosterone so that led me to read Nelson's book and so I am glad to come aboard.

Even with a trainer and vigorous workouts I am unable to build muscles like I'd like to was once able to.

I'm glad for this forum (thanks Nelson!) I'll chronicle my progress starting with the following:

My integrative physician has experience prescribing testosterone he has me do a saliva hormone panel that showed my test to be "mid range" (blood tests show 500 and 600 ng/dl.) My estrodial is a bit high so I am using Myomin (natural aromatase inhibitor) and will retest after 1 month of that to see how the testosterone levels are (now that less is being converted into estrodial.)

Our goal is to get me to the high end of a young male (1100 to 1200 ng/dl)

My testosterone scrips will commence in a few days and I'll be taking sublingual 5mg bio-identical testosterone twice daily. I'll re-test in a month. I asked for injections but he states that his experience is good with the sub-lingual drops so that the course for now.

I am considering delaying the testosterone and instead using HCG and may contact Dr. Shippen and/or read his book. From what I glean from Nelson it may be worth a try: "You can try it. Some men do not feel that great on HCG monotherapy. Start with 500 IU every other day alone and see how high your total and free testosterone raises in 4 weeks. If not over 600 ng/dL increase dose to 1000 IU three times a week. Measure your estradiol by ultrasensitive." Nelson also states "Yes, it is effective but chances are your T will come down again if you stop it. Only younger men may have a "reset" of their axis using HCG".

Shippen states that HCG acts like Lutenizing hormone and can increase testosterone production depending on which part of the axis is deficient. Since my testosterone is already 500-600 (not too deficient) I wonder if HCG can get me to 1100 - 1200?

Anyone have experience using HCG to boost Testosterone?

Anyone have experience using sub-lingual testosterone drops?

John, welcome to EM. I'm reading what you put down, I know you're frustrated! It's good to see that you want to take a piece of your youth back!
If I may ask, what was your serum level? 500? 600? I'm more of a fan of actual blood serum for testosterone assays, but that's just my preference. John, don't take this wrong, but you're putting all your eggs into the testosterone nest. If we're going to focus on testosterone, then let's also look at free and bio-available test. Do you know where you sit on this? You could very well be sitting with some high SHBG finding a lot of free test is being tied up. Supplementing with therapy dosages of Vitamin D3 (or Drisdol D2 Script), plus possibly some Nettle Root can get that in order. For some, it could be the difference between 1% moving up to 2% (so basically doubling your actual free testosterone).
On your E2, you say "is a bit high", what does that mean? Again, IMO, there's too much focus on just this one variable. I don't see any thyroid numbers, LH or FSH, iron, cortisol, or a multitude of other labs from CBC's to Metabolic, which is all needed to help assess a diagnosis from a doctor's standpoint, and needed to engage in deeper discussion with this forum. You are paraphrasing quotes from Dr. Shippen .. Do you know what part of your axis is deficient? 500ng to 600ng might not be completely optimal, but it's not suppressed by any means. For me, I am at/around a 700ng/dl range, and I'm sitting a tad over 3% free test.
Again, congrats for grabbing this by the horns, but I suggest stepping back and looking at the whole picture of what is needed to help you attain your goal(s). If exogenous testosterone fits into that plan, excellent, but it could be more of complication if the other variables are not being considered.

Hi Chris, great to read your post. Your points are well taken and I am still doing homework and consulting more expertise. Much of my reading indicates I need to account for more than just testosterone, so I agree with you.

To answer your questions as best possible:

My most recent blood test (2 days ago) shows 516/6.8 ng/dl (total/free.)

Esrtadoil is 2 pg/ml (saliva test from mid March) - normal

Estrone is 75 pg/ml (saliva test from mid March) - elevated

More data: I just halted HCG (used for weight loss) at 125 IU per day - that was 4 or 5 days before that test AND I suppose that should have elevated the Testosterone above baseline. However, a blood test from 8 months ago showed 591 ng/dl (where no HCG was in use.) These data points seem to show a deficient axis - what part? the lydig cells?

BTW: I have postponed taking the sub-lingual testosterone (10mg/day) since I am second guessing my local doctor. I actually think he's a great doctor (integrative physician.) His goal is to get me to 1100 - 1200 mg/dl. I am anxious to begin taking testosterone.

About the other hormones and metrics you mention - the complications all seem very relevant. I've consulted 2 doctors locally (who have a single tool: exogenous Testosterone.)

What clinic or doctor will actually all the hormones and metrics into account and yield the best treatment? I spoke with Defy Medical today and they impressed me.