28 year old with low-normal range testastorone. TRT worth it?

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tuskir

New Member
Hello forum! I'm here for advice on the best way to treat my low testastorone and would really appreciate your advise. I have been having low t symptons for as long as I can remember, in high school I was that fat kid everyone picked up.

Thankfully, through extremely hard work and eating perfectly, I was able to lose weight in college. I'm now 28, in alright shape, but not great (I'm 5'8 and 170lbs and my maxes are 200 bench, 225 squat 365 deadlift).

I have been tracking my testastorone for the past 3 years (all other hormone test results are good), taking all the natural T supplements you can think of it. My total has been 400 to 500 and free 10 to 14 for past several years. My main issue is lack of energy, not very good recovery after training, as well as mild depression and mild social anxiety. Also, very hard to lose fat and gain muscle, my diet and training has to be absolutely perfect. No libido problems though.

I visited a well-respected endocrinologist and he suggested the following HRT protocol:

Mon: hCG 500 units
Tue: hCG 500 units
Wed. 80mg Testosterone Cypionate
Thurs: Arimidex 0.5mg

I would like to know your thoughts on this protocol for an otherwise healthy 28 year old. Technically, my levels are still in the normal range, so I guess I'm wandering if it's worth it to start with the possibility of having to do HRT for life. Do you think this will really help me raise my energy levels and improve recovery? And overall better feeling?
 
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Vettester Chris

Super Moderator
Thanks for joining! Like you noted, your serum level isn't exactly tanked. Of course it would maybe be a little "optimal" for you if it were up just a bit. With that being said, once you start, you're all in, it's for life! Your physician has you on HCG, Test & AI, which leads me to ask what was your LH/FSH results, and what was your E2 Sensitive result? If you have any/all labs, it would be good to see.

IMO, at 28yo and everything you've described, I think I would first want to see some other labs like your thyroid, adrenals, etc., just to see if there's some other areas that might need focused on, and/or that could be contributing to the semi-low test serum result. Again, noted above, maybe you already have done this?
 

Gene Devine

Super Moderator
I agree with Chris; a 28 year old with serum levels of a 60 years old is not normal and given your history I am wondering if you are Primary Hypogonadal.

To Chris's point; LH/FSH, complete Thyroid panels and Prolactin are a must.

The problem now is your on TRT so we can't see baselines and see what the underlying cause may me.

It it very very rare for a 28 year old who should be peaking with natural production to have lower serum levels like you state and be symptomatic.

Do you have your blood work before you started TRT and if so can you post them here?
 

tuskir

New Member
I am currently NOT on TRT. These results are all before any type of treatment. The only stuff I'm on is tribulus, tongkat ali, zma, and DAA :)

Thank you for the fast reply sir, much appreciated! The result of my results are as follows:


T3 FREE - 3.4 (1.8-4.6 range)
T4 FREE - 1.43 (0.9 - 1.7 range)
TSH --- 1.3 (0.27 - 4.2 range)
LH ------- 2.6 (1.7 - 8.6 range)
Estradiol E2 -- 22.7 (7.6 - 42.6 range)
DHEA-Sulfate 221.8 (160 - 449 range)
Sex Hormone Bind Globulin 27 (10-80 range)
Test total -- 427 (280 - 1100 range)
Test free ---- 10.68 (1.9 - 27 range)
IGF-1 ------- 273 (150 - 222 range)
Cortisol ---- 18.1 (6.2 - 19.4 morning range). Looks a bit high?
Blood count - everything good
General chemistry - all good, Glucose a bit towards high range.
Cholesterol -- 174 total (<200).. HDL 63 and LDL 99.

According to my endo, the TRT treatment is not necessarily a "life sustenance". His theory is that my treatment is very lose dose and with hCG, so if I do decide to stop, it might drop for a few month under my current range, but then within several months stabilize to around 400-500 and I'm back where I was before.

Would you not agree with such assessment? It is definitely a scary prospect being on weekly injections for the next 50+ years. But on the other hand, I feel like I should be at my peak physically and I don't feel like that at all. Don't want to waste my best years thinking "what could have been"...
 

Gene Devine

Super Moderator
Other than the slightly suppressed Testosterone levels everything looks solid.

Sometimes it just happens...

As for restarting HPTA, even with the use of HCG during TRT a HPTA restart may or may not happen on its own with the later being more likely the case.

If you did come off TRT your Doc will, or should know, how to get HPTA restarted...but now that you are on TRT and know the benefits why come off and go back to that old way of life?
 

tuskir

New Member
I actually just got these tests back today and decided to get a second opinion here before starting. What about the weekly protocol and dosages suggested by my doc? Does it look solid for someone in my situation?
 

Gene Devine

Super Moderator
I like what your Doc recommended with the exception of the AI.

Tell him you'd like to hold off till blood work deems it necessary.

At the low dose he has you on it's unlikely you will ever need it...but it is a conservative protocol given where you are at and makes total sense...just hold off on the AI unless E2 levels warrant its use.
 

tuskir

New Member
Thank you! I agree 100%, it's best to hold of on Arimidex and add if it estrogen gets too high after starting treatment. Can always add it... but might not be necessary.
 

Gene Devine

Super Moderator
If you do this you will feel and look like a new man, your sex drive will be insane and if you train seriously you will see tremendous results:)
 

Vettester Chris

Super Moderator
I am currently NOT on TRT. These results are all before any type of treatment. The only stuff I'm on is tribulus, tongkat ali, zma, and DAA :)

Thank you for the fast reply sir, much appreciated! The result of my results are as follows:


T3 FREE - 3.4 (1.8-4.6 range)
T4 FREE - 1.43 (0.9 - 1.7 range)
TSH --- 1.3 (0.27 - 4.2 range)
LH ------- 2.6 (1.7 - 8.6 range)
Estradiol E2 -- 22.7 (7.6 - 42.6 range)
DHEA-Sulfate 221.8 (160 - 449 range)
Sex Hormone Bind Globulin 27 (10-80 range)
Test total -- 427 (280 - 1100 range)
Test free ---- 10.68 (1.9 - 27 range)
IGF-1 ------- 273 (150 - 222 range)
Cortisol ---- 18.1 (6.2 - 19.4 morning range). Looks a bit high?
Blood count - everything good
General chemistry - all good, Glucose a bit towards high range.
Cholesterol -- 174 total (<200).. HDL 63 and LDL 99.

According to my endo, the TRT treatment is not necessarily a "life sustenance". His theory is that my treatment is very lose dose and with hCG, so if I do decide to stop, it might drop for a few month under my current range, but then within several months stabilize to around 400-500 and I'm back where I was before.

Would you not agree with such assessment? It is definitely a scary prospect being on weekly injections for the next 50+ years. But on the other hand, I feel like I should be at my peak physically and I don't feel like that at all. Don't want to waste my best years thinking "what could have been"...

Nothing alarming on the thyroid .. Your FT4 is at 66% of reference range (decent reverses), FT3 at 50%. Ideally, good to see both of these at 50% to 80% of the reference range, and fairly close together in % percentages. The only variable that would be good to see is Reverse T3, although I don't suspect it's out of ratio with FT3 (usually you will see FT3 elevated above FT4 when that's the case .. Not always, but usually ..). Look into some selenium and kelp (iodine), little extra D3 in your plan, and I anticipate that you might see a little improvement with T4 to T3 conversion, maybe both would meet a little closer at that point; possibly around the 60% of reference range, +/-.

Cortisol, no, the AM should be at the top end of the reference range in the AM. The only problem with this test is it leaves the guessing for wondering what the circadian profile looks like with your adrenals throughout the day. In the future look at the 4x saliva kit w/DHEA-s combination. Again, I don't suspect anything majorly off on this end either, or it would probably be prompting some other results with your thyroid. All this is just speculation, so if there's any doubt, run further labs.

LH is definitely on the low side. Here's where I don't agree with your doctor ... Once on exogenous treatment, LH is going to totally tank! Your HPTA will be fully suppressed, as your increased serum levels will signal the pituitary to take a vacation. My take is ... If he's going to put you on TRT, then he needs to commit and put you on for the long-haul .. OR, if he senses there's hope to improve gonadotropin production (LH from the pituitary) to stimulate more endogenous test production, then do it now with some form of SERM/HCG protocol to see if you can increase LH .. Maybe something on the lines of Clomid & HCG combo. One or the other, that's my personal take on it, but others may see it differently.
 

Gene Devine

Super Moderator
Chris, so funny man; I was thinking Clomid to get LH serum production up and HCG to give the testes a boost.

A low daily dose of Clomid could be a nice option. Dr. Crisler has had good results with this as well and wouldn't require the need to inject once or twice a week.

An option to discuss with your Physician as well.
 

Vettester Chris

Super Moderator
Chris, so funny man; I was thinking Clomid to get LH serum production up and HCG to give the testes a boost.


That's what I was thinking as well, Gene! Double down on the LH route first to see if life can improve on the natural side of it .. If they run the course of a PCT, then the TRT option is always in the bag "if needed" if the restart proves to be unsuccessful. I'm not a huge fan of running TRT first, then down the road " let's see if a PCT can restart the HPTA".:confused:
 

tuskir

New Member
I actually did quite a bit of research on Clomid and did discuss a low dose. What really puts me off clomid is when you google about it, you see so many threads about how people feel like shit on it mentally and strange side-effects such as vision problems. And also, it seems like testastorone is more natural for your body since its a bio-identical hormone? It just seems like there are way more positive reports for low dose TRT, you see so many "I feel great on TRT" posts and almost zero "I feel great on clomid" posts.
 

Gene Devine

Super Moderator
I actually did quite a bit of research on Clomid and did discuss a low dose. What really puts me off clomid is when you google about it, you see so many threads about how people feel like shit on it mentally and strange side-effects such as vision problems. And also, it seems like testastorone is more natural for your body since its a bio-identical hormone? It just seems like there are way more positive reports for low dose TRT, you see so many "I feel great on TRT" posts and almost zero "I feel great on clomid" posts.

The good news is you have options and you've done your research which is commendable.

Like I said, I like your Doc's approach sans the AI unless E2 levels warrant.

Do it man and change your life;)
 

Vettester Chris

Super Moderator
I actually did quite a bit of research on Clomid and did discuss a low dose. What really puts me off clomid is when you google about it, you see so many threads about how people feel like shit on it mentally and strange side-effects such as vision problems. It just seems like there are way more positive reports for low dose TRT, you see so many "I feel great on TRT" posts and almost zero "I feel great on clomid" posts.

Agree, there are some that don't do all that well with Clomid. However, keep in mind this exploring two different options ... 1) To first explore getting your natural production at a level where you don't need any medications (at least hopefully not til you get quite a bit older). 2) The option of TRT (Test Cyp, HCG), where you are now making a commitment to go on these medications for life.

Again, totally agree, you might be feeling excellent and you can be perfectly dialed in, BUT, I suggest you don't get the impression that you can just pull off of it down the road, HRT/TRT shouldn't be treated that way, JMHO! If you're looking at short-term testosterone, then that would be more of a AAS cycle. Knowing your LH is already on the low/suppressed side, I think I'd rather either get it sorted out, or just make the decision with your physician to go TRT, and the decision is made.
 

Gene Devine

Super Moderator
Tuskir - TRT is for life; there is on stopping...you need to understand that.

If I missed that in the thread I am sorry.

Like Chris said, it's not a "Cycle"...it's for life.
 

tuskir

New Member
The other thing I was wondering, based on my results, is my problem primary or secondary hypogonadism? As I understand, clomid is only effective for secondary.
 

Gene Devine

Super Moderator
The other thing I was wondering, based on my results, is my problem primary or secondary hypogonadism? As I understand, clomid is only effective for secondary.

If you were Primary it would be testicular failure due to pathology or injury and LH would be super elevated.

You have low normal LH and are producing Testosterone...you are not Primary.
 
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