New member from Oregon

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Tonman

New Member
Hi Everyone,

I have finally decided to join and post after reading countless hours worth of material on all different types of sites related to TRT. Like many others I have read about on this site and others I have not felt like myself in many years. I am 38yrs old, 215lbs, 6' tall, medium build, and have always been a hard charger at work and in life in general. I have not been consistent in a Gym for many years but overall I am healthy, eat decent, and probably only get minimal exercise due to my intense work schedule.

I recently had an issue with pain in my testicles that got me worried. I found that I had a moderate sized varicocele on my left side and also had epididymitis on my right side. I had a couple rounds of antibiotics a few weeks ago to hopefully clear the epididymitis. After reading about these issues and that they can sometimes be related to low T, I then looked up low T symptoms, low and behold I exhibited many of the symptoms of low T. That's when I decided a blood test was in order. Since then Ive had 3 blood tests over the last few months all of which showed I had depressing T levels. Here are my test results ( note that they did not do many of the tests that are recommended ). Though my total levels are terrible at below 300, I think the Free T actually looks worse, any comments about that?

8/20/16: Total T = 219 ( No other tests performed or requested by G.P. )

9/26/16: Total T = 268
Free T = 6.1
SHBG = 19.7
LH = 5.2
FSH = 5.0

10/20/16: Total T = 283
Free T = 4.8
SHBG = 26.5
PSA = .515
TSH = 1.66
Free T4 = 1.19
Prolactin = 7.11

Needless to say my total T and free T are really low. The last test was ordered by an Endo and he decided to prescribe me Test - cypionate 200mg every two weeks. I have already read enough that every two weeks is a terrible schedule so I asked him if we could go 100mg once per week and he was ok with that. I asked him multiple times about and AI and HCG and he said he has never prescribed either and neither has any of his colleagues. He said that we are trying to get my T to low/moderate levels like 450-500 which seemed silly to go through all this trouble for a marginal increase.

I had my first shot today and am excited to see what will come of this adventure. I am anxious to get my energy back and lose the fog/depression that I have felt for sometime. I have always struggled sleeping and I am hopeful this will actually help. I am still apprehensive about only being prescribed test for now but I have a follow up appointment in 8 weeks so we will see how the labs turn out. I will definitely be requesting labs for E2.

Based on my story above I would appreciate any feedback any experienced members have, such as other labs I should request, should I just go to an anti aging clinic and get and AI and HcG, etc.

Thanks for reading, any feedback or advice is very welcomed.
 
Defy Medical TRT clinic doctor

Nelson Vergel

Founder, ExcelMale.com
Hi Tonman

Welcome to ExcelMale.com ! You will find a lot of educated and friendly guys here willing to help.

I am glad you got on TRT. So, are you on 100 mg per week? Tell us more about injection technique and syringe size you are using.


I am including posts related to varicoceles here. Are you going to get yours treated?

Varicocele - Causing low Fee T and high SHBG?

Varicocele - Causing low Fee T and high SHBG?Varicocele...

Hi all, So I am fairly certain I have a varicocele. My nurse practitioner seemed fairly ignorant to them, and said I definitely had some swelling ...

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Varicocele Surgery Improves Testosterone and Sexual Function

Varicocele Surgery Improves Testosterone and Sexual FunctionVaricocele...

Urology. 2016 May 16. pii: S0090-4295(16)30194-7. doi: 10.1016/j.urology. 2016.04.044. Improvements in Patient Reported Sexual Function ...

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Getting varicocele ligation, do you think it could restore my T levels?

...varicocele...do...

Hi, I am diagnosed with hypogonadism due to varicoceles. I have a grade 2+ on the right side. It causes a lot of pain and a grade 1 on the left ...

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At this point, can varicocele surgery help my testosterone level?

At this point, can varicocele surgery help my testosterone level?...varicocele...

Even though my LH and FSH was low normal, I was diagnosed with hypogonadism due to grade 2+ varicocele on my right testicle and a grade ...

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When is a varicocele repair indicated: the dilemma of hypogonadism ...

...varicocele...

1713 Asian J Androl. 2015 Dec 18. doi: 10.4103/1008-682X.169560. When is a varicocelerepair indicated: the dilemma of hypogonadism and ...

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Anyone Ever Dealt With a Varicocele?
 

Tonman

New Member
Thanks for the reply and info on varicocele's Nelson. I am doing 1ml injections once per week IM. I am using a 21 ga. needle for the injections, only had my first one today and it seemed fine.

My G.P. thought that my varicocele had no impact on my low T. He felt that it was small to moderate sized and that I have probably had it for a long time and never noticed it until I got the pain related to the epididymitis and started researching.

I have read a lot about varicocele's and I don't think mine warrants any surgery, its not even visibly noticeable, it was only confirmed through an ultrasound. I think some supplements to promote vein health and certain exercises will help.


I really wish I knew my E2 levels before I got my first injection today, but I guess I am committed at this point to TRT, so I will evaluate them at my next blood test.

My Endo said he wanted me to have my next labs done mid way between my injections, but everything Ive read says to have them done the day before your next injection. Is there a reason he would want it halfway in between, its seems like that may be the time for the typical spike ( 3-4 days after injection ) so he would not know what my trough level was and I think that's what everyone wants to base their doses on. Any thoughts on this?
 

CoastWatcher

Moderator
Thanks for the reply and info on varicocele's Nelson. I am doing 1ml injections once per week IM. I am using a 21 ga. needle for the injections, only had my first one today and it seemed fine.

My G.P. thought that my varicocele had no impact on my low T. He felt that it was small to moderate sized and that I have probably had it for a long time and never noticed it until I got the pain related to the epididymitis and started researching.

I have read a lot about varicocele's and I don't think mine warrants any surgery, its not even visibly noticeable, it was only confirmed through an ultrasound. I think some supplements to promote vein health and certain exercises will help.


I really wish I knew my E2 levels before I got my first injection today, but I guess I am committed at this point to TRT, so I will evaluate them at my next blood test.

My Endo said he wanted me to have my next labs done mid way between my injections, but everything Ive read says to have them done the day before your next injection. Is there a reason he would want it halfway in between, its seems like that may be the time for the typical spike ( 3-4 days after injection ) so he would not know what my trough level was and I think that's what everyone wants to base their doses on. Any thoughts on this?

There is no reason to measure your testosterone at the mid-point of an injection cycle. What are your SHBG levels? They impact the success of your cycle - the lower the recorded value, the more need for frequent and smaller injections. Capturing your testosterone prior to next injection lets you and your doctor know what you're looking at in terms of your response to the prior injection.

The vast majority of doctors with knowledge of the ins and outs TRT will start patients on two injections per week of testosterone, every 3.5 days. Not all men need this, a point to keep in mind, but most of us respond best to multiple injections (every 3.5 days, every other day, or a very few - I am one - every day). Remember this as you move down the hormone highway.

As to the reason he suggested you test at mid-point, it may be simply because he's not well informed. Most doctors, despite board certifications, know very little about androgen replacement. That includes endocrinologists and far too many urologists. Here at EM the vast majority of our members, almost all of us, had terrible protocols prescribed by inept doctors. We had to fight to find good care; most of us have.

We we hope you'll be an active member here. Please stay in touch.
 

Re-Ride

Member
This endo seems obsessed with a "low norm" target of 450-500 TT total rather than treating you on symptom relief. That's a flag for me. You say you are getting good nutrition. Personally until I got the supplements, aminos, minerals and proper form of vitamins down I didn't make headway on the fog thing. Post the ones you are considering. Check their proven effectiveness on Examine.com. Belly fat reduction is important to reduce aromatase enzyme activity and for general health.

Continue the multi-prong approach you are on and you'll be happy with the results.
 

Sean Mosher

Member
450-500 definitely is way too low for TRT purposes.
Hopefully you can convince him to bump that quite a bit, say at least 800 ng/DL.
If not, then you're right, you'll need to consider transferring to a specialist.
 

Tonman

New Member
SHBG levels

There is no reason to measure your testosterone at the mid-point of an injection cycle. What are your SHBG levels? They impact the success of your cycle - the lower the recorded value, the more need for frequent and smaller injections. Capturing your testosterone prior to next injection lets you and your doctor know what you're looking at in terms of your response to the prior injection.

The vast majority of doctors with knowledge of the ins and outs TRT will start patients on two injections per week of testosterone, every 3.5 days. Not all men need this, a point to keep in mind, but most of us respond best to multiple injections (every 3.5 days, every other day, or a very few - I am one - every day). Remember this as you move down the hormone highway.

As to the reason he suggested you test at mid-point, it may be simply because he's not well informed. Most doctors, despite board certifications, know very little about androgen replacement. That includes endocrinologists and far too many urologists. Here at EM the vast majority of our members, almost all of us, had terrible protocols prescribed by inept doctors. We had to fight to find good care; most of us have.

We we hope you'll be an active member here. Please stay in touch.

Hi coast watcher my SHBG levels were 19.7 and 26.5, I'm not sure if these are considered low or not and if I should be paying extra attention to these numbers in the future.
 

CoastWatcher

Moderator
Hi coast watcher my SHBG levels were 19.7 and 26.5, I'm not sure if these are considered low or not and if I should be paying extra attention to these numbers in the future.

SHBG sits where it sits. It is simply another factor - a very important factor - that has to be taken into account when designing a protocol. A level of 19.7 is low, many of us have lower, and 26.5 is reasonable. You will do much better on multiple injections per week. I would argue for that in any case.
 

ERO

Member
Agree with everything already said. I would add that most anti-aging clinics are both very expensive and often far out of date with TRT protocols. I would give strong consideration to Defy Medical and their tele-medicine model. A great many of use use and highly recommend them. Save you a ton of money too compared to most anti-aging clinics.
 
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