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Testosterone Replacement, Low T, HCG, & Beyond
Blood Test Discussion
First lab post! Posted an intro as well. Pre-TRT. High DHEA and IGF-1.
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<blockquote data-quote="Cataceous" data-source="post: 216417" data-attributes="member: 38109"><p>In nearly every case of primary hypogonadism, which is testicular insufficiency, we see LH close to or above the top of its range. A more definitive diagnosis can be obtained via an hCG stimulation test. Basically you're given a large dose of hCG and testosterone is subsequently measured to evaluate testicular response.</p><p></p><p>Enclomiphene is preferred over clomiphene. Basically clomiphene is enclomiphene plus estrogen. You likely will not need more estrogen because your estradiol-to-testosterone ratio is normal. When testosterone is normalized then estradiol will be too, because estradiol is made from testosterone.</p><p></p><p>If you go with Defy then you should be able to choose any of the treatment options—but you may need to be insistent to get your way. Not everyone there has a good understanding of nasal gel and enclomiphene as alternative treatments. I view the nasal gel as the best place to start. You're getting only more testosterone, which is what you likely need. Enclomiphene works well for some, but it's not a natural substance and its long-term effects are not fully understood. However, it is convenient, with only one oral dose daily or every other day. Regular TRT should be kept as a last resort. There are not rigorous studies on the problems associated with HPTA shutdown, but I believe they exist and affect most men on TRT to some degree. The most universal problem is testicular atrophy, which might be kept at bay with hCG. Some men experience long-term problems with low libido and impaired cognition. I offer some speculation connecting these to reduced levels of <a href="https://www.excelmale.com/forum/threads/is-gnrh-suppression-hurting-us.20407/" target="_blank">GnRH</a> and <a href="https://www.excelmale.com/forum/threads/kisspeptin-suppression-under-trt-can-it-affect-mood-and-libido.21374/" target="_blank">kisspeptin</a>. Personally I experienced these problems and seemed to resolve them by <a href="https://www.excelmale.com/forum/threads/pituitary-restart-while-on-trt-promising-initial-results-with-gnrh-plus-enclomiphene.20864/" target="_blank">adding back</a> these suppressed hormones. But this is a complicated solution and you'd be better off avoiding the issue to begin with, if possible.</p></blockquote><p></p>
[QUOTE="Cataceous, post: 216417, member: 38109"] In nearly every case of primary hypogonadism, which is testicular insufficiency, we see LH close to or above the top of its range. A more definitive diagnosis can be obtained via an hCG stimulation test. Basically you're given a large dose of hCG and testosterone is subsequently measured to evaluate testicular response. Enclomiphene is preferred over clomiphene. Basically clomiphene is enclomiphene plus estrogen. You likely will not need more estrogen because your estradiol-to-testosterone ratio is normal. When testosterone is normalized then estradiol will be too, because estradiol is made from testosterone. If you go with Defy then you should be able to choose any of the treatment options—but you may need to be insistent to get your way. Not everyone there has a good understanding of nasal gel and enclomiphene as alternative treatments. I view the nasal gel as the best place to start. You're getting only more testosterone, which is what you likely need. Enclomiphene works well for some, but it's not a natural substance and its long-term effects are not fully understood. However, it is convenient, with only one oral dose daily or every other day. Regular TRT should be kept as a last resort. There are not rigorous studies on the problems associated with HPTA shutdown, but I believe they exist and affect most men on TRT to some degree. The most universal problem is testicular atrophy, which might be kept at bay with hCG. Some men experience long-term problems with low libido and impaired cognition. I offer some speculation connecting these to reduced levels of [URL='https://www.excelmale.com/forum/threads/is-gnrh-suppression-hurting-us.20407/']GnRH[/URL] and [URL='https://www.excelmale.com/forum/threads/kisspeptin-suppression-under-trt-can-it-affect-mood-and-libido.21374/']kisspeptin[/URL]. Personally I experienced these problems and seemed to resolve them by [URL='https://www.excelmale.com/forum/threads/pituitary-restart-while-on-trt-promising-initial-results-with-gnrh-plus-enclomiphene.20864/']adding back[/URL] these suppressed hormones. But this is a complicated solution and you'd be better off avoiding the issue to begin with, if possible. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Blood Test Discussion
First lab post! Posted an intro as well. Pre-TRT. High DHEA and IGF-1.
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