Hi Need Help on TRT from Pune India

[Raaj]

Hi All, I am 41 year old male from India Pune. I was born low T and now have worst low T symptomS
Testicles size reduced to left 2.5 vm and 1.2 cm and right measures 2.9 and 1. Cm. Also developed bilateral vericocele of 4.5 mm and 3.5 mm on right. Very low testicular volume.
TT Total - 450
Estradiol - 34
Lh - 9
Fsh - 7
Prolactin - 7
Tsh - 0.5
Please let me know as I would like to be in range 900-1000 and would like to go for lifelong TRT
Life is a hell right now severe brain fog, no energy, no libido and no mood, no motivation can not sleep and memory loss and cognition issued
Please let me as it's Primary Testicular failure and my pituitary is working.
Is there any way I can restore my TT level to optimized level using Hcg monotherapy or TT alone or TT plus Hcg to stay Testicular function active. Or any stem cell therapy would be helpfulL
I am from Pune, India
Thanks and appreciate positive responses from you all.

 

[Systemlord]

Assuming LH ranges top out close to 9, it would mean the bilateral varicocele is interfering with testosterone production and the pituitary is responding appropriately by increasing LH to compensate. I don't think you are primary, not with a respectable total testosterone of 450 unless of course SHBG is high. I think you need surgery on your bilateral varicocele before resorting to interventions like TRT.

You have no SHBG testing which would give us a hint where free testosterone lies, it's difficult to gauge whether or not total testosterone is sufficient enough since you have no SHBG value, if SHBG is lower, free testosterone may be perfectly fine, however if SHBG is elevated this would change things considerably.

Men normally have between 2-3 percent of their testosterone free and bioavailable, so without SHBG or free testosterone testing, your bioavailable testosterone is an unknown. If you are having low testosterone symptoms at 450, I suspect SHBG must be high which would bind up the majority of your free testosterone.

As far as stem cell therapies, I think it's too soon for anything like that. Optimizing testosterone on HCG has it's problems, HCG only stimulates the top half of the testicles and suppresses the other half, in short it doesn't stimulate all pathways and can be difficult to control estrogen in the high normal ranges because estrogen can get out of control inside the testicles and estrogen blockers can't affect estrogen produced inside the testicles.

 

[Raaj]

Thanks for the reply. I will test for shgb and psa soon and will post them here. But I should be steady range let's say 800 and 900 till end of my life
Few queries if you can answer
1.how much risk of vericocele surgery and will it restore my TT and Testicular Volume and size. My testicles are now 1/3 of the shatbdard testicle size of 2.5 inches + 1.2 inches
2. If I would like to go to nebido dosage how I can control my estradiol and testicular function with Hcg as I want testicular volume also for natural feel good feelings
Right now I am on very low energy and feeling sheet like 90 year old man with no libido and morning erections
Thanks

 

[Raaj]

Attaching some reports for referencE
Below are symptoms I am facing alobwith anemia
Signs and Symptoms Signaling a Problem:2,3 Red flag symptoms: Low sex drive Difficulty with erection Low sperm count Unexplained loss of hair Hot flashes Low bone density Additional signs: Testicular atrophy (changes in testes) Diminished lean muscle mass Increased body fat Elevated hemoglobin A1c Osteopenia or low trauma bone fracture Problems sleeping (insomnia) Fatigue Difficulty concentrating, lack of motivation, depression

 

[Systemlord]

I don't think there is any risk in varicocele surgery, it will either work or it won't. A low dose HCG 350-500 2-3 times per week together with TRT can restore testicle volume. As far as using Nebido, you will have to experiment on injection frequencies as everyone metabolizes testosterone at different rates.

A 90 year old man, I know firsthand how that feels as my testosterone 3 years ago was 120.

 

[at15]

Thanks for the reply. I will test for shgb and psa soon and will post them here. But I should be steady range let's say 800 and 900 till end of my life
Few queries if you can answer
1.how much risk of vericocele surgery and will it restore my TT and Testicular Volume and size. My testicles are now 1/3 of the shatbdard testicle size of 2.5 inches + 1.2 inches
2. If I would like to go to nebido dosage how I can control my estradiol and testicular function with Hcg as I want testicular volume also for natural feel good feelings
Right now I am on very low energy and feeling sheet like 90 year old man with no libido and morning erections
Thanks

wait until you see your free testosterone. your total is largely irrelevant. you may not even need to start trt right now. there can be other causes to all of your problems besides testosterone.

 

[Raaj]

Thank you all the members for all your valuable inputs. But as I studied here and 2 months in research I have seen that Hcg monotherapy will cause large E2 problems And will not work for primary. In India doctors are not familiar with trt and they do not even know about testoreone, estradiol, shgb, and injection frequency. They only presrive you with cialis or ssri and say go home. They will only treat diabetics and low high BP. I have seen 5 famous endocrinologist in pune and they even do not know when I ask them testoreone range. I told them people die with low testoreone and not with normal to high testoreone. They will leave you with all ugly symptoms. Now I got hold of one endocryonoligist in pune with whom I going to work out the trt therapy in next week