Hi Guys
Hope some of you can relate to this. Long story cut short. 33 year old male presenting most, if not all classic symptoms of low testosterone. Diagnosed with Secondary Hypogonadism. Testing was formally extensive including numerous blood tests, physical exam, MRI etc. Results showed a normal hormone profile (including thyroid) with the exception of a low LH output and, of course, low Testosterone (baseline 5.0-8.7nmol/L). MRI shows normal pituitary size, shape and structure with no tumor or mass present. No other abnormalities in other brain tissue or other body parts! Duration between first test and TRT - 1 year of investigation.
Subsequently, I was placed on an 8 month trial of TRT in the form of Tostran gel. After a few tweaks, my levels increased to a stable 15nmol/L - which proved the sweet spot for me - and in regards to the dose which I finally started to feel better with. That was obtained with 10 pumps per day of Tostran gel applied over my upper body. On paper, it translates to 100mg of testosterone applied to the skin daily.
Unfortunately, my RBC increased dramatically on the worthwhile dose - so much so it made me secondary Polycythemia Vera, with a RBC of 182 g/L. The risks were explained - I was placed on Asprin and 6 weeks ago - TRT was completely stopped without a taper. All of my symptoms have returned - although my baseline Testosterone level is 9.5 nmol/L on the latest test (higher than I expected) and importantly the RBC has come down 158 g/L.
Here's the thing. How an earth am I suppose to obtain adequate Testosterone levels if my Hemoglobin demonstrate they rise so easily? TRT has still been considered - but they explained I would need close monitoring and a blood drain on a regular basis for life. Not to mention the risks. That is a big deal. Not so much the procedure, but the bad side of TRT.
I also lift weights and have done for 5 years. Because of this - on paper, my weight looks too much - and was advised to lose weight - to encourage endogenous production of Testosterone. In reality though I was in great shape. I am 5ft'6 and in the peak of my training was 15 stone (210lbs) fit and healthy.
After some self investigation and research - I have traced the route cause of my Testosterone problem to chronic ongoing insomnia, anxiety and depression. The sleep issues would be massively responsible for a low to non existent LH, which, in theory you would assume equates to low testosterone. I've had sleep issues for years and as such, my natural Testosterone levels cannot be considered stable - because that is down to too many variables which unfortunately don't go in my favor. Since starting a supplementation of Tryptophan and ZMA - I am sleeping better. So what next if I consider against TRT?
I have been looking at the possibility of using an otc SERM, AI & Test booster - as you would think LH would be the component to target specifically. However - I am curious if stimulating LH would also increase RBC secondary to increasing Testosterone -like TRT did? Or is an increase in RBC a side effect of exogenous testosterone exclusively? Whatever the outcome, I have to hit that 15nmol/L mark at least to get any real benefit from TRT. Don't know what to do next.
Thoughts?
J
Hope some of you can relate to this. Long story cut short. 33 year old male presenting most, if not all classic symptoms of low testosterone. Diagnosed with Secondary Hypogonadism. Testing was formally extensive including numerous blood tests, physical exam, MRI etc. Results showed a normal hormone profile (including thyroid) with the exception of a low LH output and, of course, low Testosterone (baseline 5.0-8.7nmol/L). MRI shows normal pituitary size, shape and structure with no tumor or mass present. No other abnormalities in other brain tissue or other body parts! Duration between first test and TRT - 1 year of investigation.
Subsequently, I was placed on an 8 month trial of TRT in the form of Tostran gel. After a few tweaks, my levels increased to a stable 15nmol/L - which proved the sweet spot for me - and in regards to the dose which I finally started to feel better with. That was obtained with 10 pumps per day of Tostran gel applied over my upper body. On paper, it translates to 100mg of testosterone applied to the skin daily.
Unfortunately, my RBC increased dramatically on the worthwhile dose - so much so it made me secondary Polycythemia Vera, with a RBC of 182 g/L. The risks were explained - I was placed on Asprin and 6 weeks ago - TRT was completely stopped without a taper. All of my symptoms have returned - although my baseline Testosterone level is 9.5 nmol/L on the latest test (higher than I expected) and importantly the RBC has come down 158 g/L.
Here's the thing. How an earth am I suppose to obtain adequate Testosterone levels if my Hemoglobin demonstrate they rise so easily? TRT has still been considered - but they explained I would need close monitoring and a blood drain on a regular basis for life. Not to mention the risks. That is a big deal. Not so much the procedure, but the bad side of TRT.
I also lift weights and have done for 5 years. Because of this - on paper, my weight looks too much - and was advised to lose weight - to encourage endogenous production of Testosterone. In reality though I was in great shape. I am 5ft'6 and in the peak of my training was 15 stone (210lbs) fit and healthy.
After some self investigation and research - I have traced the route cause of my Testosterone problem to chronic ongoing insomnia, anxiety and depression. The sleep issues would be massively responsible for a low to non existent LH, which, in theory you would assume equates to low testosterone. I've had sleep issues for years and as such, my natural Testosterone levels cannot be considered stable - because that is down to too many variables which unfortunately don't go in my favor. Since starting a supplementation of Tryptophan and ZMA - I am sleeping better. So what next if I consider against TRT?
I have been looking at the possibility of using an otc SERM, AI & Test booster - as you would think LH would be the component to target specifically. However - I am curious if stimulating LH would also increase RBC secondary to increasing Testosterone -like TRT did? Or is an increase in RBC a side effect of exogenous testosterone exclusively? Whatever the outcome, I have to hit that 15nmol/L mark at least to get any real benefit from TRT. Don't know what to do next.
Thoughts?
J
