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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Low Testosterone symptoms. 10 years of finding a solution
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<blockquote data-quote="madman" data-source="post: 218424" data-attributes="member: 13851"><p><strong>My symptoms are:</strong></p><p></p><ul> <li data-xf-list-type="ul">Extreme brain fog to the point that I am forgetful and it takes a lot more effort to articulate my thoughts.</li> <li data-xf-list-type="ul">Awful sleep. I never wake up feeling refreshed and wake up during the night multiple times.</li> <li data-xf-list-type="ul"><em><strong><em>Low energy and mood</em></strong></em></li> <li data-xf-list-type="ul"><em><strong><em>Low libido/ED</em></strong></em></li> <li data-xf-list-type="ul">Overall I don't feel like myself anymore. I feel like an old man in a younger mans shell.</li> </ul><p></p><p></p><p>Hoping you had your blood work done between 7-10 am in a fasted state as we want to test at peak.</p><p></p><p>Let alone if you are training in the gym it would be better to take a week off before getting labs.</p><p></p><p>The causes of erectile dysfunction let alone decreased libido are complex and multifactorial.</p><p></p><p>Low libido/ED (lack of nocturnal/spontaneous daytime erections) are common symptoms of low-t.</p><p></p><p>Keep in mind dysfunction thyroid/adrenals can easily mimic low-t symptoms.</p><p></p><p>From your most recent labs, you were hitting a descent TT 17.7 nmol/L (510ng/dL).</p><p></p><p>Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.</p><p></p><p>FT 5-10 ng/dL would be considered low.</p><p></p><p>FT 16-31 ng/dL (high-end) is healthy.</p><p></p><p>Most men on trt will do well with FT 20-30 ng/dL and yes there are some who will do just fine with FT 15-20 ng/dL.</p><p></p><p>Comes down to the individual.</p><p></p><p></p><p></p><p></p><p>With a TT 510ng/dL SHBG 33.5 nmol/L (normal) and Albumin 4.2 g/dL, then your FT would be around 17 ng/dL (far from low).</p><p></p><p>[URL unfurl="true"]https://tru-t.org/[/URL]</p><p>[ATTACH=full]19952[/ATTACH]</p><p></p><p></p><p>TT of 8-12 nmol/L would be considered the grey zone and even then many men with higher T levels can still suffer from low-T symptoms due to high/highish SHBG.</p><p></p><p>You are hitting a TT low 500s and you have normal SHBG so your FT is definitely not going to be borderline/low.</p><p></p><p>Even then no one can say that these levels are optimal for you let alone should not cause any symptoms.</p><p></p><p>Much more involved especially if we get into the sensitivity of the AR/polymorphism of the AR and CAG repeat length (short/long).</p><p></p><p>As others have stated would be wise to look into Natesto or clomiphene/EN before jumping into full-blown trt.</p><p></p><p>You stated that Natesto is not an option so if you are concerned about using clomiphene/EN and were dead set on using exogenous test then I see no harm in giving it a go as long as you have a decent understanding let alone realistic expectations.</p><p></p><p>Shutting down your HPGA is not something to take lightly!</p><p></p><p>Many men do well on trt whereas others may constantly struggle especially when it comes to libido/erectile function.</p><p></p><p>No harm in trying even short-term as you can always stop and you will eventually return to baseline levels.</p><p></p><p>PCT or cold turkey.</p><p></p><p>6 months would be a decent amount of time to put in.</p><p></p><p>The most sensible approach would be to find a doctor in the know who will work with/guide you.</p><p></p><p>Taking the UGL route and flying solo may not be your best move especially if you lack the understanding of how exogenous esterified T works.</p><p></p><p>Blood work using accurate assays is critical.</p><p></p><p>Do what you feel is best for you!</p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/low-testosterone-in-men-recommendations-on-the-diagnosis-treatment-and-monitoring.23933/#post-206879[/URL]</p><p></p><p></p><p><strong>Figure 1. Threshold continuum to hypogonadism.</strong></p><p><strong>[ATTACH=full]19953[/ATTACH]</strong></p><p><strong>[ATTACH=full]19954[/ATTACH]</strong></p><p></p><p></p><p></p><p></p><p><em><strong>post #7</strong></em></p><p><em><strong></strong></em></p><p><em><strong>*No consensus has been reached regarding the lower TT threshold defining TD, and there is no generally accepted lower limits of normal TT.</strong> <strong><u>This lack of consensus follows from the fact that no studies have shown a clear threshold for TT or free T that distinguishes men who will respond to treatment from those who will not</u></strong></em></p><p></p><p></p><p></p><p></p><p><strong><em>post #8</em></strong></p><p><strong></strong></p><p><strong><u>AR CAG repeat lengths</u> (short/long)</strong></p><p></p><p><em><strong>*The number of cytosine–adenine–guanine triplet (CAG) repeats in androgen receptors differ in men and influences the androgen receptor activity [88,89,90,91] (Figure 1). <u>Hence testosterone sensitivity may vary in different individuals</u>.</strong></em></p><p><em><strong></strong></em></p><p><em><strong>*The same applies to <u>androgen receptor gene CAG repeat lengths >24 in the presence of symptoms and normal testosterone levels</u> may be considered as a state of preclinical TD [93]</strong></em></p><p><em><strong></strong></em></p><p><em><strong>*In general, it is currently speculated that variable phenotypes of androgen insensitivity exist, mainly owing to mutated androgen receptors. <u>More subtle modulation of androgen effects is related to the CAG repeat polymorphism in exon 1 of the androgen receptor gene</u>: transcription of androgen-dependent target genes are attenuated with the increasing length of triplets.</strong></em></p><p><em><strong></strong></em></p><p><em><strong><u>*As a clinical entity, the CAG repeat polymorphism can relate to variations of androgenicity in men in various tissues and psychological traits</u>: The longer the CAG repeat polymorphism, the less prominent is the androgen effect when individuals with similar testosterone concentrations are compared.</strong></em></p><p><em><strong></strong></em></p><p><em><strong>*<u>A strictly defined threshold to TD is likely to be replaced by a continuum spanned by genetics as well as symptom specificity</u>. In addition, the effects of externally applied testosterone can be markedly influenced by the CAG repeats and respective pharmacogenetic implications are likely to influence indications as well as modalities of testosterone treatment of hypogonadal men. Investigation of CAG repeat polymorphism in exon 1 of the androgen receptor gene may be useful in testosterone treatment regimens adjustment</strong></em></p></blockquote><p></p>
[QUOTE="madman, post: 218424, member: 13851"] [B]My symptoms are:[/B] [LIST] [*]Extreme brain fog to the point that I am forgetful and it takes a lot more effort to articulate my thoughts. [*]Awful sleep. I never wake up feeling refreshed and wake up during the night multiple times. [*][I][B][I]Low energy and mood[/I][/B][/I] [*][I][B][I]Low libido/ED[/I][/B][/I] [*]Overall I don't feel like myself anymore. I feel like an old man in a younger mans shell. [/LIST] Hoping you had your blood work done between 7-10 am in a fasted state as we want to test at peak. Let alone if you are training in the gym it would be better to take a week off before getting labs. The causes of erectile dysfunction let alone decreased libido are complex and multifactorial. Low libido/ED (lack of nocturnal/spontaneous daytime erections) are common symptoms of low-t. Keep in mind dysfunction thyroid/adrenals can easily mimic low-t symptoms. From your most recent labs, you were hitting a descent TT 17.7 nmol/L (510ng/dL). Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects. FT 5-10 ng/dL would be considered low. FT 16-31 ng/dL (high-end) is healthy. Most men on trt will do well with FT 20-30 ng/dL and yes there are some who will do just fine with FT 15-20 ng/dL. Comes down to the individual. With a TT 510ng/dL SHBG 33.5 nmol/L (normal) and Albumin 4.2 g/dL, then your FT would be around 17 ng/dL (far from low). [URL unfurl="true"]https://tru-t.org/[/URL] [ATTACH type="full" alt="Screenshot (11169).png"]19952[/ATTACH] TT of 8-12 nmol/L would be considered the grey zone and even then many men with higher T levels can still suffer from low-T symptoms due to high/highish SHBG. You are hitting a TT low 500s and you have normal SHBG so your FT is definitely not going to be borderline/low. Even then no one can say that these levels are optimal for you let alone should not cause any symptoms. Much more involved especially if we get into the sensitivity of the AR/polymorphism of the AR and CAG repeat length (short/long). As others have stated would be wise to look into Natesto or clomiphene/EN before jumping into full-blown trt. You stated that Natesto is not an option so if you are concerned about using clomiphene/EN and were dead set on using exogenous test then I see no harm in giving it a go as long as you have a decent understanding let alone realistic expectations. Shutting down your HPGA is not something to take lightly! Many men do well on trt whereas others may constantly struggle especially when it comes to libido/erectile function. No harm in trying even short-term as you can always stop and you will eventually return to baseline levels. PCT or cold turkey. 6 months would be a decent amount of time to put in. The most sensible approach would be to find a doctor in the know who will work with/guide you. Taking the UGL route and flying solo may not be your best move especially if you lack the understanding of how exogenous esterified T works. Blood work using accurate assays is critical. Do what you feel is best for you! [URL unfurl="true"]https://www.excelmale.com/forum/threads/low-testosterone-in-men-recommendations-on-the-diagnosis-treatment-and-monitoring.23933/#post-206879[/URL] [B]Figure 1. Threshold continuum to hypogonadism. [ATTACH type="full" alt="Screenshot (11170).png"]19953[/ATTACH] [ATTACH type="full" alt="Screenshot (11171).png"]19954[/ATTACH][/B] [I][B]post #7 *No consensus has been reached regarding the lower TT threshold defining TD, and there is no generally accepted lower limits of normal TT.[/B] [B][U]This lack of consensus follows from the fact that no studies have shown a clear threshold for TT or free T that distinguishes men who will respond to treatment from those who will not[/U][/B][/I] [B][I]post #8[/I] [U]AR CAG repeat lengths[/U] (short/long)[/B] [I][B]*The number of cytosine–adenine–guanine triplet (CAG) repeats in androgen receptors differ in men and influences the androgen receptor activity [88,89,90,91] (Figure 1). [U]Hence testosterone sensitivity may vary in different individuals[/U]. *The same applies to [U]androgen receptor gene CAG repeat lengths >24 in the presence of symptoms and normal testosterone levels[/U] may be considered as a state of preclinical TD [93] *In general, it is currently speculated that variable phenotypes of androgen insensitivity exist, mainly owing to mutated androgen receptors. [U]More subtle modulation of androgen effects is related to the CAG repeat polymorphism in exon 1 of the androgen receptor gene[/U]: transcription of androgen-dependent target genes are attenuated with the increasing length of triplets. [U]*As a clinical entity, the CAG repeat polymorphism can relate to variations of androgenicity in men in various tissues and psychological traits[/U]: The longer the CAG repeat polymorphism, the less prominent is the androgen effect when individuals with similar testosterone concentrations are compared. *[U]A strictly defined threshold to TD is likely to be replaced by a continuum spanned by genetics as well as symptom specificity[/U]. In addition, the effects of externally applied testosterone can be markedly influenced by the CAG repeats and respective pharmacogenetic implications are likely to influence indications as well as modalities of testosterone treatment of hypogonadal men. Investigation of CAG repeat polymorphism in exon 1 of the androgen receptor gene may be useful in testosterone treatment regimens adjustment[/B][/I] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Low Testosterone symptoms. 10 years of finding a solution
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