New guy - Long term issues

[Fett_Muscle]

Hello,

I will try to summarize my issues quickly, and I truly appreciate anyone who takes the time to read and offer any assistance.

About 6 years ago when I was 34, I purposefully lost about 40 lbs, and decided to get into weight lifting. Started off just hitting the gym more, and had success, so I decided to try supplements. Did a little research, I purchased some over the counter products (not sure if I should say the name) from the mall store and began using specifically because they claimed to be non-hormonal. Unbelievable results immediately. Super fast muscle gains and my lifts went up so quickly it was absurd. I followed the instructions for dosing times and breaks, but actually dosed lower than recommended to be safe since I had never done this before. A few weeks in I started having erection issues, but didn't want to assume anything 100%. Shortly after, I couldn't get an erection at all. So, I got off the supplement, and a few weeks later everything was normal again. So I assumed all was safe enough as long as I cycled. Got on again, and everything was exactly the same with a few additional issues. Along with the ED, I noticed that my scrotum (not testes) had gone from hanging very low to being tight all the time. Like 1/5 the size it was previously. That, and one day in the mirror I noticed my sweat looked white, almost like milk. At that point, I said "screw it, I'm not taking any chances, I'm getting off this stuff for good."

Of course, no luck going back to normal. My scrotum never recovered, my libido (which was always raging) is non existent, and while my erections recovered somewhat, they are hit or miss, and I can't rely on them. Each day is a different story, and morning wood (which was every day) almost never happens, and when it does, it's minor. I also gained weight, and couldn't gain muscle no matter how hard I tried.

Now it's been 6 years and this is on my mind constantly. Good looking, in shape, single guy who doesn't want to risk embarrassing himself in front of women. I have a Viagra Rx, but I hate the way I feel using it (swollen head and ears). If I could get back 1/2 of what I used to be I'd be happy.

First endo looked at labs, said I was normal, refused to do anything. Second endo saw my test in the 400-550 range and offered for us to try TRT. The first week I felt like a new man in every way, and then I went back to where I was in almost every way. I have lost a little weight and gained some muscle but that is it. He just decreased my dosage because my last labs had me in the 1200's. He doesn't take any time with me, and refuses to discuss HCG, Chlomid and various other products I read about.

I just need some direction. I am so scared to try any chemicals in my body now, but clearly something changed in my hormones. I can post labs as I know they help with info, but does anyone have any idea what might have affected the size of my scrotum or the blood flow to that region? I feel like that should be a clear symptom of something, but I haven't found anything online where someone had the same issue, and I can find no one who had the same results from the products I took.

I would love to find a doctor who cares and actually understand this medicine.

Thank you for any help.

 

[CoastWatcher]

Welcome to ExcelMale. What was in the supplements you were were consuming, how much and how often? We need your lab values, with the associated reference ranges, in order to generate discussion. That would include tests run prior to the start of TRT and your most recent report. Total and free testosterone, SHBG, estradiol (sensitive test, LC, MS/MS), CBC, CMP, PSA, LH, FSH, thyroid (TSH, t3, t4, rt3, and antibodies), DHT, and prolactin - the standard pre-therapy package. Since you are on a TRT protocol, please provide us with details; I would guess you are injecting, but we need to know how much and how often you inject.

What about the rest of your health? Sleep problems? Other medications? Use of (long-term) opiates or anabolics? We hope you'll become and active member...and we hope we can help you sort things out.

 

[Vince]

I'm using my phone so I'll keep it short. For testicules you need HCG. But at your age a restart may be better.

 

[Fett_Muscle]

Thanks you for trying to help me.

Unfortunately for chemicals in the products, it is hard to say because of the "proprietary blend" listing.

One with proprietary blend including chiorophytum borivillanum root, velvet bean. 1 to 2 caps a day, recommended 9
One with proprietary blend with trib and chebulic myrobalan bean. 1 to 2 caps a day, recommended 6.
A preworkout with the infamous 1,3 dimethylamylamine

Not on any type of medication at that time or now. Other than standard vitamins and fish oils, no other products at all. No additional health problems to speak of. No negative affects in the long run outside of my genitals and libido.

I am injecting into my thigh. It started out as every two weeks. When my test dropped the lab assistant told me to switch to 1.0 cc per week, and I questioned her on whether or not that was correct. She verified it was. Thought it sounded high, but did it anyway. That's when my test went to 1200, and the doctor corrected that it should be .5cc per week.I honestly don't feel like they really have a grip on this at all. From your experience here, what seems like the correct dose?

• TESTOSTERONE ENANTHATE 200 MG/ML SOLN
• Directions: 0.5 cc (100mg) every week

Labs below. Three sets. This is everything I've ever been given. When I asked if he could go into detail. He simply said everything is normal, so there was no need. Again, he won't discuss any other options for medication.

Feb 2016 - before starting TRT

luteinizing hormone, serum
3.72 m[iU]/mL 1.24-8.62 completed Not applicable 02/04/2016

testosterone, total
557.00 ng/dL 198.00-679.00 completed Not applicable 02/04/2016

prostate specific antigen
1.27 ng/mL 0.00-4.00 completed Not applicable 02/04/2016

prolactin, serum
6.79 ng/mL 2.64-13.13 completed Not applicable 02/04/2016

ollicle stimulating hormone, serum
5860 m[iU]/L Units converted. See lab report for original value. completed Not applicable 02/08/2016

thyroid stimulating hormone (TSH), ultra sensitive
2.68 u[iU]/mL 0.40-4.00 completed Not applicable 02/04/2016

triiodothyronine (T3), serum
111 ng/dL Units converted. See lab report for original value. completed Not applicable 02/04/2016

thyroxine, serum, free
0.78 ng/dL 0.58-1.64 completed Not applicable 02/04/2016

urea nitrogen, blood
27 mg/dL 2-24 completed 02/04/2016

sodium, serum
138 MEQ/L 135-145 completed Not applicable 02/04/2016

protein, total, serum
6.6 g/dL 6.4-8.3 completed Not applicable 02/04/2016

potassium, serum
4.3 MEQ/L 3.6-5.0 completed Not applicable 02/04/2016

creatinine, serum
1.00 mg/dL 0.62-1.28 completed Not applicable 02/04/2016

chloride, serum
102 MEQ/L 101-111 completed Not applicable 02/04/2016

carbon dioxide, venous blood
30 MEQ/L 21-31 completed Not applicable 02/04/2016

calcium, serum
9.0 mg/dL 8.4-10.5 completed Not applicable 02/04/2016

blood glucose
99 mg/dL 70-105 completed Not applicable 02/04/2016

bilirubin, serum, total
0.80 mg/dL 0.30-1.40 completed Not applicable 02/04/2016

aspartate aminotransferase (SGOT), serum
2 U/L 10-42 completed Not applicable 02/04/2016

alkaline phosphatase, serum
44 U/L 32-92 completed Not applicable 02/04/2016

Aug 2016

urea nitrogen/creatinine ratio, serum
17 9-20 completed Not applicable 08/11/2016

urea nitrogen, blood
19 mg/dL 6-24 completed Not applicable 08/11/2016

testosterone, total
242 ng/dL 348-1197 completed 08/11/2016

testosterone, serum, free
0.27 ng/dL Units converted. See lab report for original value. completed 08/11/2016

sodium, serum
144 mmol/L 134-144 completed Not applicable 08/11/2016

red blood cell distribution width
14.2 % 12.3-15.4 completed Not applicable 08/11/2016

protein, total, serum
6.5 g/dL 6.0-8.5 completed Not applicable 08/11/2016

potassium, serum
4.4 mmol/L 3.5-5.2 completed Not applicable 08/11/2016

platelet count
262 X10E3/UL 150-379 completed Not applicable 08/11/2016

neutrophils as percent of blood leukocytes
61 % completed Not applicable 08/11/2016

monocytes as percent of blood leukocytes
10 % completed Not applicable 08/11/2016

monocyte count, blood, automated
1.0 X10E3/UL 0.1-0.9 completed 08/11/2016

mean corpuscular volume, RBC
90 fL 79-97 completed Not applicable 08/11/2016

mean corpuscular hemoglobin, RBC
29.1 pg 26.6-33.0 completed Not applicable 08/11/2016

mean corpuscular hemoglobin concentration, RBC
32.3 G/DL 31.5-35.7 completed Not applicable 08/11/2016

lymphocytes as percent of blood leukocytes
24 % completed Not applicable 08/11/2016

lymphocyte count, blood, automated
2.4 X10E3/UL 0.7-3.1 completed Not applicable 08/11/2016

leukocyte count, blood
9.9 X10E3/UL 3.4-10.8 completed Not applicable 08/11/2016

hemoglobin, blood
13.8 g/dL 12.6-17.7 completed Not applicable 08/11/2016

hematocrit, blood
42.7 % 37.5-51.0 completed Not applicable 08/11/2016

globulin, serum
2.5 1.5-4.5 completed Not applicable 08/11/2016

Jan 2017

testosterone, total
1223 ng/dL 348-1197 completed 01/13/2017

testosterone, serum, free
3.08 ng/dL Units converted. See lab report for original value. completed 01/13/2017

red blood cell distribution width
13.5 % 12.3-15.4 completed Not applicable 01/13/2017

platelet count
309 X10E3/UL 150-379 completed Not applicable 01/13/2017

neutrophils as percent of blood leukocytes
59 % completed Not applicable 01/13/2017

monocytes as percent of blood leukocytes
12 % completed Not applicable 01/13/2017

monocyte count, blood, automated
1.3 X10E3/UL 0.1-0.9 completed 01/13/2017

mean corpuscular volume, RBC
89 fL 79-97 completed Not applicable 01/13/2017

mean corpuscular hemoglobin, RBC
29.8 pg 26.6-33.0 completed Not applicable 01/13/2017

mean corpuscular hemoglobin concentration, RBC
33.7 G/DL 31.5-35.7 completed Not applicable 01/13/2017

lymphocytes as percent of blood leukocytes
21 % completed Not applicable 01/13/2017

lymphocyte count, blood, automated
2.4 X10E3/UL 0.7-3.1 completed Not applicable 01/13/2017

leukocyte count, blood
11.2 X10E3/UL 3.4-10.8 completed 01/13/2017

hemoglobin, blood
14.8 g/dL 12.6-17.7 completed Not applicable 01/13/2017

hematocrit, blood
43.9 % 37.5-51.0 completed Not applicable 01/13/2017

erythrocyte (RBC) count
4.96 X10E6/UL 4.14-5.80 completed Not applicable 01/13/2017

eosinophils as percent of blood leukocytes
5 % completed Not applicable 01/13/2017

Eosinophil Absolute Count
0.6 X10E3/UL 0.0-0.4 completed 01/13/2017

basophils as percent of blood leukocytes
3 % completed Not applicable 01/13/2017

basophil count, absolute
0.3 x10E3/uL 0.0-0.2 completed 01/13/2017

Absolute Neutrophils
6.6 X10E3/UL 1.4-7.0 completed Not applicable 01/13/2017

[TH="class: ui-widget-header header"][/TH] [TH="class: ui-widget-header header"][/TH] [TH="class: ui-widget-header header"]	[/TH]

 

[Fett_Muscle]

What exactly is a restart? Sounds a little scary.

 

[Will Brink]

I would love to find a doctor who cares and actually understand this medicine.

Thank you for any help.

You came to right place for that goal at least.

 

[CoastWatcher]

Where are the rest of your labs - estradiol (sensitive), SHBG, DHT? If they weren't run, you received a totally inadequate workup prior to beginning therapy...AND...you are being inadequately monitored during the course of therapy. You deserve far better care. We can point you in the right direction. Do you have more results?

 

[Fett_Muscle]

That is absolutely every result. I also asked what other test should be run, and he said nothing.

He wasn't even willing to go over them because they were "normal".

 

[CoastWatcher]

That is absolutely every result. I also asked what other test should be run, and he said nothing.

He wasn't even willing to go over them because they were "normal".

It's clear you need a new doctor. As has been noted, we can point you in that direction, but it is likely (though not certain) that you will have to go to a cash/fee-for-service plan.

 

[kspat]

fire that doctor.

 

[Fett_Muscle]

So what should my first step be to find the right doctor here?

 

[CoastWatcher]

There are two national practices that are sponsors of this site, Defy Medical and Prime Body. I am a patient of neither, but in good conscience can suggest you contact both of them and explore your options.

I know now more about Defy, and their medical director, Dr. Justin Saya. He is one of the leading physicians practicing in this field today, a moderator here at EM, and a good fellow. Type his last name, Saya, in the search box here on the Forum and browse some of his posts to get a sense of his contributions. Then call Defy and ask them as many blunt questions as you can. They won't dodge. Lots of our members are satisfied, very satisfied, with their treatment.

Prime Body works on a different model, but treats many of our members as well, satisfied members. You owe it to yourself to contact them, and ask the same blunt questions (cost and style of treatment) that you posed to Defy.

You may be able to find a doctor practicing near you who can manage your case with skill - but your current situation is proof of how hard that may be. The simple fact is that few doctors know what they are doing when it comes to androgen management (even specialists who ought to be leaders in this field). It's a sad truth that many of us have had to learn the hard way.

 

[Fett_Muscle]

OK, so a pretty big development here. I requested a Rx refill for my Test. The pharmacy kept screwing around, and when they finally got approval again from my insurance company, the Rx was now two days past due, and they couldn't fill it. Then, my doctor took forever to fill the new Rx. During this whole time I had no medication to inject. It finally came through to the pharmacy yesterday. I have actually lost count, but it has been 3 weeks to a month with no injection. BUT, with no aid to restart, and just going off cold turkey because I had to, my testes are back to normal size, and in fact larger than they ever were, and each day the tightness in my scrotum (that has been super tight for 5 years) is loosening up more and more each day. My boys are hanging for the first time in years, and I have the best erections I've had in 5 years. The only thing that hasn't returned yet is my libido, but I'm hoping.

Is this in any way typical? Will this probably just go away? Should I have tests done to check my levels right now so I know where I feel best? Am I just waiting for an inevitable crash, or did my system just rebound by being forced into the current situation? I am very hopeful, but scared. I honestly feel no negative side effects from going off. How long does it take for the last injection to pass through my system?

Fingers crossed.

 

[CoastWatcher]

OK, so a pretty big development here. I requested a Rx refill for my Test. The pharmacy kept screwing around, and when they finally got approval again from my insurance company, the Rx was now two days past due, and they couldn't fill it. Then, my doctor took forever to fill the new Rx. During this whole time I had no medication to inject. It finally came through to the pharmacy yesterday. I have actually lost count, but it has been 3 weeks to a month with no injection. BUT, with no aid to restart, and just going off cold turkey because I had to, my testes are back to normal size, and in fact larger than they ever were, and each day the tightness in my scrotum (that has been super tight for 5 years) is loosening up more and more each day. My boys are hanging for the first time in years, and I have the best erections I've had in 5 years. The only thing that hasn't returned yet is my libido, but I'm hoping.

Is this in any way typical? Will this probably just go away? Should I have tests done to check my levels right now so I know where I feel best? Am I just waiting for an inevitable crash, or did my system just rebound by being forced into the current situation? I am very hopeful, but scared. I honestly feel no negative side effects from going off. How long does it take for the last injection to pass through my system?

Fingers crossed.

When last you injected, what was your protocol like? How much and how often were you injecting? I would obtain a total and free testosterone level through Discountedlabs.com. In addition to which, I would add LH and FSH to see where your axis may be functioning.

Let me just add that it is highly irresponsible of your doctor to - essentially - abandon you without medication for such a period of time. As has been noted in the past, you are deserving of better medical care.

 

[Vince]

What exactly is a restart? Sounds a little scary.

How to stop testosterone safely and possibly reset your hormone axis

 

[Fett_Muscle]

Last round I was directed to do .75 cc per week.