Newbie questio: go on TRT or not TRT?

[Teddy]

Hello. Newbie here. Instead of writing out my history and question in a paragraph format, I will just list them to make it easier to follow.

1. 39 yo. Asian male 5.9, 162lb

2. Just finished my very first cycle 3 months ago. It was a bad cycle in that I didn't have all my gear ready so the amount and the source of test cypionate varied from week to week. (300mg to 500mg). The "cycle" lasted about 4 months. I was bit scatter brained but felt amazing. Had morning erections and libido like I never had. It also gave me a great pump at the gym but I already had amazing workout routine and body before going on the cycle. The reason I did it was because I was at a plateau for a couple of years and was tired of only getting tiny improvements or not seeing better results for the amount of time I was spending at the gym.

3. Last two weeks of the cycle, I broke out MASSIVELY. Cystic acne all over my neck, chest and back. Now I am learning that it was due to spikes in hormones and estrogen that was the cause of this massive break out. But why isn't it because of the dihyrotestosterone instead which has affect on the skin? Anyways, lab test at the end of my cycle showed that my dihyrotestosterone level was 71ng/dl (higher end of normal range) and my estradio level was 83 which was I think like 3 times the normal range.

4. Before the cycle, all my blood work showed that my testosterone level was 462. So lower end of normal. My libido was fine, not great. My workout was just as good as when I was on testosterone. But of course nothing compared to when I was actually doing the cycle.

5. Since the cycle, I am trying to take care of my skin and liking that my pores have gotten smaller on my face and like looking less bloated.

6. Should I go on TRT? I don't like the idea of being at the lower end of the normal range for someone my age. I also could use more help with erection and libido but I can still live with it. My Dr. Prescribe me 200mg per week of test cypionate which I have not touched since the massive acne break out.

Any comment or help will be much appreciated. Thank you

 

[CoastWatcher]

You realize that in cycling, you were injecting massive doses of testosterone, well above the amount used in TRT? And you understand that TRT doesn't involve cycling? It is a life-long commitment. Can you post all the lab values you have along with their reference ranges? At a minimum, total testosterone and free testosterone, SHBG, estradiol, thyroid values, estradiol, psa.

 

[Vision]

[QUOTE
1. 39 yo. Asian male 5.9, 162lb

Let me guess, you are really 15 and some guy in 3rd period chem class said if you take test you'll get "swole"....
Lol....

If I'm wrong I'm sorry.

 

[Teddy]

LOL

No, I am not 15 although I may write like one or think like one....

Anyways, I don't have the exact lab values on me, but from what I was able to manage to write down while I was at my Dr's office, my pre cycling Test level was 462 ng/dl. I don't think thyroid value was something my dr. tested me for but I can ask him to.

And yes, I do realize that during that cycling I was putting supra level of testosterone but still lower than the amount that other people seem to use. Again, the two lab values 2-3 weeks after the cycle ended that I was able to write down was that my estradiol level was through the roof and my dihydrotest level was at the upper limit of the normal range. Which I am suspecting was the reason for the massive acne breakout.

Also, yes I do realize that TRT is a life long thing if I decide to go on it and cycling was just a cycling. This is why I am asking a question on the board here. Danger and Play blogger Mike Cernovich and his guests seem to make a valid point that there is no reason to have testosterone level of an average 60-70 year old man when it can easily be boosted. But at the same time, I am bit afraid of the commitment first because of possible acne breakout again even at lower TRT dosage of testosterone, and second that it will be a life long process where I will have to worry about ball shrinkage and having to shoot it up every 5-7 days and etc.

Regarding the acne issues, there is a pod cast which that blogger Mike and his professional body builder guest says that Acne issues doesn't come about if your are on a consistant testosterone therapy at at dosage of 150mg - 200mg per 5 - 7 days and that acne breakout only occur when there is massive flucutations in hormone especially when there is inbalance between estradiol and testsosterone level.

Here is a pubmed supporting that theory. http://www.ncbi.nlm.nih.gov/pubmed/2527144

but then here is another pubmed that supports completely the opposite.
http://www.ncbi.nlm.nih.gov/pubmed/142752.

In terms of clinical symptoms of low T, I didn't really have any issue with being tired or depressed. I still had amazing work out and great build (sorry to be pompous). I just wanted extra edge. ED or libido were the only two issues that I noticed while I was on cycle that I wish I was able to maintain on a regular basis though.

BTW, my dr is not an endocronologist or someone that familiar with hormone replacement therapy. He referred me out to see an endo but it's taking forever to make an appt due to my having medical and etc.

 

[CoastWatcher]

Again, without solid lab work to refer to, the advice members here can give is limited. Have you read the sticky posts on the Forum that detail what tests need to be run prior to beginning a TRT protocol? It is worth your time to look at them.

 

[Vettester Chris]

Did you run any sort of PCT when your cycle was finished? If not, your HPTA is no doubt probably suppressed.

As noted above, the first step is running all of your labs (LH, FSH, Test, Free Test, Thyroid, E2 Sensitive, DHEA, Lipids, CBC's, etc.). From there you need to have a qualified physician review it with you, then review your options. Having a doctor throw 200mg/wk at you and call it a day isn't a solid plan. Having a doctor sit down with you and review your options, then design a solid goal is the plan.

Keep us posted ...

 

[Teddy]

Yeah I just ran nolva 20mg several times a week for about 3-4 weeks. I kept reading mixed information about how Nolva can cause more acne so I wasn't fully committed to taking it everyday. It feels like everything is almost back to full working function except my acne is still very bad. I am about to go on accutane. I had a major libido issue for the last month but I think that has subsided.

(LH, FSH, Test, Free Test, Thyroid, E2 Sensitive, DHEA, Lipids, CBC's) out of these tests, the only thing that my dr consistently measures are the test and free test. Lipids and CBC's were all normal. Also my dr didn't know anything about LH or FSH when it came to prescribing trt Guess that makes him not such a good dr. I only learned about them through my own research. I will see what my endo says. I am afraid that he might just say that my level is within "normal" limit and just dismiss the idea of trt all together.

My insurance is medical (hmo) so I am very limited on how often I can change my dr and what kind of endo I can seek out so I sort of have to force my dr for stuff. He wasn't the one who just gave me 200 mg test. I had to force him.

 

[CoastWatcher]

You need good medical care. Consider Defy Medical - linked from these pages (I have no affiliation with them). Yes, you will have to go out of pocket and directly pay them, but it is a reasonable cost. Consider it an investment in your future health.

 

[captq]

You need good medical care. Consider Defy Medical - linked from these pages (I have no affiliation with them). Yes, you will have to go out of pocket and directly pay them, but it is a reasonable cost. Consider it an investment in your future health.

I agree with Coastwatcher, I ran into a roadblock with my doc great guy but no way was he going to prescribe HCG for what he felt was off label which in his mind equaled inappropriate use. Dr Saya at Defy was fine with handling that part of my care and in reviewing my labs made some very good suggestions. Considering the time spent trying to get something done in network out of pocket can be cheaper.

When you strong arm your doctor but then have no medical follow-up on the results of that RX is it really a good deal?

Funny how we will spend $100's if not $1000's on various supplements but balk at going out of pocket a few bucks to get advice from a real doctor who specializes in TRT.

 

[Teddy]

like what is the expected cost to get treated by someone like Dr. Breen? I live in LA so there are lots of anti aging clinics out here. The thing is how do I balance between the lab that my dr is willing to give when asked and how to utilize an expert in TRT management?

Thanks

 

[CoastWatcher]

Go with a TRT expert and let them coordinate your care; your current doctor can continue to handle the balance of your care. Call Defy - they are in FL but they specialize in telemedicine and discuss their pricing model. Contact a number of other programs in your local area, ask them the same questions.

 

[Teddy]

Is it absolutely necessary to get LH and FSH level checked? So if they are low and go to HCG, would that really bring my test level back up to higher level of the normal range? of is TRT really the only solution to bring my test level to higher end of the normal range?

 

[CoastWatcher]

Accutane can lower your testoterone and wreak havoc with your liver. Nelson has noted that it is a "last resort" choice when deal ing with the acne flair you are experiencing. I had missed that in your earlier post.

 

[Teddy]

I read that about accutane, but I have been on accutane several times as a teenager and in my 20s and it worked wonders for me with no side effects what so ever. I also get my liver enzyme monitored routinely as basic health care.

 

[dallas101346]

why does this guy need trt again?

 

[CoastWatcher]

why does this guy need trt again?

He had labs showing total T of 462 before going on an ill-planned cycle with testosterone. He whacked out his system in a number of ways.

 

[Teddy]

why does this guy need trt again?

My T level is at the lower end of the "normal" range and I'd like it to be at the higher end. Also I do show some sexual symptoms of low T.

 

[CoastWatcher]

My T level is at the lower end of the "normal" range and I'd like it to be at the higher end. Also I do show some sexual symptoms of low T.

But there's no objective lab work for us to offer concrete suggestions (other than bring in some labs and we'll all dive in).

 

[Teddy]

He had labs showing total T of 462 before going on an ill-planned cycle with testosterone. He whacked out his system in a number of ways.

well it was my first cycle. You live and learn. I actually thought the stuff I ordered on line (for the cycle) would arrive on time but it didn't and I had a bad reaction to the stuff so they had to send me different bottle - hence the ill planned cycle. Finished the cycle with Nolva. But the resulting acne seems to be pretty common side effect to cycling even in trt

 

[dallas101346]

I wouldnt mess with it to be honest with you, you can probably raise it naturally, or wait a bit longer and it will come up. what was your level before trt?