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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
ON TRT after losing both testicles to testicular cancer
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<blockquote data-quote="Cataceous" data-source="post: 252123" data-attributes="member: 38109"><p>The OP reached out to me directly for comments. I'm going to duplicate some of them here in case they're of interest to others.</p><p></p><p>You have a possible advantage over guys with secondary hypogonadism in that it's likely that your hypothalamus and pituitary are capable of working normally. I have hypothesized that some men still have problems when on TRT because of the upstream hormonal disruption: TRT can suppress kisspeptin, GnRH, LH and FSH. In this view you are right to be concerned that your LH is low. The implication is that your dose of testosterone is higher than is natural for you.</p><p></p><p>There are some men with primary hypogonadism who tune their doses so that LH and FSH become normal—not too high or too low. I believe this is the safest and most natural way for these individuals to be on TRT. I'm doubtful this would work well with once-weekly injections, as there would probably be too much hormonal variation. It might work with twice-weekly injections. Every-other-day would be better yet, but the feasibility of that depends on individual tolerance.</p><p></p><p>On dosing, keep in mind that 100 mg per week of testosterone cypionate is providing more testosterone than most men could ever make naturally. The normal range of production would be covered by 30-90 mg per week. I take the equivalent of 44 mg, divided into daily doses. In my opinion the majority of men on injections are using more testosterone than they need, and frequently experience side effects as a result. In any case, if you decide to tune your dose to achieve normal LH then don't be alarmed if it requires doses much lower than 100 mg per week—this is expected. Monitor free testosterone, either directly with a good test, or indirectly by measuring SHBG along with total testosterone. You want to insure it's reasonable, which ties into my next point.</p><p></p><p>There is one caveat I can think of: Excess body weight can lower the body's natural set point for testosterone. Hopefully this won't be an issue for you much longer, as you are making good progress on that front. This could be a reason for you to initially target low-normal LH/FSH until you've reached your weight loss goals. At that time you could reduce the TRT dose further to yield mid-range LH. Unfortunately you can't entirely trust single LH measurements to tell you the whole story. LH is delivered in pulsatile fashion, and you can't be sure when you measured relative to the peak levels. I attach a picture below to illustrate.</p><p>[ATTACH=full]30817[/ATTACH]</p></blockquote><p></p>
[QUOTE="Cataceous, post: 252123, member: 38109"] The OP reached out to me directly for comments. I'm going to duplicate some of them here in case they're of interest to others. You have a possible advantage over guys with secondary hypogonadism in that it's likely that your hypothalamus and pituitary are capable of working normally. I have hypothesized that some men still have problems when on TRT because of the upstream hormonal disruption: TRT can suppress kisspeptin, GnRH, LH and FSH. In this view you are right to be concerned that your LH is low. The implication is that your dose of testosterone is higher than is natural for you. There are some men with primary hypogonadism who tune their doses so that LH and FSH become normal—not too high or too low. I believe this is the safest and most natural way for these individuals to be on TRT. I'm doubtful this would work well with once-weekly injections, as there would probably be too much hormonal variation. It might work with twice-weekly injections. Every-other-day would be better yet, but the feasibility of that depends on individual tolerance. On dosing, keep in mind that 100 mg per week of testosterone cypionate is providing more testosterone than most men could ever make naturally. The normal range of production would be covered by 30-90 mg per week. I take the equivalent of 44 mg, divided into daily doses. In my opinion the majority of men on injections are using more testosterone than they need, and frequently experience side effects as a result. In any case, if you decide to tune your dose to achieve normal LH then don't be alarmed if it requires doses much lower than 100 mg per week—this is expected. Monitor free testosterone, either directly with a good test, or indirectly by measuring SHBG along with total testosterone. You want to insure it's reasonable, which ties into my next point. There is one caveat I can think of: Excess body weight can lower the body's natural set point for testosterone. Hopefully this won't be an issue for you much longer, as you are making good progress on that front. This could be a reason for you to initially target low-normal LH/FSH until you've reached your weight loss goals. At that time you could reduce the TRT dose further to yield mid-range LH. Unfortunately you can't entirely trust single LH measurements to tell you the whole story. LH is delivered in pulsatile fashion, and you can't be sure when you measured relative to the peak levels. I attach a picture below to illustrate. [ATTACH type="full" width="303px"]30817[/ATTACH] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
ON TRT after losing both testicles to testicular cancer
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