Questions regarding TRT

[drew16669]

Hello, recently(11/21/16) I went to my primary doctor and informed her of some issues I was having(fatigue, head fog, erectile issues, mood swings and lack of motivation). After discussing she decided to run full blood work on me(pulled 6 vials of blood). I went back in for follow up on 12/05/16 and my lipids, heart, lungs, kidneys, thyroid and everything else came back perfect. However, my testosterone levels came back at TT- 287ng/dl. I am 26 years old, and have experienced all these symptoms for the majority of adulthood. She stated she didn't see any reason for my results to come back as low as they had, however due to the low levels she prescribed me 200mg test cyp biweekly. My wife delivered the 1st injection that night around 5pm. The 1st week of my 200mg shot, I felt amazing, everything was improved greatly. My wife and I were both extremely excited about this, until week 2 came, towards the tail end of day 9, I started feeling very lethargic and sluggish, with a horrible headache. Day 10- called into work, and stayed in bed all day. Day 11- felt a little bit better, managed to get to work however it was mostly pointless as I just showed up and that was about it. I called my Dr. and told her, she advised me to split the dose and do 100mg weekly. So on day 12- my wife drew .5cc and delivered the 1st 100mg injection. That was 5 days ago, and I have noticed this week very slight improvements over my baseline pretrt symptoms. I understand the treatment could take awhile to really feel the full effect, so I'm going to stick with the dr.s plan and go back in 3 months for follow ups, and see if any adjustments need to be made, at this point I have a feeling the 100mg is not enough, however 200mg is probably a little high- however it felt great! Here is my preTRT test results

Albumin 5.0 (3.0-5.5)
SHBG 34.7 (16.5-55.9)
Total T 287 (249-836)
Free T 5.05 (4.50-25.00)
Free T % 1.8 (1.1-3.0)
Bioavailable T 137 (108-500)

I don't see anything in regards to FSH/LH/or Estradiol

My main concern is fertility- my wife and I have been trying to conceive for 8 months now, with no success. I was with my previous partner for 3 years, not using birth control, and she never got pregnant either. I have found research supporting HCG- however it seems to restore you back to baseline preTRT if I am understanding that correctly- and while I have no analysis to verify anything- due to past events I have a feeling my count was extremely low to begin with(also my ejaculate has always been clear and watery). I am wondering 1- would HCG be able to improve over my baseline fertility? 2- with my dr. I highly doubt she will even prescribe the HCG, could I go to someone specifically for HCG only in relation to my current TRT parameters? 3- I found research supporting use of tamoxifen(I think she will give me this) along with TEST-Udeconate that improved fertility- would this apply to cyp as well? 4- My blood was drawn around 2pm on the date of the test- as I have found, that seems to be late- could my levels have been remotely normal during the morning of this test?(I woke up at 10:30am, after 9 1/2hrs of sleep.)

 

[johndoesmith]

Hello, recently(11/21/16) I went to my primary doctor and informed her of some issues I was having(fatigue, head fog, erectile issues, mood swings and lack of motivation). After discussing she decided to run full blood work on me(pulled 6 vials of blood). I went back in for follow up on 12/05/16 and my lipids, heart, lungs, kidneys, thyroid and everything else came back perfect. However, my testosterone levels came back at TT- 287ng/dl. I am 26 years old, and have experienced all these symptoms for the majority of adulthood. She stated she didn't see any reason for my results to come back as low as they had, however due to the low levels she prescribed me 200mg test cyp biweekly. My wife delivered the 1st injection that night around 5pm. The 1st week of my 200mg shot, I felt amazing, everything was improved greatly. My wife and I were both extremely excited about this, until week 2 came, towards the tail end of day 9, I started feeling very lethargic and sluggish, with a horrible headache. Day 10- called into work, and stayed in bed all day. Day 11- felt a little bit better, managed to get to work however it was mostly pointless as I just showed up and that was about it. I called my Dr. and told her, she advised me to split the dose and do 100mg weekly. So on day 12- my wife drew .5cc and delivered the 1st 100mg injection. That was 5 days ago, and I have noticed this week very slight improvements over my baseline pretrt symptoms. I understand the treatment could take awhile to really feel the full effect, so I'm going to stick with the dr.s plan and go back in 3 months for follow ups, and see if any adjustments need to be made, at this point I have a feeling the 100mg is not enough, however 200mg is probably a little high- however it felt great! Here is my preTRT test results

Albumin 5.0 (3.0-5.5)
SHBG 34.7 (16.5-55.9)
Total T 287 (249-836)
Free T 5.05 (4.50-25.00)
Free T % 1.8 (1.1-3.0)
Bioavailable T 137 (108-500)

I don't see anything in regards to FSH/LH/or Estradiol

My main concern is fertility- my wife and I have been trying to conceive for 8 months now, with no success. I was with my previous partner for 3 years, not using birth control, and she never got pregnant either. I have found research supporting HCG- however it seems to restore you back to baseline preTRT if I am understanding that correctly- and while I have no analysis to verify anything- due to past events I have a feeling my count was extremely low to begin with(also my ejaculate has always been clear and watery). I am wondering 1- would HCG be able to improve over my baseline fertility? 2- with my dr. I highly doubt she will even prescribe the HCG, could I go to someone specifically for HCG only in relation to my current TRT parameters? 3- I found research supporting use of tamoxifen(I think she will give me this) along with TEST-Udeconate that improved fertility- would this apply to cyp as well? 4- My blood was drawn around 2pm on the date of the test- as I have found, that seems to be late- could my levels have been remotely normal during the morning of this test?(I woke up at 10:30am, after 9 1/2hrs of sleep.)

Welcome. You like most guys find this forum due to their doctors being uninformed regarding TRT.

Do you have the full results from pre TRT? Reason I ask is because "everything came back perfect" means absolutely nothing here. Guys will be at 400 total testosterone in a range of 348-1197 and told that's "perfect".

It's rather difficult to say much based on what you gave us.

Unfortunately, without the proper baseline tests like LH, FSH, and E2, it's tough to figure out what's wrong.

Your experience of feeling amazing after a shot is common, but incorrect, as testosterone simply doesn't work that way. It's not like caffeine or alcohol where the effects are immediate, testosterone takes months to work.

Your doctor starting at 200mg E14D is common, but also incorrect, and unfortunately shows her unfamiliarity with TRT. So does the unwillingness to prescribe hCG, and order sufficient testing.

I'd urge you to seek more qualified care, as you're unlikely to achieve the results you'd like with an unqualified provider. Defy medical and prime body are site sponsors and many have great success with them. I use defy medical and have nothing but great things to say about them, it's the first time I spoke to someone who knew more than I did about TRT, which is sad.

If you were infertile before TRT, it's likely you won't be fertile after, but not impossible. It may be due to severe secondary hypogonadism. It's impossible to say without proper testing.

 

[drew16669]

Welcome. You like most guys find this forum due to their doctors being uninformed regarding TRT.

Do you have the full results from pre TRT? Reason I ask is because "everything came back perfect" means absolutely nothing here. Guys will be at 400 total testosterone in a range of 348-1197 and told that's "perfect".

It's rather difficult to say much based on what you gave us.

Unfortunately, without the proper baseline tests like LH, FSH, and E2, it's tough to figure out what's wrong.

Your experience of feeling amazing after a shot is common, but incorrect, as testosterone simply doesn't work that way. It's not like caffeine or alcohol where the effects are immediate, testosterone takes months to work.

Your doctor starting at 200mg E14D is common, but also incorrect, and unfortunately shows her unfamiliarity with TRT. So does the unwillingness to prescribe hCG, and order sufficient testing.

I'd urge you to seek more qualified care, as you're unlikely to achieve the results you'd like with an unqualified provider. Defy medical and prime body are site sponsors and many have great success with them. I use defy medical and have nothing but great things to say about them, it's the first time I spoke to someone who knew more than I did about TRT, which is sad.

If you were infertile before TRT, it's likely you won't be fertile after, but not impossible. It may be due to severe secondary hypogonadism. It's impossible to say without proper testing.

Thanks Johndoesmith, I agree with you in the fact it seems she is not up to par with TRT, and I have already been thinking about Defy, however my main concern is now that the TRT has already been started, how would we determine what the baseline numbers were? I have the results of the CBC for my lipids and everything, and it does fall all within normal healthy ranges, just unsure of what was actually relevant and didn't want to post 10 pages of results. No other results for e2/lh/fsh, are included in the documentation she provided- so I assume it wasn't tested. I am unsure if this could have been an underline cause but just felt it may be noteworthy that, I have been extremely obese for the majority of my life, during my childhood and all through puberty (6'2, 330lbs at heaviest- 270+lbs by 13), until I was 20 when I dropped down to 205lbs, now I sit at 255-260lbs, however I started weight training 3 years ago and built up quiet a bit(figure im at around 20-25% bf now- tested at 205(9.1%- however I had zero muscle mass)

 

[johndoesmith]

Thanks Johndoesmith, I agree with you in the fact it seems she is not up to par with TRT, and I have already been thinking about Defy, however my main concern is now that the TRT has already been started, how would we determine what the baseline numbers were? I have the results of the CBC for my lipids and everything, and it does fall all within normal healthy ranges, just unsure of what was actually relevant and didn't want to post 10 pages of results. No other results for e2/lh/fsh, are included in the documentation she provided- so I assume it wasn't tested. I am unsure if this could have been an underline cause but just felt it may be noteworthy that, I have been extremely obese for the majority of my life, during my childhood and all through puberty (6'2, 330lbs at heaviest- 270+lbs by 13), until I was 20 when I dropped down to 205lbs, now I sit at 255-260lbs, however I started weight training 3 years ago and built up quiet a bit(figure im at around 20-25% bf now- tested at 205(9.1%- however I had zero muscle mass)

Well, there's no way to establish a baseline now AFAIK. There is the possibility of stopping TRT, and attempting a restart with clomid to assess the response of your HPTA.

With your tests, best thing to do is take pictures or screenshots, and post them here. Any information you have is relevant.

How are you 205lbs, 9% bf, but have no muscle mass? That sounds like you're fairly muscular, and at a healthy weight for a guy who's 6'3. I think 180lbs is average healthy weight for a man, unsure of height for that, but I assume shorter than 6'3.

 

[drew16669]

Well, there's no way to establish a baseline now AFAIK. There is the possibility of stopping TRT, and attempting a restart with clomid to assess the response of your HPTA.

With your tests, best thing to do is take pictures or screenshots, and post them here. Any information you have is relevant.

How are you 205lbs, 9% bf, but have no muscle mass? That sounds like you're fairly muscular, and at a healthy weight for a guy who's 6'3. I think 180lbs is average healthy weight for a man, unsure of height for that, but I assume shorter than 6'3.

Will do on the tests when I get home and have access! my patient portal only has the testosterone tests! I am sure I had some but I felt like none lol, at 205lbs- I was doing a Kickboxing and jiu jutsu class 3-4x a week. So I probably had some but had never lifted weights when I started lifting I could barely bench 95lbs, and squat 115(at 205lbs)- squat now 445lbs and 315lbs bench. again not sure if any of this is relevant just felt the obesity may have been something good to know since it cause cause low t, usually your test levels would rejuvenate if the weight is lost, but it's possible that it didn't right?

 

[Vince]

I would try to find a good TRT doctor, like Dr. Saya at Defy. If you're trying to conceive, I would consider doing a restart if possible, it is hard to make good semen when you're on testosterone.

 

[drew16669]

I would try to find a good TRT doctor, like Dr. Saya at Defy. If you're trying to conceive, I would consider doing a restart if possible, it is hard to make good semen when you're on testosterone.

Thank you vince, and johndoesmith for the input, I felt Defy was probably the route to go after going over some of the topics on this forum. I really do appreciate it!