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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Starting TRT: Treatment options
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<blockquote data-quote="overvolting" data-source="post: 132622" data-attributes="member: 37898"><p>I've done a bunch of research and I'm familiar with the HPT axis and the treatment options including:</p><p>clomiphene, test cypionate, HCG, pellets, gels etc.</p><p></p><p>My question is, now the time has come to pull the trigger I'm being offered almost anything I want as a treatment option. Am I making the right choice with test cyp + HCG and is the protocol I'm being offered decent?</p><p></p><p>I'm 40yo, in good shape, exercise 3-4 times a week with hiit and weights and was feeling tired, difficulty gaining muscle, ease in gaining fat and low libido. I have no other illnesses and am not on any medication except for vitamins and I had my GP do a battery of blood tests, everything came back either good or great, except for testosterone and I'm slightly anemic.</p><p></p><p>First set of tests oct 2018:</p><p>total test 389 ng/dL, range >280</p><p>shbg 30 nmol/L, range 13-90</p><p>albumin 4.0 g/dL, range 3.4-5.2</p><p></p><p>free test, calculated: 300 pmol/L, range >200</p><p>test, bioavailable: 189 ng/dL, range > 130</p><p>estradiol by TMS 27.6 pg/mL, range 10-42</p><p>estrone 33.9 pg/mL, range 9-36</p><p>total estrogens 61.5 pg/mL, range 19-69</p><p></p><p>TSH 1.84 uIU/mL range 0.3-4.5</p><p></p><p>Hemoglobin A1C, vitamin b12, vitamin D, cholesterol and lipids, salts, creatinine, glucose, phosphatase and a battery of others all normal to good.</p><p></p><p>Second set of tests December 2018:</p><p>Prolactin 11 ng/mL, range 4-15</p><p>FSH 4.2 mIU/mL, range 1.4-18.1</p><p>LH 5.0 mIU/mL, range 1.7-8.6</p><p></p><p>total test 337 ng/dL, range >280</p><p>shbg 37 nmol/L, range 13-90</p><p>albumin 3.5 g/dL, range 3.4-5.2</p><p></p><p>free test, calculated: 238 pmol/L, range >200</p><p>test, bioavailable: 132 ng/dL, range > 130</p><p></p><p>Iron serum / plasma 49 ug/dL, range 50-170</p><p>TIBC 236 ug/dL, range 250-430</p><p></p><p>My GP refered me to an endocrinologist, who said and I almost quote:</p><p>"You're a young guy and I can see that you can grow a beard so you don't have low test. Low test would be less than 50 or 100 ng/dL. I'll give you some viagra. I don't want to do it, but I'll leave you a prescription for clomiphene."</p><p></p><p>Immediately I knew that treatment option was going to suck because he didn't know what he was talking about. Research on here and pubmed showed that clomiphene does raise test levels but almost nobody feels better...</p><p></p><p>Next I went to a Men's Health clinic at a major city nearby. They basically offered me anything I want:</p><p>Gels, pellets, HCG monotherapy, test cyp, test cyp + HCG. The guy first recommended HCG monotherapy because I might want to have another kid in 3 years, I told him, sure but I don't even have a partner right now and that I'd prefer test cyp + hcg. He said most people do feel better on that than HCG alone and to give them 3+months notice of when you wanted to try for a child since it takes that long for them to do anything to get fertility up again.</p><p></p><p>I asked for both protocols, to evaluate.</p><p>HCG mono: 1000-1500 units 3x / wk</p><p>Test cyp + HCG: 500 units 2x / wk HCG and I forgot to ask amount of test cyp doh. I can ask at the next meeting but I got the impression they would let me work with them to select the dosage / wk and pick what levels to be at.</p><p></p><p>They took labs including test, estrogen, PSA. They did a rectal and prostate exam (yeah that was fun).</p><p></p><p>My 2nd appointment at the Men's health is in 10 days and they said they'd go over my labs and give me my first shot of test cyp and hcg and get me started, then on my 3rd appointment they would teach me how to do it myself. They said I can expect to pay about $40/mo for the test and about $75/mo for the HCG (would be about $200/mo for the HCG monotherapy). They would see me more frequently at first, then drop it to every 3-6 months once things are dialed in and same for bloodwork.</p><p>They said they don't manage estrogen unless it becomes a problem and that most men don't need it, but if they do they start with 0.5mg anastrazole 2x wk usually.</p><p></p><p>I've also got an appointment with an urologist at the same hospital as the endocrinologist, but that's 20 days from now, so if I go with the men's health clinic, I will already be on treatment.</p><p></p><p>What do you guys think?</p></blockquote><p></p>
[QUOTE="overvolting, post: 132622, member: 37898"] I've done a bunch of research and I'm familiar with the HPT axis and the treatment options including: clomiphene, test cypionate, HCG, pellets, gels etc. My question is, now the time has come to pull the trigger I'm being offered almost anything I want as a treatment option. Am I making the right choice with test cyp + HCG and is the protocol I'm being offered decent? I'm 40yo, in good shape, exercise 3-4 times a week with hiit and weights and was feeling tired, difficulty gaining muscle, ease in gaining fat and low libido. I have no other illnesses and am not on any medication except for vitamins and I had my GP do a battery of blood tests, everything came back either good or great, except for testosterone and I'm slightly anemic. First set of tests oct 2018: total test 389 ng/dL, range >280 shbg 30 nmol/L, range 13-90 albumin 4.0 g/dL, range 3.4-5.2 free test, calculated: 300 pmol/L, range >200 test, bioavailable: 189 ng/dL, range > 130 estradiol by TMS 27.6 pg/mL, range 10-42 estrone 33.9 pg/mL, range 9-36 total estrogens 61.5 pg/mL, range 19-69 TSH 1.84 uIU/mL range 0.3-4.5 Hemoglobin A1C, vitamin b12, vitamin D, cholesterol and lipids, salts, creatinine, glucose, phosphatase and a battery of others all normal to good. Second set of tests December 2018: Prolactin 11 ng/mL, range 4-15 FSH 4.2 mIU/mL, range 1.4-18.1 LH 5.0 mIU/mL, range 1.7-8.6 total test 337 ng/dL, range >280 shbg 37 nmol/L, range 13-90 albumin 3.5 g/dL, range 3.4-5.2 free test, calculated: 238 pmol/L, range >200 test, bioavailable: 132 ng/dL, range > 130 Iron serum / plasma 49 ug/dL, range 50-170 TIBC 236 ug/dL, range 250-430 My GP refered me to an endocrinologist, who said and I almost quote: "You're a young guy and I can see that you can grow a beard so you don't have low test. Low test would be less than 50 or 100 ng/dL. I'll give you some viagra. I don't want to do it, but I'll leave you a prescription for clomiphene." Immediately I knew that treatment option was going to suck because he didn't know what he was talking about. Research on here and pubmed showed that clomiphene does raise test levels but almost nobody feels better... Next I went to a Men's Health clinic at a major city nearby. They basically offered me anything I want: Gels, pellets, HCG monotherapy, test cyp, test cyp + HCG. The guy first recommended HCG monotherapy because I might want to have another kid in 3 years, I told him, sure but I don't even have a partner right now and that I'd prefer test cyp + hcg. He said most people do feel better on that than HCG alone and to give them 3+months notice of when you wanted to try for a child since it takes that long for them to do anything to get fertility up again. I asked for both protocols, to evaluate. HCG mono: 1000-1500 units 3x / wk Test cyp + HCG: 500 units 2x / wk HCG and I forgot to ask amount of test cyp doh. I can ask at the next meeting but I got the impression they would let me work with them to select the dosage / wk and pick what levels to be at. They took labs including test, estrogen, PSA. They did a rectal and prostate exam (yeah that was fun). My 2nd appointment at the Men's health is in 10 days and they said they'd go over my labs and give me my first shot of test cyp and hcg and get me started, then on my 3rd appointment they would teach me how to do it myself. They said I can expect to pay about $40/mo for the test and about $75/mo for the HCG (would be about $200/mo for the HCG monotherapy). They would see me more frequently at first, then drop it to every 3-6 months once things are dialed in and same for bloodwork. They said they don't manage estrogen unless it becomes a problem and that most men don't need it, but if they do they start with 0.5mg anastrazole 2x wk usually. I've also got an appointment with an urologist at the same hospital as the endocrinologist, but that's 20 days from now, so if I go with the men's health clinic, I will already be on treatment. What do you guys think? [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
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Starting TRT: Treatment options
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