TRT consideration

[OsiemPiec]

Hello all, This will be quite a long post though I hope for some interesting resposnes.

I’m considering TRT right now and looking for some advise. Here’s my background. I’m 35yo right now and feeling like crap most of the time - low libido, always tired and sleepy, poor recovery and regeneration, cannot get rid of love handles, whenever I try to put on some muscles I put on mostly fat (starting with my stomach). There was a time I had a little bit of conflict with my wife due to my low sex drive as she felt guilty that I’m not much into sex at all.. After years of struggling I finally decided to do something with it. No steroids background thus far.

I went to do the labs in the middle of last year and came up with that (norms in parenthesis):

• * Estradiol 12,89 (27,10 - 52,20)
• * Prolactin 10,88 (4,04 - 15,20)
• * Testosterone 270,00 (249,00 - 836,00)
• * Free Testosterone 9,42 ( 4,50 - 42,00)
• * FSH 3,56 U/l (1,5 - 12,4)
• * LH (s) 4,21 mIU/ml (1,7 - 8,6)
• * TSH (s) 1,29 mlU/l (0,27 - 4,20)
• * ATG 11,24 IU/ml (< 115)
• * ATPO 5,1 IU/ml (< 34,0)

Repeated soon after:

• * Estradiol 5,29 pg/ml (7,63 - 42,6)

So low estradiol and testosterone. I went to andrologist and he prescribed me 2x25mg DHEA, after 6 weeks:

• * Testosterone 3,07 ng/ml (2,8 - 8,0)
• * DHEA-S 307,2 ug/dl (160 - 449)
• * SHBG (s) 14,71 nmol/l (11,4 - 52,3)

Testosterone was still low and I still didn’t feel any better so he put me on clomid 1x25mg for 2 months. Labs after:

• * Testosteron 6,55 ng/ml (2,8 - 8,0)
• * Estradiol (s) 34,51 pg/ml (25,8 - 60,7)
• * LH (s) 6,14 mIU/ml (1,7 - 8,6)

And one week after going off clomid:

• * Testosterone 5,81 ng/ml (2,8 - 8,0)

I was feeling a little bit better at some point, however after few weeks mood and feeling went down again and I got me test checked (with some additional checks in it):

• * Testosterone 3,05 ng/ml (2,8 - 8,0)
• * CRP (s) <1 mg/l (< 5)
• * Glucose SI 4,7 mmol/l (3,8 - 5,5)
• * Glucose 85 mg/dl (70 - 99)
• * TSH (s) 0,95 mlU/l (0,27 - 4,20)
• * Potassium 4,3 mmol/l (3,5 - 5,1)
• * Na 141 mmol/l (136 - 146)
• * Hematocrit 46,8 % (40,0 - 55,0)
• * Hemoglobine 15,9 g/dl (11,8 - 17,2)
• * RBC 5,38 x10´6/ul (3,50 - 6,50)
• * WBC 5,52 x10´3/ul (3,50 - 10,00)

So off to andrologist again, this time clomid for 3 months with dosage 1x25mg. Lab test in the meantime:

• * Testosterone 5,18 ng/ml (2,8 - 8,0)

However three weeks after going off:

• * Testosteron 3,34 ng/ml (2,8 - 8,0)

The same story here - I felt a little bit better during, however after going off clomid I felt as before. In the next visit doc decided I should go off clomid for longer period of time since I was taking it with breaks for about 7 months during 10/11 months timespan. His next suggestion was androgel as a last resort since there was nothing more to do (???). I was supposed to be on it for about 2 months. While being on androgel I did check of testosterone in lab:

• * Testosterone 1,43 ng/ml (2,8 - 8,0)

Since it was really annoying to use gel - daily, need to make sure my wife won’t get it. I workout in the morning so I had to apply early at work sitting in toilet and waiting for it to dry. On top of it it was expensive. So while still using it, I went off to different doc - female endo. She told me to get off gel, do the lab one month after it and we will go from there. Here are results after one month off gel:

• * PSA total 0,914 ng/ml (< 4,0)
• * SHBG (s)19,02 nmol/l (11,4 - 52,3)
• * Glucose SI 4,7 mmol/l (3,8 - 5,5)
• * Glucose 84 mg/dl (70 - 99)
• * Testosterone 2,04 ng/ml (2,8 - 8,0)
• * Cholesterol total162 mg/dl (< 190)
• * HDL Total 63,4 mg/d (l> 40)
• * LDL Total 88,9 mg/dl
• * Triglicerides Total 43 mg/dl (< 150)
• * 25 (OH) Vit D3 25,8 ng/ml (20-30: low range)
• * Hematocrit 47,1 % (40,0 - 55,0)
• * Hemoglobine 16,2 g/dl (11,8 - 17,2)
• * RBC 5,55 x10´6/ul (3,50 - 6,50)
• * WBC 5,57 x10´3/ul (3,50 - 10,00)

She told me to wait one more month, redo some labs and we should decide what to do next. Her proposal was to go on trt. However one thing was mentioned that during discussion that I wasn’t aware of. She told I will fertility and I might not recover it even while going off trt. That’s surprising since my andrologist earlier gave me androgel and didn’t mention anything about it and as I understand it might have similar effect. What’s worth mention, recently I became father - my boy is little over 2 month old. So I know I’m not shooting blanks at least. And even though I’m not the youngest (35) I still consider possibility of having maybe one more child.

I still feel like crap however. Do you guys think I can gain anything in terms of what bother me most (mentioned in beginning) with going on trt? And how about fertility? I’m little bit scared right now with pulling the trigger after what she told me… I've read about hcg but I guess I still need to understand it more to see if it can give me a better chance of recovering for period when we might try with wife to have one more kid. Does any of you have any experience with stopping trt for a while and trying to conceive?

I will appreciate any input.

 

[Vince Carter]

There's no need to stop TRT while trying to conceive. Around here and any GOOD clinic/Dr will prescribe it's use, is HCG while on TRT. HCG will preserve your fertility and testicular function. There is no start/stop on TRT. It's a lifelong commitment. You can stop, you can do a therapy regimen/restart but it's a commitment to the therapy, if you want the benefits, you have to stay committed to it. Most none of us have any luck with Gels, topicals, or clomid. Injections of Testosterone is where it's at.

 

[CoastWatcher]

Welcome to Excelmale; we hope you'll be an active member. I take it you are outside the United States. That is important in respect to measuring your estradiol as you may well find access to the sensitive estradiol test (LC, MS, Ms) limited to non-existent. That noted, what are your options for injectable testosterone? Is testosterone enanthate or cypionate customarily prescribed? Finally, please take some time to read through the posts here on the Forum. You are at the point where you must become your own advocate and that means it's necessary to familiarize yourself with the contours of androgen replacement.

We're glad you're here and wish you all the best.

 

[Vince]

I'm also wondering where do you live? Injecting testosterone along with HCG every 3 1/2 days seems to work best. I inject both T and HCG same day and time. Here's my latest labs. https://www.excelmale.com/forum/showthread.php?8533-My-New-LabCorp-Labs I also eat a high-fat low-carb diet.

 

[Henry]

While on TRT, with HCG, I still had 75 mil sperm (over 20 mil is good) and I've been on for 3 years. I've taken HCG since I started and get my sperm tested every 6 months for the first year and now it's yearly. I'm still fertile.

4 pumps of Androgel daily and 500ui's of HCG every other day.

 

[OsiemPiec]

There's no need to stop TRT while trying to conceive. Around here and any GOOD clinic/Dr will prescribe it's use, is HCG while on TRT. HCG will preserve your fertility and testicular function. There is no start/stop on TRT. It's a lifelong commitment. You can stop, you can do a therapy regimen/restart but it's a commitment to the therapy, if you want the benefits, you have to stay committed to it. Most none of us have any luck with Gels, topicals, or clomid. Injections of Testosterone is where it's at.

Yup, I will try to read more on HCG and consult this possibility with my endo. I wasn't aware up until recently that there is even such an option so it's glad to hear. And yes, I understand that this will be life long commitment however I've had enough of being that version of myself that I'm recently and it's definitely time to do some changes hoping for positive outcome.

Welcome to Excelmale; we hope you'll be an active member. I take it you are outside the United States. That is important in respect to measuring your estradiol as you may well find access to the sensitive estradiol test (LC, MS, Ms) limited to non-existent. That noted, what are your options for injectable testosterone? Is testosterone enanthate or cypionate customarily prescribed? Finally, please take some time to read through the posts here on the Forum. You are at the point where you must become your own advocate and that means it's necessary to familiarize yourself with the contours of androgen replacement.

We're glad you're here and wish you all the best.

That place is so full of interesting information that I definitely plan to hang around for little bit longer. And since I'm leaning towards going on TRT, having such a place is going to be so useful - to have something to read on what other people experienced and also looking for a help.


You are right, I'm from Europe/Poland (I guess my english sold me ) It's not that easy to get testosterone prescribed in here. I have very bad experience with one doc - I even went to urologist in the meantime asking for trt possiblity... omg. He was so pissed at me, saying I'm fine, I should live with all the symptoms, even though I have low T I'm father so everything is working. And the only prescription he can give me is for... viagra! So I never went back to him, it was so ridiculous. So in short I'm happy to found doc (and it's female) that is seriously giving me possibility of going on trt and putting decision completely in my hands. And fertility is the only thing that is holding me back however it seems like it's not that bad as I thought.

I'm also wondering where do you live? Injecting testosterone along with HCG every 3 1/2 days seems to work best. I inject both T and HCG same day and time. Here's my latest labs. (...) I also eat a high-fat low-carb diet.

As mentioned - it's Europe/Poland. The only thing that worries me is that my endo mentioned that she might want to put me on some longer periods between shots - like 2 or 3 weeks. However I will definitely talk to her to make them shorter. I've read enough bad things on long periods between shots. Interesting protocol with HCG, I guess it's very convienent to have it both together.

While on TRT, with HCG, I still had 75 mil sperm (over 20 mil is good) and I've been on for 3 years. I've taken HCG since I started and get my sperm tested every 6 months for the first year and now it's yearly. I'm still fertile. 4 pumps of Androgel daily and 500ui's of HCG every other day.

Good to know, so seems like that's real possibility - I will have to explore this. I'm curious whether any negative side effects of HCG, I will have to read more on this topic.

 

[johndoesmith]

As mentioned - it's Europe/Poland. The only thing that worries me is that my endo mentioned that she might want to put me on some longer periods between shots - like 2 or 3 weeks. However I will definitely talk to her to make them shorter. I've read enough bad things on long periods between shots. Interesting protocol with HCG, I guess it's very convienent to have it both together.

You have test cyp or test E available there? I thought europe only had nebido and sustanon.

If you are allowed to self inject, and can buy needles over the counter there, let her think you're doing E14D and just split your injections. Not the best thing to do, but you gotta do what you gotta do.

 

[OsiemPiec]

You have test cyp or test E available there? I thought europe only had nebido and sustanon.

If you are allowed to self inject, and can buy needles over the counter there, let her think you're doing E14D and just split your injections. Not the best thing to do, but you gotta do what you gotta do.

I just did quick research through online drug stores - seems like there is Testosteronum prolongatum with testosterone enantan in it. I haven't found anything else, so not sure if that's the anwser to question. However I plan to push for more frequent injections and ask them to help me learn how to do it on my own. Being reliable on nurses in clinic will suck for long term (like any travelling, vacations etc).

 

[johndoesmith]

I just did quick research through online drug stores - seems like there is Testosteronum prolongatum with testosterone enantan in it. I haven't found anything else, so not sure if that's the anwser to question. However I plan to push for more frequent injections and ask them to help me learn how to do it on my own. Being reliable on nurses in clinic will suck for long term (like any travelling, vacations etc).

Yeah I'd never let that happen, think about it, TRT is a life long treatment, and not having control of your life long medication makes absolutely no sense.

Inevitably, you will either have something come up so you can't go into the office, or a holiday like christmas will fall on injection day, a snow storm, hurricane or something not to mention vacation.

 

[OsiemPiec]

Yeah I'd never let that happen, think about it, TRT is a life long treatment, and not having control of your life long medication makes absolutely no sense.

Inevitably, you will either have something come up so you can't go into the office, or a holiday like christmas will fall on injection day, a snow storm, hurricane or something not to mention vacation.

Yup, that's why I wan to learn how to do it on my own. Having to rely with something like this on somebody else for rest of the life is just asking for troubles. No way I will make it happen. Thanks for making sure though.