26 years old with Low test, need advice/help

[ctstrength]

Saw my Doc back in Oct 2013 about feeling tired all the time. Did a basic blood panel along with auto immune tests and everything came back normal. Vitamin d was 45 which I thought was on the low end. Following came back too
total cholestrol was 173
hdl cholestrol 69
triglycerides 66
ldl cholestrol 91
Non HDL Cholestrol 104
T3 total 78
T4, Free 1.1
T4, Total 6.7
TSH, 2.48
At this time I was around 158, macro intake was 70 fat/490 carb/180-190 protein. Had dieted down from being 180 @ end of june.

December, I start getting unmotivated to train and tired all the time. I spend the next 3 months doing minimal training and eating whatever I want.
Feb 2014, I'm 181 and 15% body fat, feel like crap.
I start dieting back down on 40-50 fat/90-130 carb/160-180 protein. I do medium intensity cardio 3 days a week for 45 minutes and 3 days a week of 10 intervals followed by 10-20 minutes of low intensity.

*Currently still on this plan but I have begun cutting down on the cardio and maintaining my fat intake around 50 grams, just bumped up my carb intake to 140 today. I work with a nutrition coach who also started try at 26, which I just found out, and he felt there was no need to adjust my nutrition or training given all these test results*

March 2014, I attend a seminar where a trainer friend presents on the importance of having blood work and hormones checked. Still dealing with fatigue so I decide to ask doctor to check my sex hormones. Only requests that I get total test looked.
Mid April get my blood work results
Total test comes back at 246
Free test 22.9
bioavailable test 51
shbg 46
albumin, 4.9

Doc prescribes androgen which I am told is no good and not to even bother with it.

I contact my trainer friend who works with a doctor. I see the doctor and he has more of my sex hormones looked at. Following comes back
Total test 150.7
Free test 1.49
LH 3.1
FSH 3.3
Progesterone .39
Prolactin 7.8
Estradiol <5.00
Insulin <2.0

He prescribed Test cyp 200 mg/ml , 1 cc every 2 weeks. I have been google searching all about this topic and am wondering if this is the right course of action for someone my age and at my levels. My main concern is having children, the doctor assured me that he was very confident I would be able to have a child with my wife. All the information I keep finding and getting from colleagues is over whelming and I feel like I have no one to talk to about this.

 

[Megatron28]

At your age and with your Secondary Hypogonadism, I would definitely try a restart of your HPTA before starting injections. See if you can get your natty T fired up again.

Give the following a read.

http://www.steroidology.com/forum/testosterone-replacement-therapy/662394-basic-trt-overview.html

 

[ctstrength]

What can I do if I already did 1? Is restarting the HPTA still an option?

 

[Megatron28]

Did 1 what?

 

[Daniel_IMT_Staff]

Hello CTstrength,

An HPTA restart could be an option for you. The first action is to try to pinpoint what could have caused the low T which you may not want to go in full detail here. But speaking to your Doctor about it and finding an answer is in your best interest. Getting a full panel hormone panel should be done as well and MRI scan on the pituitary and a possible sleep study.

Fertility isn't a problem while on TRT using hCG, if it is. You can start a program to increase fertility so the problem will get solved either way!

 

[ctstrength]

I have already done one injection of testosterone (w/ doctor prescription) Megatron28.

What does a restart entail?

I had a phone consult with a second doctor, he mentioned possibly using HCG. When I returned this info to my other doctor, they said HCG only works when LH and FSH are low, which in my case they are not. If they were, HCG would've been their first line of treatment.

I felt as though my LH and FSH were low
LH: 3.1 (1.7-8.6)
FSH: 3.3 (1.5-12.4)

The second doctor also felt their prescription was outdated (200 mg every 2 weeks) and that a better prescription would be a smaller dose injected twice a week to avoid the roller coaster. I'm 1 week post first injection of test cyp.

I guess all this information is just incredibly overwhelming consider my age and the desire to have a family with my wife.

 

[Megatron28]

I have already done one injection of testosterone (w/ doctor prescription) Megatron28.

What does a restart entail?

I had a phone consult with a second doctor, he mentioned possibly using HCG. When I returned this info to my other doctor, they said HCG only works when LH and FSH are low, which in my case they are not. If they were, HCG would've been their first line of treatment.

I felt as though my LH and FSH were low
LH: 3.1 (1.7-8.6)
FSH: 3.3 (1.5-12.4)

The second doctor also felt their prescription was outdated (200 mg every 2 weeks) and that a better prescription would be a smaller dose injected twice a week to avoid the roller coaster. I'm 1 week post first injection of test cyp.

I guess all this information is just incredibly overwhelming consider my age and the desire to have a family with my wife.

I talked a bit about restarts in that overview link I gave you. I would also contact IMT who also posted a reply to you in this thread. They have worked with a lot of guys on restarts. If it doesn't work then you could go on TRT for the rest of your life.

You LH and FSH are relatively low and indicate Secondary Hypogonadism which means a restart is an option for you.

Pinning once every two weeks is a terrible protocol. It is very outdated. The other doc you talked to was correct.

 

[ctstrength]

Why would the other doctor say my LH and FSH are not low making HCG not an option? (looking into IMT and saw the HPTA restart involves HCG in phase 1). Doesn't make sense to me.

 

[Megatron28]

Why would the other doctor say my LH and FSH are not low making HCG not an option? (looking into IMT and saw the HPTA restart involves HCG in phase 1). Doesn't make sense to me.

Didn't that same doc put you on the terrible testosterone protocol of 200mg once every two weeks? Did he discuss the high estradiol you are going to get from that with you? Sensing a pattern here that he doesn't know anything about TRT?

 

[ctstrength]

Very true. He did not discuss the high estradiol, would that matter if my levels were <5.0?
The more I educate my self on this matter, the better this second doctor is beginning to look.

 

[RR88]

Hey Ct,

In my opinion you should be doing Test Cyp 100mg every week minimum to avoid the dip. 100 a week is not a lot. Yes seeing your Natural test for a man is much lower I still believe synthetic dosages are not absorbed and equal natural serum levels. According to your levels I believe Test Cyp is the way to go. It's a life long treatment that can truly change the quality of your life. Be patient and see how you feel in about 4-6 weeks. As well get blood work done regularly to see if levels such as estradiol is exacerbated. I doubt any auxiliary drugs will be needed in such low doses but always get regular checks to ensure your best possible quality of life. Best of luck!

 

[ctstrength]

Hey everyone,

Saw a new doctor and he wants me to stop test to try HCG, 1200 units 3 times a week. I haven't been able to find a clear and concise recommendation for HCG. We will be doing blood work every 6 weeks though. He thought Test should be a last resort and mentioned Clomid as a second option.

 

[Megatron28]

Hey everyone,

Saw a new doctor and he wants me to stop test to try HCG, 1200 units 3 times a week. I haven't been able to find a clear and concise recommendation for HCG. We will be doing blood work every 6 weeks though. He thought Test should be a last resort and mentioned Clomid as a second option.

He is suggesting that you try a restart which we discussed earlier in this thread with you. I would do it if I were in your shoes.