31 and VERY low Testosterone! Dr. says TRT But I dont want to shut down natural Test?

[garymaurizi]

Hello Forum,

I'm 31 years old and my testosterone is EXTREMELY low. I recently found out 3 weeks ago after a bunch of bloodwork and testing that I have thyroid problems (subclinical hypothyroid/hashimoto's thyroiditis) and extremely low testosterone .

I have been training hard 2 hours a day 5 days a week for the last 9+ months trying to put on some muscle, and have been completely 100% failing, I have a pristine/clean diet & really good supplementation plan, is this why?

My Dr. wants to put me on exogenous testosterone/cypionate , but I don't know if I want to do this? I do not want to completely destroy my body's natural ability to produce testosterone, nor do I want to be permanently infertile? Are the side effects of TRT the same for men with secondary hypogonadism? I'm already producing way less Testosterone than I should, so wouldn't TRT completely destroy my body's natural ability to produce permanently?

He did not mention PCT or cycling, he did not mention any aromatase inhibitors or anything, just 250mg testosterone cypionate indefinitely? Doesn't this mean my balls will shrink, I will become infertile, and eventually my body's natural ability to produce testosterone will shut down entirely and permanently? if I don't cycle off of it from time to time?

Is there some better alternative like clomid or anavar that would allow me to build muscle without shutting down my natural testosterone production?

I upped my supplement game recently, and completely changed up my diet to only eat foods that boost testosterone, and started taking a few highly rated natural testosterone boosters, for someone with levels as low as mine, is it even possible to get to mid- or high-normal levels through diet and natural supplementation? or is TRT my only hope?

I'm really sick of putting this effort into my work outs and getting almost no results.

My levels from bloodwork follow:


03/20/2012:
TSH: 1.61 mUI/L

03/09/2013:
TSH: 1.29 mIU/L

11/04/2016:
TSH: 2.20 mIU/L
FT4: 1.34 ng/dL
Testosterone, Serum: 376 ng/dL
Free Testosterone: 5.3 pg/mL (REF: 8.7 - 25.1)

08/24/2017:
TSH: 4.54 mIU/L
FT4: 1.51 ng/dL

08/31/2017:
Testosterone, Serum: 324 ng/dL
Free Testosterone: 2.6 pg/mL (REF: 8.7 - 25.1)

09/05/2017:
Testosterone, Serum: 610 ng/dL
Free Testosterone: 7.7 (REF: 8.7 - 25.1)

09/08/2017:
TSH: 2.25 mUI/L
FT4: 1.10 ng/dL


Also, if TRT is the only practical solution for someone with levels as low as mine, how does steroid use fit in with someone like me who is very young to be on TRT (31 y.o)? What if I eventually wanted to cycle something like anavar or winstrol ? would I still have to take an AI, do PCT and cycle the anavar? would I cycle the testosterone too? (I have limited, almost no experience with steroids , but I've been trying to learn before starting TRT).

Thank You so much for your help, I'm really confused on the best course of action here.

My Dr. hasn't run any tests on LH, FSH, DHT, SHBG, I don't think he has a clue what is the cause of my hypogonadism? regarding if its primary or secondary? etc...

 

[Mycelium]

TRT takes the place of natural testoserone. hCG is used to keep tour testicles from shrinking and to continue to function producing what they do. Test, sperm . .

Cycling on TRT is called "blast and c r u i s e."


09/05/2017:
Testosterone, Serum: 610 ng/dL

That's not really low total testoserone. If you are still having problems you need detailed labs.

Added:

If you're training 2 hours 5 days a week what is your diet like? What is your training exactly? That's pretty intense. Lack of gains can be due to improper training and/or diet. Possibly over training if you hit the gym hard.

 

[garymaurizi]

TRT takes the place of natural testoserone. hCG is used to keep tour testicles from shrinking and to continue to function producing what they do. Test, sperm . .

Cycling on TRT is called "blast and c r u i s e."


09/05/2017:
Testosterone, Serum: 610 ng/dL

That's not really low total testoserone. If you are still having problems you need detailed labs.

Added:

If you're training 2 hours 5 days a week what is your diet like? What is your training exactly? That's pretty intense. Lack of gains can be due to improper training and/or diet. Possibly over training if you hit the gym hard.

Thank You! This is exactly the type of information that I need to know.

I think I'm going to request that we test all of the following before I start any hormone therapy: E2, LH, FSH, SHBG, DHT, PSA, estradiol is there anything I should add or remove to this?

I was wondering what blast & c***se meant, TY for clarifying this for me.

My doctor plans to put me on 200mg IM depot-testosterone cypionate WEEKLY, and he prescribed 100mcg t4 and 5mcg t3 for my subclinical hypothyroidism. Is this a good plan?

Should I request that I be put on hCG and to cycle the testosterone to keep my natural production functioning? if you are hypogonadal like me and on exogenous testosterone, and also taking hCG to protect the testes, do you even need to cycle on/off to restore production? or can you just lower the dose and then follow this with raised dose for a while?

Thank You all so much for your help, I'm just starting to understand all of this.

 

[garymaurizi]

TRT takes the place of natural testoserone. hCG is used to keep tour testicles from shrinking and to continue to function producing what they do. Test, sperm . .

Cycling on TRT is called "blast and c r u i s e."


09/05/2017:
Testosterone, Serum: 610 ng/dL

That's not really low total testoserone. If you are still having problems you need detailed labs.

Added:

If you're training 2 hours 5 days a week what is your diet like? What is your training exactly? That's pretty intense. Lack of gains can be due to improper training and/or diet. Possibly over training if you hit the gym hard.

Forgot to add, my training isn't what most would consider great, I do p90x classic and I've been doing that religiously for about 10 months now. I'm 3 times through and literally look the same if not worse then when I started. I push myself hard, follow them rep for rep, and bring intensity every time. I know I should probably move onto a more serious/simplified weight lifting routine, but I work out at home with adjustable dumbbells and a ceiling mounted pull-up bar at the moment. I'm always sore after every workout, sometimes It feels like when I recover I don't grow...

As far as my diet im mostly vegan and recently started eating only testosterone boosting whole foods, I do supplement with whey protein though and make sure to get at least 180 grams a day, I take jym brand pre and post workout supps, life extension mix vitamin/mineral supplements, and a bunch of other life extension supplements like cognitex, mitochondrial energy optimizer, ampk activator, ToCoq10, etc. I know the vegan thing is not great for testosterone or muscle building but it's a life choice. I try to make sure I eat enough daily and track things with myfitnesspal.

Thanks,
Gary M.

 

[Mycelium]

Lifting for mass is a system. Powerlifting has it's routines. I'm no expert as my picture shows but I think you need to lift with a mass based philosophy and make sure you always eat more than you need TOTAL. Workouts included.

I use HIT style workouts. I've never been huge but they got me to 172lbs once. High volume didn't work for me.

 

[Entourage_Doc]

You my friend, have low Testosterone. 200mg/wk is standard dosing to begin treatment. Need to be on hcg and an AI at that dose as you will most likely convert. Don't worry about "shutting down" your natural HPTA as most likely you are deficient and not producing endogenous test, obviously. It is a very common problem in US

Need lsh and fsh to determine secondary or primary, other than that the thyroid treatment looks good. Always good to see where shbg is initially.

Remember, diet is 80% of how you look. Up your macros if you want to put on size. Do not burn too many calories as this will surely inhibit your growth.

Dr B

 

[Slhardee]

You will probably start to put on a good amount of mass even with a P90X type work out once you start your therapy. Your body will adjust and probably grow quite a bit for the first few months. If you're eating vegan you only be putting on lean muscle mass.

As far as your question about shutting down your age HPTA, once you start taking TRT, you will no longer produce your own testosterone. Your FSH and LH will go in the gutter. This is normal and fine. However, be prepared to take TRT forever, unless you plan on doing a restart somewhere along the way. HCG and having your estradiol monitored are great ideas. You will probably need armidex or anastrozole Depending on what dose of testosterone you end up on.

 

[Mycelium]

"09/05/2017:
Testosterone, Serum: 610 ng/dL". . . .

That's an off score compared to the others. Went from 324 up to 610 ng/dL in 6 days?!?! That's a huge variation. When is your doctor having your labs pulled? Time if day. First thing in the morning or is it after you get off work at 4:30pm?

OP how is your sex drive? Erections? Hair growth? Feeling down at all? Irritated a lot? Night sweats?

Added:
"do you even need to cycle on/off*" NO!!! TRT is life long. There is no going off. There is dosage adjustments but no going off it. It's a medication to treat a problem. Going off will just crash you and you'd return to low T. TRT should put you into "normal ranges" of Test, free test and estrogen.

TRT is like insulin in a very broad way. Not how it works or anything. Just you have low levels of T / low insulin. Your body isn't holding normal levels so you inject them. Rather than insulin we inject testoserone, hCG to keep testicles functioning and an AI to keep estrogen in control.

 

[Mycelium]

http://www.steroidology.com/forum/diet-forum/591318-work-out-diet-vegeterians.html

I haven't even looked in it but if it was stickied I think the information is legit.

 

[garymaurizi]

"09/05/2017:
Testosterone, Serum: 610 ng/dL". . . .

That's an off score compared to the others. Went from 324 up to 610 ng/dL in 6 days?!?! That's a huge variation. When is your doctor having your labs pulled? Time if day. First thing in the morning or is it after you get off work at 4:30pm?

OP how is your sex drive? Erections? Hair growth? Feeling down at all? Irritated a lot? Night sweats?

Added:
"do you even need to cycle on/off*" NO!!! TRT is life long. There is no going off. There is dosage adjustments but no going off it. It's a medication to treat a problem. Going off will just crash you and you'd return to low T. TRT should put you into "normal ranges" of Test, free test and estrogen.

TRT is like insulin in a very broad way. Not how it works or anything. Just you have low levels of T / low insulin. Your body isn't holding normal levels so you inject them. Rather than insulin we inject testoserone, hCG to keep testicles functioning and an AI to keep estrogen in control.

Yes I agree that 610 ng/dL is pretty out of place!

When we were initially testing we were mostly looking for thyroid issues not expecting testosterone issues so he didn't instruct me to go to the lab at any specific time. I usually go to the lab pretty late between 2pm and 4pm to be honest.

I just got word back from my doctor again, he IS planning on giving me an AI (anastazole) but he said that they DO NOT prescribe hCG? he would not tell me why they do not prescribe hCG? He also said "cycling pause can be beneficial after you get your levels optimal 1100-1200" and that "clomid can be discussed on an individual basis but its not a routine part of our trt program".

How important is hCG in all of this? does it sound like I have a good doctor with a good plan to protect my normal functioning? or should I find a specialist/endocrinologist? I know this doc personally (worked as his IT admin for years) so I trust he has my best interest at heart, and he is rather knowledgeable about the latest stuff in medicine, but he is not a specialist just a practicing GP.

I definitely do have the symptoms of low T, but it's hard to tell if thats actually the hypothyroidism causing it or the Low testosterone? maybe the hypothyroidism CAUSED the low testosterone and getting my thyroid levels normal would fix the testosterone issue? or maybe it just caused the near identical symptoms? I don't know because we haven't done blood work since starting thyroid meds.... I also don't know the cause of my testosterone issue, if its primary or secondary, have not tested FSH+LH, SHBG, E2/Estradiol, etc...

When we initially got my results back I found out i had a SEVERE vitamin D deficiency, subclinical hypothyroidism with hashimoto's antibodies, and low testosterone. I don't know if it plays into any of this but we also recently found some mysterious nodules in my lungs I'm now seeking treatment/diagnosis for.

Because of the lung nodules I quit nicotine/vaping, prior I had a pretty intense nicotine/vaping habit. I do not consume any other drugs, but I do take a good amount of vitamins/supplements daily.

Thank You so much, I was really clueless and afraid going into all of this, and your help has been invaluable.

 

[Mycelium]

I learned real quick researching epilepsy and low T that things can get really specific and things can get really complicated fast.

Read the TRT stick by Megatron.

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

He dives into hCG and if you quote it to your doctor and he looks into it Is bet he would see it's true. hCG has been studies for fertility.

There are people taking just hCG and Ana for low T.

I'm hoping for TT above 540 but below 1000. I see a lot of people over 1000 with other values getting off like hemocrit.

Testoserone and thyroid function play together for sure.

Got a lot going on man!!! Damn!

 

[IMT staff]

Question: If your testosterone is already very low, how can you "shut it down"?