31 y/o male 10 years on & off testosterone replacement therapy (TRT) / hypogonadism

[Sketch2000]

31 y/o male 10 years on & off trt / hypogonadism

Hi all.

I'm a 30 y/o male (I'll be 31 on Sunday).

First off I suffer from Subclinical Hyperthyroidism which consists of a low TSH ONLY. Therefore its not treated if all the other Thyroid hormones are normal. This is something that has run in the family.

Since the age of 18 I've had a real problem with my libido - to the point where I (still) can't have a stable relationship, and so on. Low Libido and ED were my first symptoms. Since I (at the time) was using antidepressants it was thought that this was the cause. However, as years passed (and did the medication - I wasn't using antidepressants anymore) my libido NEVER improved.

I used Steroids (anabolic) in 2001. One cycle of Sustanon / Dianobol / Test - I gained a great deal of muscle, trained and ate well - but still - no libido!

After my steroid use (first and only time) I used Clomid to get my levels up to par. Based on the Dr.'s I had seen at the time my Testosterone levels were normal (although at this time in my life - I was about 21-23, they were only testing "total t" not "free t".

In 2003 I had full hormone levels checked which showed fluctuations in my Testosterone levels to the LOW SIDE / not low-normal (free and total) and with my SHBG.

My Dr. at the time knew of my problems and wrote a letter stating that a patch could / should be used if low free test persisted.

By 2005 I met with a urologist who checked all of my prior labs and re-did them. They were some fluctuations due to other medications at the time - prolactin and such. But given the low test (this time it remained normal but in the normal low range) and the way I was feeling (no libido) I began treatment with "Testim" (first kind of Androgel) and felt great! My libido returned and about 6 months later my labs came up with my free test getting too high so we titrated off).

Since then things have been the same...or worse. I returned to the same urologist in 2008 with the same complaints and we discussed that testosterone replacement therapy (TRT) would need to be used on and off perhaps as it shouldn't be used long term. A Sperm count came back showing NO SPERM! And my hormone profile came back with elevated prolactin likely due to medication at the time (psychotropic medication).

I was then referred to an educational institution that has a medical school and met with an endocrinologist. She has reviewed EVERY single one of my lab tests since Day 1 - and even made a chart noting fluctuations. She is also very well educated and empathizes with me.

In her opinion, my Sublclinical hyperthyroidism doesn't need to be treated (as all the other endocrinologists have said) unless they are fluctuations in the other thyroid hormones.

As for the testosterone replacement therapy (TRT). She agrees that despite me testing in the low-normal range (if total test is 300-800 mine is within the 300's / same for free test, always LOW NORMAL) that if the quality of my life improves she doesn't mind testosterone replacement therapy (TRT). My sperm count also returned to normal and I suspect it was a result of the psychotropic medication. As for the testosterone replacement therapy (TRT) she thinks in the long term that if i use it then gonadtrophins could be used to help with the natural production of sperm and such if and when I'm ready to have kids. She has given me a RX for Androgel which i am unable to afford since I am uninsured. Given my history of depression and antidepressants over the last 10 years I have had to deal with the "its psychological" label - which I don't argue that there couldn't be some cause of that. But for someone with 10 years of this problem and having been diagnosed with LOW TEST via lab results and/or results only in the LOW NORMAL range i don't think its a coincidence.

Anyway, given the Androgel was too expensive she has no given me Clomid. I am taking 25mg per day and I am having my TEST checked (free and total) within 30 days from the start date and then continue. I anticipate her allowing me to stay on it for another few months after the initial 30 days (I had my labs checked prior, but the lab messed up and only did Total T) so we can check for progress.

As for how I'm feeling - far better ! Increased libido. I am grateful to have now met a doctor who understands this problem and the balance between quality of life and medicine. She has also written a letter stating my condition so if i relocate I am able to obtain testosterone replacement therapy (TRT) due to what she has written. I have read several reports about people abusing steroids and having a "total shutdown" of natural production of test using Clomid for 6 months and having levels return to normal - which is my hope.

What are your thoughts on this?
I would much rather the Androgel as I feel the effect almost immediately (despite it shutting off your natural production) however I am unable to afford it.

Given that I have used anabolic steroids in the past and didn't feel any difference with my libido there is some argument that it remains psychological and it could be some kind of placebo effect, but despite that if it is done correctly / and supervised by a Dr. then my qualify of life is vastly improved.

Anyway. I wanted to know if anyone has had similar problems with low test and ED for so long and if any other things have worked. One on end of the spectrum you have people going into "rejuvenation clinics" and getting diagnosed with hypogonadism like I legitimately have and getting heaps of anabolic test and HGH and they are in far better shape than me! But I've been doing it the "right way" seeing Dr.'s and what not...and I'm still fighting it. It seems now with the letters and depending on what i can afford its going to be something i use on and off for life (TRT) - I don't have a problem with that, as long as it works.

BTW - This problem PRE-DATES my first and only time using Steroids, by about 3-4 years.

 

[BigFella]

" I began treatment with "Testim" (first kind of Androgel) and felt great! My libido returned and about 6 months later my labs came up with my free test getting too high so we titrated off)."

And:

"My sperm count also returned to normal"

That's good news!!!

This is a really well-written post. It is obvious that you know a lot - it is also obvious hat you've got lucky with your doctor. But I think it is up to you to determine what your treatment should be and get her on-side with it.

Gut feel:

1. You're in the right place for help.
2. Your thyroid is causing the problems with your T, and if you can't fix the cause then you can at least easily fix the problem.
3. Get onto injectable T and HCG - the latter because kids are fabulous, an you need to be able to have some.

I really don't think you should wait. Life s too short, and I hear what you are saying about getting your libido back - but you have probably never experienced normal libido, which is when you are only concerned whether they are warm - they definitely don't have to be pretty, breathing or homo sapiens. Watermelons are fine. That what normal teenagers are like.

And there is no doubt you are suffering psychologically, and that just has to stop.

 

[Sketch2000]

Thanks for your response.

I feel far better than I ever have (on Clomid 25mg daily!) and its my 4th week!

I just want to feel this way forever - (from a libido standpoint, I'm not a bodybuilder...) because you are right, I've likely never experienced a "healthy libido" before.

Thanks again.

Chris

 

[Sketch2000]

This shi--s killing me bro.

Not feeling the same way I did last week on Clomid - which is weird.

Had labs done today and my PCP didn't do Free Test - only Total...which is ridiculous.

Now I'm going to have to find a way to pay for the proper labs to be done.

Forget about how I'm going to pay for treatment.....

10 years gone.....

Chris

 

[David1963]

I'm not familiar with clomid use, so I hope it works for you. I'd suggest that if the Clomid doesn't work for you, and your doctor is willing to prescribe Testim, and it's too expensive, perhaps you could talk them into prescribing injectable testosterone, which is less expensive.

You're on the right track, just keep at it and you'll find relief!

Good Luck!

 

[Sketch2000]

I'm not familiar with clomid use, so I hope it works for you. I'd suggest that if the Clomid doesn't work for you, and your doctor is willing to prescribe Testim, and it's too expensive, perhaps you could talk them into prescribing injectable testosterone, which is less expensive.

You're on the right track, just keep at it and you'll find relief!

Good Luck!

Thanks David.

 

[vpi]

Hey man, David is right just keep at it. I too have had very low T for basically all my life. I'm 40 now and had pretty much no libido as a teen. On and off for years I've tried to get a doc to prescribe something for my low T but nothing. Some would not even bother running the blood test saying that I "look fine" so I must have enough test. Nice.

My current PCP has been willing to put me on Androgel which I've been on for about 9 months. It took a while to get my T up high enough for me to feel anything but finally I did. It was incredible for a while. But now my body is not regularly feeling it. I have a day here and there but many of the days I feel over tired and no libido. From what I've been reading it is likely that Androgel, being a transdermal, causes an increase in estrogen which can counter the effects of T... Aromitization

I've also read that with injections there is far less aromitazation and the delivery is more steady especially if you pin once a week. I'm talking to my PCP next week to try getting him to prescribe test C injections and maybe an Aromatase inhibitor (AI) if my estrogen is I. Fact high.

From what I hear injections are far less expensive so that may be a good option for you for cost and for effect.

I have to admit, there are times I wishes I did a steroid cycle like you did in you 20's. Sounds like you gaind a lot of muscle from it. I've gaind some over the years but with this low T issue not nearly as much as I've worked at gaining. I'd love to finally gain some good sized muscle like you have!

Let us know if you try the injections and how it goes for you!

Keep at it man, I'm right there with you in this battle my friend... Don't give up, you and me can feel better we just have to find what works best.

Victor

 

[BigFella]

I'm not at all surprised that you're not experiencing consistent good results with cream. I didn't, and there aren't many people on this forum who have. Initially I had absolutely fantastic results - I look back at my log and see "Crystal clear thinking for the first time in years" and "Pushed way more weight in the gym - must remember to be careful as the ligaments aren't getting as strong as the muscles".

And then - pretty much nothing.

So I drove my T levels down, got two low T readings and qualified (in Oz) for legal testosterone replacement therapy (TRT) - injected.

Injecting is better in every way. It's so much easier, less hassle, faster, more stable T levels, no greasy skin (Yee har!) no chance of transferring to kids or women, much cheaper - everything.

Oh yes - the biggie for me: Way less aromatization. And way higher T levels, and higher libido . . . the list goes on and on.

 

[Sketch2000]

So I drove my T levels down, got two low T readings and qualified (in Oz) for legal testosterone replacement therapy (TRT) - injected.

Injecting is better in every way. It's so much easier, less hassle, faster, more stable T levels, no greasy skin (Yee har!) no chance of transferring to kids or women, much cheaper - everything.

Oh yes - the biggie for me: Way less aromatization. And way higher T levels, and higher libido . . . the list goes on and on.

Thanks for the support guys!
I really appreciate it!

While the Clomid is making me feel slightly better I know there is a risk of aromitization with it also - that, and i SHOULD be on testosterone replacement therapy (TRT) - the reason for using clomid is only because I can't afford it.

I will discuss with my Endocrinologist the use of injectable T. I think she has even mentioned it before....

The big problem is affordability, but if its cheaper than the gel...than i can afford it.

@ Big Fella - by saying "in oz" I assume you mean Australia. Which is ironically my place of birth.

I am planning on returning at the end of August or early September and its one of the reasons i really want to get my prescriptions in order (and any medical letters I need for testosterone replacement therapy (TRT) in Oz).

 

[BigFella]

@ Big Fella - by saying "in oz" I assume you mean Australia. Which is ironically my place of birth.

I am planning on returning at the end of August or early September and its one of the reasons i really want to get my prescriptions in order (and any medical letters I need for testosterone replacement therapy (TRT) in Oz).

Yeah mate, that's it. Look, it isn't hard to drive your T levels down to the point where you qualify for legal, sponsored TRT. You need two readings below 8 on the international scale - I got 5.6 and . . . 1.6. Yep. So now I'm legal. For evuh. Worth the effort. If you want to do it, grab your Testim, apply very heavily for two weeks, stop cold turkey for five days at the same time as getting on the grog - heavily! - every night, then spend one night awake all night and get tested. No AIs, no HCG, no healthy food, nothing.

You have fun with that. You will feel like total shit, but it will be worth it - you will get your magic number. Then repeat six weeks later. All done. Enjoy legal T for life.

 

[Sketch2000]

Yeah mate, that's it. Look, it isn't hard to drive your T levels down to the point where you qualify for legal, sponsored TRT. You need two readings below 8 on the international scale - I got 5.6 and . . . 1.6. Yep. So now I'm legal. For evuh. Worth the effort. If you want to do it, grab your Testim, apply very heavily for two weeks, stop cold turkey for five days at the same time as getting on the grog - heavily! - every night, then spend one night awake all night and get tested. No AIs, no HCG, no healthy food, nothing.

You have fun with that. You will feel like total shit, but it will be worth it - you will get your magic number. Then repeat six weeks later. All done. Enjoy legal T for life.

Thanks bro.

I really don't want to have to go thru all this again when I return but If i have to i have to...

I have 3 letters on hand -

1) From my Physician in Oz from 2004 that stated I had low testosterone levels and if it persisted i should be treated with testosterone replacement therapy (TRT) / Transdermal

2) A Dictation from my endocrinologist here at UM (University of Miami Miller School of Medicine - sounds fancy...) stating that she saw me in 2008 and since at least 2004 I have had fluctuations in my testosterone levels (both free and total) in the low and low normal range and have experienced ED for 3-4 years prior to 2004. She goes on to note that I have had fluctuations in my LH and FSH (FSH low) and in 2007 tested for no sperm (aziosperma). It states that to rule out any other psychogenic component I saw a sex therapist which proved unsuccessful. She said I responded very well to 2.5 mg Androgel daily. To the point where my libido returned, erections returned and I felt far better. She said despite him now testing in the normal range and being low-normal mostly even if this is a "placebo" type effect it would be worthwhile me being treated long term due to the effect on my quality of life. She said Human Chorionic Gonadotropin (HCG) could be used in the future if my sperm count remained low.

3) I have a letter from my endocrinologist (same as above) stating I am a patient of hers with hypo--- hypogonadism. I was prescribed Androgel but could not afford it. Therefore we are doing a trial of clomid for 3 months and will check labs...etc.


*** Is this enough to get me by? Or will they want to re-test me again in Australia? I would have to have to go thru this again but if so be it so be it.....I am meeting with her on July 25th to go over the results of the clomid but am going to ask for injectable T and see what she says. If not, at the very least get loaded on a prescription for Androgel (and talk to her about the Aromatization) as when you arrive in Oz your prescriptions are still good for 6 months.

Chris

 

[BigFella]

Mate, just get tested low here and relax. It's worth going through hell for four or five weeks to get two low numbers. Once you do you're gtg on subsidised TRT.

You can drive your T relatively high with transdermals, and it will stop your natty production. Then stop cold, and get tested five days later. You will be low. Repeat. But also treat yourself like shit or those five days and DO NOT SLEEP prior to your blood draw. Alcohol is your friend!

I repeat : it is worth it.

 

[BigFella]

You don't need low range. You MUST be below 8.0 (230 or so). Twice. I got to 1.6, if that counts as to what is achievable.

 

[Sketch2000]

Mate, just get tested low here and relax. It's worth going through hell for four or five weeks to get two low numbers. Once you do you're gtg on subsidised TRT.

You can drive your T relatively high with transdermals, and it will stop your natty production. Then stop cold, and get tested five days later. You will be low. Repeat. But also treat yourself like shit or those five days and DO NOT SLEEP prior to your blood draw. Alcohol is your friend!

I repeat : it is worth it.

Gotcha.....Thanks for the heads up.

 

[Sketch2000]

Hey guys. Its been about 6 weeks on Clomid 25mg daily.

For some reason...some days I feel great (from a libido standpoint - what this whole thing is really about) - I feel like I feel "normal" or like other people do for the first time in my life!

But on other days I feel shitty. I couldn't get it up if i tried......seriously. Just like before.

Anyway, I'm curious as to if the effects are similar to that of the androgel / testim as with your experiences (but sooner) - aromatization.

Although Clomid has several studies dictating that use over a period of 6 times has been extremely beneficial, it all depends on the person.

Anyway, I wanted to ask -

If worse case scenario -

@ Victor - If your doctor is not able to prescribe you the injectable test (which I wouldn't see why) can't they give you a drug that blocks aromitization or its effects to keep your androgel working like it did initially?

BTW - Had labs done. Total Test has increased to the normal range. I will post my full labs when my Free test comes back by the beginning of next week.

Given that I am having these "on and off" experiences with Clomid I am concerned too about aromitization and also concerned that my doctor may not be up for prescribing the injectable T. Either way are there any suggestions on aromatization blockers if that is the case?

 

[UJMRYDER]

I just wanted to weigh in on Clomid.

I too was prescribed Clomid 25mg every day. Did some blood work and got good T numbers (750-800) but felt somewhat crappy.

Felt better than nothing but nowhere near as good with T cypionate.

I have not done blood work for a while but I can tell you I feel much better (still not as good as T) now that I have dropped the dosage way down. I am currently doing 12.5mg every third day. ED and libido is better and do not feel so depressed.

Good luck and maybe dropping the dose may help you. It helped me.

 

[Sketch2000]

I just wanted to weigh in on Clomid.

I too was prescribed Clomid 25mg every day. Did some blood work and got good T numbers (750-800) but felt somewhat crappy.

Felt better than nothing but nowhere near as good with T cypionate.

I have not done blood work for a while but I can tell you I feel much better (still not as good as T) now that I have dropped the dosage way down. I am currently doing 12.5mg every third day. ED and libido is better and do not feel so depressed.

Good luck and maybe dropping the dose may help you. It helped me.

My Total T came back in the upper normal range. Waiting on Free T...I assume its increased also.

From what I've heard and read above T Cypionate is the way to go. I just want to have an alternative if I can't afford or can't get my hands on it right now.

So I want to know as much as I can about the Clomid.

I have had some severe bouts of depression which tend to last the entire day and night but then fade away. Otherwise I feel fine depending on how my libido is functioning.

On another forum a guy told me that 12.5 mg is good every third day as a starting point then increase based off of those results. I'll discuss lowering the dosage due to these responses with my Dr. when I see here in about a week.

 

[Sketch2000]

Seeing my Endo tomorrow morning.

Full labs have been done.

Total Test has increased as well as Free Test. I still have my "on and off" days w/ regard to my libido.

So I'm unsure if i should lower the dose as (one of you) mentioned above. As I have seen on another thread a guy did it and actually felt better. I just don't want my system to crash. So I will discuss this with her tomorrow.

My assumption is that she's going to want me to stay on course and keep on this long term. The Test levels have increased....my libido is better than before - definitely. But some days its gone - obsolete, just like before.

I doubt she'll consider the injectable T since this has worked. And if she does she'll have to explain that if in the event i can't afford or get it I'll have to do the "clomid restart" ....

I'll post my FULL LAB RESULTS (pre clomid and post) tomorrow and what happened with my doc.

Thanks for the help guys.

 

[SamSong]

Hi Sketch. Beg, plead, threaten, do anything you need to to get injectable T. I drove my T levels down to 1.6 (ring any bells?) and I'm happily sitting at 1300 on the US scale and I like it A LOT.

I was on cream for four months. Mood up and down - never as bad as before, but never consistently good. Now on Test E for two months and life is very very good.

 

[Sketch2000]

Hey guys.

Well, good and bad news I guess.

NO Injectable T....

My Testosterone results have come back with a significant increase, so my Dr. it hesitant to throw something else in the mix if this is "working". I hate to say it but I agree with her....as much as I'd like and WANT injectable T. I'll have to wait and drive my levels down. I can't expect her (or any other Dr.) to prescribe it when what I'm taking is working.

Anyway...I had printed out certain postings from the internet regarding Clomid usage and also printed out some of the postings on certain forums about guys taking the same or similar dosage to me or in the studies (25mg or 50mg) but starting to feel "shitty" (less libido and ED AGAIN!!) This is all despite the increase in testosterone levels.

So I told her it can't be a coincidence I'm not feeling as good as I did when I started (if others have had a similar problem). So the solution - or what others have done is lower there Clomid down to 3 times a week and they tend to "feel" better.

(UJMRYDER - Your the 3rd person I've seen on this forum whos had the same problem with Clomid. While it increased your T levels you started to feel a lack of libido and ED like I am but by lowering it you've started to feel better. Your the 3rd person that's had better results with a lower dosage).

So I told her how I felt when I started - first 3 weeks were great. Since then, I've started to feel like I did prior to usage - no libido, or lack thereof.

So we reached an agreement to lower my dosage to 25mg 3 x a week and I can go even lower. It all depends on how I feel. If I begin to feel like I did when I started, then we know it could have been the medication causing the problems with the libido and ED....

The next part is that I need to re-test my labs (Test specifically) one month into lowering the dosage so we can see the difference.

So I skipped my dosage today. Will take 25mg tomorrow and then resume 25mg on M,W,F (I'm debating on whether to go even lower than that. Most people have dropped there dosage to 12.5mg).

We then discussed if you can use this long term. Studies usually range up to 2 years or slightly more.

But if i wean myself off and the problem continues I'm just going to ask for injectable and HCG.

I will likely be overseas than and can proceed with getting my levels low enough if that's what it takes because like I told my Doc yesterday. All this shit about coming off and getting tested and this and that is a pain in the ass.

If I feel good when I lower my dose I'll take this shit forever....lol...

Neway. Here are my lab results -

PRIOR TO CLOMID -

LAST YEAR -

TOTAL TESTOSTERONE 314 (300-1080)
SHBG 17 (11-80)
FREE TESTOSTERONE 76 (47-244)
TESTESTERONE, PERCENTAGE FREE 2.4 (1.6-2.9)

3 WEEKS PRIOR TO CLOMID START

TOTAL TESTORONE 333 (280-800)

* ALL OTHER LABS FINE (COMP METABOLIC PANEL, LIPID PANEL, CBC W/ DIFFERENTIAL, HEMOGLOBIN, ETC.)

1 MONTH AFTER STARTING CLOMID 25MG PER DAY

TOTAL TESTOSTERONE 588 (280-800)

* TOTAL T ALMOST DOUBLED

6 WEEKS AFTER STARTING CLOMID 25MG PER DAY

TOTAL TESTOSTERONE 660 (300-1080)
SHBG 22 (11-80)
FREE TESTOSTERONE 157 (47-244)
TESTOSTERONE, PERCENTAGE FREE 2.4 (1.6-2.9)

* ALL OTHER LABS - COMPREHENSIVE METABOLIC PANEL, CBC W/ DIFFERENTIAL, TSH FINE


These labs indicate that I've had an increase of almost double what I had before starting Clomid.
Before I started (and for the last 12 miserable years) I've had Testosterone in the 300's (low normal) or even lower (which is low). I am now in the mid-range.

660 Total T on a Range from 300-1080 is about mid.
157 Free T on a Range from 47-244 is almost 3/4.

Free - being the Test that really matters. But Total T needs a boost also.

So...to make a long story short. The treatment has worked in increasing my Testosterone levels both free and total.

The only problem now being -

a) Keeping them there or higher (mid range is good - but not really acceptable. I'd like to be in the upper range)

b) Getting my libido back by lowering the Clomid dosage and hoping this doesn't intefere with my T levels.

Plan -

a) Lower the Clomid dosage

b) Re-do labs in one month


Thanks guys. Let me know if you have any thoughts.
I threw out the injectable T during our conversation but was shot down pretty quick. I could tell it wasn't going to go anywhere given my treatment is working but rest assured if this doesn't pan out and I've already been approved for AndroGel which I know only works for a short period of time (but is better than this) I'll drive my levels down if necessary to get it.

Sketch-----