Doc wants to start me on testosterone replacement therapy (TRT) tomorrow. I'm 26 years old.

[adk98]

Doc wants to start me on TRT tomorrow. I'm 26 years old.

I'm 26 years old. I've ran 6 cycles in my past no longer than 8 weeks each and with post cycle therapy (pct). Never more than 2 a year. Over a year ago I forgot Human Chorionic Gonadotropin (HCG) during my 7 week prop/tbol cycle and my testicles shrunk. I've never had them shrink that bad, probably to the size of small grapes or something. Ever since then, I've been paranoid they're still not the normal size, even after a couple runs of clomid. I've been to an endo and my last BW came back with my free T in the low normal range and my total T was in the 500's. My LH was 3.9 and FSH low at 1.1 (ref range 1.5-9.?). I was also treated for a pituitary tumor that was very small 1mm and cabergoline brought my barely high prolactin levels back into range. On the Cabergoline, I had morning erections and better sex for the most part. However, now my prolactin is in range and I'm running into ED probs again. I've seen another doc that isn't an endo who wants to start me on T shots tomorrow. I don't know what the heck to do. I have all the low T symptoms- anxiety, fatigue, ED, poor focus and motivation,etc- however, I'm not sure if this may be due to my paranoia of being messed up. I still feel like my balls aren't the same. I've seen a therapist about the anxiety. I keep thinking that maybe I should run some Human Chorionic Gonadotropin (HCG) to see what happens, or even go ahead with the Human Chorionic Gonadotropin (HCG) and testosterone replacement therapy (TRT) to see if that helps my well-being. With my low FSH numbers, I'm scared to death I'm going to be infertile.

Can someone offer me some advice on what to do since my docs and endo aren't being of too much help? They don't seem to be as educated on these subjects and I can prob have them prescribe me what I need if I explain it well enough. I don't want to self medicate and make myself worse and I don't want to be on testosterone replacement therapy (TRT) unless it's positive that it will help my problem. Any help would be greatly appreciated as I'm feeling pretty alone in this matter. I've no desire to lift or do anything and that is totally uncharacteristic of me.

 

[halfwit]

Total test in the 500's and your doc wants to put you on testosterone replacement therapy (TRT) at 26 years old? You obviously have issues with your pituitary gland, but COMPLETELY shutting down your LH/FSH through exogenous test may not be the answer. I'd get a second opinion from another doctor. Clomid treatment might be a better option for you, although you may find yourself on testosterone replacement therapy (TRT) in the future if your levels continue to decline. HMG can be used to stimulate FSH, but I would cross that bridge when it's time personally.

My .02c

 

[adk98]

Total test in the 500's and your doc wants to put you on testosterone replacement therapy (TRT) at 26 years old? You obviously have issues with your pituitary gland, but COMPLETELY shutting down your LH/FSH through exogenous test may not be the answer. I'd get a second opinion from another doctor. Clomid treatment might be a better option for you, although you may find yourself on testosterone replacement therapy (TRT) in the future if your levels continue to decline. HMG can be used to stimulate FSH, but I would cross that bridge when it's time personally.

My .02c

Thanks for your 2 cents man. My free T is what's making me awful is my guess bc on the range of 9-26, it's at 11. I'm just really lost for what to do and I've been feeling like crap for a while. I've become pretty self-conscious about myself and if testosterone replacement therapy (TRT) is the answer I'd be alright with it. Like you said, shutting my LH/FSH down for good is scary. What do you think about those numbers, for the FSH/LH? Do you think I'm fertile still? I was thinking of going to get some of my sperm banked if I do go the testosterone replacement therapy (TRT) route. Also, would Human Chorionic Gonadotropin (HCG) while on testosterone replacement therapy (TRT) keep my testicles plump?

 

[halfwit]

Thanks for your 2 cents man. My free T is what's making me awful is my guess bc on the range of 9-26, it's at 11. I'm just really lost for what to do and I've been feeling like crap for a while. I've become pretty self-conscious about myself and if testosterone replacement therapy (TRT) is the answer I'd be alright with it. Like you said, shutting my LH/FSH down for good is scary. What do you think about those numbers, for the FSH/LH? Do you think I'm fertile still? I was thinking of going to get some of my sperm banked if I do go the testosterone replacement therapy (TRT) route. Also, would Human Chorionic Gonadotropin (HCG) while on testosterone replacement therapy (TRT) keep my testicles plump?

The problem with free test is that it is largely dependent on several factors including SHBG. While injecting exogenous testosterone likely will bring that number up, I'd want to see that estradiol as it does tend to go hand-in-hand with SHBG. Your LH is what many would consider normal, but as you had a pituitary gland tumor, it's easy to understand why your FSH is indeed low. Whether or not this will be a cause for sterility is something that only a sperm count could deduce, but I do know many men that have had far lower numbers and still have children. Those little swimmers are far more resilient than we give them credit for.

I do think your idea of going to the sperm bank is a good one before you begin testosterone replacement therapy (TRT) as that would at least put your mind at ease for that just in case scenario. Human Chorionic Gonadotropin (HCG) will keep your testes from atrophying as it does mimic a healthy LH signal, which keeps them "awake". I suspect that there's an issue with your estradiol/SHBG here in my non-doctor opinion, and would love to know what numbers you have on a blood test for these. I'd bring that up with your doc too as they should be shooting to fix the base cause for your issue, not just shotgun blast hormones at you in an attempt to fix the symptoms.

 

[adk98]

The problem with free test is that it is largely dependent on several factors including SHBG. While injecting exogenous testosterone likely will bring that number up, I'd want to see that estradiol as it does tend to go hand-in-hand with SHBG. Your LH is what many would consider normal, but as you had a pituitary gland tumor, it's easy to understand why your FSH is indeed low. Whether or not this will be a cause for sterility is something that only a sperm count could deduce, but I do know many men that have had far lower numbers and still have children. Those little swimmers are far more resilient than we give them credit for.

I do think your idea of going to the sperm bank is a good one before you begin testosterone replacement therapy (TRT) as that would at least put your mind at ease for that just in case scenario. Human Chorionic Gonadotropin (HCG) will keep your testes from atrophying as it does mimic a healthy LH signal, which keeps them "awake". I suspect that there's an issue with your estradiol/SHBG here in my non-doctor opinion, and would love to know what numbers you have on a blood test for these. I'd bring that up with your doc too as they should be shooting to fix the base cause for your issue, not just shotgun blast hormones at you in an attempt to fix the symptoms.

The SHBG is a question to me too. However, I did have my E2 checked and it was in a good range, right in the middle if I remember correctly. I've just been to so many dr.s appts and I'm ready for this problem to be fixed already. So obviously, the testosterone replacement therapy (TRT) is becoming very appealing to me. What would you do if you were in my situation? Thanks again for the help man. It's so frustrating to feel like I do and not be able to get the knowledgable advice I need. The testicle size thing really bothers me. Do you think that could be in my head? Since it's been over a year, they should be normal right? I'm thinking I've just developed some type of dysmorphia from the initial anxiety of it all.

 

[halfwit]

The SHBG is a question to me too. However, I did have my E2 checked and it was in a good range, right in the middle if I remember correctly. I've just been to so many dr.s appts and I'm ready for this problem to be fixed already. So obviously, the testosterone replacement therapy (TRT) is becoming very appealing to me. What would you do if you were in my situation? Thanks again for the help man. It's so frustrating to feel like I do and not be able to get the knowledgable advice I need.

The problem I have is that I know once you start down this path, you are pretty much committed. Sure there are restart protocols that *might* work if you change your mind, but the fact is that the longer you are on exogenous testosterone, the less the odds are in your favor. I personally was hypogonadal at your age (primary with high LH/FSH but very low TT) and did not know it for several years. I tried every damn drug to try to feel right including the all time favorites like xanax and other benzo's. It wasn't until after a decade that I finally found out what it was all along. So I totally know what you're going through (assuming it's the same feeling) as I just wanted it fixed without going further into seeing why I was having these problems as I had lived with them for so long. I was able to piece together what happened (extended opiate usage) over the years, but it would have been nice to know at the time what was going on.

With all that said, I think the choice comes down to you. Could testosterone replacement therapy (TRT) fix how you feel and give you a much higher quality of life? Yes, it most certainly can. But what if it doesn't and the problem lies elsewhere? I do know that increasing androgens will decrease SHBG and therefore increase your free testosterone, but you also start down the path of having to manage estradiol and other blood values such as hematocrit (think of it as the viscosity of your blood) which requires blood donations among other preventative maintenance features of TRT. You still have a few options as your body hasn't been introduced to these exogenous hormones yet, so you can still get a second opinion and see what another doctor might be able to find that your current one has not.

You pretty much have two choices right now:
1. Start testosterone replacement therapy (TRT) and possibly feel better with a few extra issues that come along with it.
2. Keep looking for other alternatives such as clomid therapy or possibly something else that may restore your natural balance without the need for being married to the needle and vial the the rest of your life.

I'd put some serious thought into it. For me the choice was much easier as I had a total test of 120ng/dL and was feeling VERY ill with classic signs of primary hypogonadal hypogonadism. Your case isn't so cut and dry to be honest, and I think I would take a good hard look at what else could be done before taking that last resort known as TRT.

My .02c

 

[adk98]

The problem I have is that I know once you start down this path, you are pretty much committed. Sure there are restart protocols that *might* work if you change your mind, but the fact is that the longer you are on exogenous testosterone, the less the odds are in your favor. I personally was hypogonadal at your age (primary with high LH/FSH but very low TT) and did not know it for several years. I tried every damn drug to try to feel right including the all time favorites like xanax and other benzo's. It wasn't until after a decade that I finally found out what it was all along. So I totally know what you're going through (assuming it's the same feeling) as I just wanted it fixed without going further into seeing why I was having these problems as I had lived with them for so long. I was able to piece together what happened (extended opiate usage) over the years, but it would have been nice to know at the time what was going on.

With all that said, I think the choice comes down to you. Could testosterone replacement therapy (TRT) fix how you feel and give you a much higher quality of life? Yes, it most certainly can. But what if it doesn't and the problem lies elsewhere? I do know that increasing androgens will decrease SHBG and therefore increase your free testosterone, but you also start down the path of having to manage estradiol and other blood values such as hematocrit (think of it as the viscosity of your blood) which requires blood donations among other preventative maintenance features of TRT. You still have a few options as your body hasn't been introduced to these exogenous hormones yet, so you can still get a second opinion and see what another doctor might be able to find that your current one has not.

You pretty much have two choices right now:
1. Start testosterone replacement therapy (TRT) and possibly feel better with a few extra issues that come along with it.
2. Keep looking for other alternatives such as clomid therapy or possibly something else that may restore your natural balance without the need for being married to the needle and vial the the rest of your life.

I'd put some serious thought into it. For me the choice was much easier as I had a total test of 120ng/dL and was feeling VERY ill with classic signs of primary hypogonadal hypogonadism. Your case isn't so cut and dry to be honest, and I think I would take a good hard look at what else could be done before taking that last resort known as TRT.

My .02c

Glad to talk to someone who can relate and offer smart advice. Believe me, I'm thinking very hard about it and considering all the pros/cons. My main fear is what you said- what if I start and the problem isn't resolved? That would suck. However, if it was the problem, I'd be the happiest guy in the world because I've felt like this the last year and a half. My confidence is in the gutter and has been along with many other things. I even feel insecure in my relationship bc of the bad sense of well-being.

What I wonder is what if I get some sperm banked, because at FSH of 1.1, there's gotta be some swimmers somewhere in there. And then I start TRT. If I don't feel better on testosterone replacement therapy (TRT) after a couple months, run a solid post cycle therapy (pct) like you would on cycle and see if that gets me back knowing my T levels aren't the problem.

I hear you on the Xanax thing. My therapist has tried antidepressants on me and I'm now taking a mood-stabilizer bc I was all over the place, prob due to all the anxiety and my hormonal imbalance. At 26, it's just such a scary decision to make.

 

[halfwit]

Glad to talk to someone who can relate and offer smart advice. Believe me, I'm thinking very hard about it and considering all the pros/cons. My main fear is what you said- what if I start and the problem isn't resolved? That would suck. However, if it was the problem, I'd be the happiest guy in the world because I've felt like this the last year and a half. My confidence is in the gutter and has been along with many other things. I even feel insecure in my relationship bc of the bad sense of well-being.

What I wonder is what if I get some sperm banked, because at FSH of 1.1, there's gotta be some swimmers somewhere in there. And then I start TRT. If I don't feel better on testosterone replacement therapy (TRT) after a couple months, run a solid post cycle therapy (pct) like you would on cycle and see if that gets me back knowing my T levels aren't the problem.

I hear you on the Xanax thing. My therapist has tried antidepressants on me and I'm now taking a mood-stabilizer bc I was all over the place, prob due to all the anxiety and my hormonal imbalance. At 26, it's just such a scary decision to make.

You'd be surprised at how many of us there are. I'd at least get a sperm count and motility test before banking your sperm. That way you know you're putting good swimmers on ice so you're not wasting money/hopes. I truly do not envy your position as I know how nagging that feeling is to jump on what may be a fix for all your woes. Yes, you could always post cycle therapy (pct) - but keep in mind, that it's not a guaranteed recovery and may push you further into being truly dependent on exogenous hormones as your pituitary may give up the ghost for good. Just a thought.

 

[adk98]

You'd be surprised at how many of us there are. I'd at least get a sperm count and motility test before banking your sperm. That way you know you're putting good swimmers on ice so you're not wasting money/hopes. I truly do not envy your position as I know how nagging that feeling is to jump on what may be a fix for all your woes. Yes, you could always post cycle therapy (pct) - but keep in mind, that it's not a guaranteed recovery and may push you further into being truly dependent on exogenous hormones as your pituitary may give up the ghost for good. Just a thought.

Exactly my thoughts too on doing further damage or putting me deeper in the hole. I'm going to be making an appointment with the sperm doctor to get that stuff taken care of so all measures are properly taken care of.

 

[halfwit]

Sounds like a plan. Good luck man!

 

[adk98]

Sounds like a plan. Good luck man!

I really appreciate it halfwit. I'll keep you posted. Thanks for the help

 

[Megatron28]

Halfwit has given you great advice. I agree with him in that you should go to the lab and see if you viable sperm still. If you do, bank some of it. I would definitely try a "restart" with clomid first before beginning TRT. This might be able to improve your natural test production. I really think that is worth the additional wait to see if that can make a difference. And keep in mind it will raise your TT while you are on it so you will have a chance to see if higher TT makes you feel any better. The question will be what happens to your TT when you go off it. But you can cross that bridge when you get there.

 

[adk98]

Halfwit has given you great advice. I agree with him in that you should go to the lab and see if you viable sperm still. If you do, bank some of it. I would definitely try a "restart" with clomid first before beginning TRT. This might be able to improve your natural test production. I really think that is worth the additional wait to see if that can make a difference. And keep in mind it will raise your TT while you are on it so you will have a chance to see if higher TT makes you feel any better. The question will be what happens to your TT when you go off it. But you can cross that bridge when you get there.

About 4-5 months after my post cycle therapy (pct) I ran another cycle of clomid, but at a very low dose for a few weeks. Do you think it would benefit me to do it again and would it raise my free test? I'm also wondering if this is something I should try on my own or ask the doc for clomid. I'm not trying to sound immature, but I feel like a 3 week run of clomid is something I could probably attempt on my own. Also, when thinking of doing this, I'm sure the clomid would definitely improve my sperm count so I could def bank some of it. I couldn't get ahold of the fertility clinic yesterday so I'm trying again today.

Thanks for chiming in Megatron. I also want to mention the thought of starting testosterone replacement therapy (TRT) and waking up with boners in the mornings as well as randoms throughout the day is pretty tempting. I might go ahead and let the doc prescribe the T for me and hold out for further testing. I'll tell ya tho, after 15 months of this, it gets pretty old especially at 26.

 

[Megatron28]

I think you should work with a doctor that has experience with restarts. Then you know your clomid and other meds are pharmacy grade and real. You may run more than just clomid. Make sure this gets done right. IMT is supposed to have some very good restart protocols that I would investigate. It is free to call them and talk.

Hard to say what the effect on your free T will be. Too many variables to sort through (for me anyway).

Don't start running test cyp yet if you are going to try the restart. Hopefully you have the maturity to be patient a little bit longer. If you can get restarted it will be totally worth it.

 

[adk98]

I think you should work with a doctor that has experience with restarts. Then you know your clomid and other meds are pharmacy grade and real. You may run more than just clomid. Make sure this gets done right. IMT is supposed to have some very good restart protocols that I would investigate. It is free to call them and talk.

Hard to say what the effect on your free T will be. Too many variables to sort through (for me anyway).

Don't start running test cyp yet if you are going to try the restart. Hopefully you have the maturity to be patient a little bit longer. If you can get restarted it will be totally worth it.

I had an appointment yesterday with a reproductive endocrinologist and it was probably one of my best appointments I've had. This guy didn't seem to want to let me get out of his office even after 1.5 hrs bc we were discussing what might be going on and what we should/will do. This is what was decided. The thing that scares me about testosterone replacement therapy (TRT) is fertility especially since I've got a serious GF and things are heading that way. He said that we would do a sperm analysis to see where my sperm count is and that would indicative of how my testicles are functioning bc low FSH isn't always a sign of a low sperm count. He said if my sperm count is low then we would initiate HCG therapy. If everything checks out ok and my sperm count is normal, he said I could go on the test cyp and as long as HCG is implemented alongside, fertility down the road would be ok. He said it's just like women's birth control. That if you were once fertile you will always return to your normal state and if not HCG and other protocols will make you. He said he's had cases of guys with zero sperm and getting them fertile again. Also, he said if I go on the cypionate, that we could do sperm test every now and then to keep up on my fertility.

This sounded like a good plan to me. What do you make of all this?

 

[halfwit]

Sounds like you found a keeper. I'd definitely stick with him and see how it goes.

 

[adk98]

Sounds like you found a keeper. I'd definitely stick with him and see how it goes.

Thanks halfwit and I want to say thanks for your previous posts too. Here's what I think will probably happen and of course I could be wrong... My sperm count is going to come back normal and I will start the testosterone replacement therapy (TRT) with test cyp while taking the fertility tests over the course of it. If I never need to come off, this doc will prescribe me an HCG blast to get my sperm count back up. Does this sound like a good route to take if my count comes back normal? He mentioned using HCG as a form of therapy in itself but I worry about all the E2 problems associated.

I just want my freakin confidence and drive back man!

 

[halfwit]

That's honestly what I would do. I thought HMG was used for FSH, but I'm not a doctor either.

 

[adk98]

That's honestly what I would do. I thought HMG was used for FSH, but I'm not a doctor either.

Do you think once I boost my T levels up with the cyp that my confidence and energy will come back? I'm worried that I'm going to go this route and still feel the same.

 

[halfwit]

Do you think once I boost my T levels up with the cyp that my confidence and energy will come back? I'm worried that I'm going to go this route and still feel the same.

That's very hard to say, as I don't know what the root causes are for your issues. If they are indeed linked to low-T, then you should most certainly see a life-changing improvement. I know I did.