Military physician wants to start me out on TRT

[Fullgoldcrown]

Hello Steroidology,

I am seeking your guidance because this website is a refreshing source of knowledge on a subject that the majority of physicians and specialists still don't understand as well as they should.
I have been experiencing a great deal of syncope when standing as well as general lethargy and fatigue with daily activities. My exercise endurance has never been phenomenal in cardiovascular intensive events but as of lately it has become increasingly more difficult. Please keep in mind that I am 25.

My past cycles were always- Moderate doses of test E with HCG on cycle into a clomid and nolva PCT. This was always complete with bloods from private companies and my test has always returned to the 600 range 6 weeks post PCT.

I consulted a physician that works in the same facility as me (DID NOT TELL HIM ABOUT MY AAS usage) and he decided to run a full blood panel, liver values, kidney values, thyroid, and a full testosterone panel.

The only downside to this testosterone panel is that it did not test for LH or FSH concentrations.

The results read:

Free testosterone: 36 pg/ml with a reference range of 52-280
SHGB nmol/L : 53.3 with a reference range of 16.5 and 55.9 for ages 20-49
Total testosterone: 330 ng/dL with a reference range of 348-1197 for ages >18
Albumin: 4.4 g/dL with a reference range of 3.5-5.5
Free testosterone %: 1.1% with a reference range of 1.5-3.2
Bioavailable testosterone: 84 ng/dL with a reference range of 128-430 Ages 20-39y
Bioavailable Testosterone 25.5%

The lab that performed my tests was:
LABCORP PROD
IN DALLAS, TX

My total testosterone is remarkably low for my age group and I was truly shocked by the results. He was so surprised he came and found me so he could inform me of my results. Being in the military I know that providers opt out of less common methods like TRT but much to my surprise he said, "we have two options".

Androgel or Testerone injections.

To be perfectly honest the entire conversation was very informal and in the back of my mind I kept thinking.. shouldn't additional tests be done to confirm if its primary or secondary hypogonadism?
I didn't even consider fasting before I got my blood work done and it was late afternoon when I got my blood.

Regardless I chose the test cyp and he chose a dosing protocol of 200 mg every 2-4 weeks. I also looked at this and thought about how big of a difference that would be in blood values for test.

SOOO of course I would choose 2 weeks and he is cool with it.
I have not done my first injection because there is too much left unknown.
If my test is low now then I want to know what my LH and FSH is at. I would love to know if I am primary or secondary and if I need to get an MRI.

I plan to stay in the military until retirement so this would be free when I retire but I want to approach this intelligently and with additional experience from this community.

Should I ask for LH and FSH testing, as well as 3 more testosterone tests ( which I would take fasted during 8-10 AM)?

or should I start my TRT tonight and go about my business?

 

[Megatron28]

I would want to know what is going on personally. I would repeat labs again. But this time you also need to check TSH, Prolactin, LH, FSH, Estradiol and Vitamin D.

Get labwork done first thing in the morning (i.e. 8AM). Fasting does not matter.

Once you have those results we can figure out what is next.

BTW: pinning once every two weeks is a terrible protocol that will put you on a big rollercoaster ride. Once or twice a week is better.

Have you read the Basic TRT Sticky thread yet? Has lots of good info for you.

 

[Fullgoldcrown]

Hey Mega,
Glad you came in! I think I may just get private labs done. Ill be sure to do it this weekend first thing in the morning. It would be nice to get the tests from the military for documentation but I don't know how to tactfully approach him with additional requests. Rank and position make our life more complicated. I kinda have to say "I was looking at a medical journal that stated I would need to check e2, FSH and LH to get a better idea of where I am at Sir", "Do you think we could run those tests?". I hate beating around the bush with people but he was hesitant when I brought up additional tests so I don't want to come at him the wrong way because he was the one to initiate something that very rarely occurs in the military (from my understanding). He did check vitamin D and TSH so I will request those results.
I read your sticky, it was very helpful. I chose the every 2 weeks option but I planned on 50 mg every 3.5 days.

Thanks for your time, its greatly appreciated!

 

[Alpin]

I would look into doing some kind of restart...
Even a few before pursuing TRT.
Getting your T levels up with either should make u feel better.
Many guys on here have used HCG at the beginning and then move onto clomid/nolva....or just clomid for a few months then off every thing.
Definitely get LH, FSH and Prolactin checked.