Need Advice for a new Low T member

[bodyofageekgod]

Hi, So I've been lurking around this and other forums, but finally decided to ask for your advice, particularly Chip or some of the routine posters. (sorry in advance if this turns into a long post, skip to the bottom for the questions).

History
I'm not a body builder, pro athlete, etc. Just an average 35 year old white guy, 6', 210lbs (could loose a few lbs). I have a good although stessful job in I.T., have a great family and try to live a relatively healthy life (workout a couple times a week, eat pretty healthy, 3-5 alcoholic drinks a month, etc).

But the last couple years, I've just felt off, unwell, fatigued, poor sleep quality, low libido and just blah. My wife kept asking me if I was depressed. And while I'm not suicidal or clinical depressed, I'm certainly not happy. I just can't seem to get excited about much of anything and I'm tired all the time.

About a year ago we started to try for a second child. I have a great son who is 4 and we had no problem conceiving. All through our 20s we had an active sex life but lately it's been infrequent at best. After 6+ months of trying, so about 4 months ago, I finally went to my general practice physician for a physical and described my symptoms and how the low libido and recent mild ED had been making it difficult. She said that it sound like stress or mild depression and to try and reduce my stress somehow. She could prescribe a mild anti-depressive. I've never liked taking drugs of any type and I asked for a complete blood workup instead. I also requested that we check things like thyroid and particularly testosterone (I'm glad I did).


Lab Results
Hematocrit: 41.2 (42.0-52.0)
Triglyceride: 156 (0-150 MG/DL)
Cholesterol: 190 (<200 MG/DL)
HDL: 32 (<40)
LDL: 127 (<100)
FSH: 2.2 (1.27-19.26 MIU/ML)
LH: 2.8 (1.24-8.62 MIU/ML)
ESTRADIOL: 23 (0 - 56 NM pg/mL)
Prolactin: 8.0 (1.6 to 18.8)
SHBG: 14.3 (11 to 80 NM nmol/L)
Total Testosterone: 211 (332 - 896ng/dL L)
FREE T: 8.9 ( 5.0 to 40.0 NM pg/mL)
Total T3: 115 (80 to 200 ng/dL)
Free T4: 0.92 (0.58-1.64 NG/DL)
VITAMIN D: 37 ( 30 to 150 NM ng/mL)
Albumin: 4.3 (3.2-5.5 GM/DL)
FERRITIN: 103 (20-350 NG/ML)
TSH: 1.70 (0.34-5.60 uIU/ML)
PSA: 0.44 (0.00-4.00 NG/ML)

Endocrinologist and More Tests
So as you can see my Total T of 211, is off the low end of the score, not double digits but still very low and since my LH and FSH are also low, my primary physician diagnosed me with Secondary Hypogonadism. She referred me to an Endocrinologist, who ran tests again recently with pretty much the same results. He sent me in for an MRI, Sperm Count and sleep study. All of them came back with no problems found.

Since we are still trying to conceive he doesn't want to put me on T therapy, he suggested putting me on Human Chorionic Gonadotropin (HCG) but cautioned that it had some unpleasant side effects mostly related to increases in the blood estrogen levels. I asked him about Clomid or other anti-ester and he claimed he didn't see how those would help me as my estradiol is low and that those are only temporary as Clomid,etc lead to liver damage. I told him I needed to think about this. I see him again on Wed, June 15. While not the nicest guy, he does seem willing to work with me and I have really good insurance.

Here are my questions:
1. If I go on HCG, should it be only Human Chorionic Gonadotropin (HCG) or should I push for it be combined with Clomid or other anti-estrogen drugs?
2. What is the standard protocol dosage for HCG?
3. Beyond the textbook side effects of HCG, what are your guy's personal experience? How common are they?
4. Can a guy remain on Human Chorionic Gonadotropin (HCG) long term without increasing side effects or permanent damage like desensitized LH receptors?
5. Will the Human Chorionic Gonadotropin (HCG) or T Therapy help with the mild ED I've had lately? (The Endo thought it would help with the libido but didn't think it would help the ED.)
5. Once my wife and I conceive should I expect to go on T Therapy without HCG, or is there a protocol that combines the two?

Sorry if this post was crazy long but I figured it was best to give all the information up front.

Thank you in advance for any insights or answers you guys can provide.

 

[Packgus]

I think you need more testosterone then HCG. also a proper anti estrogen (not clomid).

also tweek your diet some to get those cholesterol numbers better. I would like to see a higher HDL and lower LDL. aka better LDL/HDL ratio as well as a lower total cholesterol number.

 

[bodyofageekgod]

Thanks

Thanks for the feedback packgus.

These test results are about 2 months old now. I've already made significant changes in my diet and dropped about 15 pounds but its hella hard to make gains when the fatigue is so bad. I'm hoping to get a new panel as a baseline before I start a protocol.

I guess what my main question is, is do I start treatments with one change at a time (start HCG, then add anti-estrogen, then add in T if needed) or do I request the endo start me on a combined protocol?

Also what is the best/most common anti-
estrogen?

 

[Nordic11]

As a word of friendly advice, find an experienced Hormone Replacement Therapy (HRT) clinic and go through them. Your GP and/or Endo just don't deal with hypogonadism enough to know how to effectively treat the condition. You will waste lots of time (months/years) trying to get an inexperienced doctor to dial you in with mid-range numbers.

I was someone that wasted 4 months with a doctor that "specialized" in Hormone Replacement Therapy (HRT) just because they took my insurance. 4 months isn't a ton of time but in that time, my total test dropped by 12%. That is especially bad when you consider I started with double digit numbers!

When I realized I didn't want to waste any more of my life feeling horrible, I called Chip.

I know it seems like there are just a bunch of Maximus fanboys on this site. Clearly, Chip has a number of dedicated clients. You can't build a loyal client base without being very, very good at what you do.

 

[CHIP WADOWSKI]

hi, so i've been lurking around this and other forums, but finally decided to ask for your advice, particularly chip or some of the routine posters. (sorry in advance if this turns into a long post, skip to the bottom for the questions).

history
i'm not a body builder, pro athlete, etc. Just an average 35 year old white guy, 6', 210lbs (could loose a few lbs). I have a good although stessful job in i.t., have a great family and try to live a relatively healthy life (workout a couple times a week, eat pretty healthy, 3-5 alcoholic drinks a month, etc).

But the last couple years, i've just felt off, unwell, fatigued, poor sleep quality, low libido and just blah. My wife kept asking me if i was depressed. And while i'm not suicidal or clinical depressed, i'm certainly not happy. I just can't seem to get excited about much of anything and i'm tired all the time.

About a year ago we started to try for a second child. I have a great son who is 4 and we had no problem conceiving. All through our 20s we had an active sex life but lately it's been infrequent at best. After 6+ months of trying, so about 4 months ago, i finally went to my general practice physician for a physical and described my symptoms and how the low libido and recent mild ed had been making it difficult. She said that it sound like stress or mild depression and to try and reduce my stress somehow. She could prescribe a mild anti-depressive. I've never liked taking drugs of any type and i asked for a complete blood workup instead. I also requested that we check things like thyroid and particularly testosterone (i'm glad i did).


lab results
hematocrit: 41.2 (42.0-52.0)
triglyceride: 156 (0-150 mg/dl)
cholesterol: 190 (<200 mg/dl)
hdl: 32 (<40)
ldl: 127 (<100)
fsh: 2.2 (1.27-19.26 miu/ml)
lh: 2.8 (1.24-8.62 miu/ml)
estradiol: 23 (0 - 56 nm pg/ml)
prolactin: 8.0 (1.6 to 18.8)
shbg: 14.3 (11 to 80 nm nmol/l)
total testosterone: 211 (332 - 896ng/dl l)
free t: 8.9 ( 5.0 to 40.0 nm pg/ml)
total t3: 115 (80 to 200 ng/dl)
free t4: 0.92 (0.58-1.64 ng/dl)
vitamin d: 37 ( 30 to 150 nm ng/ml)
albumin: 4.3 (3.2-5.5 gm/dl)
ferritin: 103 (20-350 ng/ml)
tsh: 1.70 (0.34-5.60 uiu/ml)
psa: 0.44 (0.00-4.00 ng/ml)

endocrinologist and more tests
so as you can see my total t of 211, is off the low end of the score, not double digits but still very low and since my lh and fsh are also low, my primary physician diagnosed me with secondary hypogonadism. She referred me to an endocrinologist, who ran tests again recently with pretty much the same results. He sent me in for an mri, sperm count and sleep study. All of them came back with no problems found.

Since we are still trying to conceive he doesn't want to put me on t therapy, he suggested putting me on Human Chorionic Gonadotropin (HCG) but cautioned that it had some unpleasant side effects mostly related to increases in the blood estrogen levels. I asked him about clomid or other anti-ester and he claimed he didn't see how those would help me as my estradiol is low and that those are only temporary as clomid,etc lead to liver damage. I told him i needed to think about this. I see him again on wed, june 15. While not the nicest guy, he does seem willing to work with me and i have really good insurance.

here are my questions:
1. If i go on hcg, should it be only Human Chorionic Gonadotropin (HCG) or should i push for it be combined with clomid or other anti-estrogen drugs?
2. What is the standard protocol dosage for hcg?
3. Beyond the textbook side effects of hcg, what are your guy's personal experience? How common are they?
4. Can a guy remain on Human Chorionic Gonadotropin (HCG) long term without increasing side effects or permanent damage like desensitized lh receptors?
5. Will the Human Chorionic Gonadotropin (HCG) or t therapy help with the mild ed i've had lately? (the endo thought it would help with the libido but didn't think it would help the ed.)
5. Once my wife and i conceive should i expect to go on t therapy without hcg, or is there a protocol that combines the two?

Sorry if this post was crazy long but i figured it was best to give all the information up front.

Thank you in advance for any insights or answers you guys can provide.

holy long post batman! J/k. Lot's of very thorough info to base protocol on. Your situation is textbook and a brainless (monumental dumbass) m.d. Should be shot to have let you go on with levels at 211. I'd have you dialed in, in no time and have you banging away so hard that you'd be begging yourself to stop. A perfect little, synergistic Hormone Replacement Therapy (HRT) cocktail is all you need, my brother.

FEEL FREE TO CALL ME. LEAVE V/M IF YOU DONT GET ME. JUST TO MANY QUESTIONS TO TYPE BACK RESPONSES FOR. EASIER OVER PHONE. THX

 

[bodyofageekgod]

Chip, thanks so much for your input.

I saw the Endo yesterday and came away pretty frustrated. Long story short, he wanted to put me on just Test. I told him that I was interested in staying fertile and wanted to try HCG. He then proceeded to use scare tactics about how terrible Human Chorionic Gonadotropin (HCG) would be like it was $400 a bottle, insurance wouldn't cover it, it required huge painful needles, could only be given IM and that no local pharmacy would stock it. I called him on almost all of his points as I knew better based on the information from these forums.

He finally gave me an Rx for a 10,000IU vial and a dose of .5ml 3 times a week. I'm terrible with IUs so I'm not sure how many IUs it is a week (1,500?).

I honestly felt like I knew more about the options, doses, and side effects than he did.

Anyways, after the appointment I called my GP, left a VM asking for a different referral.

Chip depending on what my GP says, I may be calling you early next week.

 

[cjw2021]

The dose depends on how much bacteriostatic water you mix the powder you get with. Standard protocol is like 250 iu twice a week. In any event do not screw around and just call Chip. You'll need an Aromatase inhibitor (AI) and whatnot and it is such a hassle to attempt to get half assed treatment from these docs that are totally ignorant when it comes to Hormone Replacement Therapy (HRT). Most of them will admit they know nothing if you just ask them enough questions. It is unbelievable how this can be someone's profession and they know near nothing about treating people with hormones.

 

[SVT123]

Don't keep running around!!! My GP at first give me Androgel, not successful. Then she wanted to give me 150mg cyp once per month. She finally agreed to give me 200 mg once per month. Hell no.

I called Chip. He answered my ?'s. We discussed some long term items and so forth. After faxing and reviewing my protocol, a few days later received my package.

Maximus is awesome and the customer service is the best I've ever dealt with.

 

[Visio]

Chief I have just read ur post and figured I can help out I will type in another post

 

[Visio]

So her goes,

HRT totally totally Forget about it dont even talk about having HRT I don't know how people even talk about this around her without having clue what is it, HRT is not something u have for a month or two it's for life!!!! And of course with time your testicles will be very small u can hardly feel them as they won't be working.
So please forget about HRT,

HCG yes it's a good temporarily solution BUT ! I have a better one.
I have been diagnosed for hypogondasim for some reason as I hit the 30 I am a body builder since I was 21, to know what did went wrong I started doing tests every two weeks for one year during this time I was on and off the gym.

During workout and I mean spending good 50 minutes in the gym heavy weight 10 rep.
In one month I saw an increase of testosterone to almost double !!!!!
I showed the results to dr Eugene shippen which was a very interesting thing. usually people increase testosterone by lefting weights but no one knew how much exactly.
Now this is one ay to have a higher testosterone.
Another way is check those herbs , fenugreek (methi) Indian used it for years I don't see them complaining about it you can do more search on herbs increase Lh.
They act in a similar way to Human Chorionic Gonadotropin (HCG) but much much less side effect. Do your search on these I think they are the best way to go. At least from the way I see it.

Please FORGET ABOUT this HRT it will shutdown your system and u won't have testicles any more with time !!!!!!!!!

 

[jomamma007]

So her goes,

HRT totally totally Forget about it dont even talk about having HRT I don't know how people even talk about this around her without having clue what is it, HRT is not something u have for a month or two it's for life!!!! And of course with time your testicles will be very small u can hardly feel them as they won't be working.
So please forget about HRT,

HCG yes it's a good temporarily solution BUT ! I have a better one.
I have been diagnosed for hypogondasim for some reason as I hit the 30 I am a body builder since I was 21, to know what did went wrong I started doing tests every two weeks for one year during this time I was on and off the gym.

During workout and I mean spending good 50 minutes in the gym heavy weight 10 rep.
In one month I saw an increase of testosterone to almost double !!!!!
I showed the results to dr Eugene shippen which was a very interesting thing. usually people increase testosterone by lefting weights but no one knew how much exactly.
Now this is one ay to have a higher testosterone.
Another way is check those herbs , fenugreek (methi) Indian used it for years I don't see them complaining about it you can do more search on herbs increase Lh.
They act in a similar way to Human Chorionic Gonadotropin (HCG) but much much less side effect. Do your search on these I think they are the best way to go. At least from the way I see it.

Please FORGET ABOUT this HRT it will shutdown your system and u won't have testicles any more with time !!!!!!!!!

I can't even tell if this is a joke. Human Chorionic Gonadotropin (HCG) will keep your testicles on during HRT and they will be fine. HRT is literally saving lives, because living with a 200 test levels isn't even living in the first place, so don't knock it until you try it properly, ie with CHIP

 

[Packgus]

Visio = troll

 

[Visio]

Jommama007 do your home work and google desensitize LH receptors !!!!!!
This is why Human Chorionic Gonadotropin (HCG) should not be used for long term I am aware of the work of dr Eugene shippen and James .....something forget the name where you are exposed to small very small amount of Human Chorionic Gonadotropin (HCG) but by doing this you are only have your testicles there as a decoration manimg they will get the look only but it won't be working.

 

[Visio]

If it really necessary to do HRT don't jump at it now do whatever possible way before jumping to it !!!!!!!

 

[TR2838]

Herbs don't work.. Lifting weights will increase natty testosterone, if you can get the energy to even get off the couch to go to the gym w/ 211 levels.. Human Chorionic Gonadotropin (HCG) will keep your balls functioning while on Hormone Replacement Therapy (HRT), but, you need an Aromatase inhibitor (AI) also.. There is tutorials on you tube and other places for mixing HCG..Google.. Don't mess up the math or you'll be walking around like a balloon and make sure you use sterile technique or you'll wind up in the ER w/ an infection

 

[TR2838]

Yeah Viso, most people do whatever they can before hopping on HRT and herbs are a joke! HRT= lifetime? Yeah, so what? He can always hop off and his body will go back to producing almost zero testosterone as it is currently