Should I be on Testosterone Replacement Therapy??

[JoshHarold]

Should I be on TRT?I am 38 5'7" 150 very little body fat.I have not had any medical problems until recently.Is there other ways to raise my free T,LH.Any advice would be appreciated .my test results are from my urologist.

TT 471
Free 8.5 8.7-25 normal
Lh 3.4 2.6-10 normal
Fsh 2 1-8 normal

I am on 100mg a week TC.Is there a way to raise my Lh and
fsh while on trt.I was having just about every symptom of Low T before starting Trt and everything is much better now its only been a month.Havent had post trt blood work yet he wanted me to wait for six weeks.Any and all advice would be greatly appreciated.I also really appreciate the general educational advice in the trt thread. When I do have labs in two weeks what other test should I have done?Thks

 

[hiram1st]

You might want to read the TRT overview again.

Your HPTA will shut down and your lh and fsh will be zero when you inject exogenous test.

 

[Megatron28]

So those are your Pre-TRT lab results? What time of the day was your blood drawn? Did you repeat the labs to confirm the results? Did you check prolactin, TSH and Vitamin D?

Did you have a sleep study done? How is your diet? Are you exercising? What else did you look at prior to deciding to start TRT?

Why did you not try an HPTA Restart prior to getting on TRT? What was the conversation around this with your doctor?

Just for the record, Hypogonadism is usually defined as Total Testosterone being less than 300ng/dl. You are well above that. The average for your age is about 600ng/dl which you are slightly lower than.

 

[Mprtz]

I think OP is asking about TRT alternatives like Clomid monotherapy. I will let someone with more experience weigh in on that.

4 weeks into TRT if there is to be a change in strategy the sooner the better.

 

[Megatron28]

You might want to read the TRT overview again.

Your HPTA will shut down and your lh and fsh will be zero when you inject exogenous test.

To add to this, there are ways to boost LH and FSH when you are not taking exogenous testosterone. But not while you are on TRT.

 

[JoshHarold]

So those are your Pre-TRT lab results? What time of the day was your blood drawn? Did you repeat the labs to confirm the results? Did you check prolactin, TSH and Vitamin D?

Did you have a sleep study done? How is your diet? Are you exercising? What else did you look at prior to deciding to start TRT?

Why did you not try an HPTA Restart prior to getting on TRT? What was the conversation around this with your doctor?

Just for the record, Hypogonadism is usually defined as Total Testosterone being less than 300ng/dl. You are well above that. The average for your age is about 600ng/dl which you are slightly lower than.

There was no discussion of a restart.I asked about tsh the first visit and he said that could be the problem but after getting labs he said he didnt think so.No check for vitamin D.Yes I have always been active and in very good shape until I started having all these problems wasnt sleeping,any kind of exercise took everything out of me,started experiencing low libido and ed also feeling very weak.Since starting trt I sleep as good as ever.My energy level is as good as ever.My strength is just slightly below my best ever but will be back.Libido and erections are close to normal and getting better everyday it seems.I just want to know what my other options are.I dont want my testicles to shink atrophy or be in pain.I also dont want to be sterile.

 

[JoshHarold]

My free T is half what he said he usually sees.Blood for my labs was done in the morning for all lab.

 

[hiram1st]

Have you discussed HCG with your dr?

Keeps the atrophy (shrinking ) away and it keeps the testes active.

 

[JoshHarold]

No but I am going to when I go get 6 weeks labs.Should I do it before then?

 

[hiram1st]

I don't think you need to rush it. Wait for your appoint and explain your concerns which are valid and see what he sats. Not all dr's are up to date with how trt should be administered. Do your home work make sure you understand how HCG will benefit you and be able to convey it yo your dr

 

[Megatron28]

I am really shocked that you went straight on TRT. You are not hypogonadal. You could have tried a restart to get your HPTA functioning at a more optimal level. You should look for a new doctor that knows what he or she is doing.

 

[JoshHarold]

I am really shocked that you went straight on TRT. You are not hypogonadal. You could have tried a restart to get your HPTA functioning at a more optimal level. You should look for a new doctor that knows what he or she is doing.

What drugs are commonly used for restart?My doctor is one of the most refered specialist in my town.Everyone says he is good.I don't understand either thats why Im here.

 

[Megatron28]

What drugs are commonly used for restart?My doctor is one of the most refered specialist in my town.Everyone says he is good.I don't understand either thats why Im here.

A combination usually of hCG, Clomifene and Tamoxifen. Depends are your situation as to which ones are used and how.

 

[JoshHarold]

A combination usually of hCG, Clomifene and Tamoxifen. Depends are your situation as to which ones are used and how.

My doctor says my lh fsh #s are fine.Says that my testes are under producing and will only get worst.Is this incorrect in your opinion.should I have tsh or any other labs before my labs scheduled in two weeks

 

[Megatron28]

My doctor says my lh fsh #s are fine.Says that my testes are under producing and will only get worst.Is this incorrect in your opinion.should I have tsh or any other labs before my labs scheduled in two weeks

No, the problem is with your pituitary. But you also need to note that your do NOT have hypogonadism.

Read the Basic TRT Overview thread. It walks through how the HPTA works.

 

[JoshHarold]

Lh 3.4 is not enough

 

[Megatron28]

Lh 3.4 is not enough

You need to read that thread to understand how LH and FSH work with hypogonadism -- which you do not have by the way.

 

[JoshHarold]

I am almost positive that low T has caused all my problems because by taking T all has been alot better.Now what I dont understand is why my free T is so low and my total is in range but a little low as well.What could cause this? thyroid?what labs would you suggest and what route?Thks

 

[JoshHarold]

I read the thread which I already knew because my doctor told me that how it works.He said I didnt have hypogodism from the start. Until labs were reconfirmed with lh and fsh done the second time.then he told my pituitary was working fine and that the problem was my testes

 

[Megatron28]

I read the thread which I already knew because my doctor told me that how it works.He said I didnt have hypogodism from the start. Until labs were reconfirmed with lh and fsh done the second time.then he told my pituitary was working fine and that the problem was my testes

If the problem was with your testicles (Primary), your pituitary would be "yelling" at them to make more Test. It would "yell" at them by sending out an above normal level of LH. Your LH however is on the low end. This implies that your pituitary thinks you have plent y of testosterone so it is not "asking" your testicles to pump out more.

Thus the possibility that a restart could get your pituitary to work better. Sleep issues could be at play too. Diet. Exercise. Body fat. And other possibilities could be suppressing your TT. Or this may be where your TT has always been and something else is causing your symptoms.