Super low testosterone (108) 32yr old male Hormone Replacement Therapy (HRT) Questions???

[snoe1013]

Super low testosterone (108) 32yr old male HRT Questions???

I am a 32 yr old male who recently went to the Low T Center because I had all classic symptoms of low testosterone. My bloodwork revealed a 108 testosterone level. They want to start me on testosterone replacement therapy (TRT) shots, but I dont feel like I am prepared or know what I am getting into. They ran extra bloodwork and said my pituitary gland numbers were good and no need for an MRI.

Some more numbers:
TSH 1.490
LH 2.0
FSH 1.6
Prolactin 9.3
WBC 6.0
RBC 5.04

Should I be searching for a anti aging Dr or urologist or endocrinologist. I feel overwhelmed with all the info on here and am not sure where to begin. I am in Kansas and the Low T Center wants to just start injections but I read alot about HCG and Aromatase inhibitor (AI) and estrogen and am not sure if any of this is taken into account with this Dr.

Any thoughts or advice are greatly appreciated. I am assuming I will feel much better regarding quality of life if I begin the injections, just not sure if its ok to do for 50+ years...???

Thanks!

 

[BigFella]

1. You need your Estrogen levels before you start anything.
2. Injecting is less hassle than teeth cleaning.
3. You must inject at least once per week, preferably twice.
4. Your natural T production is screwed anyway, so you're not going to damage anything.
5. You'll be on Hormone Replacement Therapy (HRT) for life, unless you choose to stop. (See previous point.)
6. Look forward to the new you.

 

[noobmuscle]

Your concern is understandable but the reality of something such as HCG boosting you back is pretty slim with an FSH/LSH level like that. Still, I am not the authority on testosterone replacement therapy (TRT) by no means here, so I will yield my time to those with greater knowledge on the subject.

 

[SecOffTes]

Review what BigFella said.

And here's my story. I'm 25, been on testosterone replacement therapy (TRT) off and on (financial reasons not lack of necessity) since I was 23. Mine was a result of pain killers doctors kept me on for almost a year, trashing my HPTA. (Hypothalamus, pituitary, testicular axis - the wonderful system that keeps us balanced)

You will be on testosterone replacement therapy (TRT) for the rest of your life. If you get on it, and stop it, all the symptoms come back (sometimes worse). If your levels are that low and you haven't been playing with steroids, your HPTA is trashed as well. That likely means you have no options. My levels were mid 300, then down to 180 after starting testosterone replacement therapy (TRT) and stopping when I ran out of money, and attempts to restart my HPTA only got me back to the mid 200 range. So I went back to, and am now back on TRT.

hCG is used for two purposes with regards to testosterone. During steroid cycles, it's used to keep the natural function of the testicles on standby in essence. From what I understand it helps kick start HPTA during the post cycle AFTER a steroid cycle has suppressed HPTA function. During testosterone replacement therapy (TRT) it's primary function is to prevent testicular atrophy which can inhibit sperm count, fertility etc.

My brother is 22, also low T as a result of a genetic predisposition called a varicocele that interferes with proper blood flow to his testicles.

We are both on the same dosage of testosterone, 200mg/week. He is taking the hCG we were both prescribed, and I couldn't afford it. Initially both of our semen production increased. Since I'm not taking hCG, my testicles have atrophied slightly, which has caused a reduction in ejaculate. Other than that, I'm not suffering any side effects.

We both had an increase in estrogen. His is now being controlled with a prescription as his levels were 1100 total test, 300 free test, and approx 80 on estrogen. Anything about 30 on estrogen is considered above range per our lab sheets.

I suffered the return of a gynocomastia (growth of mammary tissue in the breast), it's small but tender and painful. I'll be getting my labs and a subsequent prescription to control my estrogen as well.


I would recommend you find a doctor who specializes in hormone therapy and rejuvenation. The low T centers in our area are very expensive, not usually covered under insurance, require you come in for injections (which they charge for) and focus more on testosterone levels than the other side effects, like testicular atrophy or estrogen.

Injecting yourself is extremely intimidating if you have a fear of needles. I hated them. The first injection I did myself took a lot but it relieved me of years of fear of injections and bloodwork because it was painless and simple. My brother almost passed out during his first injection because of that intimidation. However after the first two or three, it was cake. Him and I both inject twice a week and we prefer our thighs because it's easier to see than trying to inject in the glutes (for us anyway).


In short, read what BigFella said. I advise you find a hormone therapy specialist, more specifically a Bioidentical Hormone Therapy/Testosterone Hormone Therapy medical provider. If you can't find one, the clinic you found will at least get you started.

Once you get your levels up, it's amazing how many things you'll attribute to the low T. My brother wasn't convinced his symptoms were related. Two months in, he's glad he finally listened to me. Motivation, and energy are the our biggest benefits.

Look forward to a better future, and don't succumb to the fear of the unknowing or a fear of needles...life with no T is far worse than one to two injections a week!!!

 

[snoe1013]

Thank you guys for the replies. I think I will cancel my appointment for my first testosterone replacement therapy (TRT) injection and try to find a local Dr who specializes in this treatment. They did not run my estrogen levels and I want to go somewhere that will allow me to eventually perform the injections myself rather than go to an office visit each week. I appreciate the encouragement and want to make sure I start out right. This forum has been a great source of info and I am still trying to understand it all. I am just a little uncomfortable with how fast they wanted to start injections at this center without performing any additional analysis or bloodwork. I have not even technically seen a Dr, but rather a PA. Not sure how common this is but makes me a little uneasy. Thanks again for the support and information. I thought I was super young at 32, but its great to hear success stories from other young men going through similar situations.

 

[BigFella]

Snoe, it can be hard to find a doctor who knows what he is talking about. One way which has been suggested, and it worked for me, is to talk to a compounding pharmacy in your area and ask which doctors prescribe T. I got a fifteen minute rundown on pretty much everyone in the country. It is recommended that you visit, not phone, and I agree with that. If you actually turn up they'll know you are serious, that you aren't a roid junkie. (Or whatever.)

Be aware though that you will still need to become an expert in this, because even the best doctors won't know as much as you can learn.

 

[j2048b]

snoe,
where r u located? IF u dont want to run with the board sponsor, who is actually pretty knowledgable, and know their stuff, (im not a client by the way, with another clinic formally known as the sponsor), but have talked to them a few times, and todd knows his stuff as does det oak, and cashout, and a few others on here,

BUT

go to google earth and type in compounding pharmacies, check in ur area, and there will be a ton of hits, simply select a few, call them and ask who they recommend, call those doc and do a telephone interview and beet them with questions to gauge how well in depth they know testosterone replacement therapy (TRT), ask if they prescribe an Aromatase inhibitor (AI), hcg and test and what other chemicals they prescribe in order to make a well rounded testosterone replacement therapy (TRT) protocol, and ask if they take insurance?

ive found a few here in cali that way, some take insurance but did not know their ass from a hole in the ground and some did not and still dont know their ass from a hole in the ground,

Go from there and see what u can do!

hope this help?

 

[SecOffTes]

Bigfella, that's a great suggestion. I wish I'd have asked about that when I first started this adventure. I spent over $1000 during failed attempts to find a doctor who wasn't trying to rip me off.

Snoe, I would recommend when you talk to the doctors that you ask how they provide you with the medications they believe you need. I would be wary of any doctor who DOESN'T/WON'T write you a prescription, but rather sells you what they order for their clinic.

I came across a clinic that did the injections in the office, $40 an injection after the initial doctor visit. I advised I couldn't drive to their location once a week and my dad is a nurse who could do the injections for me. They tried to sell me a bottle of Testosterone 100/mg per ml for $250. $250!!!

There are two problems with this. A. $250!!! That same bottle costs $50-80 at Wal-Mart pharmacy when you're given a prescription. B. Because the doctor ordered it, it wasn't labeled with my name in any way like my prescription testosterone is. That can spell trouble if a cop finds you with it.

Ask the doctor if they write prescriptions, and what methods they prefer their patients use. I would recommend against the creams/gels because of risk of contact transfer (I have a little girl and applied it to my feet/ankles and always had to make sure she stayed away from them). There's a sublingual but I don't know how well it works or it's absorption rate. And a new thing here is implanted pellets. They make an incision in your glutes, and stab an "on demand" release testosterone pellet in to the meat of your butt. Expensive and they said the incisions hurt for a few days despite being very small, but you don't have to do it as frequently as a once/twice a week injection(every one to three months, as long as six to nine in some cases I was told).

I had to request injections from my doctor because he preferred the cream I started with and the pellet implants. He had no problem writing me a prescription for testosterone injections. However I have talked to doctors and clinics who refuse to write prescriptions for the injections because of potential abusers.

And as mentioned, come here with your questions. I'm a newb on these forums, I just spent the last two years dealing with the testosterone replacement therapy (TRT) thing so I have a little to say on that. These guys are great.

 

[snoe1013]

Thanks again for the many replies! I appreciate you guys taking a few minutes to share your stories and try to save me a few headaches from doctors. My initial reaction when I was told I needed testosterone replacement therapy (TRT) was to go find a good endocrinologist, but after reading through here I am going to search through some of the local anti-aging and DO doctors. They seem far more experienced with hormones than a typical endo or urologist. I am curently calling around trying to find one that takes insurance and will write a presciption for self-injections. That may be tough to find, but hopefully there are some here in kansas. When you guys are talking about HCG and atrophy... How much atrophy typically occurs when only using testosterone injections (no HCG)? Are we talking 70-80% reduction or just that they are slightly reduced? I have kids and do not plan on having any more, so Im not sure the HCG is the best way for me, and because it appears to cause the most estrogen issues as well.

 

[boaterkevin]

Snoe - I recently dropped HCG from my protocol all togther and have noticed about a 30-40% reduction in testicular size. I too am married with children so for me the expense and estrogen spikes just weren't worth it.

 

[snoe1013]

OK so I spoke with several compounding pharmacies and didnt really get any references. They said they could let me know who was prescribing Troches, but that there were hundreds of doctors prescribing testosterone, HCG and Aromatase inhibitor (AI). I found a few local bioidentical hormone doctors who talked with me for quite a while on the phone and seemed very knowledgeable and had protocols that seemed logical, but they dont take insurance. They give me a form to send in for myself. Is it very rare to find a doctor that is very knowledgeable about Hormone Replacement Therapy (HRT), HCG, Aromatase inhibitor (AI), estrogen, etc and is willing to write a presciption for self injections AND takes insurance? Maybe I need to keep scouring, but so far it seems nearly inpossible. I live in Kansas City, which is a pretty decent sized city with several compounding pharmacies and doctors. So far my best option is a doctor (DO) very familiar with Hormone Replacement Therapy (HRT), HCG, Aromatase inhibitor (AI), estrogen, etc and is willing to write a prescription for self-injections, but everything is cash upfront and he will give me a form t send to my insurance. Has anyone found this to be a smooth process (insurance forms) related to these doctors or do they refuse to pay? The doc charges like $700 for a 3hr appointment to get started, then gets full bloodwork, then gets a tailored program developed for you. Then charges monthly fee of 100. Sounds a little odd to me, but is this normal?

...As a side note, has anyone had success with the Troches? I read a little and it sounded like they were mainly used by folks for boosters between injections, rather than the primary source of T.

 

[BigFella]

Snoe, I wish I could help you but I'm not sure I can. The only thing I'd say is to keep trying to find the perfect doctor. He/she is there somewhere. Mine is a four hour plane ride away from me (in Perth, Western Australia) but I will probably never have to see him again in person. He is comfortable with my self-diagnosis, allows me to self-titrate (adjust the dose) and he's also fine with prescribing HGH for me when I'm ready, which is a great example of a doctor who respects my knowledge and will work with me. It actually didn't take me much time to find him, but it took a lot of internet research.

I recommend you do everything you can to get a legal, repeatable supply of affordable injectable T. You will have to work hard to get it, but it is worth it.

 

[snoe1013]

As an update, I found a local anti aging MD that specializes in Hormone Replacement Therapy (HRT). I spoke with his nurse and she said he frequently prescribes Human Chorionic Gonadotropin (HCG) and Aromatase inhibitor (AI) and sounded very knowledgeable with TRT. He monitors estrogen and bloodwork every 3-4 months once started. He also takes insurance and prescribes testosterone injections for home use (rather than office injections). You guys were right that apparantly the hardest part is locating a DR that is knowledgeable AND meets your needs (insurance, self-injections, etc). My first appointment with him is Monday so I have my fingers crossed that I found a decent DR and I am looking forward to getting my levels back up where they need to be and feeling better.

That you all for your responses and encouragement. There is a ton of bad information out there and Im glad I found this forum to bounce ideas off of people who have already gone through these issues and are succeeding. I would still be interested in knowing if anyone has had any experience with the Troches (kind of like a testosterone cough drop?)... Thanks again for all the feedback and suggestions!

 

[mmkcmo]

Snoe, can you PM me please?

 

[Cpt Hawk]

I know this thread is slightly dated...

Snoe, I'm running into the same issue in KC - can you send me a PM on who you used? If you can't post it here...

Thanks.

 

[dale5671]

I too am in Kansas City(north) and am interested in any help one can give about finding a specialized doctor in this area, Thanks.

 

[Megatron28]

IMT, the forum sponsor covers Kansas City. Their info is on the right hand side of your screen. They do great work and lots of guys here use them.