TRT and HCG at 26 years old?

[swoldoggy]

Hello everyone. I recently found out I have low testosterone levels. My doctors believe it to be related to a medication I used to take.

I have seen two specialists: one wants to go with a conservative approach and see if my testosterone levels return to normal on their own after stopping the medication; the other wants to begin TRT either via a compounded cream, or injections, as well as HCG for fertility.

I am 26 years old and have a wife I hope to have kids with one day. I just wanted to get the opinions of some of those with experience with this kind of thing what the pros and cons of either approach might be and which route they would suggest.

Thanks!

 

[Jimstigator]

What is the medication? Accutane, Finasteride, SSRI? In almost all cases, its a guessing game if T will climb back up.

Pro of waiting is that well - you don't have to get on TRT for life. I tried to wait, and spent years doing it with no luck. Restarts are a viable option for nearly anyone. Generally that would be Nolvadex or Clomid for a month or two then test to see what happened. Some restarts work and stick long term afterwards, some don't.

I personally like TRT, and in most cases, HCG will preserve fertility. Some hate to inject a few times a week... some like to know their hormones are optimal at all times.

-Jim

 

[swoldoggy]

Thanks for the reply. It was an opiate painkiller (oxycodone). It's been documented to lower T but typically rebounds after stopping the medication. However, it's been about a year since I stopped taking it and T is still low. I have taken Tamoxifen which brought it up somewhat, but it is still very low for my age.

I've also been to the psych and treated for depression, anxiety, and ADHD, all of which I now think are related to low T, as the symptoms began around the time I started taking the pain meds. My first doctor wants to continue the conservative approach for awhile longer, but the second opinion I got wants to start treatment because he believes the levels would have returned to normal if they were going to.

If I do start treatment, should I try the cream first as my doc suggests, or push for injections? I don't like injections but if it's cheaper and a more effective delivery method I can handle it.

Thanks again!

 

[Jimstigator]

Thanks for the reply. It was an opiate painkiller (oxycodone). It's been documented to lower T but typically rebounds after stopping the medication. However, it's been about a year since I stopped taking it and T is still low. I have taken Tamoxifen which brought it up somewhat, but it is still very low for my age.

I've also been to the psych and treated for depression, anxiety, and ADHD, all of which I now think are related to low T, as the symptoms began around the time I started taking the pain meds. My first doctor wants to continue the conservative approach for awhile longer, but the second opinion I got wants to start treatment because he believes the levels would have returned to normal if they were going to.

If I do start treatment, should I try the cream first as my doc suggests, or push for injections? I don't like injections but if it's cheaper and a more effective delivery method I can handle it.

Thanks again!

I spent about 10 years "waiting" and being "conservative". Now I just consider that a loss of 10 years of my life.

How long on Nolvadex and what dose?

I would imagine ALL of that stuff is related to low T. How does your thyroid look? How do you sleep?

I am not an expert or Dr, but injections, no doubt. They are the gold standard. Most patients have trouble with creams/gels. The first injection is scary, then its just life. I sat, frozen, for about 30 minutes before my first shot. Now, its not even a thought. Besides, alot of guys use baby syringes like 29g, 1/5in.

-Jim

 

[swoldoggy]

20 mg a day for about the last 6 months. T went from 64 to 206. TSH was at 1.77 (0.40-4.50 mIU/L) and T4 at 1.8 (0.8-1.8 ng/dL). I've been sleeping like crap for awhile and occasionally get bad night sweats too.

I'm probably going to start treatment as it seems my T is not going to come back up to acceptable levels. Even my conservative doc was saying that if it doesn't rise soon he wants to start treatment.

What are some good dosages for the Cream versus Injection? I've done some research online but their seems to be a lot of variance in opinion. I did a cycle a few years ago (Test. Cyp. 500mg) with proper pct and everything was fine after, but I understand TRT doses are significantly lower. I'd like to get the most out of it (gym wise) but still remain safe (health wise).

What do you think? Thanks

 

[Jimstigator]

That is an adequate time on and dose for Tamoxifen. You might be stuck. Hot flashes can be a side of Nolvadex... fun fun. As well as zippy libido. Its a good option to try, but obviously you aren't responding. After 6 months on Nolvadex, my TT was up above 900 from like 200.

I don't know dosing of creams. For injections, I believe everyone should start with 80-120mg a week, injected every 3.5 days to start. Obviously most guys adjust from here, but its an excellent starting point. Ideally, 50mg Monday morning, and 50mg Thursday night. After 4-6 weeks, you test and see what happened. Might be perfect, might raise estrogen too high and you need an AI, who knows.

You also mentioned HCG. Standard dose would be 250iu twice a week, ideally injected the day before each T shot, which would actually give you 4 injections a week. Some guys do it on the same day as the testosterone. Others split it up and do like 100mg EOD. Again - everyone is so different its hard.

If I was asking for a starting regimen, it would be...
100mg test cyp, twice a week, injected subq with insulin syringes
250iu HCG, twice a week, day before each test shot, injected subq with insulin syringes
Arimidex on hand to dose at .25mg twice a week if estrogen sides appear

Also, in your case, being on Nolvadex, you likely have high SHBG. So when you stop Nolva, that will lower. What you feel initially from TRT, and see in your first few bloodworks, might be different from where you end up as your SHBG levels off. Nolvadex is known to raise it. With me, I went from 22 pre Nolva, to 46 on Nolva, to 22 post Nolva.

-Jim

 

[swoldoggy]

Thanks for all the info. That really helps clear some things up for me.

 

[Jimstigator]

Thanks for all the info. That really helps clear some things up for me.

Something else I wish I knew. If you to start TRT - do it in phases. I went full bore right out of the gate - test cyp, HCG, AI, etc etc. It was a disaster.

You don't loose fertility overnight. I would personally dial in just the testosterone first, to see where it puts you. Then, after a month or two, add HCG. You need to dial in things slowly so you know which is causing the effects.

-Jim

 

[swoldoggy]

Funny you should say that, I saw the doc today and he said the exact same thing. I'm starting with cyp shots, 100mg a week, with the first dose being front loaded at 200mg. He said not to worry about HCG until I'm ready to have kids and that sperm production shouldn't be a problem. Didn't really talk about arimidex, he just said it shouldn't be an issue at that low a dose. It's nice to hear similar opinions from multiple perspectives! Helps reinforce the idea that I'm getting on a good program. Thanks again!

 

[Jimstigator]

Funny you should say that, I saw the doc today and he said the exact same thing. I'm starting with cyp shots, 100mg a week, with the first dose being front loaded at 200mg. He said not to worry about HCG until I'm ready to have kids and that sperm production shouldn't be a problem. Didn't really talk about arimidex, he just said it shouldn't be an issue at that low a dose. It's nice to hear similar opinions from multiple perspectives! Helps reinforce the idea that I'm getting on a good program. Thanks again!

If you can get him to let you split to a shot every 3.5 days, you will have even less estrogen worries. Some guys love once a week, but most prefer twice a week.

Also - self inject. It will get old quick going to the Dr. Don't let them prescribe harpoons, you can inject with small insulin syringes. My syringes are 29gauge, 1/5inch and work great.

-Jim