TRT: Need advice before making the decision...

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Hi all

Wondering if you can help me out please, I need some help other than from my Endo as I want to be 100%.

-

History; I had a macroprolactinoma with levels of 30,000 of prolactin, now down to 200 range so that is fine, been taking Cabergoline for the prolactin treatment.

Now my T has always been on the lower end, and my Endo has told me to do TRT.

Done some research myself before starting and I have a few questions (I am also 20 years old). These questions are all from the multiple sites I've visited so Im not sure if I've picked up any "made up" statements....


1) If I start testosterone replacement therapy (TRT) will it be for life, or can I go on it for 3 months and hope that it boosts my natural T?


2) If I am on testosterone replacement therapy (TRT) for a while does it a) Shrink your testies & make them "rise"?


3) Before I start testosterone replacement therapy (TRT) I have scheduled LH, FSH and Test... do I need to ensure I have E2 tested along with that too?


4) My next scheduled appointment is 4 months after I begin TRT... is that too much of a gap to be 'monitoring TRT'?


5) I have been perscribed 280mg of testosterone replacement therapy (TRT) Gel per week, is that too high? I have read that I may need to take 'anti-E2' to keep E2 levels down due to the elevated T?


6) Are there any bad side effects that I should know about?


7) Do I need to be on more than just the testosterone replacement therapy (TRT)? (i.e; Human Chorionic Gonadotropin (HCG) to keep the sack working - any side affects of this?)


I've essentially had low T all my teen years, after looking at the symptoms it pretty much maps out my entire life as a whole to be honest! Now my prolactin levels must have taken 3-4 years to get to that level and I've got to say i'm noticing a slow increase of facial hair etc and feeling a bit better - My entire question is really that if testosterone replacement therapy (TRT) is for life is it a better option to see if I can naturally produce it to a sufficient level ?? I'm quite confused so would really appriciate your thoughts and input into this.
 
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1) If I start testosterone replacement therapy (TRT) will it be for life, or can I go on it for 3 months and hope that it boosts my natural T?
You can go and jump off and your levels will be what they were before at those 300 levels. 300 is basically a castration level.

2) If I am on testosterone replacement therapy (TRT) for a while does it a) Shrink your testies & make them "rise"?
My testicles have not shrank significantly while on testosterone replacement therapy (TRT). Chip at Maximus gives Human Chorionic Gonadotropin (HCG) to all his clients so that your balls will be full sized forever.


3) Before I start testosterone replacement therapy (TRT) I have scheduled LH, FSH and Test... do I need to ensure I have E2 tested along with that too?
Yes, definitely, and free testosterone in addition to the total testosterone level checked.

4) My next scheduled appointment is 4 months after I begin TRT... is that too much of a gap to be 'monitoring TRT'?
You have to go by how you feel and find the right dosing as far as an anti estrogen goes and the testosterone timing of injections. Good luck getting your doc to prescribe you an anti estrogen.

5) I have been perscribed 280mg of testosterone replacement therapy (TRT) Gel per week, is that too high? I have read that I may need to take 'anti-E2' to keep E2 levels down due to the elevated T?
Gel is worthless. You're better off on shots. Gel converts significantly to estrogen immediately due to the aromatase enzyme on the skin compared to shots. That and the half life is so short that it is like being on a hormone roller coaster all the time.


6) Are there any bad side effects that I should know about?
The shots aka Maximus' approach to testosterone replacement therapy (TRT) will not cause side effects. The gel will cause all kinds of nasty side effects which get worse over time as the estrogen stress wears on your body.

7) Do I need to be on more than just the testosterone replacement therapy (TRT)? (i.e; Human Chorionic Gonadotropin (HCG) to keep the sack working - any side affects of this?)
Ideally you'd have at least an AI- aromatase inhibitor to control excessive estrogen if it flares up. I don't even know if it'd be applicable in the case of using gel though since it spikes your estrogen so quickly. Human Chorionic Gonadotropin (HCG) is also ideal to keep your balls normal sized.

There aren't many docs out there that truly understand testosterone replacement therapy (TRT) and are willing to treat you as a patient and not just totally disregard your health because of a lab reading.
 
1) If I start testosterone replacement therapy (TRT) will it be for life, or can I go on it for 3 months and hope that it boosts my natural T?
You can go and jump off and your levels will be what they were before at those 300 levels. 300 is basically a castration level.

2) If I am on testosterone replacement therapy (TRT) for a while does it a) Shrink your testies & make them "rise"?
My testicles have not shrank significantly while on testosterone replacement therapy (TRT). Chip at Maximus gives Human Chorionic Gonadotropin (HCG) to all his clients so that your balls will be full sized forever.


3) Before I start testosterone replacement therapy (TRT) I have scheduled LH, FSH and Test... do I need to ensure I have E2 tested along with that too?
Yes, definitely, and free testosterone in addition to the total testosterone level checked.

4) My next scheduled appointment is 4 months after I begin TRT... is that too much of a gap to be 'monitoring TRT'?
You have to go by how you feel and find the right dosing as far as an anti estrogen goes and the testosterone timing of injections. Good luck getting your doc to prescribe you an anti estrogen.

5) I have been perscribed 280mg of testosterone replacement therapy (TRT) Gel per week, is that too high? I have read that I may need to take 'anti-E2' to keep E2 levels down due to the elevated T?
Gel is worthless. You're better off on shots. Gel converts significantly to estrogen immediately due to the aromatase enzyme on the skin compared to shots. That and the half life is so short that it is like being on a hormone roller coaster all the time.


6) Are there any bad side effects that I should know about?
The shots aka Maximus' approach to testosterone replacement therapy (TRT) will not cause side effects. The gel will cause all kinds of nasty side effects which get worse over time as the estrogen stress wears on your body.

7) Do I need to be on more than just the testosterone replacement therapy (TRT)? (i.e; Human Chorionic Gonadotropin (HCG) to keep the sack working - any side affects of this?)
Ideally you'd have at least an AI- aromatase inhibitor to control excessive estrogen if it flares up. I don't even know if it'd be applicable in the case of using gel though since it spikes your estrogen so quickly. Human Chorionic Gonadotropin (HCG) is also ideal to keep your balls normal sized.

There aren't many docs out there that truly understand testosterone replacement therapy (TRT) and are willing to treat you as a patient and not just totally disregard your health because of a lab reading.

Couldn't answer it any better! Go with Maximus and stay
away from any Endo,Urologist,or GP. They gave me 2yrs of hell you hit in the normal range with them and thats all you get. If you don't go with maximus your better off educating yourself and self medicating. Good luck!
 
All great answers above. Matches up to both my personal experience and what my doc has told me. I have a good local doc, but have asked Chip a few questions in case I need to ever switch...and they seem to know what they are doing. Definitely a better place to start than a doctor that wants you on gel. Blech!
 
hi all

thank you all for taking the time to post here - your input is truly appriciated.

Regarding Maximus, is he situated in the USA? I am in the UK so not sure if that would work? But I am all ears for suggestions as I feel that my endo isn't taking my case seriously.

Does anyone have any reccomendations of good Endo's in London - do any good Endo's exist on the NHS?

My endo did offer me a choice, gel or shots - and I ofcourse selected Gel at the time due to being unaware of the disadvantages (the advantage was of course easier to apply a gel than inject to a new user who has never heard of testosterone replacement therapy (TRT) before).

Due to my prolactinoma I have frequent blood checks, so would you reccomend obtaining them all, would posting the latest here help at all?

I would usually go-along with it, but testosterone replacement therapy (TRT) is serious and after doing some research I've heard some of the unnecessary rollercoasters that occur due to being 'sampled with'. I don't want to be part of some experiement.

What concerns me the most is the prescribed gel, with no prescription of Human Chorionic Gonadotropin (HCG) & Anti Estrogen - so the scenario would be in 4 months I re-visit and THEN he prescribes me? What mentality is that surely prevention is better than a cure.

i have some more questions, I really appricaite you guys reading into my thread and posting your thoughts/comments - it will help me a whole lotta good!

Thank you.
 
We need reference ranges for those labs too. Gel is not worth it. Chip is in the US, so I guess you have to find a doctor there. I don't know if the NHS has anti aging doctors or doctors well versed in testosterone replacement therapy (TRT). Check free testosterone and estrogen levels as well.
 
I'd just like to take a minute and truly thank all you guys that are members of "team maximus" and for the ongoing, ever, and always positive that you speak of myself and maximus Hormone Replacement Therapy (HRT). We work very hard to stay on the cutting edge of therapeutic treatment. Thanks guys!
 
This is common knowledge among any doctor that has ever administered any of the above therapy. You shouldn't need studies. Google is your friend. We use Chip who actually has competent doctors.
 
Hey guys,

I now have my blood results with ranges attatched. These results are about 2 months old (my latest didn't include LH and FSH levels).

Please help me out, hopefully now they have ranges they are more useful in seeing the picture.

After the research I've done it shows me that LH and FSH are low - so rather than trying Testosterone and shutting down natural production would it not be better to increase LH/FSH to allow my body to produce testosterone naturally?

I'm aware of the high prolactin levels, I have/had a macroprolactinoma. However, they are decreasing but so is my test (should be opposite right?). Unfortunatley my doc didn't ask for LH and FSH on my most recent test so I can't tell if they are increasing or decreasing.

I've been diagnosed with secondary issues, knowing it is not primary (due to pit. tumour).

Hope you can all help!
 
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You can try l-tyrosine and macuna pruriens multiple times a day (l-dopa is in it) to increase dopamine to excite the pituitary's LH production and lower prolactin. Dopamine and prolactin oppose each other.
 
You can try l-tyrosine and macuna pruriens multiple times a day (l-dopa is in it) to increase dopamine to excite the pituitary's LH production and lower prolactin. Dopamine and prolactin oppose each other.

currently on cabergoline which is reducing the prolactin anyway.

just thought that there would be something else to increase LH/FSH.

anyone??
 
currently on cabergoline which is reducing the prolactin anyway.

just thought that there would be something else to increase LH/FSH.

anyone??


increaing LH/FSH is something different. You stated you were trying to lower prolactin. I don't believe any prolactin antagonizers are going to have much effect on your LH levels. Something like clomid would be what you need to increase LH levels.
 
sorry I realise i didn't mention it - yes the prolactin is 'being taken care of'.

My endo seems to think giving me the testosterone replacement therapy (TRT) is the solution - but I have low LH and FSH... would you agree that I have low T due to low LH and FSH?

If so, would it be an idea to try increasing them before going onto TRT?
 
absolutely. How old are you? If your still relatively young that should most definitely be the approach you should take. If LH is high, but your test levels are low, that would indicate primary hypogonadism, and that's when you would start talking TRT.

And thats not to say you don't have that, it's entirely possible if you were able to increase your LH you still wouldn't increase your test levels, simply because you DO have primary hypogonadism. But the only way to know for sure would be to try it. Those LH levels would be concurrent with low test levels from what I can see. Now if your test level was what it is, but your LH was up in the normal range, I would say you should look into TRT.
 
Yeah, didn't see that. Just jump on legal testosterone replacement therapy (TRT). Maximus Hormone Replacement Therapy (HRT) is the best and most convenient.
 
Yeah, didn't see that. Just jump on legal testosterone replacement therapy (TRT). Maximus Hormone Replacement Therapy (HRT) is the best and most convenient.

I think my biggest concern, which I haven't yet discussed with chip, but I will next time we speak, is that testosterone replacement therapy (TRT) is a for life thing you know. And what's gonna happen when chip no longer does this anymore? Or if something should happen and he CAN'T provide this service anymore? Will the pertinent info be retained and forwarded to a new set of people who will be able to take care of us all without skipping a beat in our meds? Just kind of scares me I guess that a year from now I might be SOL on how to get my meds...
 
absolutely. How old are you? If your still relatively young that should most definitely be the approach you should take. If LH is high, but your test levels are low, that would indicate primary hypogonadism, and that's when you would start talking TRT.

And thats not to say you don't have that, it's entirely possible if you were able to increase your LH you still wouldn't increase your test levels, simply because you DO have primary hypogonadism. But the only way to know for sure would be to try it. Those LH levels would be concurrent with low test levels from what I can see. Now if your test level was what it is, but your LH was up in the normal range, I would say you should look into TRT.

Hi bbe

I am 20 years old.

I understand what you're saying re primary and secondary but before making the lifetime decision of testosterone replacement therapy (TRT) it would be best to at least try to increase lh/fsh to see if that could work?

Any suggestions from you guys as to what may be the best way to increase those levels?

Thanks
 
I think my biggest concern, which I haven't yet discussed with chip, but I will next time we speak, is that testosterone replacement therapy (TRT) is a for life thing you know. And what's gonna happen when chip no longer does this anymore? Or if something should happen and he CAN'T provide this service anymore? Will the pertinent info be retained and forwarded to a new set of people who will be able to take care of us all without skipping a beat in our meds? Just kind of scares me I guess that a year from now I might be SOL on how to get my meds...

The Roman Colisseum is still standing, son, and I SHOULD have been dead years ago had I not self administered my own testosterone replacement therapy (TRT). I aint goin nowhere, Chief!...... Only growing bigger abd making new clients have to wiat an extra couple days or so to pin down my time.
 
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