Very unhappy with TRT

[Ratt64]

Cal,
looking at your posted labs the numbers that stick out are your tsh levels. The optimal tsh level should be in the 1.5-2 range. Your results are all around 4 which would indicate you are hypo-thyroidal, which will give the same symptoms as low test. This will also shut down your test production and lead to hypogonadism.
You need to address this issue first. I am pretty sure you are not feeling the effects of your therapy due to your elevated tsh levels. With the tsh levels, higher is not better. I can't believe that your endo did not pick this up and address this issue first. If he/she says they are fine you should seek another doctor. Once you get your tsh levels down, then you can dial in your testosterone replacement therapy (TRT) protocol and feel the positive effects of trt.
Also, Your E2 levels look great. Transdermal applications of test will raise dht levels. This is one reason why injections would be more beneficial. Less dht conversion and more test for your body to use.

 

[cal]

@ norcaltrt

You mean that clomid alone isnt strong enough? But then why not add some clomid to the testosterone to keep the balls working? i wonder if this could be an alternative to hcg.

@ ratt64

I also dont understand it. My endocrinologist didnt comment on this at all! I was the one who brought it up when I called him and then he said we can do ultrasound the next time. What if he says ultrasound looks normal and tells me to simply wait? I mean shall I demand to get thyroid hormones?

My E2 is okay but keep in mind that it only shows how my E2 is at when my T is low. I dont know how E2 will behave when T gets up.

Btw, I wonder does DHT suppress LH the same way T does? Cause if DHT didnt suppress LH then this would also be interesting. Then you could use T-gel to get high DHT levels while at the same time your T doesn't go up that much because most gets converted to DHT. But I don't know if this works. What's generally better and more powerful T or DHT? I read stuff online which sounded like DHT is the real shit and T is not. But then shouldn't I have felt like superman with such high DHT levels?

Could high TSH also mean that I lack iodine? I'm asking cause I don't use salt with added iodine. I use unrefined, untreated salt. I have no idea if my iodine levels are low or not. Should I, before taking thyroid hormones, first get my iodine checked and supplement iodine if it's too low and then see if TSH goes down?

 

[juced_porkchop]

Btw, is anyone here using clomid instead of Human Chorionic Gonadotropin (HCG)? Why do all people recommend hcg but not clomid? Is clomid less safe than Human Chorionic Gonadotropin (HCG)?
From what I read clomid can be used to treat hypogonadism as well and it would be easier to take cause it's not an injection.
Do you know if clomid is generally safe? I remember a urologist told me years ago that clomid is "too dangerous".

with OUT adding any sort of testosterone it has been used, but for most it dosn't make them feel the same.
if you try clomid so it along for a few months stay off for a couple more and go for blood work.
in most cases you will juts go back to your low levels.
HCG is not like Clomid, they dont act the same in all regards. HCG is NOT needed unless you care about ball size. it WONT fix any issue, it may even desensitize them with over use , for good (not good)
short bursts while on Hormone Replacement Therapy (HRT) to keep up nut size sure. as a fix for ever? no

Keep researching my man you will get the info you want and learn from it.
nibedo (test undec) is a GREAT option for Hormone Replacement Therapy (HRT) (one of the best for long term in my op), it will take a while to get levels stable (first frequent shots then slowly less and less till stable,) after a while shots every 1-3 months are easily possible. in USA/Canada it is not used, in Europe it is so if you are there you can prob look into it. its not as main stream as teste or cyp. (also doc's/pharms want money and want you to come in, greed only fuels the fire in my op to holding back better Hormone Replacement Therapy (HRT) option if $$$ is not the top of list.) just op here on that though lol

Is nibido an option for you?

 

[cal]

Yes, I can get nebido. That's not a problem. But I'm scared of having this stuff in me for 3 months. What if I get side effects like bad acne, hair loss or what if my eczema flares up? Then I cannot just get off it. That's a huge disadvantage.
And I also don't know what kind of levels does nebido produce? Are they midline levels? For example before going on testosterone replacement therapy (TRT) I had levels between 8-12nmol/l. Now what if nebido gave me levels of 15nmol which would be normal then would it be worth it? I dont know if going on testosterone replacement therapy (TRT) and then having 3nmol more would make a huge difference. If I don't feel any better on testosterone replacement therapy (TRT) then what sense does it make? When I go on testosterone replacement therapy (TRT) then at least it has to pay off.

I also worry about the injection itself. Nebido has 4ml afaik. Doesn't it hurt to have that much stuff injected? Or what if the stuff gets squeezed out of the muscle and then gets into the fat tissue? Another issue is that I'm pretty skinny. I don't have much glute mass to inject into. I don't know if that could be a problem, too.
And now where I read about the possible side effects after an injection like trouble breathing or fainting and what not I really worry that I'd get a panic attack during or after the injection. After the gnrh test I also felt dizzy and started to sweat as a reaction to the stuff they injected and I was also close to getting a panic attack in the office.

I care about ball size in the sense that I want to prevent them from getting too small. Now they're really small and feel soft and I don't even know if they're stable now or if they will become even smaller. I'd like to be more in charge of my balls and not just stand there watching.

 

[cal]

Seems like clomid isn't an option for me. I read in another thread that clomid can cause strong emotional reactions. That's also what I read many years ago that
it can cause depression or make you unstable. Then it's too dangerous for me cause I already have depression. That's bad news.

 

[Ratt64]

@ ratt64

I also dont understand it. My endocrinologist didnt comment on this at all! I was the one who brought it up when I called him and then he said we can do ultrasound the next time. What if he says ultrasound looks normal and tells me to simply wait? I mean shall I demand to get thyroid hormones?

When you see your endo you need to tell him that you have been doing some research and found your tsh level point indicate you are suffering from hypothyroidism. As I mentioned before, this condition needs to be addressed first and then tackle your low t issue. If you have an option to see another endo i would recommend it and you could mention that you would like to seek another opinion if you are not happy with the treatment you are receiving. regardless of the results from an ultra sound this needs to be treated.

My E2 is okay but keep in mind that it only shows how my E2 is at when my T is low. I dont know how E2 will behave when T gets up.

Your E2 doesn't fluctuate like t levels. E2 usually builds up slowly and until you start to get symptoms associated. If someone uses an Aromatase inhibitor (AI) and crashes their E2 it takes time to recover to normal levels.

Btw, I wonder does DHT suppress LH the same way T does? Cause if DHT didnt suppress LH then this would also be interesting. Then you could use T-gel to get high DHT levels while at the same time your T doesn't go up that much because most gets converted to DHT. But I don't know if this works. What's generally better and more powerful T or DHT? I read stuff online which sounded like DHT is the real shit and T is not. But then shouldn't I have felt like superman with such high DHT levels?

Looking at your blood work prior to starting gel, your LH was very low which indicates that you pituitary was not producing LH which would signal your nads to produce testosterone. I had the same issue, my MRI came back good and it is unknown why my pituitary stopped producing LH. End story, I've been on testosterone replacement therapy (TRT) for 3 years now and couldn't be happier.

Could high TSH also mean that I lack iodine? I'm asking cause I don't use salt with added iodine. I use unrefined, untreated salt. I have no idea if my iodine levels are low or not. Should I, before taking thyroid hormones, first get my iodine checked and supplement iodine if it's too low and then see if TSH goes down?

You could be lacking iodine. I wouldn't add iodine to your diet at this point. You should mention it to your endo and see if he is willing to get blood work done to check your levels. Iodine is very strong and if you start adding to could make things worse for your thyroid.

I know you have a number of concerns and when you don't feel well and can't get answers it can be frustrating. Hang in there!

 

[Ratt64]

Yes, I can get nebido. That's not a problem. But I'm scared of having this stuff in me for 3 months. What if I get side effects like bad acne, hair loss or what if my eczema flares up? Then I cannot just get off it. That's a huge disadvantage.

You had mentioned that you can get the doctor to inject test enth. If you are concerned about the long acting ester in the nebido, maybe you could start with the enth and if things improve you can change over to the nebido. that way it won't take as long for the enth to wear off if you don't like it. As far as sides go, I personally have had very few side with my protocol. I have noticed a slight increase in facial and body hair, no acne or hair loss. The amount of test you are injecting is only a fraction of the amount of some doing a steroid cycle which would may expect the sides you mentioned.

And I also don't know what kind of levels does nebido produce? Are they midline levels? For example before going on testosterone replacement therapy (TRT) I had levels between 8-12nmol/l. Now what if nebido gave me levels of 15nmol which would be normal then would it be worth it? I dont know if going on testosterone replacement therapy (TRT) and then having 3nmol more would make a huge difference. If I don't feel any better on testosterone replacement therapy (TRT) then what sense does it make? When I go on testosterone replacement therapy (TRT) then at least it has to pay off.

I have read on this and a couple of other forums that nebido can get you in the upper third of normal range. Most guys seem very happy and only need to get an injection every 10 weeks. I live in Canada and can't get it here, but I would definitely be willing to try it out given the positive things I've read.

I also worry about the injection itself. Nebido has 4ml afaik. Doesn't it hurt to have that much stuff injected? Or what if the stuff gets squeezed out of the muscle and then gets into the fat tissue? Another issue is that I'm pretty skinny. I don't have much glute mass to inject into. I don't know if that could be a problem, too.

4 ml is a fair amount but if the person administering it takes their time and injects it slowly it should minimize any discomfort. I wouldn't worry about it leaking or squeezing out as you mentioned. Even if you have a small arse there should be more than enough mass to inject the nebido into.

And now where I read about the possible side effects after an injection like trouble breathing or fainting and what not I really worry that I'd get a panic attack during or after the injection. After the gnrh test I also felt dizzy and started to sweat as a reaction to the stuff they injected and I was also close to getting a panic attack in the office.

The side effects are minimal. I can tell from your posts that you would probably have a little anxiety when you go for your injection. Take a shot of whiskey or take something to calm your nerves if you are having any anxiety. Your doctor maybe able to give you something. You need to keep in mind that injections like these are done every day and I've never heard of anything more than some discomfort at the injection site for a day or 2 later.

I care about ball size in the sense that I want to prevent them from getting too small. Now they're really small and feel soft and I don't even know if they're stable now or if they will become even smaller. I'd like to be more in charge of my balls and not just stand there watching.

We all care about our luggage, IMO think your issue may be that your elevated dht levels are causing more shrinkage than you would have from injections.

Once you get your tsh and test levels in order you will never want to go back to feeling like shit again.

 

[Megatron28]

Yes, I can get nebido. That's not a problem. But I'm scared of having this stuff in me for 3 months. What if I get side effects like bad acne, hair loss or what if my eczema flares up? Then I cannot just get off it. That's a huge disadvantage.
And I also don't know what kind of levels does nebido produce? Are they midline levels? For example before going on testosterone replacement therapy (TRT) I had levels between 8-12nmol/l. Now what if nebido gave me levels of 15nmol which would be normal then would it be worth it? I dont know if going on testosterone replacement therapy (TRT) and then having 3nmol more would make a huge difference. If I don't feel any better on testosterone replacement therapy (TRT) then what sense does it make? When I go on testosterone replacement therapy (TRT) then at least it has to pay off.

I also worry about the injection itself. Nebido has 4ml afaik. Doesn't it hurt to have that much stuff injected? Or what if the stuff gets squeezed out of the muscle and then gets into the fat tissue? Another issue is that I'm pretty skinny. I don't have much glute mass to inject into. I don't know if that could be a problem, too.
And now where I read about the possible side effects after an injection like trouble breathing or fainting and what not I really worry that I'd get a panic attack during or after the injection. After the gnrh test I also felt dizzy and started to sweat as a reaction to the stuff they injected and I was also close to getting a panic attack in the office.

I care about ball size in the sense that I want to prevent them from getting too small. Now they're really small and feel soft and I don't even know if they're stable now or if they will become even smaller. I'd like to be more in charge of my balls and not just stand there watching.

You are seriously worrying to much. You need to see a psychologist and get your head straight. Meds can help you out too.

 

[cal]

I don't think that my low T has something to do with my thyroid. I have been having low T ever since I first got tested 10 years ago. So TSH isn't the explanation.
But of course if high TSH is a problem then it needs to be addressed.

What kind of thyroid med is usually used to treat something like this? In the US armour seems to be popular but we don't have this here. Here people get L-thyroxine.

Do you guys know if sleeping very little also lowers LH? Cause on the day before I got the labs done where my LH was totally low I didn't sleep much. Having that low LH and T is abnormal for me. In all those years my LH and T have always been low normal which is why all docs told me I'm fine...

And should I ask my doc about clomid? But I'm almost sure he will either say no or say that he doesn't use this or something like that. I mean I needed a good reason to ask for it. Simply saying I worry about my balls might not cut it.

 

[cal]

What do you guys think about this here? This got me worrying. Now I don't know if I should even take thyroid hormones even if they were offered to me.

chriskresser.com/three-reasons-why-your-thyroid-medication-isnt-working

 

[juced_porkchop]

Yes, I can get nebido. That's not a problem. But I'm scared of having this stuff in me for 3 months. What if I get side effects like bad acne, hair loss or what if my eczema flares up? Then I cannot just get off it. That's a huge disadvantage. then use teste first
And I also don't know what kind of levels does nebido produce? Are they midline levels? For example before going on testosterone replacement therapy (TRT) I had levels between 8-12nmol/l. Now what if nebido gave me levels of 15nmol which would be normal then would it be worth it? I dont know if going on testosterone replacement therapy (TRT) and then having 3nmol more would make a huge difference. If I don't feel any better on testosterone replacement therapy (TRT) then what sense does it make? When I go on testosterone replacement therapy (TRT) then at least it has to pay off.

I also worry about the injection itself. Nebido has 4ml afaik. Doesn't it hurt to have that much stuff injected? not sure what you are asking here if a bottle comes with 4ml or 10ml you dont take it all at one time, i would see 2ml per shot being the most, if you need more you get 2 shots than Or what if the stuff gets squeezed out of the muscle and then gets into the fat tissue? then it absorbs regardless, it dosnt matter, but inmuscle is optimal Another issue is that I'm pretty skinny. I don't have much glute mass to inject into. I don't know if that could be a problem, too.
And now where I read about the possible side effects after an injection like trouble breathing or fainting and what not I really worry that I'd get a panic attack during or after the injection. After the gnrh test I also felt dizzy and started to sweat as a reaction to the stuff they injected and I was also close to getting a panic attack in the office.

I care about ball size in the sense that I want to prevent them from getting too small. Now they're really small and feel soft and I don't even know if they're stable now or if they will become even smaller. I'd like to be more in charge of my balls and not just stand there watching.

but your taking it to replace HEALTHY levels and NOT to take super high levels and get super high levels , sides should be minimal if any at all and even if there where any , an Aromatase inhibitor (AI) like letro or Stane could be used to lower estrogen. I think you are freaking yourself out for the most part.

 

[cal]

Hi, one reason why I'm freaking is because in Europe stuff like hcg and aromatase inhibitors aren't used by doctors. I only know that bodybuilders use this stuff. But like I wrote I have a book about andrology written by leading european endocrinologists who focus on andrology and they do not even touch on AIs or hcg in testosterone replacement therapy (TRT). This is a major problem. It doesn't help me when this stuff is out there and everybody in America uses it and I cannot get it.

And nebido needs to be injected all at once. You cannot inject half of it and keep the rest for later. That's also what the instructions say and the woman on the hotline also said that it has to be injected completely. It also wouldn't make sense to split nebido cause then you could as well directly get the regular testosterone ethanat.

 

[Megatron28]

Hi, one reason why I'm freaking is because in Europe stuff like Human Chorionic Gonadotropin (HCG) and aromatase inhibitors aren't used by doctors. I only know that bodybuilders use this stuff. But like I wrote I have a book about andrology written by leading european endocrinologists who focus on andrology and they do not even touch on AIs or Human Chorionic Gonadotropin (HCG) in testosterone replacement therapy (TRT). This is a major problem. It doesn't help me when this stuff is out there and everybody in America uses it and I cannot get it.

And nebido needs to be injected all at once. You cannot inject half of it and keep the rest for later. That's also what the instructions say and the woman on the hotline also said that it has to be injected completely. It also wouldn't make sense to split nebido cause then you could as well directly get the regular testosterone ethanat.

I think gels, creams or a patch would be the best choice for you. Injections are not going to work for you. No offense, but you are too much of a head case and you are not willing to deal with your psychological issues. Lot's of guys are fine without Human Chorionic Gonadotropin (HCG) or Aromatase inhibitor (AI). You may find you don't need them either. Good luck.

 

[cal]

Yo guys, thought I might give you an update. I have been to the doc and now I got thyroid hormones. I will start low and see what happens.

I asked about Human Chorionic Gonadotropin (HCG) and he said that this stuff is only used temporarily and that it would costs thousands of bucks a year and that the insurance would not pay this.
I don't think that Human Chorionic Gonadotropin (HCG) is that expensive I mean if it was that expensive how come so many in America use it? Or are there price differences?

I also brought up that my balls have shrunk and he said can't be. He said that they only shrink after years of heavy abuse. I know
that they have shrunk within a few weeks!! I don't know where he gets this stuff that balls only shrink after years. I imagine it like this that once LH is down the balls
start to get smaller. Why should it take years? This makes no sense and I also know that they got smaller so no argument in the world can convince me that I'm wrong.

What do you think about this? Do your docs understand testosterone replacement therapy (TRT) totally well or do they also say stuff which you know isn't correct? This makes me feel a bit unsafe.

 

[Ratt64]

Cal,
Here's the way I see your situation.
You are currently on gel and it hasn't improved your symptoms and has raised your DHT levels. IMO, you can triple the amount and it won't matter.
Your E2 levels look great and you don't need an Aromatase inhibitor (AI). If you take an Aromatase inhibitor (AI) at this point, it will crash your E2 and make you feel worse.
I understand you have concerns about the nibedo injections, but you need to know that this method of delivery has been tried and proven. You may experience tenderness and some localized discomfort for a short time, but once your test levels improve you will understand just how prowerful and essential this hormone is.
Other than that there really isn't much more anyone can tell you to get you over your fears. You need to at least give it a try and move forward.
Best of luck.

 

[Ratt64]

Yo guys, thought I might give you an update. I have been to the doc and now I got thyroid hormones. I will start low and see what happens.

Glad to hear your getting your thyroid issue looked at.

What do you think about this? Do your docs understand testosterone replacement therapy (TRT) totally well or do they also say stuff which you know isn't correct? This makes me feel a bit unsafe.

You will be very hard pressed to find a doctor who is up to speed in all areas of hrt.

See above in bold

 

[cal]

Yeah, I hope that adding some thyroid hormones will make some kind of a difference. What positive symptoms should I look for and how fast? I'll start with 50mg of l-thyroxine.

Is Human Chorionic Gonadotropin (HCG) really that expensive? Or did he confuse Human Chorionic Gonadotropin (HCG) dosages for different goals? How much do 5000IUs cost in America? And how much Human Chorionic Gonadotropin (HCG) do you even need per week in order to prevent atrophy? For me it would only be about atrophy and not so much about boosting my own production. Maybe if I could show him that Human Chorionic Gonadotropin (HCG) isn't that expensive when used in small doses he would prescribe it, but I'm not sure.

 

[Ratt64]

Yeah, I hope that adding some thyroid hormones will make some kind of a difference. What positive symptoms should I look for and how fast? I'll start with 50mg of l-thyroxine.

Not sure

Is Human Chorionic Gonadotropin (HCG) really that expensive? Or did he confuse Human Chorionic Gonadotropin (HCG) dosages for different goals? How much do 5000IUs cost in America? And how much Human Chorionic Gonadotropin (HCG) do you even need per week in order to prevent atrophy? For me it would only be about atrophy and not so much about boosting my own production. Maybe if I could show him that Human Chorionic Gonadotropin (HCG) isn't that expensive when used in small doses he would prescribe it, but I'm not sure.

I can't answer your Human Chorionic Gonadotropin (HCG) question, I'm on a testosterone only protocol. The atrophy I experienced is very minor and I'm done having kids.

 

[cal]

I can't say how much smaller they are but I'd say 30% is likely. They feel really soft now, too. And they also hardly ever hang low anymore. The scrotum is flexed most of the time which makes it look even more stupid. My doc also said that you only become infertile when you abuse testosterone but according to my knowledge you stop producing sperm even on normal TRT.

 

[Ratt64]

I would venture to say that mine are also about 30% smaller and most of the time my sack is tight. The tight sack will make your hammer look bigger. lol
I personnaly couldn't care about how my sack looks, I feel great and since starting on testosterone replacement therapy (TRT) and would not trade it for a bigger sack or balls. Regardless of size they are just there for decoration anyway as they don't function as they once did.
When ever you introduce an artificial source of tetstosterone into your system, regardless it it is for Hormone Replacement Therapy (HRT) or cycling it will shut your natural test production down and alter your HTPA pathways, resulting in decreased sperm count.

When I started I was skinny like yourself and noticed over time I was carrying extra weight in my mid section and couldn't take it off regardless of diet or exercise. I found I was less active and had no desire to get to the gym and when I did it would take a week to recover. When I started testosterone replacement therapy (TRT) I found I wanted to go to the gym all the time, I could recover from a work out by the next day. I have since lost the extra fat I was carrying and increased my muscle mass. I'm 48 yrs old and can say that with my levels in the mid to upper range I am in the best shape of my life.