19 and Possibly Low T

Pharma / TRT Testosterone Replacement
21

Hey man,

I’m not an expert, since I’m pretty new to this whole endocrinology thing but here’s a few things based on what I’ve learned so far.

  • The most sensible way to attack this problem is by discarding possible causes, one at a time. You are doing the Iodine thing so that’s one.

  • After you are finished with your iodine replenishment, take new labs and see where you’re at. If your thyroid function is still impaired, you can consider treating it with medication.

  • If things are not getting better, start looking at your HPA Axis (adrenal issues). Adrenal function and the HPTA axis are intimately related and issues in this department will definitely affect your sex hormones and sex drive, both directly and indirectly. Basic tests to see how you are doing in this department are: DHEA-S, Pregnenolone and Cortisol (preferably 4 sample saliva test to see how your levels behave during the day). If your adrenals are screwed up and very high, then you would discard serious conditions like adrenal or pituitary tumors. If they are low, you discard Addison’s. If the condition is serious, you can get it treated. If it is sub-clinincal, there are methods and supplements you can try.

  • After you get this fixed (if it needs fixing) and you still have symptoms, then you might want to consider TRT. Taking the previous steps before getting into TRT will improve the chance of it being successful. As KSman said, if you jump right into it you could start feeling better at first but then hit a wall if your other hormones are bottlenecking your progress.

I really hope this helps somewhat. Maybe someone more knowledgeable will chime in and correct this post if it needs correcting. In any case, I do believe that a systematic approach where you discard possible causes is critical. Eventually you will hit the nail in the head and you’ll get better.

22

Yeah that’s the plan for now. I’ve finished iodine replenishment, now I just supplement a bit of iodine everyday to make sure I’m still at a good level. I’m gonna try to find another endo/urologist or something that I can get some more tests done. I’ll get hormones checked again soon hopefully, along with a lipid panel (KSman seems to think my low cholesterol could part of the problem), possibly more thyroid stuff.

Tests are expensive is the problem, so gotta get money or talk to my parents or something.

23

So I sent my doctor a message asking about whether or not I could start TRT if I felt okay about it, and if he’d prescribe HCG along with it etc, and saying that lowering my tamoxifen dosage has been causing problems with my erections, and my other symptoms haven’t been helped at all. so he sent me this message in return:

“It’s difficulty to say how much benefit you might have since your testosterone levels were actually in the normal range. If you were to try testosterone, you’ll need to also be on clomid or HCG to preserve your testicular function. I’m happy to move up your appt to discuss further in person. Please contact my office to move up your appt”

Do you guys think that I have a real chance of getting test prescribed by this doc? Or should I just go look for a new one? Also, it does seem like he knows what he’s doing with saying that I would need HCG along side, but clomid? Maybe I’m just not familiar with the functionality of clomid at all, but I didn’t think clomid would help at all with testicular function.

24

Since many doctors wouldn’t touch hCG with a ten foot pole, the fact that your doc mentioned it is a pretty good sign. He’s not afraid to go off-label in order to work with you. Can’t say much about clomid as I’ve never tried it, but I hear nolvadex is better. I was on nolvadex for 2 months for a restart attempt, but I made the mistake of not tapering it off properly. I’ve not had any sides from nolva.

25

I’ve been nolva for about three months now, and am in the middle of tapering (I’m going 10mg every three days now). But it doesn’t seem to have helped at all. I still got sides like tiredness, and my mental fog has actually gotten worse to be honest. Also, my ED is still here, so that’s really shitty. I’m thinking about moving the appt up so I can deal with this, but I do also need to talk to my parents about it I suppose. Considering it would be going through their insurance and all that, they’d need to know for when they get the bill…

26

Well…brought a girl over the other night, having a good time, getting ready to have sex, and here comes the ED. That really sucked, I even have some cialis I took in preparation probably an hour or so before I thought I’d have sex…yet another opportunity missed because of this…I’m definitely calling my doctor’s office on monday now

27

So quick update. Went to the urologist again, and he gave me clomid on top of nolvadex. So now it’s 25mg clomid/day, and 10mg/2x/day for nolvadex. Seeing if this helps, doesn’t seem like it, and if not probably gonna hop on TRT or something, not sure yet.

28

So after I started Clomid at 25mg/day, my doc got my testoserone and stuff tested again. I have to say I’m feeling better, though I still get mentally foggy and stuff, and still a bit of trouble concentrating. Haven’t been having sex to know whether or not the ED’s going away, though I still don’t have much of a sex drive, but that could be due to my fairly high estrogen. now. Anyway, here are the lab results:
Lab results 7/1/13
LH: 24 mIU/mL (1.5-9.3 mIU/mL)
FSH: 22.5 mIU/mL (1.6-8.00 mIU/mL)
Total test: 1214 ng/dL (300-1080 ng/dL)
SHBG: 28 nmol/L (11-80 nmol/L)
Free test: 290pg/mL (47-244 pg/mL)
test Free %: 2.4% (1.6-2.9%)
E2: 91 pg/mL (<43pg/mL)

So my estrogen level is the only thing that concerns me. I’ve been on nolvadex 20mg/day for now, so I think that would hopefully stop any further gyno or anything like that, but that may also be stopping me from being 100%. So my question is, should I hop on TRT? If my doc gives me the option, should I do it? Will he give me the option? I’m thinking since I feel better already, but my estrogen is a bit high, if I had some arimidex while I did TRT it would help considerably.

Another question is, would this clomid “restart” or whatever lead to anything long term? could I come off the clomid and live with testosterone in similar amounts, or will it just go down once I stop taking it, which is actually today.

29

you need to lower that E2. I would get on an Ai as quick as

That’s a crazy high level of estrogen. Does your doctor not say anything about this?

Why no new thyroid labs?

Don’t just hop on trt man… It’s for life. You’re to you g for your doc to be messing with your hpta like this with lh and fsh this high desensitization is a worry.

Your lh and fsh were not deprived to begin with. I don’t get it…

30

I have an appointment next week on Tuesday to talk about the lab results. I stopped taking clomid today, so my estrogen should be coming down. I’m going to bring up the AI with the doc when I see him, but he also won’t order the thyroid labs for me and I’m kinda low on cash to be getting them from a private lab. I just got a job again, so waiting to start getting paid and I’ll have to see what I can do.

31

He won’t order the thyroid labs for me is a joke…

Bet he would for me… I wouldn’t except no … It’s your health and you don’t have to take his shit…

32

Your SERM dose is way too high, your LH/FSH is too high, leading to high T–>E2 inside the testes, AI cannot work inside your testes and can only reduce T–>E2 in peripheral tissues. AI not expected to work. Cut SERM dose by at least 50%.

There is a risk of LH receptor desensitization, a huge problem [induced degree of primary hypothyroidism.

Need an update on temperatures, iodine etc.

This is standard advice maintained here:

There is a huge amount of knowledge in the stickies. Please study these. Start with the advice for new guys sticky.

There is a lot to read there, so read carefully. There are suggestions for things that are root causes of low testosterone [T]. Low T is a symptom, not a root cause itself. But low T itself is a root cause of many of the symptoms one experiences. Note that other things cause the same spectrum of symptoms, so do not have T tunnel vision. Many docs are guilty of that and they only treat the symptom [low T] and do not attempt to find the real problem. If you go to a clinic that specializes in low T, you will get T tunnel vision for sure.

Post info about yourself as suggested in the above sticky. We need labs, almost all of your labs, not just hormones. We also need the lab ranges.

We see a very high number of thyroid issues in the population of guys that show up here. So there is a strong focus on that. Most people are iodine deficient to some degree. Your history of iodine intake from iodized salt and vitamins that list iodine is important. If you become iodine deficient, the RDA [recommended daily allowance] is inadequate for recovery of iodine stores. Please see the thyroid basics sticky for more information.

You do not want to suffer from subclinical hypothyroidism or get Rx thyroid meds to treat iodine deficiency.

If you are injecting T or contemplating that, read the protocol for injections sticky.

There are stickies for finding a TRT doc, estradiol [E2] and lab work.

Do not place your history or treatment details in the stickies! That belongs in your thread. Keep all of your posts in your thread so we can have a clear picture of your situation and needs.

33

Dude you always advise people to taper off a serm and land on an AI. If the E2 is inside the testies or not he still need the AI… What are you talking about?? Get the AI,you need whatever help you can get to bring down e2. Them get some good liver support items and read about foods that are good for your liver… You will clear the E2 eventually I hope.

Ksman you talk in circles sometimes… Make up your mind man

34

So I went back today for another appt, and he told me to do clomid 25mg every 2 days, and 10mg nolvadex a day. I tried to talk to him about my estrogen levels, but he said that they were fine and that it was more about the ratio than the actual levels. Also, no go on the thyroid labs, says it’s pointless. What should I do…

will update temp soon, but I’ve been taking iodine periodically. I did the replacement that was outlined in the sticky already though.

35

Ksman said cut the dose in half. What if u drop the clomid and just run nolvadex now??

How long have u been on clomid and nolvadex?

your doc is hurting you more then helping you. No need for lh to be this high and could cause in repairable problems

36

I did clomid for a month. I’m not taking it anymore, stopped last week. Nolvadex for roughly 3-4 months I think. Started at 10mg 2x/day, then tapered to 10mg EOD. Then I went back on to 20mg/day. Now I’m just doing 10mg/day.

Should I just not pick up my clomid script?..I honestly don’t know what the hell to do anymore…I think my estrogen is really concerning, I don’t understand why the doc thinks it’s okay.

37

Wow… And all this dosing was from your doctor for this long??

I think it’s time to taper off or drop down to just Nolva and then taper off. Your body will take time to adjust but if you can get back to where you were E2 seemed to be ok before.

I am not a doctor I’m a dumb ass who listened to doctors just like you :slight_smile:

I hope someone can give you some answers your looking for bud.

What is the doctors end plan anyways

38

he says he wants to keep me on clomid long term…I think that sounds retarded. He says it’s better than testosterone long term because test can sterilize me, and since I’m 19 that’s not a good thing.

From he was saying, he says I should be doing clomid for a while longer, then come off and do nolvadex for a while, and taper off that…but that’ll just put me back to the beginning which is retarded. I’d rather be on test long term than clomid first of all, but he says that he wouldn’t do that because I clomid worked.

39

I guess on the bright side, I have a lot more energy during the day. rarely get tired unless I’m doing something that takes a lot of energy.

on the flip side, pretty much no libido. Last few times I even masturbated were just because I was bored and was trying to kill time.

40

Alright that’s enough master nation talk lol

Why not get off an figure out what’s wrong?

You’re to young for this shit