Can you provide insight? It would be greatly appreciated!
Bump.
Any and all help would be appreciated
Bump. Any help is appreciated.
Well I guess I’ll just use this as my log.
More bloodwork came back:
FT: 10.8 (5.05-19.8)
TT: 374 (240-950)
LH: <.5 (1.7-8.6)
FSH: <.5 (1.5-12.4)
Estradiol: <25pg/ml (8-43pg/ml)
Prolactin: 17.5 (4.0-15.2)
This was after 3 months of hCG EOD 500iu. After these labs came back, the doctor told me to bump the dosage to 750iu EOD. After 3 weeks of this, i started getting some very sensitive nipples and started struggling being able to pay for the hCG. So just today i requested to be switched to a different treatment. Will be doing 20mg Nolvadex EOD and labs in 3 months. Starting to get very frustrated by the whole thing and ready to just go to TRT, but i’ll try a SERM and see what it does i guess. I have an appointment for a doctor to get a second opinion. Will bring all my labwork and see what he says about them and my current treatment. Frustrated that 3 months of hCG only raised my test levels slightly:
8/2:
FT: 10.8 (5.05-19.8)
TT: 374 (240-950)
5/19:
FT: 7.51
TT: 289 (same ranges for both.
LH: 3.1 (1.7 - 8.6)
FSH: 3.7 (1.5-12.4)
Also noticed my LH and FSH has completely shut down, so i’m not sure what that means.
Diary… day 872…
Switched from HCG to Clomid because the HCG only slightly increased my numbers and when i increased the dosage it gave me nasty side effects of sensitive nipples. I’ve been on Clomid every other day (50mg) for probably 5-6 months now, i started in late august. Numbers started climbing significantly and i felt great in December/January/February. Then in March i started feeling like crap again. Low libido, low energy, no motivation, balls feel like they have shriveled up, and my progress in the gym has again halted. I lost 40 pounds from May or so (when i started HCG) through December of this past year. Since then i have stayed about the same, but i still have 40+ pounds to go. Feeling discouraged in the gym because i’m working my ass off and seeing little to no results. For a while there i felt the best i’ve ever probably felt in my life. I felt like a man. Idk if that makes any sense. But now i’m back to my mopey self. So i do a followup with my endo and she says that Clomid isn’t really a very reliable drug and it could just be tapering off or the body could be getting used to it. So she recommended we add an AI and see if that helps the T from converting to E in my fat. This doesn’t really make a whole lot of sense to me as my E2 levels have been at the lower end of the spectrum. She also prescribed that i take the Arimidex 1mg every day, which sounded really high to me. So i am doing .5mg every other day in conjunction with my Clomid dose. I just started this AI about 4 days ago and don’t feel any better yet. She also said that she thinks TRT would be my best bet and i should think about getting some sperm frozen. I have yet to look into that, because my wife and are aren’t exactly making bank and because if i’m fertile now, maybe it would make more sense to wait until after we are done having kids.
All of that being said, I have 2 questions to pose to the dark web… or maybe just myself since it seems nobody is responding to this.
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I would like some feedback on the Endo’s AI addition. I honestly don’t believe it will do anything for me as my E2 levels are already showing as low.
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Can’t TRT be done in conjunction with HCG or Clomid to maintain fertility? I’ve tried talking to my Endo about this and she completely refuses to do this and the only way she will prescribe TRT is if i want to lose my fertility.
Overall, I feel like crap, and although my numbers are better than when i first started Low T treatment (i also feel better than when i first started treatment), my numbers show that also. My LH and FSH is down, my test is down 200 almost. Is it normal for levels to fluctuate so significantly on Clomid when the dosing has remained the same? I have updated labs below, i have the dates Month/Year above the reults, i hope it makes sense.
@KSman any thoughts?
TESTOSTERONE
240 - 950 ng/dL
4/17 5/17 8/17 11/17 12/17 4/18
312 289 374 494 624 430
TESTOSTERONE FREE
5.05 - 19.8 ng/dL
4/17 5/17 8/17 11/17 12/17 4/18
8.42 7.51 10.8 10.9 13.1 9.89
LUTEINIZING HORMONE
1.7 - 8.6 mIU/mL
5/17 8/17 11/17 12/17 4/18
3.1 <0.5 5.2 5.5 4.0
ESTRADIOL
8 - 43 pg/mL
5/17 11/17 12/17 4/18
<25 30 26 <25
FSH
1.5 - 12.4 mIU/mL
5/17 8/17 11/17 12/17 4/18
3.7 <0.5 4.4 5.2 3.1
A doctor that doesn’t care about fertility, uh that’s the first clue your need another doctor. TRT together with HCG is very common, it keeps the testicles alive and functioning. It sounds like your doctor is behind the times and not up to date on her protocols.
Perhaps your insurance is the one refusing HCG and your doctor is just following protocol. You do not need an AI with those E2 numbers. However if you start HCG then that will change. We men have LH receptors all over our body and they are there for a reason, HCG mimics LH. It’s ok to replace testosterone when low, but not the hormones TRT drives down to zero? This makes zero sense.
Thank you for the response Systemlord.
Any idea how to find a solid doctor? I’ve seen the sticky posted by ksman and have tried 3 doctors. My PCP, a urologist, and currently an Endo. The urologist I went to after a while of being with my current Endo just for a second opinion apparently went to school under my Endo, so all he had to say was positive things about her and how she is the best at male reproductive issues in the area and agreed with her treatment plan. There are testosterone specialist “centers” or what-have-you in the area, but most have seemed very expensive. Any clues for finding another Endo or Urologist? And is one preferred over another? My current doctor is actually an Andrologist which is why i first went to her.
Thanks again
Recent update… I met with a new Endo last week and he was also very confused by my treatment plan and my doctor’s unwillingness to add any sort of TRT without freezing some sperm. He wants to start on me on a low dose of 200mg every 2 weeks of Test Cypionate. I’ve read that dosing that infrequently can result in mood swings and whatnot, so i’m planning on halving the dosage and administering weekly to try to make it more even. He has suggested i stay on clomid 50mg EOD and we start with the low dose Test and monitor my test results. He said no AI for now as my Estradiol was fine based on most recent labs. This appointment lasted well over an hour and he listened to my concerns… with him being the 5th doctor i’ve gone to for this, it was the first time a doctor has actually listened to me and my symptoms. He tried pushing the testosterone gel on me, but i’ve read a lot of bad reviews so i pushed for injections. Completely new to TRT, are there any posts you all can recommend as far as dosing, mixing, injecting protocol? I’m only familiar with hCG, is it similar? He said that it cannot be subQ, it has to be IM.
It would be easy to recommend a protocol if I knew your SHBG level, without it you’re kind of driving blindfolded going forward, your doctor sounds like another idiot who is way behind in androgen replacement. Whenever a doctor pushes for Gels it’s do to the $400 he gets for every prescription filled, remember he runs a business and the sole purpose of a business is to generate profit often putting the patient last.
He’s got to pay the bills and his mortgage, you understand. The 200mg every 2 weeks actually originally was a directive by insurance companies to save on healthcare costs, insurance doctors aren’t running their own show, insurance companies are making a lot of the hard decisions about treatment options and whether you even get TRT.
New Endo wanted me to get labs done to get a baseline (even after seeing my labs from the past 1.5 years, which is fine) and my numbers came back really high (in a good way) and i’m a little confused.
Total Test: 818 (250-1100)
Free Test : 144.2 (35-155)
SHBG: 46 (10-50)
FSH: 7.3(1.6-8.0)
LH: 7.2(1.5-9.3)
Estradiol was not measured but i demanded it for the next test so it will be on there.
Please note that this test was BEFORE my first pin of TRT. So this was when i was doing clomid EOD in a slightly elevated dose. So for example M-50mg, W-75mg, F-50mg, SUN-75mg etc etc. Also was on the AI and i was doing .5mg every other day on the same day as the clomid.
All of this to say, I don’t feel a whole lot different than 3-4 months ago when my numbers were in the 400 range. I felt BETTER back in December when my number was in the 600’s. Erections are iffy, morning wood is gone, mood is mellow, etc. I’ve read that some men on clomid don’t feel a lot better even when their number is pretty high. The only variable here is Estradiol and i’m not sure where that would have been.
These labs were drawn 5/26/18 and my first pin was 5/29/18 and my second was yesterday each at 100mg. Still doing clomid in the same dosing, but again new Endo requested i drop the AI until we see where my levels are at in August.
You shouldn’t drop the AI without knowing where E2 is at, that’s dumb!
Hello all, just writing an update.
Updated synopsis:
Endo prescribed Test Cypionate 100mg every 2 weeks in conjunction with 75mg clomid EOD and discontinued the AI. Labs 7/20/18: total 528 (250-1100), free 63.1 (35-155) Estradiol 24 (<39).
Bumped dosage of Test Cyp to 100mg every 10 days, still on clomid 75mg eod. Labs 9/5/18 total 589 (250-1100), free 59.9 (35-155) SHGB 47 (10-50) Estradiol 18 (<39). Upped dosage of Test Cyp to 100mg every 7 days.
I’ve been on Test Cyp 100mg every 7 days for about a month now. I honestly feel unchanged. Libido has definitely gone up since starting TRT, but my ED has gotten worse. No random erections throughout the day as I had before TRT. Still holding onto fat very easily and muscle gain is difficult.
I have a couple of questions and please anyone who has knowledge, please contribute. The Testosterone doesn’t seem to be increasing my test levels. Why would this be? I understand that TRT takes a while to take effect but I thought I would have some kind of noticeable results by now. Would the answer be to keep upping the dosage? My numbers were better on Clomid and AI, but i didn’t feel spectacular.
Also, the latest is that I’ve moved to a different state across the country, i’m hoping to find a doctor soon here and continue treatment. Again, any suggestions or input is greatly appreciated.
Injections once weekly is as far from idea as one can get, levels peak within 24-48 hours and by the end of the week levels are low, this is why your levels are low.
You need to inject your doses twice weekly to maintain stable levels instead of having your levels bounce around the range in between injections. This is why you feel nothing, because your levels never stay elevated long enough to reap the benefits of TRT.
Show this study to your doctors, figure 1 shows what happens after 6 days, levels drop below optimal. Remember estrogen drops as well.
12 Year-Old Study That Proves Testosterone Injections Every Two Weeks Fail
Systemlord,
Thank you for your continued contribution and input throughout my journey, it is much appreciated.
So when injecting 2 times a week is that a compounding effect? Let me better explain my question… After injections (once a week right now) I don’t feel any different on day 2 post injection than I do day 7 post injection. Am I supposed to be able to tell a noticeable difference 24-48 hours after injections? Because if that is the case, then maybe testosterone just doesn’t work with my body for some reason. Do you think halving the dosage and pinning 2x a week (thinking sundays and wednesdays) will change this? Thanks again for your help.
New appointment with a urologist at my new state of residence is scheduled for 10/15 hopefully this doctor will listen as much as my last.
Once you’ve had stable levels without fluctuations in between injections, you will start to feel the effects of TRT, but first gene expression must occur and tissue must be repaired, then you will feel the effects of testosterone. Increasing the dosage is the wrong move if your levels are sufficiently elevated.
If you have low thyroid hormone you will feel nothing from TRT, in fact you may feel worse. Urologist and endocrinologist typically don’t have much knowledge in sex hormones as you have already found out.
Most doctors have no knowledge and are just following guidelines which are outdated and haven’t been update in quite awhile. That’s why you were on Test Cypionate 100mg every 2 weeks, and that 12 year old study just goes to show you outdated the guidelines really are.
A Urologist and or endocrinologist is the last place I would go for hormone replacement therapy! I would seek private care of someone that has more experience replacing hormones.
An Endocrinologist put me on trt and a urologist is managing it.
An Endocrinologist is the first Dr a young man should see when they have a hormone issue. It is very complex.
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Update on new urologist… he seemed to really listen and know what he was talking about (probably best doctor so far although a little too cocky for me). He didn’t like the idea of me being on TRT and recommended slowly tapering off and switching to HCG+AI. He stated that he’s pretty confident my side effects with sensitive nipples was due to high estrogen aromatizing. He prescribed 750iu HCG EOD + .5mg AI EOD on injection days. I also told him that i’ve never had a full thyroid lab done and he ordered (i think) T3, T4, and then the rT3 (or rT4) i’m not as familiar but can look later.
I think he has a really good point with my previous issue with sensitive nipples and HCG, i’ve learned a lot since then. I honestly felt best on HCG (other than that side effect). I think adding the AI could really help and also resolve my fears about losing fertility.
My main concern is jumping back and forth between treatment plans and not giving my body time to adjust. I’ve been on TRT maybe 6 months now and only a few weeks doing 100mg every week and about 2 weeks of switching to 50mg 2x a week instead of 1 pin a week. I’ve decided to continue my current treatment of TRT+clomid+AI for the time being and go to another doctor for a second opinion. I really did like this doctor and i’m not against staying with him, just undecided on how to move forward.
Damn! That is no good! I can’t elaborate at the moment maybe someone else can
Can anyone expound on @charlie12’s comment? is .5mg eod too high?
@rb1234, your case are very interesting, I have the same problem with my sensitive nipples when I use testosterone in a cycle with hcg + anastrozole, what I do is change the anastrozole for letrozole 1/2 pill every other day (1.25mg ) … And things went well
I remember the first time I used anastrozole I used .5mg EOD and my nipples were still very sensitive I had to increase the dose to .5 ED and better a little :(, but when I changed to LETROZOL things changed, I really do not know.
I hope my friend can find the solution to your problem.
God bless you.