26 with Low Testosterone

Pharma / TRT Testosterone Replacement
1

Age-26
Height-5-5
Waist-32
Weight-155
Current medications- test.cyp200mg half ml every week.,megamen sport,vitaminC,B12,Fish oil,

Seen doctor for symptoms of low testosterone
Lab Results 8:38 am

Chloride-104, mmol/L, (98-107)
CO2-32.3, mmol/L, (21.0-32.0)
Calcium Lvl-9.1,mg/dl, (8.5-10.1)
Glucose Lvl-67,mg/dl, (74-106)
BUN-15.0,mg/dl, (7.0-18.0)
Creatinine-1.20,mg/dl, (0.60-1.30)
eGFR-AA- >60,ml/min/1.73 m2
eGFR-NAA- >60,ml/min/1.73 m2
Bili Total- 0.9,mg/dl (0.2-1.0)
Bili Direct- 0.17,mg/dl (0.00,0.20)
Bili Indirect- 0.73,mg/dl (0.00,0.80)
AST- 19,unit/L (15-37)
ALT-39, unit/L (30-65)
Alk Phos-116, unit/L (50-136)
Total Protein-6.9, gm/dl (6.4-8.2)
Albumin Lvl-4.40, gm/dl (3.40-5.00)
Globulin-2.50, gm/dl (2.40-3.50)
A/G Ratio-1.8, ratio (1.1-2.0)
Total Test.-195.4 ng/dl (241.0-827.0)
Vit.D 25 OH-28.67 ng/ml (30.00-80.00)

After I received the test results he offered me testosterone but I had mentioned me and wife were thinking bout having another kid later on so he sent me to an endo. which took 2 months and he did more blood work at 10 am.

ACTH, Plasma-9.7,pg/ml, Flag 1, (7.2-63.3)
Cortisol-4.6, ug/dl, Flag 1, (2.3-19.4)
Cortisol AM (6.2-19.4)
Cortisol Pm (2.3-11.9)
IGF-1-252, ng/ml, Flag 1, (75-275)
LH-2.2, mIU/ml, Flag 1, (1.7-8.6)
T4,Free(Direct)-1.57, ng/dl, Flag 1, (0.82,1.77)
Testosterone,Serum-228, ng/dl Flag L, (348-1197)
Testosterone,Free-9.48, ng/dl, Flag 1, (5.00-21.00)
Free Testosterone-4.16, %, Flag 1, (1.50-4.20)
TSH-.56, uIU/mL, (0.34-4.82)

During those 2 months I took Tribulus trying to help sex drive without messing with my labs, he then prescribed me Chorionic Gonad 10,000unit for 1,000 units IM twice weekly. I took but after about the third shot I was hating it cuz of estrogen, so I stopped for a week until he prescribed tamoxifen 10mg tabs then finished. which he kept cancelling my appts. and i was always tired and foggy, and didnt wannna eat so i went back to doctor and I decided to just start my testosterone. I was given test. cypionate 200mg/ml to take one ml every two weeks, after my 2nd shot i called cuz still nothing was happening so he said to take half every week which helped my focus but still no energy, sex drive anything. so i would appreciate the advice if anyone knows. I am currently on 4th pin and tried taking tamoxifen daily also from the endo. but still no diff. I have refills on HCG and tamoxifen too, any suggestions on labs or what is happening? should I be gettin more test or taking more often?

10

2

Please read these stickies:

  • advice for new guys
    – provide more data about you
  • protocol for injections
    – hCG dose was way too high, stupid!
  • thyroid basic
    – check your oral body temperatures, waking and mid afternoon

You might be a bit hyperthyroid. But signs are vague. Please describe your use of iodized salt over the years. Were you using a vitamin product for years that contained iodine? Does your throat seem thick where your thyroid gland is? Symmetric? Lumpy? Doc palpates your thyroid. Ever feel a discomfort there?

It would have been good to have AM cortisol done at 8AM. Describe stress levels and how you react to major stress events.

LH is low, but changes so much from hour to hour, it is sort of useless. Really need FSH as its longer serum half life is a much better indicator of what is going on. When contemplating why your gonadotrophins might be low, we need to look for things that will suppress your HPTA. So your labs should have included E2 and prolactin. Now that you are on TRT, that diagnostic window is closed.

We can infer from your TT and FT that your SHBG was lowish and E2 was then probably not causing your issues. That leaves prolactin. With young men, prolactin should be tested a possible cause. High prolactin can be a symptom of a pituitary adinoma. If prolactin is high or high-normal a MRI is used to determine if there is an adinoma. If found, easily managed with 0.5mg/week cabergoline/Dostinex.

Please read the stickies. It is a big learning curve. You can’t be passive about these things as your doc have already mismanaged your case. Come back with questions. Please address all of the requests for more info in this post.

3

yea my Prolactin Lvl-Arup-14.6, ng/mL, (2.1,17.7)
FSH-Arup-1.9, IU/L, (1.5-12.4)
LH-ARUP-4.8, IU/L, (1.7-8.6)
forgot these they were when I first got tested by doc., should I ask my doc to test for anything else or jus not sure why im still not feeling good, and I know my doc dont know too much either so id rather hear from you

4

With that prolactin level, there is some concern.

You have secondary hypogonadism. See above.

5

Just recently seen doc again cuz I am on my 8th pin and still tired all the time and not feeling like I should. Currently on aderal,clonazepam,test cyp., and same vitamins. Well the first two pins were every two weeks until i called to see if i can take every week, i then pinned half a c of 200mg every 7 or 9 days. After four pins like that I had seen him and told him there was still fatigue, real moody, and low libido still. Facial hair thick,grows fast, and recently have more body fat in the stomach area, only thing it helped was my focus and motivation. Dont have healthy diet jus recently started workin out few days a week. have testes shrinkage now. he increased my dosage to 1.5 every 7 days of 200mg test cyp. and i asked to have a my estradiol tested which he agreed to that and another total test. I went right after to do the lab of estradiol and results were on 3/7

Estradiol by TMS-Arup-54.8-pg/ml- (10-42)

Took whole c that night-3/7 and on 3/9 did Am TT results-

TT-1636.0 H (241.0-827.0)

after getting the labs back i requested arimidex or anything for estrogen and he said my levels were fine.
he said my test levels were too high which i noticed.

So my question is how can my TT jump that high while only on 5 c and if its that high why am i not feeling good. I think it is estrogen too high but im jus guessing from everything i been reading …Can someone please give opinions and answers cuz looks like ill have to get adex on my own if thats what it is.

and he also dropped me back down to 100mg every week cuz of high TT results…

6

I am 27 started TRT in Jan after my wife got pregnant, keep switching pin schedule couldn’t feel good for anything, I been on (200mg) Test Cypionate 1c every 7 days which I do .50 twice weekly I then started HCG 250iu EOD in April, after few weeks got a gland on my chest so started liquid Letro on may 10, 5 drops a night for 4 days until it went away then got off, had hot flashes like crazy so took 2 drops of liquid anastrozole, couple times but stopped, then my wife had miscarriage which is why I went do sperm check test recently because we want to have just one more kid.

well I got the results and don’t really know how to understand them but purchased some Liquid Letro 2.5mg/ml, Liquid Anastrozole 2mg/ml, liquid Clomiphene Citrate 50mg/ml, liquid Tamoxifen Citrate 40mg/ml, and still have 5,000iu’s of HCG not mixed, which was ordered, I was planning on taking a break after my apt. Thurs and doing a PCT to get my sperm back. Here are the results:
Hematology

-Date collected 5/24/2013
Procedure Units Reference Range

-Sperm Count 16L - Million/ML - (20-150)
-Collection Time 200
-Time Analyzed Semen 245
-Temperature Semen 23.0 - DegC
-Color Semen Grey/Opalescent
-Viscosity Semen Abnormal a (Normal)
-pH Semen 8.0 (7.2-9.0)
-RBC Semen None (None)
-Bacteria Semen None (None)
-Volume Semen 2.0 - mL (2.0-10.0)
-Morph Semen see below-T1,I1
-Motile Sperm see below-T2,I2

Textual Results
T1: 5/24/2013 14:00 CDT (Morph Semen)
Morphology
_71% of normal spearm
_27% of head defects
_2% of neck/middlepie
_% of cytoplasmic droplets

T2: 5/24/2013 14:00 CDT (Motile Sperm)
Motility:
_14% A: Rapid progressive motility. Greater than half a tail length/sec (20 um/s).
_5% B: Slow or sluggish progressive motility.
_17% C: Nonprogressive motility. Less than 1/8 tail length (less than 5um/s)
_67% D: Immotile
Motility Normal Range: Grades A+B = 50% Grade A = 25%

Interpretive Data
I1: Morph Semen
Reference Range for Morphology: >15%
I2: Motile Sperm
A reported result of decreased sperm motility may be due to either non-viable or non-motile sperm.

Collected date 5/24/2013
Collected Time 14:00 CDT
Procedure Units Reference Range
-WBC Semen 0 [0-1000000]

Now I did the test on my own cuz doc doesn’t know much at all, and to have a kid I’m seeing that I would have to get off for couple months or however long to get my sperm back. I was wondering if anyone had suggestions or advice on what to do, or how I should do a PCT, or procedure or anything would help. I also read that adding clomid would help on TRT too but don’t know if true neither my doc and cant afford to see endo. again. anything would help thanks…