Do I Need T Injections? Half Success w/ SERMs and AIs

Pharma / TRT Testosterone Replacement
1

At the beginning, I would like to say hello, as this is my first post.
Do not come from English speaking country so please forgive me errors. Im 28 years old, I try to regularly train (weights, bike)

Within a short period of time I gained weight significantly. On top of that I was constantly tired.

My initial lab test:
T: 221,9 ng/dl(249-836) -5% below range
Estradiol: 9,93 (7,63-42,6)
LH: 3,09 (1,7-8,6)

The doctor diagnosed a secondary hypogonadism.
Fortunately, pituitary MRI showed no significant changes. The same for ultrasound of testis.

Doctor put me on 10 day clomid test (50mg ED)
After that:
T: 373
LH: 4,4
Estradiol was not rechecked

He than told me that I have low T because I am fat. He mentioned that it may be other way round but he cannot diagnosed nothing until I lose 30kg… I am trying to lose it all the time!

I was frustrated so I get clomid on black market and did longer - 30 day trial on my own (50mg ED)
After a month: (I changed the lab, so there are different references)
T: 16,7 nmol/l (9-38) 26% in range
LH: 5,63 (2-12)
E2: 52 (20-77)

Then I switched to Nolva 20mg ED + Aromasin (exemestane) 10mg ED
T: 18,2 (9-38) (more or less 520 ng/dl (269-1100)
E2: 19,5 (20-77)
LH: 7,6 (2-12)

To be honest i expected higher T from such doses. Especially if the fat was problem.
But even using AI and having E2 under control it seems I cant go above 30% of range.
Testis seems not reacting fully to increase in LH.

At the time I stop everything and I am thinking about next steps.
maybe i should give a try to HCG? But if problem is in testis that won’t help a lot…

Is it possible that my testis require more time to react properly on LH increase?

If you have any ideas, please share.

2

Your testes were exposed to high LH levels. There is no reason to expect that hCG would create a different result. Your testes simply are not working as well as you want.

At your age, we should be looking at causes to fix and not covering up the problem with TRT when low-T is a symptom of something else.

We see a lot of problems with low thyroid function and often from low iodine intake.
Have you always used iodized salt?
Are your body temperatures low?

Please read these stickies:

  • advice for new guys
  • thyroid basics
  • things that damage your hormones

Low T and low thyroid function can lead to weight gain. You can’t fix that by dieting. Low T sometimes leads to low thyroid levels and vice versa.

Low thyroid function affects every cell in your body. I do not know if that can lower LH sensitivity in the testes, have not seen enough data in cases here.

Do you feel better or different with Nolvadex VS Clomid?

3

KSman, what can he do to look for a cause if the testes are not responding adequately to ample LH? Aren’t teste the cause themselves?

OP, any case of varicocele? Or an sporting event impact to the area and such?

4

I changed clomid for nolva because I noticed strange pain of my eyes on clomid . Absolutely nothing bad on nolva.
I went through threads mentioned. I was not aware about iodine importance. Actually I tried not to use a lot of salt. As I don’t eat a lot of seafood maybe in fact I have significant deficite …
I will update my profile soon. Ill post all my lab tests results as I see now how complex it is and everything may be important…
(tests after nolva 20mg + aromasin 10mg ed )
Tsh: 0,841 mlu / l (0,27-4,2)
Ft4: 13,1 (12-22)
FSH: 3,15 (1-8)
Progesterone : 0,807 (0,2-1,4)
Prolactin: 11,4 (1,61-18,77)

I forgot to mention that during clomid/nolva treatment I felt kind of pain in my testes
It stop after few weeks. I thought it was a good sign. Didn’t notice change in size.
After few days off I noticed that pain started again. I am quite worried about it.

Thanks for your help.

5

[quote]Igs wrote:

OP, any case of varicocele? Or an sporting event impact to the area and such?[/quote]
Varicocele - I had USG few months ago - nothing found.

Don’t recall any impact. I used to cycling a lot (but rarely over 100km)

6

I discussed this. If LH does not lead to higher T levels, then there is a degree of primary hypogonadism and I also addressed the unknown of whether this might be thyroid related.

Are your body temperatures low? Are your body temperatures low?
Are your body temperatures low?
Are your body temperatures low?
Are your body temperatures low?
Are your body temperatures low?