Help with 7 Month TRT Levels, Fertility, Doctor

Pharma TRT
1

Hey guys,

I’m 26, 6’3" 185 lbs. 15ish% bf. I’ve been on TRT for 7 months after I finally got my levels checked because of fatigue, depression, no morning wood, bad erections, etc.

I’m having trouble because even after 7 months my levels aren’t where they should be, I still have most of the symptoms, though some are much improved, and I’m beginning to be concerned with my current and future fertility.

I was born with an undescended testicle and had pubertal gyno that was corrected surgically.

I had a sperm count last week that resulted in the doctor calling me back an hour later saying that it was so low he wanted me retested at an outside lab to make sure it wasn’t an error.

I’ve been on 60ml test. cyp. injected twice weekly, and on and off anastrozole. At some point I had a noticeable decrease in testicle size and ejaculation volume. My Dr. put me on HCG 250iu 3xweek. Both problems corrected but my levels were never checked. I was told I could only stay on a month before I would have to cycle off for a month before restarting. After discontinuing the nuts shrank again, etc.

I started TRT with low dhea-s levels(97 160-449ug/dl), was told to start supplementing, shot up to 800, was told to stop. Now down to 50…told to restart supplementation.

Labs time:

Pre-TRT LH/FSH

LH 2.3 1.7-8.6 mIU/mL
FSH 1.8 1.5-12.4mIU/mL

Test. and Estrogen labs were taken 1 month and 7 months after starting TRT.

Estradiol 19.3–>18.4 7.6-42.6 pg/ml
Total Test. 334–>647 280-1100 ng/dl
Free Test. 4.41–>8.23 1.9-27 ng/dl
SHBG 53–>55 10-80 nmol/l

Other Labs Taken at 7 months:

Pregnenolone 314 38-350 ng/dl
DHEA-S 49.5 160-449 ug/dl
t3 free 3.9 1.8-4.6 pg/dl
TSH 1.22 .27-4.2uiu/ml

I’m concerned that my symptoms haven’t corrected and that my levels aren’t coming up high enough. I’f I started at 4, then jumped to 8 free test. and want to be in the 20s, it seems like I have a long way to go.

How do I accomplish that without ending my chances at naturally conceived children?

I haven’t seen much to back up my doctor’s claims that anything over 1 month of hcg is counterproductive. How long is reasonable to use hcg while on trt?

Any other ideas to present to my doctor to get my test. levels up, fertility back to normal, etc.?

Thanks for any ideas

Michael

2

I have never seen anything indicating that hcg should be cycled off. This seems asinine.

Your levels are a bit low for being on TRT–you said “60 mL” twice per week, but didn’t state the potency of your Test. Is it 100 mg/mL or 200 mg/mL, or other?

It doesn’t look like the hcg is keeping your fertile. Some guys need HMG, which is very expensive. You could also try stopping TRT entirely until you conceive then go back on it. Neelydan, a member here, has a thread with such a method.

3

[quote]VTBalla34 wrote:
I have never seen anything indicating that hcg should be cycled off. This seems asinine.

Your levels are a bit low for being on TRT–you said “60 mL” twice per week, but didn’t state the potency of your Test. Is it 100 mg/mL or 200 mg/mL, or other?

It doesn’t look like the hcg is keeping your fertile. Some guys need HMG, which is very expensive. You could also try stopping TRT entirely until you conceive then go back on it. Neelydan, a member here, has a thread with such a method.

[/quote]

The hcg cycling seemed strange to me too. I didn’t have a sperm count or hormone panels run during my 1 month hcg “cycle”, but testicles returned to normal size as did pre-trt ejaculatory amount. I don’t know if that corresponds to increased fertility or not. I have no immediate need to produce children, but I’d like the option available.

My Test. Cyp. Is 100 mg/ml

4

Best idea may be to go back on the hcg and retest and see what happens. If nothing, maybe come off for a while and have some of your swimmers frozen.

5

Both your lh, fsh were borderline. Did you ever try a SERM or hcg monotherapy before jumping on test? If your boys are able to produce with more stimulation it might be an option for you? Or have you been diagnosed Primary?

Your lh,fsh look like they could do with improvement.

6

[quote]VTBalla34 wrote:
Best idea may be to go back on the hcg and retest and see what happens. If nothing, maybe come off for a while and have some of your swimmers frozen.[/quote]

Would you suggest raising the test. dosage as well?

[quote]iroczinoz wrote:
Both your lh, fsh were borderline. Did you ever try a SERM or hcg monotherapy before jumping on test? If your boys are able to produce with more stimulation it might be an option for you? Or have you been diagnosed Primary?

Your lh,fsh look like they could do with improvement.[/quote]

We never tried a serm or hcg only. We discussed clomid, but she felt like it wouldn’t get me to where I’d need to be and it would end up being a waste of time and money.

7

[quote]tmichael11 wrote:

Would you suggest raising the test. dosage as well?

[/quote]

Not if you feel good at your current dose.

8

[quote]VTBalla34 wrote:

[quote]tmichael11 wrote:

Would you suggest raising the test. dosage as well?

[/quote]

Not if you feel good at your current dose.[/quote]

I don’t. I wasn’t sure the protocol for jumping up. If I’m at 120 ml now, is 150ml the next step? 200?

9

[quote]tmichael11

We never tried a serm or hcg only. We discussed clomid, but she felt like it wouldn’t get me to where I’d need to be and it would end up being a waste of time and money. [/quote]

Yeah I know the story, a endo told me the same thing when I wanted clomid or hcg. She said my nuts will not produce and I will need test but she will not prescribe as I am not low enough.

Found another doc who gave me clomid. Short story is my test level went up 400% and went over range by about 30%. I also had very similar lh and fsh levels.

Wish I could slap the endo over the head with the results.

10

[quote]tmichael11 wrote:

[quote]VTBalla34 wrote:

[quote]tmichael11 wrote:

Would you suggest raising the test. dosage as well?

[/quote]

Not if you feel good at your current dose.[/quote]

I don’t. I wasn’t sure the protocol for jumping up. If I’m at 120 ml now, is 150ml the next step? 200?[/quote]

My doc and PA have jumped me up 20 mg at a time…I consider this too little and wish they would have jumped more…So at 120 mg, 150 is a good option, or even a bit higher.

11

I was bumped up to 200 ml test. cyp per week and 250 iu hcg 3x per week. I felt the best I had for years for a couple weeks, but I have seemed to have lost part of it. I went from having lots of energy to feeling fatigued. I’m having erection and sex drive problems that I haven’t had before. Dr ordered more bloodwork because of this but haven’t had a chance to discuss it with her. I have no idea why my estrogen wasn’t checked after doubling my trt dose and adding hcg.

6/29 tests:

dheas 213.4 160-449 ug/dl
TT 1068 280-1100 ng/dl
shbg 31 10-80
Test, Free 24.12 1.9-27
vit. d 58 >30 ng/ml

Tests from last week:

Estradiol 40.3 7.6-42.6 pg/mL
Prolactin 14.7 4.0-15.2 ng/mL
Progesterone 0.9 0.2-1.4 ng/mL

Is this an easy fix by just adding arimidex? My e2 went from 13 pre-trt, to 18 at 100 ml test. per week to 40. I am far from an expert but I think the erection problems and libido issues are probably because of the prolactin and estrogen. Any thoughts or guidance is really appreciated.

12

Yes address the E2, then if that doesnt help, look at prolactin. Did you masturbate or have sex within 12-24 hours of the test?

13

[quote]VTBalla34 wrote:
Yes address the E2, then if that doesnt help, look at prolactin. Did you masturbate or have sex within 12-24 hours of the test?[/quote]

No, nothing for 24 hours.

14

Ok my advice still stands.

Also, what were your DHT levels? This is important for sexual functioning.

15

[quote]VTBalla34 wrote:
Ok my advice still stands.

Also, what were your DHT levels? This is important for sexual functioning.[/quote]

I’ve never had DHT levels tested.

16

[quote]tmichael11 wrote:

[quote]VTBalla34 wrote:
Ok my advice still stands.

Also, what were your DHT levels? This is important for sexual functioning.[/quote]

I’ve never had DHT levels tested.[/quote]

And what do you intend to do to correct that?

17

Dr. put me on .5 mg arimidex 2x per week. I’m a little worried 1 mg/week isn’t enough for 200 ml test. + hcg. Blood work in 4 weeks to include dht.

18

DHT 46 30-85 ng/dl

19

DHT isn’t bad…not great, but not awful. I would focus on the E2, as it looks like you are doing.

1 mg/week is pretty standard, even if you are taking 200 mg test/week. The HCG may cause a bit more aromatization and may drive the need for more adex, but 1 mg is a good starting point.

20

estradiol 27.5 7.6-42.6 pg/mL