My Story and a Couple of Questions

Pharma / TRT Testosterone Replacement
1

Hi All. I’ve been reading threads and the stickies on this forum, as this topic is near-and-dear to me. I thought I would chime in with my own back-story to precede a couple of questions…

I am 35 years old today, and I basically have never had a hard time putting on decent muscle mass and maintaining very good strength for my size (bench is circa 375 x5 presently, and was around 325x5 in college. Played college football, the whole nine yards).

At 25 I moved to a new city and started a new job as a programmer. Over the course of that year my weight went from around 208 to 230. Most of that was due to a sedentary/party lifestyle (on my ass all day at work…lifting twice per week was the only real exercise I did. Drinking like a fish on the weekend and eating like crap all the time was the norm).

Somewhere between 25-31 my libido all but disappeared. My erections became very weak (barely enough to get off from masturbating…let alone allow for sex). I also started feeling very fatigued all the time, and very moody.

I finally saw my GP, who ran some blood tests and an MRI. Long story short, it was discovered that I had a prolactinoma. My prolactin levels were through the roof, and my T-levels were in the mid 100s. This was always confusing to me, as I never really displayed physical symptoms of low T (my testes were of normal size, as I said, my strength and musculature were well above average, I am a hairy mofo, etc.)

I was referred to an endo, who put me on cabergoline. I then went to work in the gym and at the dinner table and managed to cut down to ~200 @ 14% bf. I felt a million times better between the lost weight and getting the prolactin under control. My libido improved as did my erections…though they never felt 100%, and ed still occurred at the worst possible times.

Last year (my last checkup with the endo), he discosed that my T-levels had only crept back up to the mid 300s but they were pretty much stable. He also let me know that I was anemic (the good news just kept coming). I decided not to pursue TRT at the time, thinking that I did not want to be dependent on it, and that I could manage at this sub-optimal level of T.

Well, my annual checkup with the endo is coming around this week. I have printed out a couple of the stickies to take with me to the checkup, as it’s my intention to ask to be put on TRT, as I have decided that ‘managing’ things where they currently are is just not acceptable any longer.

I seem to be fatigued an awful lot. My erections are all over the place: I’ll still get morning wood, or the occasional stiffy just sitting at my desk at work, but ED still pops up frequently. Even while having sex, I’m nowhere near as sensitive as I should be, and I barely feel anything…which leads to a loss of erection.

That has ruined one relationship already, and may be ruining a second. It seems everything has to be ‘just right’ for sex to occur without any problems (usually in the morning/afternoon, well-rested, absolutely no alcohol within the last 48 hours, etc.). unfortunately…‘sexy time’ occurs all-too-often at night when I am feeling rundown, or after drinks have been imbibed.

Workouts are fine/great…as they always have been. I don’t seem to have any issue either cutting or putting on mass (currently around 185 after trimming down). But that damned fatigue and sexual dysfunction are absolutely killing me. Even cialis seems to only work intermittently.

I can’t help but believe that going on TRT and boosting those T-levels will make almost all of this go away.

OK, there is my life story, now a couple of questions:

1)What are the chances the endo lets me inject at home? I will do office visits if necessary…even if that means twice per week, but it would be so much easier if I could do this at home.

2)The three main items (test cyp, hgc, arimidex) I will need seem to be readily accessible online (internationally in the case of the test cyp). Am i mistaken in believing that I could acquire all of them (and syringes) on my own, should I ever lose my insurance or move away from my current residence?

3)After I begin TRT…how quickly should the sexual issues start to resolve themselves?

Your help is much appreciated!

-Chris

2

I’m no expert in hormonal issues, but I do know that there are a host of things that come into play that can affect ED and libido in general. I assume your prolactin levels are under control now? TRT can help libido for some, but is not by any means a magic bullet for all symptoms. If you have not done so, get a full blood panel done and post results so that others with more knowledge than myself can assess.

As to your questions:

  1. Most doctors with any knowledge about TRT will allow you to inject yourself after some training. Twice per week doctor’s visits will get old fast, and the copays could add up quiclky.

  2. I don’t understand this question. If you are seeing a doctor for TRT and he/she perscribes these medications, you should be able to get them filled at any pharmacy. Most states will allow you to purchace syringes without a script, others will require one.

You cannot acquire these medications legally without a doctor’s perscription (at least in the US). Most insurance plans will cover all but possibly the HCG.

  1. As I said before, TRT may or may not solve all of your problems.
3

[quote]pcdude wrote:
I’m no expert in hormonal issues, but I do know that there are a host of things that come into play that can affect ED and libido in general. I assume your prolactin levels are under control now? TRT can help libido for some, but is not by any means a magic bullet for all symptoms. If you have not done so, get a full blood panel done and post results so that others with more knowledge than myself can assess.

As to your questions:

  1. Most doctors with any knowledge about TRT will allow you to inject yourself after some training. Twice per week doctor’s visits will get old fast, and the copays could add up quiclky.

  2. I don’t understand this question. If you are seeing a doctor for TRT and he/she perscribes these medications, you should be able to get them filled at any pharmacy. Most states will allow you to purchace syringes without a script, others will require one.

You cannot acquire these medications legally without a doctor’s perscription (at least in the US). Most insurance plans will cover all but possibly the HCG.

  1. As I said before, TRT may or may not solve all of your problems.[/quote]

Thank you for your time in answering my questions. Just to clarify:

-Yes, the cabergoline lowered my prolactin levels to where they should be.

-Well, I am not sure really what else to address with the ED. It seems to go hand-in-hand with the fatigue, occurs more frequently at night (when test levels are lower) than in the morning. The lack of sensation/sensitivity when engaged in intercourse also seems be a symptom of low test levels from what I have read. I’ll be sure to question the endo about my e2 levels at my appt. as well.

4

If low T has been a problem for awhile, TRT may not instantly work. Also, make sure your endo will even treat test levels > 300ng/dl. Endos are notorious for their conservatism. It sounds like your GP was willing to prescribe; they may be more open to treating low testosterone and “patient education” than your endo.

Don’t be discouraged if the endo says no or has archaic knowledge. Hypogonads make up a teeny tiny proportion of
their daily patients. Endos are responsible for understanding a VAST amount of knowledge. They have to understand basically the intricacies of every organ in your body. Make sure you describe symptoms that are unique to Low T. More likely than not they will be anti-TRT and will try to avoid it at all costs. Avoid describing mental symptoms: depression, anxiety, fatigue, etc. You will most likely get a prescription for Zoloft. Focus on physical things: slow beard growth (shave the day you go in), weak morning erections, poor muscle growth, not being able to work out like you used to, fat growth in your belly. Basically, things that your doctor can’t blame on “It’s all in your head”.

I would also HIGHLY recommend a urologist. It is my personal experience they are more aggressive.

5

^^ My endo is a reasonable guy. He actually asked me last year if I wanted to do the shots or androgel…but I declined at the time.

6

10-4. Haha, your screenname is so depressing.

7

^^ Haha, I know. It is semi-sarcastic…though during times when I am feeling down (or have some sexual issue) that is exactly where I feel my life is headed.

8

Blood tests first - then treatment options.

A complete blood work up per the BLood Test Sticky is imperative. It can cut years off of your HRT journey if you can find the source of the problem early on.

most docs seem to be against self injections, but you need to stay away from biweekly at all costs.

you can try Transdermals - they may work for you.

it all depends on what the blood tests show.

9

I feel like I’m talking to myself. I really used to feel just like you. You really need to not put pressure on yourself, like I did. It’s a horrible thing and it manifests itself into depression and probably makes your ED not only organic but also psychological in origin. Easier said than done, though, right?

One thing that helped me was I told myself I wouldn’t quit until I solved this or I got too old. I have like 3 or 4 doctor appointments set up already and if these don’t work out, then I’ll set up 3 or 4 more.

I wish you the best of luck.

[quote]Downward_Spiral wrote:
^^ Haha, I know. It is semi-sarcastic…though during times when I am feeling down (or have some sexual issue) that is exactly where I feel my life is headed.[/quote]

10

Get the proper labs. You need FT and E2 as well as TT. Check thyroid as well.

11

Just wanted to update this story…

My endo was mostly cooperative. He saw no problem with me going on 100mg/week Test-E self-injected (I am splitting this dosage into two Monday/Thursday 50mg shots), along with 1g of Arimidex per week (.25 EOD). I brought in some of the stickied information from this site, and he read over it briefly with an open mind and agreed with the majority of it.

The HCG he was hesitant on and asked that we try the test/arimidex combination first, and if I could bring in some more convincing information regarding the HCG, he would consider it. He was, admittedly, mostly ignorant on the subject of HCG and just did not feel comfortable prescribing it.

I counted myself lucky, and accepted his decision. I then went home and promptly ordered HCG online myself, and am injecting twice weekly, 250IU.

About 6 weeks have passed since this started and I have to say that I feel great. Overall, just night and day from where I was. I may sound greedy, but I hope things continue to improve. My sluggishness and lethargy are pretty much gone. My appetite has increased tremendously, but apparently so has my metabolism (eating more, but getting leaner).

Most importantly, my libido/erections are MUCH improved (nocturnal/morning erections every day/night as well for the first time in years). I would say that I am about 75% of where I want to be in that department. I had my first labwork done yesterday since starting TRT, so hopefully that will give me a little feedback where I can dial things in a little more closely, and try to get closer to 100%.

From all that I have read, E2 seems to be the biggest issue with erection/libido-related issues, so I will ask to have my arimidex dosage tweaked up or down (or maybe not at all) depending on the test results.

The only issue now is that it seems even having 2-3 beers once a week, and I feel a bit ‘deflated/flat’ until my next shot. I am not a big drinker at all anymore (maybe every other week I will have those 2-3 beers), but I am considering just swearing off alcohol altogether.

At any rate, I just wanted to update this tale, and thank the forum for the information.

12

great to hear. Thanks for the update. Keep us posted if you can.

did you ever test or treat your Thyroid or Cortisol?

13

Before jumping on TRT I would rule out many other factors as your cause

  1. lifestyle.
  2. sleep patterns
  3. nutritoinal content of diet
  4. current supplements you are taking may be not getting properly assimulated
  5. Environmental exposures - seeing more and more people with heavy metals and xenoestrogens
  6. liver congestion - there are many different pathways in the liver and one may be not working properly
    example (Phase 1 and phase 2 detoxifcation imbalnace) - i see this commonly in hormone and estrogen related issues. Could be genetic as found in my self. (methylation, COMT deficits
  7. thyroid, adrenal, e2 imbalances - this is commonly over looked by MD’s and they only treat by labs not how numbers feel. Find a good DR or ND in your area that is open minded about looking for the root cause.
  8. soy or diary comsumption. - excessive of either can cause hormonal fluctations in different levels not just testosterone, estrodial.
  9. iodine deficiency is running rampamts.
  10. vitamin D 25 oh - optimal levels are 70-90 best health benefits
  11. look at the emotional and mental well being past and present to identify if there was a trama in the past that could have induced cellular stress which was just hidden. Alot of people with hormone issues have had an emotional trama or physical stress in the past about 3-6 months prior to having the symptoms. I try to look for reasons why you are feeling like this and remove or identify the stress if possible then support with nutrition, herbs, or medicine if necessary just to act as temporary bridge till body rebalances it self if it is possible.
14

^^^ My issue was the prolactinoma that was diagnosed several years ago. I’ve been on cabergoline since, and the prolactin levels did recede to normal, but the test never quite made it back to where it should have been.

15

[quote]PureChance wrote:
great to hear. Thanks for the update. Keep us posted if you can.

did you ever test or treat your Thyroid or Cortisol?[/quote]

Both were tested at the time my prolactinoma was discovered, and both were apparently in ‘acceptable’ ranges. It was, however, discovered that i was anemic to some degree. I supplement everyday with D3, B12, Fish Oil, Zinc and Iron.

16

OK, “normal” is a bad work and now “acceptable” is bad too. You need to seek optimal if you can.

http://jcem.endojournals.org/cgi/reprint/90/5/2595.pdf

17

[quote]KSman wrote:
OK, “normal” is a bad work and now “acceptable” is bad too. You need to seek optimal if you can.

http://jcem.endojournals.org/cgi/reprint/90/5/2595.pdf[/quote]

Thanks for the document, KSman. I’ll definitely bring this along with me to my next visit.

18

Also check out my post: Sombebody Please Help Me - Testosterone Replacement - Forums - T Nation

In the post I listed some things that I take over-the-counter that boosted my T levels up to 450. Might work the same for you.

Heck, will save you the trouble. Here’s the snippet:

2000mg Vitamin C, 100mcg selenium, 30mg zinc, 2mg copper (do NOT take more than 30mg of zinc!), 350mg magnesium (try “natural calm”, back off once you get the shits), 1000IU D3, B vitamin complex, also I take Udo’s oil for Omega 3 and Udo’s probiotics. I also spend about 30 minutes in the sun without my shirt (very important for T production). WITHOUT this regimen my testosterone would be flagged LOW on the blood tests (200ngml), but WITH this stuff, my T goes to 450ngml. Keep in mind, this is AFTER my nuts shut down from HRT.

I’d like to point out that I have repeated my blood tests many times (going on and off this regimen) over the course of a year - it does in fact work. I cannot pinpoint which things are most important, they all have almost equal importance in getting my T levels up. When I take away any one thing, my T goes straight down.

I know a couple other guys who tried this and it worked for them as well.

In light of the stuff I’ve gone through with my own health for the past decade, and all the experimentation I’ve done on myself, I’d like to name this regimen “Richard’s Regimen” and I would like it to be known as such :slight_smile: I realize some parts are similar to ZMA, but that ZMA stuff did not get my T levels up like this regimen does (although ZMA is still good, not saying otherwise).

Also I have another trick. For anyone who dares (I will not be responsible for your health in case you get sick); try rubbing a few hundred IU of vitamin D3 oil on your scrotum. Then retest your Free T after a few days!

(there was a study that indicated direct sun exposure to the scrotum can increase T by 300%. I have the refrence somewhere, will have to look for it.)

Anyway. That’s enough from me for now.

19

“direct sun exposure to the scrotum can increase T by 300%”

Ehh, can I use sunscreen?

20

[quote]aur462 wrote:
“direct sun exposure to the scrotum can increase T by 300%”

Ehh, can I use sunscreen?[/quote]

That’d be cheating! LOL :slight_smile: