I was a month in on a PCT after being on TRT (hcg/T/ana) for several years and had these labs:
LH: 7.5 (1.7-8.6)
TT: 330 (264-916)
This was during a PCT (clomid 25mg EOD). Before that I was on TRT and used HCG 250IU 1x-2x/week. Clomid ended up giving me the worst side effects so I got off and now I feel terrible and flatlined. I do not believe I can use Nolvodex due to me being on Mirtazapine and risk of drug interaction (long-QT prolongation).
I never had initial LH/FSH labs, wondering if this is ample time for my testicles to recover or the low T output and high LH simply mean my testicals haven’t recovered. It’s been two weeks since I stopped Clomid and I have a dull ache in my left testicle and also feel depressed, fatigued, and just generally bad.
I’m 28 y/o and ideally would like to get to get a root cause diagnosis. TRT ruined a lot of my relationships. I know a lot of guys here disagree, but my E2 while on TRT was always between 22-25 and I was simply hyper aggressive and impulsive when I needed not to be. Most likely I will get back on TRT, but if I can figure out the root cause I’d rather be off.
@KSman?
KSman retired from T-Nation.
Your LH should be more than enough to be seeing optimal testosterone, but your testicles are just not getting the job done and I expect testosterone to decline in dramatic fashion once clomid is stopped.
The fact that you are experiencing testicular aching is a sign LH has decreased already. The hyper aggression and impulsivity may not be from the testosterone and/or estrogen levels, sure it might help it along, but perhaps this is neurological and the hormones are feeding it.
The HCG could have been easily been causing these mood problems because some men cannot tolerate HCG at all. The cause of your hormonal problems is clear, your testicles are underperforming and there is nothing you can do about it short of a testicular transplant.
When my testosterone and estrogen levels were excessive, I was hyper aggressive and impulsive. You say your estrogen was only 22-25, maybe this is a little high for you. Don’t assume just because your levels are in range that this is anyway translates to normal for you.
What did your TRT consist of? Protocol? What was your reason for starting TRT in the first place?
On the HCG, was it 1x or 2x? You can’t approach HCG injections the same way you approach a rep range lol. If you were injecting 250IU, you should have probably been injecting more frequently, and for sure more consistently. That’s about half of what a recommended dose is using a 3x / week protocol, so if you are only injecting 250IU “1x-2x per week”, then there’s really no benefit. Why even bother?
Sorry to hear about your situation.
Did you ever get a medical diagnosis of hypogonadism before starting TRT in the first place? If not did you had symptoms of androgen deficiency? Genetics ever done?
You were either hypogonadal before starting TRT (already towards primary) or - the existence of which many here simply ignore or deny - have permanent testicular failure due to long term TRT. Its rare, but the longer someone stays on TRT, the higher the chances are.
If you were consistently injecting 2x 250 IU per week then your intratesticular T should have been high enough to prevent testicular shrinkage and failure (hCG has a half life of 2-3 days)
I guess you will end up on TRT again. Make sure to stay within the ref range to control the other side effects that you experienced (agression). Many here will tell you, that you need to be at the higher end or above but thats just lacking scientific merit.
When it comes to fertility it might be a tricky one. If you dont improve naturally or on Clomid/Nova then testicular sperm aspiration (TESA) combined with IVF might give you an option.
@johann77
I thought you left? Welcome back
What did your TRT consist of?
It was supposed to be HCG 500iu 2x/week, but instead I did lower amounts and less frequently for manybe six months. Before that I was doing something closer to 250IU 3x/week. Then 80mg T-Cyp/week in divided doses, and 0.1mg anastrozole (I’m an over-responder) 2x/week.
What was your reason for starting TRT in the first place?
I had severe fatigue. I saw a naturopath who put me on the cream. I did some online research and decided against cream and got on injections. Then I realized it was too late for initial FSH/LH labs so I stuck with the protocol. I don’t know if it’s too late to recover my testes with HCG, I never noticed them shrink or had any physical symptoms that made me worry.
@johann77
ever get a medical diagnosis?
I had 250TT on my initial labs which lead to TRT before I could get LH/FSH labs my doctor didn’t know to test those. Genetics? I’ve had 23&me as well as genomind…not sure what you’re referring to in regards to TRT.
permanent testicular failure
Is a month on clomid sufficient? Perhaps my testes simply haven’t recovered yet? I was doing 250iu EOD for the first couple years and I was only bad with my HCG usage for ~6 months at 1-2x/week. I didn’t visually see shrinkage.
I guess you will end up on TRT again
Yeah…things are headed in that direction. It’s not the end of the world, but it’s scary to not know the cause. I recently had surgery for severe sleep apnea and I was thinking the cause could be: stress → weight gain → sleep apnea → more weight gain == HPTA suppression + aromatization - I’ve found studies that obesity (I’m 5’11" and weigh 200lbs) suppresses HPTA through inflammatory cytokines (IIRC) as well as through E2 conversion. I did not have low T symptoms when I weighed 160 lbs. But at this point I guess my focus is on the possibility of recovering my testes.
So you really don’t know if you were originally primary or secondary?