TRT? Exhausted all other options

Pharma TRT
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I’m feeling very stuck. I tried multiple sources and clinics. But mixed response

Looking for a bit of clarity/second opinion/testimonials.

40 year old male 6’0 185 lbs

Follow bodybuilding split/diet/macros for over 10 years.

Don’t smoke/drink.

Sleep well, low stress etc.

**Trying to emphasize that I’ve really went out of my way to get several blood tests over the past 2 years, make many small changes, research etc to try and naturally boost or help myself.

Been taking**: Zinc chelated ,Magnesium,Vitamin D, Creatine, Probiotic
**
Also taking (within last 6 months)**: P5P 200mg +vitamin E * This was due to higher prolactin (was 30. now 15) issue, after taking it for months, was able to lower prolactin to within range, helped slightly with symptoms.

*Boron 6mg x 2 *
*> > Just started this 3 weeks ago, at the advice of a knowledgeable coach, to help with SHBG, to possibly help free test. so far have not seen much results.

Symptoms: Extremely low libido, low mood/no motivation, struggling to hold muscle mass, recovery in gym is terrible/weaker/no pumps, first time in my life, not happy to workout, developing more anxiety, find myself very sensitive and bothered by things I normally let go. Morning wood, 1-2x per week, weak erections, mostly feels related to no libido. In general, I feel defeated.

Check bloodwork. Substantial drop in 3 tests over 6 months. Zero changes or impacts on lifestyle.

Clinic/prescription: After 2 separate assessments, I was given 2 opinions for how to go forward.

  1. Start TRT- 90mg week. .45 x 2 injections, with estrogen blocker after each pin.

2.Start HCG- Pregnyl 500 unit 2x week for 12 weeks, Use Arimidex 0.25 2x week day after injection.

I apologize if TMI, but I see from previous posts, that more info/detailed/researched is better responded to.

At this point I want to do what might actually help me

It’s affecting my relationship (no libido/mood) work (mood) gym(zero gains, look worse than i ever have, even tho following a really good split/push myself, proper diet/macros for bulking or cutting etc (been doing this a long time, i have this dialed)

I would like to note, that as far as sides go, I’m a bit worried about acne, as i’ve always struggled with it, and have gotten it pretty much under control the past few years, I am also worried about gyno (altho i know this low of dose for trt won’t matter, the HCG and aromatization might pump that estrogen which is already not good)I’ve tried my best to research what best course of action is, but its a flip flop of stories for HCG. Mainly I need to get myself sorted out and on course to improving, I do not want worse libido, or estrogen blockers to possibly make me feel shit, like i don’t want to have HCG not do anything, grind out 3 months of that, only to up the dose, or go on TRT anyways.

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Kids/fertility not an issue

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My advice is find another clinic, 90 mg per week and an AI, you’ve got to be joking! The majority of regular members here aren’t on AI’s.

TRT in isolation is the preferred route, at least in the beginning. You don’t want too many moving parts.

HCG can directly stimulate the LH receptors in the breasts, which can trigger gyno.

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Interesting. I have had zero patients report breast symptoms with hCG.

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Ya I don’t intend to take that AI. Figured I’ll keep it on hand.

But In terms of bloodwork.
I’m thinking TRT makes sense. I have higher SHGB. My LH is out of range already and free test is very low.

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500 IU twice per week isn’t much HCG and likely will have little effect on estradiol levels.

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That doesn’t mean hCG can’t trigger gyno by directly stimulating the LH receptors. A guy over on Excelmale right now is dealing with gyno shortly after starting hCG.

If the OP never had gyno up to this point in his life, he probably never will, even with hCG…

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TRT typically suppress the SHBG, which binds estrogen, however more weakly than testosterone.

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Of course it doesn’t mean that. I don’t know how you thought it could. In fact, the study I provided supported your statement. I stated I have never seen gyno from hCG. I did not say I have seen everyone in the world, except the Excelmale guy.

There was no intent to attack you.

Maybe this will be clearer: Based on my personal experience, men experiencing gyno like symptoms after taking hCG are rare, maybe very rare. Outliers for sure.

Here, do you want me to disagree with you? Based on the evidence I have seen (experience of the clinician), I think avoiding hCG because of a fear of gyno symptoms is silly. Based on the evidence I read (the literature), it is equivocal. Given a patient who would like to get his wife pregnant (the wants, needs, desires of the patient), I’d give it. That is evidence based medicine.

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I’d take 70-80mg twice weekly, dependent on your comfort/patience level. Good luck.

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