TRT or HCG??

[DAAS]

So im pretty sure im one of those people that just cant recover from a cycle. its been over a year and Ive gone through several bottles of nolva a bottle of clomid, a bottle of tore and a couple OTC PCT's. still have extreamly shrunking testicles and symptoms of low test.

I will post blood work later it on the very low end of the 'normal range"

Now what options do i have. Can they put some one on hcg? i would assume that would be for life as well?

[xelnaga]

Can you please share your cycle history?

[DAAS]

P6 black
epistane
hdrol
seemingly full or near full recovery.

9 week of test e @ 400mg a week
also ran Aromasin and hcg on cycle.

this cycle ended a year ago.....

[Lemonada8]

Post blood work when you can. It will help paint a better picture.

[bass]

also post your stats!

[dec11]

So im pretty sure im one of those people that just cant recover from a cycle. its been over a year and Ive gone through several bottles of nolva a bottle of clomid, a bottle of tore and a couple OTC PCT's. still have extreamly shrunking testicles and symptoms of low test.

I will post blood work later it on the very low end of the 'normal range"

Now what options do i have. Can they put some one on hcg? i would assume that would be for life as well?

why would you waste money on that?

[DAAS]

why would you waste money on that?

just simply because the Serms were not working for me, so i thought I would try them.

blood work is as follows...

prolactin 8.1 r 4-15.2

FSH 1.1 R 1.5-12.4

LH 2.1 R 1.7-8.6

Test Serum 315 R 249-836

I guess what im asking is Ive heard of people with low test going on HCG, but wouldnt that be life long as well?

[Lemonada8]

Your FSH and LH are VERY low! that is a sign of primary hypogonadism, not secondary... you need to see a doc ASAP!
Maybe a session of HCG/HMG may help restimulate, or Triptorelin (a GnRHa at a low dose) or even kisspeptin-10... but those values are very low for someone your age..

Your prolactin is reasonable, so i wouldnt think it would be due to your cycle and long-cycle feedback of testosterone..

Seems TRT is in your near future if that cant be straightened out

[DAAS]

Wouldnt a session of those things only temporarily restore me. aka after I stop i would just go back to low numbers. and yeah...I live with this shit every day, im shocked i have as much energy and muscle as I do. I should be a big blob

[dec11]

Wouldnt a session of those things only temporarily restore me. aka after I stop i would just go back to low numbers. and yeah...I live with this shit every day, im shocked i have as much energy and muscle as I do. I should be a big blob

go to the doc

[Lemonada8]

^^ If it doesnt 'jumpstart' your natural production, yea you would go back... but those are low values very close to medical castration...

did u ever take a peptide? and 100% knowing what it was? I hope not a GnRHa, high doses of GnRHa would do that..

[DAAS]

I took test e

HCG

and a AI

[DAAS]

So If i am unable to have a Endo appointment for a while, what would my best option be?

Should I put my self on HCG?

[dec11]

So If i am unable to have a Endo appointment for a while, what would my best option be?

Should I put my self on HCG?

just wait on the endo, you could further damage yourself

[xelnaga]

So If i am unable to have a Endo appointment for a while, what would my best option be?

Should I put my self on HCG?

If you let his staff know that you are not just going to a typical endo check up they may get you in sooner. Just like whenever I find myself in an emergency room I answer " yes" when asked about having trouble breathing... turns a 2 hours wait into a 2 minute wait.

[dec11]

If you let his staff know that you are not just going to a typical endo check up they may get you in sooner. Just like whenever I find myself in an emergency room I answer " yes" when asked about having trouble breathing... turns a 2 hours wait into a 2 minute wait.

im guessing it doesnt work that way in every instance

[MR10X]

Primary or secondary
Primary - defect is inherent within the gonad: eg. Noonan syndrome, Turner syndrome (45X,0), Klinefelter syndrome (47XXY), XY females with SRY gene-immunity
Secondary - defect lies outside of the gonad: eg. Kallmann syndrome and Polycystic ovary syndrome, also called hypogonadotropic hypogonadism.[5] Hemochromatosis and diabetes mellitus can be causes of this as well.

Hypogonadism is also categorized by endocrinologists by the level of the reproductive system that is defective.Physicians measure gonadotropins (LH and FSH) to distinguish primary from secondary hypogonadism. In primary hypogonadism the LH and/or FSH are usually elevated, meaning the problem is in the testicles, whereas in secondary hypogonadism, both are normal or low, suggesting the problem is in the brain.

[MR10X]

Positive Outcome Of Clomiphene Citrate Treatment In Young Hypogonadal Men
In conclusion, CC is an effective and safe alternative to testosterone supplementation therapy in hypogonadal men. The present study showed that there were significant improvements in testosterone levels with long-term CC therapy. Nearly all patients had improvement in at least one hypogonadal symptom on the ADAM questionnaire, with more than half improving in three symptoms. CC therapy has a role to play in the testosterone deficient man and should be incorporated into the clinician-patient discussion.




Katz DJ, Nabulsi O, Tal R, Mulhall JP. Outcomes of clomiphene citrate treatment in young hypogonadal men. BJU Int. http://onlinelibrary.wiley.com/doi/1...702.x/abstract


Study Type - Therapy (case series) Level of Evidence 4
What's known on the subject? and
What does the study add?


Hypogonadism is a prevalent problem, increasing in frequency as men age. It is most commonly treated by testosterone supplementation therapy but in younger patients this can lead to testicular atrophy with subsequent exogenous testosterone dependency and may impair spermatogenesis. Clomiphene citrate (CC) may be used as an alternative treatment in these patients with hypogonadism when maintenance of fertility is desired. This study shows that CC is a safe and efficacious drug to use as an alternative to exogenous testosterone. Not only have we validated previous findings of other papers but have proven our findings over a much longer period (mean duration of treatment 19 months). This prospective study is the largest to date assessing both the objective hormone response to CC therapy as well as the subjective response based on a validated questionnaire.


OBJECTIVE: * To prospectively assess the andrological outcomes of long-term clomiphene citrate (CC) treatment in hypogonadal men.


PATIENTS AND METHODS: * We prospectively evaluated 86 men with hypogonadism (HG) as confirmed by two consecutive early morning testosterone measurements <300 ng/dL. * The cohort included all men with HG presenting to our clinic between 2002 and 2006 who, after an informed discussion, elected to have CC therapy. CC was commenced at 25 mg every other day and titrated to 50 mg every other day. The target testosterone level was 550 +/- 50 ng/dL. * Testosterone (free and total), sex hormone binding globulin, oestradiol, luteinizing hormone and follicle stimulating hormone were measured at baseline and during treatment on all patients. Once the desired testosterone level was achieved, testosterone/gonadotropin levels were measured twice per year. * To assess subjective response to treatment, the androgen deficiency in aging males (ADAM) questionnaire was administered before treatment and during follow-up.


RESULTS: * Patients' mean (standard deviation [sd]; range) age was 29 (3; 22-37) years. Infertility was the most common reason (64%) for seeking treatment. The mean (sd) duration of CC treatment was 19 (14) months. * At the last evaluation, 70% of men were using 25 mg CC every other day, and the remainder were using 50 mg every other day. * All mean testosterone and gonadotropin measurements significantly increased during treatment. * Subjectively, there was an improvement in all questions (except loss of height) on the ADAM questionnaire. More than half the patients had an improvement in at least three symptoms. * There were no major side effects recorded and the presence of a varicocele did not have an impact on the response to CC.


CONCLUSION: * Long-term follow-up of CC treatment for HG shows that it appears to be an effective and safe alternative to testosterone supplementation in men wishing to preserve their fertility.