New TRT patient

[Babyslim]

Hey guys, iv'e been reading like crazy on this site and really appreciate the info.

I'm 25 years old and have had symptoms of low/lower T my whole life. I waited until now to see if maybe I was just a late bloomer, no luck.
I worked my ass off eating(not clean)to get up to 160 lbs. In the past working out and eating clean i would actually lose weight and strength. About a month and a half ago I had bloods done(Attached). The doc started me on TRT, 200mg every two weeks. Per my request I am now running 100mg ew. My doc doesn't know much, but is willing to work with me. I directed him to Dr. Crislers' website and his published papers. Currently i'm waiting to hear back from him about putting me on HCG and an AI since my balls hurt, i'm starting to feel like crap, and my nipples just started to get a little puffy and sensitive. Dr. Crisler has a great case to support the use of HCG, however I haven't seen any papers that go in depth and support the use of an AI. Any suggestions on finding this information?

I have experienced many benefits on TRT, Increase in libido, erections, no longer have extreme irritability and mental fog(starting to come back, i believe due to rising E2), lots of hair growth, voice is getting deeper, lots more energy, and I no longer need to take my ADD medicine.

Any thoughts on my blood work(before treatment), my doc said we will do it again after 4 months, I told him I need it done asap, and need a sensitive E2 done.
How do i communicate about using an AI? I know I need bloods done again first.
Anyone know of any good TRT docs in Kansas city area that could help me? It bothers me that I have to essentially teach my doc, and I don't feel qualified. Plus i'm wasting valuable time going back and forth with him, i want to get on track NOW.

Thanks again guys,
Mike

[edmundo22]

Hey dude sorry I can't contribute but can I ask are all the benefits you mentioned fading out or is it just the brain fog due to the rising E2 you mentioned ?

[JD250]

In the stickies there is a thread about finding a doc, there is a list and I know that there are some in your area.

[Vettester]

Welcome to our forum, glad you joined. Sorry that you have been dealing with this stuff at such a young age.

Although your total serum score isn't in the tank, I won't dispute that it's definitely on the low end. However, to me, that's only one little piece of the whole puzzle ...

- Did your doctor investigate this further to determine why you're levels are low? (MRI? Urology exam of testicles?)
- Did your doctor run other labs, especially LH/FSH to determine your condition (primary or secondary)?
- Any pituitary issues noted when you were younger?

An E2 panel is also only another piece of the puzzle. Yes, AI's are used to control estrogen increase, but this really needs to monitored effectively. An AI can turn into a nightmare if you let it tank your E2. BW is the only way to know if this will be needed or not.

Please let us know what response you get from your doctor about the HCG and your nipple issues. IMO there's nothing impressive about this doctor so far ... Start putting some thoughts into plan B. Your statement says that your doctor does not know much. My question is: Why then is he treating someone for HRT? (It would be like me being on my business flight this week and the flight attendant tells me that the pilot really doesn't know much about flying!! I'm counting on that these guys are where they are because they're competent. No difference in your situation, you're ultimately at his disposal if he can't make the correct decisions).

[kelkel]

Read all the stickies Babyslim and print out what you need to. If you feel your doctor will work with you then that's a plus. If not, read the Finding a TRT Physician" sticky and use some of the links provided to hopefully find a doc. Definitely get the BW done soon. Complete BW list is in the previously mentioned sticky also. If you can't schedule the BW via your doc you can get it done privately. Just do a search here and you will find labs to use. When it comes to high E you can obtain what you need through our sponsor here. You'll have it in about two days in liquid form. No issues. Just make sure you do it based on BW. Don't crash your E as it's easy to do.

Regarding your BW posted. More modern range for Total Test is 348 - -1197 so yes, your low. Be nice to see Free and or Bio-Available T as well as SHBG, LH, FSH, unless I'm missing them and they're there? Could be, late here! You need to find out what is causing the low T at your age. We see this so often here. TRT without a proper diagnosis. Is it a pituitary issue, testical issue, etc? This is what the doc needs to diagnose and treat accordingly. There are alternative forms of treatment out there instead of starting a life time of TRT at such a young age unless you absolutely have to. Try and fill in some blanks for us.

Welcome to the forum. Glad to have you!

(evening Vette)

[JD250]

Kel and Vette.........you guys are exemplary of how to greet a new member and be thorough in giving advice, excuse my short and barely helpful post, I should take notes from you two. Keep up the good work, you're appreciated.

[kelkel]

Thanks JD, my eyes are getting misty. Could just be my hereditarily low E level though!

But seriously, right back at you though JD. We just beat you to it.

[Babyslim]

After spending 20 minutes of adding numbers and misspelling words to get past the spam filter Iv'e decided to just copy my now nearly unintelligible response into a text document, which I have attached... Please open it if you would like to view my post.

Can a mod bump me passed that filter? I swear I'm not a spammer.

Thanks guys!
TRT post.pdf

[kelkel]

Start with the Finding a Physician sticky. No need to stop your therapy just start looking for a good doc asap. Get copies of all your BW asap and keep them. Continue to always get copies. They are yours, you paid for them. Your next doctor if knowledgeable with TRT will be able to interpret them based on your current protocol.

Good luck, hang in there and do not give up. Keep us posted on this thread.

[Babyslim]

Awesome, thanks kel. Ill post back in here once I find a doc.

[Vettester]

Kel and Vette.........you guys are exemplary of how to greet a new member and be thorough in giving advice, excuse my short and barely helpful post, I should take notes from you two. Keep up the good work, you're appreciated.

JD, you're one of our MVP's!! Thanks for the compliments and many back to you.

[Babyslim]

Alright, So I called a handful of doctors today and interviewed them briefly. A few I wasn't impressed with. One wouldn't do home injections. And one really seemed to know what the hell he was talking about. I told him I just started TRT and HE asked if I was using an AI and HCG. Have a free consult with him on Tuesday. But here's the kicker, I'm on a limited income but have great insurance through BCBS but he doesn't take any insurance. Said he would give me a form i could submit. What are the odds my insurance will cover his services and prescriptions? I don't know much about insurance practices.

Thanks guys.

Mike

[kelkel]

There are certain doc's and compounding pharmacies like that. The compounding pharmacy I use is that way but they know the deal and give you exactly the paperwork you need to submit in detail. Call your ins carrier tomorrow and find out their protocol for it. I'd think you will be good to go.

[Babyslim]

Met with the new doctor I mentioned above today for a free 15 minute consult, turned into a great 45 minute visit. He is a TRT patient himself for the past 10 years. Of course, I needed BW done for E2 and PSA. Once I get that to him we will start. His pricing wasnt bad at all and hes working with me to keep cost down. Ill start injecting test IC once a week, 200iu HCG twice a week(two days before and one day after T shot), and an AI based on my blood work. I think he said he used Tamoxifen at 2.5mg per week split, might have been letro?

Anyway I cant wait, my balls are starting to scream more and more, and overall I just dont feel great right now, BW will help...

Thanks guys, will post up results soon.

[kelkel]

Glad to hear it's working out. You don't need Tamox as it's a SERM and will not block your E from rising. It just blocks it at the receptors in your chest. Which is fine if you've crashed your E and are looking for some protection while it rises. Letro may be a bit harsh. We would recommend Anastrozole (Arimidex) at the lowest dose possible, if you need it at all. It all needs to be based on your BW and be sure to make only one change at a time. Hopefully, you wont need an AI at all which is the best case scenario.

[Babyslim]

I asked "why not arimidex?" and he said "Cheaper". I need to call him tomorrow to find out what he said he uses, lurking on this site 5 hours a day kind of mushes some things together lol. I think I'll have issues with high E. Iv'e even had symptoms before i started TRT(gyno).
I asked him where he would like to see my E and T levels. He said E between 18 and 22. Usually he shoots to get total test between 800 and 1000, but because of my age(25) he would wouldn't have an issue if it was up to 1200 as long as i didn't have any sides. Any thoughts on those goals? I know the ranges iv'e read for others and in the stickies, and I know it can vary a bit person to person based on how they feel, but there's not a ton of info for TRT for younger guys... Sound reasonable?

[Brohim]

how does he intend to get e2 down to 22 without an AI? Nolvadex is not the best idea. 1200 TT and 22 E2 sounds good to me. Did you ever figure out if your primary or secondary?

[Vettester]

Agree with Kelkel about the Tamox being a SERM. It's not an AI, and shouldn't be used as one.

Me personally, I think the 18 -to-22 range is pretty low, and it might be hard to keep in such a limited range. My best well being is actually in the low to mid 30's. IMO, estrogen gets too much of a bad rap for guys. Like testosterone, it's very much needed in men just the same. Too much is obviously not good, but having a healthy amount in the body can be beneficial. It will be hard to micro manage it with a 4 point spread ... just my .02

Also, thanks for your kind words in your PDF post. It makes such a huge difference knowing some of these posts actually get through with the younger members (like yourself), and/or a few of the new members too. There were some really "key" guys at this place that helped me get my program on track, 1 being a guy named T-Mos who passed away just shortly after I joined here.

The members seem to be getting younger and younger all the time here. As you get your own program and experiences dialed in, you could be quite beneficial to the younger guys here going through similar ordeals, who might not relate as well with a lot of us who are quite a bit older. Something to think about ...

[Babyslim]

Agree with Kelkel about the Tamox being a SERM. It's not an AI, and shouldn't be used as one.

Me personally, I think the 18 -to-22 range is pretty low, and it might be hard to keep in such a limited range. My best well being is actually in the low to mid 30's. IMO, estrogen gets too much of a bad rap for guys. Like testosterone, it's very much needed in men just the same. Too much is obviously not good, but having a healthy amount in the body can be beneficial. It will be hard to micro manage it with a 4 point spread ... just my .02

Also, thanks for your kind words in your PDF post. It makes such a huge difference knowing some of these posts actually get through with the younger members (like yourself), and/or a few of the new members too. There were some really "key" guys at this place that helped me get my program on track, 1 being a guy named T-Mos who passed away just shortly after I joined here.

The members seem to be getting younger and younger all the time here. As you get your own program and experiences dialed in, you could be quite beneficial to the younger guys here going through similar ordeals, who might not relate as well with a lot of us who are quite a bit older. Something to think about ...

Thanks Vette. Honestly this site surprises me, I never expected the care here to be so great! Great people here that dedicate a great amount of their time to help others. I may be on here hours everyday, but it's mostly for my own selfish reasons. Iv'e been trying to post more and contribute, I just don't feel qualified yet... That said, once I get dialed in I do plan on sharing my experiences in a 'sticky type' post for younger people. Not that i'm an authority on the subject, but I really wish I had more targeted info to go on for my age group. I do plan a sticking around though, it's time I focused on my health and started living.

Thanks agian,
Mike

[kelkel]

Agree with Kelkel about the Tamox being a SERM. It's not an AI, and shouldn't be used as one.

Me personally, I think the 18 -to-22 range is pretty low, and it might be hard to keep in such a limited range. My best well being is actually in the low to mid 30's. IMO, estrogen gets too much of a bad rap for guys. Like testosterone, it's very much needed in men just the same. Too much is obviously not good, but having a healthy amount in the body can be beneficial. It will be hard to micro manage it with a 4 point spread ... just my .02

Also, thanks for your kind words in your PDF post. It makes such a huge difference knowing some of these posts actually get through with the younger members (like yourself), and/or a few of the new members too. There were some really "key" guys at this place that helped me get my program on track, 1 being a guy named T-Mos who passed away just shortly after I joined here.

The members seem to be getting younger and younger all the time here. As you get your own program and experiences dialed in, you could be quite beneficial to the younger guys here going through similar ordeals, who might not relate as well with a lot of us who are quite a bit older. Something to think about ...

Who you calling old, Vette!

And definitely stick around Mike!

[Babyslim]

Nothing to see here, apparently im retarded. Will post crap up at later date.

[Vettester]

Who you calling old, Vette!

And definitely stick around Mike!

Hey, when the cute little hairdresser remembers me as the "Salt n Pepper" guy, I know it's time to accept mortality. Geesh ...

[Babyslim]

I'm seeing a new DO tomorrow to get some blood work done. Since iv'e been on TRT for over a month now is there any use in getting a full panel done(initial type bloodwork) since I didn't have one before I started? So far I plan on requesting the following:

Total T
Bio T
LH/FSH
FSH
SHBG
E2 ultra-sensitive
CBC
Comp. Metabolic Panel
PSA
prolactin


For the past 2.5 weeks iv'e been injecting subQ 50mg cyp. e5d since iv'e been having gyno and other symptoms of high E. Last injection was monday morning. My current plan is to get on HCG as soon as possible, run 40mg QD tamoxifen till gyno and sensitive nipples is gone/stable then taper off and switch to adex as per my blood work.

[kelkel]

Add free T and Vit D if you don't know your level. If this is your first BW post therapy leave lh/fsh in. If not, get rid of them. Once stable, go to every 3.5 days cycle.

[ecdysone]

But here's the thing, none of us knows if 50+ years of TRT is survivalble.

I would also caution you that so far your approach has been completely wrong: what you should have done (and could still do) is to determine if you are primary or secondary (would need LH levels) BEFORE starting to supplement with testosterone. Are your age there are other alternatives to just injecting test all of your life (not to mention the 10,000+ holes in your skin ).

Test levels of 1200 with E2 <20 may well be a formula for future problems. Bone growth/cardio protection/brain development requires mid-range estrogen levels. "Older" guys might get away with subnormal values, it's unlikely you will.

Anyway, something to think about.

[Babyslim]

Had I known not to trust my doctor i wouldn't have started without a proper diagnosis. I didn't CHOOSE this path - I got screwed. Currently I just started the busy season at work. The next few months justify my job and paycheck. I may go off for a few months to get a diagnosis but not until i'm in the clear at work, possibly this fall. Frankly I don't have any desire to live another 50+ years feeling the way i have for the past seven... The risks of TRT are similar to having low T. I do appreciate your concern and my new doctor expressed the same.

My new doc is great. Hes just my old family DO. Got all my blood work and will follow up blood in 6 weeks. He went ahead and gave me adex, HCG, and a new test script.

[keep fightin]

hey Babyslim, welcome! although I wish you did not need to be here. Really a good thread and it would be great if you have the time and resources to track down just why your in this predicament. Dr Michael Colhgin [sp?] wrote an article awhile back called "your not half the man your grandfather was" talking about falling T levels compared to the G.I's of the 40's. Glad to see you taking charge and making progress on this as you will probably live into your 90's at least!

[Babyslim]

hey Babyslim, welcome! although I wish you did not need to be here. Really a good thread and it would be great if you have the time and resources to track down just why your in this predicament. Dr Michael Colhgin [sp?] wrote an article awhile back called "your not half the man your grandfather was" talking about falling T levels compared to the G.I's of the 40's. Glad to see you taking charge and making progress on this as you will probably live into your 90's at least!

Thank you! Ill check that article out soon, that's pretty interesting. I think the food we eat and some other factors are really destroying our bodies and hormonal systems, especially men.

I really do understand why it's important to have a clear definition as to why i'm in this position. However, I feel like I have tasted LIFE for the first time. Today I had an extremely productive day building a shed at my parents house. Beautiful weather I was able to appreciate, singing while I worked hard with seemingly endless energy, dealing calmly with a sibling that irritates me, not feeling constant pain in my joints and muscles, showing my wife that I love her... If I could go back and get the proper diagnosis I would, but I feel happy and alive for the first time in my life and i'm not even close to being dialed in yet. I just can't walk away from that. Call me a fool, but ill deal with any issues and 10,000 holes in my ass and stomach to live this way.

[Babyslim]

Update:
For the last several weeks i've been on the following protocol:
S 250MG HCG
M Morning - 50mg cyp subq
T .25mg Arimidex
W 250iu HCG
T Night - 50mg Cyp subQ
F .25mg Arimidex
S 250mg HCG

The extra dose of HCG really makes a big difference in my mood for starting out the week, Happy mondays. I feel pretty darn level, and I think I notice fluctuations from the HCG more than anything. Nipple sensitivity and puffiness is down, but I still feel like I may have some soft gyno active. I have blood work this week to check e2, total and free T, and PSA. I think I may need to up my AI by another .25, we will see.

Physically other than the gyno I feel pretty good. Mood is great, i'm like a different person in a very good way. Energy has increased as well as strength. New hair popping up weekly. I went from bare body to a full 'road to paradise' from my upper chest to groin. Close to a full beard. Hands have grown a lot, can no longer wear my wedding ring. Neck has out grown most of my dress shirts. Some muscle gains. Cognitive effects are very noticeable. Other than mood, I no longer stutter, my dyslexia has greatly decreased, and my memory is sharp again.

[grilla]

Slim-

Nothing to add...just glad to read that you're doing so well!

grilla

[Babyslim]

Thanks for all the help and support guys!
Update:
Just got blood work back. Notice the Free T. I have been fairly good. Test was done on Monday afternoon when my E2 and T levels should been their highest(see protocol below).

Total Testosterone 897 Range: 250 - 1100 ng/dl
FREE Testosterone 258.6 Range: 35 - 155.0 pg/ml
E2 29 Range: < OR = 39 pg/ml (Was Ultrasensitive LCMSMS)
PSA 0.9 Range: < OR = 4.0 pg/ml

My protocol for the 6 weeks before this draw was as follows:
S 250MG HCG
M Morning - 50mg cyp subq
T .25mg Arimidex
W 250iu HCG
T Night - 50mg Cyp subQ
F .25mg Arimidex
S 250mg HCG

I just started taking 5000iu of D3 today. Since D3 lowers SHBG and I've never taken it what do you think will happen to my FREE T? Any other thoughts or suggestions?

[dr_barf]

Had I known not to trust my doctor i wouldn't have started without a proper diagnosis. I didn't CHOOSE this path - I got screwed. Currently I just started the busy season at work. The next few months justify my job and paycheck. I may go off for a few months to get a diagnosis but not until i'm in the clear at work, possibly this fall. Frankly I don't have any desire to live another 50+ years feeling the way i have for the past seven... The risks of TRT are similar to having low T. I do appreciate your concern and my new doctor expressed the same.

My new doc is great. Hes just my old family DO. Got all my blood work and will follow up blood in 6 weeks. He went ahead and gave me adex, HCG, and a new test script.

Babyslim, if you happen to check this, can you send me PM. It might really save my time in my TRT search for KC.