Heavily considering TRT - need some oversight

[mut3k1]

Hi guys and thanks for having a wonderfully well laid out and populated forum for HRT!

Quick introduction; 37 now, Former fatty (120kg), got in shape (8% BF around 2006) had a kid also. Ran 2 cycles around 2009 after my kid was born (500mg Test E x 12weeks, 2nd cycle was 500mg Test E and Tren H x 12 weeks) recovered fine but stayed off to focus on work and family. Got back into better shape again recently (12%BF perhaps) and had some blood work done to see where I was at.

Was surprised at the result:

Prolactin was 17.4ng/mL (3.6~12.8 ng/mL)
LH 1.6 mIU/mL (0.8~5.7 mIU/mL)
FSH 1.9 mIU/mL (2.0~8.3 mIU/mL)
Free Test 3.5 pg/mL (7.3~28.9 pg/mL for my age range)

Prolactin being slightly high I was referred and had an MRI and more blood work done. MRI revealed a small 5mmx7mm prolactinoma on my pituitary gland but the blood work showed my prolactin was back down (and almost under reference levels). Doc believes it was related to some stomach acid medicine or just stress related from work (Japan, eh?).

TSH, FT3, FT4 were all in range
DHEA-S 891
GH 3.12
E2 9.5 (19.0-51.0)
Prolactin 4.8 ng/mL (3.6~12.8 ng/mL)
LH 1.5 mIU/mL (0.8~5.7 mIU/mL)
FSH 1.9 mIU/mL (2.0~8.3 mIU/mL)
Free test 4.4 pg/mL (slight improvement but still very low)

Suggested I come back in 6 months to do blood work and MRI again to see how things are progressing. I suggested my test was low and I had a fair few symptoms of low T including some joint pain, neck and shoulder stiffness, general irritability, slow recovery from training and injuries, poor sleep etc etc but he wasn't interested and was probably more focused on the prolactinoma vs the low T.

HRT is not really a thing in Japan unless you're female but fortunately there are options for self administration. I think most anti aging clinics offer weekly shots of 150mg cyp IIRC but it's on the expensive side but I will check my options.

I was considering starting either Test Prop 50mg/EOD or Test Cyp 75mg twice a week. I would have Arimidex on hand just in case (I had problems as a kid but nothing bad during my cycles). My concerns are if I'm missing anything, especially relating to the prolactinoma (E2 conversion etc). I don't have concerns for children etc since my wife is much older than I am also.

Any thoughts or suggestions? Thanks!

[AR's King Silabolin]

Im no HRT specialist but 50 mg prop eod seems a lot. It could get you above 1200 ng/dl (300-1000) and you would then also need AI (Arimidex) for the rest of your life. Thats is not good cause AIs are bad for cholestrol. And your hct would also increase. Very slowly.

[mut3k1]

No I think you're right, it would put me at 150mg 1 week and 200mg the next; Pinning EOD is also a hassle. 125/150mg cyp is a better starting point? 150mg may even be a little high perhaps.

[AR's King Silabolin]

I think 125 mg cypionate would be where i would begin, if i put my self on TRT. Then do bloods in a coulpe of weeks. Aim for the 6-700 ng/dl range. Check total test, free test, and maybe bioavailable test, e2 and hct. No AI.
I would drop hcg too. But ive red some guys use hcg with their Trt.

[Mr.BB]

Suggestions? Yes, change doctor or go to the same doctor but specifically to treat the low testosterone. Plenty of studies linking low testosterone to heart and metabolic problems. Exagerate if needed, low libido, ED, brain fog, anxiety, low energy, etc

[mut3k1]

Agreed, the doc himself wasn't related to TRT so I'll have a look around for some TRT/Anti aging clinics. Generally they charge the earth but AAS is not illegal in Japan and there are options for self administration (almost always way way cheaper). Just regarding my blood work, age etc would you consider a good time to start TRT? I don't really see the point in going for a SERM restart or HCG.

[JKW]

All good advice.