30 y/o on TRT... question for the experienced!

[solit1ea]

Hey Fellas-

Give you some background...

I'm 30 and I recently got diagnosed with low T. I don't have the results this minute (doing some MBA work at a library and took a break quick lol), but the first test came back with Total T @ 240, then two weeks later another test came back @ 187 (both done early in the am too). So the endo decided to put me on Test C, 100mg/week. Did this for 6 weeks or so and went back yesterday for a follow up and my results came back @ 280. Now the Free Test, SHBG, Estrodial, etc all came back "within range" for all the tests (again, from what I can recall). So he bumped me up to 140mg/wk

Ok, that's out of the way now so here's the question. For now, we are meeting up every 4-5 weeks for follow ups until he sees my Test levels are within his accepted levels and my quality of life is acceptable as well. I was flirting with two options:

1) Running a SARM, LGD-3303 with some T-3 for 12-16wks (obviously not T-3 for as long) with my TRT dose of Test C
or
2) Running a 16-24 week cycle of EQ at 200-400mg/wk

Any suggestions or recommendations based off of knowledge or prior cycles? Also, should I wait until we find that "balance" and i'm not going back so often to the endo? Would LGD 3303 raise my test levels, thus skewing the results of the blood work? I wouldn't mind him bumping me up to 200-250mg/wk of Test C for TRT dosage. Last question, how long did it take most of you to get to the point where you were only doing follow ups every 6 months or so with the Dr for insurance purposes (or just bc he/she requested)? Sorry for all the questions, just anxious to get the ball rolling with this!

Thanks in advance and I'm curious to see what you all have to say!

[kelkel]

Well, you were diagnosed with low T but did the doctor ever try to find the actual cause of it? Just because your T was low doesn't mean is was not fixable? Did he check your thyroid as hypothyroidism causes hypogonadism. Prolactin, cortisol, etc? I'd hate to be put on TRT a decade or more earlier than needed by a doc who's just putting a band aid on the problem, like so many do.

So after 6 weeks your results came back at 280. Correct me if I'm wrong but I'm assuming the blood work was pulled about 6-7 days after your last injection, correct? If so then that's your trough level. Once per week injections put you on a hormonal roller coaster every week. Meaning you inject, test peaks in a day or so then steadily drops to a much lower level by weeks end. Instead of upping the dose you'd be much better off splitting it in half and injecting 50 mgs twice weekly. This will allow more steady levels. It will also help mitigate the need for estrogen control as well as hematocrit issues down the road.

Your doctor just upping the levels only puts you at (arguably) supraphysiolocigal levels in the beginning of the week only to have you come in at a number that he accepts at the end of the week. Makes sense to literally no one who understands hormones, and most doc's don't. The end doesn't justify the means long term. Your doctor should also be gauging things based on your free test, not your total test.

Your goal here should be a healthy balance of testosterone and to feel good, using as few ancillaries as possible. I would do nothing extra until completely dialed in. Big difference between TRT and cycling. Keep them seperate.

One thing I'll repeat. I'd be sure to pester your doctor about why your levels were low. Pituitary failure, testicular failure, combination, etc. If you have a copy of your initial blood work post it up.

[solit1ea]

Kelkel-

Thanks for the response! I'm glad you were the first to respond actually, since I've been following your posts and you are very knowledgeable in the area. To answer some of your questions:

- He didn't specifically say what caused this. He made me believe that I've been suffering from this since I was 15 because thats when I started having gyno problems. See, I was a fat kid growing up and when I went through puberty I lost 50+lbs in a summers time. Maybe that contributed to the issue? I don't know the answer to that, but he made me believe that this was a factor.
- The first blood work done by him, and the second were about 3-4 weeks apart. He made me do the blood work on the initial visit, then a week later we had the follow up and he placed me on TRT that day. He told me to do blood work in between two injections, and in 2-3 weeks we would do a follow up. Yesterday (1/17) was the follow up and he upped my dosage. Blood work on the bottom of this...
- I think you are right, I should pester him more on the root cause of this. Based on the results I posted below, what should be some follow up questions I should ask and what are your thoughts on this?
- And yes, maybe I was a bit forward thinking on the extra ancillaries lol. I'll be more patient and wait until I get my body more hormonally balanced before I do anything else

Results:

1st Test (initial)
Total Test- 184 Normal Range: 210-1274
FSH- 3.2 Normal Range: 0.7-11.1
LH- 3.4 Normal Range: 0.8-7.6
Estradiol- 34 Normal Range: <10-52
Prolactin- 10.5 Normal Range: 2.5-17

2nd Test (2 weeks into TRT)
Total- 218
SHBG- 35.5 Normal Range: 10-68
Testos, FR-Index 21.3% (not sure what this is?) Normal Range: 20.4-81.2
Didn't run LH of FSH on this blood work for some reason
Estradiol- 19.4

Are there any additional blood work I should make him run along with these? Thanks again, much appreciated and a big help!

[kelkel]

He's guessing on how long you've been suffering. Prepubertal gyno is quite common and often is simply related to body fat and estrogen levels, which go hand in hand. At that age your hormones are all over the place and some simply pay the price with gyno symptoms. It does not mean you had low T.

The first panel (pre trt) shows your low test. It also shows decent LH/FSH levels assuming the ranges are normal. Editing your post and adding the ranges would be helpful to everyone. Prolactin appears in range as well but again, I'm guessing here and we have no historical values. Elevated prolactin can be inhibitory to both LH/FSH and testicular function. Missing would be a thyroid panel and cortisol.

Have you ever suffered any testicular trauma? Been examined for varicoceles? For pituitary abnormalities? Normally when someone is primary hypogonadal their LH/FSH values are ramped up in effort to stimulate production. In your case they are not elevated yet your T is still abysmal. If you were secondary (pituitary failure) then your LH/FSH values would be nil and so would your T levels.

On your second set of BW your level still sucks due to the reasons I mentions in my first post. LH/FSH is normally useless to run after initiation of endogenous testosterone as it shuts down due to a basic feedback mechanism.

I'd speak to your doc more regarding the causative factor. Add in TSH, FT3 and FT4 and cortisol as well as prolactin to see if it's rising. Along with a basic hormone panel and CBC, CMP.

[solit1ea]

He's guessing on how long you've been suffering. Prepubertal gyno is quite common and often is simply related to body fat and estrogen levels, which go hand in hand. At that age your hormones are all over the place and some simply pay the price with gyno symptoms. It does not mean you had low T.

The first panel (pre trt) shows your low test. It also shows decent LH/FSH levels assuming the ranges are normal. Editing your post and adding the ranges would be helpful to everyone. Prolactin appears in range as well but again, I'm guessing here and we have no historical values. Elevated prolactin can be inhibitory to both LH/FSH and testicular function. Missing would be a thyroid panel and cortisol.

Have you ever suffered any testicular trauma? Been examined for varicoceles? For pituitary abnormalities? Normally when someone is primary hypogonadal their LH/FSH values are ramped up in effort to stimulate production. In your case they are not elevated yet your T is still abysmal. If you were secondary (pituitary failure) then your LH/FSH values would be nil and so would your T levels.

On your second set of BW your level still sucks due to the reasons I mentions in my first post. LH/FSH is normally useless to run after initiation of endogenous testosterone as it shuts down due to a basic feedback mechanism.

I'd speak to your doc more regarding the causative factor. Add in TSH, FT3 and FT4 and cortisol as well as prolactin to see if it's rising. Along with a basic hormone panel and CBC, CMP.

Thanks again for the quick reply! I edited my post to show the "normal ranges" for each. As far as historical goes, this is really the first time I've done blood work for this as well, so I have no other thing to reference other than whats supposed to be normal. I've had no trauma to the family jewels that I can recall, no family history of thyroid or pituitary issues, and no varicoceles that I recall. I've had physicals done in the past if that helps lol.

In reading about Low Test and from what I've seen on this forum, I wanted to mention having a thyroid panel and cortisol levels checked just due to what you mentioned above. I guess I was just as convinced as he was about the cause of it that I didn't bother to proceed with it. But I think when I go back next month I think I'll have him test for: Thyroid, Cortisol, Prolactin, and FT3/FT4.

[kelkel]

Your case is just odd to me as I don't see anything jumping out as a direct cause as I explained previously. If you can rule everything out the only thing I can think of would be early on-set andropause. But at least by ruling things out you have a clear conscience. When it comes to Varicoceles most would not be detected by a normal physical. They would require actual palpation followed by an ultrasound.

Any harsh medication in the past? Previous addictions, etc.?

[solit1ea]

Your case is just odd to me as I don't see anything jumping out as a direct cause as I explained previously. If you can rule everything out the only thing I can think of would be early on-set andropause. But at least by ruling things out you have a clear conscience. When it comes to Varicoceles most would not be detected by a normal physical. They would require actual palpation followed by an ultrasound.

Any harse medication in the past? Previous addictions, etc.?

Odd??? Your telling me! I've been trying to figure it out for a while now. In fact, it started off trying to get my insurance to cover my gyno removal surgery and it sparked me the idea of getting BW to see what my hormone levels are. Then all this happened. All I wanted is for my gyno to be removed because I'm embarrased by it. I've had throughout my teen years and I've always been afraid/ashamed to take off my shirt in public (beaches/pools).

So is it rare/highly abnormal to have andropause this early? I guess I didn't think about that... should I be worried maybe? I think ruling out the above tests will help clear some things up.

As far as addictions, I have none and had none. Harsh meds.... natta. I've dabbled with test boosters a few years ago (Diesel Test V2) for like 4-6 weeks at a time but they never did anything nor did I notice much of anything but the occasional boner lol. I did one time try a prohormone stack from LG Sciences back sophomore year in college. Did it for 8 weeks or so and took their PCT. This was before they had that big ban on prohormones and I knew the owner of LG so he gave me the stack to try. Again, nothing too obvious or great. I already had the gyno at that point so I couldn't really tell you if it worsened it or made it better. Same with suppression, didn't notice much of anything.

[kelkel]

Rare may not be the operative word, how about less likely without a cause.
Test levels in men normally begin to drop in their 30's so it's anyones guess with your case.
Always best to make every effort to find the cause before starting therapy.
Some test boosters can be suppressive over time just as some prohormones / sarms can be.

[David LoPan]

This might be a good read for you.https://forums.steroid.com/hormone-r...ogonadism.html KelKel is the expert. on here with TRT. You had asked "long did it take most of you to get to the point where you were only doing follow ups every 6 months or so with the Dr for insurance purposes".....me it took a long ass time. I was a regular every 3 months for a blood draw and then I got the test results. Good news it that TRT is very common now unlike it was when I was in my early 30s.

Sorry to hear you are embarrassed by your gyno, keep fighting for the surgery. You can always shop around for doctors and get prices, there are HUGE variances and you might be able to find a plastics guy that will do it in office for cash much cheaper. IDK myself, but it is worth looking into.

Remember, we are just here to help on our own time. Doctors "practice" medicine and each individual is different. It is good that you went to get your BW done so you know what your levels are, 90% of the population does not do this.

Wish you the best of luck.