Just got blood work back

[Dpyle]

Ok so I'm 26 and went for a physical last week (get one free every year through insurance), and asked for some blood work because I've had a lowered libido and some Ed problems. Also thought it would be good to have a baseline in my records for future reference. Got the results today and.

Total T - 444 (ref 175 - 788)
Free T - 1.31 (ref .95 - 4.30)
Prolactin - 4.1
Lh - 3.6
Fsh - 4.2
Thyroid - .75

The nurse only gave me the reference range for total and free T, and said the doctor said I'm good to go and he doesn't know what is causing my symptoms. She then tells me he said I should come back if I keep having problems. Maybe it's just me but these numbers seem a little low for a 26 yo. Anyone have any advice on what I should talk to the doc about or should I find a new doc?

[GotNoBlueMilk]

So they didn't test for E2? Only one thyroid test?

[Dpyle]

Yeah. I even had to push to get them to run the free test. He tried to tell me that total would be fine. First indicator that he has little to no experience was when he told me if it was low a monthly shot was one option I would have.

[zaggahamma]

yet another different reference range....who makes things up??????????
imo,
its gonna be hard to get treated from him and maybe any endo, etc. as you are within the "accepted" "range"(s"
save your pennies and look into an anti aging clinic....your young bro are you possibly low from a recent/previous cycle?

[Dpyle]

Never cycled. That's the problem, and it's only been about the last year that I've really noticed anything. Just been drained all the way around which has made caffiene one my best friends and worst enemies when trying to get to sleep at night.

[steroid.com 1]

You're to young for these results. You need to find an Endo and find out why. This Doc isn't going to do it. Something is definitely not right.

[bass]

i agree with the guys, there are things you can do to naturally boost your test, like lifting weights and taking good supplements! TRT is for life. there is no turning back!

[funkymonk]

Perhaps e2 is elevated, but at those ranges I almost wonder if it's something else entirely.

[Dpyle]

Bass I totally agree. I didn't expect to have the results come back this low. In the past year I've made a lot of lifestyle changes. Been back in the gym 4 days a week, diet is good still needs some work to be right but it's a far cry from the general population, and I've cut alcohol intake from a few drinks every night down to a couple drinks with the guys one night a week. Gonna schedule another appt with this doc and see if I can get a referral for an endo just to be sure my insurance will cover it. Def didn't go into this hoping to go on trt this early.

[gmantheman]

Keep the alcohol to a couple of drinks one night a week or eliminate it all together. One culprit for the lower test could have been sleep or lack of quality sleep. The few drinks every-night although may help you fall asleep, they hinder the quality of sleep. Testosterone is produced when you are sleeping. Try to get 7-9 hrs of sleep per. night.

[Dpyle]

Usually get around 7 every night with 6 mg of melatonin to help get me there faster.

[Dpyle]

Have an appt. With the urologist today maybe he can shed a little light on the situation for me.

[zaggahamma]

Have an appt. With the urologist today maybe he can shed a little light on the situation for me.

hope so bro

[Dpyle]

Well that appt. Was a waste of time. Urologist said the exact same thing as my GP and even said the GP ran more bloodwork than he would have. Oh well maybe about 10 years from now they will actually look at it as a problem rather than say there is no reason for my symptoms.

[Dpyle]

I mean I'm not fishing docs to get put on TRT, but it would be nice to know why I can't hold an erection for more than 10 minutes after I pop a 50mg Viagra or why I constantly feel like I'm coming down with the flu.

[zaggahamma]

dont give up bro....

[Dpyle]

Ok so I've given it some time and nothing has changed. Went to a new doc today and they ordered more bloodwork. Go back next thur to find out more.

[Dpyle]

Upside to the new doc is even after hearing about the previous tests they told me they could definitely help. So I'm feeling good actually hearing something positive.

[bass]

great! keep us posted!

[Dpyle]

Tomorrow is the big day I suppose. Go in for the follow up to see what they say. Down side is it is a clinic ( and I know trt should be a last resort I'm still weighing my options), but after only having 1 erection firm enough for sex in the last 2 months and being so depressed that I can't feel happy about my first child being here in Dec. I'm just looking for anything to help. I'll definately drop a line after the appt to let you guys know what they say.

Did have one question though. If I were to try the trt and it isn't helping after the 8-10 week mark ( if it is I should know by then) would it be possible to run a pct have some labs drawn and take those results to my GP to go from there? It wouldn't have come to this if upon my first visit to the GP with my symptoms he hadn't looked at my results told me I was within normal range and didn't know why I was having these problems. I also got the same response from the urologist I went to for a second opinion.

[zaggahamma]

why wouldnt it be possible

[Dpyle]

I knew it would be possible. I suppose I was just looking for opinions and/or reassurance on my thought process.

[zaggahamma]

i think its a valid thought process twofold:

yes you should notice something in 10 weeks and like you said if not you can pct and bring yourself back to atleast close to where you were

good luck and keep us posted...

seems theres quite a few younger guys with lower than optimal levels with symptoms...id like to see more follow ups on those that went trt

[Dpyle]

Will definitely keep you guys posted. I've gotten more help from the people on this forum than I ever could have imagined. By far the best Internet discovery I've made so far.

[steroid.com 1]

Dpyle - See the stickie at the top of the forum on how long it takes for "things to change" on a TRT protocol.

[Dpyle]

Gdevine: thank you for pointing that sticky out. Definitely gives me a good idea about the time frames on feeling the effects.

The appt went really well. Had a good long talk with the doctor, and his protocol falls really close to the protocol used by Dr. Crisler. I started today with a jumpstart of 200mg test cyp and the injections will be 100mg per week from now until follow up labs are done. He said after we get the follow up labs back we will look into adding HCG and possibly an AI if needed.

No chance for self injecting IM, but he said he has seen people do really well on subQ injections done 2 times per week. I'm not sure about that one though but he does offer the subQ in a take home script. He said the subQ injections have a higher absorption rate than IM because it's mixed in grapeseed oil rather than linseed or cottonseed. Thoughts on that?

[steroid.com 1]

[QUOTE=Dpyle;5756***]Gdevine: thank you for pointing that sticky out. Definitely gives me a good idea about the time frames on feeling the effects.

The appt went really well. Had a good long talk with the doctor, and his protocol falls really close to the protocol used by Dr. Crisler. I started today with a jumpstart of 200mg test cyp and the injections will be 100mg per week from now until follow up labs are done. He said after we get the follow up labs back we will look into adding HCG and possibly an AI if needed.

No chance for self injecting IM, but he said he has seen people do really well on subQ injections done 2 times per week. I'm not sure about that one though but he does offer the subQ in a take home script. He said the subQ injections have a higher absorption rate than IM because it's mixed in grapeseed oil rather than linseed or cottonseed. Thoughts on that?[/QUOTE]

He's 100% correct.

He's on top of the game.

Good for you, you're in good hands.

Very happy for you

[Dpyle]

That's really good to hear because the subQ cyp is cheaper, but I wasn't sure because everything I've read said IM is best. Looks like I found the right doc and glad to know he's gonna take care of my situation rather than just try and make a buck off me.

[Fred40]

I was always led to believe that IM injections were preferred and that subQ resulted in a higher rate of aromizatation of T into E2?

I don't understand why subQ would be approved for home injections and IM would not be?

[Dpyle]

I suppose the risks involved with IM i.e hitting a vein or artery or an infection that could start deep in the tissue. Wasn't really sure on that one either.

[bass]

congratulations Dpyle! please keep us posted on your progress.

[bass]

man I'd love to do subq but my clinic said its not near as good as the IM. i wonder what Dr. Crisler thinks about that!

[Dpyle]

I'm still reading his papers when I find them online but haven't seen that in anything yet. If I find anything I'll throw it up in the forums.

[Logonzo]

I suppose the risks involved with IM i.e hitting a vein or artery or an infection that could start deep in the tissue. Wasn't really sure on that one either.

I'm not at a clinic but an endo, he has got me doing self injections IM. I'm pretty sure that the SQ are the ones not recommended.

[Dpyle]

That's kind of my thinking behind it to. I know I've read that the gels have a higher rate of aromitization due to the mode of delivery through the fatty tissue. Which leads me to believe that subQ injections would present the same problems. This is why I opted for the IM injections. Until I can find some good supporting research I'll pay the higher price, which isn't as bad as I thought it would be,.

[steroid.com 1]

Any one please post a study or any research that indicates SC injections of Test increase E2 or anything else for that matter. Anything...

Read:
STABLE TESTOSTERONE LEVELS ACHIEVED WITH SUBCUTANEOUS TESTOSTERONE INJECTIONS

M.B. Greenspan, C.M. Chang
Division of Urology, Department of Surgery, McMaster University,
Hamilton, ON, Canada

Objectives: The preferred technique of androgen replacement has been intramuscular (IM) testosterone, but wide variations in testosterone levels are often seen. Subcutaneous (SC) testosterone injection is a novel approach; however, its physiological effects are unclear. We therefore investigated the sustainability of stable testosterone levels using SC therapy. Patients and methods: Between May and September 2005, we conducted a small pilot study involving 10 male patients with symptomatic late-onset hypogonadism.

Every patient had been stable on TE 200 mg IM for 1 year. Patients were instructed to self-inject with testosterone enanthate (TE) 100 mg SC (DELATESTRYL 200 mg/cc, Theramed Corp, Canada) into the anterior abdomen once weekly. Some patients were down-titrated to 50 mg based on their total testosterone (T) at 4 weeks.

Informed consent was obtained as SC testosterone administration is not officially approved by Health Canada. T levels were measured before and 24 hours after injection during weeks 1, 2, 3, and 4, and 96 hours after injection in week 6 and 8.

At week 12, PSA, CBC, and T levels were measured however; the week 12 data are still being collected.

Results: Prior to initiation of SC therapy, T was 19.14+3.48 nmol/l, hemoglobin 15.8+1.3 g/dl, hematocrit 0.47+0.02, and PSA 1.05+0.65 ng/ml. During the first 4 weeks, there was a steady increase in pre-injection T from 19.14+3.48 to 23.89+9.15 nmol/l (p¼0.1). However, after 8 weeks the post-injection T (25.77+7.67 nmol/l) remained similar to that of week 1 (27.46+12.91 nmol/l). Patients tolerated this therapy with no adverse effects.

Conclusions: A once-week SC injection of 50–100 mg of TE appears to achieve sustainable and stable levels of physiological T. This technique offers fewer physician visits and the use of smaller quantity of medication, thus lower costs. However, the long term clinical and physiological effects of this therapy need further evaluation.

More and more Docs are allowing SC injections of Test:

* Less Painful
* No Muscle Damage
* Smoother Metabolic Uptake (slower release of esters)
* Economical

There are members here who inject SC and they can chime in as well.

In short, SC injections of Testosterone is an effective, less painful and more economical approach to IM Test injections.

[Fred40]

I will have to look into this further when I have the time. A test comprising of "10" people can not be considered statistically significant.

Show me a long term test of 300 men (I know.....none exist yet).

This study said absolutely nothing about conversion to E2. It would still make sense that SC would result in a higher conversion rate.......but you're right.....where are the studies?

I'll see what I can find. Might not be much out there yet.

[steroid.com 1]

Show me proof, speculation is useless. More and more TRT Docs "in the know" are recommending SC injections. The OP's Doc knows exactly what he's doing and why he's recommending SC injections.

SC T is absorbed slower, less T spikes and less E spikes and lower E and SHBG overall, providing more FT. This was proven with clinical work in Canada above. Also, much less chance of hitting a vein, deep muscle infections, scar tissue...

I mix my injections sites and mode both IM and SC and have E2 of 22.6 pg/ml...but that's just me (1. mg AI weekly).

[Dpyle]

Indeed gdevine. I'm thinking after I get my levels stable. I may give the SC a try and see how it goes. Worst case scenario I just switch back to IM.

[steroid.com 1]

Indeed gdevine. I'm thinking after I get my levels stable. I may give the SC a try and see how it goes. Worst case scenario I just switch back to IM.

It's not so much where one injects as to how much and when it's injected. That's the key...