Low-T, wasn't surprised. Strategy time!

[bluesman]

Greetings gentlemen,

I have a few posts in this forum about getting back into working out and eating right and feeling better. I gave it a few good tries, but noticed something considerably different as compared to when I used to work out as a younger man.

My background: 38-year-old male 5 foot 10, 230lbs. Despite not working out consistantly have maintained some muscle mass, I have relatively wide shoulders and large bone structure.

I've always been a good eater, and tend to favor protein sources such as fish, red meat, poultry and eggs, as well as fresh vegetables.

Over the past few years, I've come to notice, especially now ,signs of low testosterone. Some depression, low energy levels, reduced libido, and a difficult recovery process after working out.

I took a private lab draw a few months ago and came up with the following information

Serum testosterone 309 ng/dL reference (249-836)
luteinizing hormone, S 3.2 mIU/mL reference (1.7-8.6)
FSH, serum , 2.5 mIU/mL reference(1.5-12.4)
Estradiol 24.7 pg/mL reference (7.6-42.6)

I then took another test about a month ago with the following results:

Total testosterone 100.6 reference range (196-782) ng/dL
free testosterone 2.75 reference range (5.2-18.0) ng/dL
bioavailable testosterone 63 reference range (119-470) ng/dL
SHBG 15 reference range(12-59) nmol/L
TSH 4.40 reference range 0.35 – 4.94 uIU/ml
total PSA 0.49 reference range 0.0 – 4.0 ng/ml

My doctors impressions were abnormal low testosterone, okay SHBG, borderline low thyroid, and okay, prostate.

These were the results after my second visit with the doctor, and after having taken finasteride 5 mg for a month.

He is a general practitioner, but seems to be very enthusiastic about helping me with my issues. He ordered testosterone gel 5% 120 g jar 1/4 teaspoon per dose.

I'm actually a little hesitant to start HRT, primarily after reading some of the posts here regarding complete shutdown, shrinking balls, I am wondering if I need to make sure I have some HCG on hand. I also have some reservations about testosterone gel in terms of safety for my pregnant wife, my dog, and the fact that I am sweaty a lot, and that the cost is prohibitive as I am trying to support my family.

I have seen the various threads recommending consultation from doctors specializing in TRT protocols. I am curious of the impressions that you may have regarding my situation.

[zaggahamma]

at 100 ng/dl you are bout as close to shutdown as obama is to helping the economy so lose the reservations

yes very few here like the gel(s) , to be completely sure of not contaminating your family you would want to put it on and dry and cover up with clothes of course EVERYDAY for the rest of your life but no biggie

hcg is needed to keep testicles from atrophy and many other benefits are shown...you dont need it on hand from the get go...it would be best added in later when you have your testosterone implemention down/dialed in to a good level

equally important is most trt'ers use an AI to keep their estrogen down while on trt as during trt your body wants to convert some of the quality hormone testosterone into the nasty estrogen...you most likely need this sooner than the hcg...

do some thourough reading within this hrt forum and you can gain quite a bit of understanding and maybe answer some of your next questions

welcome

[bullshark99]

Well said above, you are basically down already. I would think a solid protocol would make a tremendous difference in how you feel both mentally and physically.

[sirupate]

Give TRT a go. Sounds like you need it. I'd be more in favor of the gels (especially A-gel) if your insurance covers than a compounded cream. Injections will be much cheaper than gels or cream if your doctor will go along. Some guys will need an AI, but a few won't. We are all slightly different and all need to be "tuned" to a protocol that works for each of us.

Update us as you go through this.

[SEOINAGE]

Have you mentioned injections to your doctor? When I mentioned I was worried about the gel, he mentioned a new product coming out that is applied like deodorant that is applied to your arm pits, so as in an area that is less likely to come in contact with others. Personally I am going to push for injections, but he mentioned a whole bunch of alternatives and things to do to avoid contact. but sometimes I wonder if he is just pushing the gel cause because of cost and who knows what influences him, I know he pushes snythroid over armor thyroid because of vendors etc, but he will do either if you like, although his receptionist gave me a ton of crap when i told her i wanted to switch.

I think people gave some good advice, ai and hcg are definite things to consider, you are fortunate your doctor checked your estradiol, might be willing to prescribe an ai if that gets out of hand, just be careful because some aren't quite sure on the proper dosages.

[steroid.com 1]

Your Thyroid is not okay at 4.4; your thyroid is working very very hard and there is a reason for that.

Many of the same symptoms of low Test are in Hypothyroidism and another reason why you may feel like you do.

Need to see:

T4
T3
RT3
Antibodies

[bass]

at 100 ng/dl you are bout as close to shutdown as obama is to helping the economy so lose the reservations

yes very few here like the gel(s) , to be completely sure of not contaminating your family you would want to put it on and dry and cover up with clothes of course EVERYDAY for the rest of your life but no biggie

hcg is needed to keep testicles from atrophy and many other benefits are shown...you dont need it on hand from the get go...it would be best added in later when you have your testosterone implemention down/dialed in to a good level

equally important is most trt'ers use an AI to keep their estrogen down while on trt as during trt your body wants to convert some of the quality hormone testosterone into the nasty estrogen...you most likely need this sooner than the hcg...

do some thourough reading within this hrt forum and you can gain quite a bit of understanding and maybe answer some of your next questions

welcome

LOL! i agree he is shutdown, his free T is below normal. also agree with GDevine, thyroid working hard. OP, run the tests GD suggested.

[HRTstudent]

Your first test had you in range, but your second test had you below the range. So... that tells me that we still don't really know where you stand.

If you are simply low-normal there are things you can do before commiting to T therapy. There are a lot of options actually and it's worth exploring those.

Also, if you can control it, try to get bloodwork done at the same lab for consistency reasons in the future.

[steroid.com 1]

Just so everyone knows, and as may be the case of bluesman; very low testosterone serum levels can and will cause Hypothyroidism so his TSH assay comes as no surprise.

His Physician should have caught this and said something.

With a good TRT protocol it may correct itself.

Bluesman needs to discuss this with his Physician and get the other panels noted here tested.

[zaggahamma]

also
imo, for those in late 30's and older i wouldnt recommend pct unless they had optimum levels and just ran a cycle and thats why they are low normal

[bluesman]

first off,I like to say thank you to everybody who has replied so far. Right now I'm sitting here with my shirt off, I just got done putting the testosterone gel on. I think my fears were unfounded, as the material that I applied was quite nearly dry by the time I left the bathroom. Following Dr. Crisler's recommendation, I just put the quarter teaspoon between my palms, and rub it into my shoulders, when my shoulders were done, I rubbed the very small remainder on my flanks. My hands were nearly clean by that time, and I washed my hands well under the running faucet. I'll let this set up for a few minutes and then just throw a shirt on.

I spent quite a few hours last night after my post getting educated on what I'm facing here.

In regards to my low testosterone level, I am confident that I need to have a levels restored, regardless of what I fine tuning may ultimately be utilized. I will therefore began my TRT, and follow-up with my doctor on watching my estrogen levels, and other hormones, any side effects, and most conspicuously, my test level.

I should have put quotation marks around my statement about the impressions my doctor wrote regarding my various levels, especially the TSH level. I feel that just being borderline is not good enough anymore. I will initiate further inquiry into this situation as new results and tests are performed. I would bet that my elevated TSH level indicating hypothyroidism is exacerbating the symptoms that I am experiencing, i.e., increased body fat, lethargy etc. and from what I've read as mentioned below, the low testosterone may be the causative factor.

In regards to the statement about where I got my labs, I fully agree. The private lab draw that I took was my own doing. Off insurance. This latest lab draw was under a new insurance and employer. I intend to stick with the same lab to get consistent results, of course.

In regards to my doctor's ethics. I truly believe that he is on the up and up. He stated to me unequivocally that he supports my goal fully of restoring my drive libido and enthusiasm to former levels via testosterone and hormone repla***ent therapy. The compounding pharmacy that he put me in touch with is the only one in the state, as far as I know. I spoke with the pharmacist about alternatives, when I went to pick up my gel a few weeks back. The pharmacist stated that the cost of the injectables would be cheaper at the current dose that I was using. At that time as I stated in my initial post I was apprehensive about the gel product. I am less so now. The pharmacist gave me no impression that he would be interested in putting me into less affordable products, nor has the doctor indicated such. I have other medications that the doctor has ordered double doses for, for me to split in half to save more money, so I truly feel that he is bound ethically to me. One thing I find good about the gel product is the consistent dosing, rather than half-life scenarios with injectables. To a point of course, as I'm not terribly excited about a short ester daily or every other day injection scenarios..

So in short, I'll be keeping a close eye on the balls, nipples and lab values. Thank you for your support and encouragement, I'll be around and updating.

One new question I'd like to ask, if I have a prescription for various TRT, AI, HCG, etc. products, is my possession of those products regardless of the source, i.e., UGL's/legitimate brick-and-mortar compounding pharmacies/mail order/Internet pharmacies, legal? I want to save as much money to support my family as I can, but I can't support my family if I lose my job or go to jail. This is extraordinarily important to me and am completely unwilling to jeopardize my family in any way. I'll go back to no TRT at all if I feel we can't make ends meet properly.

Sorry about the book, I guess I'm inspired.

[zaggahamma]

first off,I like to say thank you to everybody who has replied so far. Right now I'm sitting here with my shirt off, I just got done putting the testosterone gel on. I think my fears were unfounded, as the material that I applied was quite nearly dry by the time I left the bathroom. Following Dr. Crisler's recommendation, I just put the quarter teaspoon between my palms, and rub it into my shoulders, when my shoulders were done, I rubbed the very small remainder on my flanks. My hands were nearly clean by that time, and I washed my hands well under the running faucet. I'll let this set up for a few minutes and then just throw a shirt on.

I spent quite a few hours last night after my post getting educated on what I'm facing here.

In regards to my low testosterone level, I am confident that I need to have a levels restored, regardless of what I fine tuning may ultimately be utilized. I will therefore began my TRT, and follow-up with my doctor on watching my estrogen levels, and other hormones, any side effects, and most conspicuously, my test level.

I should have put quotation marks around my statement about the impressions my doctor wrote regarding my various levels, especially the TSH level. I feel that just being borderline is not good enough anymore. I will initiate further inquiry into this situation as new results and tests are performed. I would bet that my elevated TSH level indicating hypothyroidism is exacerbating the symptoms that I am experiencing, i.e., increased body fat, lethargy etc. and from what I've read as mentioned below, the low testosterone may be the causative factor.

In regards to the statement about where I got my labs, I fully agree. The private lab draw that I took was my own doing. Off insurance. This latest lab draw was under a new insurance and employer. I intend to stick with the same lab to get consistent results, of course.

In regards to my doctor's ethics. I truly believe that he is on the up and up. He stated to me unequivocally that he supports my goal fully of restoring my drive libido and enthusiasm to former levels via testosterone and hormone repla***ent therapy. The compounding pharmacy that he put me in touch with is the only one in the state, as far as I know. I spoke with the pharmacist about alternatives, when I went to pick up my gel a few weeks back. The pharmacist stated that the cost of the injectables would be cheaper at the current dose that I was using. At that time as I stated in my initial post I was apprehensive about the gel product. I am less so now. The pharmacist gave me no impression that he would be interested in putting me into less affordable products, nor has the doctor indicated such. I have other medications that the doctor has ordered double doses for, for me to split in half to save more money, so I truly feel that he is bound ethically to me. One thing I find good about the gel product is the consistent dosing, rather than half-life scenarios with injectables. To a point of course, as I'm not terribly excited about a short ester daily or every other day injection scenarios..

So in short, I'll be keeping a close eye on the balls, nipples and lab values. Thank you for your support and encouragement, I'll be around and updating.

One new question I'd like to ask, if I have a prescription for various TRT, AI, HCG, etc. products, is my possession of those products regardless of the source, i.e., UGL's/legitimate brick-and-mortar compounding pharmacies/mail order/Internet pharmacies, legal? I want to save as much money to support my family as I can, but I can't support my family if I lose my job or go to jail. This is extraordinarily important to me and am completely unwilling to jeopardize my family in any way. I'll go back to no TRT at all if I feel we can't make ends meet properly.

Sorry about the book, I guess I'm inspired.

can u send me the audio dvd for this post

[steroid.com 1]

can u send me the audio dvd for this post

Funny shit!!!

[SEOINAGE]

Lol I actually read it, last few minutes of work for the week and super bored.

[bluesman]

Sorry guys, like I said, inspired.

[HRTstudent]

Sorry guys, like I said, inspired.

That's great. Like you, I am trying to make gels work because of the favorable more-natural rise and fall. And with an injection it more replicates the rise and fall of elderly men.

As for the place you buy a drug, if you are on a gel I think the cheapest way to get it it is through insurance anyways. And that will probably be the same price anywhere except perhaps express scripts if you can use that. Also, you might not need an AI or HCG. Those are really only used if necessary and many people, on gels especially, don't need an AI. HCG, it seems, might be something to benefit you but from what I gather it is very subjective.

Finally, if price really does become a concern then simply go to injects. They have been around for decades and your co-pay would probably be around 10-20 bucks for a 2-3 month supply.

[bluesman]

I'm not covered on testosterone... $70/120gram jar.

[zaggahamma]

jar is for jelly

test comes in vials