25yo blood test, need help

[jamull2852]

Ill start off saying that I am 25 years old and about a year ago I started feeling really tired, lazy, lack of energy in the gym. I would have to force my self to go to the gym and try to stay for atleast 30 mins. Few time I left after about 10mins just because I felt so weak. Deceided to get my blood tested and the Testosterone results came back at 350-360. Dr. told me this was within range and everything else looked good so after doing some research I figured my test should be way above 350-360. I think the range was 300-1100 according to the blood test. So I found another dr. who was wiling to put me on the gel which I didnt like and it didnt help either. After a month of that I was put on 200mg of test cyp. Dr made me feel like I was lying to him the whole time and just gave me the script just because and made me feel like I was wasting his time. So around the 4-5 week on 200mg a week I started feeling better in the gym, more energy, and sex was where it use to be. I couldnt stop touching my wife and stayed this way the all day which I like. Before the shots I couldnt even think about sex and was to tired when my wife was ready. So my blood test come back after the 5 week on 200 a week and test levels were 550 (7 days from last shot) I asked if they were testing estrogen levels and they said yes well come to find out they didnt and they told me to see a endo bc one of my gland levels were really low. Think it was the LH and FSH. So went see the endo and he had me to redo the blood work and this are the results.

LH .01L range(1.7-1.9)

FSH <0.2 range(1.5-1.7)

Test 1080 range(348-1197) 3 days after my shot

Free test 35.8 range(9.3-26.5)

Cortisol 16.8 range(2.3-19.4)

Prolactin 12.0 range(4.0-15.2)

Estradiol 49.8 range(7.6-42.6)

IGF-1 272 range(83-344)

So obv my LH, FSH, and estrogen is out of range. He told me my estrogen level is ok because I am on the testosterone. Which threw up a red flag for me because Ive read it should be around 20. HE wants me to get off the shots for 4 weeks and get blood done again to see if its the shots causing these low LH, FSH or if I really do have a problem. He also said 350 my orginal level was ok and normal but I told him how I was feeling and dont see how the very bottom of the range can be normal for some one my age.

9 weeks on 200mg a week and these are some of things I noticed.
-gained atleast 20-25 pounds(sure most is water bc of estrogen level)
- got a little stronger in gym
-week 4-5 libido was awesome, now its pretty much not their again
-feel an increase in energry
-sleep is way better than ever
-wake up middle of the night with pillow wet from sweat
- seems like its harder for me to "finish" while having sex
whats your thoughts on this and Im thinking I should also be on HCG , and an AI?

[HRTstudent]

Couple things...

Most importantly, you need to find a true expert doctor in male testosterone replacement . There is so much info on this site on how to do this. If you don't bother with this step, I honestly think about coming off TRT altogether.

Secondly, you are probably on too high of a dose. 200mg is, for every physician I have talked to or expert I read online, the upper limit. That means that only a minority of people need to be there... and really you shouldn't start there.

Finally, it sounds like you MIGHT be experiencing the beginnings of too-high estradiol. You need an estradiol SENSISITIVE/ULTRASENSITIVE test to be sure. Regular "estrogen" tests are completely meaningless... this is not just some exaggeration either. The right test for E2 is the difference between having some of value and having no test at all.

(Oh and for the most part, a blood cortisol test is not accurate/worthwhile as well)

If I was in your shoes I would ask the doctor to lower the testosterone dose anywhere from 50-100mg, and at the same time start researching for a new physician.

[jamull2852]

The first dr. gave me the 2oomg a week. The same dr. that made it seem like I was wasting his time. The new dr. Im going to seems alot better hes an endo, but threw a red flag at me when he said my estrogen was ok being that high. He wants to get me off the test for 4 weeks and have another blood test to get to the rut cause of why my test is low, and he said after the next blood test he will prescribe me test accordingly. Ive also thought 200 was high bc I havent read but like 3 ppl with 200 weekly, and my dr. also said the same.

[Brohim]

The first dr. gave me the 2oomg a week. The same dr. that made it seem like I was wasting his time. The new dr. Im going to seems alot better hes an endo, but threw a red flag at me when he said my estrogen was ok being that high. He wants to get me off the test for 4 weeks and have another blood test to get to the rut cause of why my test is low, and he said after the next blood test he will prescribe me test accordingly. Ive also thought 200 was high bc I havent read but like 3 ppl with 200 weekly, and my dr. also said the same.

Your E2 is out of range. Do you inject yourself? If so I would split your dose into two shot's, one on Monday mourning and one on Thursday night. This will help with spike in androgen level's which should help.

I concur with above, you need to find a specialist in TRT. Your libido will come back when you get your E2 within range (20-30)

[jamull2852]

Yes I was injecting once a week, thought about trying twice a week when I start back. Isnt an endo a TRT specialist?

[jamull2852]

do you think my LH, and FSH levels will come back where their suppose to be after the four weeks off of testosterone ?

[Brohim]

Yes I was injecting once a week, thought about trying twice a week when I start back. Isnt an endo a TRT specialist?

nope some endo's no nothing about TRT.

And why would you go off treatment for 4 weeks?

[Vettester]

HE wants me to get off the shots for 4 weeks and get blood done again to see if its the shots causing these low LH, FSH or if I really do have a problem.

Seriously?? Any doctor with any sense would know that exogenous test is going to suppress the HPTA!

Here's the answer to your concern: YES, the shots are responsible for your LH/FSH results being in the tank.
Internet Office Charge: Free (Tell your doctor you expect the same from him)

[Brohim]

LMAO! Your doctor is ignorant

[HRTstudent]

Yes I was injecting once a week, thought about trying twice a week when I start back. Isnt an endo a TRT specialist?

Absolutely not. Its a common misconception. But endos are specialists in diseases of the thyroid and, most of all, diabetes specialists. They often have very little training in male TRT other than literally a few diseases like klinefelters.

A specialist in TRT is more likely to be an internist or urologist who specifically goes after self-training in TRT. Its not taught much in medical training.

[jamull2852]

I thought my self that once you start taking testosterone that your body will stop producing its own, and Ive always read that you will need clomid or something else to help kickstart your natural test again. So I dont see why he will want me to come off the test cold turkey and try another blood test. He said he wants to see if the test is the reason of my low levels, but even I could have told him it was. It just makes me mad that I waste 2.5 hours in his office and waste a co pay for him to just say come off for 4 weeks and try another blood test.

What do you think I should do? Stay on it and find another dr. and start over? Maybe I can go to my first dr. (urologist who sent me to the endo) and get the two blood test that I took their and give them to him since one was without any shot?

[jamull2852]

I think thats what Im going to do is get all my blood work test together from my previous dr. and bring to him and stay on the shots until I can find another dr.
Now a few more questions
When you see the levels I have what do you think I need?
Would HCG and of coarse an AI be what I would need?
And when should I do blood work, like how many days after my last shot?

Thanks for your help so far guys I just want to try to feel normal again and cant see going back to feeling like crap again for 4 weeks to prove nothing

[oldschoolfitness]

i went to a urologist for my trt. my wife worked under him as a nurse for 5 yrs so i know him well. i've only been on a few days and he started my out on 200mg/wk (bloodwork after a month). what really surprised me is the amount of info he knew about test; which secured my decision to see him and made me confident in his practice. i think you should see a urologist (hope you get a well trained one). best of luck to ya

[jamull2852]

My urologist is the one who sent me to an endo and the urologist almost made me feel like I was wasting his time and just wrote me a script bc I said I would like to try the injections over the gel. Didnt really explain anything to me and wrote the script and that was it.

[Vettester]

Agree that because he's an endo doesn't make him a specialist. I worked with an endo early on in my HRT campaign, and that guy was the absolute worst doctor I've ever dealt with. He actually fired me as a patient when I sent him information on HCG from the Journals of Endocrinology. It hurt his ego that even his own peers went against what he was telling me ...

Your original baseline test score was low, but not totally in the tank. What we need from that time is your original LH & FSH score, and any other labs you might have taken. Hoping Thyroids were in the mix back then. If LH/FSH was low, you may need to go back to square one and start with an MRI.

Not sure if you would be successful restoring any natty or not. Just know, when you start HRT, it's a lifetime commitment. It's not meant to jump on it today because someone has a few symptoms and their score is kind of low, then six months later decide to go back.

[jamull2852]

Yes I know it was an lifetime commitment and I will be getting my three other blood test hopefully tomorrow from my urogolist and will post them when I get them.

Looking at my low LH/FSH what would raise that? would HCG take care of it?

[Vettester]

Yes I know it was an lifetime commitment and I will be getting my three other blood test hopefully tomorrow from my urogolist and will post them when I get them.

Looking at my low LH/FSH what would raise that? would HCG take care of it?

No, HCG will have no effect with stimulating GnRH production with your HPTA. It will only mimic LH to the leydigs in the testicles, which will stimulate them to produce natural, or call it endogenous testosterone .

If there's any hope with trying to restart your HPTA, you would need to research a SERM like Clomid or Nolva. I would suggest reading up on these compounds, the HPTA, and how the negative loop process factors in with making it all function.

[jamull2852]

Might be a dumb question but I know being on the shots it will lower my LH,FSH but is it suppose to be that low, is it normal for it to be that low while on 200mg a week?
Sorry for all the questions Im trying to research and ask as much as I can so I can talk more with the drs.

[jamull2852]

Found this on another site
"If you go on TRT, your LH and FSH will remain low. This is the normal HPTA process. When your pituatary is working correctly, the LH and somewhat FSH levels will go up with lower testosterone levels . LH stimulates the testes to make testosterone . If you introduce testosterone yourself, the LH and FSH will fall or remain low. You need to eliminate a possible pituatary tumor. If your pitutary function is low, I would also test TSH, fT4, fT3, Cortisol. Your pitutary gland releases a lot of hormones that make a lot of different functions happen in your body."
Makes sense to me now, and will just wait until I try to get my other test from before my TRT and post them here.
Thanks everyone esp. VETTE