New to TRT

[gymbud]

Hi Guys,

I'm 28 -- my Test levels were low for my age range, but not outside of range. Anyhow, my endo has agreed to trial 200mg/2wk of Delatestryl - I am mostly happy with the results. I just had my 3months bloodwork done. Everything is normal, except for LH and FSH which is not unexpected (my appt with doc is on Wednesday). As far as sides are concerned, I think I have experienced a general 'increase in body temp' (especially noticeable in hands, feet) and initially some bloating (which I think has subsided now). My question is, other than shrinkage, could these low levels of LH and FSH have other adverse outcomes? I am not concerned with having children, and so I was wondering if there's any reason to suggest to the endo that we add in a low scheduled dose of HCG or leave things as they are?

(these values are 2weeks after injection)
Follicle Stimulating Hormone 0.2 range:2.0 - 18.0 U/L
Leutinizing Hormone (LH) < 0.2 range: 2.0 - 18.0 U/L
Test: 12.5 range: 8.4 - 28.7 nmol/L

(all CBC values are normal)

Thanks

[kelkel]

Welcome gymbud. Sorry you were left hanging for hours but weekends are inherently a little slower here. First and foremost your doc doesn't understand the half life of test. It's around 5-7 days. You need to split that dosage to 100mg per week for much more stable levels. Your LH & FSH levels are crashed as your in HPTA shutdown. That's normal now as your body is not producing on its own anymore and living off of exogenous Test. Effects of low levels? Read GD's sticky at the top of the forum on HCG. It explains why you need it in detail so I won't go into it here. Your answer: "YES." Read up. Read all the stickies actually.

Your bloating could be caused by water retention relative to Estrogen levels and test levels. Or even due to some internal inflamation, diet, thyroid, way to many things to guess without seeing complete BW. Was a sensitive estrogen assay performed? If so, what are the results? It's possible you may need an AI to help control your E. But that's guessing without the above assay. The range for Test that you listed. Is that serum or free? Either way it's a bit low still. When was your BW pulled prior to the last injection? If it two weeks that can explain it as your test will be in the toilet two weeks after injection (see half life.)

A lot of questions above but answer if you can. It will help us help you out.

Again, welcome to the forum. Stick around and learn!

[gymbud]

Welcome gymbud. Sorry you were left hanging for hours but weekends are inherently a little slower here. First and foremost your doc doesn't understand the half life of test. It's around 5-7 days. You need to split that dosage to 100mg per week for much more stable levels. Your LH & FSH levels are crashed as your in HPTA shutdown. That's normal now as your body is not producing on its own anymore and living off of exogenous Test. Effects of low levels? Read GD's sticky at the top of the forum on HCG. It explains why you need it in detail so I won't go into it here. Your answer: "YES." Read up. Read all the stickies actually.

Your bloating could be caused by water retention relative to Estrogen levels and test levels. Or even due to some internal inflamation, diet, thyroid, way to many things to guess without seeing complete BW. Was a sensitive estrogen assay performed? If so, what are the results? It's possible you may need an AI to help control your E. But that's guessing without the above assay. The range for Test that you listed. Is that serum or free? Either way it's a bit low still. When was your BW pulled prior to the last injection? If it two weeks that can explain it as your test will be in the toilet two weeks after injection (see half life.)

A lot of questions above but answer if you can. It will help us help you out.

Again, welcome to the forum. Stick around and learn!

kelkel: First off, thanks so much for your thorough response.

1. Agree -- HPTA shutdown is to be expected. I will read up on the stickies as you suggested. I guess I just wanted to make sure I'm prepared for my meeting with the doc Wednesday -- he had previously asked whether having kids is a concern, etc. so I think he would be open to adding HCG to the regimen, although that was never specifically mentioned. He does seem to be knowledgable about TRT in general (he's an advocate for it for the most part, works at the university, and has a bunch of work and even youtube vids on testosterone).

2. I did mention the 2weeks vs 1week issue to him when we first started all of this -- he suggested we start with 2 and see how it goes. I don't know what he will be expecting for a value 2 weeks after last injection. In my own mind I argued: yes, it's starting to get low, but likely only been "lowish" for a couple of days, and thus maybe not such a big deal? Or, perhaps switch over to a regimen where I do 150mg week 1, supplement week2 with a 50mg pin, and then back to 150.. alternating.. or is that a stupid idea and much better to just do equal 100mg shots?

3. Agreed -- I would've liked him to request E2, but he hadn't and gave me the paper work when I saw him 3 months ago. Thus, I have not yet told him about the bloating side effect. On my original bloodwork, prolactin was slightly elevated.. I think I've narrowed down the cause to some sleeping meds that I take somewhat often (trazodone), where there's one report of increased prolactin in the literature.

4. The T value was total serum testosterone.. I'm Canadian and the gov. pays for the tests..unfortunately they only indicate free testosterone when values are below 10nmol/L for total. I don't seem to have the option to pay for the test either. Although I will discuss this with endo if need be.

5. He had requested SHBG be done also -- for some reason, it's not on my test results. I'm wondering if it's the same deal as with the free test, or if the lab made a mistake. I will discuss this with him on Wednesday also.

[kelkel]

kelkel: First off, thanks so much for your thorough response.

1. Agree -- HPTA shutdown is to be expected. I will read up on the stickies as you suggested. I guess I just wanted to make sure I'm prepared for my meeting with the doc Wednesday -- he had previously asked whether having kids is a concern, etc. so I think he would be open to adding HCG to the regimen, although that was never specifically mentioned. He does seem to be knowledgable about TRT in general (he's an advocate for it for the most part, works at the university, and has a bunch of work and even youtube vids on testosterone). Sounds like a decent doc then. Seriously read the sticky on HCG and evaluate

2. I did mention the 2weeks vs 1week issue to him when we first started all of this -- he suggested we start with 2 and see how it goes. I don't know what he will be expecting for a value 2 weeks after last injection. In my own mind I argued: yes, it's starting to get low, but likely only been "lowish" for a couple of days, and thus maybe not such a big deal? Or, perhaps switch over to a regimen where I do 150mg week 1, supplement week2 with a 50mg pin, and then back to 150.. alternating.. or is that a stupid idea and much better to just do equal 100mg shots? Bad idea. You want consistency of levels, not a roller coaster ride which has a domino effect on other hormones as well

3. Agreed -- I would've liked him to request E2, but he hadn't and gave me the paper work when I saw him 3 months ago. Thus, I have not yet told him about the bloating side effect. On my original bloodwork, prolactin was slightly elevated.. I think I've narrowed down the cause to some sleeping meds that I take somewhat often (trazodone), where there's one report of increased prolactin in the literature. Definitely find a way to get E2 done. It's a needed element on a TRT protocol. Keep an eye on your prolactin.

4. The T value was total serum testosterone.. I'm Canadian and the gov. pays for the tests..unfortunately they only indicate free testosterone when values are below 10nmol/L for total. I don't seem to have the option to pay for the test either. Although I will discuss this with endo if need be. Be good to know it although there are those that feel TT is just as good a measurement as TT is the "bank" from which free T comes from. If you don't know your D level start supplementing with D3. It will raise your free T by lowering your SHBG level. Most all are low.

5. He had requested SHBG be done also -- for some reason, it's not on my test results. I'm wondering if it's the same deal as with the free test, or if the lab made a mistake. I will discuss this with him on Wednesday also.

Answers above in bold...

kel

[gymbud]

2. I did mention the 2weeks vs 1week issue to him when we first started all of this -- he suggested we start with 2 and see how it goes. I don't know what he will be expecting for a value 2 weeks after last injection. In my own mind I argued: yes, it's starting to get low, but likely only been "lowish" for a couple of days, and thus maybe not such a big deal? Or, perhaps switch over to a regimen where I do 150mg week 1, supplement week2 with a 50mg pin, and then back to 150.. alternating.. or is that a stupid idea and much better to just do equal 100mg shots?

Bad idea. You want consistency of levels, not a roller coaster ride which has a domino effect on other hormones as well

OK, thanks. At least on this issue I don't need the doc's 'approval' since I'm doing injections myself

3. Agreed -- I would've liked him to request E2, but he hadn't and gave me the paper work when I saw him 3 months ago. Thus, I have not yet told him about the bloating side effect. On my original bloodwork, prolactin was slightly elevated.. I think I've narrowed down the cause to some sleeping meds that I take somewhat often (trazodone), where there's one report of increased prolactin in the literature.

Definitely find a way to get E2 done. It's a needed element on a TRT protocol. Keep an eye on your prolactin.

Will do. Worst case scenario, I will get my dad to request it (he's an MD not too far from me), but rather keep open lines of communication with the endo for now

4. The T value was total serum testosterone.. I'm Canadian and the gov. pays for the tests..unfortunately they only indicate free testosterone when values are below 10nmol/L for total. I don't seem to have the option to pay for the test either. Although I will discuss this with endo if need be.

Be good to know it although there are those that feel TT is just as good a measurement as TT is the "bank" from which free T comes from. If you don't know your D level start supplementing with D3. It will raise your free T by lowering your SHBG level. Most all are low.

Yeah, since Vancouver isn't a very sunny place, it's likely that D is quite low. I will keep supplementing with D3 as I've done in the past -- didn't know it lowered SHBG

Will update you once I have some more info