Determining if you are Primary or Secondary *after* TRT started

[junk2222yard]

Like many people doing TRT, I realize I jumped into it before I was informed enough, and with a doctor whom I respect, but who may have been a little hasty to let me begin! Symptoms I had supported a Low T diagnosis, which was confirmed with bloodwork, and I began using exogenous testosterone with an Rx from him, all covered by insurance!

Only after the fact have I read about being Primary Hypogonadal, versus Secondary Hypogonadal, and how testing LH and FSH before jumping in would have told me the story. And would have helped me choose the right protocol. But I am well into this now. I am on Test E, an AI, and yesterday added hCG for the first time.

Is it too late to determine if I am Primary or Secondary now? And does it even matter now?

I will say, from the get-go of using Test E., I got an ache in my balls. And they are tighter now -- zero hang! -- and after only two months, smaller by a fair bit. (Which is why I added the hCG!) Does the fact that my balls shrank considerable since starting T tell shed light on if I am Primary or Secondary?

[Sworder]

No, your labs pre-TRT are the only thing that can tell if you are primary or secondary. If you have a history of AAS use and that may be the causation, a restart may be possible!

[GetItHot]

When I started I was very uninformed. My doc just ordered labs for test and total test. After months of screwing around I got my referral to my endo. To find out if I was primary or secondary, I could go off trt for a month and get my lh and fsh levels checked, or I could get an MRI.

[highpsi]

Same conclusion here, stopping mine after 3 weeks. Was just thrown in without complete BW. Hoping things start up quick.

[pugster]

unless you are young and want to try hcg mono (if secondary) the standard treatment for both is TRT , when i was waiting for my dx i was thinking 'primary or secondary ?' , only to be told 'you have mixed primary+secondary hypogonadism' - so im **cked both ways

[junk2222yard]

unless you are young and want to try hcg mono (if secondary) the standard treatment for both is TRT , when i was waiting for my dx i was thinking 'primary or secondary ?' , only to be told 'you have mixed primary+secondary hypogonadism' - so im **cked both ways

Yes, I was thinking this may be he case. I have seen comments here mentioning that hCG alone will not work long term. (And I am not young, either, although I didn't know that was a requirement or at least "nice to have". I am 42 years old.)

I thought there are people that believe that hCG mono can work, however? One of the big names I keep seeing (either Shippen or Crisler I think) recomends starting with hCG mono, and add more to the mix only if that proves ineffective. Maybe this has been debunked in recent years?

[pugster]

i dont know much about hcg use tbh as im in the UK and its not used here on a routine basis , i think tho that desensitisation occurs with long term hcg use, so at some stage it has to be stopped for awhile (im sure one of the vets here can clarify this)

[BillyBob210]

Too late to tell now, but you should get an MRI to test for pituitary tumors. Just in case you are secondary and the removal of tumors could reverse the situation......with some help to kick start the system.

[kelkel]

Call your doc or your lab and get a copy of your pre-TRT BW. It's on file at both places. Post the results here and let us take a look.

And 42 is not old, btw.

kel

[Brazensol]

Add me to the list of unknowns! It would be nice to have known primary or secondary but at this point and time (50 years old) I will stick with the trt/hrt.

[steroid.com 1]

A simple fertility test will tell you if your testes are functioning or not.

Now that you are on HCG watch and see if you have any changes in your testes like bigger in size and shape; if so, they are reacting/responsive to the HCG and would point to Secondary condition.

If you are primary, the testes will not respond to HCG.

Primary conditions are usually due to injury or pathology which you'd know if you had either.

How old are you?

[junk2222yard]

A simple fertility test will tell you if your testes are functioning or not.

You mean as proof of whether the hCG is working? (As in if I have sperm, the hCG is doing the trick?)

Now that you are on HCG watch and see if you have any changes in your testes like bigger in size and shape; if so, they are reacting/responsive to the HCG and would point to Secondary condition.

If you are primary, the testes will not respond to HCG.

Primary conditions are usually due to injury or pathology which you'd know if you had either.

Ok, good to know. I will be disappointed if my balls don't bounce back and hang!

How old are you?

42.

[xtitan1]

Just wanted to share one anecdote for anyone thinking about stopping TRT to figure out primary/secondary from LH/FSH numbers...

I was on Androgel for about a year. I stopped the gel in order to figure out whether I was primary or secondary. After 2 months my LH and FSH had risen from out of range low to normal. After another 2 months, my LH and FSH were now out of range high!

Moral of the story: while everybody is different, at least in my case I had to wait about 4 months to see my true numbers after stopping TRT.

[steroid.com 1]

You mean as proof of whether the hCG is working? (As in if I have sperm, the hCG is doing the trick?)

Yes and the number of.

Ok, good to know. I will be disappointed if my balls don't bounce back and hang!

They should respond if you're Secondary.


42.

Age related androgen deficiency?

[junk2222yard]

Age related androgen deficiency?

Had to google that term: "Age related androgen deficiency".

This is just a fancy term for getting old and having testosterone levels decline, right? As in "Andopause", right? (Not trying to be glib, I am honestly not 100% sure.)

[steroid.com 1]

Had to google that term: "Age related androgen deficiency".

This is just a fancy term for getting old and having testosterone levels decline, right? As in "Andopause", right? (Not trying to be glib, I am honestly not 100% sure.)

The term is commonly used by most clinicians and specialists as there are many conditions that can cause hypogonadism in men.

[junk2222yard]

Now that you are on HCG watch and see if you have any changes in your testes like bigger in size and shape; if so, they are reacting/responsive to the HCG and would point to Secondary condition.

If you are primary, the testes will not respond to HCG.

Primary conditions are usually due to injury or pathology which you'd know if you had either.

How old are you?

Ok, I have been on hCG for 3 weeks and have had a confusing response:

1. my actual ball size has not changed (they are about 80% of pre-TRT size)
2. my actual gonads are harder (less "mushy")
3. my balls ache much less (though still do every now and again)
4. my sack is hanging much better!

I kind of feel like the hCG has halted further ball shrinkage, but I will be stuck with the loss already incurred?

And I am guessing since the balls are somewhat affected by hCG, I have a Secondary condition?