Test levels at 20

[NEVERBIGENOUGH]

So I already know screw the pooch on this. Not the first time and prolly why
I am 33
Several cycles
I usually jack the pct some how but have come out with sex drive and very minimal loss of muscle and strength
So I got a Hernia went to dr.
Did a blood panel worried about my bp. It's fine now 120/78
But the kicker is
I ran 4 or 5 weeks and had to stop
100 mg test c
150 tren e
For those weeks, I know imam stupid but I didn't run pct
It's been a month or so since.
A week ago ,y sex drive disappeared. No morning wood nothing
I have always felt up and down before aas even my moods
So my test came back at 20
Yes i said 20!!!
So have I always been low t or did I **** my self?
It slow felt like its coming back but I have a lot on mind that week too. But 20!!!!!
I went to dr on 10/30/2012
She wants me on 200 mg test c everyb2 weeks
I did the dumb guy thing and didn't tell her I was on short cycle and stopped
I wonder if imam still shut down or I really am low t.
But my level is 20

[NEVERBIGENOUGH]

I have no shrinkage in my testes.
Just tired lack of sex drive which my fiancé is pissed about.
I am going to call dr. This morning. I wasn't totally honest with her. Ugh I know. Maybe I am just shut down. But this is first time this has happened to me.
I moved this thread from pct to here.
They suggested I call dr get on some hcg and clomid

[kelkel]

Do you have the complete BW that you can post with ranges? It would help us to help you. 4-5 weeks is more than enough to shut you down and yes, PCT would obviously be a great idea. Hopefully your doc is understanding and will help you with this. Print out some info regarding PCT and get it to her and ask for her help. A basic simple pct is below:

nolva 40/20/20/20
clomid 100/50/50/50

Or, take a look at this. This is from Dr. Scally who is a leading researcher in the field:

"HPGA Normalization Protocol After Androgen Treatment
N Vergel, AL Hodge, MC Scally
Program for Wellness Restoration, PoWeR


Objective Results Discussion

To develop an approach to cycle androgens that would result in significant changes in body composition and accelerate the normalization of the hypothalamic pituitary gonadal axis (HPGA) after cessation of androgens.

Methods

An uncontrolled study of 19 HIV-negative eugonadal men, ages 23 – 57 years, administered testosterone cypionate and nandrolone decanoate for 12 weeks, and then were treated simultaneously with a combined regimen of human chorionic gonadotropin (hCG ) (2500 IU/QODx16d), clomiphene citrate (50 mg PO BID x 30d) and tamoxifen (20 mg PO QD x 45d), to restore the HPGA.

Results

Mean FFM by DEXA increased from 64.1 to 69.8 kg (p<.001); percent body fat decreased from 23.6 to 20.9 (p<.01); strength increased significantly from 357.4 lb to 406.4 lb (p=.02). No significant changes in serum chemistries and liver function tests were found. HDL-C decreased from a mean value of 44.3 to 38.0 (p=.02). Mean values for luteinizing hormone (LH) and total testosterone (T) were 4.5 and 460, respectively prior to androgen treatment. At the conclusion of the 12-week treatment with androgens the mean LH <0.7 (p<.001) and total testosterone was 1568 (p<.001). The mean values after treatment with the combined regimen were LH=6.2 and testosterone=458.

Discussion

The use of androgens has been reported to improve lean body mass, strength, sexual function, and mood accompanied by side effects caused by continuous uninterrupted use of these compounds (polycythemia, testicular atrophy, hypertension, liver dysfunction [oral androgens] and alopecia.) Androgen-induced HPGA suppression causes a severe hypogonadal state in most patients that often require an extensive period of considerable duration for normalization. This prevents most if not all individuals from cycling off these medications due to the adverse impact of this state on their previously gained LBM and quality of life. The protocol of hCG-clomiphene-tamoxifen was successful in restoring the HPGA within 45 days after androgen cessation. Further controlled studies are needed to determine if these results can be duplicated in HIV positive subjects.


PRACTICAL APPLICATION

The esters used in the abstract were cypionate and deconate however the administration of the PCT medications were started the day after aas cessation. Essentially the aas esters were still active when PCT began. The first 16 days a large amount of HCG was used in order to increase the mass of the testes so that they could sustain output of testosterone sooner. The HCG was stopped about the time the esters cleared so that estrogenic activity from the HCG would be reduced. During those first 16 days 2 different SERM’s were also employed (Clomid and Nolvadex ) This protocol is contrary to what is typically recommended in many forums but regardless the protocol was effective in all 19 men. This is a 100% success rate! After the HCG was discontinued both SERM’s were continued. The following is the exact protocol in laymen’s terms.

Day 1-16 : 2500iu HCG every other day. (I believe this has been reduced to 2000)
Day 1-30 : Nolva 20mg/day; Clomid 100mg/day (50mg was taken twice per day)
Day 31-45 : Nolva 20mg/day

I now strongly believe that an AI should be used as long as there is an aromatizing compound being administered. In this case Testosterone and HCG aromatize therefore using an AI until these meds clear is now what I am recommending. There is some evidence that adding Nolva to an AI does not increase the effectiveness of estro control therefore Nolva has no real advantage alongside an AI unless one is experiencing gyno. Additionally Nolva has been shown to reduce IGF-1 and GH levels. This is not a big deal on cycle as testosterone increases IGF-1 in a dose dependant relationship. However off cycle this is a problem. PCT is a fragile time and lower IGF-1 and GH levels is not desireable as I am sure you can appreciate. The last few days I have been relooking at AI's to find one that is specific to men that can be used on cycle and during PCT. It is my conclusion that Aromasin is the obvious choice.

Aromasin (Exemestane) is a Type-I aromatase inhibitor, or suicidal aromatase inhibitor. It’s called this because it lowers estrogen production in the body by attaching to the aromatase enzyme, and permanently deactivating it. (1)

Personally, I find this to be a very interesting mechanism of action when compared to type-II aromatase inhibitors, which bind competitively to the aromatase enzyme, and eventually unbind, rendering it active again. In the case of Aromasin, this doesn’t happen, and once it does its job on the enzyme, those particular enzymes will no longer function.

Because the enzyme is permanently deactivated there is no estrogen rebound with Aromasin. Estrogen rebound at this critical time during PCT is undesirable so using Arimidex would be inferior. Therefore I believe Aromasin is the AI of choice during PCT.

Reference:

1. A predictive model for exemestane pharmacokinetics/pharmacodynamics incorporating the effect of food and formulation.Br J Clin Pharmacol. 2005 Mar;59(3):355-64.


The following is a study done in men with Aromasin that shows significant effect on estrogen and testosterone;

Pharmacokinetics and Dose Finding of a Potent Aromatase Inhibitor, Aromasin (Exemestane), in Young Males

Suppression of estrogen, via estrogen receptor or aromatase blockade, is being investigated in the treatment of different conditions. Exemestane (Aromasin) is a potent and selective irreversible aromatase inhibitor. To characterize its suppression of estrogen and its pharmacokinetic (PK) properties in males, healthy eugonadal subjects (14–26 yr of age) were recruited. In a cross-over study, 12 were randomly assigned to 25 and 50 mg exemestane daily, orally, for 10 d with a 14-d washout period. Blood was withdrawn before and 24 h after the last dose of each treatment period. A PK study was performed (n = 10) using a 25-mg dose. Exemestane suppressed plasma estradiol comparably with either dose [25 mg, 38% (P 0.002); 50 mg, 32% (P 0.008)], with a reciprocal increase in testosterone concentrations (60% and 56%; P 0.003 for both). Plasma lipids and IGF-I concentrations were unaffected by treatment. The PK properties of the 25-mg dose showed the highest exemestane concentrations 1 h after administration, indicating rapid absorption. The terminal half-life was 8.9 h. Maximal estradiol suppression of 62 ± 14% was observed at 12 h. The drug was well tolerated. In conclusion, exemestane is a potent aromatase inhibitor in men and an alternative to the choice of available inhibitors. Long-term efficacy and safety will need further study."

***

If whatever pct you choose does not bring you back to a relative normal level, then you need to look further into pathologies as a possible reason for your low levels. Don't wait, speak to your doc and choose a path forward. Even simply adding nolvadex would be a big plus as opposed to nothing.

[NEVERBIGENOUGH]

I need to read all of that my doctor has been great.
The rands was 300 1197 my free test serum level was 20
She said its been six weeks my mat levels should have come online already she is suggesting I do a month of test 400 mg then re test bw

[kelkel]

Right now I'm unclear. The range your providing is similar to Labcorps which is, going from memory, 348-1197. Are you saying your Total Testosterone level was 20 or your Free Test level is 20? There's a big difference between the two. Free is more important than total as that is what is "usable" for you. You really need to put up all the levels, clearly typed please, with ranges. Total T, Free T, E2, LH, FSH, SHBG, all you have.

Now, if your levels are low your doc should be looking to restart your HPTA, not put you back on Test which will just continue to keep you in shutdown. It makes no sense at all. You'll retest in a month and your levels will be elevated. Then what? Proper PCT? Your doctor is lost unless something is being left out of this conversation.

You need to make an effort to re-start, barring another medical issue that precludes it from happening. If after the effort is made and you still don't attain normal levels then you and a competent doc need to search for the reasons why, be it primary or secondary hypogonadal, thyroid, etc.

[NEVERBIGENOUGH]

Ok it was lab corp
Test serum 20 (L). Ref range 348-1197
Tsh 2.760 Range 0.450-4.500
I am not leaving anything out I assure u

[NEVERBIGENOUGH]

Thyroid was fine bp is 120/76
So either I am turned off or I am low t
I have never experiences this before I have done 10 cycles. In last 8 yrs
Should I run a pct or getbs2nd opinion
She wants me to run to see if I have another issue like a estrogen or pituitary

[labuski]

dude tren will shut you down super hard.. you need to do a proper pct, no need to start on hrt.

try a restart by using pct, if it doesnt work start hrt.

be straight up with your doc, if she doesnt want to help you these compounds are easily obtainable.

[kelkel]

Well the TSH is within that range but a more modern range actually is .3 - 3.0 for TSH. Without seeing FT3, FT4 and RT3 is really hard to tell as TSH is a weak indicator.

Anyway, I'll refer back to my first post. You need complete blood work which is in the Finding a Doc Sticky. I will always suggest a competent docs care over self-medicating. Maybe use some of the search engines in the thread to locate another doc close by you if possible. Right now I'm not sure what your doc is thinking. Your T is so low you will not have an estrogen issue. E follows T.

Whether your pituitary is functioning properly remains to be seen. If you can get restarted and your LH/FSH returns to a normal range your good to go. If she puts you back on Test your LH/FSH (pulsed from your pituitary) will continue to be nil as your shutdown. So, in the absense of a restart and if you go back on Test then an MRI will be the only way to determine if a pathology exists.

[NEVERBIGENOUGH]

Yeah I am going to ask again I was completely honest
Which is why I got on here.
I am gonna get second opinion. Run a pct I will get dr to run full panel

[NEVERBIGENOUGH]

I can get everything I need but until it show is there something OTC I can get