Test injections vs. Test gel vs. Clomid

[louie2400]

So I have been struggling with low T for a couple of years now and had many tests over the past year, but have held out on intervention, doing all I could do naturally to see if my body would respond and up my T. So I was originally prescribed clomid to see how I would respond to that, but held off. The reason I didn't want to go with Test gel or injections is because I want to have kids (I'm 28). But after talking to my Dr he said that there is a) still a possibilty that I could have viable sperm on exogenous testosterone and B) If I went on T gel or injections and had sperm issues I could always taper off the testosterone and use clomid to raise lh, fsh and once the kid was in the "oven" could go back to test gel or injections.

He has also mentioned HCG , but it is pretty expensive with my insurance to have this as my sole T raiser. I was thinking to start with clomid and see how I react, but a) it seems like long term use would not be good for my liver b) I have heard in some cases it will raise total T, but you won't get all the "benefits" of other T treatments (improved memory, thinking, less foggy, higher energy, increased libido). And if I went with the straight Test gel or injection route I'm not sure which way I would lean? What do you see as the positives and negatives? From your experiences what would you start with Test injections (guessing 1x a week, my urologist knows his stuff), Test gel, or clomid? I see my urologist next week. side note: If you guys really need I can post all of my labs, but I have had everything looked over multiple times: thyroid is always ok, lh and fsh very low, estradiol: mid range and total test always low: lastest total test was ridiculously low at 82 (300-1050).

[HRTstudent]

Few things.

Most importantly, what your doctor said about testosterone and fertility is only half the truth - in fact, the good and not the "bad". Testosterone will not make you infertile, but what it will do is lower your chances at fertility. And make no mistake, its not as easy to just "go off" testosterone therapy and act like this is either easy or quick. It could take months. It could be difficult mentally. It's far easier to go from clomid to T than the other way around.

Beyond that, however, is the fact that getting your wife pregnant is more important that a testosterone boost. What's another few months of doing nothing or experimenting with clomid? Now compare that to possibly making it harder to conceive. That's a personal decision for you.

Ok, other than that important thing. It's worth considering that clomid may very well work for you. You simply don't know until you try. You seem to be a prime candiate for such a trial. You could also consider an aromatase inhibitor. But clomid is far more studied, and quite proven.

If I was in your shoes, I woudlnt even be considering testosterone because of my concern for fertility. One of the two (I blieve there are only two) contraindications for starting testosterone is having prostate cancer or wanting to conceive in the next year. "Why play with fire?", I say.

[louie2400]

HRT student- thanks for the quick reply. You make some good points. I am actually single right now and in grad school. Being single is probably due in some form or fashion to having low t for so long. I haven't had a long term relationship in years. Right now my libido is zilch. But I have been dating more lately and want to keep the door open for having kids someday even tho I'm not getting any younger at 28. So I won't be trying to have kids in the near future. One of the biggest reasons I finally made the decision to start a form of TRT/HRT is my performance in school is starting to hurt. I have to study everything 3x as much and concentration and reasoning etc. is pretty bad. And at this rate I'm not sure if I will make it through school (doctoral degree).

[HRTstudent]

It's hard to say that is directly related to your testosterone issues, but that point is a bit moot. Getting your testosterone tuned up can probably only help in the long term. In the short term, however, TRT might not help as much as you want when it comes to academics. I'm really just not sure how much it can help, but I only throw this caveat out there because I just don't see a whole lot of feedback from people who talk about this particular aspect.

Personally, I would tackle the low T issue but also incorporate some serious nutrition and lifestyle changes. I'd look into thyroid as well of course. I can only imagine funds are tight for you as a student, but you may have insurance that might help you out as far as lab testing.

To be quite frank, I'm young like you. Although I'm not in school I imagine my issues started towards the end of my schooling. If I had to go back then, I doubt TRT would help me, but I would have considered some of the other drugs out there - namely the popular stimulants. Back then, I didn't want to take anything because I didn't like the thought of drugs... didn't think I needed it or whatever. But if I was 5 years down the road and in grad school, id probably reconsider. Those would definitely have a positive short term impact.

TRT, for me, was quite a bit of trial and error. Even after a year now, I'm still figuring things out. My T is definitely higher, but overall, I'm not that much different than before starting TRT.

With regard to fertility, given the new info and not wanting to have kids for at least a couple years, I would not discount TRT. As long as you have good fertility before going on TRT you SHOULD have good fertility when you come off. That is, of course, no guarantee, but it is the general rule.

If you happen to be in/near California id suggest you look into seeing Dr Mariano. He is a psychiatrist by training, but deals extensively with HRT. Sounds like the perfect match for you.

[sparverius]

When my T was low and before I went on TRT, I had major problems thinking and concentrating. I was seriously depressed. Once I got my T level right I went back to normal. It was a huge difference.

Louie, do you know why your LH and FSH are low? Have you had an MRI to look for pituitary tumors? Brain damage can also cause the pituitary to make less LH and FSH.

HCG doesn't seem that expensive from the prices for research peptides. It may be some work to get insurance to cover it. Clomid is easy to try but you may need AI to go with it.
Whatver you end up doing, it'll be some months of experimenting to get it right.

Between gel and injections I preferred gel, until it stopped working. I didn't need AI on gel but do on injections, and my libido isn't the same on injections.

[bp2000]

OP your T is "82" and your 28 years old? I would get a pituitary scan asap. Are you on any pain meds? I don't see how you can function with that low of T that is like female range of test.

[louie2400]

HRTstudent:

Yeah I have had thyroid labs TSH, free t3 and t4, and antibodies done multiple times but were always normal. Yeah, I'm not in Cali, but the urologist I started seeing seems to know his stuff.

sparverius:

I definitely know I am secondary, but not totally sure why. My diet is pretty is VERY clean. Lots of veggies, fruit, meat, and virtually no processed foods. I was working out 4x a week focusing on heavy lifting and high anaerobic stuff like sprinting. I haven't been working out as much lately due to school and very inefficient recover as you can guess. I have never had a pituitary MRI because my dad recently had one done and had pretty bad reaction to the gadolinium contrast dye, so I opted to not have one. He also has low T and they did not find any pituitary disfunction. We are guessing that I have some genetic disposition to having low T. So you liked the gel more when it worked? How long did it work for you? Why did it stop working?

bp2000:

No pituitary scan and no pain use now or ever. I was taking very low dose of 5-htp at night to help with sleep, but stopped because I did not like how it made me feel. Yeah my levels last checked are super LOW. The 82 test was done about a week ago and are by far the lowest it has ever been. About a year ago I was 150 (250-850) and have been up to about 300ish (250-850) (those were done at a different lab, so different reference ranges) sometime during the past year (I'd have to check specifics).

Anyone else have any suggestions for my situation?

[sparverius]

So you liked the gel more when it worked? How long did it work for you? Why did it stop working?

It worked for six years although I needed a high dose to get good levels. Then I attempted a restart with clomid. It failed and I went on gel again. Some months after I'd gotten settled on the gel my levels dropped too low. I didn't want to fight insurance every time to get enough gel and applying so much gel was difficult, so I switched to injections. I don't know why it lost effectivness.

I've used 5htp and wound up taking a very small amount. More than that would kill my libido. I'd take the gel caps apart and take 1/10th or less of the powder. The longer I was on it the lower I had to go to avoid effects on libido.

If you go on TRT you will have to spend time tuning to get it right.