Starting HRT in mid 30's

[rednorse]

34 yr old male, 6'1, 205lbs, 25% BF.
Shoulder surgery 2 years, took a long time to recover, pulled hamstring not healing after 1 year. Felt like my body just wasn't healing properly. Also showed other signs of low T so went to Dr. Had initial basic lab work done by GP, then referred to endo. More tests as below.
Endo prescribe only 200 mg IM/EOW Test cyp, nothing else.
Saw urologist for 2nd opinion (prescribed Clomid 25 mg/day), so am scheduled with other endo that is more known in the TRT/HRT community.

I am looking to just be healthy and fit again, able to train and recover, and of course lose a few lbs. I would like to get back into triathlons if possible. I have 2 kids, so fertility is not a primary concern, but teste health and looks are. In an ideal world i would lose 20 lbs fat and gain 5-10lbs muscle, but more important is healing and general well being at this stage.

Do i need to start AI/HGC immediately, or can i start test only and add if needed (or is that too late for certain man-boob side effects)?

Would Clomid be a viable option for 2-3 years to reduce side effects?

Any additions for joint/tendon health, ie HGH?

I would certainly require the test cyp to be weekly instead of EOW.

There were alot of tests, i am not sure what they all mean, so your knowledge and experiences are much appreciated.

ACTH, PLASMA: 21.3 pg/mL (7.2-63.3)
CORTISOL AM: 13.1 ug/dL (6.2-19.4)
FSH :1.7 mIU/mL (1.5-12.4)
LH: 1.8 mIU/mL (1.7-8.6)
TSH : 1.55 uIU/mL (.45-4.5)
Growth Hormone Serum: .1ng/mL (0-2.9)
IGF-1: 164 ng/mL
Prolactin: 2.8 ng/mL (4.0-15.2)
Test Free: 7.9 pg/mL (8.7-25.1)
Estradiol:16.5, not sure of range, dr. assistant said normal.
also have complete metabolic panel, Lipids, CBC w/ differential platelets, urinalysis.

Hope it's enough, ha.

[rt12008]

I just want to say good luck. I am just a month in and I don't have any value to add. The vets do. Similar age and stats. I will be watching this thread for myself too. Welcome!

[kelkel]

34 yr old male, 6'1, 205lbs, 25% BF.
Shoulder surgery 2 years, took a long time to recover, pulled hamstring not healing after 1 year. Felt like my body just wasn't healing properly. Also showed other signs of low T so went to Dr. Had initial basic lab work done by GP, then referred to endo. More tests as below.
Endo prescribe only 200 mg IM/EOW Test cyp, nothing else. Horrible. Dose should be weekly at a minimum based on tests half life of app 5-7 days metabolism dependent. Meaning 100mg per week app.
Saw urologist for 2nd opinion (prescribed Clomid 25 mg/day), so am scheduled with other endo that is more known in the TRT/HRT community. So you stopped the test and are doing just clomid?

I am looking to just be healthy and fit again, able to train and recover, and of course lose a few lbs. I would like to get back into triathlons if possible. I have 2 kids, so fertility is not a primary concern, but teste health and looks are. In an ideal world i would lose 20 lbs fat and gain 5-10lbs muscle, but more important is healing and general well being at this stage.Exactly

Do i need to start AI/HGC immediately, or can i start test only and add if needed (or is that too late for certain man-boob side effects)?If on TRT then yes to HCG. Normal dose would be 250 IU's x 2 or 3 per week. It keeps your HPTA somewhat functioning and promotes overall health. Read GD's sticky thread on it at the top of this forum. Gyno is contingent on your E2 and how receptive you are to it as we all are different. Normally AI's are not immediately prescribed unless your E2 is high. Hopefully your E2 test was a sensitive assay specific to males.

Would Clomid be a viable option for 2-3 years to reduce side effects? Not in my opinion. A properly monitored bio-identical testosterone protocol is your best path if you remain on TRT. Form is your choice, gel, shots, etc.

Any additions for joint/tendon health, ie HGH? You did not provide a range on your IGF-1. Depends on where you're at. Many anti-aging docs prescribe Sermorelin (GHRH) to assist. Actual GH is not really prescribable unless you fall into certain specific catagories such as stunted growth, children with GH deficiencies or certain age related variables.

I would certainly require the test cyp to be weekly instead of EOW.

There were alot of tests, i am not sure what they all mean, so your knowledge and experiences are much appreciated.

ACTH, PLASMA: 21.3 pg/mL (7.2-63.3)
CORTISOL AM: 13.1 ug/dL (6.2-19.4)
FSH :1.7 mIU/mL (1.5-12.4)
LH: 1.8 mIU/mL (1.7-8.6)
TSH : 1.55 uIU/mL (.45-4.5)
Growth Hormone Serum: .1ng/mL (0-2.9)
IGF-1: 164 ng/mL
Prolactin: 2.8 ng/mL (4.0-15.2)
Test Free: 7.9 pg/mL (8.7-25.1)
Estradiol:16.5, not sure of range, dr. assistant said normal.
also have complete metabolic panel, Lipids, CBC w/ differential platelets, urinalysis.

Hope it's enough, ha.

LH & FSH are in the tank, hence low T. Need to find out why and then treat! Did any of your doc's send you for a pituitary MRI by chance?

[rednorse]

Thanks for the response.
To clarify, I have not started any treatment, i just recieved the labs 2 weeks ago and got a 2nd opinion last week.
I will follow up on the E2 test type, can order additional if needed.
There was not a range on the IGF-1 results, i can follow up.

Can you explain further the very low LH and FSH, and why an MRI could be needed?

[kelkel]

LH & FSH are pulsed by the pituitary and signal your testies to produce both testosterone (LH) and spermatogenesis (FSH.)
So, low LH and low T levels can sometimes indicate a pituitary issue which needs to be ruled in/out. This would constitute secondary hypogonadism. The opposite, high LH/FSH and lower T levels would mean testicular failure thus, primary hypogonadism.

A properly conducted MRI would rule this in or out. I have a pituitary tumor myself and it's not the end of the world. Just a condition that's treatable like many others. It would also be prudent for you to review past BW if possible and see if there's a downward trend with those numbers.

Very, very happy you did not jump into anything like so many do. You need to find the causative factor here and not just bandaid it with testosterone.

Keep us informed and welcome to the site!

kel

[rednorse]

Update:
Saw another doctor, who was referred based on being a provider of TRT. Couldn't really answer any questions on HCG , ai or what the root cause could be. They referred me to another endo, but they have a month wait list!

Estradiol was 16.5 (7.6-42.6)
IGF1: 164 (132-333) 31-40yrs
So, Low T (esp. free)
Low estradiol (could be good)?
Very Low Prolactin
Very Low LH
Very Low FSH
After 2 endo's and 1 urologist, they can't answer why its low, but will prescribe Test cyp.
Does anyone know of a knowledgeable Doc in Houston?
Should I try a clinic instead?
Does anyone have some documentation that i can give to the doc, with references...etc? they seem to not be very knowledgeable.