Trying a new protocol.

Hey guys, hope everyone is well.

I'm starting a new protocol so I'm starting a new thread.

26 years old. Had low test most of my life. Pituitary checks out ok! Testies work a few weeks of the year at random times. Started TRT early last year, ran for eight months on 50mg test cyp twice a week Subq. Adex based on bloods at .25 every five days. HCG 250ui three times a week. Put me at the top of the range on total test, over the top free test, and E2 around 34. Sounds great, but I felt like shit.

3 months ago I started tapering off everything. Went 8 weeks with zero medication. I don't need to explain how I'm feeling right now.

What I've learned. I don't feel any effects from HCG what so ever. But sometimes, I could tell my body kicked in and made something happen, I'd feel great for about a week without changes in protocol or new batches of meds. I believe my pituitary and boys still function and always have, I think my entire issue is a communication problem. Also I'm very sensitive to e2, even at 34. Gyno is a real problem, I've lost most of my muscle and put on considerable fat in all the wrong places.

What I'm doing now. I had bloods drawn today to see where I'm at, fully suppressed it would seem. Balls are about normal in size and feel. I'm going to take 20mg of Tamoxifen every day. If I don't notice anything ill slowly add low doses (25-50) of test c and base my protocol purely on how I feel. In six weeks ill take bloods again and see where I'm at. Ill add adeX based on that blood work. My goal is to feel my best. When I first started TRT I passed a point that I felt amazing, and could never find it again. So my plan is to start very small, and creep my levels up. If I feel good without test, ill slowly up the tamoxafine and watch my bloods.

If it works, it works. If not ill change it. I'm a lab rat this year to try new things and see if something sticks. Maybe we can learn something from my failures?!

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I'm going to take 20mg of Tamoxifen every day. If I don't notice anything ill slowly add low doses (25-50) of test c and base my protocol purely on how I feel.

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I can't say I agree with this. Are you under the impression that your T-levels were too high when you were on TRT? Are you under the care of a doctor?

What were your original numbers before you started TRT?

Yes, I believe SOMETHING was too high, though I couldn't pin point what. I am under doctor care 100%. I have never used AS and avoided TRT untill I was sure I was through puberty.

Before I started about a year ago my total test was ~230, free less than 1%. I do not have unlimited resources to run bloods more often than 6 weeks. I believe something in my body, at times, clicks and my HPTA would fire up - even on TRT. My thought is that by going higher in the chain of command I may trigger the production of whatever it is I'm missing.

I started yesterday at 9pm, slept like a bear which is a big difference from the insomnia I've been fighting. This morning my testicles are significantly more firm than usual. Something is already happening.

If you think your testies work a few weeks of the year at random times and you believe the spike may be whats making you feel bad.
Why not add exogenous testosterone for 6 weeks verify with blood work that you are completely shut down no hcg adjust your dose on how you feel. Your natural production is the wild card here why not take it out of the equations from the start.

You need to post your blood work; everything else is conjecture.

I hope you got comprehensive hormonal panel run including complete Thyroid labs as well.

Something is clearly amiss.

I didn't see the answer to the question; are you under a trained Physician's care?

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Originally Posted by gdevine

You need to post your blood work; everything else is conjecture.

I hope you got comprehensive hormonal panel run including complete Thyroid labs as well.

Something is clearly amiss.

I didn't see the answer to the question; are you under a trained Physician's care?

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Will post as soon as it gets back. I agree it's all conjecture, this is an experiment. My bloods in the past looked ideal, but I didn't feel as good as I think I should. I've been under physician care since day one.

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Originally Posted by steroid.com 1

You need to post your blood work; everything else is conjecture.

I hope you got comprehensive hormonal panel run including complete Thyroid labs as well.

Something is clearly amiss.

I didn't see the answer to the question; are you under a trained Physician's care?

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Blood work is back. Try screwed up on the e2 essay. This is me after being off TRT for about 8 weeks. First time my cholesterol has ever been high, which I find kinda neat.

http://i41.tinypic.com/hupqfn.jpg
http://i39.tinypic.com/65o083.jpg
http://i44.tinypic.com/4kwoki.jpg

Here is some info I found helpful on thyroid as you can see you can be hypo and still be with in lab ranges. I really don't what your plan is but as you can see from your LH and FSH 20mg of Tamoxifen every day is not cutting it. I didn't see prolactin on your labs either need to get you cholesterol in check. I'm sure its tuff to do anything with T numbers that low.

In an effort to improve diagnosis of thyroid disease, in 2003 the American Association of Clinical Endocrinologists (AACE) revised the "normal" TSH range as 0.3 to 3.042. The previous range was defined as 0.5 and 5.0, which red-flagged only the most glaring hypothyroidism cases.

However, the new range is still not wholly reliable as the sole indicator of a sulky thyroid gland. You simply cannot identify one TSH value that is "normal" for every person, regardless of age, health, or other factors.

Having said that though most physicians who carefully follow this condition recognize that any TSH value greater than 1.5 could be a strong indication that an underactive thyroid is present.

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Originally Posted by 100%

Here is some info I found helpful on thyroid as you can see you can be hypo and still be with in lab ranges. I really don't what your plan is but as you can see from your LH and FSH 20mg of Tamoxifen every day is not cutting it. I didn't see prolactin on your labs either need to get you cholesterol in check. I'm sure its tuff to do anything with T numbers that low.

In an effort to improve diagnosis of thyroid disease, in 2003 the American Association of Clinical Endocrinologists (AACE) revised the "normal" TSH range as 0.3 to 3.042. The previous range was defined as 0.5 and 5.0, which red-flagged only the most glaring hypothyroidism cases.

However, the new range is still not wholly reliable as the sole indicator of a sulky thyroid gland. You simply cannot identify one TSH value that is "normal" for every person, regardless of age, health, or other factors.

Having said that though most physicians who carefully follow this condition recognize that any TSH value greater than 1.5 could be a strong indication that an underactive thyroid is present.

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Again, this blood work represents me NOT taking any medications for the past 8 weeks. I started the tamoxifen the evening that this blood was drawn. My goal with this protocol is to reduce my Gyno sensitivity and see if the tamoxifen will get my own system to function to any extent. Blood work in 6 weeks will show if the tamoxefin is causing an increase in LH and FSH.

If an increase of LH and FSH is detected it may help determin if HPTA is capable of producing on its own and to what degree. If all components of my HPTA are functioning, I may be able to kick start it. I'm 26 years old, I don't think attempting to get off TRT is a waste of time.

I don't think attempting to restart is a waste. You might try this if that is your goal
Chorionic Gonadotrophin is presently available through most pharmacies
or distributors as Profasi, Pregnyl or generic Chorionic Gonadotrophin
10,000 units per 10 cc vial. Various stimulation tests have been
described, from high dose, short course testing to more normal
physiologic doses over a longer time period. I have found that a typical
treatment course for three weeks is best for determining those
individuals who will respond well to this type of treatment. It is
administered by injection 500 units (0.5 cc) SQ, Monday through Friday
for three weeks. Teach patient to self administer with 50 Unit Insulin
Syringes with 30 gauge needles in anterior thigh, seated with both hands
free to perform the injection. Measure: Testosterone, total and free,
plus E2 before starting CG and on the third Saturday AM after 3 weeks of
stimulation (salivary testing may be more accurate for adjusting doses).
Studies have shown that SQ is equal in efficacy to IM administration.

Results:

1. <20% rise suggests poor testicular reserve of leydig cell function
(primary hypo-gonadism or eu-gonadotrophic hypo-gonadism indicating
combined central and peripheral factors).

2. 20-50% increase indicates adequate reserve but slightly depressed
response, mostly central inhibition but possibly decreased testicular response as well.
3. > 50% increase suggests primarily centrally mediated depression of
testicular function.

Options for treatment vary both with the response to CG and patient
determined choices.

1. If there is an inadequate response (< 20%), then replacement with
testosterone will be indicated.

2. The area in between 20-50% will usually require CG boosting for a
period of time, plus natural boosting or "partial" replacement options.
I believe that full replacement with exogenous testosterone is always
the last option in borderline cases since improvement over time may
frequently occur as leydig cell regeneration may actually happen. Much
of this is age dependent. Up to age 60, boosting is almost always
successful. 60-75 is variable, but will usually be clear by the results
of the stimulation test. Also, disease related depression of
testosterone output might be reversible with adequate treatment of the
underlying process (depression, AMI, obesity, alcohol, deficiency, etc.)
This positive effect will not occur if suppressive therapy is instituted
in the form of full replacement.
3. If there is an adequate response, >50% rise in testosterone, there is
very good leydig cell reserve. Natural boosting or CG therapy will
probably be successful in restoring full testosterone output without
replacement, a better option over the long term and a more natural
restoration of biologic fluctuations for optimal response.

4. Chorionic Gonadotrophin can be self-administered and adjusted
according to response. In younger, high output responders (T >
1100ng/dl), CG can be given every third or fourth day at bedtime or in
the AM. This also minimizes estrogen conversion. In lower level
responders(600-800ng/dl), or those with a higher E2 output associated
with full dose CG, 300-500 units can be given Mon-Wed-Fri. At times,
sluggish responders may require a higher dose to achieve full
Testosterone response. In these cases, the diluent is lowered to 7.5cc
or even to 5 cc, which increases the CG concentration 1 ½ - 2 X. This
can be administered in variable doses 0.3 - 0.5cc given every 3rd day.
Check salivary levels on the day of the next injection, but before the
next injection to determine effectiveness and to adjust the dose
accordingly. Keep in mind that later as leydig cell restoration occurs,
a reduction in dose or frequency of administration may be later needed.

5. Monitor both Testosterone and E2 levels to assess response to
treatment after 2 - 3 weeks after change in dose of CG as well as
periodic intervals during chronic administration. Sublingual testing is
very easy and cost effective. It will also better reflect the true free
levels of both estrogens and testosterone. (Pharmasan Labs 888-342-7272
is very good)

6. Adjustment of dosage is a result of symptomatic response and hormone
level boosting. It is based on clinical judgement as much as actual
hormone levels. Remember that "Normal" ranges are for populations, not
individuals!

7. Except for reports of antibodies developing against CG (I have not
seen this), there are no adverse effects of chronic CG administration.
An additional benefit is the boosting of Growth Hormone output which has
also been reported, either as a direct effect of CG or as an effect of
increased levels of testosterone.

*Protocol adapted from "The Testosterone Syndrome" by Eugene Shippen, M.
D. (M Evans and Co, NY 1998).

I have taken HCG and blood work showed a rise in Total levels, I already know my testies a working. My pituitary is tumor free. Hcg Mono therapy will not have an effect stimulating the pituitary since it breaks HPTA chain of command and is suppressive. Tamaxifen can stimulate the pituitary to possibly reestablish a functioning HPTA. Even if I find that the maximimum physiologic capability of my HPTA is in the low to mid ranges it will still be functioning and intact, and my body will have that much more natural LH for many functions in the endocrine system.

If it initiates a restart I'm good to go. If not I can fine tune my levels by supplementing test, not need to take HCG since my HPTA may have some level of function with tamaxifen, and possibly avoid full suppression.

When used in conjunction with nolva HCG 's suppressive nature is blocked... Check this study out ...

Tamoxifen suppresses gonadotropin-induced 17 alpha-hydroxyprogesterone accumulation in normal men.Smals AG, Pieters GF, Drayer JI, Boers GH, Benraad TJ, Kloppenborg PW.
Intramuscular administration of 1500 IU hCG daily for 3 days induced a transient accumulation of 17 alpha-hydroxyprogesterone (17 OHP) relative to testosterone (T) in normal men, reaching its maximum 24 h after the first injection (17 OHP to T ratio, 1.7 +/- 0.3 times baseline; P < 0.01). Simultaneous administration of hCG and the estrogen antagonist tamoxifen (20 mg twice daily) almost completely abolished the hCG-induced steroidogenic block localized between 17 OHP and T (17 OHP to T ratio at 24 h, 1.1 +/- 0.1 times baseline; P < 0.01 vs. hCG alone). These data indirectly suggest that, in man, the hCG-induced steroidogenic lesion might be mediated through its estrogen-stimulating effect.

PMID: 7419679 [PubMed - indexed for MEDLINE]

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Originally Posted by 100%

When used in conjunction with nolva HCG 's suppressive nature is blocked... Check this study out ...

Tamoxifen suppresses gonadotropin-induced 17 alpha-hydroxyprogesterone accumulation in normal men.Smals AG, Pieters GF, Drayer JI, Boers GH, Benraad TJ, Kloppenborg PW.
Intramuscular administration of 1500 IU hCG daily for 3 days induced a transient accumulation of 17 alpha-hydroxyprogesterone (17 OHP) relative to testosterone (T) in normal men, reaching its maximum 24 h after the first injection (17 OHP to T ratio, 1.7 +/- 0.3 times baseline; P < 0.01). Simultaneous administration of hCG and the estrogen antagonist tamoxifen (20 mg twice daily) almost completely abolished the hCG-induced steroidogenic block localized between 17 OHP and T (17 OHP to T ratio at 24 h, 1.1 +/- 0.1 times baseline; P < 0.01 vs. hCG alone). These data indirectly suggest that, in man, the hCG-induced steroidogenic lesion might be mediated through its estrogen-stimulating effect.

PMID: 7419679 [PubMed - indexed for MEDLINE]

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I'm so confused. If the nolva works and raises LH and FSH to an acceptable level - why would I take HCG? If my bodies response to the nolva gets LH and FSH to acceptable levels but my testicals don't produce enough testosterone I could still take exogenous testosterone and the nolva would continue stimulating my pituitary so that my LH wouldn't drop.

If you were using hcg up until you stopped you could have went right into you nolva your suppressed now. You should never add exogenous testosterone when trying to restart you HTPA

Selective estrogen receptor modulators (SERMs) such as Clomiphine (Clomid) and Tamoxifen (Nolvadex) increase pituitary LH secretion in secondary manner by blocking estrogen negative feedback on the HPTA. On average, this is not strong enough by itself to counteract the severe imbalance of the androgen:estrogen ratio that is encountered post cycle, especially in the presence of testicular atrophy. Therefore, SERMs are used during PCT primarily as an anti estrogen and to continue the stimulation of pituitary LH after HCG has been discontinued.

Quick update: Something interesting is despite my blood work above showing me as suppressed, my testicals have remained more or less normal size. Though I am not producing testosterone, my testicals are active in spermatogenisis... Go figure. Count appears to be a little on the low side, but most looked normal and swim properly. I need to calibrate to get an accurate sample count.

So I have no LH or testosterone, but I'm producing sperm...

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Originally Posted by Babyslim

Quick update: Something interesting is despite my blood work above showing me as suppressed, my testicals have remained more or less normal size. Though I am not producing testosterone, my testicals are active in spermatogenisis... Go figure. Count appears to be a little on the low side, but most looked normal and swim properly. I need to calibrate to get an accurate sample count.

So I have no LH or testosterone, but I'm producing sperm...

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There seems to be some veritable conjecture and large assumptions going on in this thread - or at least that's my take. First, did you have a semen analysis performed? What was the sperm count and volume? Second, your original post said "Testies work a few weeks of the year at random times." What does this even mean and how do you know? And third, I would recommend Clomid as the primary medication to restart your HTPA.

If you indeed are fertile, then there is some pituitary response (albeit minimal from your labs). I would begin a closely monitored protocol of Clomid; check labs every four weeks, and if testosterone, LSH, and FSH are not within normal limits, revert back to TRT with hCG/hMG supplementation.

Also, your TSH warrants free and total T3/T4 labs, in my opinion.

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Originally Posted by phaedo

There seems to be some veritable conjecture and large assumptions going on in this thread - or at least that's my take. First, did you have a semen analysis performed? What was the sperm count and volume? Second, your original post said "Testies work a few weeks of the year at random times." What does this even mean and how do you know? And third, I would recommend Clomid as the primary medication to restart your HTPA.

If you indeed are fertile, then there is some pituitary response (albeit minimal from your labs). I would begin a closely monitored protocol of Clomid; check labs every four weeks, and if testosterone, LSH, and FSH are not within normal limits, revert back to TRT with hCG/hMG supplementation.

Also, your TSH warrants free and total T3/T4 labs, in my opinion.

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I love how the few that respond in my thread, reply as I'd they have sped through my posts, reading every other sentence.

I agreed that some of my statements were conjecture. I understand this is not a normal protocol, and explained that this is an experiment. I expressed that I was feeling like shit on my old protocol, except for a few weeks a year, which I don't know why. Something isn't right with me, and I don't have the finances to dump into this right now but I'm working with I have. My goals her do not fit any single protocol. In 4 weeks when I have blood work done again I will have learned something about my bodies response and can go from there.

If you read my post above its clear that I didn't just guess that my testies are actively producing sperm. I used a microscope. To get an accurate count I have to calibrate the lenses to have an exact magnification, take multiple samples from a determined volume, calculate the volume placed on each slide, then count the member of sperm in a defined grid of multiple sample and slide locations to determin averages. With those averages you can calculate more than accurately enough(for these purposes) the total of sperm in the total mass of the ejaculate.

Everyone keeps getting their panties in a wad that this isn't 'standard', so it's it is wrong. The standard protocols were not working for me. Something isn't standard with my body's response.

I'm not focused on a 100% effective restart or a long term protocol. Until my next bloodwork I'm focused on not feeling like trash, getting ride of as much of my gyno(which is why im using tamaxofien instead of clomid) and seeing how my pituitary responds do a low dose of tamaxifen. This is an experiment.

When soliciting for advice, it would be of great benefit to read over your tentative reply before you post. Your poor sentence structure, grammar, and spelling discredit any sense of seriousness or proficiency at the subject -- just a thought for you to consider in the future posting.

I'm not here to argue or find fault with your silly nonsense, but everything you have done up to this point is not within a 1000 miles of "standard." My last suggestion for you is to read the stickies, find some competent medical professional to help you, and clean up that bit of cheeky attitude. Oh, and one more thing: this certainty is NOT an experiment. It's more or less a random and haphazard attempt to patch up an indisposed treatment from the onset.

Given your pretentious reply, and with absolutely zero quantitative answers to the questions asked, I find this thread a waste of my time.

I'm out.

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Originally Posted by phaedo

When soliciting for advice, it would be of great benefit to read over your tentative reply before you post. Your poor sentence structure, grammar, and spelling discredit any sense of seriousness or proficiency at the subject -- just a thought for you to consider in the future posting.

I'm not here to argue or find fault with your silly nonsense, but everything you have done up to this point is not within a 1000 miles of "standard." My last suggestion for you is to read the stickies, find some competent medical professional to help you, and clean up that bit of cheeky attitude. Oh, and one more thing: this certainty is NOT an experiment. It's more or less a random and haphazard attempt to patch up an indisposed treatment from the onset.

Given your pretentious reply, and with absolutely zero quantitative answers to the questions asked, I find this thread a waste of my time.

I'm out.

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I posted to show what I was doing, not to ask for your precious help and time. Get ****ed.