TRT do I need it?

[E5Charlie]

I'm 36 yo male. 2 weeks ago I got my test levels checked at my local VA hospital, I'm a VET, and my total test was 139 (250-1100 range) and free test was 32 (35-? Range) I hurt my back in the Marines a few years back and I'm taking a total of 150mg of oxycodone a day. Today I talked to my doc, and he says these levels are a bit low for my age, but the pain pills may have something to do with it. He ordered another round of hormone tests to be done, and if low testosterone is confirmed, he will send me to get an MRI for my head ( pituitary glands) before placing me on HRT. My question is, how low are my levels really for my age? What is LH test? Does pain pills commonly lower testosterone , and is it reversible after stopping pills? I've heard so many good things about HRT and I'm really hoping I qualify. Thanks in advance!

[kelkel]

Hi E5.

Yes, they are piss poor levels to be honest. "A bit low" is an understatement.
Pain meds can definitely effect T levels.
LH is leutinizing hormone and is pulsed by the pituitary gland along with FSH. In short, LH signals the testies to produce Test and FSH initiates spermatogenesis.
Low LH levels and low T can be an indicator of secondary hypogonadism (pituitary issue.) High LH and lower T can indicate primary hypo (testical failure.)

You need full blood work, not just a hormone panel. It worries me that you will just end up on TRT due to ancillary meds being used, instead of trying to find the cause and correct it. Be it the pain meds or something else.

Welcome to the site!

kel

[tigerspawn]

Thanks Kel. Are there any pain meds that are safe to take? I know that acetaminophen and Ibuprofen suppress protein synthesis. If the pain med doesn't contain acetaminophen is it safe?

[Vettester]

Kel hit it on the money (Like usual)!

It is quite possible that the pain meds have suppressed your HPTA, but usually even LH values of 1.5mIU/Ml or a little higher will still "usually" generate serum levels >180ng/dl "if" the leydigs are in good shape. I don't know how many members baseline labs I've read over the years, but I've made some observations ... Obviously more guys coming in are usually diagnosed with secondary hypogonadism, which is failure with the HPTA (low LH & FSH as noted by Kel), and primary being the failure is at the testicular level (pathology or leydig damage in most cases). My observation has be (not all the time) that more times than not, men with secondary will usually have initial serum levels > 150ng/dl, and members with primary or testicular failure seem to be less than the 150ng mark.

Again, the meds may have suppressed your axis to the point where there's very, very little GnRH production, but labs will be the only way to tell. On that same note, you really need to include some other labs, including a complete thyroid panel. If you're hypothyroidism, it could be contributing to your condition. Kel has a great sticky on "Finding a HRT Physician", and you will find all the labs to be considered in there. Keep us posted.

[HRTstudent]

They are quite low on a chart... but without symptoms there is no need to treat low testosterone. Many men function fine with "low testosterone". Might not be your case, or maybe it is.

To be sure, starting TRT can be worse before it is better and that is often magnified until you get a good doc.

Why did you get the T tested?

[E5Charlie]

I got the test due to symptoms, including extreme fatigue, non existent libido (I'm married and haven't had sex since January!) sleep problems and depression. From what I've read, these seem to all be symptoms of low T. I've been feeling like this for a few years, and I'm glad I finally have something to poit my finger at. My doc order a new blood test, but I'm not sure what it's called. Hopefully I can get started on TRT soon. Do these symptoms generally take a long time to materialize? I won't stop the pain mess because the pain is pretty bad, but would rotating opioids help?

[E5Charlie]

In last post meant to ask " do these symptoms generally take a long time to go away?"

[HRTstudent]

Things like depression are multi-faceted and almost guaranteed to be much more than simply low testosterone. It's also the chicken and egg scenario, maybe the low T is merely a side effect of the depression. That wouldn't surprise me at all.

It doesn't mean that you shouldn't consider TRT. But if it were me, I would certainly not put all my eggs into that basket. I would favor a multi-faceted approach for a multi-faceted problem.

I have no idea about rotating pain meds or pain management. I would try my damnedest to lower the dose as much as possible though. Off the top of my head that would include alternative pain management things like acupuncture and meditation.

Aside from the low testosterone, how is your general health? Just on these few posts, my mind is painting a picture that is an individual with poor health in many areas with likely numerous nutritional deficits. Just a hunch I get...

[E5Charlie]

I'm 5'8 and weigh 220 lbs. before I hurt my back I weighed 170 and muscular. I must admit I've gotten fat since my back surgery a few years ago. I try working out but my lack of energy and progress are very demoralizing. I walk a couple miles every day, but that's about the extent of my exercise. I know testosterone replacement alone will not be a magical elixer, but does it give you energy and motivation to exercise? Anybody out there that was in my situation, and if so, how did it work out for you?

[Vettester]

Charlie, when you get your labs in, let's take a look and see what they say. Would like to see other hormones upstream (pregnenolone, DHEA, cortisol, prolactin), as well as a complete thyroid assay, including FT4, FT3, RT3, TSH, and antibodies. B12 should be in the mix, which will also support your quest for improved energy. Other variables like SHBG will dictate how much actual free & bio test is in your system, so keep that in mind when looking at the big picture. Total serum doesn't paint a complete picture, so I highly advise getting the gamut of the other labs covered. I am also interested in your standard CBC's, metabolic, and lipid panels. Will look forward to seeing the updates when you get them. Kel has a good sticky for finding a HRT physician, which provides a list of detailed labs to be considered.

[E5Charlie]

Thanks guys, you all seem extremely knowledgeable. This is my first time posting in any forum, ever, and by the looks of it I think I chose the right one. I was a little skeptical at first. I will keep you guys posted and I will tell you my test results when I get them. Doc said a few days. Thanks to all!

[E5Charlie]

Hi guys, I talked to my doc yesterday after a blood test and he said the signal that goes to the testicles to make testosterone are low. I'm going to get an MRI of the head to make sure I don't have a growth around my pituitary gland. He said if I do, he will send me to an endocrinologist. If they treat that growth, I could increase testosterone naturally, and, if not, we will start testosterone replacement. Does someone here know what he's talking about regarding this growth. He said its not cancerous, so what is it?

[100%]

Probably a pit tumor few guys on here have them.

Most pituitary tumors are noncancerous (benign). Up to 20% of people have pituitary tumors. However, many of these tumors do not cause symptoms and are never diagnosed during the person's lifetime.

The pituitary gland is a pea-sized endocrine gland located at the base of the brain. The pituitary helps control the release of hormones from other endocrine glands, such as the thyroid and adrenal glands. The pituitary also releases hormones that directly affect body tissues, such as bones and the breast's milk glands. These hormones include:

Adrenocorticotropic hormone (ACTH)
Growth hormone (GH)
Prolactin
Thyroid-stimulating hormone (TSH)

[E5Charlie]

Are some of you guys doctors or med students? You all seem to know quite a lot about this topic.

[powerlifterty16]

most drs dont know shit

[E5Charlie]

I just got a call from my doc, and he said my new testosterone test came back normal...total test was 325 and free test was 80. how could these numbers be so different from my original results (139 total and 32 free)?it was only 3 weeks apart.

[Vettester]

I just got a call from my doc, and he said my new testosterone test came back normal...total test was 325 and free test was 80. how could these numbers be so different from my original results (139 total and 32 free)?it was only 3 weeks apart.

Seeing this now puts my speculation that you are more than likely in the secondary category for a diagnosis. We need your LH/FSH to see the activity of your HPTA. 325 is still quite low, and is maybe "normal" in a 70yo old male. Your doctor is under performing here, take note!

[powerlifterty16]

your doctor is an idiot...325 is still low..fire him

[E5Charlie]

I understand that total testosterone is still on the low side (250-1100 range) but supposedly the free testosterone is pretty good at 80 (35-? Range) and free testosterone is basically the one that really counts. Am I mistaken on this? Does the total still need to be higher? Also, how can the total and free more than double in the span of 3 weeks? Is that normal? Also, he said I'm still going to get an MRI of the pituitary, and if there's a growth, treating it will raise my testosterone levels even further without TRT.

[E5Charlie]

Just talked to my doctor after my MRI, and he says I don't have a pituitary tumor. My total test is 299 and free test is 80. He says my prolactin levels are high so he's referring me to an Endocrinologist. What is prolactin and what does it do? How does a high level affect testosterone?

[powerlifterty16]

prolactin helps women lactate lol.

[powerlifterty16]

the range is 35-155..80 isnt anything spectacular.

I understand that total testosterone is still on the low side (250-1100 range) but supposedly the free testosterone is pretty good at 80 (35-? Range) and free testosterone is basically the one that really counts. Am I mistaken on this? Does the total still need to be higher? Also, how can the total and free more than double in the span of 3 weeks? Is that normal? Also, he said I'm still going to get an MRI of the pituitary, and if there's a growth, treating it will raise my testosterone levels even further without TRT.

[E5Charlie]

I was just put on trt, I pick up my supplies tomorrow. My dose is 200mg every other week, but my doctor said I can do 100mg weekly. Which is better? Weekly or bi-weekly?

[EverettCD]

Are you injecting yourself at home?

What were you prescribed? Testosterone Cypionate/Ethanate?

HCG and AI?

Do you have your most recent blood work results to post? You will get much more accurate advice & guidance by posting it.

1 injection per week is preferred. Many here inject twice per week (every 3.5 days/84 hours). I recently made the move from topicals to IM Test Cyp & absolutely love it. If you inject 200mg every 14 days you will have a big spike in Test & Estrogen levels in the 24-48 hours post injection, you will probably feel much better most of the first week & the remaining days you will most likely feel terrible since your levels with plummet back to Pre-TRT levels. Injecting half of the dose (100mg) will ease this some. This is why so many of us inject every 3.5 days, so we keep our levels even with much less highs & lows.

The resident experts that are more knowledgable than I am will chime in on this soon & give you more solid advice & guidance than I can provide.

Good call on returning to this forum, it's a great place to educate yourself & others on our TRT issues & protocols.

Good luck to you, hopefully your new found TRT will turn your life around & you will have a good quality of life again.

[powerlifterty16]

I was just put on trt, I pick up my supplies tomorrow. My dose is 200mg every other week, but my doctor said I can do 100mg weekly. Which is better? Weekly or bi-weekly?

weekly

http://forums.steroid.com/hormone-re...-outdated.html

[E5Charlie]

I have Test Cyp...my total test was 298 and free was 32. I wasn't given any AI...with my dose, is an AI even needed?

[E5Charlie]

Has anyone here been put on trt because of use of opiates? I use oxycontin for my back problems...and the doctor thinks that is the reason for my low testosterone. If so, how has trt worked for you?

[EverettCD]

Long term opiate use can cause Low Testosterone. Test Cyp injection should make you feel much better as long as you keep estrogen levels under control. I would split your dose up to 50mg injected two times per week (every 3.5 days) to keep estrogen from spiking.

For example my Dr. wanted me to inject 200mg every 10 days. The day after my appointment I emailed him & asked if he was supportive of me injecting every 3.5 days, he was all for it. I asked him why he didn't just put me on that protocol to begin with & he said he didn't think I would want to stick myself that often since some PT's complain about it. Obviously I don't mind, I actually look forward to injection days. To make a long story short I inject 70mg every 3.5 days & I feel great at this point (about 2.5 weeks in). I go for BW in about 2.5 weeks to see what my levels are on this protocol & make any adjustments necessary.

[Low Testosterone]

I have not read through every comment, just the OP and Kelkel's post below.
Yes, you have low testosterone. I'm sorry, more test will not change this. I understand a physician's desire to be as thorough as possible but let's make sure we always call a spade a spade. More importantly, you're not low for your age. You're low for any age. More importantly yet again, optimal testosterone is not dependent on age. Optimal testosterone remains the same regardless of age. Here's a good example of what I mean:

A 20yr old man has 20/20 vision. Fast forward 20yrs and he now has 20/80 vision. The doctor could bring his eye sight back to 20/20 very easily, but instead he says "your eye sight is a little off for your age, let's make your vision, 20/50" of course the guy still can't see but he's "Normal" for his age. Now of course this would never happen in a million years. Any optometrist will always do all he can to improve your eyesight as much as possible, but this is exactly what happens in testosterone therapy most of the time.

[E5Charlie]

Good responses,thanks a lot guys...I injected myself today with 200mg before I read the suggestions to split it. I just finally got the test in my hands and I couldn't wait to stick myself. I got 2 tiny doses of 200mg/ml. Next month I'll ask the doc to give me four 100 mg/ml doses.

[E5Charlie]

What kind of muscle gains can one reasonably expect on 100mg/wk and good diet and moderate weight lifting? I can't lift like before because of my back, I use lighter weight for more reps. Also, how long after 1st injection would one expect to feel any different? All these questions I have may sound stupid to the more experienced members, but this is my first experience with testosterone. Thanks in advance.

[EverettCD]

Check this out:

http://forums.steroid.com/hormone-re...questions.html

[FRDave]

What kind of muscle gains can one reasonably expect on 100mg/wk and good diet and moderate weight lifting? I can't lift like before because of my back, I use lighter weight for more reps. Also, how long after 1st injection would one expect to feel any different? All these questions I have may sound stupid to the more experienced members, but this is my first experience with testosterone. Thanks in advance.

With good diet, a great training program and dedication, you can achieve your max genetic potential. Unfortunately know of us can tell you what that is... My squats were stuck at 218 lbs for a good year no matter what I did, and within 8 month on TRT in a calorie deficient (I'm trying to loose weight) I am now squatting 265lbs at a weight of 154lbs. Nothing crazy, but the only thing that changed was Starting TRT so it does help (results will differ for each and every one of us).

Check out the stickied threads for some good reading. One has full details on what you can expect on TRT within certain time frames, but once again, this is only a general estimate. I didn't feel a huge difference till I got my test to estrogen levels dialed in which took a good 7 months :-/

[E5Charlie]

I'm going to keep this thread open to keep a record of my progress on trt. It has been a couple of days since I injected my first 200mg of test cyp, and of course I feel nothing yet. I've read it could possibly take weeks, so I'll be patient. Had sex last night, and it was actually pretty good. I have been lacking in that department lately. Been lifting weights and I'm very sore. 1 question I have is how does testosterone help with muscle recovery? Does the soreness take less time to go away?

[E5Charlie]

Does anyone have an answer to my soreness question?

[EverettCD]

Does anyone have an answer to my soreness question?

To my knowledge the best remedy for sore muscles from working out is a full nights sleep every night & a lot of water. When your drinking enough water your urine will be clear, now drink more water

I'm sure there's some truth to an extent of upper range test levels playing a role in better muscle recovery but I'm not 110% sure.

Sent from my iPhone that was manufactured in a sweat shop in China

[E5Charlie]

It has been 1 week today since my first injection. I injected 200 mg to do it bi-weekly, but because of all your suggestions, I will do 100 mg weekly starting with my next injection. So far the only thing I have noticed is spontaneous erections. I've been working out, moderate weight for high reps because of my back problems. I have a question though. Anybody on TRT have back problems and did your back become stronger with less pain due to the TRT?

[bullshark99]

E5C,

I also have back issue's more importantly was basically "addicted" to Oxy from years of use. I was a spinal fusion canadate and opted against it. To this day i beleive that to be the smartest move health wise I have ever done. Obviously I do not know your situation but TRT in itself is not gonna corrrect your back and or alieviate pain. What will help and has helped me tremendously is getting in the best shape you can and this includes diet not just excercise. I rarely use opiate meds anymore, just on crisis days and their arent many of them anymore. I will tell U this, getting off the opiates is even more painful than the back!! I wish that on no one, u are on a high daily dose, be carefull.

[EverettCD]

I have two herniated disks. Since starting TRT & getting back in the gym my back is much better.

Sent from my iPhone that was manufactured in a sweat shop in China

[E5Charlie]

Today is two weeks since my first injection. The first was 200 mg but two weeks later, today, I injected 100mg because of your suggestions. I'll do 100mg weekly from now on. I still haven't felt any different. The spontaneous erections I was having are also gone. I think it was just in my head. I'm getting impatient, although I know it takes time. I'll keep you posted on my progress and will consider any and all suggestions.