About to start TRT. How does this sound?

[dask]

Hi all,

I'm a 22 year old male who was recently diagnosed with low testosterone. I have pretty much every low T symptom you could name. Depression, anxiety, low libido, low energy etc. Been lifting in the gym for a solid 4 years and haven't seen much progress despite a great diet and workout plan.

I went to see an endocrinologist and my testosterone levels were tested at 6.8nmol/L (195ng/dL)! So that explains it finally. Today he prescribed Reandron 1000 (testosterone undecanoate) injections for me to try and see how I felt on it - two doses, 8 weeks apart. That seems like a BIG interval by the way. Would more frequent injections help with the peaks and valleys? If I see an improvement, which no doubt I will, he will continue to prescribe it. The problem is that in order to be covered by insurance my T levels must be <6nmol/L (173ng/dL). The endocrinologist recommended getting retested so I want to make sure I'm below that level on my next bloodwork. Obviously I don't want to start with the injections until I have my T lowered slightly. I'm going to try not sleeping the night before or lifting weights to help bring it down a little. I didn't do anything to manipulate the levels on my last test and normally wouldn't but I need to get this covered to be able to afford it long-term, especially with something like TRT being a lifelong treatment.

I've been dealing with low testosterone my entire life and it's been pretty miserable so I would optimally like to end up in the high normal range (1000ng/dL).

Anyway, how does this all sound? Recommendations/Suggestions?

Also how does testosterone undecanoate compare to testosterone enanthate, which I believe is the most commonly prescribed TRT medication?

Thanks guys.

Ps. I'm from Sydney, Australia if anyone on here has any region-specific advice.

[Back In Black]

What is the reason for your low T? What tests other than a blood test were done?

Have you suffered testicular trauma,

Been tested for varicoceles?

MRI scan done?

What are the results for your LH and FSH and what ranges?

you really shouldn't jump on TRT without knowing the cause and fixing that if possible.

[dask]

I had a pituitary MRI done which the endocrinologist says it's fine. Never suffered testicular trauma. He inspected my testes on my first appointment and said they were of a good size and felt fine. I saw a different endo years ago who did the same thing. So I guess a physical examination is the extent of checking for primary hypogonadism. I don't have varicoceles. All this seems a bit contradictory for me since aren't the causes of male hypogonadism either from the pituitary or testicles? The endo believes my low T is caused from being on anti-depressants. The truth is I never really took any antidepressant for any stretch of time. I believe the depression and anxiety started back when I was 16 years old BECAUSE OF low T, not the other way around but who knows.

I don't have the LH and FSH on me but I'll get the test results sent to me tomorrow and post them up if that will help.

[Simon1972]

totally agree with black here.

terminal half life.
Testosterone Enanthate: 4.5 days

Testosterone Undecanoate: 20.9 days​



active testosterone % of dose

Testosterone Enanthate: 70%

Testosterone Undecanoate: 61%

find your cause first before starting on trt, could be something that needs attention.

wake up at 4am the morning of the test- this might help if you go to sleep at midnite first...but im guessing- not scientifically tested

how long ago were you on Anti depressents, and for how long?

[MMAasrealasitgets]

dude, I am a newbie here and rushed into a TRT before. Dont do it, although now it may appear as a light at the end of the tunnel, you dont want to start on it till you have covered ALL bases.

I mean BW for thyroid, pitu, cortisol, blood sugar and everything suggested on here the works. Dont get them done once, do them two or three times over a few weeks. It may take more time, but dont be chasing an anomaly or a red herring.

Test U is classed as a depot injection and one I had. You normally have an initial shot then a booster at 6wks. After that its usually 12 weeks between shots.
However, I got mine down to 7 weeks apart. The inj is a depot hit deep in your arse and takes about 30-45secs to inject in as very oily. Each shot is injected into the alternate butt.

I did notice peaks and throughs though nothing too bad once I got my cycle right.

as for coming off it, thats left me here. 18months with nothing and my levels were unchanged. I am now on a PCT to try and restart.


Please bear with it for a few more tests / weeks - you have been affected this many years, what's a few weeks to get the FULL PICTURE? I would urge anyone who doesn't quite know the real reason for low T to check everything and build a understanding of whats involved in TRT (without HCG, you will be chemically castrated), you will suffer mood swings but maybe not as bad as now and you will be looking for the next 20+ years of injections every couple of months if you got TestU.

good luck and post here what you find, I am no good on BW but there are many who are!

[dask]

Thanks for the replies guys. MMAasrealasitgets I have no desire to rush into TRT after doing some more research. I really want to pinpoint the cause first and if I still have to go on TRT then that's fine.

It took a bit longer than I thought to convince the doctor to give me my blood work but here it is.

Notable results:

TSH 4.9mIU/L (normal range: 0.5-4.0). This is up from 2.7 at my previous test in December.
Testosterone 6.8nmol/L (normal range: 8.3-29).

The pituitary MRI showed a very small tumor which the endocrinologist was not concerned about.

Is it possible for it to still be primary hypogonadism if a physical examination of the testes showed no problems?

And are there any other tests I should get done?

Thanks!

[Chauffeur]

Whoops, wrong thread.

Please delete this post.

[kelkel]

I would think an ultrasound of the testicals would be in order. To much margin for error in palpation for varicoceles, imho. What's interesting is the significant drop your LH took in 5 months. Now, factor in the new microadenoma. They can do many things such as elevate prolactin, thus lowering LH. Cause the release of GH. They can also secrete TSH which coincidentally yours is now elevated. If the elevated TSH was backed up by poor thyroid function (full panel needed) that again can suppress testosterone production.

I'm curious why your doc ruled it out that quickly. The onset of an adenoma's and it's impact can be slow in developing.

[dask]

Time for an update.

I visited another endocrinologist for a second opinion. He seems like a far more thorough doctor who actually listens. I told him about my low T level and that I had been prescribed reandron but hadn't started injections yet. He ran some more blood tests.

The new results were:

SHBG - 25nmol/L (15-50)
Testosterone - 18.7nmol/L (11.5-32)
Free Androgen Index - 74.8% (15-100)
FSH - 2.2IU/L (1.0-12)
LH - 3.7IU/L (0.6-12)

So without any treatment my T levels are now reading 18.7nmol/L or 538ng/dL...

This is really confusing to me. The only difference between the two tests is that the first (195ng/dL) was taken at 12pm instead of 8am. Both tests were fasted. I know testosterone levels dip throughout the day, but that significantly?

Also, the new endo diagnosed me with Hashimoto's disease based off of my symptoms and elevated TSH. He prescribed 50mcg thyroxine which I've been on for 1 week now and already noticed a significant decrease in facial bloating and maybe a slight increase in thought clarity. If it continues to help me he'll increase my dose to lower my TSH levels further. So I'm glad I'm at least making some progress even though my mood is still pretty much in the gutter.

My reason for seeing the new endo was to pinpoint the cause of my low T so I could say for certain what was causing it, before jumping on TRT for life. Now I feel more lost than ever. The latest endo says my T is totally normal. This constant anxiety and depression. All my other symptoms. I feel like I can't escape it now. That TRT was the only way to fix me. I can't function socially at all and hide in my room all day. It's really sad. I've completely isolated myself. Now I don't even know what the problem is. I've read a bunch of stories by people who have started TRT and report the complete disappearance of anxiety and depression. This feels like my only light at the end of the tunnel.

I've still got the prescription for Reandron from the first endocrinologist and I'm seriously considering using it just to see if it helps. Right now I'd do anything to feel well again. The one thing is that I only have the Reandron - no HCG or AI or whatever else I would need. I don't wanna mess up my body because I took it improperly.

Hashimoto's is known to cause anxiety and depression as well and I feel like the thyroxine will help a bit but won't be enough to make me feel well again since my TSH levels were only slightly elevated to begin with.

Advice?

[kelkel]

Advice would be to be patient and give this doc and his protocol time to work. You did not get in this condition over night and won't recover over night. Give the doc time to nail your thyroid issue and see what happens. TRT is not a panacea. People tend to think it can fix just about everything but that's just not the case. Taking Reandron now would be a poor choice, imho.

[ab037]

Im sure Kel will give you a more thorough answer. But, i am hypo / hashi as well and getting the proper meds/ dosage are huge and could be the difference for you. http://www.stopthethyroidmadness.com Hang in man you will get it figured out

Also the PM cortisol is high. Could just be from the low thyroid function. Or could be stress related.
The adrenals and thyroid work in unison, like a balance beam, when one us up the other down.

[dask]

Fatigue, puffy face, unexplained weight gain and the forgetfulness that I've been experiencing are all symptoms of hypothyroidism. I also know it's much harder to lose fat with hypothyroidism. But can it make gaining muscle near impossible despite eating and training well? I just seem to be getting fatter and weaker. If I cut down on calories I lose a lot of muscle. An increase in calories will see strength and muscle gains go up marginally with lots of fat gain. I mean I've been lifting for 4 years and still have 12 year old boy forearms. Correct me if I'm wrong but it seems like a testosterone deficiency as well as hypothyroidism.

However, I will give the thyroid medication some time to work. But if my TSH normalizes and my symptoms persist then what? I'm not saying TRT is a panacea but my first test was at 195ng/dL.

[dask]

Does anyone know if hashimoto's can cause an extreme difficulty in adding muscle? Is it possible that getting the right thyroxine dose could solve this issue?

[Baxter35]

Low thyroid can cause low T and if course all the symptoms that go with it. This includes loss of muscle mass among other things. Knowing you have hashi, stick with the thyroid treatment alone for now and don't start the TRT until you've given the thyroid meds time to take effect. Its quite possible your T will come back in line with your thyroid straightened out. It can take several months for the thyroxin to have a noticeable effect, and its likely you'll need to up your dose in the process with ongoing blood work, but be patient. You can always start TRT later on if the thyroid doesn't fix it, but for now Id advise to leave it out. I'm hypothyroid btw, and have been through all this. Keep us posted.

[kelkel]

Im sure Kel will give you a more thorough answer. But, i am hypo / hashi as well and getting the proper meds/ dosage are huge and could be the difference for you. Stop the Thyroid Madnessâ„¢ - Hypothyroidism and thyroid mistreatment Hang in man you will get it figured out

Also the PM cortisol is high. Could just be from the low thyroid function. Or could be stress related.
The adrenals and thyroid work in unison, like a balance beam, when one us up the other down.

Low thyroid can cause low T and if course all the symptoms that go with it. This includes loss of muscle mass among other things. Knowing you have hashi, stick with the thyroid treatment alone for now and don't start the TRT until you've given the thyroid meds time to take effect. Its quite possible your T will come back in line with your thyroid straightened out. It can take several months for the thyroxin to have a noticeable effect, and its likely you'll need to up your dose in the process with ongoing blood work, but be patient. You can always start TRT later on if the thyroid doesn't fix it, but for now Id advise to leave it out. I'm hypothyroid btw, and have been through all this. Keep us posted.

Really great advice from ab and Baxter and there's zero need to be more thorough! Like I said previously, step 1 is correcting your thyroid. Your path after that should be determined by your BW and how you feel. Patience!

Like the analogy ab!

[newtotrt]

Hey,

I have a similar issue... Actually last october after years of feeling like absolute crap and trying to treat all my symptoms (depression, lethargy, aches and pains, anxiety, libido to name a few) I asked my GP to test my testosterone levels and they came back at 9... a low average apparently and my Dr left it at that. A year later I asked for the same test and it came in at 7.7 so I was retested and my results came in a week later at 14.

I was then referred to an endocrinologist who looked at my results and said that the 14 must be some calculation mistake in the lab. He told me to stop taking any pre gym supplements, wait 1 week and get retested twice.My next appointment with him isnt for another 10 weeks so he has given me a private script to start Reandron 1000 the day I get my second blood test.

Due to the new PBS rules here in AUS we have to have 2 tests below 6 to qualify otherwise we have to pay for private scripts... either way I don't care, I am just glad someone finally understands how bad my life is with this low T.

Im 32 and fit and healthy. Dont drink, smoke or do any recreational party favourites. I eat healthy and exercise 6 days a week. I just cant shift my gut and have no interest in hanky panky at all. It is ruining my life. I am ready for bed each day by 4 pm.

Have you had any further progress dask?

[kelkel]

Hello newtotrt.

Great post but what you need to do it paste it over to a "new" thread for us to comment on. We'll have a few questions / comments for you if you can do so.

Thanks!

[newtotrt]

Hello newtotrt.

Great post but what you need to do it paste it over to a "new" thread for us to comment on. We'll have a few questions / comments for you if you can do so.

Thanks!

Done!

Thanks... I appreciate it