Been On HRT 3 Months and Still Really Tired?

[GetUpandLift]

Hey guys,

Lets start off by stating some basic facts about myself.

-27 Years Old
-Diagnosed with Secondary Hypogonadism (pituitary normal, left testicle has a varicocele but doc said surgery might not fix my levels, no signs of any thyroid issues)
-Very active (gym 5 days a week)
-6'4" 230lbs
-Started out with 230 Total Testosterone and now it is at 600. I just got my recent 3 month blood work back and everything came back within range.
-Testosterone Injections 1 time a week at 170mg
-HCG twice a week (2 days after injection and 2 days after that). 500iu x2 a week
-Estrogen Blocker

So I don't really feel any different after being on TRT for 3 months .. The only thing I have really noticed is that I'm more motivated to go to the gym and feel like my muscles are growing easier than before. I am drinking 1.5-2 gallons of water a day and typically just do 2 fish oils a day and sometimes a multi-vitamin.

I mostly eat clean (ground turkey, chicken, salmon, tuna,etc). My calorie intake is around 4000 calories a day and I am fairly lean at around 16% BF.

I was really tired and wanted to sleep all day before I started treatment. I wasn't interested in sex and just felt depressed and tired all of the time.

I still feel the same exact way.

If my blood work is all "normal" according to my TRT doctor, what could this be?

They keep mentioning sleep apnea, but I do not have the signs of it according to my girlfriend (I don't snore at all).

I really want to get this figured out.

Here is my lab work back in July before I started TRT:

SHBG - 23.2 (range is 16.5-55.9)
Estradiol 15.4 (range is 7.6-42.6)
TSH- 1.680 (range is .450-4.500)
LH - 2.4 (range is 1.7-8.6)
FSH- 2.1 (range is 1.5-12.4)
Prolactin - 12.2 (range is 4.0-15.2)
Hemoglobin - 17.6 (range is 12.6-17.7)
Hematocrit - 50.4 (range is 37.5- 51)
Free T- 9.8 (range is 9.3-26.5)
T4 Direct - 1.06 (range is .82-1.77)
Total T- 208 (range is 350-1000)

This is the only full panel they have done in the 3 months. The most recent bloods have been just Total T, Free T, Estradriol and Hemogloblin/hematocrit. I can get these numbers if you need them as well. They told me they are all normal and my Estradroil is back down to under 20, total T was in the 600's, and Free T was 21. (same ranges).

Please help.

[Chauffeur]

It would be really helpful if you posted your labs, including reference ranges, here in your thread. Without labs we would all just be guessing, so you may not get a ton of replies without them.

Along with the labs, please clarify how long after your injection they were drawn as well as the dose of your aromatase inhibitor.

[GetUpandLift]

It would be really helpful if you posted your labs, including reference ranges, here in your thread. Without labs we would all just be guessing, so you may not get a ton of replies without them.

Along with the labs, please clarify how long after your injection they were drawn as well as the dose of your aromatase inhibitor.

Hey again, I just posted all of that. My Aromatase inhibitor is Anastrozole and it is .25 mg twice weekly (I take it on the HCG days Friday and Sunday (I get my shot on Wednesday). The bloods I posted were before I started TRT and the newest ones under those with just the few tests are the ones they take one week after I get my shot, which is right before my weekly shot.

[Chauffeur]

Hey again, I just posted all of that. My Aromatase inhibitor is Anastrozole and it is .25 mg twice weekly (I take it on the HCG days Friday and Sunday (I get my shot on Wednesday). The bloods I posted were before I started TRT and the newest ones under those with just the few tests are the ones they take one week after I get my shot, which is right before my weekly shot.

I should have clarified, I was only asking about the labs you've had since you started treatment...

If your estradiol is "under 20" on this assay, it's far too low and could absolutely be making you feel like garbage. I'd expect it to be a bit higher earlier in the week, but I guess we can't really assume anything.

This is the standard estradiol assay, which overstates estradiol quite a bit, especially when dealing with low levels of the hormone like this.

At 20 pg/ml on the standard test, the sensitive assay from Labcorp would surely show that your actual estradiol value is probably close to undetectable. You may not need the Anastrozole at all...or maybe you just need a lower dose. If I were you I'd try to get my estradiol up and see how I felt.

How have your hemoglobin, hematocrit, and RBC lab values looked since you began treatment? Your HGB and HCT were already pushing the top of the ranges prior to TRT, and there's a good chance that they've gone up since then.

[ks1234]

I think your estrogen is too low. I'd cut back the AI and see how you feel. What dose are you taking?

P.s. I'm no expert

Edit. I saw your dose. I +1 what was said above

[kelkel]

It can take up to a year to realize the full, positive effects of a good protocol. We are all different. Agree with the guys above regarding your estrogen. I can never understand why doctors automatically start patients out with an AI when they have no clue if it's needed or not.

[GetUpandLift]

I should have clarified, I was only asking about the labs you've had since you started treatment...

If your estradiol is "under 20" on this assay, it's far too low and could absolutely be making you feel like garbage. I'd expect it to be a bit higher earlier in the week, but I guess we can't really assume anything.

This is the standard estradiol assay, which overstates estradiol quite a bit, especially when dealing with low levels of the hormone like this.

At 20 pg/ml on the standard test, the sensitive assay from Labcorp would surely show that your actual estradiol value is probably close to undetectable. You may not need the Anastrozole at all...or maybe you just need a lower dose. If I were you I'd try to get my estradiol up and see how I felt.

How have your hemoglobin, hematocrit, and RBC lab values looked since you began treatment? Your HGB and HCT were already pushing the top of the ranges prior to TRT, and there's a good chance that they've gone up since then.

I think your estrogen is too low. I'd cut back the AI and see how you feel. What dose are you taking?

P.s. I'm no expert

Edit. I saw your dose. I +1 what was said above

It can take up to a year to realize the full, positive effects of a good protocol. We are all different. Agree with the guys above regarding your estrogen. I can never understand why doctors automatically start patients out with an AI when they have no clue if it's needed or not.

Hey guys, I started out at the end of July with no Estrogen blocker at all.. Just 140mg of test once a week and that was it. Then 2 weeks later I started 1 time per a week 1000iu of HCG , which I now split in half day 2 and day 4 after my injection (I get injected Wednesday and do the HCG on Friday and Sunday with the Estrogen blocker).

My Estradiol was 41.6 on a 7.6 to 42.6 range one month after I started testosterone .

That's when they put me on an estrogen blocker.

For some reason a month after I started treatment my SHBG was 14.4 on a 16.5 to 55.9 scale.

What do you guys think now about the estrogen?

Do you guys know why my RBC started out on the high side? They mentioned that as well. It has gone up a little from what I remember, but he just told me to go donate blood, which I will end up doing most likely. I have just never done it and I'm pretty scared of donating that much blood since I almost passed out just giving a few vials one time!

Does any of this have to do with the left side varicocele on my testicle? I have read really mixed things regarding these and my doctor said that if it isn't causing me any pain then there is no need for surgery. Also the things I'm reading is that people only go up by about 100 on their total testosterone count after surgery or none at all.

Thanks a lot guys. I go back to the doc Wednesday for my shot so I can get those other bloods from the most recent 3 month draw as well.

[kelkel]

Well, first thing I'd do is cut your HCG in half. It's contributing to your E2 issue and honestly you do not need that much. 250 iu's x 2 is just fine. The reason your shbg dropped is the exogenous testosterone . Test will suppress shbg. Always has, always will. Speaking of which, splitting your dose to 70 mgs x 2 per week would probably help here. It will also reduce T to E conversion. Think about it, less injected at one time equals less conversion to estrogen. Works for many guys here.

You'll be fine giving blood. Just don't watch. Wear an ipod, listen to music, etc.

Regarding your varicocele. Your doc gave you shitty advice, imho. Varicocele surgery is an effective way to restore normal testosterone levels and there are plenty of studies to show just that. Here's a couple:

Varicocele repair for low testosterone. - PubMed - NCBI

Varicocele as a risk factor for androgen deficiency and effect of repair. - PubMed - NCBI

[Chauffeur]

My Estradiol was 41.6 on a 7.6 to 42.6 range one month after I started testosterone .

That's when they put me on an estrogen blocker.

For some reason a month after I started treatment my SHBG was 14.4 on a 16.5 to 55.9 scale.

What do you guys think now about the estrogen?

Do you guys know why my RBC started out on the high side? They mentioned that as well. It has gone up a little from what I remember, but he just told me to go donate blood, which I will end up doing most likely. I have just never done it and I'm pretty scared of donating that much blood since I almost passed out just giving a few vials one time!

Does any of this have to do with the left side varicocele on my testicle? I have read really mixed things regarding these and my doctor said that if it isn't causing me any pain then there is no need for surgery. Also the things I'm reading is that people only go up by about 100 on their total testosterone count after surgery or none at all.

Thanks a lot guys. I go back to the doc Wednesday for my shot so I can get those other bloods from the most recent 3 month draw as well.

I agree with everything that Kel said above, so I'll refrain from repeating the same info.

I just want to stress the importance of keeping your RBC and hematocrit under control through blood donation. You're must get over your fear of blood and take care of this issue on an ongoing basis.

Allowing those values to go unchecked puts you at a much higher risk for strokes and cardiac events, so it's not something you want to ignore. It may take several donations to get your numbers down, but stay on top of it. Many of us need to donate every few months to keep things from getting out of control.

Besides, it's good for you...as well as the person who will receive your blood.

If you wait until your values are sky high, it's possible that you'll be turned away from donation. So that's another reason not to delay.

Also, don't mention that you're donating for the purpose of lowering RBC/HCT. Use of testosterone isn't an automatic DQ at the Red Cross, but they are a humanitarian aid organization and don't like to be used as a therapeutic phlebotomy site.

They may ban you for life if they feel that you're there for the wrong reason, then you'll be in a sticky situation.

Nobody gets hurt by not disclosing your use of testosterone.

[GetUpandLift]

Well, first thing I'd do is cut your HCG in half. It's contributing to your E2 issue and honestly you do not need that much. 250 iu's x 2 is just fine. The reason your shbg dropped is the exogenous testosterone . Test will suppress shbg. Always has, always will. Speaking of which, splitting your dose to 70 mgs x 2 per week would probably help here. It will also reduce T to E conversion. Think about it, less injected at one time equals less conversion to estrogen. Works for many guys here.

You'll be fine giving blood. Just don't watch. Wear an ipod, listen to music, etc.

Regarding your varicocele. Your doc gave you shitty advice, imho. Varicocele surgery is an effective way to restore normal testosterone levels and there are plenty of studies to show just that. Here's a couple:

Varicocele repair for low testosterone. - PubMed - NCBI

Varicocele as a risk factor for androgen deficiency and effect of repair. - PubMed - NCBI

Hi again, I read those articles about test levels and varicoceles. Do you think that it would even help me much since I am starting out in the low 200's total test wise? Also, there are several different surgeries on the repair. Which is the most effective one? I didn't go to a specialist for the varicocele advice, just my normal doctor. I also read online several places like ********* and most said that it didn't help their T levels and the varicoceles kept coming back after surgery. Also, from my understanding most docs will not operate if there is no pain in the testicles. I don't have any pain like some people do with mine.

I won't know my Estrogen levels from my most recent blood work until Wednesday, but you still recommend doing 250 and 250 (500iu total) of HCG over 500iu and 500iu (1000 per week)?

Also, I go to the Low T Center for the injection 1 time per a week (they were the only ones that would actually prescribe HCG with the TRT protocol and I definitely want to try to have kids one day so that's where I get my shot and prescriptions. So going in twice a week would be a complete pain and they only do 1 appointment a week and that's to keep cost down for me as well.

I will suck it up and start giving blood. How frequently do I need to go? Like 3-4 times a year?

I think those varicoceles just run in my blood because I have a few on my right leg as well. The doc has never been worried about them before. I think I got them on my leg from running on concrete and that's my bad side (my knee is pretty jacked up).

Do you know what is up with feeling like a zombie all day long? I feel completely out of it ... The only thing they say at the Low T Center is it could be sleep apnea, but since I do not snore according to my girlfriend, I do not think that is what it is so what else could it be?

If you were me, would you get the varicocele removed and who do I need to see to do that? Would this take me off of TRT? I just don't want to walk around with a 300-400 total T level and feel like sh*t and go through the surgery and then have to end up doing TRT anyways.

Finally, do i need to mess with the dosing of the estrogen blocker or just the HCG? I take .25mg twice a week (2 days after my injection and then another 2 days after that (same with HCG)).

Thank you!

I agree with everything that Kel said above, so I'll refrain from repeating the same info.

I just want to stress the importance of keeping your RBC and hematocrit under control through blood donation. You're must get over your fear of blood and take care of this issue on an ongoing basis.

Allowing those values to go unchecked puts you at a much higher risk for strokes and cardiac events, so it's not something you want to ignore. It may take several donations to get your numbers down, but stay on top of it. Many of us need to donate every few months to keep things from getting out of control.

Besides, it's good for you...as well as the person who will receive your blood.

If you wait until your values are sky high, it's possible that you'll be turned away from donation. So that's another reason not to delay.

Also, don't mention that you're donating for the purpose of lowering RBC/HCT. Use of testosterone isn't an automatic DQ at the Red Cross, but they are a humanitarian aid organization and don't like to be used as a therapeutic phlebotomy site.

They may ban you for life if they feel that you're there for the wrong reason, then you'll be in a sticky situation.

Nobody gets hurt by not disclosing your use of testosterone.

Thank you for all of this information. When I go to donate, I won't tell them I take testosterone. I realize how important this is now so it sounds like I will be going soon. I need to prepare myself for it though.. Can I eat and drink a lot of water before I go?

The guys at the Low T Center think that my RBC and all of those levels were high because I am most likely dehydrated when I do my blood tests. Could drinking more water, like I have been, make my levels go down? I don't know what causes having a high RBC in the first place. That's very weird. I do have a lot of anxiety so maybe that is it?

Hopefully I can figure out why I am feeling like a zombie all day and night. I feel terrible, like nothing has changed since I started TRT.

Thank you for all of your help so far!

[kelkel]

Hi again, I read those articles about test levels and varicoceles. Do you think that it would even help me much since I am starting out in the low 200's total test wise? Also, there are several different surgeries on the repair. Which is the most effective one? I didn't go to a specialist for the varicocele advice, just my normal doctor. I also read online several places like ********* and most said that it didn't help their T levels and the varicoceles kept coming back after surgery. Also, from my understanding most docs will not operate if there is no pain in the testicles. I don't have any pain like some people do with mine.

I think it's worth every bit of your time to find a specialist who will look into your varicocele further. Yes, it's worth it imho. I disagree that most doc's won't operate. If it's effecting your T level why wouldn't they.

I won't know my Estrogen levels from my most recent blood work until Wednesday, but you still recommend doing 250 and 250 (500iu total) of HCG over 500iu and 500iu (1000 per week)?

Abolutely. 1000 is simply unnecessary and will contribute to estrogen issues.

Also, I go to the Low T Center for the injection 1 time per a week (they were the only ones that would actually prescribe HCG with the TRT protocol and I definitely want to try to have kids one day so that's where I get my shot and prescriptions. So going in twice a week would be a complete pain and they only do 1 appointment a week and that's to keep cost down for me as well.

I will suck it up and start giving blood. How frequently do I need to go? Like 3-4 times a year

Doubtful you need to go that much. Most really don't. Giving blood too much can drive you toward anemia.

I think those varicoceles just run in my blood because I have a few on my right leg as well. The doc has never been worried about them before. I think I got them on my leg from running on concrete and that's my bad side (my knee is pretty jacked up)

Negative. Varicocele and varicose veins are two different things

Do you know what is up with feeling like a zombie all day long? I feel completely out of it ... The only thing they say at the Low T Center is it could be sleep apnea, but since I do not snore according to my girlfriend, I do not think that is what it is so what else could it be?

Dialing in TRT takes time. Some people notice a difference very quickly, others can take up to a year to feel 100%

If you were me, would you get the varicocele removed and who do I need to see to do that? Would this take me off of TRT? I just don't want to walk around with a 300-400 total T level and feel like sh*t and go through the surgery and then have to end up doing TRT anyways.

I'd talk to a Urologist and discuss options. If surgery is performed then you'll need to come off TRT to allow endogenous levels to attempt to return.

Finally, do i need to mess with the dosing of the estrogen blocker or just the HCG? I take .25mg twice a week (2 days after my injection and then another 2 days after that (same with HCG)).

Lowering your dose of HCG may require you to lower your adex dose. Only BW will answer than.

Thank you!



Thank you for all of this information. When I go to donate, I won't tell them I take testosterone . I realize how important this is now so it sounds like I will be going soon. I need to prepare myself for it though.. Can I eat and drink a lot of water before I go?

Legitimate TRT is none of their business. Fasting is not required to donate blood.

The guys at the Low T Center think that my RBC and all of those levels were high because I am most likely dehydrated when I do my blood tests. Could drinking more water, like I have been, make my levels go down? I don't know what causes having a high RBC in the first place. That's very weird. I do have a lot of anxiety so maybe that is it?

Dehydration will impact RBC's but short term for BW will not dramatically alter results.

Hopefully I can figure out why I am feeling like a zombie all day and night. I feel terrible, like nothing has changed since I started TRT.

Thank you for all of your help so far!

in bold above...

[GetUpandLift]

in bold above...

Hi again,

I got that blood work today. The Estradiol was 22 on my 3 month blood work. The Free T was 20.5. They do this blood work right before I get my injection.

I had been doing 170mg of Test Cypinate 1 time a week (Wednesdays), up until today. I switched it to 160mg. Is this fine?

I told the guy at the Low T Center about how you said to split the HCG into 250iu and 250iu twice a week and he said that 500iu and 500iu should be more than fine. What gives here? I don't know anything about HCG and it doesn't seem like he does either.

Is 160-170mg of Test too much once a week? It seems like most people are on 100-150mg.

Also, what days do you recommend doing the HCG and do you think with my estradiol being 22 that I should still cut the dose and possibly cut the dose of my .25 x2 a week estrogen blocker?

They don't seem to test much on the 3 month blood test except for SBHG, Estradiol, Free T, Hemoglobin, Hemocrit, and some other misc things.

I definitely want to see someone again about that varicolce soon, but I'm having to find another family doctor because my insurance is no longer covered with my current doctor so it could be some time until I get that thing figured out so that's why I want to see if I can feel better on TRT.

Finally, if I never got that varicolce fixed and just continued doing TRT, would it be okay? That's the only thing that could be messing with my T level (202 total T when I first started treatment). Would I be fine at 27 doing TRT for the rest of my life.

My T doc said to give blood every 2 months if I can, but I definitely don't want to do that. Once every 6 months should be enough, correct?

Thanks again!!!!!

[kelkel]

Ok. Estradiol is really not the correct test for men. It should be E2 Sensitive. Estradiol reads higher in men as the test is not "sensitive" enough to be accurate. It can be a dramatic difference or a minimal one. Sure your drop in dosage is fine. Now be consistent until your next BW otherwise you won't know what's working. Whether your dosage is to much can only be determined via BW.

Re HCG , most all experts will advise you that 250 iu's either two or three times per week is fine. There's no need to start out at a max dose. Some guys even go as far as injecting smaller doses on a daily basis, such as 100 iu's. Google Dr. John Crisler's HCG Update and read up on it. He's arguably one of the best TRT doc's in the country. You can also search up Nelson Vergel and HCG.

Injection protocol with HCG: For a one shot per week Test protocol many will recommend your HCG shots to be both one and two days before your next injection. The thought is to use the HCG to bump up waning test levels. Test has about a 5-7 day half life, metabolism dependent. IMHO, you'd be just fine on two evenly spaced days of the week with one being the day before your shot. Just be consistent for testing purposes.

Re adex. HCG can add to estrogen levels, which is another reason to keep it minimal. That said with your current estradiol level I'd probably consider dropping your dose to .25 either the day or injection or day after and skip the second dose. Retest in about 4 weeks and titrate accordingly. Know that when you make multiple changes you'll often need to get frequent BW for several months in a row to dial in.

You can no doubt feel better on TRT than when you had poor natural T levels. Your varicocele and TRT for life is a personal decision. Me, I'd be all over fixing it and trying to have good, natural levels for another couple decades. TRT is not as hard as it seems and yes, you'd be fine for life but who wants to inject themselves for 50 + years when they may not have to?

Base how often you give blood on your hematocrit level. Remember what I said above that sometimes giving blood too often can lead to problems such as anemia. It's definitely not a rule that you have to give blood. Some do, some don't. All this plays into finding the lowest possible dose that makes you feel good as well as keeps your numbers on your BW in line.

[GetUpandLift]

Ok. Estradiol is really not the correct test for men. It should be E2 Sensitive. Estradiol reads higher in men as the test is not "sensitive" enough to be accurate. It can be a dramatic difference or a minimal one. Sure your drop in dosage is fine. Now be consistent until your next BW otherwise you won't know what's working. Whether your dosage is to much can only be determined via BW.

Re HCG , most all experts will advise you that 250 iu's either two or three times per week is fine. There's no need to start out at a max dose. Some guys even go as far as injecting smaller doses on a daily basis, such as 100 iu's. Google Dr. John Crisler's HCG Update and read up on it. He's arguably one of the best TRT doc's in the country. You can also search up Nelson Vergel and HCG.

Injection protocol with HCG: For a one shot per week Test protocol many will recommend your HCG shots to be both one and two days before your next injection. The thought is to use the HCG to bump up waning test levels. Test has about a 5-7 day half life, metabolism dependent. IMHO, you'd be just fine on two evenly spaced days of the week with one being the day before your shot. Just be consistent for testing purposes.

Re adex. HCG can add to estrogen levels, which is another reason to keep it minimal. That said with your current estradiol level I'd probably consider dropping your dose to .25 either the day or injection or day after and skip the second dose. Retest in about 4 weeks and titrate accordingly. Know that when you make multiple changes you'll often need to get frequent BW for several months in a row to dial in.

You can no doubt feel better on TRT than when you had poor natural T levels. Your varicocele and TRT for life is a personal decision. Me, I'd be all over fixing it and trying to have good, natural levels for another couple decades. TRT is not as hard as it seems and yes, you'd be fine for life but who wants to inject themselves for 50 + years when they may not have to?

Base how often you give blood on your hematocrit level. Remember what I said above that sometimes giving blood too often can lead to problems such as anemia. It's definitely not a rule that you have to give blood. Some do, some don't. All this plays into finding the lowest possible dose that makes you feel good as well as keeps your numbers on your BW in line.

UPDATE and some questions.

So first off, I want to talk about the HCG. I read those articles that you linked me to. Thanks for that. I switched my HCG 2 weeks ago to one day before injection and one day prior to that. Does timing matter at all? I have been doing it towards the night each time. I also switched from doing 500iu 2x per a week to 250iu 2x per a week now.

I also changed the Adex to the day of my injection. I have been doing it after I get injected. Is this fine or is it supposed to be before? I'm just doing the .25 once per a week.

I didn't realize that they are doing the wrong estrogen test. How am I supposed to get this e2 sensitive test done? The Low T Center that I go to every week says they only do the estradroil test and won't do this e2 sensitive test. They told me to stop reading on the forum too, lol..

I just really want to get to the bottom of everything and know what doses that I actually need. I just feel like complete crap taking 160mg of test once a week with the adex and HCG. Also, I am getting pretty bad (at least for me) back acne and some on my arms. Is there anything to help with this acne? My face doesn't get it a lot, just mainly arms and back.

Finally, I went ahead and donated blood yesterday. They almost didn't take me because my iron was at an 18.9 on their 20 scale and I'm not sure what my hemocrit was but they said that they should have denied me for that as well.. They said both were at the very top of what they should be and were very concerned. What should I do about this? They kept asking me if my doctor sent me in to donate blood with that high of a level and I said no. They also said that donating once every 2 months won't help with my RBC and that I would have to get it done weekly for it to benefit me.

This was my first time ever donating blood and I felt terrible yesterday. I was really light headed and EXTREMELY TIRED the whole day (I did it at like 1pm and was up until 4am). I worked today and have felt the same way today as well. There have been 2 times where it felt like a jolt in my heart or something (once last night and once today) and I'm not sure if that has anything to do with the blood draw.. but I've never had that happen to me before. My body is really not liking the blood draw at all.. I feel extremely weak, tired, and light headed. I was able to work an entire shift today but now that I'm home, I feel much worse and that whole jolt thing in my chest freaked me out last night and tonight. (just happened twice).

Any ideas? I am concerned. I have a regular doctor's appointment on Friday this week. I am going to ask him about that varicocele and see if I should go to a urologist about it (this is a new doctor). I am also going to tell him about everything I've been going through.

I hope you can help.

Thanks

[kelkel]

UPDATE and some questions.

So first off, I want to talk about the HCG . I read those articles that you linked me to. Thanks for that. I switched my HCG 2 weeks ago to one day before injection and one day prior to that. Does timing matter at all? I have been doing it towards the night each time. I also switched from doing 500iu 2x per a week to 250iu 2x per a week now.

Timing during the day, no.

I also changed the Adex to the day of my injection. I have been doing it after I get injected. Is this fine or is it supposed to be before? I'm just doing the .25 once per a week.

Test peaks in about a day or so. Adex has about a 50 hr half-life. Taking it the day of or day after is fine.

I didn't realize that they are doing the wrong estrogen test. How am I supposed to get this e2 sensitive test done? The Low T Center that I go to every week says they only do the estradroil test and won't do this e2 sensitive test. They told me to stop reading on the forum too, lol..

If you're in the states (and depending on what state) you can try discounted labs .com or private md labs .com. The former has the cheapest E2 sensitive at the moment. Of course they want you to stop reading forums. An educated client does not help them. An E2 Sens test via a Doc or Clinic using Labcorp is $200+. Using one of the labs mentioned and paying for it yourself is around $30 from memory...

I just really want to get to the bottom of everything and know what doses that I actually need. I just feel like complete crap taking 160mg of test once a week with the adex and HCG. Also, I am getting pretty bad (at least for me) back acne and some on my arms. Is there anything to help with this acne? My face doesn't get it a lot, just mainly arms and back

It would really be good to actually see current labs and ranges. Feeling like crap could be the possible low estrogen level that Chauffeur mentioned or your T dose may be to high. We are all different and it takes time to dial in. A lower dose of T along with the HCG may help to mitigate your break outs as well as your hematocrit issues.

Finally, I went ahead and donated blood yesterday. They almost didn't take me because my iron was at an 18.9 on their 20 scale and I'm not sure what my hemocrit was but they said that they should have denied me for that as well.. They said both were at the very top of what they should be and were very concerned. What should I do about this? They kept asking me if my doctor sent me in to donate blood with that high of a level and I said no. They also said that donating once every 2 months won't help with my RBC and that I would have to get it done weekly for it to benefit me

That's a high hemoglobin level. It would put your hematocrit level at about 56.7. A DRBC donation would have been best. That said, whole blood will drop your levels by arguably 2 pts. DRBC is twice that amount. They mentioned weekly as it will take more than the normal (allowed) amount of donations to get you to a healthy range. Ask your doctor if he will write your a script (s) for therapeutic draws. Do some research on polycythemia. Remember to hydrate well.

This was my first time ever donating blood and I felt terrible yesterday. I was really light headed and EXTREMELY TIRED the whole day (I did it at like 1pm and was up until 4am). I worked today and have felt the same way today as well. There have been 2 times where it felt like a jolt in my heart or something (once last night and once today) and I'm not sure if that has anything to do with the blood draw.. but I've never had that happen to me before. My body is really not liking the blood draw at all.. I feel extremely weak, tired, and light headed. I was able to work an entire shift today but now that I'm home, I feel much worse and that whole jolt thing in my chest freaked me out last night and tonight. (just happened twice).

Honestly it sounds like anxiety.

Any ideas? I am concerned. I have a regular doctor's appointment on Friday this week. I am going to ask him about that varicocele and see if I should go to a urologist about it (this is a new doctor). I am also going to tell him about everything I've been going through.

I hope you can help.

Explain everything to him. Take your BW with you. Get the scripts for blood draws. Take the time and write down your questions so you don't forget any. Nothing worse than walking out of an appt and realizing you forgot some important questions.

Thanks

In bold above. Let us know how this weeks appt goes please. Hopefully he's knowledgeable in this area.

[GetUpandLift]

In bold above. Let us know how this weeks appt goes please. Hopefully he's knowledgeable in this area.

So here is an update..

I still have not gotten any E2 sensitive blood tests done. Do I really need to do this? My TRT Low T Center doc says that they have never measured this and just do estradiol to monitor my estrogen levels.

How much different is this E2 sensitive test over the estradiol test that they do every 3 months? I am in college and only work part-time so I do not have a lot of extra money to get extra blood work. Is there any way we can go off of the results I posted here and not need the E2 test?

I changed my dose a few weeks ago to 150 mg of Test Once per a week instead of the 170 mg of Test once per a week that I was on. I also lowered the Armidex to .25mg one time per a week (I do it the day of the shot). I lowered the HCG to 250iu 2 times per a week (one day before shot and one day prior to that).

I am still very tired and my girlfriend is always mad at me because I pre-ejaculate a lot. We can only have sex for a few minutes after we start (no condom). When I masterbate, I pre-ejaculate before I even get a hard on usually!

I have started going to the new doctor and he thinks my protocol of HCG+test+armidex is crazy, especially at my age (27). He thinks that if I fixed my sleep schedule then having a low T level will not be an issue. He doesn't even consider 300 on a 1100 scale (total T) an issue and wouldn't personally prescribe testosterone for someone with that kind of level. He thinks that when my total T was 202 that it was probably mid day and that's why it was lower. He wants me to get on a consistent sleep schedule going to be at 10 to 11 PM every night and getting up at the same time every day and getting 7-9 hours of sleep each day. I currently go to bed at 2 to 4am and get up anywhere from 9am to 3pm the next day. I work retail hours so it really varies, but I always go to bed late at night/early in the morning.

He prescribed a muscle relaxer that I take an hour before bed and I seem to be sleeping better on it, but it also seems to make me even more tired the next day.

Also, I got an ultra-sound done on my testicles and saw a specialist for that and there is a varicole in the left testicle but it is VERY tiny and the urologist as well as my doctor do not think that I should do anything about it. They measured the blood flow on both of my testicles and they were very close with very good blow flow. The urologist said that they usually put a measurement on the varicole, but with mine they just said "small" varicole instead because of how small it is. He was only worried about fertility with this and not my testosterone level.

My TRT doc thinks that I should have just stayed on 170mg of Test once a week, 1000iu once a week for HCG, and 2x .25mg of Armidex. They said they are not concerned with my RBC and won't worry about it until it reaches the 60 mark. At that point they would want me to give blood every week and would write a prescription to do so. I really do not want it to get high so that's why I cut my dose down to 150mg once a week. They also told me to start taking 450mg or higher of Saw Palmetto a day to help stop the production of RBC.

On another note, my new regular doctor says that his endo has had success with just prescribing Clomid to patients like myself that have lower T levels and he does not like my protocol at all. He thinks it is completely insane actually..

I really do not know what to do at this point. I was really hoping that it was just that little varicole in my left testicle, but after these ultrasound results and the doc and urologist not being concerned about it, I'm back to square one.

Please help.. I really do not know what to do.. my regular doctor wants me to completely stop this crazy HCG+Test+armidex protocol and give it 6 months to let myself go back to normal and then retest and see if the normal sleep patterns will help, but I cannot let my test get that low again since I had to take welbutrin+lexapro to keep my anxiety in check. Now I just take k-pins 1mg as needed and it helps.. I get anxiety still but not nearly as bad as when my test levels were super low. I just want to start feeling normal again. With the 170mg of test, 2x a week of armidex, 500iu of HCG 2 times a week, my free T was close to 20, which is good and my estradiol was 21 which is supposed to be good according to the low T center, but now my free T is going to be low again with 150mg (probably 14 or lower).

Sorry for all of the info.. I just want to try to put everything out there. I really hope you guys can help.

[GetUpandLift]

In bold above. Let us know how this weeks appt goes please. Hopefully he's knowledgeable in this area.

Kelkel, did you see my last post? Anyone? I really need help.

[kelkel]

So here is an update..

I still have not gotten any E2 sensitive blood tests done. Do I really need to do this? My TRT Low T Center doc says that they have never measured this and just do estradiol to monitor my estrogen levels.

It's common for clinics to only do estradiol as it dirt cheap compared to an accurate E2 Sens test. You'll survive without it but if estrogen control is an issue then it's one test you should run.

How much different is this E2 sensitive test over the estradiol test that they do every 3 months? I am in college and only work part-time so I do not have a lot of extra money to get extra blood work. Is there any way we can go off of the results I posted here and not need the E2 test?

We can't really guess the difference. For some it's minimal, others it's dramatic. Remember there are sites where you can pull this BW yourself very inexpensively.

I changed my dose a few weeks ago to 150 mg of Test Once per a week instead of the 170 mg of Test once per a week that I was on. I also lowered the Armidex to .25mg one time per a week (I do it the day of the shot). I lowered the HCG to 250iu 2 times per a week (one day before shot and one day prior to that).

Good. Now be consistent with it until you pull BW. I'd suggest at least a month before you pull any.

I am still very tired and my girlfriend is always mad at me because I pre-ejaculate a lot. We can only have sex for a few minutes after we start (no condom). When I masterbate, I pre-ejaculate before I even get a hard on usually!

I'd give it time. Think dead kittens....

I have started going to the new doctor and he thinks my protocol of HCG+test+armidex is crazy, especially at my age (27). He thinks that if I fixed my sleep schedule then having a low T level will not be an issue. He doesn't even consider 300 on a 1100 scale (total T) an issue and wouldn't personally prescribe testosterone for someone with that kind of level. He thinks that when my total T was 202 that it was probably mid day and that's why it was lower. He wants me to get on a consistent sleep schedule going to be at 10 to 11 PM every night and getting up at the same time every day and getting 7-9 hours of sleep each day. I currently go to bed at 2 to 4am and get up anywhere from 9am to 3pm the next day. I work retail hours so it really varies, but I always go to bed late at night/early in the morning.

He prescribed a muscle relaxer that I take an hour before bed and I seem to be sleeping better on it, but it also seems to make me even more tired the next day.

Well, it does suck to have to be on all this at your age. Caveat is that he thinks a 300 level is fine and that 200 or so in the afternoon must be ok as well. I bet he wouldn't accept that level if it were himself. Ridiculous, imho.

Also, I got an ultra-sound done on my testicles and saw a specialist for that and there is a varicole in the left testicle but it is VERY tiny and the urologist as well as my doctor do not think that I should do anything about it. They measured the blood flow on both of my testicles and they were very close with very good blow flow. The urologist said that they usually put a measurement on the varicole, but with mine they just said "small" varicole instead because of how small it is. He was only worried about fertility with this and not my testosterone level.

Well, hard to argue if the V-cell is that small and blood flow is good. I assume they consider it sub-clinical then. Interesting article here:

Male infertility and varicocele: myths and reality

My TRT doc thinks that I should have just stayed on 170mg of Test once a week, 1000iu once a week for HCG, and 2x .25mg of Armidex. They said they are not concerned with my RBC and won't worry about it until it reaches the 60 mark. At that point they would want me to give blood every week and would write a prescription to do so. I really do not want it to get high so that's why I cut my dose down to 150mg once a week. They also told me to start taking 450mg or higher of Saw Palmetto a day to help stop the production of RBC.

You say TRT Doc. You mean clinic right? Why on earth would you wait for it to hit a critical number before taking corrective action. That makes no sense at all.

On another note, my new regular doctor says that his endo has had success with just prescribing Clomid to patients like myself that have lower T levels and he does not like my protocol at all. He thinks it is completely insane actually..

Clomid is an effective form of TRT for many people. It stimulates production at the hypothalamic - pituitary level in turn signalling the testies to produce more testosterone. Not uncommon for doc's to go this route with younger patients. All this assuming your pituitary accepts the stimulation and increases production.

I really do not know what to do at this point. I was really hoping that it was just that little varicole in my left testicle, but after these ultrasound results and the doc and urologist not being concerned about it, I'm back to square one.

Yes, you have a decision to make. Do you go back to square one (as you said) and start over? If so, BW is crucial to try and chase down the culprit. Is there something in the thyroid that's being missed causing an issue? Sometimes it's extremely minor and can cause sub-clinical issues that will effect your T production. Like elevated RT3 for example. Adrenal issues, cortisol, etc.

If you chose to come off testosterone I would request a Clomid protocol for a period of time to help stimulate production at the hypothalamic level. Then come off and see how your T holds up with BW after 8 weeks or so. Hopefully you can find an issue and correct it and it's not simply idiopathic. Remember, something as innocuous as hitting your head can impact T production.

Please help.. I really do not know what to do.. my regular doctor wants me to completely stop this crazy HCG+Test+armidex protocol and give it 6 months to let myself go back to normal and then retest and see if the normal sleep patterns will help, but I cannot let my test get that low again since I had to take welbutrin+lexapro to keep my anxiety in check. Now I just take k-pins 1mg as needed and it helps.. I get anxiety still but not nearly as bad as when my test levels were super low. I just want to start feeling normal again. With the 170mg of test, 2x a week of armidex, 500iu of HCG 2 times a week, my free T was close to 20, which is good and my estradiol was 21 which is supposed to be good according to the low T center, but now my free T is going to be low again with 150mg (probably 14 or lower).

Sorry for all of the info.. I just want to try to put everything out there. I really hope you guys can help.

Watch this video which will help you understand your hormonal pathways and how minor alterations can have major impacts on you:

https://www.youtube.com/watch?v=_xrU...27uzRg&index=6

[GetUpandLift]

Watch this video which will help you understand your hormonal pathways and how minor alterations can have major impacts on you:

https://www.youtube.com/watch?v=_xrU...27uzRg&index=6

That was a great video. It sounds to me like my Cortisol could be the culprit. If you have higher Cortisol couldn't that cause Low T? It couldn't be too dramatic though, right? How am I able to lower my cortisol? I am looking at my blood work from back before I start TRT from 3/16/15 and my Cortisol was 38.4 on a 2.3-19.4 scale. I got it tested again one month later on 4/01/15 and it was 26.9 on a 2.3-19.4 scale. Thoughts?

EDIT: I saw on places like Amazon there are supplements like "Cortisol Manager." It is a supplement you can take daily to lower cortisol naturally. Could I take something like this and see if it helps? Can you check out the product and see if the ingredients would help? It is like 65 bucks. Also, I read on here that taking a lot of Vitamin C helps lower these levels as well.

Also, my LDL-P was 1754 on a <1000 scale as well as my Small LDL-P 1590 on a <=527 scale. This was when I used to eat A LOT of egg yolks (I try to do only 2 for every 4 egg whites now so typically 2 a day). Does having higher cholesterol affect T levels at all?

Here are other blood tests from back in early march this year before I started TRT (started that in July):

Hemoglobin 17.7 (12.6-17.7 scale)
Hematocrit 50.3 (37.5-51.0 scale)
TSH 1.360 (.450-4.500 scale)
Testosterone, Serum 202 (348-1197)
LH 2.4 (1.7-8.6)
FSH 2.1 (1.5-12.4)
Estradiol 15.4 (7.6-42.6)
SHBG 23.2 (16.5-55.9)
Free Testosterone 9.8 (9.3-26.5 scale)
Prolactin 12.2 (4.0-15.2)

Is there any other test results that I would need other than these? There are a bunch on my paperwork but I figured these are the major ones that relate to Low T.

Before I started TRT, I tried Clomid + Novaldex for 2 months straight per this forum to see if it would make my levels go back to normal, but it didn't work. I ordered the 2 products in liquid form from CEM products online so I'm not sure if it was the source or they just didn't work. I had read good things about this website from other forums, which is why I ordered there. If I have to go this route again for Clomid, is there a better reputable source and what doses would I take and for how long? I know the TRT clinic won't give me clomid because they make their money on giving me TRT and my normal doctor just wants me to stop everything cold turkey and let my body restart itself, which I'm not willing to do due to my extreme anxiety (I used to take lexapro and wellbutrin and got off of it after starting TRT due to better anxiety).

I'm glad that I read that article about the correlation between infertility and varicoceles. Mine is small enough to where I do not think that would be a problem. Plus I once got a girl pregnant so I don't think I have issues in that regard.

I would really prefer to try to fix the issue with something like Clomid if you think it is even worth my time. This TRT protocol doesn't seem to be helping and I'm worried about my RBC as I started high before even starting treatment.

Thoughts?

Thanks A LOT!!!!!

[kelkel]

That was a great video. It sounds to me like my Cortisol could be the culprit. If you have higher Cortisol couldn't that cause Low T? It couldn't be too dramatic though, right? How am I able to lower my cortisol? I am looking at my blood work from back before I start TRT from 3/16/15 and my Cortisol was 38.4 on a 2.3-19.4 scale. I got it tested again one month later on 4/01/15 and it was 26.9 on a 2.3-19.4 scale. Thoughts?

Ahh, now we're making progress! I'm glad you were able to look find your old BW and yes, cortisol can suppress Test production both at the pituitary level and testicals. Causes are many: thyroid, sleep issues, obesity, stress, etc.

Also, my LDL-P was 1754 on a <1000 scale as well as my Small LDL-P 1590 on a <=527 scale. This was when I used to eat A LOT of egg yolks (I try to do only 2 for every 4 egg whites now so typically 2 a day). Does having higher cholesterol affect T levels at all?

No, it won't effect T levels. But exogenous T can suppress HDL levels.

Here are other blood tests from back in early march this year before I started TRT (started that in July):

Hemoglobin 17.7 (12.6-17.7 scale)
Hematocrit 50.3 (37.5-51.0 scale)
TSH 1.360 (.450-4.500 scale)
Testosterone, Serum 202 (348-1197)
LH 2.4 (1.7-8.6)
FSH 2.1 (1.5-12.4)
Estradiol 15.4 (7.6-42.6)
SHBG 23.2 (16.5-55.9)
Free Testosterone 9.8 (9.3-26.5 scale)
Prolactin 12.2 (4.0-15.2)

Is there any other test results that I would need other than these? There are a bunch on my paperwork but I figured these are the major ones that relate to Low T.

Full thyroid panel to include TSH, FT3, FT4, RT3 and Antibodies. Don't forget cortisol and estradiol should be switched to a Sensitive Estrogen Assay. Take a look at the BW listed in the Finding A Doc Sticky at the top of this forum.

Before I started TRT, I tried Clomid + Novaldex for 2 months straight per this forum to see if it would make my levels go back to normal, but it didn't work. I ordered the 2 products in liquid form from CEM products online so I'm not sure if it was the source or they just didn't work. I had read good things about this website from other forums, which is why I ordered there. If I have to go this route again for Clomid, is there a better reputable source and what doses would I take and for how long? I know the TRT clinic won't give me clomid because they make their money on giving me TRT and my normal doctor just wants me to stop everything cold turkey and let my body restart itself, which I'm not willing to do due to my extreme anxiety (I used to take lexapro and wellbutrin and got off of it after starting TRT due to better anxiety)

I'd talk to your doctor and impress upon him you don't want to go cold turkey and that you'd prefer Clomid therapy for a while to stimulate your HPTA which is currently shut down from exogenous T administration. A reputable source would be your doctor, or find another doctor who will listen. A common dose of clomid is 25 mgs EOD.

I'm glad that I read that article about the correlation between infertility and varicoceles. Mine is small enough to where I do not think that would be a problem. Plus I once got a girl pregnant so I don't think I have issues in that regard.

I would really prefer to try to fix the issue with something like Clomid if you think it is even worth my time. This TRT protocol doesn't seem to be helping and I'm worried about my RBC as I started high before even starting treatment.

Thoughts?

Thanks A LOT!!!!!

My thoughts are many with your situation. If you choose to stay on TRT then realize that it takes time to dial in. It doesn't always happen in two or three months. If you feel the problem is fixable then either speak more in depth with your doctor about clomid or if he's a stubborn ass find another one willing to help. You need to be your own best advocate here. Unfortunately the majority of doc's don't really understand hormones in depth as they are not really trained in them in Med School.

If I were in your shoes I'd be doing everything possible to find the causative factor and correct it. Wouldn't it be nice to find the issue, correct it and be normal for a few more decades? It would suck to be on TRT without a clear conscience as to why you're on it.

Are you in the states?

[GetUpandLift]

My thoughts are many with your situation. If you choose to stay on TRT then realize that it takes time to dial in. It doesn't always happen in two or three months. If you feel the problem is fixable then either speak more in depth with your doctor about clomid or if he's a stubborn ass find another one willing to help. You need to be your own best advocate here. Unfortunately the majority of doc's don't really understand hormones in depth as they are not really trained in them in Med School.

If I were in your shoes I'd be doing everything possible to find the causative factor and correct it. Wouldn't it be nice to find the issue, correct it and be normal for a few more decades? It would suck to be on TRT without a clear conscience as to why you're on it.

Are you in the states?

Hey again,

So if my TSH is in check, along with the basic thyroid values, then my thyroid would be fine right? Or would they need to do a full panel to really see and there could be one value that could be off that would only be seen in a full panel? I thought they never did a full panel like this unless something popped up on the basic panels for thyroid? Same for kidney, liver, etc?

That's interesting to hear about the Cortisol. Do you think my numbers were really out of whack? I read that they could be higher during certain times of the day and a lot impact it like how frequently you eat, how stressful of a day you've had, etc? It sounds like it is really difficult to get a good read on what an actual Cortisol level is because it varies so much! I am definitely not obese. I am 6'4" 230lb mainly lean muscle. I sleep A LOT, but who knows how good of quality it is. I currently take a muscle relaxer some nights to go to sleep so I can get a full nights rest or benedryl, or a klonopin since I have anxiety. So it would be sleep, thyroid (doubt it, but never know), or my anxiety. Could I take some of those over the counter supplements that are sold on Amazon and my Test level could just magically just come back up and cortisol go down?

My doctor doesn't think I should be on anything with the levels that he saw. He just thinks that I need to get on a normal sleep schedule like 11pm to 8am every day since my sleep schedule is so messed up currently. I sometimes go to bed at 4 or 5am and then I'll sleep in until 2 or 3pm the next day since I work Retail and my hours vary so much. Then some days I will go to bed at 2am and have to get up at 7am. It really varies but for the most part, I typically get 8 or more hours (sometimes 10 to 11 hours) most nights. Thoughts? It is just so hard for me to get up in the morning when I have nothing going on because my body is soooooo tired.

Is there any other places to get Clomid online like when I got it from CEM products online? I don't know if it was the right stuff or not. I stored it in a regular tubberware (it was liquid) at room temperature and put it in blank gel caps and took it with the novaldex but it didn't do anything for my body. I retested my T levels and they didn't go up.

Do you think with such a low free T and total T that something as little as sleep or cortisol being elevated a little bit would even make me have a good natural level? I'm really into lifting and I don't think I would be happy with anything under 500 total t or 15 free T.

I'm in the United States. I'm in Southern Indiana to be exact.

One last thing, if you think I could get off of this TRT thing and try to reboot my natural T and have a decent level by fixing cortisol and sleep, then should I still order my HCG (it is like $125 for the supply that I get that lasts 3 months at 250iu 2x a week). I have to order it as I am out. Could I still use it if I stopped taking Test and did clomid?

Thanks again!! I look forward to hearing from you and I really would like to fix this issue!

[kelkel]

Hey again,

So if my TSH is in check, along with the basic thyroid values, then my thyroid would be fine right? Or would they need to do a full panel to really see and there could be one value that could be off that would only be seen in a full panel? I thought they never did a full panel like this unless something popped up on the basic panels for thyroid? Same for kidney, liver, etc?\

If all values are in order then yes. TSH alone is a weal indicator of thyroid health. Yes, one value off can make a bit of a difference. RT3 for example. Correct, most rely on TSH before looking further. And most use a scale for TSH that is way to broad.

That's interesting to hear about the Cortisol. Do you think my numbers were really out of whack? I read that they could be higher during certain times of the day and a lot impact it like how frequently you eat, how stressful of a day you've had, etc? It sounds like it is really difficult to get a good read on what an actual Cortisol level is because it varies so much! I am definitely not obese. I am 6'4" 230lb mainly lean muscle. I sleep A LOT, but who knows how good of quality it is. I currently take a muscle relaxer some nights to go to sleep so I can get a full nights rest or benedryl, or a klonopin since I have anxiety. So it would be sleep, thyroid (doubt it, but never know), or my anxiety. Could I take some of those over the counter supplements that are sold on Amazon and my Test level could just magically just come back up and cortisol go down?

Yes it varies which makes arguably the best method for testing a 24 hr saliva cortisol test. When it comes to OTC test booster many have been found to suppress testosterone levels. I'd stay away from these.

My doctor doesn't think I should be on anything with the levels that he saw. He just thinks that I need to get on a normal sleep schedule like 11pm to 8am every day since my sleep schedule is so messed up currently. I sometimes go to bed at 4 or 5am and then I'll sleep in until 2 or 3pm the next day since I work Retail and my hours vary so much. Then some days I will go to bed at 2am and have to get up at 7am. It really varies but for the most part, I typically get 8 or more hours (sometimes 10 to 11 hours) most nights. Thoughts? It is just so hard for me to get up in the morning when I have nothing going on because my body is soooooo tired.

The lifestyle you describe makes me think of Adrenal Fatigue. Research this.

Is there any other places to get Clomid online like when I got it from CEM products online? I don't know if it was the right stuff or not. I stored it in a regular tubberware (it was liquid) at room temperature and put it in blank gel caps and took it with the novaldex but it didn't do anything for my body. I retested my T levels and they didn't go up

There's plenty of research chem sites but I cant recommend any. Again, I'd talk to your doc about clomid.

Do you think with such a low free T and total T that something as little as sleep or cortisol being elevated a little bit would even make me have a good natural level? I'm really into lifting and I don't think I would be happy with anything under 500 total t or 15 free T.

It can be several things impacting you at once. It's not always just one thing. It's very hard to tell just by speaking via the internet. I understand your concern regarding lifting and T levels, trust me.

I'm in the United States. I'm in Southern Indiana to be exact.

Well, I'd look into giving Dr. John Crisler a call. He's in Michigan and is arguably one of the best TRT related doc's in the country. It would be worth the trip for you. I believe after one initial face to face appt the rest can be virtual.

One last thing, if you think I could get off of this TRT thing and try to reboot my natural T and have a decent level by fixing cortisol and sleep, then should I still order my HCG (it is like $125 for the supply that I get that lasts 3 months at 250iu 2x a week). I have to order it as I am out. Could I still use it if I stopped taking Test and did clomid?

No to HCG when off TRT as it is suppressive to your natural LH production. It mimics LH and when taking it your own production will eventually suppress as your body realizes it doesn't need to produce it. Same logic as with testosterone supplementation.

Thanks again!! I look forward to hearing from you and I really would like to fix this issue!

In bold above.

[GetUpandLift]

In bold above.

Hey again!!

Now that I'm on a better sleep cycle since my hours have been pretty consistent and I actually have to get up, I'm not really really tired like I usually am for some reason. I read up on the adrenal fatigue and do not think that is me. I think it is more to do with that Cortisol thing.

Now since I'm worried about red blood cells, I'm thinking about going to the local HRT specialist. He is also a urologist and a lot of guys from the gym go to him. He mainly does pellets, gels, creams, etc. I don't think he does injections. Would I be okay with something like pellets? Would I still have to take HCG and estrogen blocker with it? I think my body might respond better to pellets since it is more consistent from what I have read. Thoughts?

Dr. Crisler is an option as I saw there is a virtual online everything type of thing. Will it matter that I am already on TRT from a clinic and if you remember correctly, I was trying to lean away from my protocol because of my naturally higher red blood cell count. How much will it impact my RBC numbers if I am really dehydrated before I go in? I drink a gallon of water a day, but notice towards the end of the day I'm still peeing a darker yellow. I am 6'4" 232 right now (pretty good shape) so maybe I just need more water while being on TRT?

Also, I saw Crisler's crazy prices which is a concern since it isn't covered by insurance like my current clinic and like the HRT local urologist is. I don't think I can afford his prices. Do you think I would be fine with something like pellets if they end up recommending that? Are any of the gels/creams good? I would really not like to go the gel/cream route as I prefer injection, but then again I do not like just doing ONE large dose of T at once and having to go in once a week since it spikes my estrogen compared to doing it myself twice a week (that isn't an option and I don't want to do anything illegal).

I thought about going to the local HRT/urologist to see if he could also figure out if there is anything that can be fixed as well. My doc won't prescribe clomid and I really do not want to buy it from a rat lab online not for human consumption type of thing. I have done that and like I said, I think it was not potent at all, but then again I've never had doc prescribed clomid.

Thoughts?

Thanks so much again!!! I really look forward to hearing your thoughts. I hope that my local HRT doc can offer something good for me versus the clinic, especially since they are both covered by insurance versus crisler. I don't have a lot of extra money like Crisler would want.

[GetUpandLift]

In bold above.

Thoughts?

I spoke with the Urologist that does pellet therapy and they think that it might be better for me since I have a high RBC and it will be more consistent dosing than going in once per a week and getting 150mg of test. I am optimistic that the pellets could be a good thing. They also said that they sometimes prescribe HCG with it as well. How would I get them to prescribe the HCG so that I can continue using that since I want to have kids one day and don't want testicular atrophy?

Thanks again. I quoted you above, but haven't heard back from you.

[kelkel]

Sorry I'm late getting to this. Feel free to pm me to direct me to a thread if you need to as it's hard for me to catch everything. First, I'd like you to read this link in it's entirety as it will directly answer many of your questions.

Comparison of the Effects of Testosterone Gels, Injections, and Pellets on Serum Hormones, Erythrocytosis, Lipids, and Prostate-Specific Antigen

You're Uro is correct when it comes to pellets and rbc's. But along with pellets normally comes lower T values, etc. It's really a personal choice. I prefer the control that self-injections give me. I've used gels and don't care for the daily mess involved. Pellets are also a "procedure" and more of a money maker in most cases. Nothing says you have to stick to one. You can always change later. All that said, it's always best to deal with someone near home and reachable as long as the treatment is effective and to your satisfaction.

Re HCG , simply ask them. You're now familiar with Crisler so look up his paper on HCG and present it to your doctor. A side note, on most package inserts for HCG hypogonadic hypogonadism is listed as a viable use for it.