18yo TRT - Have I got the facts straighT?

[imgettingup]

Hi guys. Excuse me for the wall of text. If you don't feel like reading it all, I would really appreciate if you could just take a look at the bolded text.
I've decided to go on self-prescribed TRT.
Please before you flame, The country I live in is far behind in TRT and endocrinology in general. There are no private doctors, so there isn't anyone I can seek to except for the state doctors. The state doctors follow outdated guidelines and all I've met lack forward thinking.

I have had no libido, no motivation, unwillingness to do anything, nothing feels fun anymore, no joy, I'm like a zombie. Gym gains were non-existent except for fat, despite of IIFYM with 200g protein, 400 calorie surplus and progressive overload in the gym. I can't live like this anymore, frankly if I go on I fear I might get dark thoughts.

TRT for the ones who is able to get is prescribed (almost impossible if you're under 40) is undecanote 1000mg once every 12-14 weeks with almost 0 possibiltiy to change the interval. estradiol management is unheard of, if your RBC/hemacrotit goes above the reference or close you are put off TRT cold turkey by most doctors instead of going to donate blood.

I know when you're young with low T, you should first find the cause. i've looked thyroid numbers, diabetes, prolactin, vitamin D defiency, zinc defiency, lack of fat in diet (tried high fat diet for 3 months), exercise etc, obesity, sleeping. LH/FSH function, variecole etc.

They won't help you here. You aren't considered low until you're at 200ng/dl or lower. Since they don't consider my levels low, they won't try to find a cause either.

I've decided to self medicate TRT. Please tell me if I missed something:

150mg test C/week divided into 2 doses to keep E down and for more stable levels
arimidex 1mg/week (in 2 doses) if needed
HCG 200-250iu 2 or 3 times per week

+ If I would have for whatever reason step off I would go with
wk 1-5 Clomid 25-50mg/E
starting 2 weeks after last injection

what I will monitor:
full blood count
blood pressure
fat lipids
PSA
testosterone
estradiol

and once per half year or year
Liver (ASAT, ALAT)
Kidney (Creatinine, Sodium, Potasssium, Calcium)

if RBC/hematocrit goes too high I go donate blood

I understand that putting myself on TRT includes the risk of not being to recover my hypothalamus and that my sperm count might not be good enough to have children. But with HCG my chances of staying fertile are pretty high.

Did I miss anything in my protocol?

Thank you

-----------------------------------------



age: 18
weight 74kg
height 5'11
bf 17-18%
waist: 32inch

I've got prolactin, thyroid, estradiol, testosterone, liver, kidney function, vitamin D, insulin function and blood values checked over the years:

Total Testosterone Reference: 230ngdl-866ng/dl - Values been hovering around 260-373ng/dl over the course of 2 ½ years. Latest ones at 323ng/dl, 280ng/dl, 260ng/dl.

SHBG 13-71nmol/L - values been around 15-20nmol/L Latest ones at 18nmol/L, 15nmol/L, 16nmol/L

LH- Been around 4-6iu/L on all tests. Latest ones at 4.8iu/L, 5.6iu/L, 4.5iu/L
FSH - Always been low 1.2-1.6iu/L. Latest ones at 1.3iu/L, 1.6iu/L, 1.2iu/L

Hemoglobin - Always been elevated, hovering around 160g/l. Latest test showed 150ng/dl.
Hemacromatotit- Always elevated aswell, hovering around 0,50%, Latest test was 0,43%.

I think it's because of dehydration, I will get this retested properly hydrated.

Estradiol - 19.5pg/ml

Vitamin D 88nmol/L

Thyroid: 3 TSH tests around 3-3.5. Latest one (complete) showed a more or less perfect thyroid function?

TSH 2.2miu/L (0.4-5miu/L)
Free T4 20pmol/L (10-22pmol/L)
Free T3 5.4pmol/L (3.3-6.5pmol/L)
TPO-AB <10 (0-35)
TRAB <1 (0-1.0)

Prolactin, 6.5 ng/ml, 33ng/ml, 16ng/ml (2-17ng/ml)

S-Glucose 5.3nmol/L
HbA1C 32mol (27-42mol)

S-DHEAS 9.3umoL/L (5.7-13umol/L)

P-Cholestrol 3.5mmol/L (2.9-6.1mmol/L)
HDL Cholestrol 1.3mmol/L (1.0-2.7mmol/L)
LDL cholestrol 2.2mmol/L (1.2-4.3mmol/L)
Triglycerides 0.5mmol/L (0.45-2.6mmol/L)

[kelkel]

I'm sorry to hear of your issues. I'm also impressed with the effort you put into finding the root cause.
What country are you from?
I didn't see cortisol mentioned?

Assuming LH ranges are normal you're showing decent pituitary function. Consider an HCG stimulation test (google it) to determine how functional your testicles are. You mentioned varicocels but were you actually examined or did you have an ultrasound performed? If you don't or can't try a stimulation test then at your age I'd opt for clomid therapy until you can find a better doctor to help you.

[imgettingup]

Thanks
I'm from Sweden.
I haven't measured cortisol yet. I will do another batch of blood tests before treatment with cortisol included.

As for the varicoceles I was both examined and also performed a ultrasound. None of them showed any abnormalities.

I will read more about clomid therapy.
What are your thoughts on my protocol + potental PCT? (Not cycle, but post trt therapy I guess)