What to make of my BW ~ TRT candidate?

[Brosef]

Just a little background, I've done 2 cycles in my life.

So I got my test checked around 2 years ago before ever injecting anything into my body and had a baseline of 306 total test.

Here are my results for the past two blood tests:

May 2017:
Total Testosterone: 211 (250-827) L
FSH: 5.6 (1.6-8.0)
LH: 9.8 (1.5-9.3) H
TSH: 1.29 (.4-4.5)
Glucose: 60 (65-99) L
Creatinine: 1.48 (.6-1.35)

July 2017:
Total Testosterone: 137 (250-1100) L
Free Testosterone: 25.3 (35-155) L
Sex hormone: 18 (10-50)
FSH: 7.1 (1.6-8.0)
LH: 4.4 (1.5-9.3)
TSH: 1.88 (.4-4.5)
Glucose: 79 (65-99)
Creatinine: 1.1 (.6-1.35)
B12: 754 (200-1100)
Vitamin D: 63 (30-100)
Prolactin is at 6.7 (2.0-18)

I have been on Clomiphene (50mg) for 6 weeks because my T was at 211 in May. I am now at 137. I'm experiencing a lack of energy and have hit a plateau in the gym. Feeling very weak and sex drive is still there but not explosive like I used to be. The first cycle was one 8wk with just test e at 600mg wk, about 2 years ago. About 9 months ago I did a 9 week with Test E (600mg) and Tren (400mg) wk. I did proper PCT with Clomid at 100/100/50/50. My pituitary test came back that my hormones were slightly out of line back in May but my most recent blood work says that I am ok in that regard. I'm 30 years old. Is it possible that I am just suffering from low Testosterone? Or is it possible that my use of steroids has inhibited my natural production for good? I just left the Doctors office yesterday and he gave me a shot in the ass of 200mg Test Cyp. He said I should feel it by today and I feel the same (I thought it takes weeks to kick in). He increased my Clomiphene dosage to 75mg/day and after 5 weeks I go back for BW. I also have to get an MRI of my pituitary gland bc this shouldn't be happening, me being 30. Also, have to go for semen analysis to make sure I am producing sperm, which I think will be fine bc My FSH and LH are normal.

Do you guys think that I just have low T and will have to get on some sort of TRT? I'm in great shape, eat right and work out daily. Do you think there will be a way to get my body to increase test without being on TRT? I feel like I'm still young and that is kind of a last resort for me. Thoughts? Thanks for the help guys.

[Youthful55guy]

Just a little background, I've done 2 cycles in my life.

So I got my test checked around 2 years ago before ever injecting anything into my body and had a baseline of 306 total test.

Here are my results for the past two blood tests:

May 2017:
Total Testosterone: 211 (250-827) L
FSH: 5.6 (1.6-8.0)
LH: 9.8 (1.5-9.3) H
TSH: 1.29 (.4-4.5)
Glucose: 60 (65-99) L
Creatinine: 1.48 (.6-1.35)

July 2017:
Total Testosterone: 137 (250-1100) L
Free Testosterone: 25.3 (35-155) L
Sex hormone: 18 (10-50)
FSH: 7.1 (1.6-8.0)
LH: 4.4 (1.5-9.3)
TSH: 1.88 (.4-4.5)
Glucose: 79 (65-99)
Creatinine: 1.1 (.6-1.35)
B12: 754 (200-1100)
Vitamin D: 63 (30-100)
Prolactin is at 6.7 (2.0-18)

I have been on Clomiphene (50mg) for 6 weeks because my T was at 211 in May. I am now at 137. I'm experiencing a lack of energy and have hit a plateau in the gym. Feeling very weak and sex drive is still there but not explosive like I used to be. The first cycle was one 8wk with just test e at 600mg wk, about 2 years ago. About 9 months ago I did a 9 week with Test E (600mg) and Tren (400mg) wk. I did proper PCT with Clomid at 100/100/50/50. My pituitary test came back that my hormones were slightly out of line back in May but my most recent blood work says that I am ok in that regard. I'm 30 years old. Is it possible that I am just suffering from low Testosterone? Or is it possible that my use of steroids has inhibited my natural production for good? I just left the Doctors office yesterday and he gave me a shot in the ass of 200mg Test Cyp. He said I should feel it by today and I feel the same (I thought it takes weeks to kick in). He increased my Clomiphene dosage to 75mg/day and after 5 weeks I go back for BW. I also have to get an MRI of my pituitary gland bc this shouldn't be happening, me being 30. Also, have to go for semen analysis to make sure I am producing sperm, which I think will be fine bc My FSH and LH are normal.

Do you guys think that I just have low T and will have to get on some sort of TRT? I'm in great shape, eat right and work out daily. Do you think there will be a way to get my body to increase test without being on TRT? I feel like I'm still young and that is kind of a last resort for me. Thoughts? Thanks for the help guys.

I'm assuming that AAS use is a thing of the past and your goal is to undo the endocrine damage. Right?

Assuming that's the case, I don't understand the recent shot of 200 mg of T-cyp. That's just going to set you back another 2 or so months to resetting the HPTA. My gut reaction would be to try a couple of months of HCG at about 1000 IU per week, but I even question whether that's going to be helpful, as the labs point to primary hypogonadalism as the source of the problem. You seem to be producing sufficient gonadotropins (LH/FSH), but yet your total and free T is still low.

I am concerned about your low SHBG. The low total T may be due to hyper metabolism of T by the liver, as the primary purpose of SHBG is to act as a buffer and protect the T from rapid metabolism and excretion. I'm guessing your E2 will also be low since it generally parallels T levels and will also be quickly metabolized without adequate SHBG.

I'm no expert on AAS use/abuse, but I'm wondering if there was some long-term effect of the Tren use on liver function (SHBG is primarily produced by the liver). Again, I would looks at a round of HCG might help the SHBG levels as anecdotal reports are that testicular produced T tends to aromatize more than supplemental T due to the high local concentration of the enzyme in the testicles. E2 is known to increase SHBG, so indirectly the HCG may help restore some balance to the system.

Another thought is that even though your TSH levels are normal, you may want to get some baseline labs done on T3 and T4. After that, consider supplemental T4 or Armour Thyroid. Supplemental T4 has been implicated in boosting SHBG levels. My understanding is that even though Armour Thyroid is desiccated pig thyroid, it has a slightly higher ratio of T4 to T3 than typical human thyroid ratios.

[Brosef]

I'm assuming that AAS use is a thing of the past and your goal is to undo the endocrine damage. Right?

Assuming that's the case, I don't understand the recent shot of 200 mg of T-cyp. That's just going to set you back another 2 or so months to resetting the HPTA. My gut reaction would be to try a couple of months of HCG at about 1000 IU per week, but I even question whether that's going to be helpful, as the labs point to primary hypogonadalism as the source of the problem. You seem to be producing sufficient gonadotropins (LH/FSH), but yet your total and free T is still low.

I am concerned about your low SHBG. The low total T may be due to hyper metabolism of T by the liver, as the primary purpose of SHBG is to act as a buffer and protect the T from rapid metabolism and excretion. I'm guessing your E2 will also be low since it generally parallels T levels and will also be quickly metabolized without adequate SHBG.

I'm no expert on AAS use/abuse, but I'm wondering if there was some long-term effect of the Tren use on liver function (SHBG is primarily produced by the liver). Again, I would looks at a round of HCG might help the SHBG levels as anecdotal reports are that testicular produced T tends to aromatize more than supplemental T due to the high local concentration of the enzyme in the testicles. E2 is known to increase SHBG, so indirectly the HCG may help restore some balance to the system.

Another thought is that even though your TSH levels are normal, you may want to get some baseline labs done on T3 and T4. After that, consider supplemental T4 or Armour Thyroid. Supplemental T4 has been implicated in boosting SHBG levels. My understanding is that even though Armour Thyroid is desiccated pig thyroid, it has a slightly higher ratio of T4 to T3 than typical human thyroid ratios.

Yes, for sure. If I can get my hormones back to normal I would like it to just keep it that way and no longer mess with AAS.

I'm assuming SHGB is the sex hormone that i got an 18 on? I mentioned HCG when I was with the Doctor and he insisted that I didn't need that. He said it was very very expensive and often times doesn't do anything. At this point I'll try anything before trt. Do you think a short 9 week cycle with Tren can shut me down for good? What exactly is T3 and T4? Sorry, I'm relatively new to all this and I appreciate your time and effort in helping me out.

I tried getting another appointment with a different endocrinologist but the closest appointment I could get is 2 months out. Ugh

[Youthful55guy]

Yes, for sure. If I can get my hormones back to normal I would like it to just keep it that way and no longer mess with AAS.

I'm assuming SHGB is the sex hormone that i got an 18 on? I mentioned HCG when I was with the Doctor and he insisted that I didn't need that. He said it was very very expensive and often times doesn't do anything. At this point I'll try anything before trt. Do you think a short 9 week cycle with Tren can shut me down for good? What exactly is T3 and T4? Sorry, I'm relatively new to all this and I appreciate your time and effort in helping me out.

I tried getting another appointment with a different endocrinologist but the closest appointment I could get is 2 months out. Ugh

I'm assuming too that "sex hormone" is actually SHBG. The range you poster (10-50) is about right for it when it's measured in nmol/L. While you are not out of range, you are on the low side. You have pretty good levels of LH & FSH, so the low T has to be either primary (testicles not responding to the LH) or hyper metabolism due to low(ish) SHBG. If you are primary, the HCG probably wouldn't help much, but if it's due to the low SHBG, it may increase your E2 (which I suspect is very low) and that could bring up your SHBG. You can easily obtain it from alternative sources, so if you want to thumb your nose at the doc and try it, it should be easy to obtain. It's not really that expensive either from alternative sources. I pay $30 to $60 for 5,000 IU vials. Cost depends on vendor.

T3 & T4 are your primary thyroid hormones. TSH stimulates the release of T4 from the thyroid and then some of it is converted to the more active T3 form. Armour Thyroid is desiccated pig thyroid which contains T4, T3, T2, & T1.

I have no experience with AAS, so I can't answer the tren question.

[Brosef]

I'm assuming too that "sex hormone" is actually SHBG. The range you poster (10-50) is about right for it when it's measured in nmol/L. While you are not out of range, you are on the low side. You have pretty good levels of LH & FSH, so the low T has to be either primary (testicles not responding to the LH) or hyper metabolism due to low(ish) SHBG. If you are primary, the HCG probably wouldn't help much, but if it's due to the low SHBG, it may increase your E2 (which I suspect is very low) and that could bring up your SHBG. You can easily obtain it from alternative sources, so if you want to thumb your nose at the doc and try it, it should be easy to obtain. It's not really that expensive either from alternative sources. I pay $30 to $60 for 5,000 IU vials. Cost depends on vendor.

T3 & T4 are your primary thyroid hormones. TSH stimulates the release of T4 from the thyroid and then some of it is converted to the more active T3 form. Armour Thyroid is desiccated pig thyroid which contains T4, T3, T2, & T1.

I have no experience with AAS, so I can't answer the tren question.

Wow, so much to learn here and thanks for your help. So you would recommend trying HCG for say 6 weeks at how many mg? Is it an injection? Should I use the HCG in addition to the Clomid 75mg / day? It's weird and maybe it's placebo but I'm pretty sure I feel back to my old self after the 200mg shot of Test C the doc gave me. But, I would like to solve the root of the problem and have my own body produce T.

[Youthful55guy]

Wow, so much to learn here and thanks for your help. So you would recommend trying HCG for say 6 weeks at how many mg? Is it an injection? Should I use the HCG in addition to the Clomid 75mg / day? It's weird and maybe it's placebo but I'm pretty sure I feel back to my old self after the 200mg shot of Test C the doc gave me. But, I would like to solve the root of the problem and have my own body produce T.

First off with your T levels, I suspect your E2 levels were (before your T shot) extremely low, so Clomid isn't going to do anything. Clomid is a selective estrogen receptor modulator (SERM) that selectively blocks E2 receptors in the hypothalamus (part of the brain), which controls the release of Gonadotropin Releasing Hormone (GnRH), which controls LH & FSH (gonadotropins) release from the pituitary. E2 is the primary negative feedback controller of T secretion in men, so if your E2 is low to begin with, the clomid has nothing to block but it does have certain E2-like side effects, so the risk-benefit ratio seems lopsidedly low. You might want to confirm this with an E2 lab (make absolute sure they are using the E2 sensitive lab (LC/MS/MS). Check out this resource for getting it done yourself and making sure it's the correct lab (
https://www.discountedlabs.com/estra...itive-lc-ms-ms).

That 200 mg of T your doc gave you is going to mess up your "normal" labs (including E2) for about 6 weeks. You probably don't want me to say this, but it was not a good idea. Most of your hormones (not just T) will be all over the map until it clears and the system settles back into it's "normal for you" state. If your are going to consider using TRT, consider it to be a lifetime medication and work toward getting a stable and sustainable protocol. Going on and off is just going make things much worse and send you an a hormonal rollercoaster to hell. Yes, it may kick in a few days, and you'll feel better for about 5-6 days, but wait until it wears off. You'll be pounding on the docs door like a crack addict. Taking more "temporary" T will just make the situation worse.

If you are going to try HCG (again, I think it's a long shot), then my recommendation is 1000 IU per week splitting up the dose into multiple injections per week. My standard dose is about 450 IU every 3 days. I choose this dose and schedule because I am on an every 3 day T-cyp dosing schedule. I am currently at 41 mg every 3 days, which equates to about 96 mg per week. HOWEVER, I have a very different problem than you. I have very high SHBG but I keep it under control by suppressing it with low doses certain androgens that are more commonly used as anabolic steroids. I talk about this at length in other strings.

[Brosef]

Hey youthfulguy thanks for all the info. I have been feeling back to my old self again after the T shot but I'm worried that after it wears off I should strait to feel bad again. What do you think is the best long term solution? I would love to be able to make enough T on my own but not opposed to TRT if it makes me feel normal. What is the frequency of shots I have to get and how will that affect my chances of having a kid? I don't want to be out of commission (no energy, no focus,low sex drive) for 6 weeks for everything to normalize and figure out another action plan.... are you saying that there is something wrong with my E2 levels? If so how can I go about getting those normalized so I can produce sufficent t again. I am worried though bc my baseline T from 2 years ago is 306 which was very low.... even if we get the E2 normal will it just limit out around 300?

[Youthful55guy]

Hey youthfulguy thanks for all the info. I have been feeling back to my old self again after the T shot but I'm worried that after it wears off I should strait to feel bad again. What do you think is the best long term solution? I would love to be able to make enough T on my own but not opposed to TRT if it makes me feel normal. What is the frequency of shots I have to get and how will that affect my chances of having a kid? I don't want to be out of commission (no energy, no focus,low sex drive) for 6 weeks for everything to normalize and figure out another action plan.... are you saying that there is something wrong with my E2 levels? If so how can I go about getting those normalized so I can produce sufficent t again. I am worried though bc my baseline T from 2 years ago is 306 which was very low.... even if we get the E2 normal will it just limit out around 300?

Not sure I understand the last question. Male E2 levels are normally between 8-35 pg/mL using the sensitive assay (for men). If your total T is low, then you E2 is probably also low, since E2 is derived downstream from esterification of T. I was just saying that getting E2 labs now, or any labs for that matter, are going to be worthless until that initial 200 mg shot clears your system and your system has had a chance to adjust back to your normal state. This takes anywhere from 4 to 6 weeks.

Your LH and FSH levels that you posted were in the normal range, but your Total T and Free T is very low. Your SHBG is on the low side. I suspect you are a rapid metabolizer of T rather than you being primary gonadotropic. Most guys with low SHBG are rapid metabolizers. There's no way that I know up to amp up your SHBG. My gut reaction is to try TRT with small frequent injections. This seems to work best for guys with low SHBG from what I've read in the forums (I have the opposite problem, so I'm not speaking from experience). I would suggest you start out at 40 mg every 2 days (using an insulin syringe) and then get labs in about 4 to 6 weeks. If you are still low, then bump it up to 50 mg E2D and repeat labs in 4 to 6 weeks.

If you are not primary hypogonadotropic, then HCG should work well to preserve fertility. I know of at least 2 guys in the forums that got their wife pregnant on TRT with just 500 IU per week. I would recommend 1000 IU per week in 3 divided doses (e.g., about 350 IU on M,W, F). There's good published data that that is the optimal dose for guys on TRT to preserve fertility.

[Brosef]

Not sure I understand the last question. Male E2 levels are normally between 8-35 pg/mL using the sensitive assay (for men). If your total T is low, then you E2 is probably also low, since E2 is derived downstream from esterification of T. I was just saying that getting E2 labs now, or any labs for that matter, are going to be worthless until that initial 200 mg shot clears your system and your system has had a chance to adjust back to your normal state. This takes anywhere from 4 to 6 weeks.

Your LH and FSH levels that you posted were in the normal range, but your Total T and Free T is very low. Your SHBG is on the low side. I suspect you are a rapid metabolizer of T rather than you being primary gonadotropic. Most guys with low SHBG are rapid metabolizers. There's no way that I know up to amp up your SHBG. My gut reaction is to try TRT with small frequent injections. This seems to work best for guys with low SHBG from what I've read in the forums (I have the opposite problem, so I'm not speaking from experience). I would suggest you start out at 40 mg every 2 days (using an insulin syringe) and then get labs in about 4 to 6 weeks. If you are still low, then bump it up to 50 mg E2D and repeat labs in 4 to 6 weeks.

If you are not primary hypogonadotropic, then HCG should work well to preserve fertility. I know of at least 2 guys in the forums that got their wife pregnant on TRT with just 500 IU per week. I would recommend 1000 IU per week in 3 divided doses (e.g., about 350 IU on M,W, F). There's good published data that that is the optimal dose for guys on TRT to preserve fertility.

Ok, you're saying most likely the best solution to my problem would be to go 40mg T-Ethanate EOD? I have just been letting my body normalize since the last T shot a couple weeks ago. Now, do you think I should bank some of my sperm before starting TRT just in case? Also, do you think it's worth continuing Clomid at 75mg/ day to see if that helps with raising my T levels? I am kind of looking for a quick solution. Should I try HCG and see if that will help raise T levels after I get BW in 4 weeks? Or do you think I should just start TRT on my own. I have a ton of T laying around... Thoughts?

and thanks again sir

[Youthful55guy]

Ok, you're saying most likely the best solution to my problem would be to go 40mg T-Ethanate EOD? I have just been letting my body normalize since the last T shot a couple weeks ago. Now, do you think I should bank some of my sperm before starting TRT just in case? Also, do you think it's worth continuing Clomid at 75mg/ day to see if that helps with raising my T levels? I am kind of looking for a quick solution. Should I try HCG and see if that will help raise T levels after I get BW in 4 weeks? Or do you think I should just start TRT on my own. I have a ton of T laying around... Thoughts?

and thanks again sir

The only way you are going to get accurate labs is to do nothing for a minimum of 4 4 weeks after your last injection of anything TRT related. That includes clomid. Right now your system is in flux and the labs are worthless.

Given that your July 2017 results are accurate, and that you are looking for a quick solution, starting TRT and incorporating HCG into the protocol may be your only (short term) solution.
Total Testosterone: 137 (250-1100) L
Free Testosterone: 25.3 (35-155) L
Sex hormone: 18 (10-50)
FSH: 7.1 (1.6-8.0)
LH: 4.4 (1.5-9.3)

So, if that's the case and you decide to pursue TRT on your own, then yes, I would recommend starting at 40 mg E2D and ~1000 IU HCG per week in divided doses. I'd make the program simple and also inject about 300 IU HCG on an E2D schedule too (but don't try to mix the two in the same syringe).

I don't see any reason why you would want to continue clomid if you are using HCG. Clomid has too many estrogenic side-effects for me. I much prefer HCG.

Banking of semen sounds like an expensive proposition and that shot of T you already got will no doubt have affected you fertility in a negative way by now anyway. I would only consider doing this if you knew that you had sufficient sperm levels and that motility was good. You really need to get a fertility expert consult on that.

[Brosef]

Hey Youthful55guy, I got bloodwork earlier this week and I am going to see endocrinologist tomorrow. I've allowed myself 4 weeks for my body to normalize after the T shot from the Doc... I also got a semen analysis and should have that info back tomorrow. Should I recommend to the doc that I try hcg before TRT? Or do you think it's too much of a long shot?

Also, I have another question on a different topic.... My girlfriend and I have been together for a little over a year, first 6 months we had sex pretty much every day, the last 6 months I'm lucky if it's twice a week. She told me it's because she's comfortable with me and she can just tell me when she's not in the mood. She's a good, loyal girl. We live together now and I'm trying to get to the bottom of her lack of libido.... even with my low T it's no where even close to where mine is. My question is, I've read that sometimes testosterone in very small doses in women can raise libido as well as viagra works for about 30% of women. Is this true? I would like her to see an endocrinologist to hopefully get some labs and see where her hormones are at. I had her get off birth control and she still isn't horny. She really only wants sex when she's on her period.

[Brosef]

So I got my BW and semen analysis back. My total T is up to 368, up from 137. That's good news but my semen production is at .05 and it should be at least 20. This leads me to believe that my testicle is not performing as it should. I think it's because I have a varicocle in my scrotum. Research indicates that having a Varicocle in your scrotum can lead to low semen count and low T production. I am a very health conscious 29 year old so that has got to be it. Does anyone have any experience with varicocles? What are my treatment options? Thanks