Advice for TRT treatment.

[Bridger]

This is a post I made at Irontrybe(another board i frequent) a few days ago. I have had no response there and think this forum will have more helpful people. Also, I am 22.



Well, I don't really know how to feel about this. I started seeing an internal medicine MD a few weeks ago because I *knew* my test was low. I had the normal symptoms. Tired all the time, no energy/endurance, decreased libido, fat around the midsection(even with a healthy diet), irritability, depressed mood (more than expected with bipolar), just feeling like crap, etc.

At first she didn't think that was the issue because of lab work from 2 years ago that showed my Total testosterone to be in the 400 range. So, she only checked my CBC, kidney, and thyroid at first. Those were fine, thyroid a little off but normal. So my second visit I got her to test my test levels. She tested my Total, Free, free %, bio-available, SHBG, and Albunim(sp?). My Total test came back at a whopping 132!! range is from 400-1080. Her nurse called me with the results and said the Dr. didn't want to do anything about it except test it again in a few months. I called back and said thats not good enough and saw her again this morning.

Today she drew blood to check my pituitary functions to possibly find out the cause. LH, FSH, and Prolactin. And she talked briefly about treatment; androgel, testim, and injections. I should get the results of today's bloodwork beginning of next week. I asked her if she has experience treating this in men, she replied that she does but that an endo obviously has more exp.

My concern is how she wants to treat this. Whether she will be aggressive and smart or just enough to put me in range. I'll be 23 in two weeks, if im going to be on supplemental testosterone i think i should be in the upper 1/2 or 1/3 of range based on my age. Also, whether she knows that an anti-e should be used to combat sides. I don't expect feeling or results like i would be on a cycle, but i don't want the bare minimum dosage either.

I'm thinking that I will discuss what the options are and what she is willing to do after the bloodwork comes back. If i think her idea of treatment is sufficient, I will give it a go. Otherwise, I will take my test results and see an endo. Time is of the essence as my current insurance runs out at the end of March. And I won't have insurance again until July, i think(New job).



Can any of you who are on HRT/TRT or have knowledge about this offer me some direction?

Or what should i find out about a new Dr?

Are the creams/gels or injects a better way to begin to try and get my test up in range?


I can't afford anti-aging clinics unfortunately and don't know anyone who has gone through this who can recommend a good doc in my area. So i don't know what to look for.

Thanks for any advice.

 

[JetCityDude]

Hi

Lots of info to cover here. One goal would be to find out why you are low. TRT is for life and if you can solve it, do so.

If your LH comes back low, then it most likey means that your pituitary is not sending enough LH to the testes and you have "secondary hypogonadism". If your LH is good, then your testes are not making the Testosterone and you are "primary"

Most people here like injections. The standard to get you in the upper-third is 100 mg/week of testosterone, with the injection done weekly. Inexperienced doctors like to do 2 weeks @ 200, but that puts you too high and lets you go too low.

As far as gels, Testim seems to work better. There is a big cost difference though. A bottle of T that will last you 18 weeks or so costs $125 or less. The testim could be $200/month. If you will be out of insurance, consider the injections.

Regarding Anti-E, this can be tough and I am struggling with it myself. I do not want to be on Arimidex for the rest of my life because I have no idea what long-term effects it has. I am trying to use DIM (Di-Indoyl-methane) which comes from broccolli and similar to keep mine in check.

Also, look for male Urologists, not just endos. On another board, we hate endos. I know insurance is important, but making the right decisions are more important.

go to www.allthingsmale.com and look for the documents under publications. They can explain more than I can.

I will try and write more this weekend. I also have 50 medical journals on TRT. PM me with an email and I will get them to you.

 

[Primordial Performance]

This is a post I made at Irontrybe(another board i frequent) a few days ago. I have had no response there and think this forum will have more helpful people. Also, I am 22.



Well, I don't really know how to feel about this. I started seeing an internal medicine MD a few weeks ago because I *knew* my test was low. I had the normal symptoms. Tired all the time, no energy/endurance, decreased libido, fat around the midsection(even with a healthy diet), irritability, depressed mood (more than expected with bipolar), just feeling like crap, etc.

At first she didn't think that was the issue because of lab work from 2 years ago that showed my Total testosterone to be in the 400 range. So, she only checked my CBC, kidney, and thyroid at first. Those were fine, thyroid a little off but normal. So my second visit I got her to test my test levels. She tested my Total, Free, free %, bio-available, SHBG, and Albunim(sp?). My Total test came back at a whopping 132!! range is from 400-1080. Her nurse called me with the results and said the Dr. didn't want to do anything about it except test it again in a few months. I called back and said thats not good enough and saw her again this morning.

Today she drew blood to check my pituitary functions to possibly find out the cause. LH, FSH, and Prolactin. And she talked briefly about treatment; androgel, testim, and injections. I should get the results of today's bloodwork beginning of next week. I asked her if she has experience treating this in men, she replied that she does but that an endo obviously has more exp.

My concern is how she wants to treat this. Whether she will be aggressive and smart or just enough to put me in range. I'll be 23 in two weeks, if im going to be on supplemental testosterone i think i should be in the upper 1/2 or 1/3 of range based on my age. Also, whether she knows that an anti-e should be used to combat sides. I don't expect feeling or results like i would be on a cycle, but i don't want the bare minimum dosage either.

I'm thinking that I will discuss what the options are and what she is willing to do after the bloodwork comes back. If i think her idea of treatment is sufficient, I will give it a go. Otherwise, I will take my test results and see an endo. Time is of the essence as my current insurance runs out at the end of March. And I won't have insurance again until July, i think(New job).



Can any of you who are on HRT/TRT or have knowledge about this offer me some direction?

Or what should i find out about a new Dr?

Are the creams/gels or injects a better way to begin to try and get my test up in range?


I can't afford anti-aging clinics unfortunately and don't know anyone who has gone through this who can recommend a good doc in my area. So i don't know what to look for.

Thanks for any advice.

There is a problem here and it could be so many things. At you age, three things come to mind. Obesity, sleep patterns, and stress. Do you have either of these?

Secondary primary causes are probably some over exposure to xeno or phyto estrogens. Do you eat a lot of food microwaved in plastic? How about soy foods?

Ive turned a few guys away from androgel (testim) and have gotten them to use Dermacrine instead. Since the switch they are lovin it. Id love to tell ya that you could use Dermacrine once, and it would jump start you for good… but I don’t know that for sure. It is a possibility… but I assume there are more fundamental problems here.

I can tell ya is that Dermacrine is a much better way to boost testosterone (and other androgens) than any test cream or shot that the doc will give you.
Weve got plenty of savlia tests showing Dermacrine can get you into "range" and some.

-Pp

 

[Primordial Performance]

Jetcitydude,

IC3 is a poor anti-e. Its great for reducing cancerous estrogens and increasing your “healthy” estrogens, but its not going to lower your total estrogen level. I suggest calcium-d-glucarate or resveratrol as better natural alternatives…. And of course… well.... you know.

-Pp

 

[Bridger]

Im not obese. 6'0" at 180 about 15%bf. I get plenty of sleep during the usual hours for my age. And don't eat soy products or microwaved plastic foods. My stress levels are normal for me. Perhaps even less than they've been in years.

I believe my problem comes from a deca/dbol(300mg/wk and 30mg/day) cycle i did two years ago that never fully recovered from. My PCT drugs were mistaken for recreational drugs and stolen.

However, my Dr. doesn't agree. She thinks it might be due to the Suboxone i take. Its a partial opiate agonist/antagonist. And some opiates are shown to lower Test levels. But I found a study on Pubmed that proves buprenorphine(main ingredient in Suboxone) to have no effect on testosterone levels in men.

Given this information, what might you think?

 

[Primordial Performance]

What are you using the suboxone for?

-Pp

 

[Primordial Performance]

Deca lingers in your system for years. Its possible that you remained suppressed from that Deca cycle for months after you last injection.

How long was you cycle anyway?

 

[Bridger]

The suboxone is used as methadone would be. As maintenance to control opiate cravings.

I did the deca a total of 8 weeks. I agree that it is probably the culprit for hormone suppression in my case. I don't believe my internist is very knowledgeable in regards to AAS.

 

[Primordial Performance]

Yeah Im familiar with suboxone. It is giving your hypothalamus mixed signals for sure – it [[could]] be having a negative impact on your HTPA despite what the study says. Is it necessary that you stay on it?

Any idea what you estrogen levels look like?

And are you using anything else?

-Pp

 

[Bridger]

Re: Advice for TRT treatment. *UPDATE*

Here is an update on my last lab test.

I called my Dr's office and talked to her nurse. She said that my pituitary functions (LH, FSH) came back normal. She didn't give the actual numbers and i didn't ask. I guess that means i have primary hypogonadism? This is a great birthday gift, Happy 23rd Birthday your balls don't work.

I told the nurse i want to start soon and would prefer to receive injections over test cream/gel. She said she would talk to the Dr and see when we can get started. I'm giving them one more hour to get back to me, then im calling. I'm very curious to hear what she wants to do and how open she is to suggestions.