T Nation

16(now17)Y/O, Hypogonadism in Australia, Advice?


#22

I’m fully aware I’m in for a hormonal roller coaster, it’s gonna suck… at least I’ll be higher than 4.6nmol… for about two weeks… however it’s only for 6 weeks (2 shots)


#23

Took first shot of sustanon 250 yesterday, used a 21 gauge needle. My ass hurts, hurts to flex my glute.


#24

@systemlord @KSman
I need some advice, around what dose of testosterone (weekly) would put my TT at around 1000-1100ng/dl. I know this may seem like a high level, however it was the level of testosterone I naturally produced three years ago, I have low(ish) SHBG with the lowest test reading 19 and the highest reading 25. I have reason to believe I may hyper metabolise testosterone as I hyper metabolise many medicines. I am a hyper cyp2d6 metaboliser (although that has nothing to do with testosterone).

The every three week injection had me feeling great… for about six days, then I crashed and felt like shit, I’m due for my next shot tommorow however after my last set of bloods I’m doing twice weekly shots (extra test prescribed by… myself). I am able to acquire HCG if it is nessecary, however I am not concerned about fertility or the size of my testicles, is HCG still needed? Some men say they feel better when hcg is added to trt, however I don’t see the point aside from maintaining fertility. As for an AI, I have a bottle of arimidex left over from when it was prescribed to me to keep my growth plates from prematurely fusing (I have about 100-150 1 mg pills left over).

I would highly appreciate a reply as I am at a minor crossroad as on what dosage to start out with. I would like some relief as I’ve felt absolutely awful over the past two weeks due to my docs shitty protocol. I feel just as bad as I did at baseline if not worse and it feels like I’m running in circles and getting nowhere. It seems people are on TRT doses of anywhere between 100mg PW (50mg e3.5d) all the way up to 200mg PW (100mg e3.5d).

At my age I actually wouldn’t mind being up at 1300, I’m a teenager who Is supposed to be in the prime of his life but instead has to sleep 12-14 hours a day to (barely) function… this shit is messing with my social, academic and sex life and I need it fixed. (a study which measured men’s Testosterone levels showed 1322ng/dl is the top 1 percent for men, irresponsible I know, however it isn’t far off from what I naturally produced) I’m aware I will have an excess of free hormones due to my low ish SHBG however it didn’t seem to be a problem for the first 14 years of my life (now 17).

I am aware my hematocrit will slowly climb and I can get therapeutic phlebotomy if this becomes a problem… I also have the tools to preform a phlebotomy at home and I have tried it before out of mere curiosity. I currently take 100mg of aspirin daily as a safety precaution though. Also found out I have osteopenia in certain parts of my spine (t score of -1.5 around L4) otherwise t score was still around -.03-.1.0 everywhere else) and I want higher bone density. I attribute it being so low for my age due to the years I had tanked E2 followed by hypogonadism.


#25

2nd shot of sustanon, last set of bloods next wk, I’m not dealing with the nadirs again, I crashed after day 6-7 and it got progressively worse from there. Some extra testosterone magically fell out of the sky and into my hands, I’ll probs take 10-20mg daily going by how I feel and private bloods (test prop), that should give a sustained, high normal hormone level


#26

Your pituitary gland shut down, this is the crash you speak of and in weeks/months you will start feeling better.


#27

not sure whether I’m supposed to periodically update or not, however I will periodically update anyway. I have bloods to assess where I’m at now, seven days post shot (sustanon) I am at 19nmol (548ng/dl) (total testosterone), 8-9 days post shot I’m at 14nmol (405ng/dl) and 19 days post shot I clocked in at 5nmol (143ng/dl). My FSH was elevated (mid to upper range) and my LH was low normal on all tests even though I’ve been on TRT for 6+ months, indicating primary hypogonadism
After each shot I feel great for about five days, and afterwards I crash as my testosterone levels dip well below what they were naturally before I acquired hypogonadism. I got my thyroid done and my free T4 was right at the bottom of the referance range, literally a 0.3 point drop would’ve indicated hypothyroidism, however my endocrinologist brushed it off. I’m aware of the shitty treatment of hypogonadism and hypothyroidism in Aus, therefore since I don’t have any overt symptoms of hypothyroidism (weight gain, droopy eyes) etc. I am dropping the issue, I could self medicate with thyroid medication, however I am not nearly educated enough in the field of thyroid issues to be attempting anything. My TSH was around 2 (slightly elevated) and my T3 and FT3 were good. The only symptom I have of hypothyroidism is extreme fatigue, however the fatigue goes away for a few days after each shot of testosterone, therefore I believe the fatigue is testosterone related.

I talked to my endocrinologist about my crashes and he/she was suprised I was crashing so soon, stating he/she expected me to be hitting my peaks a week or so after the injection and that 19nmol was a perfectly normal level for an adult male. I explained while that may be a perfectly normal level, it isn’t normal for me, I used to produce 36.5 nmol naturally (and handed her my previous bloods showing my testosterone level to be that high, at 1052ng/dl) and he/she said that actually equates to 28nmol, and I said “no it doesn’t check the nebido website or anywhere else” and the endocrinologist got irritated with me and said “I have a PHD in this, it’s 28nmol” so I didn’t argue. The funny thing is this endocrinologist is a professor and is supposed to be very good, the doctor who refered me to the endocrinologist praised the endocrinologist (I’m not giving gender in case my doctor sees this, I’m super paranoid about this stuff). So the endocrinologist prescribed two more shots of sustanon 250 but two weeks apart (was going to prescribe three weeks apart but my mom stepped in (shes a doctor too) and said it wasn’t appropriate to cause these lows again as it was severely affecting my mood, motivation and schoolwork.

Then the endo said he/she wanted me to get blood tests at wherever I felt best, the endocrinologist seemed irritated with me though. Then the endocrinologist wants to put me on a compounded testosterone cream. My issue with creams/gels are, testogel got me to 4.6nmol 12 hours post application at a 10 gram dose daily, I believe with my thyroid my absorption with gels and creams will be less than optimal. I am looking to get back up to my normal levels of 36.5nmol, so I will likely self medicate soon and get private bloods.

Doctors here don’t prescribe AI’s or HCG, thank god I don’t aromatise according to my bloods (spending two years on 1mg arimidex daily might’ve screwed up my aromatase enzyme as my E2 never bounced back after cecesion of the drug #jointpain). I’d take HCG but I don’t see the point of taking HCG with primary hypogonadism. The two adverse findings were that my hematocrit and RBC were high, however they were high before TRT, even when my T was low, my hematocrit is around 50 percent but my RBC is high, as in above the referance range. I told the doctor therapuetic phlebotomies are an option and that I administered one to myself out of curiousity (I know how, and I was curious too see if I could) and the doctor got mad at me saying “thats ridiculous, anyhow I don’t prescribe amounts of testosterone that raise hematocrit as that is a pharmacological change and I am just here to replace what your body would otherwise naturally produce”.

My mother’s father died of a stroke in his fifties, whether it was a genetic component or not is undetermined, however my mom thinks we are genetically predisposed to strokes. That being said he had high blood pressure, high cholesterol and was a chronic smoker when he died, I have hypotension (blood pressure 90/60), however the high hematocrit and RBC could be some underlying genetic component. Another issue I encountered was my glucose tolerance was impaired on this test, my glucose tolerance has been impaired for the past three blood tests (spacing around three years apart) in a row. I would drop the doctor now, however I want to get the glucose stuff under control, also my mom thinks the doctor is pretty good so I’m also willing to stick with the doctor slightly longer to make her happy. My mom doesn’t agree I should be back up at 1052ng/dl, she thinks I need to be at whatever level I can get to where I have no symptoms of LOW T, however I would rather be at optimal rather than sub-optimal levels as my body naturally produced that level and based on the fact I feel good for five days after each shot of sustanon I would think I generally feel at my best when my levels are 800ng/dl and above, also I’m finally at an age where I can be my own advocate and decide what is right for me (and I am quite responsible compared to most teenagers).

My endocrinologist doesn’t like sustanon as a long term treatment option due to the peaks and troughs which confuses me because if doctors would just prescribe weekly or twice weekly shots at lower doses peaks and troughts would be minimal and injections are the most cost effective and easiest way to raise testosterone levels! That being said my SHBG has raised to normalish levels (25-27), also before the appointment ended I asked if I could use primoteston instead of sustanon for the next two shots as the troughs and nadirs, will still rough, aren’t as bad as sustanon due to the fact sustanon has more short estered testosterone than the long estered stuff (use steroidcalc.com) and the endo told me they were both the same because they both get metabolised to testosterone… I don’t know how or why doctors can say things with such certainty when they are wrong. Also this is a private endo (not on public healthcare, but also not at a wellness or anti aging clinic)
@systemlord #paragraphs


#28

Paragraphs please, my eyes will thank you.