19 Y/O Thinking About TRT

My penis is longer than 6 inch so I think I am good to go as in not having Klinefelter. Estradiol was low on last blood work, unfortunately I was not tested the second time on estradiol so Idk…

Balls are surely not too small, I’ve been to the urologist but he didn’t bother make an testicle ultrasound :confused: I don’t know who I can go to so I can get a MRI…

do you supplement with boron, magnesium and zinc? These sups can be pivotal regarding optimising testicular production and hormonal output

As to drinking/drug use. I think you’re pretty safe with what you described (marijuana 1-2x/mth and drinking 5-6x/year I assume to a point of inebriation), shouldn’t have too much of an adverse affect on endocrine factors/hormonal output. As to cognitive function, memory and mental health, I’m not sure what semi regular (2x/month) use of lettuce/brocolli will do (harm wise), I can’t imagine the impact would be positive (actually I can’t imagine any amount of use is positive for long term health), however there’s far more harmful substances out there.

Ultrasound of testicles also checks for tumors and blood flow that can affect testosterone production.
See at your age my goals are to rule out diseases and try to find cause. You just don’t jump to trt .

It could be you have secondary hypogonadism. That can be confirmed with a trial of clomid pills. Should increase your testosterone nicely if your testicles are working.

I do supplement with Zinc and Magnesium is in my Multi, nothing about Boron tho Idk it would affect me this much though…

I will try to get an appointment at the urologist again and explicitly ask for a ultrasound… i really want to rule out everything else aswell before jumping on trt because trt is a lifelong commitment and starting at 19yo seems very scary

Clomid pills, should I try them then and see what happens? If they work do I have to be on Clomid lifelong aswell?

Clomid does not shut down your own production. You can trial it.
Clomid blocks your pituitary from seeing estrogen and sends out More luteinizing hormone (LH) that triggers balls to make more testosterone.

Some have undesirable symptoms when using clomid. You vacation read about that.
It’s a good trial to rule out primary hypogonadism which means balls not working well.

If it increases your testosterone you can get off of it after a couple of months to see if body can maintain. It’s like a restart.
And clomid keeps you very fertile.

I would not do more than 25mg a day. You can even go down to 25 mg every other day. I tried Clomid. It brought up my testosterone but not enough. Am 42 though.

Try to get MRI first and ultrasound. Check nutrition. Fix that if need.

Okay, I heard that Nolvadex has way less sides than Clomid, can I just take whatever I get my hands on easier or are they different?
I will of course start with the ultrasound first and then the MRI if possible, what exactly do I tell the docs what I want to be sure of in terms of MRI? Ultrasound I get it is to see if there is enough blood flow and no tumors. But the pituitary MRI what does this look for? So i don’t go there not even knowing what I want there if you get what I mean…

MRI picks up on everything. Pituitary and hypothalamus is in the brain. If your hormones are screwed up the pituitary gland is the master. Who knows you can have a pituitary tumor. Most are benign but if they are there and putting pressure on it - it affects the hormones.

You can certainly try Nova instead of clomid. This is the most Non invasive treatment other then nutrition and supps. But if your estradiol is low and testosterone is lowish you probably need some treatment. Supps will have minimal impact on my book.

I forgot your weight. Are you over weight?
If so losing weight can help.

If you want to be sure take fresh labs after a good night sleep within about 1 hour of getting up.

Total t
Free t
Estradiol
LH
Fsh

TSH
Free t3
Free t4
Thyroid antibodies
Ferritin
Dhea s
Dht

@enackers I will shoot you an email right away to the email adress in your account. Exactly we can get meds from all over the eu as long we have prescription for them…

@charlie12 i will see what I can do in terms of new blood work I don’t think the doc will just order new ones since the case is closed for her…
i am 1.80m and 74-75kg so not overweight

Every other input and help here is still very much appreciated!!

Hello everybody, this is my second post here as I wanted to update with my most recent labs. I am now fully convinced that All my symptoms come low testosterone as I have been to severals Doctors and endos and my t was never about 400ng/dl.
I am literally on the verge of killing myself as through the 5 years of surpessed testosterone I have develepoed severe depression which I was able to open up about to my parents yesterday for the very first time.
Before it felt like I had to go through all this alone, go from doc to doc from endo to endo from uro to uro and nobody wanted to listen to my severe symptoms as my numbers are always „in range“ but now at least my parents slowly start to understand that it is not always about the range but more about the symptoms:
I have the typical symptoms of low T as in no libido, ED, no motivation, always tired, teen gynecomastia which did not go away yet and I hardly gain any muscle but mostly fat around my stomach area.
Because of these symptoms I have developed depression which obviously worsens my already low T and the low T causes even more depression and now it is like a devils circle and I don’t know how to get out.
Because of the depression I have absolutely no feelings anymore I feel completely numb and have no connection to my loved ones whatsoever.

After being to too many doctors starting at age 14-15 etc. Where nobody cared about me I finally decided to take things into my own hands now at age 19 because it is only 2-3 more years until my body completely breaks physically and mentally and I will commit suicide. I don’t wish anyone to life like that. I know for most of you it probably sounds like I am exaggerating but trust me the combination of low t with severe depression is a catalyst for something very bad…

Are there any things I need to get checked before I can finally start my own TRT? What doctors have done so far:

-tons of bloodwork
-urin sample over 24 hours
-ultra sound scan of testicles and kidneys?
-one doc asked me to do a mri from my head just in case even though another told me it is irrelevant since there is no indication for something like that in my blood

I will show you the most recent bloodwork, I have tons more values about Haematology but took the most important ones, just tell me if you want others:

-Hematocrit: 43.7%

-Glucose: 5.4 mmol/l (3.9-5.5)
-Cholesterin: 151 mg/dl
-Cholesterin: 3.9 mmol/l
-free Cortisol: 82.0 ug/24h (20-90)
-free T4: 19.3 pmol/l (12.6-21)
-free T3: 4.19 pmol/l (3.93-7.7)
-TSH: 3.08 uU/ml (0.51-4.30)
-ACTH: 17 pg/ml (7.2-63.3)
-Cortisol: 9.21 ug/dl
-17alphaOH-Prog.: 71.3 ng/100ml (50-210)
-DHEA Sulfate: 457.0 ug/dl (70.2-492)
-LH: 2.47 IU/I (1.5-14)
-FSH: 1.74 IU/I (1.5-12.4)
-e2 estradiol: <25 pg/ml (11.3-43.2)
-e1 estrone: 193.8 pg/ml (25-150)
-total Testosterone: 3.81 ng/ml
-SHBG: 45.7 nmol/l (10-57)
-Androstenedione: 90.1 ng/100ml (40-350)
-IGF1: 222.0 ng/ml (136-421)
-IGF-BP3 3787 ng/ml (3420-6870)
-Prolactin 1: 5.6 ng/ml
-Prolactin 2: 5.8 ng/ml

I think obviously my T, my SHBG, my estrone and my FSH/LH and TSH are the ones causing my problems.

I tried tamoxifen after this bloodwork and I must say it worked a little bit as I went from no erection ever to 1-2 soft erections in the morning so I think my balls are working.

Can you recommend me a protocol regarding my current values as none of the „doctors etc.“ I went to want to help me. I would love to be on the cream because it seems so easy and not much can be done wrong and especially commiting to something for life the cream would be great… unfortunately in Germany I can’t get it. I might be able to find a doctor who has no knowledge in TRT but who would prescribe me testosterone privately so I Don’t have to use UGL. Is there a way that I can send this prescription to a compounding pharmacy in the Uk or like here advised to Nikolas Psathas and I can get the cream instead of the vials?

Before I start TRT Myself is there any other diagnostics that I should do or am I done after 4-5 years running from doc to doc? We unfortunately don’t have any private TrT Clinic so I will either go with pinning or will try balancemyhormones if I can’t get cream from compounding pharmacy with vial prescription.

Nevertheless please recommend me a beginning protocol in regards to my current values since I know I shouldn’t pin that often a week because of my high SHBG etc.

PLEASE HELP ME I AM REALLY SUFFERING FROM THIS AND VERY DESPERATE

How long did you try this?

5 weeks 12.5mg daily, i definitely felt something changed positively but i am very very very far away from optimized, it probably raised my free t a little

You can list medications you take and weight.

Regardless if you want trt 100 mg divided in 2 doses a week is good starting for most.

Some like to go higher but to limit initial symptoms 100 is enough. 100 gets me a mid range to high free t and total t of about 650 on trough.

Do protocol for 8 weeks THEN check symptoms and total t, free t, estradiol, LH fsh to make sure they near 0. Check LH fsh just once in trt is enough. Also monitor thyroi . TSH , free t3. Free t4. Thyroid antibodies.

And i would do MRI head / pituitary

Endo’s, uro’s and GP’s are not the type of doctors that specialized in TRT. Doctors in managed healthcare are not the ones calling the shots, it’s the insurance companies or state healthcare systems denying treatment to save on healthcare costs. Insurance companies are always finding ways to deny medical coverage so they can keep the money for themselves to empower the company.

You need to go to a private anti-aging or sports medicine clinic and pay out of pocket.

TSH is terrible and together with your high Free T4 and low Free T3 is indicating a conversion problem. Normally we see Free T4 lower in relation to Free T3, Free T3 is usually midrange of higher and Free T4 midrange or lower.

T3 only medicine is recommended for those with conversion problems.

The evidence for a narrower thyrotropin reference range

It has become clear that previously accepted reference ranges are no longer valid as a result of both the development of more highly sensitive TSH assays and the appreciation that reference populations previously considered normal were contaminated with individuals with various degrees of thyroid dysfunction that served to increase mean TSH levels for the group. Recent laboratory guidelines from the National Academy of Clinical Biochemistry indicate that more than 95% of normal individuals have TSH levels below 2.5 mU/liter.

Reference ranges for TSH and thyroid hormones

First of all the distribution of TSH reference range is not normal, with median values (also depending on population iodine intake) usually between 1-1.5 mU/L. There is also an argument that significant number of patients (up to 30%) with TSH above 3.0 mU/L have an occult autoimmune thyroid disease.

Two 50mg injections per week sounds about right, more frequent dosing may be necessary if sides are experienced.

@systemlord I know that very well, but unfortunately in Germany we don’t have anti aging and private clinicls like u guys have in the us.
My only option would be through balancemyhormones which i will most likely go to very soon

Thats what I thought too, my thyroid values are very bad aswell. I have been to thyroid specialist too and she told me i am perfectly fine and healthy since i am in range… thanks a lot bitch…
What can the underlying issue of the conversion problem be? How do i find out and how should i treat it? I will most likely have to get everything ugl or check if bmh will do thyroid optimization aswell…

50mg twice a week is that not too little? If it gave @enackers only 650? I used to have 530 total t a year or 2 ago and still felt like shit…

You can always go higher.

I’m terribly sorry you’re going through this man. I’d say diet is bad. Speaking of Thyroid issues, how’s your zinc, magnesium and selenium intake? Do you ever measure them and what’s your diet like? As for test levels “zinc, magnesium and selenium intake” can help but not to a miraculous point. TRT is definitely not the end of the world, it’ll make things better if there’s no other solution for the low T.

i wish it was the diet, i am counting my macros for years now and i have always been eating very well 200g protein 60-70g of good fats and rest carbs depening if i was trying to gain muscle or lose fat.
I am taking 50mg zinc for over a year now coupled with 5000iu vit d and a multi vitamin. I will add some magnesium very soon, whats selenium for?

Typical sick care BS, it’s the same robotic response everyone hears from a doctor these days. The doctors of today lack critical thought and are taught to treat the reference ranges, the one who do have critical thought are able to match symptoms with lab work and utilize good judgement.

Private doctors tend to be less robotic and forward thinking and are able to match symptoms to a particular range, if you see 8 out of 10 men coming to your office complaining of low testosterone symptoms under a certain threshold, then you will be a better doctor.

Some doctors just don’t give a fuck about your symptoms, they only care about the numbers and just don’t want to get in trouble by the medical board prescribing TRT to someone with numbers above the set threshold.

The guidelines state men above 345 ng/dL can be considered for TRT if their is symptomology, but most doctors lack good judgement and are just scared and spineless.

Selenium deficiency decreases conversion from T4 to T3. How’s your iodized salt intake?
Seems like you’re in for TRT my man. It’s done wonders for some of my friends, gotta find a good endo.