T Nation

20 Y/O Male Looking into Possible TRT


#1


I am a 20 year old male seeking advice for how to achieve optimal hormone levels through a type of testosterone replacement therapy. I would like to provide the forum with a bit of background of my situation. I beleive my problem initially began when I was 16 years old and I bought a "natural test booster" from a vitamin shop which in reality turned out being a prohormone. I felt that I crashed pretty hard displaying many of the usual signs of severe depression, fatigue, terrible moods, and little to no sex drive. Sure enough I began to slowly recover however the extent at which I recovered I cannot be certain was the same prior to taking prohormones. A year and a half ago I ran a cycle of testosterone enanthate at 500 mg a week with 500 mg a week of deca durabolin both at bi-weekly injections.

After running a post cycle therapy that consisted of 50 mg of clomiphene and 20 mg of nolvadex daily for 45 days, my body crashed extremely hard. Suffered all symptoms of an exteemly low T which was later confirmed by getting a testosterone result from the lab of 152.

Since that time I have slowly worked my way back to a total testosterone level of 375 with a free of 46 before any further types of treatment.

I found a trt doctor after countless hours of research online and began going through various types of treatments trying to bring my levels back up to normal. The most late treatment being dosing using HCG which began on April 10. The HCG appeared to work to an extent. He prescribed I run my first 20 days of HCG at 1000 iu's daily, and then the dosage was dropped down to 100 iu's daily which I still remain dosing with. The prblem is that with my HCG dosing I do feel soreness in both nipples which was very apparent at the higher dose but however now is much more mild to slight. Which makes me beleive a never ending HCG dosing my doctor wants is a real path that can be taken to treat things.

Also, I was diagnosed with a grade 4 varicocele in my left testacle at 16 which severely ached for a long time until treated. However after the treatment it still tends to ache however not nearly as bad. I can't help but think this has something to do with my hormones. Doctors tell me the varicocele is fine and there is nothing to do it but doctors don't know everything and the pain isnt enough to hve it worked on again.

Overall I feel in a sense "better" but I do beleive something to be lacking.

Age: 20
Height: 5' 11'
Waist: 32
Weight: 182
Body and Facial Hair: Lot of body hair, facial hair not super thick
Describe where you carry fat and how changed: mostly belly fat, not carrying much, hard to keep down.
Health conditions, symptoms [history]:
-Mild to heavy brainfog.
-Lack of energy
-Very low libido (usually never any morning erections or arbitrary erections)
-Hard to burn fat
-Increased belly fat
-Social withdrawal
-Smaller testacles
-Women don't neccesarily take on the persona of being art instead of lust anymore but its still nothing that gets me going.
-Feel tired a lot
-Get very irritable at times

Diet: High protein (150-200g per day)
higher Carbs ( 200-250 per day)
lower fats (40-65g per day)
Extremely lean diet with all food coming from whole foods and non proccessed with the excveption of one artificial protein source a day (shake or protein bar)
I drink 1 to 1.5 gallons of water a day.
I supplement with a mens multivitamin one in morning and one in evening and do not take a fish oil supp because it tends to induce acne for me.

Training: 50 minutes to an hour of moderate wieightlifting with minute and a half to 3 minutes rest. Alternating muscle groups. Every other day.
Day 1: Chest and tri's
Day 2: Rest
Day 3: Legs and calves
Day 4: rest
Day 5: Back and bi's
Day 6: rest
Day 7: shoulders

My concern is that with all of these symptoms that the only ting my doc is prescribing me is HCG treatment which I don't beleive is a way of treatment that can be sustained over a long period of time. I have not felt well for a year and a half now however I have felt better with the HCG it is not great and I feel like half a man to describe it most accurately.

Prior to writing this thread I have researched and read all stickies in the trt replacement forum. I have complete bloodwork that was taken on June 2, 2013. Here are the results posted in boxes below:

I understand I am young to be considering such an option however upon reading my background and labs I would appreciate any advice the forum has to give to help me continue to move forward to the optimum solution in treating what may or may not be going on for me. I would also like to know if there is validity in thinkng that HCG is not a proper long term treatment since it is not even putting my levels up to where they need to be anyways. I noticed there is a lot wrong after reading the stickies and researching the forum, especially in terms of my testosterone and my estradiol. Thank you


#2


page 2 of lab


#3


page 3 of lab


#4

page 4 of lab


#5

page 5 of lab


#6

I would like an opinion on wether or not testosterone replacement therapy is recomended in bringing my testosterone up to a high level to play a part in order to treat my conditions and if that is something that would help me. Given my age I know some would advise against it but I only want to do what will make me feel best and let me live again.


#7

Apple-shift-4 to take a screenshot of a section.

Prohormones cause a lot of damage and have not had significant studies done on how the body reacts to them. There are new ones on the market everyday.

All labs didn't attach. Reattach labs.

hCG mono therapy (which is kind of what you are doing), while not recommended often on this forum, is NOT 100iu/day. That's less than those on TRT supplement for testicular function.

If you didn't run hCG on cycle, testicles probably didn't recover properly during PCT. Not running an aromatase inhibitor probably caused an estradiol rebound after PCT, further preventing proper recovery.

What was the outcome of the varicocele? You said treatment didn't fully fix it.

Read the labs sticky and get all recommended labs. At your age, it would be best to fix the underlying issues than going on TRT. It's possible that your HPTA can be salvaged if you run another PCT, but not the PCT you ran after your cycle.

Keep reading/researching. Good luck. And keep us posted.


#8

Kaynon,

Yes I learned prohormones are very damaging the hard way.

All labs did attach however I blanked out my name and account info at the bottom of each lab page as i scrolled down to take each screen shot.

The outcome of varicocele treatment deemed that it was succesful and stopped the pain I was having from the varicocele. Which would occur from heavy lifting, running, etc. However from time to time it can get some slight soreness to remind me it is there. Like I said it is not enough pain or discomfort to really try and fight to have another surgery done but I do beleive that it plays a factor in my hormone levels. I forgot to mention that over the last couple weeks my doctor had bumped my dosage of HCG to 150 iu's a day which is just slightly more than the 100 treatment.

I did read all the stickies including the beginner sticky and that is where I found what i needed to have tested when getting this most recent lab done since I ordered it myself online. I noticed that my e2 sensitive reading was extremely low if I read it properly 6 (3-70 range), and also i noticed that for the range provided by labcorp my testosterone readings appeared to be fairly low 701 (348-1197 range).

I have understood treating underlying problem is way to go but after a year and a half i beleive I have looked into covering most/all my bases.

I have understood from some that since so much time has passed since cycle that at this point another pct would not do a lot for me. Any opinion on that?

Also I was concerned that taking what I did at such a young age may have damaged my hormones in a more permanent way than can be fixed since I was still in growing stages.

Thoughts from anybody?


#9

I'm assuming this test was done while on your hCG monotherapy? That would affect LH/FSH values; making them read low.

If you're still feeling bad with those labs, it's probably something other than your T levels. Post the link to your thread here:

http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/ksman_is_here?id=5524961&pageNo=8

Have KSman look at it. It looks to me like you have thyroid issues going on.

Assuming that those labs were done WHILE on hCG monotherapy, your testes are functional and you are a degree of secondary hypogonadism. You could, at some point, attempt a SERM (clomid OR nolva) challenge to see if your pituitary will fire effectively. The only way to know if the damage is permanent is to try.


#10

Thank you,

Yes those tests were done while on HCG monotherapy and I didn't know HCG would influence the LH and FSH. I thought those were only influenced after starting the TRT therapy.

I posted the link to KSman's forum and hopefully he will find some time to help out with whats going on.

I am interested in potentially trying another SERM challenge but I already tried to do another serm a couple different times since my original PCT and then once I am done with the SERM i feel like total garbage again.

So I am not neccesarily too crazy about wanting to try another one since it tends to put me lower than what I felt before the SERM in general.


#11

So labs are 100iu hCG per day or 1000? BTW, that was way too much and risks making things worse as per stickies.

Have you read the thyroid basics sticky? Does your thyroid appear large, feels lumpy or asymmetrical? Body temps OK? Always used iodized salt.

PCT: MUST slowly taper off of SERM, never stop suddenly.

Anything that increases T will tend to shut down LH/FSH.

Your total cholesterol is pathologically low and by itself could alone wreck your hormones. Please explain diet and fat. If you get acne, that may be a good sign that something normal is happening.

E2 should be in lower 20's. E2=6 typically messes with libido and mental health. May have negative effects on muscle mass. Are you talking a drug to do this?


#12

Labs at this point were 150iu hCG per day. I had been at this dose for 2 weeks prior to having those labs taken.
This last thursday I began seeing a new doctor who recomended me to take 500iu's hCG daily now because she felt that 150iu's a day was not sufficient to cause any beneficial changes in my body. What are your thoughts on the 500 iu dosage? I have been taking the 500 iu dosage since last friday (6/14).

Thyroid does not appear, large, lumpy or assymetrical and yes I have read the thyroid sticky. Have not checked my body temperatures yet and I am actually going to go buy a thermometer tonight to have these checked first thing in the morning.

I have not been using iodized salt and I find it fascinating that this alone could fix issues I may be experiencing. I will buy iodized salt tablets as well to begin supplementation. However could drinking too much water be a large cause for a iodine defficiency as well?

Diet:
Meal 1: 6 egg whites, 2 cups oatmeal, 1 oz. of sea salted peanuts (multivitamin)
Meal 2: 4 oz. chicken breast, 1 cup of oatmeal
Meal 3: 6 egg whites 2 cups oatmeal, 1 0z. of sea salt peanuts
Meal 4: Quest Protein bar
Meal 5: 6 egg whites, 2 cups broccoli, 1 oz. of sea salt peanuts
Optional meal 6: Another protein source such as eggs, chicken, or a shake

I do get acne so if thats a good sign then great.
I am not taking anything to alter my E2. However 3.5 weeks prior to that test I had taken 2 days of 40mg of tamoxifen to try and combat an HCG estrogen rebound from the beginning 1000iu daily dosing..

I also looked into adrenal fatigue to see if that could be what my case is.. with that being said what do you think of my cortisol reading?

All that being said I feel like my test level is still unusually low for a 20 year old.
Would you say that this could be a likely cause for what might be going on and would you recomend SERM again?
I have a doctor who is willing to administer testosterone therapy if that may be neccesary.

Thank you again so much for your help

Thank you for your help


#13

Also just a day before these tests i have posted that i ordered myself, I got a test done through a doctor for bioavailable and total test.

the total came in at 469 on a range of 300-1100
bioavailable was 120 out of a 250 max range

(I also have had sperm stored by clinic for future use so a shutdown is not something I am neccesarily worried about with a replacement therapy)

will post temperature results in morning as well


#14

Took my temperature with a digital thermomemter with accuracy to the nearest tenth and my result was a 98.0 degrees flat.

Followed protocol for temp reading as directed by the throid sticky.


#15

Your diet needs red meat fats and egg yokes. Cholesterol is low that that undermines your whole steroid hormone cascade, including your ability to make Vit-D3 which is important for immune system and many other vital functions. Vit-D3 is low! Odd that preg and DHEA are not depressed...

You are EFA deficient. Essential fatty acids are exactly that, essential. Note that oatmeal reduces abortion of all fats and oils. Do not take EFA's or vitamin D3 with or near oatmeal consumption.

You need fish oil caps, flax seed oil or meal, nuts. If you get acne, so be it. I would consider that a good sign. When a old guy on TRT gets acne, I consider that a good sign. Some have problems with their skin when their hormone levels a good - it may simply be the way things are for you when you are healthy.

Get 5000iu Vit-D3 tiny oil based caps, Walmart has these as well. Take 15,000 per day for a week then 5000 per day thereafter.

You are iodine deficient, read the thyroid basics sticky. You cannot correct that will RDA amounts of iodine.

With long term iodine deficiency, TSH can be elevated and thyroid can change and start to make iodine outside of TSH control loop, then TSH levels go down to normal levels but can later progress towards zero. This is a progression from hypothyroidism --> hyperthyroidism. That is why I asked about your thyroid physical state which can have the issues I asked about.

How many years have you been not using iodized salt?

I think that your sea salt and diet are causing a lot of your problems. As per stickies, cholesterol levels below 160 are associated with increased all-cause mortality. Diet extremes can wreck hormone systems. Your doc does not understand that low cholesterol is a problem, because the drug industry has told docs that cholesterol is bad and that low is better - DEAD wrong.

You need to change your mindset and accept that your diet may be killing you. If you have a body image obsession, you will need to change your value system. Can you make changes that are contrary to your current obsessions.

When I indicate in the stickies that guys wreck their lives with diet extremes and over-training, I was referring too cases like yours. You do not need meds or labs, you need behaviour modification. See where that goes and get to a different nutritional foundation.

So that was not a nice post, but I do not know how to candy coat this.


#16

God I love KSman


#17

For follow up body temp reading of mid afternoon it came in at 99.0 degrees flat just for a sidenote for consistency.

I picked up Iodine tablets, vitamin d3 5000iu, and flax seed oil capsules (1000 mg total. 550mg omega3, 140 mg omega 6, and 160mg omega 9) per capsule

How would you recomend supplementation of the flax seed? I have read the thyroid sticky and saw about iodine supplementing and from what i understood to replenish iodine it is optimal to supplement 50 mg iodine per day and that was for 2 weeks? After the 2 weeks what would be the amount you use once your system has replenished?

I cannot remember ever making it a point to intake iodized salt. However about 8.5 months ago since I refined what I was eating down very drastically and about 4 months ago I began eating similar to what I told you with variation day to day in a meal or two because life comes up. I began dieting drastically because I had become 235 lbs. after hormone levels dropping significantly low post cycle.

I have no body image obsession. Everybody lifts and looks into their nutrition for a reason and mine would be to stay leaner, and ya I stopped taking fish oil because I felt it was giving me acne. I feel it would be common for most to not want acne, and I'm learning. If i went about that wrong then thats why I am on here, to continue to learn more and improve. If it came across that I have disregarded what you were telling me about fixing my diet by talking more about TRT, I would like to make clear that was not what I am doing. I figured you're a busy guy and if I could post as many of my concerns/angles to attack at once if it could save more time and help get everything solved just a bit quicker. I by no means was blowing that off because diet I feel is critical to somebody's well-being.

Would you give thoughts on HCG dosage of 500iu's daily? You said I don't need meds but I would like to stick to the monotherapy even if you recomend a lower dose.

Is there a specific thread, nutritional foundation, type of diet/eating that you like in particular?
I would appreciate if you may be able to point me in the right direction in those regards. I also had never heard anything about needing fats from yolks or red meats before you said that. How much cholesterol would you recomend in my diet?

I didn't want anything sugar coated, I came here for advice and to hear the truth of what needs to be done so thank you for what your doing.


#18

I also never would have felt like I have a diet obsession because I have never felt like I was starving myself or anything like that so I didn't feel I was taking anything to an extreme.


#19

Cholesterol: If you can get to 170-180, that would be idea. We see some who can't get to that even when eating foods that should lead to higher cholesterol levels. As your diet had very low cholesterol potential, I am hoping that you can increase your cholesterol levels.

Red meats, butter, oysters, eggs and cheese might be useful. These are all cholesterol rich. Everything that we are told is bad :wink:

Flax seed: Buy whole, not ground as that is very prone to oxidation. Get a cheap whirly blade coffee/spice grinder. Grind a table spoon and sprinkle on you oatmeal [not idea delivery] with some walnuts.

Anyone there who can also use that thermometer for a reference? It is good that your temperatures are that high, sort of expected otherwise.

Adults store 1.0 - 1.5 grams of iodine. Taking 50mg for two weeks loads one up with 750mg, sort of a 1/2 point. There is no rocket science, this is not optimal, just seems to work. Search for the 'ksman has a thyroid problem' thread.

Take dietary oils with a meal that is low on fiber. Taking with oatmeal would be a waste.

Well, you certainly do not do things by half measures. If you apply the same diligence to your 'new' diet as the old, you should do as well as can be expected.

The only thing that I can't get a handle on is the low E2. Simply getting low BF would not explain this. One always has to be aware of the possibility of a lab error as the simplest explanation.


#20

Too many thread to prescribe too... so continue ping me at my thread.