T Nation

20 Yrs Old: Low Test. Advice

-Age: 20
-Height: 5’9
-Waist: 34
-Weight: 220lbs
-Describe body and facial hair: Very little facial or body hair. I can go weeks at a time without shaving and the only thing that will grow is peach fuzz.

-Describe where you carry fat and how changed: I don’t look overweight at all with clothes on but when I take my shirt off you can clearly tell I have a belly. Also, my butt.
-Health conditions, symptoms [history]: None, except low testosterone.

-Diet:I wouldn’t say my diet is terrible but I definitely do not count calories or have strict guidelines on what I can or cannot eat. I rarely, if ever eat processed food. It is mostly chicken, steak, potatoes, etc-home-cooked meals I should rather say.

-Training: None. I used to lift weights 5 days a week with a day or two of cardio every few weeks. This was when I was on testosterone replacement therapy so I actually had the energy.
-Testes ache occasionally-only when I take HCG and they grow/shrink accordingly.

  • TRUE Morning wood-NEVER. I do usually wake up with a very weak erection out of my need to urinate every morning though.

Okay, my story: I have had weak erections and little to no libido for my entire life. This past summer I finally decided to make an appointment with a urologist after learning about testosterone replacement therapy.

I do not have the exact blood work he ordered, but I remember specifically my total testosterone being 268 with a range of (250-1100) Seeing this my urologist put me on Testosterone cypionate 300mg ever other week. He made me come into his office to get the shot and I would consistently crash nearing the end of the second week.

He would not budge from his protocol and it was at this point that I began to do my own research and discovered websites like these. Well I stopped seeing that doctor and began seeing a different one a few months later. On the interim, I felt very shitty. He did not send me on a way with a PCT so I was left to suffer as a result of quitting TRT cold turkey.

So a few months ago, I found a supposedly good doctor. We did a bunch of blood work to see where my baseline would be. My total testosterone was 115(160-726) so he prescribed nolvadex 20mg ED for 4 weeks with bloods being drawn 1 week after cessation. Well I just got my labs back today and my total testosterone came out to be: 479(160-726). We were both happy with the numbers, except that my symptoms were all still there. My sexual function did not increase in the slightest, even though my levels rose by like 300 points.

Well he sent me on my way with a script to get blood work in 2 weeks(4-5 weeks after cessation of nolvadex) to see if my levels remain or decrease with nolvadex not being in my system anymore. Now here is where I need some guidance. I asked him what he would do if my levels did in fact come back low again. He said, well being so young, I would start you on HCG monotherapy and if that works you can stay on that for life. I got into an argument with him because this is absolutely not what I want. I want to be on TRT+HCG+ai if needed.

I need to have a good argument for my next appointment so he does not do this. I was thinking of saying: "HCG has to be kept refrigerated at all times so traveling will be a pain), it is expensive and I do not even think it is FDA approved for long term so insurance will likely not cover it, estrogen will likely skyrocket. Any others you can come up with?

Do you see anything wrong with my experience so far with this doctor? Anything I should have or should not have done? My goal right now is to absolutely make sure my levels come back low on my next blood test. The only way I will feel better is on testosterone. I know this because when I was on TRT, the first week after my shot I felt amazing. Like a new person.

If you are young and your testes are good, hCG monotherapy would be a good way to go! When travelling, you can do nolvadex for the duration and that will work. If your testes were not responding, your doc would do T+AI+hCG.

Get your lab results and post them with ranges. We cannot get much done without that.

You appear to have secondary hypogonadism. I hope that you have some LH/FSH results from before TRT and while on the SERM.

At your age, one should be testing prolactin to see if there is a prolactin secreting pituitary adinoma.

We also need E2 estradiol lab results, TT, TF.

Because thyroid problems can cause low T, we need you to re-read the protocol for injections stick and read the [new] first sentences and respond re TSH, fT4, fT3, iodized salt, sea salt, iodine in vitamins post your body temperatures.

You cannot loose weight with adverse T/E2 issues or low thyroid function.

Insurance plans do not off-hand restrict off-label use of drugs. A 10,000iu vial of hCG lasts 80 days, not really that costly. hCG is a grey area in terms of been understood by the medical community as a general replacement hormone for LH.

Please so not miss any of the above points or questions. I get tired of asking for information 2 or 3 times. ;}

My TSH has consistently tested in the 3.8-4.1 range. Anything over 4.2 would be out of range. While I do not believe my thyroid is optimal, I have been told by multiple doctors that there is nothing they can do unless it goes out of range. Both my LH and FSH were 1.0 when I tested at 119. 1.0 was considered normal, although it was barely in range. My FSH was 6.0 and LH 3.3 when I tested at 479. Prolactin has always been in the middle of the range and I have recently had a pituitary mri that came out normal so no worries there. E2 has been tested in the 30-40 range although it wasn’t the “sensitive assay” so I don’t know if those values are even relevant. Future tests I will make it is the sensitive one though.

How can nolvadex and/or HCG be viable long term? Do I not have a say in what kind of treatment I want? I would much rather be on testosterone injectables as they are FDA approved. I’m pretty sure AI mono therapy or HCG mono therapy is not FDA approved for testosterone therapy long-term. There are just too many unknowns if you go that route, I feel. AI’s have unnecessary side effects such as decreased IGF-1 and small risk of caner. HCG will cause estrogen to skyrocket, it’s expensive and a hassle to store. Unfortunately I am getting the impression this is the route my doctor will want to take though. I guess his philosophy is that if you’re secondary and your testis responsd, then what’s the point of taking straight up testosterone when you can feed them the signals for them to do so on their own. I don’t know. Well, I guess as long as my results come back low I can theoretically go to any other doctor and I will be pretty much guaranteed a test script. The only thing though, is that the doctor I am currently seeing is the only that I could find who prescribed AI’s and HCG.

When posting lab results, post in a list with ranges. And need dates and protocol for the tests.

I really do not have anything new to add at this point.

Is looking for reasons to not do something a hobby? I am not going to take the time to refute your flawed statements and thinking. If you think that the FDA does things to protect your health and that doctors are trying to undermine that, you are very very mislead.