T Nation

22 with No T

T Replacement
#1

Have just visited an Endocrinologist and been given my Blood work after over a year of next to no libido, no gains and occasionally low moods. Have been reading up on treatments for Low T but would really appreciate any help that can be given to me as I try to get this problem solved and didn’t know where else to turn.

My blood test showed 4.6nmol testosterone when the “normal range” is between 10 and 30. My Endo told me that if a 70 year old went to him with T levels below 7 he would prescribe them something so being 22 and having levels so low is certainly no fun. He is very against prescribing T to me due to my age so first wants me to have an MRI to ensure there’s no problems with my pituitary gland aswell as 2 further blood tests on consecutive days in the morning and have T replacement as a last resort. An option he put forward was Clomid to try an get me started again.

Does anyone have any advice on what I should do, questions to ask, treatments to push for?

Any further information that can help anyone to help me, I’ll do my best to provide.

Thanks

#2

  1. Nutrition: eat fat/protein/vegies meals in the AM and good carbs/protein/vegies PM.

  2. Supplements: Omega3 4g /day ; Curcumin 1 or 1.5g /day ; Resveratrol 600mg/day ; Superfood 1serv/day ; Brain Candy or Power Drive upon waking.

3: Periworkout Nutrition: Surge Workout Fuel or Plazma , Finibars

  1. Sleep: ElitePro or ZMA before Bed and Z-12

5: Hormonal Support: 1 Bottle of TRIBEX them rest and 1Bottle of Alpha Male always using it with Rez-V.

Do this for 6 month or for your whole life :smiley:

( eat.train.sex.sleep)

#3

Pretty sure this post above is not serious right? Just like to check before taking the time to properly respond ha

#4

I think it is good that your dr is not immediately putting you on testosterone as so many do. Clomid definitely may be a good option for you. More in depth labs will determine if this is a good direction. Testing for lh, fsh, estradiol, prolactin, dhea, progesterone and your thyroid (which I am sure they did a tsh test already) is the next step. If you have high prolactin for instance, then a d2 agonist will be better than clomid so getting an overall picture will help.

#5

Yh I do think it’s best to check all other options first before jumping into injecting for the rest of my life, just a little frustrating as it’s taken so long to get the first appointment and will now be over 2 months before my next.
Am glad that you agree with what my Endo has said so far as I’ve heard most are terrible. Thanks for the help, really want this problem gone as soon as possible.

#6

So I’ve been following what my Endo has recommended and been taking 25mg Clomid every day for the past 2 months. During this time I actually feel my symptoms have become worse than ever before. Have had terrible anxiety, night sweats, lack of energy and feeling low in general. After telling my Endo of these symptoms he recommended that the doctors write me a prescription of 2,000 IU HCG injected twice weekly.

Upon going to my GP to collect this prescription I was told that it’s expensive so will have to be given the go ahead by the governing body. After another call to my Endo I was told that it’s actually Pregnenalone that I need which is not expensive and will be available for me to pick up in the morning. When I went to the GP I was told that the recommendation contradicts itself as well as what the pharmacist recommends.

I’m feeling desperate to get myself on the right track to see some improvement and thinking that going straight to Testosterone Replacement Therapy would give me a quicker fix. What I would really like some advice on is will going with TRT at 22 cause me major problems in the future or are these problems reversible? For example if I became infertile, would I be able to reverse that by adding a dosage of HCG to my TRT protocol when the time comes that I want to have a child.

Would really appreciate any advice anyone can give as I’ve just become so confused and impatient a year after seeking professional help to have no progress besides tests done.

#7

Chances are you aren’t fertile anyway. Not that drugs couldn’t get you there, that would need to be determined through trials and semen analysis. Yes, there is always a chance that messing with the HPTA could alter your response to tropic hormones.

#8

That’s what I was thinking, if I’m infertile now and making next to no testosterone myself what can go worse through injecting Test?

Having said that, it would be nice not to have to rely on Test for the rest of my life so has anyone here had long term success with HCG, Pregnl? I just really don’t want to be wasting anymore time with treatments that aren’t going to help.

#9

Ok so I’ve just had my results in from my latest blood test after almost two months injection 2000iu pregnl twice a week.

LH <0.2 (1.5-9.3) low
Oestradiol 239pmol/L
Test 21.1nmol/L

So Test has improved 4 times to what it was when I started treatment but LH is very low and oestradiol seems very high to me?

I have noticed an improvement in how I feel day to day although am still feeling far from good and feel like I’m starting to go backwards. Anxiety about nothing in particular seems to be the main problem as well as the feeling of being low and having no energy. Strength hasn’t increased with the test increase although that could be due to being in a slight calorie deficit (decided to recomp seen as when I added calories I simply gained fat). I did start getting wood in the middle of the night but that seems to have stopped over the past few weeks.

Looks to me like I could benefit from an aromatase inhibitor, maybe anastrazole? Problem is I can’t see my doc prescribing an AI without good reasoning and data to back it up so if anyone could advise on what would be the best protocol for me and my current situation it would be much appreciated as this is really effecting all areas of my life and needs to be sorted.

Thanks in advance for any input

#10

Ok so I’ve just had my results in from my latest blood test after almost two months injection 2000iu pregnl twice a week.

LH <0.2 (1.5-9.3) low
Oestradiol 239pmol/L
Test 21.1nmol/L

So Test has improved 4 times to what it was when I started treatment but LH is very low and oestradiol seems very high to me?

I have noticed an improvement in how I feel day to day although am still feeling far from good and am starting to feel like I’m going backwards. Anxiety about nothing in particular seems to be the main problem as well as the feeling of being low and having no energy. Strength hasn’t increased with the test increase although that could be due to being in a slight calorie deficit (decided to recomp seen as when I added calories I simply gained fat).
I did go through a phase of waking up with wood in the middle of the night but that has pretty much disappeared over the past few weeks.

From what I’ve read an aromatase inhibitor, possibly anastrazole could help me but I can’t see my doc being very forthcoming with prescribing an AI unless I go to them with good reasoning and protocol behind the dosage. It would be much appreciated if someone could recommend my best option given my situation or any input at all as this is really having a negative impact in all areas of my life.

Thanks in advance for any comments and advice

#11

Your hormone reactions are very normal to the HCG. HCG is suppressive to LH, so it is expected to decreased LH levels. And yes you are definitely aromatizing your test to estrogen, as that is more common with HCG than test. Your low libido and “backwards” feeling is likely from the high estrogen.

You are on a really high dose for HCG…that is almost fertility level treatments. I beleive you only need 750IU per week…anymore than 1000 IU can cause LH receptor desensitization in the leydig cells.

you need to talk with your doc to decrease the dose of HCG…that should help immensely with decreasing estrogen and hopefully you won’t need an AI

#12

HCG will suppress LH production. HCG mimics LH, so your body sees HCG as LH and produces less as it sees it already has enough.

Estradiol is very high. This could be the sole cause of your Low T if it isnt hcg induced e2. The pituitary gland is regulated by estrogen.

Research “negative feedback loop hpta” This will show you how the system works.

You should probably also get prolactin labs.

a MRI of the pituitary is a great idea to rule out a tumor.

#13

Thank you for these posts, really means a lot to get some knowledgable feedback.

I did think my situation seems more in line with HCG treatment and LH dropping clearly makes sense given the role Pregnl plays.

I currently have to put 2 1500IU vials into a syringe and then get rid of some until there’s just 1.4ml left in the syringe so there’s really no reason I can’t lower the dosage myself tonight being that my injection is due although I would prefer to have an exact protocol in place as it seems a huge change to go from 4000IU per week to just 750IU? Problem is neither my Endo or doctor seem to know what the best treatment option is for me especially if he has over dosed me so badly on Pregnl to begin with so I don’t feel I can go to them for professional advice anyway.

Would you recommend I simply reduce the dosage to 500IU twice a week and tell my doctor that this is what I’m doing in an attempt to bring E2 down?

@ned I have had the MRI to rule out any Pituitary tumor already and it came back clear.

#14

A paper, May 2005, showed that 250iu SC EOD was a replacement for LH in normal men. That is near 1000iu/week.

Clomid makes some feel bad, Nolvadex has same benefit but without the estrogenic side effects that some men have.

Too much LH from a SERM or too much hCG causes high T–>E2 inside the testes and anastrozole cannot reduce that conversion rate.

Please read the stickies and you will know more than most docs [and endos]. Start with “advice for new guys” and do not ignore the first paragraph. Read “thyroid basics”

#15

[quote]Ace39 wrote:
Thank you for these posts, really means a lot to get some knowledgable feedback.

I did think my situation seems more in line with HCG treatment and LH dropping clearly makes sense given the role Pregnl plays.

I currently have to put 2 1500IU vials into a syringe and then get rid of some until there’s just 1.4ml left in the syringe so there’s really no reason I can’t lower the dosage myself tonight being that my injection is due although I would prefer to have an exact protocol in place as it seems a huge change to go from 4000IU per week to just 750IU? Problem is neither my Endo or doctor seem to know what the best treatment option is for me especially if he has over dosed me so badly on Pregnl to begin with so I don’t feel I can go to them for professional advice anyway.

Would you recommend I simply reduce the dosage to 500IU twice a week and tell my doctor that this is what I’m doing in an attempt to bring E2 down?

@ned I have had the MRI to rule out any Pituitary tumor already and it came back clear.[/quote]

Personally I would make the change myself in the HCG protocol and never say a word to the doc. To many of them are way to arrogant and may just flat out stop seeing you. Make the changes yourself without saying anything. Thats my take…do as you see fit.

Take KSMan’s advice on dosing frequency and amounts. He knows his shit.

#16

Thanks for pitching in Ksman, I know you’re an authority on these forums and seem to know what you’re talking about, if only you were my doc ha! I’ll be sure to read through all the stickies posted, definitely helpful so far.

I’ve decided to drop the pregnl dosage to 300iu eod and just tell my endo that I’m considering this protocol so he can then look into it, as Ned has said I don’t want them to stop treating me because I’m going against their prescription. I’ll then book another blood test for a couple weeks time to see what difference the lower dosage makes to my levels. If it’s successful that’ll be great and if not nolva may be an option before injecting test. Obviously I want to give the new dosage a good trial, how long would you say is a reasonable time to see apositive change?

Also as each vial is 1500iu would it be ok to inject 300iu, put the cap back on the needle, store syringe in fridge then change needle before next injection and repeat to save throwing out 1200iu of pregnl each time or is there a better way to do it?

#17

Just wanted to add that I’ll be buying myself a thermometer to test temperatures for Thyroid health, don’t want people thinking I’m dismissing that as a possible cause.

As for the Pregnl dosing, from the research I’ve done it wouldn’t be good for me to draw all 1500iu into the needle and use it bit by bit in the smaller doses. I would need to have resealable vials to put the mixed solution into, then mix with bacteriostatic water rather than the solution I currently use to inject. Am I correct in thinking this?

#18

I’ve now tested my temperature under the tongue 2 days in a row with the first reading taken at 05:15 upon waking and the second taken around 13:00

Day 1 AM - 35.6C PM - 35.2C

Day 2 AM - 35.9 PM - 35.3C

So looks like my body temperature is very low and not warming up throughout the day. Could low temperatures be a result of hypogonadism or is it almost definitely a sign of a problem with my thyroid?

AM looking to get some idoral but everywhere seems to be out of stock, can anyone recommend a reputable retailer in the UK?
Also is it ok to simply take 1 of the 50mg tablets or is it better to space it out throughout the day with the 12.5mg tabs?

Thanks again, feels encouraging to possibly be getting to the bottom of this after so long.

#19

You can space out 12.5 mg caps if you like. Might be better that way. Whatever suits you.

Yes, you can use loaded syringes as you suggest. But swab the needle with an alcohol prep pad before re-capping.

AM Temperatures are:
32+35.5*9/5=96.8
… =96.62
And afternoon temps are lower. For those, was there enough time prior avoiding eating, drinking, talking etc?

Your temps are very [horrible] low. Please see if someone else can hit 98.6F or 37C with that thermometer.

So you have deep hypothyroid symptoms if your thermometer can be trusted.

What has your intake of iodized salt. If none, for how long. If no iodized salt, others in household will be deficient. Check their temperatures.

Ask a good vitamin shop or health food shop for a high potency iodine product. Might be liquid. Kelp probably limited to 1.0 or 0.5mg per cap.

Is your thyroid enlarged? Lumpy? Asymmetrical?
You might have a thyroid condition other that iodine deficiency.
You need labs: TSH, fT3, fT4 [don’t care about T3, T4]
There are labs to detect auto immune thyroid disease.
Ask in your family to see if any have thyroid problems.

#20

Personally I’d find it easier to just take 1 tablet and be done with it for the day but wasn’t sure if it would effect absorption.

Ok so it’s fine that the pregnl will be mixed with sodium chloride and not bacteriostatic water correct?

For the afternoon temperatures I waited at least 30 mins after drinking and just sat down to relax and not talk for 5 mins before testing the temperature, also took it multiple times in the PM then took an average although it only varied by 0.2degrees. I’ll 've sure to get someone else to try the thermometer as that was the first thing in thought, can this be trusted?

As far as I know I’ve never used iodized salt, always just sea salt so looks like this could be part of the problem. Would you still recommend an iodine supplement such as kelp if I’m taking 50mg of iodoral per day or is that a suggestion if I can’t get hold of iodoral?

From inspecting my thyroid myself it doesn’t feel like there’s anything out of the ordinary, it’s not completely smooth but no large lumps that stand out to me.

I’ll call up the doctors tomorrow and ask for these bloods to be checked, did ask for full bloods last time and only got the E, T and LH but my doctor did admit over the phone that I seem to know more on this than she does (thanks to this forum) so hopefully they’ll be fully on-board.

Thanks again Ksman