T Nation

24 Y/O Cancer Survivor, HRT

T Replacement
#1

Hey all, first post here. I am 24 y/o, my test levels are 301 ng/dl, I had testicular cancer when I turned 18 and lost my right ball, went through chemo for 4 months, and now, 5 years later, everything is fine except for low testosterone levels. I have always felt the effects of low T ever since I had cancer and I am sick and tired of it. MY levels were 350ng/dl as of last year and I had them tested last week and now my level is at 301 ng/dl.

I am tired, irritable, highly sensitive, awful memory, difficulty putting on any muscle (I have been lifting consistently for almost 2 years and my strength has barely increased), and my sense of well being is plummeting by the day. I want to start HRT and do injections weekly. My endo put me on Testim gel a few years ago and that didn’t do shit so I stopped after a few months. Well I want to do it right this time and do injections. I have an appointment with my endo on Monday. Thoughts or suggestions are greatly appreciated! Thanks all.

#2

Please start by reading the advice for new guys sticky. There is a lot to read and you may need to go through that more than once. All of the stickies are worth reading.

You were not able to absorb transdermal T and that is a symptom of thyroid problems. Read the thyroid basics sticky, check your body temperatures and eval your iodine intake.

Basic protocol: T+AI+hCG
Self inject 100mg T [cypionate, ethanate] per week in divided doses, at least twice per week
get E2 into lower 20’s, 1mg anastrozole per week in divided doses typically need, but see the stickies
Self inject hCG 250iu EOD to preserve teste(s) and fertility

Note: Most doctors are extremely incompetent at these things. Endo’s are the worst and urologists are a close second. See the finding a TRT doc sticky.

#3

Here are my blood work results as of today. (I am not on any HRT or testosterone related medications yet)

Albumin, Serum: 4.5g/dL (normal range is 3.5-5.5)

Prolactin: 18.8 ng/mL (normal range is 4.0-15.2)

TESTOSTERONE TOTAL: 312 ng/dl (normal range is 348-1197)

Sex Horm Binding Glob, Serum: 21.7 nmol/L (normal range is 16.5-55.9)

GONADOTROPIN-LH: 4.0 mIU/mL (normal range is 1.7-8.6)

I don’t know what any of that means except for the low T levels. I had a phone appointment with my Uro just now and I mentioned to him that I want to stay fertile if I do test injections and asked about doing HCG while on test injections and he said that was a bad idea and would not do that. I said I read plenty of facts online about the benefits of taking HCG along with test but he wasn’t agreeing.

Anyways, he has referred me to an Endo so I will go see the Endo next week and talk to him about what I should do. MY Uro said that my low t levels could be a thyroid issue and nothing to do with the fact that I had testicular cancer and only have one teste. Pease, anyone that can help, let me know your thoughts! I am all for doing test injections if that is what I have to do but staying fertile is the main concern for me.

#4

What jumps out from those numbers is your prolactin. You may want to check for pituitary adenoma. I could be wrong, someone more knowledgable can confirm. You should post remaining of your lab results if you have any. There is ton of information in the stickies you should read.

#5

Agree, prolactin needs to be followed up.

Should be testing LH and FSH as LH levels change very rapidly. FSH levels are a better indicator of LH status than LH itself.

With one testes, LH levels need to be higher to get the one testes to do all of the heavy lifting.

Prolactin can reduce LH levels. Your SHBG level suggests that E2 would not be a major factor in reduced HPTA activity.

Please read the stickies as I suggested earlier. Check body temps.