T Nation

27 Y/O, Low T. Should I Start TRT?


I am hoping some of the experts here can chime in with advice. I am thinking of starting TRT but I am not totally sure. I am dealing with are anxiety, low energy, and low muscle development. I don’t have any libido issues. I have a daughter on the way and would like to have at least 2 more, so another concern here is keeping my fertility. I really don’t want to risk it but trt docs say it should not be an issue if using HCG and Clomid.

I am expecting the doc to call me any day now so I want to make sure I am ready to make a decision. I have also attached my test results. Just got these today. Any advice or expert opinion is appreciated.

Testosterone Total 359
Free Testoterone 52.8

You have secondary hypogonadism, that means your pitutary gland don’t produce enough FSH wich is responsable for sperm production and LH wich is responsable for testosterone production.

With low LH low testosterone is expected as well.

Best to try Clomid, Nolvadex, or HCG before start injecting testosterone and see how it goes. You will need some Anastrozole with it to control Testosterone-> Estradiol aromatization.

Never combine SERM (Clomid, Nolvadex) with HCG.

Suggest 25/20 mg Clomid/Nolvadex EOD or 12.5/10 mg ED along with 0.5 mg Anastrozole/week divided in EOD dose and see how it work.

If choose HCG inject 250 IU EOD with 0.5 mg Anastrozole/week.

New blood work needed in 4 weeks. LH, FSH, SHBG, sensitive Estradiol(if you can), total and free Testosterone.

Never test LH without FSH.

Also watch how Hematocrit goes. You may need to donate blood to control them.

I do not see a result for E2 - estradiol.

Now that you seem to have some secondary, you need to try to find out why. Prolactin is high can push LH/FSH low and also lower dopamine which can take reward and joy of of life.

Most guys who come here have some degree of low thyroid function, mostly driven by low iodine intake caused by not using iodized salt or not taking multi-vits that include 150mcg iodine and 200mcg selenium. The result is low energy and by itself can create most of the same symptoms as low-T. You can self-evaluate via oral body temperatures - see below. Ignore this at your peril! TRT with low thyroid function can make some feel worse.

Low thyroid function slows down every cell, tissue and organ system in your body, including hormone systems. Also makes you gain fat and feel depressed.

Do not combine SERM and hCG, you can switch between them for fertility timing if needed. Do not use high dose SERMs or high dose hCG. 25mg clomid, 20mg nolvadex or 250-300iu hCG every other day [EOD] will be good, more is harmful and many doctors are guilty.

You could start TRT now, or wait to see if thyroid might be the problem. If oral body temps are good now, you can start TRT. If temperatures are low, you can try to deal with that and see how LH/FSH, TT, FT, E2 respond. If facial hair is sparse and you seem to have always been lower T, you have more reason to get on TRT now as restored levels can be seen as been a low target.

Thank you guys for the replies and information. I was not aware that I could have a thyroid problem, but the sticky on it is very helpful.I am going to start taking temps first thing tomorrow morning and report back when I have enough readings. I have a full thick beard so facial hair is there.

I did have my test levels checked when I was younger at 22 years old. Total Testosterone was 332, so very close to what it is now 5 years later @ 359. I suppose it has been low my entire life.

As far as fertility how big of a concern do you think that is? I know the doc says it’s not a problem and I would just switch to clomid when we are ready to conceive, but how effective is that normally? How far in advance should I switch to it? I don’t want cause any fertility issues.

I have a temple thermometer. Is that ok to use to take temps?

Also in regards to the Estradiol result that was not shown, I just found it. It was on a separate test page for some reason. It is at 19. Is that high? The range on quest diagnostics says it is in the normal range but I don’t really know.

19 is a little low, but that is probably because your testosterone is low. Raising test will raise the E2.

Would anyone have any insight into my last question regarding going on TRT. One of the main issues I have been debating before starting. I was able to conceive naturally last year. I just don’t want this to possibly hinder future fertility.

“As far as fertility how big of a concern do you think that is? I know the doc says it’s not a problem and I would just switch to clomid when we are ready to conceive, but how effective is that normally? How far in advance should I switch to it? I don’t want cause any fertility issues.”

There’s no way anyone could know if TRT will make you infertile, there’s only one way to find out. Most respond to HCG and some don’t.

That’s a scary thought. Is it possible to completely destroy fertility forever after starting TRT even if doing everything properly ie using hcg clomid ect? If it’s risky I may just have to postpone TRT for another 4-5 years.

Freeze sperm just in case… that’s an option. Just be on the safe side. HCG will keep your boys working as long as you aren’t primary. Doesn’t sound like you are if you had a kid last year.

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Thanks mdl22, Is there normally a good success rate going this route? Also, if it does work and my test levels get to an acceptable number would I then want to stay on the Clomid or HCG with Anastrozole indefinitely?

I assume this would not shut me down in terms of staying fertile which is another reason I would rather try this over the test injections.

i was wondering, can i use clomid if my shgb is extremely high (79) 50 mg EOD.

Fertility: We have guys doing T+AI+hCG making babies who considered Clomid but got pregnant right away before they could get to that.

Oral body temperature is needed.

Get on TRT and get on with life.2.0