T Nation

27 Year Old HPTA Restart


#1

Hey guys,

Long time lurker here looking to see if any of the knowledgeable people here can get me on track. @KSman

A little bit of history; I started using AAS at the age of 21 and when I was 23 I went on a 6 month cruise of Test, Tren, and Masteron. I pct'ed with Clomid but it may have been bunk because when i tested several months later I was totally shut down, feeling unmotivated, unhappy, depressed, etc.

The endo told me to ride it out and let my body do its thing and 2 months later I tested in the 200's range of test from a mere 42 (1st blood test).

As the years continued I ran a few designer prohormone cycles and pct'ed with clomid each and every time. I was never able to relate the feelings of lack of motivation, unhappiness, and depression to my low test because I always thought I was unhappy because of personal stressors in my life and was so wrapped up in my own career.

I have had low test for 2-3 years now and have just realized I need to tackle this before it further spirals out of control. I wanted to give an example of my past abuse and acknowledge it. At this point in time I'd be willing to stop cycling for ever in order to maintain a functioning HPTA.

At 27 years old, my last cycle consisted of trestolone (can shut you down fast) and a few other designers (no long esters). 2 weeks post clomid here are my values:

CBC With Differential/Platelet
** WBC 4.4 x10E3/uL 3.4 − 10.8 01**
** RBC 5.10 x10E6/uL 4.14 − 5.80 01**
** Hemoglobin 16.2 g/dL 12.6 − 17.7 01**
** Hematocrit 46.8 % 37.5 − 51.0 01**
** MCV 92 fL 79 − 97 01**
** MCH 31.8 pg 26.6 − 33.0 01**
** MCHC 34.6 g/dL 31.5 − 35.7 01**
** RDW 14.0 % 12.3 − 15.4 01**
** Platelets 185 x10E3/uL 150 − 379 01**
** Neutrophils 56 % 01**
** Lymphs 29 % 01**
** Monocytes 13 % 01**
** Eos 1 % 01**
** Basos 1 % 01**
** Neutrophils (Absolute) 2.5 x10E3/uL 1.4 − 7.0 01**
** Lymphs (Absolute) 1.3 x10E3/uL 0.7 − 3.1 01**
** Monocytes(Absolute) 0.6 x10E3/uL 0.1 − 0.9 01**
** Eos (Absolute) 0.1 x10E3/uL 0.0 − 0.4 01**
** Baso (Absolute) 0.0 x10E3/uL 0.0 − 0.2 01**
** Immature Granulocytes 0 % 01**
** Immature Grans (Abs) 0.0 x10E3/uL 0.0 − 0.1 01**
SPACE
Comp. Metabolic Panel (14)
** Glucose, Serum 83 mg/dL 65 − 99 01**
** BUN 17 mg/dL 6 − 20 01**
** Creatinine, Serum 1.00 mg/dL 0.76 − 1.27 01**
** eGFR If NonAfricn Am 103 mL/min/1.73 >59**
** eGFR If Africn Am 119 mL/min/1.73 >59**
** BUN/Creatinine Ratio 17 8 − 19**
** Sodium, Serum 141 mmol/L 134 − 144 01**

Potassium, Serum 4.3 mmol/L 3.5 − 5.2 01
** Chloride, Serum 103 mmol/L 97 − 108 01**
** Carbon Dioxide, Total 22 mmol/L 18 − 29 01**
** Calcium, Serum 9.2 mg/dL 8.7 − 10.2 01**
** Protein, Total, Serum 6.4 g/dL 6.0 − 8.5 01**
** Albumin, Serum 4.2 g/dL 3.5 − 5.5 01**
** Globulin, Total 2.2 g/dL 1.5 − 4.5**
** A/G Ratio 1.9 1.1 − 2.5**
** Bilirubin, Total 0.4 mg/dL 0.0 − 1.2 01**
** Alkaline Phosphatase, S 71 IU/L 39 − 117 01**
** AST (SGOT) 35 IU/L 0 − 40 01**
** ALT (SGPT) 41 IU/L 0 − 44 01**
SPACE
Lipid Panel With LDL/HDL Ratio
** Cholesterol, Total 137 mg/dL 100 − 199 01**
** Triglycerides 64 mg/dL 0 − 149 01**
** HDL Cholesterol 50 mg/dL >39 01**
** Comment 01**
** According to ATP−III Guidelines, HDL−C >59 mg/dL is considered a**
** negative risk factor for CHD.**
** VLDL Cholesterol Cal 13 mg/dL 5 − 40**
** LDL Cholesterol Calc 74 mg/dL 0 − 99**
** LDL/HDL Ratio 1.5 ratio units 0.0 − 3.6**
** Please Note: 01**
** LDL/HDL Ratio**
** Men Women**
** 1/2 Avg.Risk 1.0 1.5**
** Avg.Risk 3.6 3.2**
** 2X Avg.Risk 6.2 5.0**
** 3X Avg.Risk 8.0 6.1**
SPACE
Testosterone Free MS/Dialysis
** Testosterone, Serum (Total) 391 ng/dL 02**
1.6 % 02
** % Free Testosterone (Dialysis)**

** Reference Range:**
** Adult Males: 1.5 − 3.2**
** Free Testosterone, Serum 63 pg/mL 02**
** Reference Range:**
** Adult Males: 52 − 280**
SPACE
Estradiol, LCMS, Endo Sci
** Estradiol, Serum, MS 14 pg/mL 02**
** Reference Range:**
** Adult Males: 8.0 − 35**

Cortisol, Serum LCMS, Endo Sci
** Cortisol, Serum LCMS 17 ug/dL 02**
** Reference Range:**
** Adults**
** 8:00 AM 8.0 − 19**
** 4:00 PM 4.0 − 11**
SPACE
Prolactin, Serum (ICMA)
** Prolactin, Serum (ICMA) 12 ng/mL 02**
** Hook effect or prozone effect has been ruled out by**
** performing additional dilution analysis on all prolactin**
** testing.**
** Reference Range:**
** Children and Adult Males: 3 − 18**
SPACE
Sex Hormone Binding Globulin
** Sex Hormone Binding Globulin 27.0 nmol/L 02**
** Reference Range:**
** Pubertal: 16.0 − 100.0**
** 20 − 49y: 16.5 − 55.9**
** >49y: 19.3 − 76.4**
SPACE
Hemoglobin A1c
** Hemoglobin A1c 5.3 % 4.8 − 5.6 01**
** Please Note: 01**

** Pre−diabetes: 5.7 − 6.4**
** Diabetes: >6.4**
** Glycemic control for adults with diabetes: <7.0**
SPACE
Thyroxine (T4) Free, Direct, S
** T4,Free(Direct) 1.14 ng/dL 0.82 − 1.77 01**
SPACE
TSH 2.610 uIU/mL 0.450 − 4.500 01
SPACE
Luteinizing Hormone(LH), S
** LH 3.3 mIU/mL 1.7 − 8.6 01**
SPACE
FSH, Serum
** FSH 0.8 Low mIU/mL 1.5 − 12.4 01**
SPACE
Vitamin D, 25−Hydroxy 33.4 ng/mL 30.0 − 100.0 01ACTH, Plasma 56.4 pg/mL 7.2 − 63.3 01

Here are my values about 5 weeks after the last blood draw (about 2 months off clomid)

Estradiol, LCMS, Endo Sci
** Estradiol, Serum, MS 11 pg/mL 01**
** Reference Range:**
** Adult Males: 8.0 - 35**
Testosterone, Women/Child
** Testosterone, Serum (Total) 309 Low ng/dL 01**
** Reference Range:**
** Adult Males**
** >18 years 348 - 1197**
Sex Hormone Binding Globulin 43.4 nmol/L 01
** Reference Range:**
** Pubertal: 16.0 - 100.0**
** 20 - 49y: 16.5 - 55.9**
** >49y: 19.3 - 76.4**
Luteinizing Hormone(LH), S
** LH 2.7 mIU/mL 1.7 - 8.6 02**
FSH, Serum
** FSH 0.9 Low mIU/mL 1.5 - 12.4 02**

Please let me know what you guys think is happening with my body and what sort of HPTA restart would work best in my scenario. I am going to be seeing an endo but I want to educate myself regarding this matter as much as possible. Regarding how I feel currently, It's hard to say, as I've gone cold turkey on stimulants / caffeine for the past 3 1/2 weeks and have reduced my supplement intake by 3/4 only taking KSM-66, Rhodiola, Spirulina, multivitamin, Vitamin D, and Fish oil. But i still feel lack of motivation, unhappiness, holding fat when i was always a mesomorph, even depression at times (seeing a counselor to really figure things out) despite the fact that I am quite successful in my career. I have increased my fats as well and plan on using natural test boosters like high grade tongkat ali and a few others in conjunction with whatever i use.

I was on clomid for 4 1/2 weeks at a 50/50/25/25 split and was using exemestane 25/25/12.5/12.5, the sides were terrible (depression) but i think i can handle it in exchange for correcting my hpta.

Thanks guys!


#2

High doses of SERMs are bad because if LH is high, T-->E2 inside the testes can be high. And with high LH, when you finish PCT/restart and you make whatever levels of LH, the testes see a big drop in LH and what do you expect that signal to do? Also high LH levels or high dose hCG can desensitize the LH receptors, a step backwards.

High dose SERM is a problem in the BB community.

You have secondary hypogonadism. A restart might work, but perhaps not. We do see young guys who have used prohormones, 5-alpha reductase inhibitors and deca who cannot be restarted.

SHBG is elevated. That should not occur with low E2. So something else has done this. Perhaps the high dose SERMs.

Please read these links found here:
* advice for new guys
* things that damage your hormones
* protocol for injections
* HPTA restart
* thyroid basics explained - check oral body temperatures as suggested
* finding a TRT doc

fT3 is a bit below mid-range
TSH should be nearer to 1.0
have you been using iodized salt? - history
do you get cold easily?
outer eyebrows sparse?
Stress can alter your thyroid [and adrenal] function by increasing rT3

Please use the edit option to change your post above and add lab ranges to the data.


#3

@KSman Thank you, Iv'e updated the original post and added the complete results. I will also read all the links throughly soon. Still trying to find a reputable endo in network. Money isn't really a concern just knowing what sort of ranges for treatment. I'd preferably like to try a HPTA restart and avoid TRT at first.

I really want to know what may be the best restart protocol for myself, dosing, and duration.

I believe my wife has been using sea salt so i've gotten a iodine supplement on the way. I'm usually good with the cold.

Thanks again!


#4

Please check your wife's oral body temperatures as well.
Maybe she has been feeling cold easier.


#5

Your Vit-D25 is sub optimal. Better near 60. Try 5000 - 6000iu Vit-D3

Could AST/ALT be elevated from training or sore muscles?

Your cholesterol is way too low. Some young guys are that way. But perhaps you have some changes to diet that you could make. Total cholesterol <160 is associated with increased all-cause mortality. Cholesterol is the root of all of your steroid hormone production.

See: https://en.wikipedia.org/wiki/Steroid_hormone


#6

Thanks @KSman

Since the original labs were taken i did increase vit d to 10,000 iu for a week and am now at 5,000 iu daily the new test did not test for that however.

Regarding cholesterol yes I was running a pretty strict diet but have since then added in more fats.

Regarding an actual HPTA restart what would you suggest would work optimally in your opinion? I trust you more than any endo. I have been advised to consider letro 1-2x daily at low doses but this seems like a long term solution and there is no guarantee I will crash if i come off.

I am really trying to tackle this naturally and do this the right way! Thanks for all the help. I will monitor temperature as soon as I buy a thermos and update.


#7

There are multiple options to the restart as I point out in the sticky. I have no expectation that any one is golden. Yes, restarts often do not work, but its up to you if you want to try that.

Letro does not do anything that anastrozole can do, but letro can be harsh in that the dose-response is not very predictable.

Time of day for cholesterol lab?

Get on SERM as part of HPTA restart. After 3 weeks do labs while still on SERM. If LH/FSH are low then, you can stop and go for TRT as a restart is not going to happen.


#8

@Ksman cholesterol was taken at 10 AM I believe on the original lab but as i said i have added fats to my diet since then. Did not test for cholesterol this time around since the endo just wanted to test for T.

I read your thread and discussion on serms/HCG, which SERM and what dosing would you recommend to me? I have been told to try Torimfene at 30-60mg some people even suggesting 120mg. I think doing labs 3 weeks into a restart is also golden, how long do you think I'll need to stay on the SERM for if LH/FSH rise? What LH/FSH values would determine whether the SERM is worth it or not after the bloodwork? For example LH=4 FSH =2?

In your opinion should i use a SERM ONLY till i get bloodwork results after 3 weeks before throwing in anastrazole/exemestane?

Is clomid still my best option, and any advantages using exemestane over anastrazole? Should i get a DHEA supplement? How should i dose it?

I have made a follow up appointment with an endo on June 3rd. I suppose I'll stick with him until i find out where my LH and FSH are at using a SERM. Thanks a lot man @KSman


#9

Sorry, I meant to ask time for cortisol labs. At 10AM, peak levels have dropped from peak, so your 10AM cortisol=17 is very strong.

Torimfene is a SERM and high doses need to be avoided.

On a SERM, you test LH/FSH. What is good? If T levels are good, obviously that is a good LH/FSH level. If LH/FSH levels are mid range and T is low, your testes do not work or need more time for recovery of form and function. So you can see the other bail-out criteria.

Suggest 10-12 mg of Clomid or Nolvadex ED, some need that EOD. You will get people recommending high doses and more is not better. You can't get the testes rolling on high LH then after the restart expect them to work on lower levels that you are able to produce. That is the wrong signal.

How long on the SERM? Take time for the testes to change. Depends on how long they were at low LH and how much they shrunk.


#10

@KSman I did use trestolone which was studied to be a male contraceptive on my last cycle so you're very right I may still be recovering in that regard. To further prove that, FSH rose almost 2 months after clomid instead of dropping like LH did. It rose by 0.1 not a big deal but this may mean that a SERM + time may be the remedy to properly restarting my body.

Would you say a SERM is a better remedy than HCG, I see you mention no HCG+SERM as that may desensitize your natural production once you get off.

Will low dose torem and clomid be equally as effective at restarting the HPTA or is one better than the other. With Torem i won't get the depressive sides I experienced on Clomid, but if Clomid is better than I might as well give that a try.

I cant wait to tackle this, I think Ill wait for the endo to write me a script for pharma clomid before i use anything else. How can i tackle the cortisol? I plan on hopping on some LJ100


#11

The point of a SERM is to induce useful and not high levels of LH. They can all do that.

TRT shuts down LH and FSH. I do not see what the merit of trestolone. It does shut down one's T production, so there is no T-->DHT. I have had suspicions that DHT-->zero may be harmful to some guys' HPTAs. With TRT, DHT levels are strong. I often refer to synthetic testosterone like drugs as zeno testosterones which can have unintended consequences. So while this may not have anything to do with your situation, I need to rant sometimes.


#12

I think they messed up my latest bloodwork. I am about 6 weeks on restart right now and had these tested at 5 weeks:

My LH went to 8.3 range is up to 8.7
My FSH went up to 1.8 range is 12.4
Estradiol is 14

However..

Testosterone Free MS/Dialysis
** Testosterone, Serum (Total) 118 Low ng/dL 02**
% Free Testosterone (Dialysis)
4.9 High % 02
** Reference Range:**
** Adult Males: 1.5 - 3.2**

That doesn't make any sense to me..My FT % is way above the scale but my total t is close to shut down. Iv'e been feeling a lot better so this number can't be right for total t


#13

That suggests low SHBG.

T is released in pulses and FT=4.9 could have caught a peak.
LH is released in pulses and LH=8.3 could have caught a peal.
Both are self consistent with that.

How do you feel? - better
less moody?
better appetite?
sexual function/desire?


#14

I feel better on all accords, less moody, better appetite, sexual function and desire has been good and my balls are bigger than ever. I've also been taking 12.5mg exemestane e3d to maintain that but the total T makes no sense.

Furthermore, if you look they said my Free T was 4.9% and Total was 118. They said my Free T serum is 58. 4.9% of 118 is not 58. I think they made an error and need to retest, what do you think @KSman

I am experiencing some anxiety and bouts of panic attacks / OCD from the clomid but the positives at this point are outweighing the negatives for me. I've also not been on caffeine for 4 months now to help me relax.