T Nation

27 Years Old, Low Test... Time for TRT?

Hey everyone,

New member but long time browser of the forums. I have come to the point where I have decided I need some help. I have used steroids for approximately 5 years (mostly just testosterone), always using HCG, Clomid and Nolvadex for PCT. Finished my last cycle last August (10 months ago), and have been suffering with low testosterone ever since. I have symptoms of fatigue, loss of interest/overall decrease in mood, losing muscle, having a very hard time building muscle, gaining fat, zero sex drive, and poor quality erections. After 5 months of waiting, I finally got in to see an endocrinologist today, and it was the biggest waste of time. She basically just gave me her one-sided biased view on how bad steroids are, and judged me for my previous use of AAS. She basically told me she can’t help me, and that I will have to wait it out and hope I recover in the next year or so. My recent bloodwork is as follows:

Total Testosterone at 4.2 nmol/L (Ref Range: 8-29)
Free Androgen Index at 32.3 (Ref Range: >= 30)
SHBG 13 nmol/L (Ref Range: 10-55)
LH at 3 IU/L (Ref Range: 1-9)
FSH at 2 IU/L (Ref Range: 1-18)
Prolactin at 33 ug/L (Ref Range 0-15)
Cortisol at 314 nmol/L (Ref Range: 170-500)

I have more bloodwork done prior to this, but the overall testosterone level and LH/FSH has basically stayed the same. I noticed my Prolactin is pretty high, so I started on some Cabergoline today. Hopefully that will help with the libido. I have also heard high Prolactin can suppress testosterone levels, and reduce fertility. I am at the point where I am considering TRT. My only thing holding me back is thinking about fertility 3-5 years down the road. Will this completely destroy my chances of having children? Should I do a sperm count, and consider freezing sperm? If I do TRT, should I use HCG during? I have another doctor who is willing to give me TRT, I just want to exhaust all my options before going forward. Any advice would be GREATLY appreciated.

Thank you.

You can preserve testes and fertility with T+hCG or T+SERM.

PCT: Should never stack SERMs or hCG+SERM. Most BB PCT uses way too much SERM. 25mg clomid EOD or 20mg Nolvadex is probably enough, more is harmful.

Cabergoline: 1/4mg twice a week should be adequate. It you feel better, prolactin is decreasing and dopamine is increasing. Some drugs can increase prolactin. Prolactin is released during orgasm, hugging {babies | puppies | kittens …}, and can affect lab work, avoid for a few days.

#Try HPTA Restart first, see below.

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Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.