T Nation

29 Y/O, Labs. Do I Meet Criteria for a Restart?


#1

Hi Everyone
Im 29Y/O I weight 140 pounds, 5’9 and a nursing student
About 10 months ago I started to get really fatigue but at the same time it felt like I could never get any sleep almost as If I has insomnia. So I was never well rested. Along with the fatigue I developed an erection problem. I could no longer hold a erection and if I did it was not very firm this really started to scare me because I have always had strong erections. At this point moving erections were completely gone a long with loss of sensitivity. Which means It was basically very hard for me to wear a condom anymore.

My Primary care did some blood work here are the labs

After this my Primary Care sent me to a Urologist and he put me on clomid 50mg M,W,F and 1mg of Arimedex 1/week. For one month here are the results after clomid

I still felt really bad. I mite say I was now getting even worse. My memory was not as sharp and I had no motivation. The worse part was my penis felt really rubbery almost as if it didn’t have as if wasn’t holding that much blood anymore. It just didn’t seem a its regular girth when flaccid. So after putting me on clomid for a month my doctor didn’t seem to know what to do. So I took matters into my own hands and found a very nice testosterone clinic. They decided to put me on HCG mono therapy instead of TRT. They said they ere going to do this because of my age and I mite be able to get away with just HCG mono working for me. But also they wanted to try to avoid any fertility issues. But I also forgot to mention I have bilateral Varicoceles on both sides. Grade 3 on my left and Grade 2 on my right.Also I developed twitching all over my body we still haven’t figured out where this has come from yet though.

So they had me on HCG mono 500 I.U E.O.D with .25 Arimedex 1/week after 6 weeks here are the labs


Now with the HCG my energy level did get a lot better and so did my sleep. But as far as my erections and libido nothing at all has improved. Now I will say for the first 2 weeks of HCG mono I woke up one time with strong morning erection and had strong libido for a while but after that everything went back down again. Because my FT was so high and my E2 my doctor took me down to 300 I.U M,W,F and .25 Arimedex 2/week. With that dosing my TT dropped all the way down to 423 and my E2 came down to 21ng. Its getting very frustrating because its been so long now that have been trying to figure all of this out and would do anything to get my old life back

Im really starting to get frustrated with all of this.
At the end of all this would like everyones opinion on my labs.

Questions:
i would like to know if trying a restart is worth it?

Will I ever be able to wear a condom ever again due to loss of sensitivity ?

Will my penis ever return to normal shape due to it is always feeling rubbery and looks shriveled in its flaccid form ?

Can anyone tell me what are the symptoms of a venous leakage plz?

The biggest questions is do you think I should go for TRT instead of staying on HCG mono?

Your thoughts and opinions are very appreciated thanks


#2

HCG is used in combination with TRT to help preserve fertility and keep the testicals from atrophying. When/if you ever do start TRT you will require injections at least EOD do to your SHBG, it isn’t low now but will be once you introduce androgens like testosterone to the mix. Your symptoms mirror my own even and even your labs are shockley similar, my SHBG was only half a point higher than yours which do to TRT is resting in the upper teens. My memory is much sharper now than it was 7 months ago, mood is improving even still 7 months later.

There aren’t many who have recovered by just using HCG alone and this would be the first time I ever heard of it actually working. From your description of your rubbery penis, you have venous leakage. The muscles and nerves in your penis have (hardened) atrophied and this is why your sensitivity is gone and why your penis is unable to trap blood anymore. It will take up to a year to repair the damage as the inside of your penis is rebuilt, I’m 7 months into TRT and I’m still not fully recovered, my erections are getting better. It’s a slow process for most. A lot of guys have Vitamin B deficiency together with low T. TSH is near perfect.

A successful restart is rare, but it does happen. See stickies for low dose clomid restarts.


#3

@systemlord When you say I will require injections EOD due to my SHBG, are you reffering to TRT or HGG?

I have read a lot where people have said SHBG is very important when on TRT are you able to explain that to me in a little more detail? Does it have to do with how frequent my shots should be ?

Well at least I’m not the only one by my self it feels hard not having anyone to talk too that can relate to my issues. Im glad that you are improving over time.For sum reason my numbers went up on both Clomid and HCG mono so it seems like I’m a great responder to them but not all symptoms were cured. I see that you are trying to point out the fact that things are gonna take time because I see how you said you have been on TRT for 7months and it is still taking time for things to improve.

Here my question tho and I want to utilize your expertise and hopefully more people will pitch in there opinions as well. So if my TT went up to 906 and FT went up to 212 on HCG mono if I take TRT+HCG+A.I and it brings my TT back up to 906 again how will I feel any different from when I was on HCG mono if they are the same levels. This is where I get very confused where someone brings their FT and TT up to optimal levels but one person uses HCG mono and the other uses the combination therapy (TRT+HCG+A.I) do you assume the person using the combination therapy will feel a lot better and why? Plz help me figure this one out I’m lost

So you think that I have lost sensitivity because from what you can tell from my symptoms I have a venous leakage?? and if so is there a way I can heal it? I for got to explain that when I take cialis I can with hold a erection with no problem do you think what I have Is still a venous leakage? Did you have a venous leakage as well if you don’t mind are you able explain to me some of your symptoms so I can further diagnose my self. I need sometime of hope that all this will get better

Now with all that being said do you think I’m wasting my time on HCG mono and even trying to restart I? I did read the whole entire sticky on the restart protocol. I t seems very simple but then gets little complicated when having to dissolve the A.I in vodka. Should I just tell my doc look I really want to go ahead and just jump on TRT I think if i really sit down with him and explain to him that I fell like I’m wasting my time on HCG mono he might go ahead and out me on TRT. The scariest part is my fear of thyroid problems. I don’t have any now but that would definitely suck to have more problems on top of the one that I already have now you know what I mean.

Anyone else that would like to chime in as well plz do it would be appreciated to here from everyone


#4

A lot of guys just don’t feel well on clomid or HCG even though their levels are spot on, they actually feel worse and we don’t yet know why. Some feel fine for awhile on either but fall back down after a time. If your SHBG is high you’re hold on to too much of your FT, essentially you’re low T do to it being non-bioavailable as it’s locked up in SHBG. If your SHBG is low you are dumping most of your FT into your urine through your kidneys, this is why you would require more injections per week and most doctors are completely unaware of this simple fact mine included. I wouldn’t be where I am now had I trusted my doctors, I would have thought TRT doesn’t really work for me when in fact it’s the doctors who are failing me. You can’t place everyone on the same protocol, you have to customise it to everyone. These HMO doctors triage people, get in, get out and see as many people as they possible can. Male hormones is very complex and any doctor who doesn’t take the time is cheating you.

I have venous leakage which thanks to TRT is gradually healing, I didn’t experience an erection for a full year before TRT, this cause damage to my penis. Every now and then I get a strange tickling feeling on the tip of my penis and testicals as my erections continue improving. I must warn you that there will be times during the healing process where it will seems as if your erections are getting better, and like the tide they will recede for a time only to return again sometime weeks later. This has happened many times and can be quite distressing, recently I’m starting to feel my erections a bit more frequently (more injections) and am certain perhaps after a couple more months I’ll finally have fuller erections whenever I want them. I’m starting to find every female I see as extremely attractive, I need to be careful I don’t start something I may regret as my libido only a few years ago was insane and will be the first to admit to having hypersexuality.

Remember just because your FT and TT are near perfect doesn’t mean you’re going to start feeling like superman right away, it could take you a year to get dialed into a protocol that your body prefers, knowing your SHBG will improve your odds of faster recovery. Some get lucky on their first dose and recover quite fast, but isn’t typical.

My endo doesn’t even know I’m injecting EOD, there’s no reason to tell her because she probably wouldn’t understand why guys with low SHBG need more shots. She was perfectly alright with a guy that has low SHBG injecting once a week.


#5

@systemlord If I use Cialis and I am able to achieve an erection and able to matin it does that mean I could still potentially have a venous leak?

So with your expertise by looking at my SHBG what do you think would be a good TRT+HCG protocol for me injection wise?

I my self had a very high libido and when I say high I mean very High. I will admit my self too to having hyper sexuality. To be honest I just miss my old self. How long did you go with having Low T before you decided to be on TRT? I my self is going on 9 months and I think the longer I wait the longer its going to take for me to recover. I miss my libido a lot. Im hoping that I will be able to get my sensitivity back again that way I can atlas go back to wearing condoms. Not being able to wear one is not ideal and the way things are looking i don’t know if I will be able to wear one ever again If i don’t get me sensitivity back.

Do you think me and you will ever get back to the point to where are hyper sexuality will come back?

My doctor is a pretty good doc interns of listening to my concerns and trying to figure out whats best for me but maybe its because I pay him out of pocket and not threw insurance. Im with you I can only imagine how difficult it is to deal with doctors that go by the insurances.

Also I forgot to mention I have developed muscle twitching all over my body and I was wondering If anyone else could relate to this symptom and if so how did you relive it?

I would really love to know what caused my Low T in the first place but I know not everyone is that fortunate to figure that out


#6

My hypogonadism was medication induced, not while on the medicine rather the withdraw off of it. It stressed out my pituitary gland that likely would have recovered had I given it more time, but developed diabetes as a result of lowT. I was lowT for a year and a half, it happened quickly. Whenever anyone starts paying out of pocket avoiding insurance you almost alway get better care because mediocre is fine with the average doctor who is fine with being someone else’s bitch shackled by HMO’s and insurance companies triaging people rather than spending the necessary time with the patient. A truly good doctor can go it alone and start their own practice and become successful at it. You’ll make a full recovery but it will take time, how long depends on your protocol and your doctor.

Since your numbers are so close to my own I would inject 25mg EOD since TRT will force your SHBG below the threshold of what’s considered low making your SHBG low. The larger the injection the lower your the SHBG will be. My muscle twitching started when I began TRT and has continued to this day, the only difference is now the twitching is starting to slow in frequency as my muscles improve. It used to twitch very fast repetitively and was annoying when attempting to focus on tasks. The legs get more muscle twitching than anywhere else and seems to dominate.

Unless you got something else wrong with you you’ll recover just fine, there’s a lot of mentally unhealthy guys out there who go on TRT expect it to fix their depression and other problems, those looking for a magic bullet or might even be in denial that they have any mental problems or are taking medications known to mess with hormones and know that can’t live without these medications and fail to mention their on any meds for fear it will be used as a scapegoat. These guys do not do well on TRT because their problems are being caused by other unknown factors


#7

@systemlord Ive read in other post that you don’t not take HCG and a A.I not sure if I’m recalling this rite but I think thats what I read. But because of my age I still want to have children. And after ready the stickies on the injection protocol it recommends me to inject 250 I.U EOD along with the 25mg of T EOD that you recommend due to my SHGB as well on top of me most likely needing a A.I. This all seems like a lot of injections a week. Is there anything I can do to lower the amount of injections weekly?

Its good to hear tat your twitching is getting better for the longest time I thought I was the only one because I never hear of anyone mention body twitching in any of their post. I am in the same bout as you it mainly happens in my legs. But also other places as well like my eyes and yes its very annoying and takes a toll on me threw out the day


#8

I take no AI, no HCG. You know when I started TRT I told the doctor I wanted weekly injections knowing full well it wasn’t going to be enough, I didn’t like the idea of sticking myself more often. Then I got tired of feeling mediocre and said screw it and switched my protocol to twice weekly and felt better, so I wondered would I feel even better going to EOD. Each time I increased the frequency of injections I notice big improvements and eventually started using 27 gauge insulin syringes pinning in my shoulders. We low SHBG guys dump a lot of our test into our urine, I want it to go towards me feeling good, not down the toilet. If not right away, sooner or later once you start TRT it won’t be long before you want more injections if it means feeling better cognitively and energy wise. You’ll end up taking longer to make a full recovery is you opt for less injections.


#9

Higher doses of hCG or SERMs [clomid/ nolvadex] can cause high T–>E2 inside the testes and anastrozole cannot work there.

E2=51 is expected to kill libido and can cause mood problems.

Arimidex/anastrozole cannot be dosed once a week, try .25mg 3 or 4 times per week. Anastrozole is a competitive drug to T and needs to match serum T levels. With your single dose per week, your E2 labs are a bit useless.

Many Varicoceles can be surgically corrected.


Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

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.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


#10

@systemlord man everything that you been telling me is so helpful and its putting so many of the little pieces put together that have been missing and I could not understand. Im starting to see the bigger picture now. You have no idea how much you have helped me.

With that being said I have another question what are the ideal numbers someone should be at to feel at there best

Shbg
I know E2 should be as close as 22ng as possible
Ft
TT
DHT
Prolactin

Im having trouble knowing what numbers to aim for. I know that FT and TT very from person to person I guess but what about the rest of the levels


#11

@KSman what you said makes sense and I totally agree that I can not be taking Arimidex once a week.

Here are my current labs that just came in today I had them done twice at two different places but not on the same day. The protocol that my doctor switched me to is 300 I.U M,W,F with .25 Arimidex twice a week.




So as you can see we moved my .25 Arimidex to twice a week and it brought me E2 down to 21pg from 51pg according to the Ultrasenstive test. But the regular E2 test says 37pg. But from what I read the Ultra sensitive test is the best one to go with.

So with that being said Im scared if I continue taking Arimidex twice a week I will continue to drop lower then 21pg how do I level out rite at 21pg because that seems like the perfect place to be to feel optimal.

Also with these results I still feel like crap. Don’t feel any different from when I posted my last labs. Thats why I’m going to talk to my doctor today about going on the combination therapy TRT+HCG+A.I