T Nation

34 years old, need TRT help

Hello all, I am 34 years old currently on TRT.
Height: 6 foot 3 inches tall
Weight: 215lbs
Waist: 36 inches

I had all the typical symptoms. Low energy, low strength, low sex drive, problems with erections, trouble losing fat, etc. After reading on here quite a bit I found a Dr. through my local compounding pharmacy that seems to be pretty good.

I am currently using hCG injections only (no testosterone) since I will be starting a family soon and my Dr. warned that Test would kill my sperm count. Early in the treatment plan I felt great, now I am feeling like crap again and could use some advice.

Pre-treatment baseline test results, 1/18/13
Total testosterone: 315
Free testosterone: 52.9
Dihydrotestosterone: 16
DHEA sulfate: 191
Estradiol: 25

Treatment plan #1, started on 1/18/13
hCG: 1,000 units 2 x week sub-Q
DHEA: 25mg/day

Test results #1, 2/22/13
Total test: 568
Free test: 114.2
Dihydrotest: 39
DHEA sulfate: NA
Estradiol: 42

Treatment plan #2, started on 2/26/13
hCG: 1,250 units 2 x week sub-Q
DHEA: 25mg 3 x week
Anastrasole: 1/2mg 3 x week (pill form)

Test results #2, 5/17/13
Total test: 778
Free test: 203.8
Dihydrotest: 37
DHEA sulfate: 254
Estradiol: 53

Treatment plan #3, started on 5/21/13
hCG: 1,250 units 2 x week sub-Q
DHEA: 25mg 3 x week
Anastrasole: 1/2mg 5 x week (pill form)

Test results #3, 8/2/13
Total test: 748
Free test: 205
Dihydrotest: NA
DHEA sulfate: 287
Estradiol: 36

Treatment plan #4, started on 8/6/13
hCG: 1,500 units 2 x week sub-Q
DHEA: None
Anastrasole: 1mg 3 x week (pill form)

After seeing the baseline test results it is not hard to see why I was having those symptoms.

After treatment plan #1 I felt much better at this stage but not quite there yet so my Dr. upped my hCG dose.

Within 2 weeks of starting treatment plan #2 I felt incredible, like my old self again. Energy and strength were back, I hit a new PR on several lifts including bench press. Lean mass was up, fat mass was down. Libido was awesome. I also started to get puffy and sensitive nipples, obviously from my E still being too high, but that went away after a week or so once the anastrazole started working.

At the start of treatment plan #3 I was starting to lose some of the energy that I had felt after treatment plan #2. My Dr. thought that the high E could be the cause so we increased the anastrazole dose.

Unfortunately today on 8/22/13 I am now feeling like crap again. Energy and strength are down. I have lost 20lbs off of my bench press from previous PR. Sex drive is down and erection problems are back. Lean mass is down and fat mass is up. We increased my hCG and Anastrzole doses to try and get T up and E down some more but it has not helped.

I have cycled off all meds for 2-weeks at a time twice over the course of treatment, and plan to do it again in coming weeks, but any improvements after starting back up were short lived. I stopped taking DHEA to see if that made a difference and it has not. I have had my thyroid checked and all levels look good.

How do I get back to where I felt after starting treatment plan #2?
If T is still up, and E is under control, why do I feel like crap?
Is my E just still too high?
What other levels should we be testing and looking at?
If I start a more traditional treatment using testosterone injections and just small amounts of hCG (to keep the balls from shrinking) will my energy and strength come back?

Any help is appreciated.

Please CAREFULLY read the advice for new guys sticky.

  • use the [edit] in your post above and add lab ranges
  • please post all lab work
  • you may have issues other than low-T which is a symptom, not a cause
  • your HCG dose is simply too high and causes high T–>E2 inside the testes, anastrozole cannot control that
  • note concerns with iodine deficiency and body temperatures <-- check!

Your T levels are good with hCG. If you added testosterone, there would not be any effect on your testes as your LH/FSH is already turned off. The recommended course is self injected T with low dose hCG to preserver your testes. Not that high dose hCG can desensitize LH receptors.

Suggest that you try the “standard protocol” in the sticky and self inject. You may not be able to achieve the T levels that you are seeking with hCG and get proper E2 at the same time.

Thank you for the reply KSman. I will re-read the skicky info more carefully and add the information requested. One more question in the mean time if you would not mind answering it for me.

When starting on a more standard protocol of self injected Test + low dose hCG to preserve the testes, will my sperm count still drop too low that it would prevent me from starting a family?

Thanks again.