T Nation

Age 31 Low T - Need Advice


#1

Hi All,

Stats:
Age: 31
Weight: 181 Pound
Height: 5"9
Waist: 32"

Background:
I have been training for the past 10 years. There has been gear use in cycles of 2-3 months between the age of 25 to 29. I have always used Nolvadex for PCT and recovered quite well based on feeling not by Labs. My last cycle was almost 2 years ago which I feel I did not recover well from, the PCT used in my last cycle was slightly different 1500iu of HCG EOD for 1 week followed by Nolvadex for 1 month, I did not react well to the HCG as I have got some severe acne on my face over 100 small pimples which disappeared after 1 week. Basically from there I suffered 2 years of Low T side effects, until I finally went to see a doctor

1st Labs:
Total T: 2.95 ng/mL 2.490 - 8.360
FSH: 3.61 IU/L 0.95 - 11.95
LH: 2.73 mIU/mL 0.57 - 12.07
SHBG: 31.2 nmol/l 10.0 - 80.0
DHT: 352.0 pg/ml 300.0 - 850.0
Estrogen: 98.0 pg/ml 40 - 115
TSH: 1.02 mIU/L 0.27 - 4.20
FT4: 18.73 pmol/L 12.00 - 23.00
FREE T3 5.17 pmol/L 3.10 - 6.80
Anti-Thyroglobulin, Anti-TG 11.67 IU/mL 0.00 - 115.00
Anti-Thyroid Peroxidase 10.61 IU/mL 0.0 - 34.0
Anti-TSHR 0.300 IU/L 0.00 - 1.75

The doctor put on a Clomid for 1 months but did not agree to carry on as a long term treatment. There was symptom relief but it brought up some bad side effects such as anxiety, mood swings and not the best erections. My T has returned to low after stopping clomid for 1 months and verified by Labs

2nd Labs (One month on Clomid 25mg/ed)
Total T: 8.63 ng/mL 2.490 - 8.360 HIGH
FSH: 5.70 IU/L 0.95 - 11.95
LH: 3.98 mIU/mL 0.57 - 12.07
DHT: 742.0 pg/ml 300.0 - 850.0
Estradiol(ECL): 51.5 pg/ml 8-42 HIGH

My second doctor put on Nolvadex for 2 months. Which actually felt better than Clomid or no treatment for a while but after month i had worse erectile dysfunction than not using any treatment. The labs are pretty much the same elevated Total T, FSH and LH. We also checked seaman analysis, blood glucose, PSA and prostate scan. All are fine.

My second doctor refereed me to my third doctor. He put me on Provirion 50mg ED and other herbal T booster Horney Goat Weed. I did not feel any different and no labs were done. I then gave up on trying to restart and accepted that I have low T, I requested my doctor to put me on TRT. The only injectable option is Nebido where I am currently living.

TRT Treatment:
I started Nebido. I felt great after the first shot but increase of water retention at the peak 2 weeks after my first shot. At week 6 symptoms returned and I requested my doc for a booster shot. He requested for some labs first which returned low Free T and Total T, even lower than what I started. I suggested for more frequent protocol 125mg every week and this is where we are at today.

My questions are

  1. I understand that I have secondary Hypogonadism. Is there a cure for this? or should I just accept it and stick with my TRT? I do like the idea that I am now in control of hormone level and I can aim to be in the higher range

  2. Is my protocol a good start? I choose 125mg due to the fact test undecanoate provides less T than other esters. I will be looking at adding HCG and armidiex at a later stage.

Thanks.


#2

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

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc
  • HPTA restart

SERM dosing too high, creating a lot of E2. You stoppedf the SERM and your HPTA sees all of the E2 and shuts down. 1500iu hCG EOD was harmful, again there is high T–>E2 inside the testes.

SERMs increase E2!
AI’s reduce E2. You never mentioned anastrozole above. Should be used all through cycle and PCT and cruise on low dose for a few weeks past PCT.

E2=51.5 is shutting you down. How long after you stopped clomid were the labs done? If 3=4 weeks later, take 0.5 mg anastrozole per week in divided doses. If labs were done soon after stopping clomid, E2 may be residual and could be lower later by itself.

Your PCT methods were flawed and it too a few years to mess you up. You should have been using SERM or hCG to keep testes working during your cycles so they would not have to recover form and function.

Are you in UK?

Inject T twice a week
take 0.5mg anastrozole at time of injections
250iu hCG SC EOD
Do labs in 4 weeks, adjust anastrozole to get near E2=80mol/L - 22pg/ml

Do not wait, do all of the above from the start.


#3

Thank you very much for your feedback.

Unfortunately I was following any advise on the internet and as you know there are mixed opinions on the internet. I did us anastrozole in some of my cycles but it was difficult to determine my levels without Labs. I always had joint problems after long use of anastrozole i.e 4 weeks.

I did Labs 1 month after stopping clomid

Total T: 3.41 ng/mL 2.490 - 8.360
Estrogen: 31 pg/ml 7.63 - 42.6
SHBG 34.8 nmol/L 17.1 - 77.6

4 Months after I did another labs

Total Testosterone 3.10 ng/mL 2.490 - 8.360

I am currently living in Dubai. Do you think I should give up on trying to restart my HPTA and stick with TRT?

I am using Test undecanoate (Nebido) but I will be splitting the dose for more stable levels. Do you think once a week should be fine since the half life is twice as long as cyponite / enanthate?

HCG is cheap so I can start that soon. How do I deal with this while travelling? can SERMS be used instead i.e 10mg of nolvadex EOD?

anastrozole cost 200 USD, I would like to see if I can do without it.

Unfortunately my health insurance does not cover hormone labs or any treatments including anastrozole, SERMS, HCG and Test.


#4

Anastrozole here is now an inexpensive generic. Do some more work on this. Can you get such things by mail?

Use google to see how diabetics travel with insulin that also needs to be kept cool. Yes, 10mg of nolvadex EOD may solve the travel issues. And you should swap to that anyways at your age to get a FSH tune up to support fertility.

Once a week with that ester will be fine and a larger dose before travel might could allow travel without T and syringes.


#5

Hi Again,

I will ask one of my friends from the US to bring some next time.

Can nolvadex replace HCG long term while on TRT? it is just easier to take a pill instead of preparing the HCG, the standard pregnyl 5000iu amplue comes with a solvent solution which does not last very long. I will need to order a separate vial and bacteriostatic water. Also on the same note while using nolvadex only previously I experienced ED and I read somewhere that ED is a side effect of nolvadex. Do you think I experienced ED was due to elevated e2 or a direct side effect from the medication?

Thank you


#6

ED is not an effect of hCG properly dosed. [250iu SC EOD]
E2 management is always a critical factor.

BA water is 0.9% benzyl alcohol that prevents any possible bacterial issues. The variables are wet time, temperature and agitation.

T+Nolvadex long term: Would need labs for LH/FSH and E2 to see what tuning might be required. 10mg EOD may be sufficient.

Many use 10,000iu hCG syringes over 80 days without issue. The expiry dates are not based on science but simply a made up number because there has to be one and such things were based on large dose uses for IVF, not a TRT context.


#7

Thank you very much KSman, ill be back with labs soon.


#8

Hi KSman

Here is my bloodwork 4 weeks into my trt (Saturday)

150mg test undeconate once per week (Saturday)
250iu HCG twice per week (Sunday & Wednesday)

Total T 29.7 nmol/L 8.33 - 30.19
Free T 21.53 pg/ml 4.5 - 42
E2 29.7 pg/ml 11.0 - 44.0
SHBG 25.5 nmol/L 13.5 - 71.4

I tried arimidex 10 days ago 0.5mg. I had extreme joint pain and fatigue so I dropped it all together. Lately I have nipples senstivtey which is odd because I was expecting my e2 to be really high?

Also I feel that HCG shots bloat me up and give me hives on my face. Should I lower the dose ?

Any additional feedback on my results would be appreciated.

Thanks


#9

Is the hCG from a pharmacy?
Did it arrive wet?
If you added “water”, was is BA water, 0.9% benzyl alcohol?

Please try splitting up your T dose to 75mg twice a week and see if things are different. FT seems a bit low. I assume the labs were done 7 days after injections. Lab timing does matter and changes to lab timing create artifacts. Please try to do labs halfway between injections.

E2=29.7 is not horrible, but could be better. You would need tiny doses. Dissolve 1mg/ml anastrozole in vodka with a dropper bottle. Take two drops at time of injections. Can adjust dose based on next lab results. Note changes after 7-10 days. Hopefully you do not feel like you did before. [Several here would suggest that you might be fine with that level of E2.]

How much hCG - hives?
How many doses and all gave same effect?
Keeping hCG refrigerated?
Source of hCG is OK?


#10

Hi

The HCG is from pharmacy organon pregnyl 5000iu. It comes with dry white powder and solvent solution. I am not sure what the solution is but according to instructions it should be one time use. I used 20 insulin syringes and store in fridge which makes 250iu per shot. I got hives from the first two shots only. I am not sure if I am now use to it or the HCG has gone bad

I am using testestrone undeconate (nebido) which I believe is ok for weekly injections ? I did my blood test on the day of my injection before injection to see my levels at the lowest point. Are you suggesting to get my next blood test half way through the week? Like Tuesday ?


#11

Hi

Just to add to the above, I have started arimidex 0.25mg the day after my T Shot. Assuming my T would be the highest by then and continue to decline until my next T shot (1 week after). The arimidex 0.25 should continue to decline with the Test and hopefully provide stable levels.

I will monitor based on symptoms and write a log to see if this is enough or a second dose of 0.25 maybe required sometime mid week with my HCG shot.

Just to summarize my protocol

Nebido Test Undecanoate 150mg on Saturday
HCG 250iu on Sunday and Wednesday
Arimidex 0.25mg on Sunday and possibly on Wednesday

I am also thinking about moving my HCG and Arimidex back one day. that way I only have to take drugs on Saturday and Tuesday.

Should I plan for my next bloodwork on Tuesday between T shots in 2 weeks from now?

Thanks


#12

Seems reasonable!

Undecanoate has a longer half life and anastrozole will not last the week, so E2 will climb. You could dose Arimidex day after injection then a smaller dose [.35?] mid-week. That would require some tricky pill splitting and a 1mg/ml anastrozole solution in vodka can be useful for arbitrary dosing amounts by volume or by the drop. If you dose day after, mid-week is then too close to 1st dose.

If you have problems remembering the day-after dose, take it when you inject. After the newness wears off, all of his becomes a chore after a few years.