T Nation

At the End of the Road, Help?

At 19 (2014) I suspected I had low HGH and Test levels. I went to an endocrinologist and while my HGH levels were indeed below range, my test came back “normal”. She also confirmed that I had gone through a “delayed puberty”. I went back for a 2nd blood test, which I didn’t sleep before having, so take the results with a pinch of salt. In the end, nothing was prescribed.

At the age of 20 I started a cycle of Test E. I don’t really remember but I think it was 300mg once or twice a week. After 7-8 weeks, because of certain situations in my life I had to discontinue immediately and was unable to get on PCT. While on the cycle for the first time in my life some facial hair had grown, and I put on some muscle, that was about it.

Between then (2015) and now (2019) I have continued to struggle with

  • ED
  • insomnia/sleep problems (although I had this before my cycle too)
  • terrible memory and cognition compared to before my first cycle
  • anxiety and depression, although I have had this all my life.

The first 3 problems have all got worse since the “cycle”, but they weren’t great to begin with.

I took bloods twice in 2014 and again in 2018. Here are the results of all 3

22/07/2014

  • Testosterone: 16 nmol (7.6-31.4) - converts to 461 ng/dL
  • LH: 2.3 IU/L (1.7-8.6)
  • FSH: 3.3 IU/L (1.5-12.4)
  • Free T3: 5.0 pmol/L (3.5-7.7)

Late 2014

  • Testosterone: 9.38 nmol (7.6-31.4) - converts to 270 ng/dL
  • LH: 1.4
  • FSH: 3.2
  • Free T3: 5.8
  • Free T4: 17.1
  • TSH: 3.25
  • SHBH: 24

26/10/2018

  • Testosterone: 11.90 nmol/L (9-30) - converts to 343 ng/dL
  • LH: 4.0
  • FSH: 4.2
  • SHBH: 26

I remember being pretty heavily sleep deprived at the Late 2014 blood tests, could this explain the disparity between that and my July 2014 test?

My questions are:
1. Could my 6 weeks on Test E with no PCT have messed up my test production somewhat?
2. If so, is it possible Clomid could kickstart my natural T production, even if it has been 4 years since my cycle?
3. Seeing as I have symptoms of low T (sexual dysfunction/low libido; fat in midriff area despite working out hard and regularly for 6 years; chronic insomnia; memory and cognition problems; lack of motivation or drive; very little facial or body hair), should I get on TRT even if I’m 25 years old and want kids one day?
4. I’m very short and have a baby face. One thing I have going for me is good hair genes. If I’m on TRT from 25 years old for life, is there any realistic chance of keeping my hair? Most men in my family keep a full head of hair until death.

Side note: my diet and lifestyle is on point and have been for a while. I eat clean, lift heavy (although my lifts have plateaued for about 2 years now) low BF % and look after myself well.

I can’t live with the symptoms of low T. But I would look terrible bald and I want a lot of kids one day, so it’s a big gamble. If there is no way to kickstart my T production naturally I think I will bite the bullet. But any advice would be greatly appreciated. Thanks for reading

Have you talked to a doc about any/all of this? Not that you will definitely find an intelligent ear on the subject but you need to start down your path. Clomid would probably be a good start to see if that can pull you out. If that doesnt work then yeah maybe TRT with HCG ( to preserve fertility). You should probably also delve a bit deeper into your thyroid. Your TSH is elevated. If your thyroid is fucked you wont feel well in general.

Questions:

  1. Maybe since you were quite young.
  2. Possibly.
  3. Yes if the above doesnt work and HCG can preserve fertility.
  4. TRT doesnt cause hair loss, genetics cause hair loss.
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The latest blood tests (2018) were done at a men’s health clinic that specialises in things like low T. They’re the ones who recommended clomid, and if that doesn’t work TRT. I was completely honest about everything with them.

Thanks for the thyroid advice, I’ll look into that. If I can fix my symptoms without getting on TRT I’ll be a happy man.

For 4. Every youtube progression video I see of people on TRT in their 20s seems to have led to hair loss within 2-4 years, and the majority of posts I see from people on TRT list it as a symptom. Is it really true that you can be on TRT your whole life and keep a full head of hair if you have good hair genes? I thought exogenous test leads to quicker and more hair loss than the equivalent in endogenous test? Is that mistaken?

Yes. MPB affects a large portion of the population and that is going to overlap with the TRT community. Those NOT going bald arent making vids about NOT going bald. You could look at top BB and mens fitness athletes and check out their hair. If you are genetically predisposed it would come from your mother’s side of the family so look at her brothers, dad, uncles etc to get a genetic read.

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I think of you have the genetic predisposition to loose hair TRT may speed up this process, but I think it won’t cause hairloss if you don’t have the “hairloss genes”.

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I’m 47 and went on TRT and have more longer hair than before, hair is as much genes as anything else. The reality is that hair loss in men is primarily caused by DHT, a male steroid hormone that binds to receptors in your scalp and in genetically susceptible men is responsible for hair loss.

I did experience hair loss on certain protocols, however the smaller more frequent injections seem to have curbed hair loss. Estrogen and DHT are converted from testosterone, so larger injections can increase those conversion rates.

TSH is indicating a problem, normal healthy men with no symptoms have a TSH <2.5, there’s data to back this up. The evidence for a narrower thyrotropin reference range is compelling.

It’s amazing your doctor lacked the courage to act even though it was known you experienced delayed puberty, was a reason given for inaction?

You have the hormone levels of an old man. These lower levels of testosterone are disease state levels, waiting can’t be an option or else later in life disease will rule your life. You can add HCG and FSH to your TRT protocol when you’re ready for kids.

Yup don’t think about if it will work or not jsut do chlomid first. You’ll see quick results if it is helpful. At the same time get thyroid analyzed. Without a functioning thyroid trt does not help. I jsut went through this.

Trt final option at your age.

Cycles over and it didn’t go well. Just play the cards your dealt with and don’t worry about the past. Move forward and get yourself back on top.

Losing hair and shit is the least of my concern when I’m dealing with fatigue and suicidal thoughts due to low t. That’s the least of your worries. At your age you need energy and Etc. otherwise life’s just going to suck.

Happy life with no hair or shitty life with a full head of hair!

I think you can’t Get your semen analyzed see if your fertile. If so get them frozen and when you use HCG + trt it will return 9/10 times. I think guys who have fertility issues pre trt have issues becoming fertile on trt. Someone correct me if I’m wrong.

I started on clomid today (50mg EOD for 2 months). I also had blood tests this morning and I’ve got some scheduled for the end of treatment (June) so I can compare the difference.

If the clomid works in boosting my T, do I have to stay on it for life (will it drop back down when I stop?). Does the fact that I may have shut down my natural t production during the cycle I took when I was 19 mean that perhaps the T restart will be permanent, without the need to be on clomid my whole life?

Unless you correct the cause of your low testosterone, then you will need TRT for life. No one knows the long term side effects of clomid, it’s a big gamble antagonizing the estrogen receptors and we know drugs always have side effects, some permanent.

Young men have immature HTPA’s that aren’t fully developed and are fragile, unlike a 40 year old with a fully mature HPTA who is just looking to optimise levels at a time when levels are on the decline. I believe if you were going to recover your natural testosterone production, it would have happened already.