Critique my TRT

Age: 38

Symptoms being addressed: low libido, ED, Delayed Ejaculation, lack of weightlifting progress, low energy, poor sleep, moodiness

Prescription: (weekly) TCyp 70mg x 2, Adex .5mg x2, HCG 540 IU x 2

Attached: PRE-TRT bloodwork

I’m assuming this bloodwork is while you’re “on”, correct? Are the listed symptoms present currently?

This is pre TRT bloodwork.

You had >1000ng/dL TT and 20.6 pg/mL fT pre-TRT?

Yes I did

Were you taking anything that would increase your LH / FSH? Those numbers are crazy high too.

Daily: 500 mg magnesium
5,000 iu: d3 125 mcg & k2 680 mcg
2560 Omega 3 (650/450 EPA / DHA)
Men’s multi
GABA: 750 mg
Was taking Ginkgo, have since stopped
Cialis: 20mg as needed (2x a week presently)

OP, why are you on TRT? Did an actual doctor prescribe your protocol?


Yes for the aforementioned symptoms

it’s that prescribing more testosterone for someone in your state is insanity. Or at least, it reads like it to me (an internet reader/observer). I’m withholding judgement (mostly) until I see responses from those that do more than casually dabble.

Perhaps @highpull has some experience here?


Just a couple quick searches on the treatment of high LH & FSH

First picture is relevant, second one is not.

I’m going to defer to someone with more expertise here. This sounds like a Turner, Kinefelter, or pituitary thing - none of which i know enough about to comment.

What? Having looked those two syndromes up, definitely not. I have 3 healthy kids, also. I got a vasectomy a couple of years ago, and this is making me wonder if I should go back and see him.

For the last week, I took a full round of all of the above, except the HCG which I took for the first time yesterday because it came in a different shipment.

I have been using Tongkat for the last week.

The first full day after taking Adex, along with 400 mg of Tongkat, I felt fantastic. It probably sounds placebo but I know how my body feels on Test and there was no getting around it. Then it trailed off. My girlfriend and I always have great, frequent sex with the Cialis but the other day was a completely different level.

So I am wondering if for one, the building of Adex is suppressing libido, which is why I am going to stop taking it for the time being, while continuing to run the other two as ordered.

Compensated hypogonadism​

A relatively large number of men (9.5%) were identified as having compensated hypogonadism (3, 9). The frequency of this condition showed a clear increase with age (Fig. 1, inset ) forming the largest LOH category (21.1%) in the 70- to 79-yr age group. Although smokers are overrepresented in compensated hypogonadism, there was no significant difference in total T, fT, or SHBG between smokers and nonsmokers in this group (data not shown). Excluding smokers from the analyses did not make any difference to the risk factor associations in any of the hypogonadal groups (Table 2). The explanation linking smoking with compensated hypogonadism remains unclear. Compensated hypogonadism was associated predominantly with physical symptoms. This is compatible with previous studies showing an inverse relationship between LH and muscle strength independent of T (10) and a lack of association between LH and libido (32). Although T levels in the compensated group remained above the thresholds for sexual symptoms, they may be insufficient to maintain previous levels of physical functions (33, 34). Given its wide normal range, it is possible that T had declined from previously high normal to current low normal levels in men with compensated hypogonadism. High LH may therefore be a biomarker for T decline within the reference range, indicating a readjustment of the HPT feedback set point in aging to compensate for deficiencies in testicular function and/or defective T feedback at the hypothalamic-pituitary level (35). A possible alternative explanation for the occurrence of physical symptoms in compensated hypogonadism may be the slightly lower mean fT in this group compared with eugonadal men (Table 1 and Fig. 2). However, after stratifying this group into those with low (<230 pmol/liter) or normal fT, low fT levels were not associated with increased symptoms (sexual or physical) after adjusting for age and other confounders (data not shown).

Compensated hypogonadism may be analogous to subclinical hypothyroidism (high TSH and normal thyroid hormone levels) (36) where it is accepted that most patients will go on to develop overt hypothyroidism and T4 replacement is indicated (37, 38). Our results suggest that elevated LH levels in compensated hypogonadism are not an isolated laboratory finding but significantly associated with physical symptoms. This lends support to the conclusion that it represents a genuine clinical subgroup of LOH. This condition may, therefore, be a forerunner of overt primary hypogonadism, being characterized by both elevated LH and higher age. Men with increased comorbidity and/or other as yet undefined factors may eventually progress from compensated to overt primary hypogonadism. The follow-up data in EMAS should provide verification to this hypothesized natural history of LOH.

The higher SHBG level in compensated hypogonadism could be an important proximal factor in the development of compensated hypogonadism and the higher E2 in the same group may be a potential mechanism. However, the present cross-sectional data cannot dissect out the complex but potentially important interrelationships, and more research on this aspect is warranted.

I’m not understanding. By looking at the scatter plot, TT is inversely related with LH levels. The few data points above standard TT ranges all have low LH. OP has both LH and TT over the top end of each respective reference range. OP would be an anomaly here, no?

I understand that exogenous T will shut down both FSH and LH so neither of those are an issue, I guess it’s just odd to see TRT prescribed for someone who has too much testosterone.

Is my understanding here correct?

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I dunno man it’s weird. If I were in that position I would get my pituitary checked out.


I’ll definitely update this thread in a few days when the Adex starts clearing out, and the HCG is more in effect, and then see how I look in about 14 days when the T should be based. I have a funny feeling that I’ll be in a better spot. The day and one prior that I was referencing were a full on attitude, mood and libido 180.

I’d repeat the labs and add prolactin.

Some guys need a pharmaceutical level to feel good.

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There are lots of things that can cause your symptoms, testosterone is one and I find it hard to believe this was the cause of your symptoms.

You took the blue pill, take the red pill and come back to reality. These Total T and Free T levels are outstanding!

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It’s bizarre. Truly. So then yesterday evening my girlfriend is sending me filthy texts and photos because she is out and I’m not since I’m a father with my kids over the weekend and I’m just like, ready to pounce on her. So maybe there is something working slowly here which could really only be the HCG at this point. I just shot my T & H and did not take the Adex. Let’s see how we feel.