T Nation

Endocrinologist is Comitting to HRT, Any Advice?

Looking for advice for someone with hypogonadism.

I’m 18 years old, and have had all the usual low testosterone symptoms which I don’t need to list. So I went to my endocrinologist, and the very first one I went to luckily admitted that I had low testosterone (my level was 278ng/dl). He is saying that he will treat me with HRT, testosterone in injection form. He wants to run some more tests though first, then i meet back with him in 2 weeks.

What should I request? I want to get the most benefits with the least detrimental effects. How do I make sure I am getting enough of a dosage to allow me to finally put on some muscle (for all my teen years, i have never been able to keep up with the other boys)

I guess what I am asking is, how do I make sure I am getting the most optimal dosing and strength of the Testosterone injection?

I want my levels to go from 278ng/dl to as high into the “Normal” parameters as possible.

Any advice?

Well, for one, the over 35 forum has an excellent HRT sticky.

As for your situation, though, I would ask for injectable test (probably cyp) along with an AI and HCG. Ask him to show you how to do your own injections, so you can shoot twice per week, and so you’re not going to visit him twice a month for injections. That will lead to extreme hormone fluctuations that you don’t want.

As for getting your test high into the normal parameters, that’ll take some trial and error in the form of varying dosages and regular blood work until you find your sweet spot. Under the supervision of your doctor, of course.

Good luck, man.

If low test is your problem you will feel like a new man once you get your dosages dialed in. Just be patient, it won’t happen overnight.

As for what to ask for, demand injectible test, HCG and an aromatase inhibitor (anastrozole is the most common). Many docs start people off at 100mg of test per week and move up from there depending on how that works. Tell him you want at least one injection per week. Some do better with 2 injections (same dose per week just two smaller injections) but once a week is minimum. Make sure you use the HCG immediately, don’t let him tell you “maybe later on.” It’s important for pregnenolone production as well as fertility if you might ever decide to have children. The AI is a must if and when your estrogen levels climb up.

Also, tell him clearly that you want your levels in the high normal range, not slightly higher then they are now. See what he says.

There’s plenty of research available on the forums. Search this one and you’ll find post of people asking for research to bring to their docs to convince them they need all three (test, hcg, anastrozole).

Like the guy above said, check out the over 35 forum on this site and ask your question over there too. KSMan is always super helpful and knowledgeable.

Good luck!

Your estradiol levels should be determined and if it is not near the lower end of the normal range, then it would be worth seeing if controlling your estrogen down to low normal may not entirely solve your problem without need for testosterone replacement.

Now if it is the case that you have primary hypogonadism – that is to say, your pituitary is producing enough LH that you should have normal testosterone, but the testes are failing to make enough – then that will not work.

However, unless that is shown to be the case, it is highly likely that you do not need to go on the needle (or the patch, or the gel) for the rest of your life but can perfectly good teststerone of your own, simply from taking an antiaromatase once per day at the dose appropriate for you.

Once you embark on the path of taking added testosterone for many months on end, you can wind up permanently committing yourself to that course regardless that you never really needed it in the first place.