T Nation

Help Needed - Next Step?

I had my operation this morning to repair my varicocele and it went pretty well. I was a little scared but i got over it and got the operation done in the end.

So far no change in testicle size or feeling in general at the minute but my body is still healing from the operation (got 3 wound sites from having problems locating the correct vein). I can only hope i will see some marked improvements in the coming weeks with regards to testosterone and sperm production.

If my testosterone level’s don’t come back up to a normal level after this operation the next logical step for me will be injections i think. Getting my doctor/GP to go for this will be difficult though as he claims i don’t have ‘true’ hypogonadism because my LH/FSH are in the normal range. He refuses to listen to any symptoms i tell him about. Just the usual low testosterone symptoms (ED/Libido, Muscle/Joint Pain, Mood Swings, etc).

I think i have a very strange case where my testicle atrophied due a varicocele. I only ever had one good testicle before as the other had atrophied many year’s ago due a varicocele also. My other testicle became large and fully functional but after the varicocele came 4 months ago, it caused all manner of problems for me. The strange thing was no change occured in my LH/FSH except a shift by two points in the LH (from 2.1 to 3.9). My testosterone level dropped from about 650/700 (maybe even 800 at points) down to 400 (could be lower - awaiting new results) and i got all the symptoms of low testosterone. When i felt really bad my blood result’s looked like this:

Total T : 15.2 NMOL/L (14-40)
SHBG: 26.0 NMLOL/L (20 - 45)
Free Androgen Index (FAI) : 58 (70 - 100)
Calculated FreeTestosterone (CFT) 356.7 PMOL/L (300 - 600)
FSH : 2.7 IU/L (0.7 - 6)
LH: 3.9 IU/L (0.8 - 6)
Estradiol (E2) : 73.0 PMOL/L (55 - 184)
TSH: 1.9 IU/L (0.4 - 5.5)

It was very strange, as my testosterone level was dropping it looked like i was “aging” fast. My skin changed and became less elastic, my penis shrunk up (like a balloon out of gas) and hung lifeless, my joints/muscles hurt and so fourth.

I was put on TRT (Androgel) and did this for 3/4 weeks. During this time my own system didn’t shutdown. I got a blood test done while on TRT (1 application a day - 50mg) and my LH/FSH dropped a little but nothing radical (LH - 2.7, FSH 2.1). I think the TRT was going against my own body and causing some estrogen problems while on treatment.

I stopped everything for two week’s and got another blood test done. Again my LH/FSH were in the normal range. I am still waiting on getting the full results back, i still don’t know what my baseline testosterone level was without TRT. I should know and post soon.

I stopped all TRT about two week’s ago due to going in for this operation. I guess i am wondering if it’s possible todo TRT and not shutdown your HPTA? It seem’s my own body just dosen’t want to shutdown. My theory is that the when your LH/FSH gets really low it mean’s you are getting the correct dosage of testosterone, i guess mine started lowering because i was getting near my normal range. This makes sense because i was hitting 600/700 on TRT but before i was injuryed my level was about 800.

What i can’t understand is that even though my testosterone level halfed during the delince, why the change in LH was so minimal. It seem’s odd that my body accepted such a low testosterone level without trying to stimulate the testicles further by increasing the LH.

On TRT (androgel) i was getting good result’s (600/700 range) but bad side’s from the gel itself either caused by the gel itself or E2 problems.

I think one of my problems at present is my own system is still working in the background while on TRT.

I am going to stay off everything and get my blood tested again in 2/4 weeks to see if their is any improvement. I should be able to post my latest labs from 2 week’s ago (when off TRT for two weeks) very soon, i am anxious myself to see what the level is.

I am in the UK so getting injections is going to be difficult. I am thinking a routine of 100mg weekly + HGC to maintain fertility. Being a primary sufferer i want to keep as much testicular function as possible and try to get some “regrowth”. I could also sit back and suffer from the low testosterone and see if my own system “kicks” back in on it’s own.

Not really sure what todo and really looking for some proper advice on this one.

Thanks in advance guys!