T Nation

Help with PCT and Fertility


#1

I am 27 been on TRT since Jan. and not felt good since too much trying to dial everything in, so im deciding to come off and do a PCT, also me and wife trying to have another kid, so I need help on the quickest pct advice for getting my fertility back quick, I am currently on test Cypionate 100 or 120mg weekly split into 2 doses, also was doing hcg 250iu eod but now 250e3d, and adex, I just recently got few things but still not too sure of my pct yet. SO I just got some GnRh Triptorelin 100mcg(which not too sure about just read good stuff on it), liquid Toremifene Citrate 60mg per ml,30ml, Liquid Clomiphene 50mg,30ml, and Exemestane 25mg,30ml, I also have from a while back bout half bottle of Liquid Tamoxifen Citrate 40mg/ml. I didn't stop the test yet but very soon I will when I figure out my pct and have everything I need, and the GnRh will be one shot from what I've read, I was thinking that and tamox and torem but I don't know much so advice would help me so much, and I know Nolva and Clomid is good pct but just looking for fast solution for fertility and something new. Any advice or suggestions would be appreciated, thanks


#2

This is disconnected from your other threads.

Please provide some insight into your E2 labs and E2 management. Did you have any experience with anastrozole?

Stay on hCG for now until we have PCT lined up.


#3

Well that's where I am struggling my doc got me on the test cypionate and I asked him to test my e2 twice and when I asked to do it again he said he couldn't. but my 1st e2 test was 54.8 pg/ml (10-42), which was before I started HCG. I Then ordered Anastrozole cuz started feeling the E2 build up and my 2nd Estradiol test was 85.2 pg/ml (10-42). then I continued to take the Anastrozole and just finished which is y I ordered aromasin but should I just keep with the Anastrozole?

My Last shot was .30 on 07/15 and I ordered few things will be starting in few days but still have no set plan and still think I need to order something else. now being that I was on test and hcg, would it be too much to get more hcg and do more like most protocols are or will it be too much and I need to take a break?


#4

Why is this so complicated.. I see ksman is not answering a basic question again.

I dropped off trt no clomid no Nolva sec nothing.. My system in back on board and working same as it was..

Do whatever you want but you haven't been on it that long.

I only shut down for a couple days but without your pre trt labs hard to know where you will land

If you want to use a serm use it... U don't need 15 different drugs?

Clomid has been used for fertility for many years. Even my doc uses it and he is clueless about trt


#5

Here are my first labs before being put on TRT, or paperwork says Testosterone Deficiency, but I was young and stupid and stayed on low doses on and off for few years and never did any Pct ever. And sorry I didn't put everything on same thread but here are the first labs:
Age-26
Height-5-5
Waist-32
Weight-155
Current medications- test.cyp200mg half ml every week.,Megamen sport,vitaminC,B12,Fish oil,

Seen doctor for symptoms of low testosterone
Lab Results 8:38 am

Chloride-104, mmol/L, (98-107)
CO2-32.3, mmol/L, (21.0-32.0)
Calcium Lvl-9.1,mg/dl, (8.5-10.1)
Glucose Lvl-67,mg/dl, (74-106)
BUN-15.0,mg/dl, (7.0-18.0)
Creatinine-1.20,mg/dl, (0.60-1.30)
eGFR-AA- >60,ml/min/1.73 m2
eGFR-NAA- >60,ml/min/1.73 m2
Bili Total- 0.9,mg/dl (0.2-1.0)
Bili Direct- 0.17,mg/dl (0.00,0.20)
Bili Indirect- 0.73,mg/dl (0.00,0.80)
AST- 19,unit/L (15-37)
ALT-39, unit/L (30-65)
Alk Phos-116, unit/L (50-136)
Total Protein-6.9, gm/dl (6.4-8.2)
Albumin Lvl-4.40, gm/dl (3.40-5.00)
Globulin-2.50, gm/dl (2.40-3.50)
A/G Ratio-1.8, ratio (1.1-2.0)
Total Test.-195.4 ng/dl (241.0-827.0)
Vit.D 25 OH-28.67 ng/ml (30.00-80.00)

After I received the test results he offered me testosterone but I had mentioned me and wife were thinking bout having another kid later on so he sent me to an endo. which took 2 months and he did more blood work at 10 am.

ACTH, Plasma-9.7,pg/ml, Flag 1, (7.2-63.3)
Cortisol-4.6, ug/dl, Flag 1, (2.3-19.4)
Cortisol AM (6.2-19.4)
Cortisol Pm (2.3-11.9)
IGF-1-252, ng/ml, Flag 1, (75-275)
LH-2.2, mIU/ml, Flag 1, (1.7-8.6)
T4,Free(Direct)-1.57, ng/dl, Flag 1, (0.82,1.77)
Testosterone,Serum-228, ng/dl Flag L, (348-1197)
Testosterone,Free-9.48, ng/dl, Flag 1, (5.00-21.00)
Free Testosterone-4.16, %, Flag 1, (1.50-4.20)
TSH-.56, uIU/mL, (0.34-4.82)

During those 2 months I took Tribulus trying to help sex drive without messing with my labs, he then prescribed me Chorionic Gonad 10,000unit for 1,000 units IM twice weekly. I took but after about the third shot I was hating it cuz of estrogen, so I stopped for a week until he prescribed tamoxifen 10mg tabs then finished. which he kept cancelling my appts. and i was always tired and had bad brain fog, well In meantime my wife got pregnate so i went back to doctor and I decided to just start my testosterone. I was given test. cypionate 200mg/ml which I would pin twice weekly,


#6

Well you seem to be on the low end of everything here..

I think you have more going on then low testosterone..

Cortisol should be taken at 8am and fasting. But regardless if I were you I might have a 4 point cortisol test done. Cortisol is highest In the morning so what happens when this drops? Do you have adrenal symptoms?

What are your symptoms all of them?

Wondering about RT3

I would also get a full thyroid panel..

prolactin should be checked along with E2 and shbg


#7

And by the way not sure if bad or good but I still have no set pct plan too well but I started taking on the 26th,

-Toremifene 60mg at 120 mg a night and tonight I was drop to 90 for week, then 60 and maybe another 30 if needed

-Clomid 50mg- On the (26th) I took 25mg, (27th) 50mg, (28th) 25mg, (31st) 25mg, and then decided to stop incase it was too much

-I then started Tamoxifen 40mg- on the 29th at 20mg, did that for 3days and ran out

-and also Exemestane 25mg- just took it on 29th at .22, then .40 on 31st, just not too sure about how to run that
SO I was going to finish 3 or 4 weeks on Toremifene and Tamoxifen, then after done maybe take 50mg of Clomid for 5 days, and when my BA water comes in tom I was thinking of mixing my trip 100mcg with the water but kind of nervous cuz it is a lot plus im already on day 7 and I don't know how to mix it would 1c mixed with the 100mcg trip be equivalent. I know its a lot of stuff but my wife is few years older and she wants to hurry and have another kid which im dumb when it comes to PCT. Please any advice, comments or whatever to kind of help out. By the way don't have any labs yet to prove but that Toremifene is awesome.


#8

sorry left that out too im new to this site but here are my posts:

KSman
Level 0

Join date: Aug 2006
Location:
Posts: 6887

Please read these stickies:
- advice for new guys
-- provide more data about you
- protocol for injections
-- hCG dose was way too high, stupid!
- thyroid basic
-- check your oral body temperatures, waking and mid afternoon

You might be a bit hyperthyroid. But signs are vague. Please describe your use of iodized salt over the years. Were you using a vitamin product for years that contained iodine? Does your throat seem thick where your thyroid gland is? Symmetric? Lumpy? Doc palpates your thyroid. Ever feel a discomfort there?

It would have been good to have AM cortisol done at 8AM. Describe stress levels and how you react to major stress events.

LH is low, but changes so much from hour to hour, it is sort of useless. Really need FSH as its longer serum half life is a much better indicator of what is going on. When contemplating why your gonadotrophins might be low, we need to look for things that will suppress your HPTA. So your labs should have included E2 and prolactin. Now that you are on TRT, that diagnostic window is closed.

We can infer from your TT and FT that your SHBG was lowish and E2 was then probably not causing your issues. That leaves prolactin. With young men, prolactin should be tested a possible cause. High prolactin can be a symptom of a pituitary adinoma. If prolactin is high or high-normal a MRI is used to determine if there is an adinoma. If found, easily managed with 0.5mg/week cabergoline/Dostinex.

Please read the stickies. It is a big learning curve. You can't be passive about these things as your doc have already mismanaged your case. Come back with questions. Please address all of the requests for more info in this post.

Me- yea my Prolactin Lvl-Arup-14.6, ng/mL, (2.1,17.7)
FSH-Arup-1.9, IU/L, (1.5-12.4)
LH-ARUP-4.8, IU/L, (1.7-8.6)
forgot these they were when I first got tested by doc., should I ask my doc to test for anything else or jus not sure why im still not feeling good, and I know my doc dont know too much either so id rather hear from you

KSman-
With that prolactin level, there is some concern.

You have secondary hypogonadism. See above.

Me-
Just recently seen doc again cuz I am on my 8th pin and still tired all the time and not feeling like I should. Currently on aderal,clonazepam,test cyp., and same vitamins. Well the first two pins were every two weeks until i called to see if i can take every week, i then pinned half a c of 200mg every 7 or 9 days. After four pins like that I had seen him and told him there was still fatigue, real moody, and low libido still. Facial hair thick,grows fast, and recently have more body fat in the stomach area, only thing it helped was my focus and motivation. Dont have healthy diet jus recently started workin out few days a week. have testes shrinkage now. he increased my dosage to 1.5 every 7 days of 200mg test cyp. and i asked to have a my estradiol tested which he agreed to that and another total test. I went right after to do the lab of estradiol and results were on 3/7

Estradiol by TMS-Arup-54.8-pg/ml- (10-42)

Took whole c that night-3/7 and on 3/9 did Am TT results-

TT-1636.0 H (241.0-827.0)

after getting the labs back i requested arimidex or anything for estrogen and he said my levels were fine.
he said my test levels were too high which i noticed.

So my question is how can my TT jump that high while only on 5 c and if its that high why am i not feeling good. I think it is estrogen too high but im jus guessing from everything i been reading ...Can someone please give opinions and answers cuz looks like ill have to get adex on my own if thats what it is.

and he also dropped me back down to 100mg every week cuz of high TT results...

Me-
I am 27 started TRT in Jan after my wife got pregnant, keep switching pin schedule couldn't feel good for anything, I been on (200mg) Test Cypionate 1c every 7 days which I do .50 twice weekly I then started HCG 250iu EOD in April, after few weeks got a gland on my chest so started liquid Letro on may 10, 5 drops a night for 4 days until it went away then got off, had hot flashes like crazy so took 2 drops of liquid anastrozole, couple times but stopped, then my wife had miscarriage which is why I went do sperm check test recently because we want to have just one more kid.

well I got the results and don't really know how to understand them but purchased some Liquid Letro 2.5mg/ml, Liquid Anastrozole 2mg/ml, liquid Clomiphene Citrate 50mg/ml, liquid Tamoxifen Citrate 40mg/ml, and still have 5,000iu's of HCG not mixed, which was ordered, I was planning on taking a break after my apt. Thurs and doing a PCT to get my sperm back. Here are the results:
Hematology

-Date collected 5/24/2013
Procedure Units Reference Range

-Sperm Count 16L - Million/ML - (20-150)
-Collection Time 200
-Time Analyzed Semen 245
-Temperature Semen 23.0 - DegC
-Color Semen Grey/Opalescent
-Viscosity Semen Abnormal a (Normal)
-pH Semen 8.0 (7.2-9.0)
-RBC Semen None (None)
-Bacteria Semen None (None)
-Volume Semen 2.0 - mL (2.0-10.0)
-Morph Semen see below-T1,I1
-Motile Sperm see below-T2,I2

Textual Results
T1: 5/24/2013 14:00 CDT (Morph Semen)
Morphology
_71% of normal spearm
_27% of head defects
_2% of neck/middlepie
_% of cytoplasmic droplets

T2: 5/24/2013 14:00 CDT (Motile Sperm)
Motility:
_14% A: Rapid progressive motility. Greater than half a tail length/sec (20 um/s).
_5% B: Slow or sluggish progressive motility.
_17% C: Nonprogressive motility. Less than 1/8 tail length (less than 5um/s)
_67% D: Immotile
Motility Normal Range: Grades A+B = 50% Grade A = 25%

Interpretive Data
I1: Morph Semen
Reference Range for Morphology: >15%
I2: Motile Sperm
A reported result of decreased sperm motility may be due to either non-viable or non-motile sperm.

Collected date 5/24/2013
Collected Time 14:00 CDT
Procedure Units Reference Range
-WBC Semen 0 [0-1000000]

Now I did the test on my own cuz doc doesn't know much at all, and to have a kid I'm seeing that I would have to get off for couple months or however long to get my sperm back. I was wondering if anyone had suggestions or advice on what to do, or how I should do a PCT, or procedure or anything would help. I also read that adding clomid would help on TRT too but don't know if true neither my doc and cant afford to see endo. again. anything would help thanks..

Really sorry not familiar with the site yet but I really appreciate you replying to me, THANKS ALOt


#9

I stopped the testosterone because I would always be tired and it just wasn't doing what a shot would do for me before all this. Im not familiar with adrenal symptoms, or RT3, and when I asked my doc for an Ai he said he don't do that and after the 2nd estradiol test, when I was due for my next tt test he wouldn't let me get tested for estradiol again, so basically I been doing so much research on my own because my doc is no help at all which is why im asking you guys someone who knows and has experience, Thanks


#10

Where are you from? Can you afford to spend a couple bucks and order your own labs? At least this way you can go to the doc and show him /her you have a problem. Also if you do end up needed alternative care you can show a naturopath your labs also.

Someone is missing something ill tell you that..

I don't see how this is secondary??? I mean it could be but i think thats still up in the air.. Ok fsh is a bit suppressed on this set of labs but lh is fine man... Lh is a lab for a reason and it is what produces T

I don't think any of this is easily explainable

You must feel like shit eh???


#11

Yea I am always tired and I'm from louisiana


#12

You can order labs from lef.org..

You can get an AI from reseated chemicals online..

No one ca. List sources here just google it

Hcg would be a good idea if you want to keep your balls working the doses are I. The protocol for Injections sticky

If you use a serm like Nolva go at it slow at first say Hal the recommended dose and the order lh fsh and E2 keeping lh and fsh from goi g to high will reduce lh desensitization. Taper off the serm when you are ready and land on the aromatase inhibitor the. Just ween yourself off that and you are done.

Never use hcg and a serm together.

I have heard PKNY saying test prop worked for him and swears by it.

Have you ever tested shbg??


#13

What labs should I order the LH and FSH, and Estradiol?


#14

Read the lab testing sticky. And read down a posts also.. No you need alot more then that