T Nation

How Long Should I Wait?


#1

I am new to trt and have never done steroids. I am 36 years old. I had 3 blood test taken to confirm my low t before I started trt. I also have low fsh and borderline low lh. I am seeing a urologist while waiting to see an endo. I had 2 mri's done. One was for only pituitary and one was entire head. Nothing showed up on the mri .I have been reading hours upon hours about testosterone and steroids. I started androgel 5 weeks ago. I switched to test cyp 3 weeks ago.

I take 50mg twice weekly. I want to know from others from either first hand or just general knowledge when i could take something extra. I am interested in adding anavar and extra T. I have been in the gym for 8 months straight. I was out of the gym for 2 years. I have worked out since I was 16 other than the couple years I stopped.

I hope I can get some good feedback. Only thing I have found so far is wait until I am 'dialed' in. Not sure how long that takes or what it means exactly. I feel 10x better and know my symptoms are being addressed very well since i started the trt in general and even more since i started injections.
age
-height 5'' 6"
-waist 32
-weight 165

-describe body and facial hair
I have very little body hair. I have very little facial hair. It grows under my neck on on my sides of my chin only.

-describe where you carry fat and how changed
I carry fat in a typical manner. Love handles stomach and chest. It didnt change it just increased.

-health conditions, symptoms [history]
I have no other health conditions I am aware of.

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
I take no rx otc or recreational drugs. I have no hair loss and have never taken prostate drugs.

-lab results with ranges
I posted the lab results in a later post

-describe diet
I eat 2500 calories a day 30% carbs %30 fat %40 protein.
I eat at restaurant once a week and on that day I eat far more.

-describe training
I am a carpenter. I get lots of physical work at work.
I do 10 minutes of eliptical 3 times a week before lifting weights
I train Tuesday Thursday and Sunday
I do chest back one day
Arms shoudler and legs one day
I do full body circuit training one day

-testes ache, ever, with a fever?
Testes never aches with or without a fever before trt and after. Nothing changed.

-how have morning wood and nocturnal erections changed

Morning was nonexistant for 3 months before I started injections. It was hit or missed for many months before that.

Now they are reliable and healthy.


#2

for your pitutary mri did they use contrast and dynamic slicing? without contrast your pitutary will barely show up on the mri let alone show anykind of problems with it.


#3

Please follow these links found here: https://forums.t-nation.com/t/about-the-t-replacement-category/38/2?u=ksman
- advice for new guys
- things that damage your hormones
- protocol for injections <<<<<<<<<<<<<<<
- finding a TRT doc

Please post your labs with ranges.

Labs:
TT
FT
E2
LH/FSH - must be pre-TRT
prolactin
CBC
hematocrit
AST/ALT
fasting cholesterol [can be too low]
fasting glucose
AM cortisol [at 8 AM please]


#4

For the pituitary they did not use contrast that i was aware of. I asked about the mri and i was told one was the entire brain and one was of the pituitary only. They needed the one of the pituitary because its too small to see on the other type of mri. Thats all i know about that. I can follow up with the endo when I see them in 6 months. Thanks


#5

Test results
TT 7.5 range is 8.4 - 28.8nmol
FT 183 range is 196 - 636 pmol/l
E2(estradiol) <70 range is <150 pmol/l
LH/FSH - LH 2 range is 2-6 iu/l
FSH 1 range is 2-8iu/l
prolactin 9 range is 2-18 ug/l
CBC
hematocrit i have hemocrit test ??? 157 range is 135 - 170 g/l
AST/ALT
fasting cholesterol [can be too low]
fasting glucose
AM cortisol [at 8 AM please] 548 range is 170 - 720 nmol/l

I haven't had a blood test since I've started TRT. Endo is supposed to deal with the secondary aspect regarding the pituitary not producing lh and fsh. Eventually. I live in Canada. The wait time is 6 months to a year to see an endo. Some place even longer.


#7

Ksman... I posted my blood work as you re requested. Am I missing something? I cleared up the last post and first post to correct the format.


#8

I will ask the endocrinologist about the pituitary mri. Thanks for the heads up. I dont want to bother following up with the family doctor since I have been referred to a specialist. Endo should be better with the pituitary stuff .


#9

Because of your LH / FSH you appear to be secondary hypogonadism.

SERMs can be an option for you, one that I would favor over direct T replacement.


#10

My understanding is that serms are for controlling estrogen and then as a side effect it will boost testosterone. My estrogen is also low. I am under the impression that hcg helps those like myself who are secondary but it is not effective enough to eliminate t replacement.


#11

SERMs are estrogen blockers, and the result of that is to bring your pituitary back on line, which then stimulates T production.

Are you sure that your E2 is low? I think the test you received was not precise enough to measure E2 at the granularity that you might need.

One thing to also keep in mind is that T converts to E2. More T, more E2. I wouldn't avoid a SERM because your are concerned it's going to knock out your E2.


#12

I'm not avoiding them by any means. I don't have access to SERMs.


#13

Your doctor objects to SERMs?


#14

My doctor does not object to SERMs. I am on a waiting list to see a specialist. I see a urologist at the moment. He is not aware of an approved SERM method for low testosterone so he wont prescribe them. I haven't heard of anyone in Canada doing the SERM monotherapy. I only find info put from forums like this and a couple other medical sites. I am interested in possibly replacing my test cyp with a SERM. I want the best healthiest scenario.

Do you have hands on experience with SERMs only treatment??? Do you recommend any specific protocol or have any links to any more info about specific doses and RX??

I would rather make my own T if possible... Side question is it any better to take a SERM over a testosterone? Neither one is natural.


#15

Depends. I think I'm having pretty good success on SERM. It also preserves your testicles which is nice. Recomended dose tends to be 25mg clomid (different for nolvadex) I am on 12.5mg.

There is no SERM that is marketed for use in secondary hypogonadism, all SERMs are used "off-label" for that purpose.

Personally, I find clomid to be more convenient (pill vs injection).

You may have to find a doctor that is familiar with these issues, it's a big leap for a Dr who isn't experienced in this to start prescribing female fertility (clomid) drugs and female breast cancer drugs (arimidex) to a guy.


#16

Are you anticipating taking this for life or maybe possibly it will 'kickstart' your system?? Are you aware of any studies on long term Clomid use for men?? Have you gotten any blood tests yet?? Thanks for the insight BTW I appreciate it.


#17

I doubt that my system will "turn back on" because it has never really been on. My thread will give you all the gory details, but I'm pretty sure I have been at the lowest end of the T range my whole life. If I were to go off it, I'd try and push my T levels higher (more clomid) than they are at present (575) so that if they reset lower, I'd be ok.

I haven't looked at any long-term studies. I don't know if they exist. I am trying to keep my dose low to preserve the effect for as long as I can. Anecdotally, the forums have reports of men for whom clomid did work, but fails to work over time. However, I am starting to suspect that these failures are due to a lack of management of E2 levels.

It would be major if I quit and my levels stay high, but I just don't see that happening, especially at my age.


#18

Have you read the topics that I suggested?

You are secondary and prolactin and E2 do not seem to be a factor.


#19

I read them yes. I've been a bit obsessed with the topic these days. I understand prolactin is secreted in higher amounts when a pituitary tumor is present. They are very rarely cancerous. I know I am secondary. I feel my E2 levels correspond with my low T levels. I feel like I have been low for quit some time but had enough to be "OK" and then over the years it finally got too low and it affected to too much. I think I am a simple fix of increase test and I'll be OK. I don't know what else my pituitary isn't doing properly. I am interested in finding out more on that topic.