T Nation

Lab Results, Hypogonadism or Not?

Can someone please help me understand if I have hypogonaism or not? I have visited 2 docs and both are giving different opinions! Attached lab work:-68ioagexyi531

Your pituitary levels are low. Your low testosterone could be due to pituitary dysfunction rather than testicular. If you tried hCG, and that did not increase testosterone, you could make the diagnosis of hypogonadism.

I haven’t tried anything yet. Since I’m still young, my major concern is to maintain fertility and avoid injections.There is ton of information on the internet- Clomid,estrogen blockers,TRT, HCG to name a few.What should be the best approach to proceed? Meanwhile,I have done a MRI for my pituitary and waiting for the results.
Also what do you think about the E2 levels?
PS-If I start with HCG doesn’t it mean I have to stick with it forever.Also,it isn’t available in form of gel/cream?

Labs are only part of the equation, symptoms which are ignored by a lot of doctors that lack good judgement and critical thought will latch onto only the labs to determine normal status. Your testosterone to estrogen ratios will be off the mark on TRT, you should consider very frequent injections or topical creams, otherwise erections and libido will be problematic.

As of now you are estrogen dominant, testosterone very low and estrogen on the high end of the range. You not only fit the bill for a testosterone deficiency, but hormones are out of balance for a man and is shifted closer to a female, low T and high E2.

HCG will only work for so long, eventually you’ll need TRT, either one of these treatments is needed for life unless you want to stop and return to the hormone profile of a female. You may already be on your way to infertility if not already with FSH <0.5.

Most doctors fail miserably at male hormones because it’s excluded from medical school, it’s obvious your HPTA is shifted towards estrogen dominance. It’s thought to be chemical/environmental causing endocrine disruption, it’s why we have multiple sexes where 70 years ago the world only had male/female.

Thanks for your reply! I know its not a forum for medical advice, but in your opinion what would be the approach to start?

  1. To start - if I partially inhibit estrogen( the female harmn ), can it help bring back T to normal levels? What medicines exist to achieve this? I would like to ask my doctor if you suggest something.
    Or you suggest hcg/trt directly or something else? Would would be the dosage in this case?
  2. does hcg also exist in form of topical gels like T ?

Many thanks for your time!

HCG is injectable only.

You don’t have enough testosterone to start with, so inhibiting estrogen would net you nothing and actually cause harm, estrogen is needed for bone and joint health. What you need is more testosterone which is low.

The only two options are TRT and HCG, I would recommended for your best chances at feeling good and getting hormone into balance is 10-14mg cypionate or enanthate daily dosing, this will greatly shift your hormone profile closer towards higher testosterone in relation to estrogen.

These very small daily doses minimize T->E2 conversion and keep testosterone stable and elevated while keeping estrogen lower. The larger injections will shift estrogen higher while also keeping testosterone high ruining the balance of high T and lower E2 that men are known for.

HCG is only injectable into fat tissue, an example in love handles. Oral HCG is ineffective and any doctor recommend it would indicate doctor is a little behind. Tropical gels on average aren’t very effective, often just enough to shut you down leaving you with less testosterone than pre-TRT.

You would be using 27-29 gauge insulin syringes which are painless for either TRT or HCG. T-creams applied to the scrotum are 8 times more effective than T gels applied to the skin.

Good approach.

Given your testosterone levels, your E2 is high.

No, in fact, it is not a long term answer. But, if it important to know if you have hypogonadism or if it is your pituitary, hCG will tell you. However, it is likely a moot point because you’ll need TRT either way, unless it is the pituitary and it cn be treated.