T Nation

Mid 20s - Trying to Explain my Symptoms

Okay guys… starting TRT

Lab results taking small dose of clomiphene every couple days (like a 4th tablet)

Hey guys would greatly appreciate feedback. As you can see, this thread is 2 years old.

With all the information given, what protocol should I go on?

Start 100mg weekly and adjust accordingly, ready for AI if E2 levels go up?

And fertility, 28 years old, will fertility go back?

If I take HCG or Clomid, will fertility stay?

Also, if I want fertility and I’m on T, what is the protocol for getting fertility back after off T

How about Clomid + T? Good? Bad?

Thank you

@physioLojik

TRT, HCG and FSH injections can improve fertility. Given your SHBG level, a twice weekly protocol would probably server you better and keep levels steadier and troughs higher. This would also serve to lower estrogen versus once weekly injections.

Micro dosing clomid with TRT has worked for some, I just hate recommending drugs versus hormones.

You could use hCG, 250IU 3x/wk to maintain fertility. Testosterone at 100mg will likely not be enough, but you could start with it and see as hCG will help. Also, once weekly dosing will likely be fine, especially with hCG included, though twice weekly won’t hurt you.

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Doctor originally wanted to do 50 mg per week but I convinced him to do 100 / week.

Got my scrip (even though insurance doesn’t cover it, however my doctor will attempt to authorize it)…

Based on replies here, I went with 50 mg injection. Will reinject Friday (today was Tuesday).

I’m thinking I should probably be on 150 or 200 mg weekly considering I am 6’5” 270 pounds. Yes/no?

Hit the gym today. Have a feeling in me opposed to before… see how it goes. Hoping I build muscle. Lose abdomen weight.

And have stamina through the whole game as opposed to being tired after dominating the first possession in basketball :basketball:

Yes, but considering your levels, not your size. Nothing wrong with starting at 100mg a week though. If you are happy with the results, you can stay with it. My opinion is that you’ll be happier with 150-200.

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Dosing has nothing to do with height or weight. I’m 6ft. 240 lbs and on 96mg weekly split up EOD, Free T levels are at the top of the ranges.

Two 50mg injections is best, if estrogen sides are experience you could the split up your injections EOD, injecting smaller doses more frequently lowers estrogen quite nicely.

Your doctor if he cares about your health should want your Free T levels in the optimal ranges between 20-26 p/mL per Labcorp.

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Honestly stop wasting your time. You need a doc who is not scared to dose a young man. At your age you would be in the 20s of free t. They are dosing you like a 50yr old Man.

I am 40 and both my docs started me at 200mg and one added HCG 1k iu per week. Your much younger and taking half what I was given.

More is better for young men imo. I would think that a young mans body will absorb more testosterone easier and probably with less sides. Go with 150-200 test and HCG.

Until then go with more. Otherwise low free t levels will occur and you will spend another year suffering.Unless ofcourse the 100 and the HCG can bring your levels into high normal free t ranges.

Okay so I just want to clarify, what are the optimal free T levels and what am I at now?

Your Free T is at the bottom end of the ranges, you need them at the top or preferably a little higher. According to my age ranges are 6.8-21.5 pg/mL, my doctor says the optimal range is 20-26 pg/mL, these are the ranges where he’s seeing his patient blood work do the best in all biomarkers and where they feel their best.

A doctor that chases labs ranges will have little to no critical thinking, instead doing what he was trained to do ~ a robot who will follow commands without question. I prefer a doctor that uses his own brain to determine what’s best for the patient based off all his other biomarkers.

We have some members with above range testosterone and hematocrit on the lower end, these guys can handle more testosterone than the average man, everyone should be treated differently because we are all biochemical unique.

Other than increasing dosage of T, is there things to do that can increase free T?

If my free T doesn’t come back as optimal, I’m going to be ready to strike.

You are at 337ng/dL total testosterone and 59.8 pg/mL free testosterone right now. DHEA-S is 234mcg/dL.

Obviously, you want to be at a level at which you will feel your best. If I am you, I looking at getting total test to 800-1000 and free test to every bit of 150, and I would be fine with it as high as 200 if total test is between 800-1000. Also, DHEA at least 450. The overriding focus would be on free testosterone and that is why I think you’ll need at least 150mg/week. Generally, a guy will feel better with free test at 200 than at 100. That’s generally, there are, of course, other moving parts to consider.

Good luck, try to be patient, persistence will pay off down the road as you determine what approach is best for you.

Increasing Total T will increase Free T and is dependent on SHBG levels. My SHBG is low so I only need a Total T of 500 or more to have Free T in the optimal ranges.

Most doctors consider a TRT protocol as success when levels are within ranges and care not about whether you are optimal, welcome to sick care. People looking to optimize health look to anti-aging or sports medicine.

3 shots in. last shot was pretty painful. Thinking I shower before every shot from now on.

So I definitely feel better. However, I find myself going in and out of tiredness, weird moods. I feel like this is my dosing.

My doctor initially reccomended 50 mg per week which I hear sucks (considering my levels) so I got him to do 100 mg per week. However, after this, I found that I should probably do 200 mg per week and split it up every couple days. Perhaps 50 every 2 days.

So I am currently doing 50 every 3.5 days (well actually I’m doing 50 every 3 days.) I did Tuesday PM, Friday PM, Monday PM. In a couple of weeks I’m getting a lab test and I’m going to my doctor and I’m going to tell him I’d like to do 200mg per week split up every 2 days.

Okay so now some positive aspects: things are generally easier to do. Like reaching down to pick stuff up. Getting up from bed or chairs. Before it was a pain, now its just like-- woosh. And I definitely feel the need to eat better. I’m now into steak rice and vegetables (not that I wasn’t before but now I value it.) And thats about all besides feeling more square and built with my upper body.

In all though, I’m going to ask to ask my endocrine to increase my dose and if he doesn’t will probably go with Defy.

Edit: Speaking of asking to increase my dose, there was push back when I asked to be moved from 50 mg to 100 mg per week on initial prescription (although, I eventually got 100 mg). Any recommendation on how to get the doctor to increase the dose?

The more I read on here, the more I see that Free T (which mine is at 60) is a big deal. And I want to get mine into Defy ranges (200+).

Testosterone is a controlled substance, you don’t just go into a doctor’s office ask for the keys to the kingdom, 200mg weekly split up every two days is a lot of testosterone unless you are a hyperecreter.

You need less testosterone when injecting more frequently.

He is not going go let you get to “Defy ranges” and if you accidentally do he will cut your script. Insurance Drs do not want you optimal, they want you in the middle so they can say you are not low out of range anymore and they are not taking unnecessary risks getting your levels too high. They don’t want to attract the wrong kind of attention giving out large doses of test and they don’t want to put them selves in the posistion to be sued when someone has an unrelated heart attack or blood clot or commits a violent crime and tries blaming Test and the Dr.

Testosterone is a controlled substance, you don’t just go into a doctor’s office ask for the keys to the kingdom, 200mg weekly split up every two days is a lot of testosterone unless you are a hyperecreter.

I was told by multiple people (@enackers @highpull) that I should do 200 mg per week, considering levels.

So you’re saying I should do less?

Have you got labs yet doing 100 a week? I didnt see any so apologize if I missed it but there is no reason to ask for an increase until you know where your at. Yeah a lot get started at 200 a week but there is nothing that says you actually need that much. 50 mg definitley sounds too little but 100 doesn’t sound to far off what could work. Convince your doctor after labs and on how your feeling not on what others say you should be started at.

Most guys will feel better on 200mg than 100mg. I know if my Dr asked if I wanted the extra 60mg a week to get me to 200 i would obviously take it. If I told my Dr i want the extra 60mg with no blood tests to back me up she would obviously say no

okay sounds like no reason to ask for 200 mg without a blood test. I am planning on getting tests in a week or so (2+ weeks on TRT). Do those have any merit? Anything to look for?

I understand 6 weeks is the time marker but I don’t want to go 6 weeks on 100 mg for no reason. If there’s something to catch now, I would like to. I’d rather do 6 weeks on 200 mg and adjust down if necessary. Probably something I should have told my doctor.

What I’m asking is, is there something in the 2 week blood test that I can say, “hey this isn’t working because of X. Let’s do 200 mg / week and start the 6 week process there”