T Nation

Need Help Interpreting Bloodwork

29 yrs old, 230lbs. Used AAS for 6 years total with last 2 B&C. Almost 11 months since being off and had blood work done. Just wondering what they meant. What should I do? Libido is shot with no sex drive…feel dead! The wife and I are trying but wondering if LH and FSH are low?

Based on your bloodwork, symptoms and prior AAS use, you will need to start TRT.

Would try T Cypionate 100mg split 2x/week for 8 weeks, then get the same bloodwork again to gain a TRT baseline.

After this point you will likely feel better as this protocol will increase your freely available testosterone. Then, we can make a more accurate assessment of where you need to be to feel symptom-relief if you didn’t already get it at the baseline protocol.

From that do you think my testicles are shut down? My testicles dont seem to be atrophied, feel bigger and seem to be “free dangling” rather than sucked up when I was on AAS. Would HCG help at this point?

A lot of others here had similar experiences where AAS largely shut their body’s natural production of testosterone.

HCG is primarily used by men to restore fertility - it can help, but usually not by itself and many people also note not feeling that good while on it compared to simply sticking with testosterone.

In general I wouldn’t think of HCG until you at least get a descent baseline with just testosterone.

Would going on TRT totally shut me down or could I use HCG while on TRT so that there is still sperm production?

As in your other thread

TRT can be done in combo with hCG (and FSH) to induce or keep fertility

Depending on whether you hope to return on natural T production (rather unlikely) down the line only do hCG. In case you are fine with life long TRT do T and hCG.

If your primary interest is to become fertile as quick as possible you will need to start with the hCG (plus pot FSH) now. Will take a good couple of months anyway.

If your primary interest is to improve symptoms of low T, start TRT first and then add hCG (plus pot FSH) down the road (will most likely make you azoospermic innthe first place and thereby shift recovery of fertility time wise)

I was hoping to return to natural T production hence why I thought HCG only may be a good choice?

HCG will supress the HPTA but keep the testiles producing T, so you will be producing T within the testicles but is far removed from being natural.

What hCG can do for you is to reverse (partially) the atrophied leydig cells in your testicles.
I am skeptical however that you will achieve good natural T levels after lets say 6 to 12 months of hCG potentially followed by a SERM like tamoxifen to restart your HPTA.
Honestly I think you will be stuck with these low levels. But its worth a try. Thats your call.

What I would do
Do hCG only or in combo with FSH (but no T) for 6 to 12 months, primarely to become fertile again. Then once your wife is pregnant drop the hCG (and FSH) and start the SERM for about a month. Stop all and then see where you are T wise naturally.

I would stay away from TRT for now because of a simple reason. If you add T now than you would use a lower dose of hCG to not run into side effects of very high T such as high hematocrit (the T from the hCG and the T from TRT stack up). And a lower dose of hCG might prolong recovery or might not be as effective.

As I recall FSH injections are rather expensive. I might give the hcg mono therapy a shot for 6-9 months and only add the FSH if a fetility test shows they’re just not getting there. Unless there’s time pressure, kids are expensive enough.

Makes sense, I’ll give hCG therapy a go. Will hCG help with the crippling libido? Feel like a 90yr old man

If looking to have baby now I would just use clomid. Get her pregnant than consider trt.

https://www.ncbi.nlm.nih.gov/m/pubmed/30779195/

I’ve never used it myself. I’ve heard guys comment both ways, hard to interpret the reason it may have worked for some and not others.

You may just need to get your test levels up to decent place. Whether hcg can do that on its own you’ll just have to try and see.

Response is somewhat dose dependant, no clue what an appropriate dose would be, I’d take a guess at 1500 units a week in 3 doses as a starting point, just a guess though.

Yes clomid or also continuing the tamoxifen is also an option. But as his T is really quite low at the moment I guess he would need a relatively high dose to achieve reasonable T levels and sperm concentrations. And this could be associated with negative symptoms typical for clomid.

@bear87 How did you do on the tamoxifen? And did you ever measure T whilst on it?

I did a PCT of 60/60/40/40/40/20/20/20. Saw the endocrinologist and was prescribed tamoxifen again 20mg ed. Had blood work done in November and test levels were about the same and LH and FSH were a little lower.

I tried clomid 25mg EOD. I was 350 went to 600 total. Free t mid range. Big cum loads.

Didn’t stay on cause of sides you develop.
But for short term to get miss pregnant may be good deal. Never tried novaldex and I missed op is already on that.

I may perhaps ask about how Tamoxifen and HCG would be together. Semen Anaylsis next Friday. Crossing my fingers that I’m not sterile.

Thats what I thought. You are not really responding well to SERMs.

My second kid was also conceived whilst on clomid 12.5 mg eod. Worked wonderful for me but @steven90 isnt obviously responding the same way unfortunately.

No, have completely different modes of action and doesnt make sense to combine.

Good luck for the sperm test, fingers crossed for you!

This might be TMI but I’m going to ask anyways. Had you been on TRT prior to needing Clomid for conception or was it needed at your “baseline” pre TRT?

If you were fertile pre-TRT, you will be fertile with the use of HCG. Just use HCG when you want kids. You don’t need HCG while on TRT for just symptom-relief.