T Nation

New To TRT Klinefelter's Male 30 Y/O

I was diagnoses with KS at 19. I did TRT with patches until 23, ate like shit, and hardly worked out. In the past year I have worked out 5-7 days a week, ran 3 half marathons, dropped 20lbs, and ate mostly paleo (~90% of the time). All this was an attempt to increase my natural T levels to see if it would help my testicles produce more sperm naturally( I produce zero sperm now). It the past 2 months I have had recent blood work done:
Estradiol: <15
FSH: 45.1

The doctor things that because of the size of my testes, it would not be good to try and retrieve sperm. So I decided to back on T to increase muscle mass, decrease fat, and feel better overall. I did under arm application Axiom. This gave me a rash. So my doctor said try IM Test Cyp. I am just looking for advice for a first time IM user and anyone who has KS and is successful with TRT.

I started injections last week. The protocol is 1xweek 1cc IM in thigh, shoulder, or butt. We will do this for 6 weeks and then retest blood.

My workouts are p90x3 or p90x2 m,w,f with a runs on t,th,sat,sun. Below is a most recent photo of chest and back.

Height- 6’1"
Light hair, Can’t grow beard or mustache beyond a neard
I carry my fat around my midsection/love handles
Only RX is Test Cyp, OTC Fish Oil 2000g, Opticrine Herbal Supplement http://www.alternativeworldwidehealth.com/ecommerce/apex-energetics-opticrine-k03.html and a multi vitamin
Small teste size, but my libido has been ok. Since going back on Test with the Axiom starting early dec, my libido has gone through the roof, which has been nice for my wife and I.
Never had a nocturnal emission.

Any help or guidance would be appreciated, especially KS men out there. :smiley:

I’ve just had a karyotype run due to suspected Klinefelter’s, but it came back negative. So I’m curious to see how this progresses.

Good luck.

Thank you. I just did my second injection tonight in my left shoulder. Stings like a son of a bitch. But better than the first one. I used a 18 gage to draw and a 23 gage to inject. Dosage is 200mg/ml. Injected 1 ml.

You have a shit load of reading to do, because you will need to know more than your doctors.

In the 2nd post of the first topic in this forum, follow these links:

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

To preserver your testes and perhaps fertility, you need to inject hCG.
TRT will shut down your testes.

Why was LH not tested?

FSH is very high. But perhaps you have different lab units and ranges.

You need these labs:
LH/FSH can not be done now that you started T
CBC w hematocrit
fasting cholesterol [might be too low]

How do you feel? Alert and vital or ?


My fertility doc is Karen Boyle, MD. She has been very helpful on this journey. I am in the Baltimore Area and am open to finding a new TRT doc if Dr. Boyle is not open to changing my protocol.

Because of Klinefelter’s my testes are already shut down. I am not fertile. My testes are incredibly small already. Do you think I still need hCG? Do I still need 1.0mg Arimidex/anastrozole per week in divided doses.

I will get new labs and read the stickies. I’ve gone through the protocol for injections, but had further questions because of my Klinefelter’s diagnosis. See above paragraph. I’ve gone through the advice for new guys as well. I will read “things that damage your hormones” next.

Prior to TRT starting in Dec I felt decent. I would have mood swings with bouts of depression and anxiety once a quarter. My libido has always been good. I felt better in the last year with a more dedicated exercise program and a better diet. After starting the under arm TRT, I saw an increase in outlook, mood, concentration, and libido. After getting the rash, and stopping cold turkey on the TRT, I was depressed and had decreased concetration at work. Since my injection last week, I feel better and getting back to better outlook, mood, concentration, and libido.

Thanks for reaching out.

Edit: I had labs done in 10/16/2014:
LH, Serum 23.4 miU/ML
FSH: 43.1 miU/ML
FT: 51.2 pg/mL
TT: 217 ng/dL
E2: 17 pg/mL

I have requested lab work from my doc to test what you have mentioned above in 4 weeks. I will keep this post udpated.

10/16/2014 was before TRT
With TRT, LH/FSH should go towards zero.
Your LH/FSH indicated testicular failure.
You do not need hCG.
You do need anastrozole to manage E2 is it is elevated. Most do best around E2=22pg/ml.

You need these labs:
CBC w hematocrit
fasting cholesterol [might be too low]

How do you feel? Alert and vital or ?

There is not need to inject with large needles.
Use #29 0.5ml 1/2" insulin needles.
See those stickies!

I am not new to TRT, however i was also diagnosed with kleinfelters syndrome at age 19 when I did the medical evaluation prior to joining the airforce. After various testing including karyotype , it was suggested for me not to start trt right away and instead consult with a genetic counseler. This of course was in England, where things are handled a little differently then here in the USA. Fast forward to the present i am currently taking 150 mg testosterone cypianate weekly injections with check-ups every 6 months. My current situation involves whether or not to keep paying the $345 per month plus prescription costs and primary care doctor visits, and seldom endocrinologist visits. Speaking of specialists, my last really did nothing for me psychologically and really was quite blunt and mis informed as to my condition and how i was feeling at the time despite my levels being in the ‘normal range’. I was told by a reputable source to always aim for the top 75% of the range as people with KS have fewer if very little testosterone receptors and therefore can not provide an accurate/level. Not sure of the validity of that statement, maybe someone can acknowledge that please.

Whilst i was filling out a new application for cheaper insurance that supports trt, i did some research on clinics in the area and found one called Royal Men’s Medical Center, located in Joliet Illinois . Anyone have experience with this clinic or possibly ones like it. Their program is significantly cheaper @ $200 a month with an initial $125 screening test and all medications/follow ups/treatment included. Not sure if i need hCg and Anastrozole , never been prescribed those under trt with a doctor.
Im relatively healthy other than having KS. Cut down on drinking and tobacco usage, tho i now use and electronic cigarette or vape pen as an alternative.

I agree that you should be your own doctor as i have encountered many who really dont know a thing about primary hypogonadism or its effects on how you feel regardless of your t levels. All comments would be thoroughly appreciated.

My most recent test results are as follows: (06/05/2015)

total testosterone 339
psa 0.51
LH 0.9
FSH 1.6
RDW 13.1%

Thats everything that was highlighted on the lab results. If i find any other more recent results, i will post.


In the 2nd post of the first topic in this forum, follow these links:

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Start your own thread so your case is not mixed with this one.

The classic AR [androgen receptor] problem that you may be thinking about leads to very undeveloped male sex organs. But is there an androgen resistance with KS where one needs more T. Perhaps this is not universal and cannot be generalized. I would not expect to find much in the way of clinical advice on what works.

Search for “dose” here:http://care.diabetesjournals.org/content/29/7/1591.full

See what else you can find here: https://www.google.com/search?q=kleinfelters&ie=utf-8&oe=utf-8#q=klinefelter+ar++receptor+"testosterone+dose"

or https://www.google.com/search?q=kleinfelters&ie=utf-8&oe=utf-8#q=klinefelter+ar+receptor+testosterone+dose+therapy

I got blood work done late last week. This was taken before my dose on Thursday morning. I usually dose Wednesday night and Saturday night, but withheld until Thursday morning so I could get early blood work done. I take 1mL biweekly in my butt cheek. I use a 23 gage to inject and use a cold spray before hand. I don’t feel the prick and it doesn’t hurt at all.

So I’ve been on TRT for almost 10 weeks. I feel absolutely great! My libido is way up. My wife and I are having sex 5-8 times per week which has been nice. I’m building lean muscle mass way faster than I did in the past. I’m maintaining a weight around 172-174. I’ve started training using Kinobody. Intermittent fasting has been doing wonders for my productivity and muscle gain. I am much more confident and feel much more like a real man in the last 2 months.

Here are my latest lab numbers:

TT 1726.46
FT 427.6
E2 67.6
CBC w hematocrit
WBC 9.4
RBC 5.32
Hemoglobin 15.6
Hematorcrit 47.0
MCV 88.3
MCH 29.3
MCHC 33.2
RDW 13.5
Platelt count 271
Fasting Cholesterol 172
TSH 1.589

I have not been taking Anastrozole. I am starting that today with 1.0mg 3x a week divided.

I think test is a bit high, so my doc wants me to lower that. I will probably taper with .8mL bi weekly.

What your thoughts guys?

Have you studied those stickies?

1ml of what?
please report doses in mg or iu of active ingredient, not volume of unknown concentration.
Always post lab ranges, you can edit the post above.

Have you been using iodized salt?

Hi there, I’m a 50 yr old male with ks. It is nice to see,someone with ks who was Slim priror to trt with little muscle mass and then see great results after. I am no where close to your level of fitness. I’m 5’9 280 pounds. I wasn’t diagnosed until 45 and it’s been a roller coaster since. My test levels were 89 when I started trt a few years back, went to 500 or so then back to 300 range…doc increase my daily gel dose from 1% packet to two pacakets daily. I have always struggled with weight…I notice you don’t hv the classic is shape of wider hips, but I feel like I need to build muscle mass and seeing your before and after pics is encouraging that when I finally go back to the gym…,.,building some mass is possible… updated photos as you go would be great. Ty. Tom


Can you please provide an update for your treatment plan?

I have the same condition and was on a similar dose but .6 ml (1000mg/5 mL, 200 mg/ml) which put T at 1090 before next injection and E2 at 18. The dose caused my hair to thin drastically in seven months and caused cystic acne on shoulders, did you experience the same?

Do you have any regrets with going on TRT knowing that you can no longer use HCG to kickstart natural production after a dose that high?

Why did you decide on TRT and and not go with micro TESE route? People with klinefelters with testosterone > 250 T have success with sperm extraction with testicles > 2 ml. If your T was 300 your testicle size was at least 7 ml.

Did you produce sperm before TRT? I’m confused, did the patches ruin your sperm production?