T Nation

Started TRT: Testogel 50mg for 2 months. Fertility Question


#1

Male 42 years. Recently prescribed TRT ( Testogel 50 mg) for 2 months. Prescribed due to me feeling a bit sluggish-tired-low sexdrive. Doctor didnt say much more than " come back in 2 months and tell how you are feeling".

Will this 2 months trial make me sterile? If so is it only temporarily?

What bloodwork should I get? When should I have it done ? 2 weeks-4 w,8 w ?

Thanks for any advice.


#2

Maybe and it is only temporary. HCG prevents that. Your blood work while already on Testogel 50 mg will tell you what Testogel is doing. but otherwise it’s now useless for telling you what your issues with testosterone are. It should have been done first. then again after you are on T about 4 weeks.

I’m pretty sure you need a new doctor, your protocol sucks. Read all of this you will understand


#3

Thanks for your reply Verne. I had some bloodwork done prior to the prescribiton.

First I had a test done in 2014. At this time I didnt have any symptoms.

2014

Testosteron 12 nmol ( Range 8 -35 )
SBHG 19 ( Range 8-60)
Free Testo Index 6.5

2017 bloodwork before I recently started TRT. (Do note that I in this period of bloodworks used Oxycontin painkillers occasionally.)

14.02.2017

S-Testos 14 ( Range 8 -35 )
S- SHBG 40 ( Range 8 -35 )
Free Testo Index 3,5

24.02.2017

S-Testos 8,4 ( Range 8 -35 )
S-SHBG 34 ( Range 8-60 )
Free Testo Index 2,4

S-Østradiol 0,09 ( < 0,18 nmol/L)
S-Prolaktin 79 ( <700 mU/L)
S-LH 1.9
S-FSH 1.9
PSA 0.6
S-Albumin 47

10.03.17

S-Testos 11,6 (Range 8 -35 )
S-SHBG 31 ( Range 8-60 )
Free Testo Index 3.8
S-Østradiol 0,13 ( < 0,18 nmol/L)
S-Prolaktin 79 ( <700 mU/L)
S-LH 4,6
S-FSH 2.7
PSA 0.7
S-Albumin 47


#4

I know little of Testogel and 50 mg a day sounds like a lot. But I know that gels do not adsorb as efficiently as injections. But I am sure that is more than enough to shut down your testicles unless you are given something to counteract that effect such as HCG. In other words you will be sterile while on it. It is not a permanent condition and can be treated while you are on Testogel


#5

T-gels are absorbed ~10% at best and 5mg absorbed is a bit low. Some do not absorb very well and that is a common problem if there is low thyroid function. Please eval via last paragraph in this post.

On TRT, E2=22pg/ml - 80 pmol/L is optimal and you are close to that now. TRT will only increase E2.

Do not test LH/FSH on TRT as these will -->zero

Opiates can mess with hormones.

I assume that you are not able to self-inject T ?where you are?

We do not see many guys at age 42 wanting to remain fertile.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys <-- need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.


#6

Thanks for your informative reply. I will read more and check into the Thyroid issue mentioned. Am situated in Europe. Not able to self inject.

I am a bit concerned if I really am in need of the TRT ?It was loosly prescribed to me in my opinion.

I have a suspicion that the low levels in my bloodwork in 2017 is due to the opiate use. Thats what had the testo values bump up and down if you see the 3 -2017 bloodworks. Well, I quess normal should anyway higher. My SHBG is also quite high in 2017 compared to the one test in 2014.

Have an appointment again in 2 months. Will have bloodwork done after my own research at 4 weeks and 8 weeks.

Any advice greatly appriciated :slight_smile:


#7

SHBG levels increase with estrogenic states (oral contraceptives), pregnancy, hyperthyroidism, cirrhosis, anorexia nervosa, and certain drugs. Long-term calorie restriction of more than 50 percent increases SHBG

T-gels have the highest T–>E2 potential of all deliver methods, injected is least.

High T levels and E2 near 80 pmol/L would lower SHBG. You would need anastrozole prescribed for that.

With thyroid issues, if you cannot absorb T-gels, are there any options?

Where in Europe?


#8

I am situated in Sweden.

Reading what you write I have a suspicion it was the Oxycontin usage for some time that caused the rise in SHBG, and TESTO leves going up and down. I also have Chrons discease so there is calorie restriction to some degree, but not nowhere close to 50 percent.

If I cannot absorb T-gel the option is NEBIDO intramuscular, but I presume the doc will bump me up to 100 mg ( 2 sachets x 50 mg testogel ) before that.

I checked for thyroid problems a year ago in a regular bloodtest at my doc which came out negative.

I am contemplating to go off T- gel at the 2 months mark and see if SHBG lowers after some time… I will not be needing the opiates anymore.

2 weeks till my 4 week bloodwork so will have a pointer where I am standing then…


#9

Getting SHBG down requires close management of E2 with anastrozole. Is that available by Rx or underground?

For anastrozole to work properly, you need steady FT levels. Can you self-inject smaller amounts of NEBIDO more frequently? Anastrozole is competitive with FT, so you can see the need for steady T levels.

SHBG can be slow to drop. If TRT leads to high E2 your situation may not improve.

I have seen some references to opiates and high SHBG. But some studies may have included data from guys who have hepatitis from injecting opiates. We have one guy here with high SHBG from herpes, a liver disease. Perhaps all liver diseases increase SHBG. So I consider such things.

Your E2 will be above optimal at your two week labs.
I do not know what the value will be of the TRT for two weeks or the labs.


#10

Anastrozole not available underground. Only by Rx. Dont see me doc prescribing it.

I think I am a lot closer to understanding my situation from this forum.

Unbelivable low knowledge from my doc…I think the opiate use may be the main driver behind the problem. I will see on the next bloodwork ( 4 weeks) if E2 is too elevated as suggested it will be I dont see any point for me to continue the testogel 50 mg.

Will then taper off and let things adjust naturally ? New tests in 2 months intervalls to see how things are going. If still low I will se a more experienced doc and go for IM shots.

Maybe my values from 2014 are what I am doing fine on ? Testo 12 and SHBG 19
Advice?