Hi everyone my name is Paolo i am 30 years old and i am from italy. I will start from the beginning, few months ago i was experiencing low libido, low energy, depression, anxiety,low energy, muscle loss and little bit of strenght loss, so i went to an endocrinlogist that took the following blood tests:
Total testosterone: 327ng/dl (220-910)
Free androgen index: 40.40 (24-104)
Shbg: 28 nmol/l (16-55)
Lh 5.0 iu/l (1.7-8.6)
Fsh 3.6 iu/l (1.5-12.4)
Estradiol: 20.7 pg/ml (16-52)
Prolactin: 19.3 ng/ml (4-15.2)
So as you can see my prolactin was a bit elevated, so he diagnosed me with secondary hypoganadysm and put me on 150 mg of test cypionate per week which i inject every sunday morning followed by 0,5mg of arimidex on monday morning. Now in all the bad aspects that i said i was experiencing before trt i improved a lot, no more anxiety, feeling more confident, more strenght, more enrgy, i gained 10 pounds etc… but week after week my testicles started to decrease in size and right now they are probably less than half the size they were before. So i told my endo and he prescribed me 3 vials of 5000iu of hcg, he said that i will have to take for the first 5 weeks 1000iu of hcg per week split in 2 dosages on monday and thursday, he also said to increase the dose of arimidex to 1mg per week, so he suggested to taked half a tab on mondays and thursdays right after my hcg injection, by the time i finish the first vial of hcg i will get blood work, and he said depending on results we will probably reduce the hcg to 500 iu per week split in 2 dosages of 250. By the way tonight i miexed the first vial of hcg and injected intramuscularly in my buttock the first 500 iu which is 0.5ml cause i injected 5ml of water into the vial i hope i didnt do a mistake lol. So guys what you think of this protocol, will it be enough to bring my boys back to their previous size?
Take note that any E2 test you run isn’t the E2 sensitive designed for men, countries outside the USA don’t have the proper E2 testing, so any reading you get is to be ignored as that E2 test is for females. LC/MS/MS method is for males.
The reason I mention this is because it’s going to be extremely difficult to balance your E2 levels without the proper labs, you can’t even draw any conclusions for the female E2 labs. Once you control E2 testes might hang, testes are a good gauge for E2 levels in the high range.
LH was better than midrange and T was low, if I’m not mistaken that primary hypogonadism buddy.
Thank you for the reply bro. By the way the measure they used for the e2 was in pmol/l the result was 76 i converted it in pg/ml for you guys from the states could understand. They said that they used man parameters for e2 but anyways you might be right. So yoy basicly saying that ball shrank cause my e2 might be elevated? Also if you are right and i am primary hypoganadism this means that theres no way i will ever be able to get off of trt right? Further more somebody tols me that since my prolactin was a bit high this could be the reason why my test was low. So there was no need of trt but i was just suppodlsed tp use cabergoline for some time
Patients with high prolactin levels frequently manifest low FSH, LH, and testosterone levels. The chain starts with high prolactin, then lower LH, then low testosterone. A->B->C. Most doctors would shrug their shoulders at those prolactin levels.
As far as the E2 labs, doctors either lied or are mistaken which means their clueless, not surprising. Most here in the USA get TRT wrong and most don’t even know what tests to run. You need TRT, testes might hang when TRT is dialed in.
Ok so at least i know i am not on the wrong track. I just need to find the right balance. However few hours after my hcg injection i already feel my testis fuller they dont ache but i have a feeling like they are contracting and expanding like a myscle
Further more if my prolactin will still be higher than normal upper range would it be advisable to include cabergoline to trt for some time???
Naturally my testes always contracted like a muscle, you’re just taking notice now that you have a problem.
I’ll let KSman respond your other question, you might find the thread “KSmans is here” and link to this thread for a response.
Hi KSman i am new here, i started trt 7 weeks ago and my testicles started to shrink so i opened a thread regarding my trt protocol and hcg protocol that ijust started this is the link: Testicles Shrinkage After 7 Weeks on TRT - #7 by systemlord
I would appreciate a lot if you can give your opinion about it and possibly help me. Thanks a lot again for your patience and sorry to bother you.
Non era assolutamente il caso di metterti in TRT…ero nella tua stessa barca bastava un ciclo di 6 mesi con del Dostinex (Cabergolina) a 0.5mg 2 volte la settimana e poi valutare con degli esami con metodo LC/MS/MS. La differenza con la prolattina a 0 è molto come il giorno e la notte, se eventualmene dopo 6 mesi di Dostinex i risultati non ti soddisfacevano poi potevi passare e stare in TRT, di solito con l’età stress ecc compaia un ipogonadismo indotto “probabilmente” dalla prolattina alta.
Spero che dopo due anni le cose procedano dal verso giusto BRO!
You are going to get a lot of mixed recommendations from this forum on the use of HCG. I am a proponent of using it if you wish to maintain fertility or simply that testicular size is a concern. For me it’s the latter since I’m well beyond the desire for more children. There are 2 studies that I know of that point to approximately 1000 IU per week in split dosages to help maintain testicular function while on TRT. My protocol consists of 1050 IU per week split into an every 3 day protocol on the same day as my T injections.
Regarding your once per week protocol for TRT, I recommend that you split that up into at least 2 smaller doses. I prefer every 3 day (E3D) dosing because the interval between doses is always the same and it’s easy to follow. I simply program the injection days into my computer calendar and it send me an alarm the morning of each injection day.
Regarding the use of Arimidex (anastrozole), I would stop that all together. It is difficult to dose for men and guys often crash their E2 to very low levels and that can cause all sorts of sexual side-effects. Guys need a certain amount of E2 for normal libido and erections. If you split your dose of T into more frequent dosing as I discussed above, both your peak and nadir blood levels of T should remain within normal ranges at all times, and you won’t need an AI. It’s the peak level that’s particularly important. E2 is made from T, so the higher T goes, the higher the peak E2 conversion will also be. The key to keeping E2 under control is to dampen the peak of T and that is done by more frequent injections.
Also, as you decrease the amount of T per injection, you will also decrease the volume of T ester that needs to be injected. With smaller volumes, you can switch to a smaller one-piece insulin syringe. I use a 28G 1/2 inch one-piece syringe.