Hello! I think I need an advice about using TRT for treating hypogonadism.
I’m a 37 yo man, live in Russia, recently diagnosed with “Primary hypogonadism” - it’s from blood tests, which show testosterone level at 8.7-10,3.
There are well-being issues also. I’m a long-time user of antidepressants due to OCD, ICD, anxiety - I have been using them from 2007. Unfortunately, after years of use, withdrawals, switches, trying different options and combinations, I developed both tolerance and dependency. I’m currently on Cymbalta, and while feeling shitty on it I completely unable to switch from it or combine with some other AD - because of absurd withdrawal syndrome, and because I already tried almost every AD available.
Well, at the moment my issues are:
1.) Near-zero libido.
2.) Absence of morning woods. Bad erection in overall. It doesn’t get up with girls, unless on Viagra. And even Viagra has uncomplete effect.
3.) Overall lack of arousing in anything.
4.) Heavily delayed ejaculation.
5.) Little muscle mass, low strength indices.
6.) Extreme chronic fatigue, tiredness, sleepiness, unrefreshing sleep.
7.) Low motivation, activity, very apathetic.
8.) Brain fog, poor concentration, bad working memory, lowered cognition, tinnitus.
Moreover, the condition is constantly worsening, year after year.
And why I want to try TRT:
1.) Blood tests shows lack of testosterone.
2.) I run out of options with antidepressants anyway.
3.) Every AD gives incomplete effect at best. And nothing but adverse effects at worst.
4.) Fatigue and tiredness manifested right after 30 y.o. - which can be associated with testosterone drop.
In general I feel like dead forever-sleeping potato, barely able to function, work and move.
Here are my blood tests:
LH: 1.52 mIU/ml
FSH: 4.15 mIU/ml
SHBG: 29,7 nmol/l
TSH: 3.49 uIU/ml
Prolactine: 152 mLU/L [sic!]
There are other data in the test, but nothing interesting, I believe.
Well, I visited a few local doctors - one of them prescribed Androgel, another prescribed nothing, and the third - testosterone undecanoate (Nebido) alone. I even bought that Androgel stuff, but then quickly googled and discovered that testosterone solo leads to testicular atrophy. And then I visited two other docs. “Nothing” as prescription doesn’t satisfy me also, because I’m already at my wits end, and doing something is better then doing nothing. And about Nebido - I’m not gonna solo it, and AFAIK it takes up to 10 month to start to feel the effects, not to say it costs a lot.
Here, in Russian pharmacy we have the following testosterone drugs:
And no cypionate/enanthate things.
There are problems with these.
1.) First, these drugs can be bought by one-time Rx. And the Rx costs as much as the drug itself. Going to a doctor each 1-2 months to pay a ton of money for a simple Rx is a huge waste.
2.) Local doctors don’t combine testosterone drugs with hCG, clomid, AI, etc - they don’t know how to do it and have no idea about right dosages for these combos.
3.) All these drugs seems shady to me. Gel is both quite ineffective and expensive. Nebido costs a lot, has very delayed onset, and as I heard, painful to inject and unpopular among TRT users. About Sustanon and Omnadren - I have no idea what is it, how good they are, and what to do with them.
And there are other source of receiving t drugs - online stores. I completely unfamiliar with them, not sure which ones are fraud, sell fake drugs or something. But I found one that looks like real - and it sells good old cypionate/enanthate at affordable prices at various dosages, as well as clomiphene, tamoxifen, anastrozole.
Uh… I lean towards buying from the online store. I know it is retarded to buy unreliable drugs from unreliable sources. But I presume it is also retarded to buy shady things like Sustanon/Omnadren/Nebido and pay a ton of money for Rxes forever. While the online store can actually sell quality drugs with known effectiveness.
Can you guide me with drugs, dosages, blood tests, target levels, symptoms?
1.) For t drugs cypionate/enanthate are most common. I prefer enanthate just because there are wider choice in the store. I should use it twice per week or every three days.
2.) For testicular atrophy prevention I can use hCG, or clomiphene, or tamoxifen. I would like to use tamoxifen: it is present in the store while hCG is not; no need for more injections; it’s cheaper than hCG; more tolerable than clomiphene.
3.) I have to not use anastrozole right from the start, but only if blood tests shows high estrogen levels. And if indicated, I should use it in dosage 0.25-0.5 per week.
Am I right, can you correct me? What dosage and timing can you recommend me for t enanthate and tamoxifen?
What are my target levels of testosterone? I read that some Vermeulen dude says, that lower t level for my age is 11,4, mean is ~19, and higher is ~30. Which level or range should I target?
What blood tests and how soon should I undergo to check my progress? How often?
Thanks all for reading this and possible advices.