T Nation

TRT Right or Not?

Well, hCG is an LH analogue able to increase T production, testes volume, and sperm count. Clomid can help you produce both LH and FSH. FSH is thought to increase sperm motility and viability. Somehow FSH strengthens or matures the sperm. Right now, with no hCG or testosterone ever in your system, is the most effective time to use Clomid for fertility. hCG will inhibit it’s action as will testosterone. Also, it may get your testosterone levels up as high as TRT can. Clomid could possibly be a long term option for you and have you making T and sperm in a more “natural” way.

total cholesterol is good! not low ; diet?

T is very low, DHT is high. This is very strange. DHT is HPTA repressive.

Your thyroid labs plus iodine history seem OK. Ideal waking body temperature is around 97.7

Hematocrit is lowish, but consistent with your T levels.

After you are off the 5-alpha reductase for a while, you can try an HPTA restart. If that does not work, you can try hCG, low dose Nolvadex or alternate the two. If that does not work, go for injectable T+AI+hCG

You are currently estrogen dominant, relative to your low T. I think that you will definitely require an AI.

If DHT is as high as reported, I can see why there is hair loss.
Could someone have confused DHT with total cholesterol. Seems odd to test FT and DHT and not TT

Thank You very much for nice suggestions above guys, I’m also trying to put stuff together for HPTA restart. I’m trying to examine everything as closely as possible and reading all the stuff that I can get my hands on.

KSman my TT levels have been mentioned in OP as
TESTOSTERONE, TOTAL 202.97 Low (241.00 - 827.00 ng/dl)

Free T and DHT reports were up later. Also there is no confusion in DHT and total Cholesterol. I’m also not able to decipher that if TT is so low how come the FT is in range and why is DHT so high. Does it has something to do with my SHBG levels?.. if so I got to rethink my approach for HPTA restart. I think there will be more things to consider before reaching a conclusion.

[quote]jasper41 wrote:
I’m also not able to decipher that if TT is so low how come the FT is in range [/quote]

The free testosterone is a calculation using albumin + SHBG + TT tests. Free testosterone values are estimated by simply plugging in the previously mentioned test values into the formula and it spits out the FT number. The lower SHBG and/or albumin go, the higher FT will go because there is less protein to bind to, even of what little Testosterone you have, more is left free in the plasma.

DHT I don’t know because I largely overlook it because it isn’t even on the table as a possible supplement here in canada.

C27H40O3 I also remember KSman writing about it too. He defined that TT = FT+SHBG bound T+Albumin bound T, if I remember correctly, and the formula they used online to calculate FT uses SHBG & albumin values with some data interpretation. For practical purposes I think one need to concentrate more on FT values, now in my case FT implies low SHBG T and Albumin T which may affect the dosing protocol for my HPTA restart. Too much T in my system can create too much T ==> E because of low shbg, also as is evident by high E values in my lab reports.
Do you think testing SHBG levels would be a good idea for me or just a waste of time & money as FT levels are already indicating it? Also does SHBG levels also keep fluctuating or they’re stable for most part?

I have stumbled upon another puzzle of my low T profile, recent lab findings show that I’m deficient in vitamin d. I think that it may be one of the big contributing reasons for my low T as also suggested by this study
Pilz S, Frisch S, Koertke H, et al. Effect of vitamin D supplementation on testosterone levels in men. Hormone and Metabolic Research. 2011 Mar;43(3):223-5.

Here’re the latest reports

25 - HYDROXYVITAMIN D 3.0 LOW ( Deficiency: < 20; Insufficiency: 20 - <30; Sufficiency: 30 - 100; Toxicity: > 100 ) ng/mol

I had started supplementing with vitamin d3 gel caps 10000 iu daily. It may also be the cause of inflammation and various joint pains in my body.

Hello everyone, Here’s my latest lab updates after doing a 5 week HPTA restart protocol. I used 10 mg Nolvadex ed and 1mg anastrozole a week eod.

TESTOSTERONE, TOTAL, SERUM 753.28 241.00 - 827.00 ng/dl

  • ESTRADIOL, SERUM <11.80 < 12.5 - 41.2 pg/mL
    LUTEINIZING HORMONE 4.98 1.50 - 9.30 mIU/mL
    PROLACTIN 6.93 2.10 - 17.70 ng/mL

Overall I’m happy with the results and feel grateful to KSman and C27H40O3 for their suggestions.
I’m planning my taper from today as follows:
Nolvadex 5mg ed
anastrozole 0.5mg/week

Nolvadex 5mg eod
anastrozole 0.5 mg/week

Nolvadex 5mg e3d
anastrozole 0.5 mg/week

anastrozole 0.25 mg

Please let me know if there’s something to improvise. Also I would like to mention that I’m still feeling pain in my testis and discussed it with my doc and he put me on NSAID’s for 5 days, not sure if he’s on right track or not.

Looks like you’re taking too much Adex, as your E2 is low. That’s a recipe for feeling like garbage.

I’m confused by you Adex dose/frequency. You said that you’re taking “1mg a week EOD”. Does that mean that you’re splitting a 1mg pill across the week? Or that you’re taking 1mg EOD?

Sorry for not being clear, my anastrozole dosage was 1mg a week divided into 0.25 mg eod.

You might not need any Adex at all. Your E2 is already low because you’ve been taking an AI, but it could be much lower because that’s not a sensitive E2 test. Hard to say what your exact E2 is right now.

I’d probably stop taking it altogether and let your E2 bounce back.

Thanks Alwaysup, so I’ll keep the same taper protocol sans anastrozole.

Yes, E2 is too low. But may still be needed.

“You might not need any Adex at all. Your E2 is already low because you’ve been taking an AI, …”

Not sure if AlwaysUp is thinking that Nolvadex is an AI, not, anastrozole is. Perhaps his wording is the problem for me.

You could be an anastrozole over-responder.

KSman, using your formula my adex dose comes out to be 1*11.80/22=0.54 when using 10mg Nolvadex dose. So if now I’m tapering at 5mg Nolva, is it wise to use 0.25 mg anastrozole per week?

Anastrozole is a competitive with T at aromatase sites and with the ranges involved, we get that linear relationship. Changes to anastrozole that track T changes will tend to keep E2 unchanged. So what you suggest will be valid IF your T levels are linear to Nolvadex dose changes. That is a leap of faith, but would at least be a step in the right direction.

This is the chain: Nolvadex linearity of LH production involving both the hypothalamus and pituitary, LH linearity of T [and E2] production in the testes

Thank You for taking time to explain that KSman, I understand that physiological fluctuations in body can’t be tracked always linearly and it’s always a guesstimate when calculating dosage. So I’ll try the 0.25 mg/week anastrozole dose and see how my body responds.

Hello Everyone
Its been three months since I completed my HPTA restart. Here’s my latest lab updates

ESTRADIOL (E2), SERUM @ 23.22 pg/mL <39.80

TESTOSTERONE, TOTAL 415.40 ng/dL 241.00 - 827.00

Recently I again started to feel a little tired and a bit off, libido was ok though, so I got myself tested. Blood was drawn in morning so I expected my T levels to be better, kinda disappointed with the results. How should I interpret these results? Do I need to try another SERM restart? I’m still expecting parenthood so TRT is offlimits.

Nice thread.

I don’t think numbers are too bad. You almost doubled your TT. How did you feel last few months? Do you feel worse now just because of the number you see?

I would consider one more restart.

@lgs I felt good the whole time after my HPTA restart, libido was fantastic. It’s the last few weeks that I noticed some fatigue and tiresome feeling going on along with some lack of concentration and brain fog. So I decided to get myself tested.

I don’t think you will need TRT. You respond well to a SERM. Your numbers came down again but much better then before. How was your sleep, diet, stress etc? Evaluate those, might be why you are seeing the drop.

I would do another restart and perhaps stay on a very very low dose Adex to push E2 down slightly with the hope that will raise LH/FSH and your body finds a new settling point with higher T, free T and comperable E2.

My life style factors haven’t changed much so I was not expecting my T to drop that much. My hairloss had accelerated since I stopped taking finasteride, which indicate to me that my DHT levels had gotten really high. Could high DHT be a cause for depressing my HPTA?
I was also thinking about losing some fat to help my hormones achieve a better balance. Do you think a hypocaloric diet will impact the results that I’ll will get from doing a SERM restart?