The End of Hope for Natural Testosterone Production & The Beginning of Lifelong TRT

Between the Testim yesterday and today, and the HCG I’ve been taking – I feel great. I’m not back to “normal” yet, but I’m getting there and it’s not just placebo. I’ll probably have to switch to Androgel if I want my insurance to cover it, but there isn’t much of a difference, other than smell and stickyness.

A long hard road.It has been a long, hard, six-month road of trying to get my natural testosterone production back up. I’ve tried several alternative treatments for low-T, including – for six months – only natural things like zinc, magnesium, tribulus and deadlifts at the gym. I didn’t want to go on life-long TRT at my age, so my hope (once it was clear that my secondary hypogonadism was here to stay, and that I wasn’t going to produce enough LH and FSH to make adequate testosterone) was that I could take Menopur or HCG instead of testosterone. That way at least my testes would stay “normal” and I’d be treating the problem at its source, rather than the symptom down below. But, alas, the US medical system wore me down. I just couldn’t live like that anymore. I was depressed, losing more weight every month (185, 182, 179, 175, 170, 169… how low can I go?); was losing motivation and memory by the day; and generally just felt like CRAP.

To top it off, my Peyronies Disease (post coming soon) was back again, and this time I had plenty of experience and studies showing that it was linked to (in my case probably caused by) low testosterone. OK, I can deal with all of the other stuff for awhile longer, but I’m not going to live the rest of my life with a penis shaped like a candy-cane, which is what PD eventually does to you if it doesn’t stop progressing. It stopped right away last time I went on TRT and I expect it will do the same this time.

The doctor still won’t prescribe me injectable testosterone, and I’ll be damned if I’m going to give those idiots $40 twice a month to stick a needle in my ass. So I’ll continue to get my Testim or Androgel so I can stock-pile it away (because I’m paranoid about not having access to testosterone at some point in my life now that I’ll be on it forever and life is miserable without it) and will instead be ordering injectable testosterone online from a compounding pharmacy somewhere. I’ll be sure to use up the gel stuff before it expires, but they generally last 2-3 years unopened under the right storage conditions. And that’s just the labels expiration date. They probably last a lot longer than that.

LONG STORY SHORT FOLKS…

I’m back on TRT. For good this time… unless something better comes along that is affordable (unlike menopur) and works without shutting down my testes directly (testosterone), or downregulating / desensitizing the leydig cells in the testes indirectly (HCG).

I feel good. I’m sure in six months I’ll be back to feeling like I wish I didn’t have to take this damn shot, or rub this damn gel in all the time – but right now I feel good. I’m looking forward to getting my life back. If you want to follow along the journey of a young man (33 now, 30 when I was first diagnosed, 31 when I started TRT, 32 when I tried to come off it and use alternatives) who has to take testosterone for the rest of his life – stick around. This blog is going to be up a looooooooooong time – providing, of course, that I don’t get prostate cancer at an early age and die. If I do I’ll try and let you know.

😉

Leave a Reply 97408 views, 5 so far today |
Follow Discussion

99 Responses to “The End of Hope for Natural Testosterone Production & The Beginning of Lifelong TRT”

  1. Bill Says:

    Good for you.  Consider taking your script to a compund pharmacy and getting a cream made.  It soaks in well without the sticky mess.  I love it.  I am 43 and will be on it for life as well.  You will come to terms with it.  Good luck.

    Bill

  2. CB Says:

    You keep referring to Menopur as hCG on this blog when it is actually hMG. Big difference. hMG stimulates FSH and hCG stimulates LH. LH is the hormone that stimulates testosterone production. hMG is the hormone that plays a major role in spermatogenesis.
    There are plenty of doctors out there that will let you have more freedom in treating your hypogonadism. I encourage you to find one. Instead of stockpiling the gels I encourage you to stockpile the injectable oil. One vial of that will last you six months – meaning a lot less to stockpile.
    Also, hCG is the adjunct widely used with TRT, and it can be found quite affordably. As an adjunct you will use around 500 iu’s per week. It will run you around $100 a month.
    I encourage you to check out the Meso Rx Forum for more information. There is a lot of (unintentional) misinformation here and I would be more than happy to help clean it up.

  3. TRT Man Says:

    CB, I never ONCE referred to Menopur as hCG. Not once. I do often mention them together because I believe they are both alternative (to testosterone) OPTIONS for treating secondary hypogonadism.

    I appreciate that you would like to help me clean up the information. I would be happy to make some changes if you point to medical studies or otherwise. I’ve been reading steroid forums, including Meso, Anabolex, and Elite for years. Blindly following the advice of “vets” on these boards is what has landed me in this situation in the first place.

    I rebounded just fine every time I went off a cycle until one day I decided to try Swales hCG and PCT protocol, which called for using hCG throughout the cycle. For some reason after that my testes just didn’t produce, even though they were large enough, produced plenty of live sperm, etc…

    Then one day I read, in an actual study – not on a forum – that hCG use over time (such as throughout an entire 16-week cycle) can desensitize the leydig cells. Hmmm, whish I would have read that instead of the bullshit I read on the forums. And why suddenly did my body decide to stop producing LH and FSH in levels it had previously been making? I know that has nothing to do with the leydig cells, as it is further up the HPTA chain. But could it be that hCG use, or clomid use, or any of the other PCT drugs that steroid vets on these boards insist that everyone has to take on every cycle, had something to do with it. I really, honestly, don’t know. And I’m not going to pretend to either.

    I appreciate that you want to get the right information out there, but just because someone isn’t saying the exact same thing they’re saying “over there” doesn’t mean they haven’t been around the block or that what they’re saying is completely wrong.

    As for Menopur, it’s too expensive, but let me quote something directly from THEIR website:

    “MENOPUR® contains equal amounts (75 IUs) of 2 kinds of hormonal activity: follicle-stimulating hormone (FSH), which helps stimulate egg production; and luteinizing hormone (LH),”

    Did you read that? CONTAINS…. FSH… and LH.

    I’m not a doctor, an endocrinologist, or even a medical student. This blog isn’t meant to be a medical journal. And that’s not a disclaimer. That’s just a fact. I’m one normal guy who made some bad choices in college and am now having to pay for them the rest of my life. What I’m doing here is sharing my thoughts and experiences with other people who might be in the same situation. I don’t think anyone should be dumb enough to come look at a blog and make life-altering decisions involving their health just because of what they read here or on any other blog – or forums for that matter. Lapsing into that kind of idiocy is probably what got me here in the first place.

    And, once again, I never, EVER, not even ONCE, said that Menopur and hCG were the “same thing”. Sorry if you were just trying to help, but I am in no mood to be corrected on things that I don’t need to be corrected on. I’m sure there is information on here that isn’t perfect. I invite you to give constructive input on those things. But the Menopur and HCG thing… I never said that.

  4. CB Says:

    You are correct on the Menopur, I was misinformed. I believed it was just an FSH analog. Still, the commonly used adjunct for TRT is hCG.

    Desensitization of Leydig Cells on hCG has never been shown to occur in a clinical setting (read: in a reasonable dose).

    I really wasn’t trying to rile you up, so I am sorry if I did. Interesting you state that ASIH is the cause of your hypogonadism, I don’t recall you stating that anywhere else here.

    You know – if that truly is the cause there are doctors (including mine) that will attempt longer courses of Clomid, Tamoxifen, and hCG (in the early stages) to reverse the hypogonadism.

    Do you have any evidence that would point towards your testes being desensitized from hCG, hence actually being primary. I am referring to a very high LH and low test level?

    Anyway, good luck!

  5. TRT Man Says:

    CB, no worries. Sorry if I got too riled up. I hadn’t had my coffee yet. 😉

    I didn’t mention past use of AS because I don’t want this blog to be about AS. There are plenty of forums out there for that, and I am trying to appeal to a wider audience of men who are on HRT since I don’t consider myself a bodybuilder, not even an amature, and feel more like an average Joe with a health problem. I understand, that is a glaring omission – now come to light in my comments – but the fact is that I also feel it is a piece of information that I don’t want to get “out there” in case TRT Man is ever connected with “me” as a real name in my community. I’m sure you understand.

    I’ve looked at some doctors from the boards, including the one in (Michigan?) that a lot of people recommend, but he was very, VERY expensive even just for consultations. I have also worked with a compounding pharmacy / anti-aging clinic in Florida – but those guys are all just out to make a buck and don’t seem to actually care about your health as much as a “real” doctor. I sometimes wonder if what they give isn’t just Chinese powders that they mix up in a basement somewhere. I’ve never actually been to their offices, so I wouldn’t know.

    I have evidence that my problem is secondary, but no – I don’t have evidence showing desensitized leydig cells. Actually, I wasn’t producing enough LH and FSH to get my testes to make enough testosterone so my guess is the leydig cells are fine (e.g. my testes are fine) and that the problem is somewhere else in chain, such as my pituitary gland or hypothalimus (sp?). I’ve had MRIs done on both and there aren’t any abnormal growths, which is good.

    I would be open to discussing my issues with your doctor. If you want just send a separate reply here with yours or his contact info. Include in the comment at the top (DO NOT PUBLISH) and I will be sure to delete it form the system without ever publishing it.

    Thanks again.

  6. JM Says:

    Great blog!! It’s really hard to find any good information on TRT for men. Thought I would share my story to see if anyone has any input on my situation. I’ve been on Androgel for almost 3 years now for secondary hypogonadism that was caused by my personal negligence of taking an over the counter testosterone booster (Superdrol) without doing any PCT. I stupidly didn’t think that stuff could really be that strong considering that I bought it in a vitamin supplement store. However, I would have to say I did see some very good results from the supplement. After doing an 8 week cycle and again no PCT I started feeling terrible so I did another cycle for about 6 weeks (big mistake). Well six months later I found myself in an Endocrinologists office talking about my low “T” levels which were around 180. I tried Clomd for about a week and a half but felt so terrible on it that I opted for TRT at my Dr’s suggestion. At that point I was probably well below normal “T” levels for well over a year. I should mention that I was 35 at the time.
     
    My  Dr put me on 4 pumps a day of Androgel. After the first week or so I felt great! My energy levels were way up and my overall focus and memory were much improved. Moving into year two I started noticing gyno showing up so my Dr prescribed Arimidex to me and the gyno subsided. However, I still continued to go downhill from the TRT. The Androgel seemed to mostly be converting to Estrogen rather than giving me a test boost. I was getting fat, gyno started coming back again and overall just started feeling terrible. Going into my third year I got to the point where I was only using 2 pumps of Andro a day due to how it made me feel. I should also mention that I started to feel heavy anxiety for the first time in my life which would seem to come on about an hour or two after doing the Andro.
     
    I started doing some research on TRT and found a number of horror stories where guys were reporting the same experience as I was. All started well but long term TRT is a big mistake unless of course if you have a real medical condition that prohibits your body from producing test naturally. I was fed up with the TRT and considering that my hypogonadism was as my Dr called it “idiopathic” or of unknown cause I wanted to try to make another run at seeing if I could restart my natural test production. At 38 I wasn’t ready to be on TRT for the rest of my life. At first I thought that because I was three years in on TRT that there wouldn’t be any way to restart natural test but my Endo felt it was very possible. He prescribed 100MG of Clomid for a month.
     
    I’m 8 days into no Androgel and Clomid treatment. Feel terrible off and on (headaches, abdominal pain, depression and anxiety) but with all that said I think it might be working. My boys are distended again and I’m starting to feel very strong again. My question to anyone is have you tried Clomid and if so did you feel heavy side affects? Also, anyone successful in going natural after being on TRT for a period of time? Last question, has anyone else experience similar issues with Androgel or TRT overall if you were on something else? If I’m not able to restart then I’ll have to try something other than Androgel.
     
    Thanks     

  7. TRT Man Says:

    JM you are JUST the type of person I was hoping to connect with via this blog. As you said, it is very difficult to find good info on TRT for men. Google is just crowded with overseas pharmacies, steroid sites and info about HRT for women. And when you do find a rare site that has info about TRT for men, nobody seems to have been on the stuff for more than a year or two. When you’re faced with 30+ years of TRT ahead of you, a couple of years of experience just doesn’t cut it.

    I can’t afford to pay anything because this site doesn’t make money (it’s just a personal blog), but you are more than welcome to write on here about your experiences. Let me know if you want an account to post from. Otherwise, I’m also happy just to follow along if you want to continue leaving comments.

    I am VERY interested to find out if you ever get back on track after years of being on Androgel. If you can get back to normal levels after being on TRT for so long, then there’s hope for all of us!

  8. Jim Says:

    JM –

    What do your labs say?

    Your restart is very possible. Keep in mind, your levels will probably not be great, but you will be natural at least.

    I have tried clomid and the side effects can be severe (depending on the individual).

    I have had no problems with TRT on injections for 6 months. Other health problems yes, but I do not believe them to be related to TRT.

  9. JM Says:

    My labs have been all over the place the last three years mostly because I haven’t been consistent in the amount of Androgel I was applying. Year one I was tested at 780 and then 895 6 months later. Year two – 520 and 501. Year 3 – 325 and 205 which was my last result about two weeks ago, so you can see the dramatic down turn my levels have taken. I appreciate the feedback and I would be happy to continue to post my progress to this blog. I’m so committed to trying to make this work that I’ve actually taken 5 weeks off work so I can focus on this stress free.
     
    I’m also taking herbal testosterone boosters as well (Maca, Tribulas, Tongkat Ali and Yohimbe). From what I’ve read a regimen of taking a different natural booster each day may help to stimulate the restart as well. The reason for a different supplement each day is to help to keep your body from adapting to anyone of them. Not sure if that’s accurate but I figured there wasn’t any harm in using natural supplements.    
     
    Thanks,
     
    JM     
     
     

     

  10. CB Says:

    There are many individuals who claim some of those supplements are the cause of their hypogonadism. How do you know what is truly in them? Many times they contain trace amounts of SERMS, AIs, thyroid medication, etc.

  11. TRT Man Says:

    CB is absolutely correct. Here are some examples of what he’s talking about: So-Call Dietary Supplements recalled because they actually contain REAL drugs, including hormones, estrogen blockers and ED medications. It’s crazy! You really have NO idea what you’re getting because the supplement industry is barely regulated at all.

    Stay tuned for a larger post about this.

  12. JM Says:

    Good point, it’s not worth the risk.

  13. JM Says:

    I wasn’t planning on posting my progress to natural “T” production on a daily basis however, I did experience some changes yesterday that I thought may or may not be noteworthy. Ever since I started on Clomid which was approximately 10 days ago, I’ve noticed a pretty sharp decline in body weight. To be more specific I’ve dropped about 6 lbs in water weight. Water retention has been a huge issue for me ever since I started on TRT 3 years ago. There were days when I would step on the scale and weigh 220 in the morning and then 226 by the end of the day. And my diet is very good so it’s not as if I’ve been eating a bunch of fast food or anything that’s high in sodium. I should also mention that I’m 6”4 so at 220 I don’t consider myself over weight. I’m not a body builder but I do lift weights and do cardio on average 5 days a week.
    The Clomid seemed to really help with the water retention which I know is due to the fact that it’s an estrogen blocker. Again over the last 10 days water weight has been way down and I haven’t been experiencing the flocculation in weight from morning to the evening. However, yesterday I did experience pretty heavy water retention. I gained about 5 lbs from my morning weigh to my evening. Also, felt very bloated and uncomfortable. I’ve been very consistent with my Clomid regimen, 50mg in the morning after breakfast and another 50mg’s in the evening after dinner, so the sudden onset of water retention yesterday seemed unusual. Anyone have any thoughts or experiences with this while on Clomid? I’m also still feeling very foggy with a big lack in focus and memory. I’m hoping this is due to the Clomid treatment rather than low “T”.  
    Also, below is my PCT regimen for the next 6 weeks. Any feedback is obviously welcome.   
    Week# 1 – 100MG’s of Clomid
    Week# 2 – 100MG’s of Clomid
    Week# 3 – 50MG’s of Clomid
    Week# 4 – 50MG’s of Clomid
    Week# 5 – .50MG’s of Arimidex Week# 6 – .25MG’s of Arimidex every other day    

  14. CB Says:

    PCT looks OK to me. Some may consider it a lot of Clomid, but if it is not causing you any problems…sure.

  15. JM Says:

    I’ve just began week # 3 of Clomid treatment so I thought I would post another update on my progress. I’ve been experiencing pretty heavy side effects from the Clomid so I decided to back it down to 50mg’s a couple days ago. The lower dose has helped to control the sides however, I’m still having a VERY hard time with this. I feel so depressed, lack of motivation, emotional, no confidence and memory loss. If I didn’t have the flexibility to take time off of work I probably would consider stopping the treatment. I know how important it is for me to tough through this but man it really sucks to feel this way. I have a great family, home and career so I have no reason to feel this way outside of the treatment and probably low “T” levels. When I originally discovered I had low “T” levels a few years ago I didn’t right but it was nothing like this. 

    Ok, that’s the bad side of this but on the good side I continue to feel like this might be working. The last few days when I’ve woken up in the morning I’ve been feeling much better. I feel much more focused in a good mood and also stronger and leaner. This is all of course up until I take another dose of Clomid and then I subsequently fall back to the bad sides. Today I decided to take my dose in the late afternoon and probably had my best day in terms of how I feel in the last couple years. I felt normal again! 

    At this point I’m considering taking the Clomid for one more week and then switching to Arimidex. I think that might be a long enough cycle and it would be nice to enjoy the holiday season without feeling terrible. Considering how I felt for most of the day today, I’m starting to feel cautiously optimistic that I may be able to restore natural test production. 

    I’ll update again in a week or if something changes before then 

    JM
         

  16. JM Says:

    Moving into week #4 of PCT so I thought I would post another update on my progress. Funny thing is that I understand what I’m doing is post cycle therapy however, 3+ years on TRT feels more like a lifelong commitment then a long cycle. As I mentioned in my last post, I backed down on the Clomid last week to 50mg doses for the first few days and then down to 25mg doses over the weekend. The lower does really did help to control the sides but I still have to say Clomid SUCKs (for me at least). I think I felt almost every negative side effect that’s ever been reported by men on this medication. The one thing that’s really bothering me the most is the lack of focus and memory loss. I really hope that Clomid treatment is causing this rather then another underlying issue. Has anyone else experience those types of side effects from Clomid and if so how long does Clomid linger in your system post therapy? I’m hoping to come out of this fog sooner rather than later.

    The interesting thing is that when I backed down the Clomid to 25mg last Friday I actually felt roid rage. I was getting extremely angry about situations that I would typically handle much more calmly. I hope this is a sign that my body is producing natural testosterone again! 

    My next step is to start Arimidex treatment beginning tomorrow and will probably take 25mg’s every other day. At this point I think it would be beneficial to allow my body the opportunity to balance hormone production without adding a heavy flood of estrogen blockers into the mix. 

    I’m going in for blood work next Monday 12/20 and have an appointment with my endo on 12/28 to review my results. In terms of how I feel, up until I’ve been taking the Clomid I’ve been feeling better than I have in years. I would have to say that even if my test results are still low but within the appropriate range (maybe 400+) I would not go back to TRT. Low nature feels better then high test levels on TRT. That said, I understand that I probably still have a long road ahead and I may have to take another round of Clomid if my initial results are not positive. And of course I know that at the end of the day I may not be successful in restoring natural production therefore, would have to go back on TRT. I’m keeping my mind open to both scenarios to avoid a potential let down. 

    More to come….      

    JM

  17. TRT Man Says:

    JM – in general fluctuating hormones, including high estrogen and low test, can cause those “roid rage” type feelings. I get them every time I forgot to take a shot. For your sake I hope it’s a sign that your natural testosterone is coming back, but the changes of it coming back strong enough to give you roid-like rage is, in my opinion, unlikely. But my fingers are crossed for you bro. If you can do it after three years of TRT, so can I !!!! Let us know how your blood work comes back, and good luck!

  18. JM Says:

    Well I just got my results back online and my levels increased a little but not where I need or want them to be (Serum – 269 Free – 10.9). Both are barely within normal range but the most important thing is that I still don’t feel right. Seeing my endo next Tuesday to talk about next steps.

    One thing I know for sure is that if I have to go back on TRT I definitely want to try something other than Androgel. After reading through this blog again it sounds like there’s some debate on whether HCG is a good option for TRT or PCT. My endo briefly mentioned HCG when we met last so maybe he’ll agree to prescribe it for me. Anyone have a good argument I can use to convince my endo to prescribe to me if he initially says no? 

    With that said, by no means am I giving up on trying to restore natural test production but I probably won’t wait to long if I don’t start feeling better.   

  19. TRT Man Says:

    JM,

    Depending on which scale you’re looking at, 269 can be considered below normal (anything under 300). I know the AMA puts it at 250 but I’ve seen other scales that differentiate between age.

    I hope you do feel better though. I hope you get your natural testosterone production back after years of TRT. If you do, that will give me great hope for myself. 😉

    As for going back on, you should look into testosterone cypionate injections taken subcutaneously each week. It makes the process much easier than injecting intramuscularly, and your levels will state much steadier with weekly injections.

    HCG might also be an option for you, but I know when I checked my insurance wouldn’t cover it and it was SUPER expensive. The doctor also wanted to give me way too much of it.

    Keep us posted and good luck!

  20. CB Says:

    How long after you stopped the PCT did you get your labs drawn?

  21. JM Says:

    Well really only a couple of days after. After three a half weeks on Clomid I started Arimidex .25mg every other day. Took my last dose of Ari of a Thursday and then took the labs on Monday. Should i have waited longer after PCT to take the labs? 

    Looks like my insurance is going to cover HCG, so now I just need to convince my endo to prescribe it. However, I’m still confused about HCG….is it mainly for PCT or as a part of TRT? 

    TRT Man – Thanks for the advice regarding test cyp. I did try that in the very beginning but just couldn’t get used to administering the shots. That said, if that’s the best method of TRT then I’ll work on the shots. How about Testim? As I mentioned earlier, I had a bad experience with Androgel but I’m wondering if Testim would be any different? The absorption seems to be a lot quicker so perhaps my body would absorb Testim better the Andro. 

    JM   

  22. JM Says:

    Also, anyone know how long it takes to feel the benefits of HCG? Would like to get my energy, focus and libido back sooner rather then later. 

    Thanks, 

  23. TRT Man Says:

    JM,

    I took Testim for awhile and it worked just fine in terms of raising my levels to normal ranges. I think it got me up to about 400 steadily. But I hated the thought of my wife’s hormones (or my unborn child’s) getting all screwed up because of it. No matter how hard you try you just can NOT reduce exposure to zero, I don’t care what they say. My wife does my laundry, and my shirts touch the Testim gel so… That’s just one way.

    Were you doing shots IM (muscle) or SubQ (fat) ? You can inject using a small needle into the fat on your stomach, which makes the process A LOT easier. Most steroid users don’t do this because they inject more than 1 mil at a time. For us TRT folks, that’s not a problem. I only inject .5 mil (100 mg) at a time.

    HCG made me moody as hell. I think there is a problem with my body aromatizing that stuff too much. I never got it tested, but felt as though it made my estrogen (to be precise, estradiol) spike. I felt on HCG like most people say they feel on Clomid – i.e. like I was PMSing. But everyone is different; some people love the stuff and that’s ALL they take for HRT.

    HCG can be HRT alone, or post-cycle therapy for steroid users. I would NOT use it as PCT for coming off of HRT since your goal is to get your natural testosterone going again. I know you’ll read a lot about it boosting your natural levels again, but it may also suppress your FSH and LH levels once you come off of it, which puts you back in the TRT boat.

    You’ve come this far. If I were you, I wouldn’t risk that until I was ready, mentally, to give up on the journey and accept the possibility of lifelong TRT. So no, I wouldn’t ask my doc for HCG if I were you – not at this point. Get your lab work back and see how close you are to regaining normal production. If you’re still not doing any better, consider HCG as an alternative to Testosterone, but not as PCT for your HRT. Make sense? Too many acronyms, LOL…

  24. JM Says:

    TRT Man – Thanks for the response and yes it does make sense. Well I met with my endo yesterday and discussed my test levels and next steps. He was supportive of me continuing to try and restore natural test production however, he was not very optimistic. He reminded me that I tried Clomid and Amiridex treatment on and off for 6 months with no success prior to starting TRT 3 years ago. While I want to continue to try to restart naturally I’m starting to believe that it’s not going to happen…:(. I just don’t think I can function well at levels in the 200’s. 

    Therefore, I shifted the focus with my endo to alternatives for TRT. He agreed to write me a script for HCG 1000 UI’s 3 times a week. Sounds like a heavy dose but may be right considering that I wouldn’t be adding in test cyp or a gel to my therapy. Bad news is that my insurance does not cover HCG and you’re right it is VERY expensive. I do have the opportunity to appeal this which I’ve already put into motion.

    Your feedback on HCG concerns me as I seem to have the same issue of my body aromatizing test into estrogen when I took either androgel or test cyp. Arimidex did help in lowering my e2 but I had to take as much as .50 mg’s every other day in order to keep levels in line. If HCG has an even higher conversion rate to e2 then it may not work for me either, which would be disappointing considering that HCG would keep my boys from atrophy. Could a low dose of Clomid be used in place of arimidex to keep e2 down? When I lowered my clomid dose during treatment it really seemed to keep my e levels down but I wasn’t sure if it would have the same effect if combined in TRT. At this point I haven’t done anything but need to make a decision on which direction to take very soon.  

    TRT Man, is your main concern with lifelong HRT mostly due to the unknown long-term health risks? Of course I’m not a fan of HRT either but my main issue is the fact that I can’t find the right hormone balance. If I could find the right mix of meds then I think I would be fine with lifelong HRT. I know this sounds very different from my position in my original post however, my perspective has obviously changed now that PCT hasn’t seemed to have worked for me.
    JM  
     

  25. TRT Man Says:

    JM I’m sorry to hear that man. I was pretty much in the same boat and had to finally make up my mind – it had gone on long enough and I really did try to hold out.

    Yes, my concern is the long-term health risks mostly.

    But I also have other concerns. The prescription for someone with prostate cancer is a medication that lowers their testosterone. The first thing a doctor would say if I ever had prostate cancer is that he wouldn’t prescribe testosterone anymore. Let’s hope that doesn’t happen, but if it does I wouldn’t look forward to spending the rest of my life miserable. Or what if, God forbid, I did something stupid like shoot a home intruder who was unarmed, or somehow or other end up behind bars (not that I plan on going behind bars), or… I guess none of these scenarios are “likely” to happen, but they “could”.

    Then there is the inconvenience of having to take a shot every week for the rest of my life, or put on a gel every day and worry about contaminating my wife or child.

    Then there is the feeling of knowing I can’t produce my own testosterone; what makes a man a man (literally, not figuratively), and that kinda bugs me deep down somewhere mentally.

    Then there is the cost; having to deal with doctors and the healthcare system; the social stigma of taking “steroids”; side effects, getting the dose right, taking more medications to combat the side effects of not getting the doses right… and that’s a lifelong battle since what keeps your levels stable today may not be the same amount that keeps your levels stable next year as your body changes.

    Overall, being on a medication – any medication – your whole life sucks. And Testosterone replacement sucks worse than some. But it makes me feel better and I feel MISERABLE when my test levels are below 300. And it beats having to go get weekly blood transfusions or kidney kidney dialysis like some people with other conditions have to do.

    So it sucks, but it could be worse. And it sucks less than feeling like I do without it.

    Then again, I can be in fantastic physical shape for the rest of my life and will have a good sex drive into my 80’s. If my wife can keep up it might actually turn out to be decent thing to live with in some ways. 😉

     

  26. JM Says:

    TRT Man – Great points all the way around. I completely agree that it would suck to be chained to not just one but to as many as three meds (Test Cyp, HCG & Arim) on a daily/ weekly basis. Especially considering that Secondary Hypo isn’t a well known or understood issue. Truth be told the only person I’ve told about my condition and treatment is my wife. She’s obviously very supportive but deep down I don’t think she understands what I’m going through and why I keep switching treatments. Even though she knows about my issue I still don’t talk about it much…for some reason I feel embarrassed talking about it. Sorry don’t mean to start a counseling session but thought you fellas would understand. 
     
    My plan going forward is to try HCG for two weeks and then try another round of Clomid treatment. My questions is does anyone have any recommendations for how much HCG to take and how often? My endo prescribed 1000Units or 1ML three times a week. While I would usually trust my Dr I think this was the first time he’s prescribed HCG so he doesn’t have any experience with correct dosing. I was thinking 500Units or .5 ML 3 times week. Any opinions?
     
    Thanks,   
       

  27. TRT Man Says:

    I’m hoping some other people get on here and give you their opinions on dosage. Personally, and my experience with HCG is limited, I agree with you that 1,000 IU 3x week is too much. But then again, if you take an AI with it and it’s only for a very limited time, it might be fine. That’s what the medical literature says to take so…

  28. splattimusmaximus Says:

    Wow. Interesting reading. Well noted re: women’s health issues and the plethora of HRT for them. Very limited, unreliable info on the ‘net, agreed. I also quickly surmised the fact that ‘financing’ issues would quickly run someone such as myself ‘underground’. So, I have to get my facts straight and, essentially, become  literate in the biology of the situation.
    2nd bottle of Andro just started. Changed MD”s to one who knows (actually is a woman). Fecking nervous, but glad I found out how to clear the fog.
    Feck me. But, it’s as though my IQ went up 50 points with the Androgel and I make a living with my brain, not my balls, so shrivel away, nutsack, shrivel away.
    I have my first appointment to discuss my blood-work (taken two weeks ago) next week. She said the treatment would cover the gamut of issues regarding HRT (in this case, TRT). This includes ‘reminding’ my boys to do what nature intended.
    Testes mei nocere
    Splatt

  29. JM Says:

    Splatt,
     
    Glad you posted in this blog! I’m sort of with you in that I’m more concerned with the mental and emotional effects of low “T” then the physical effects i.e…loss of libido and muscles gains. Don’t get me wrong I want to be physically fit but by no means am in this to get ripped and I really never noticed a loss of libido even when my levels were well below normal. That said don’t discount how demasculinating it can be to have your boys  shrink to the size marbles….
     
    TRT Man – I’m sorry to say that I think for the time being or perhaps for good I’m giving up on restoring natural test production. I simply can’t afford to keep trying this at the expense of my job performance. I need to get my focus and confidence back so I can get back to my normal performance. HCG was mildly effective but I think I need it in very low dosage. Even at 250IUs I was noticing high E2 conversion and that’s with taking Arimidex. I’m back on test cyp injections as of a couple weeks ago. That’s another question I have for you or the group…I’ve always noticed high aromatization on TRT and the Arimidex is only mildly effective. I feel like I have to take too much of it in order to control E2 levels. I’m taking .50mg daily to keep the water weight down so now I’m concerned about low E levels.
     
    I just took 100IUs of HCG on Thursday and then on Friday 100mg test cyp. By Monday morning I had gain roughly 9 lb of water gain and nipples were getting soft (early gyno). So as you can tell aromatization is very high for me and I mentioned I’m not sure the Arimidex is working for me. It seems to be keeping my levels down, my last labs showed E levels at 5.1…my test serm was at 201 (this was before I got back on the injections) so they were both low but I’m concerned about taking too much Arim. Aren’t low E levels really bad for you as well? I’m not sure why my E levels are so low however, I’m still having problems with water gains and gyno. Is there something else anyone could recommend to keep E2 levels in line? Would Clomid be a good substitute? I it’s not an AI but I’ve got to figure out something to get my levels (or at least the side effects) in balance. Any advice would be appreciated.
     
    Thanks,
     
    JM          

  30. Ken Says:

    I just stumbled across this site and I have to say, Testosterone Injections is the only way to go if you want to get on a real TRT/ HRT plan.  100mg Every Week along with hCG twice a week is so easy I dont understand why the hesitation??  See, for me, misinformation is not helping TRT and its ability to be more mainstream.  Injecting test with a needle is EXTREMELY easy!  If you are in desperate need of TRT, you are doing yourself a dis-service by using the Gel!  Your body will thank you and you will wonder how you ever lived without it!  IMHO, and I dont want to sound rude or be an Ass but all of these posts are drama related.
    Clomid, Nolva etc and trying to use that to get your body back on track is pointless and is doing you more harm than good.  hCG along with the Gel and or Clomid/ Nolva is not the answer.  Get on with your LIFE, quit cheating yourself and get on a real TRT program.
     
    I know 4 Men who have been on injections for 10 years, yes 10 YEARS.  Their bloodwork is the same now as it was 6 years ago when they started monitoring it every 4 months..  You will live to be 80+, and be the healthiest man you know.
     
    Good Luck!
    Ken

  31. TRT Man Says:

    Brother Ken, no offense taken. When your hormones are on a roller-coaster ride for a long period of time – one tends to become a little dramatic. I agree that test is best if you’re going to be on anything long term, but didn’t want to commit to it for life until I had tried all of the alternatives. I’m sure anyone can understand that. Stay tuned for my next post though…. 😉

    JM – I feel ya man. I know how it is with work and not being on top of your game. My performance went down the toilet every time I tried to get back to natural test production. Like you, I’m done with fooling around and just want to accept the situation for what it is and get on with my life. Regarding your gyno problems though…

    If you have low e2 and still have gyno symptoms it might be worth trying tamoxifen (Nolvadex) in addition to or instead of the Arimidex. Nolvadex won’t keep the testosterone from aromitising, but it “should” help keep it away from the fatty tissue in your chest.

    I’ll be posting about my appointment today shortly…

  32. Ken Says:

    JM,
     
    In order to start getting a feel for what you body is doing/ not doing, try this..  Stay on the Cypionate for 3-4 months..  STOP the A-Dex!  A-Dex is VERY potent as you can see (5.1) Estrogen levels..  Your normal range is 28 ish..  A-Dex has a 4 day half life and is terribly potent..
    Test Cyp every 6 days
    250iu hCG day 7 and 8
    DIET!  Stay away from Sodium!  Keep your diet at 250 Grams Protein/ 100 Grams Fat/ 100-150 Grams Carbs
    30-40 Minutes of Cardio 4 days a week!  Mon, Tues, Weds OFF, Thurs, Fri.  Sat, Sun OFF  Do this every morning if you can, before you eat ANYTHING.  If you cannot swing the morning cardio then try to do it at least 4 days a week and if you workout at the gym, thats even better!
    Too recap what I think you should do..
    100mg Cyp E6D
    250iu hCG Days 6, 7  Only if you care about your Nuts shrinking or not..  hCG is cosmetic ONLY IMHO…
    Cardio, Cardio     Cardio, Cardio….
    TAKE nothing else!  After 4 months your Estrogen levels are crazy high, read below..
    EAT CLEAN!  LEAN Meats, Fruits, GREEN Veggies, Whole Oats, Brown Rice, Potatoes..  NO SALT!  5 Meals a day!  Try to drink close to 1 gallon of water a day!
    I agree with the Nolvadex as TRT Man suggested BUT I would get you some Aromasin(12.5mg ED) instead of the A-Dex..  Its much easier on your system (lipids) and wont crash your Estrogen..
     
    Do this every day for 4 months and come back to me..  I will bet you $100, you stick to what i said above 110%, you will be the happiest man alive!
    Its going to be a LIFESTYLE change, trust me..  To get your life back, take control of it!  You have the tools above to do this, just do it! 🙂
     
    After 4 months your blood test should look like this..
    700 Total Test
    35 Estrogen
    Free Test..  Tough to call since everyone is built different..
    Your having some sort of sex with whomever/ whatever daily and cannot wait till the next time…
    BAM!  $1000’s worth of info for free…
     
    Your Welcome 😉
     
    Ken
     

  33. JM Says:

    Ken – After much trial and error with Gels, Clomid and hCG I think I agree that cyp injections are probably the best alternative. Like TRT Man says it’s not easy finding the right balance of TRT so it can be and has been a roller coaster ride. What’s your dose on the hCG twice a week and are only taking 100mg of test cyp a week with now AI? Just wondering how you’re balancing aromatization from the test? I know everyone’s different but I thought E2 conversion was fairly common in men that are on TRT. 

    TRT Man – Appreciate your response. Are you taking Arimidex as part of your treatment? If so, how much are you taking and how often and is it working well for you? My endo prescribed 1mg daily but I know that’s way too much to take.    
     JM
     

  34. TRT Man Says:

    JM – I’m going to try and just take the testosterone and nothing else. I go back in six months for a complete blood work-up and will know then if I need to take anything else. I’m hoping I don’t. If I do the blast and cruise thing (i.e. basically taking a steroid cycle once a year since I can’t really mess up my endocrine system anymore than it is) I’ll probably have to take .5mg Arimidex and/or 10mg tamoxifen every day for the last half of the “blast” cycle.

    But I think it would be wise for me to FIRST try and see if I can reach some sort of balance just using testosterone in normal doses (around 100mg – 150mg per week) for HRT. There’s no reason to throw my system out of whack again before I even find out what is going to work for me long-term.

    Thanks Ken! Stick around and hopefully we’ll all learn a thing or two along the way. If all goes well I have the next 50 years of my life to be a walking billboard for long-term HRT. Maybe this site can turn into a forum or something, or maybe I can get some health professionals to write real articles giving an alternative view of TRT from the medical community – the kind of advice your real doctor won’t give you because it’s not sanctioned by his medical associations.

    Cheers,

    TRTM

  35. Ken Says:

    JM-
    I am currently taking 150mg ish Test Enan E6D with 250iu of hCG on days 7 and 8.  Sometimes I will skip a week also..  Apparently I am not real sensitive to Estrogen so an AI is not for me..  When I do take A-dex during a 16 week “Blast” I start at week 3 then I ONLY take .25mg (E3D) Every 3 Days.  Like I said before A-Dex is VERY strong shit!  1mg a day will put a Bull into an Estrogen Crash!
     
    Do the Cyp injections and maybe a smaller dose of hCG or none at all if you dont care about your Testes..  Just hit the Cyp every 6 Days and see how it goes..  Your body has been through so much lately it needs a regimen to get back to tip top shape..
     
    I have some people on Aromasin as needed as it is much easier on your system and doesnt shock the system like A-Dex does..  Remember, A-Dex is primarily given to women with Breast Cancer.  Cancer THRIVES on Estrogen and A-Dex KILLS E.  That is what it is meant to do.  Get rid of what the Cancer is “living” on then get rid of the Cancer with Radiation, Surgery etc..  Aromasin does the same thing but its not as harsh on you..
     
    For your Gyno, I would see what happens with the Aromasin and Cyp..  Once you get gyno, you’re kinda screwed as it will never really ever go away until surgery..  I would really stop worrying about it as you have it now..  Get surgery done ASAP is what I would do..
     
     
    TRTM-
     
    I am not much older then you, and I put myself on a TRT regimen..  I had a Vasectomy 7 years ago after my 2nd child so why not??  I mean if you think about it, why not keep my levels at the mid- high range of that so called  300- 1100 NORMAL? range, right…??
     
    I’ll tell you what, whoever came up with that range needs to get their head checked…  People who are at 350-400 are so fuked up that it shouldnt even be considered in the “Normal” range..  Its pathetic how most Docs look at that range as the bible when your levels are at 300 and obese because you have no energy etc etc list goes on!
     
    TRT is just starting to get over that Ginormous hill and becoming more Mainstream..  More and more studies are coming out basically saying how good it is for you to be in the 700 Range on that terrible scale..  More and more good things with a reading that high, not so many bad things…  I cant think of any EXCEPT Colon Cancer..  We need to closely monitor our PSA levels from here on out…  I know that those tests only USED to matter to the older Gents but not anymore..  We have to be careful with our E levels once we are on Test Injections and really watch our PSA readings…
     
    Again, I cannot wait to hear how you feel in about 6 weeks…  Your poor wife…. 😀
     
    Ken

  36. Splattimusmaximus Says:

    << i.e…loss of libido and muscles gains>>
    JM:
    Start date Dec 28 (just androgel) 4 weeks and 2 days later (today, Jan 21, 2011) my back, arms, and chest are definitely making my t-shirts smaller. My stomach is hard as a rock. I DO the same thing I’ve always done which is; Run a mile (heart rate 135bpm, 10min mile), Weights for an hour (heart rate 145bpm, Swim a mile (heart rate coming out 160bpm). This takes two hours. I wondered WHY I never gained muscle and ALWAYS ached and hurt. But, over the last several years I’ve figured that I’m just looking after my heart. The androgel has been inspirational on my fitness and my BRAIN.
    I have no interest in sex…
    HaHa! That’s supposed to be ‘dry wit’ and ‘deadpan’; but it’s true! No libido! *sigh*
    Keep after it, JM, keep after it!
    Best Regards,
    splatt

  37. Splattimusmaximus Says:

    << 100mg Every Week along with hCG twice a week>>
    Good intel, Ken. Did you have insurance cover it all? What do you pay for the hCG?

    Splatt

  38. Splattimusmaximus Says:

    <<I have some people on Aromasin>>
    Ken, who are you? What do you do?

  39. Splattimusmaximus Says:

    <<I cant think of any EXCEPT Colon Cancer..  We need to closely monitor our PSA levels from here on out>>
    Ken, how is the Prostate gland and PSA related to colon cancer? Why are you not concerned with prostate cancer?

  40. JM Says:

    I understand that it’s important to keep your estrogen levels in the normal range so I’ll back off of the arimidex and then talk to my endo about Aromasin and or Nolvedex. My question though is why is it so dangerous for a guy to have low estrogen levels? Excuse my ignorance if this is too obvious of a question but I can’t seem to find any answers to this question online. The A-dex keeps my water weight down and gyno away so what are the negative sides or health risks of low “e”.
    Also, anyone experiencing elevated blood pressure from being on TRT? My BP was in the normal range 4 years ago but has been increasing year over year since I started TRT. I went to see a cardiologist a couple weeks ago and he said that he is seeing more and more men with high BP that are on TRT. I have to admit that I drink bit more alcohol then I should so that may be part of the cause of my elevated BP but it’s seems a little to coincidental that I notice my BP would elevate when I took my normal dose of either androgel or test cyp. To be clear, I’m not an alcoholic – I usually have a couple of glasses of wine in the evening or a few beers on the weekend.  
    JM
     

  41. TRT Man Says:

    JM have you had a CBP (complete blood panel) done? Do you ever donate blood?

    Increased Red Blood Cell Concentration (Polycythemia): One of the most important side effects of testosterone replacement therapy can be an increase in the red blood cell mass and hemoglobin levels. This is particularly true of older men. Increased blood cell mass may increase thromboembolic events (heart attacks, strokes or peripheral clotting in the veins). Men who develop increased hematocrit can decrease testosterone replacement or can donate blood to decrease their blood cell mass.


    Source

  42. Ken Says:

    “Good intel, Ken. Did you have insurance cover it all? What do you pay for the hCG?”

    I dont use insurance to cover it.  I put myself on TRT.  I am unsure of what hCG costs are through a Pharmacy but I can get it for fairly inexpensive. 

    “Ken, how is the Prostate gland and PSA related to colon cancer? Why are you not concerned with prostate cancer?”
    My mistake!  I meant Prostate Gland, NOT Colon Cancer.  Thats what I get for doing 10 things at once and not proof reading, wont happen again. 🙂

    “Ken, who are you? What do you do?”
    I am nobody really.  I have been involved with HRT/ TRT for quite some time now and am in the business of getting Men on the right track to better health.  TRT is becoming more Mainstream now so it just makes it that much easier for me. 

  43. Ken Says:

    “My question though is why is it so dangerous for a guy to have low estrogen levels? Excuse my ignorance if this is too obvious of a question but I can’t seem to find any answers to this question online. The A-dex keeps my water weight down and gyno away so what are the negative sides or health risks of low “e”.”

    Having low Estrogen is not really a “Bad” thing.  I would have to see your Blood Test results to really see where you are at with taking that much A-Dex but if your levels are at like 5.1 that is waaay to low and I am sure you are feeling very ‘weird’.  To build and keep muscle, men needs Estrogen in the normal range.  28-35 range for a normal, healthy, all around well being.  That is the range that seems to work the best for me and many others. 

    A-Dex has a half life of 4 days.  You might be that case that is Estrogen sensitive and needs a regimen on either A-Dex OR Aromasin to keep your E levels in the normal range.  If I were you, I would stop the AI for a month and get your E levels checked.  If you are high, I would start an Aromasin for 1 month then get another blood test.  I would bet youre E levels will be much closer to normal.
     
    5.1 is too low and in all honesty using A-Dex as a “diuretic” is not the correct way to go, IMHO.  I understand you are also using it for Gyno, however your problems with it may be more intense and other action may be needed.  Keep It Simple and eliminate any small issues one at a time.  Get the E levels in check and I guarantee you will feel MUCH better, your Gyno issue may not be totally where you want it but you can at least deal with it after you get everything else in tip top shape.  Surgery is a piece of cake, trust me! 😉

  44. JM Says:

    Ken –

    You’re very knowledgably about TRT and I (we) appreciate you taking the time to share what you know! I think you’re right about the A-dex, I started taking that about 6 – 8 months ago which is about the time that I really started to go downhill with TRT. I have my labs on line so I went ahead and copied my results below from about 2 months ago. At that time I was taking only two pumps of androgel a day and sometimes none because it was making me feel so terrible but still taking the A-dex usually every other day, which is why my test and estrodial were both so low. My test levels were in the 600 range on average when I was taking my full dose of gel.

    TRT Man – 
    JM have you had a CBP (complete blood panel) done? Do you ever donate blood?

    I’m no expert but I think they covered most of what would normally be tested in a complete blood panel below. My hemoglobin has been on the rise. 3 years ago I was at 14.2 and no I don’t donate blood often but it sounds like I need to….Thx

    WBC
    4.1
    4.0-10.5
     x10E3/uL
     

    RBC
    5.61
    4.10-5.60
     x10E6/uL
    H

    Hemoglobin
    17.0
    12.5-17.0
     g/dL
     

    Hematocrit
    49.7
    36.0-50.0
     %
     

    MCV
    89
    80-98
     fL
     

    MCH
    30.3
    27.0-34.0
     pg
     

    MCHC
    34.2
    32.0-36.0
     g/dL
     

    RDW
    13.8
    11.7-15.0
     %
     

    Platelets
    205
    140-415
     x10E3/uL
     

    Neutrophils
    52
    40-74
     %
     

    Lymphs
    36
    14-46
     %
     

    Monocytes
    9
    4-13
     %
     

    Eos
    2
    0-7
     %
     

    Basos
    1
    0-3
     %
     

    Immature Cells
     

     
     

    Neutrophils (Absolute)
    2.1
    1.8-7.8
     x10E3/uL
     

    Lymphs (Absolute)
    1.5
    0.7-4.5
     x10E3/uL
     

    Monocytes(Absolute)
    0.4
    0.1-1.0
     x10E3/uL
     

    Eos (Absolute)
    0.1
    0.0-0.4
     x10E3/uL
     

    Baso (Absolute)
    0.0
    0.0-0.2
     x10E3/uL
     

    Immature Granulocytes
    0
    0-1
     %
     

    Immature Grans (Abs)
    0.0
    0.0-0.1
     x10E3/uL
     

    NRBC
     

     
     

    Hematology Comments:
     

     
     

    Glucose, Serum
    94
    65-99
     mg/dL
     

    BUN
    15
    5-26
     mg/dL
     

    Creatinine, Serum
    1.00
    0.76-1.27
     mg/dL
     

    eGFR
    >59
    >59
     mL/min/1.73
     

    eGFR AfricanAmerican
    >59
    >59
     mL/min/1.73
     

     
     
    Note: Persistent reduction for 3 months or more in an eGFR<60 mL/min/1.73 m2 defines CKD. Patients with eGFR values>/=60 mL/min/1.73 m2 may also have CKD if evidence of persistentproteinuria is present. Additional information may be found atwww.kdoqi.org.

    BUN/Creatinine Ratio
    15
    8-27
     
     

    Sodium, Serum
    139
    135-145
     mmol/L
     

    Potassium, Serum
    3.8
    3.5-5.2
     mmol/L
     

    Chloride, Serum
    101
    97-108
     mmol/L
     

    Carbon Dioxide, Total
    24
    20-32
     mmol/L
     

    Calcium, Serum
    9.0
    8.7-10.2
     mg/dL
     

    Protein, Total, Serum
    6.9
    6.0-8.5
     g/dL
     

    Albumin, Serum
    4.5
    3.5-5.5
     g/dL
     

    Globulin, Total
    2.4
    1.5-4.5
     g/dL
     

    A/G Ratio
    1.9
    1.1-2.5
     
     

    Bilirubin, Total
    1.3
    0.0-1.2
     mg/dL
    H

    Alkaline Phosphatase, S
    52
    25-150
     IU/L
     

    AST (SGOT)
    32
    0-40
     IU/L
     

    ALT (SGPT)
    53
    0-55
     IU/L
     

    Cholesterol, Total
    167
    100-199
     mg/dL
     

    Triglycerides
    342
    0-149
     mg/dL
    H

    HDL Cholesterol
    43
    >39
     mg/dL
     

     
     
    According to ATP-III Guidelines, HDL-C >59 mg/dL is considered anegative risk factor for CHD.

    VLDL Cholesterol Cal
    68
    5-40
     mg/dL
    H

    LDL Cholesterol Calc
    56
    0-99
     mg/dL
     

    Estradiol
    <5.1
    7.6-42.6
     pg/mL
    L

     
     
    Roche ECLIA methodology

    Testosterone, Serum
    201
    280-800
     ng/dL
    L

    Prostate Specific Ag, Serum
    0.7
    0.0-4.0
     ng/mL
     

     
     
    Roche ECLIA methodology. .According to the American Urological Association, Serum PSA shoulddecrease and remain at undetectable levels after radicalprostatectomy. The AUA defines biochemical recurrence as an initialPSA value 0.2 ng/mL or greater followed by a subsequent confirmatoryPSA value 0.2 ng/mL or greater.Values obtained with different assay methods or kits cannot be usedinterchangeably. Results cannot be interpreted as absolute evidenceof the presence or absence of malignant disease.

    Vitamin D, 25-Hydroxy
    32.7
    32.0-100.0
     ng/mL
     

     
     
    Recent studies consider the lower limit of 32.0 ng/mL to be athreshold for optimal health.Hollis BW. J Nutr. 2005 Feb;135(2):317-22.

  45. Ken Says:

    A-Dex is a powerful drug!
     
    Most TRT/ HRT clients do not need an AI.  If anything is prescribed, its Aromasin.  In Men, A-Dex is for the people who are cycling 500mg/week of Testosterone and other things.  Basically the bodybuilders, olympic powerlifters, etc…  They are dumping so much test into their bodies, they need a powerful drug to combat the Estrogen buildup and even when they do use it, they take .25mg Every 4 Days…  EOD with maybe some Test Gel here and there  –>  🙁 🙁 🙁 🙁
     
     

  46. James Says:

    Very interesting blog. I’m a 36 year old guy who has been on trt for 1 and 1/2 years. I have been taking 1.5 ml of tc every 3 weeks. I have farted around with the dosing and the frequency. This is the first blog that I have actually seen weekly dosing amounts. I have heard and read that weekly was the way to go. I will certainly try .5 ml every six days. I have asked my dr about different drugs to take during this because my dudes have shrunk and he seems absolutely clueless.. At about 8 months into this, all the symptoms that caused my doc to check my t levels are back. I have asked him about this and have had no valid answer. I would very much like to stop taking the injections and have also asked my doc about this and he simply stated he had never do this and wrote a script for clomid. I filled the script, however, I didn’t stop the injections because I did not feel confident my doc would guide my through this. I have been looking for a new doc but have not had much success. Anyone know of a site to search for docs with experience with trt?

  47. Suffering for a while now Says:

    I’m very interested in your experience. I have been suffering for a long time, much of it I believe from low Testosterone.

    Me:
    -34yo male
    -grade 3 vericocele to Left testicle (which is significantly atrophied) and minor cericocele to Right.
    – low bodyfat
    -regular exerciser.
    -healthy diet (primarily: fruit, veggies, olive oil, brown rice & whole grains)
    -currently work as a nurse. Med/Surg floor
    -Testosterone checked two weeks ago in the AM and it was 172

    Possible related symptoms:
    -chronic fatigue
    -general feelings of weakness
    -fatigue easily
    -poor mental focus/stamina
    -unable to gain significant strength
    -slow muscle recovery from exercise
    -siginificatly decreased visuo/spatial brain function (been declining since my mid 20’s and now is far lower than it used to be. Can hardly remember how good it used to be….) 
    -Depression, major episode, started out in 2007, when I was 30 and got really bad, even with regular exercise (30min cardio 5-7 times a week)

    I’m scheduled for microsurgery on my vericocele’s next month and planning to take a Lutenizing Hormone booster to increase my testosterone indirectly. I understand this would be the best for my body.

    Would you please get back to me with more your experience. What symptoms were you having before supplementing with testosterone. What benefits did you notice from taking testosterone? I would be grateful for you sharing your experience.

    Trying to learn everything I can. My older brother also has a grade 3 vericocele. Educating him as much as possible as I go through this experience myself. Hoping to get some function back in my Left testicle.

    Best regards.

  48. Rodney Says:

    Good read fellas.  I’m disappointed that it stopped a couple of months ago.  I’m going to decide my treatment today.  187 Total, 2.6 Free—42 years old with no kids yet.  That’s my only concern about the treatment.

  49. Staxxx Says:

    Hi. Really hoping that this blog continues. As a Type 2 diabetic, was asked to take some preliminary tests for low testosterone. Results 355 and 14l.1. Good to read experiences on going on TRT. I am 47 with a bmi of 30. Finding it very difficult to take off weight even with a good diet and moderate exercise. Terrible problems with fatigue and energy levels in the last 6 months, coupled with a dramatic drop in libido and onset of ED, which prompted these tests. Interested to know how the NHS dealt with these treatments in the UK. Thanks!

  50. TRT Man Says:

    Staxxx,

    You should also get your thyroid hormone levels checked if you haven’t already.

    Worry not; this blog isn’t going anywhere. I’m only 34 and will be on testosterone and thyroid replacement (they had to take mine out recently because they suspected cancer. Was benign.) so – God willing – I’ll have the next 40-50 years to blog about hormone replacement therapy for men.

    Good luck with yours. At 355 testosterone and being 47 I’d consider holding off until all other avenues have been tried if I were you. Get a few more tests done and use the average level, as your results will vary day over day, or even throughout the day.

    If you do end up going on TRT we’d love to hear about your experiences.

    Mr. T.

  51. splatt Says:

    Hi guys…here’s an update:

    Went to the endocrinologist and did more tests in late March. The Androgel product made me very, uh, ‘crabby’. He prescribed the NEW transdermal ‘Fortesta’ which has been great after using for a month. I had an MRI done where he looked at my pituitary gland (no tumors) but he was concerned (and I guess I am, too) that a young person would have this low a testosterone production.

    Androgel did make my body tone up, but didn’t give a sex drive. Fortesta, on the other hand, brings me back to when I was 18 (46 this year) AND I have my sanity back with ‘normal’ energy levels (not ‘over drive’ but NORMAL interest in just doing stuff like painting the trim on the house).

    Anywhoooo, I asked the Endo what the deal is with this situation and this is what he said:

    controlled release of T is the goal
    shots are cheaper but more difficult to establish equilibrium levels thereby maintaining ‘normal’ emotions
    all transdermals deliver to the body differently but are superior than shots for controlled release
    the medical community will not offer up any other drugs like human growth or LH UNLESS it’s for FERTILITY treatment
    The T replacement will prevent osteoporosis and is, therefore, the medical justification for its use

    So far, I’m happy with applying Fortesta every day. My distance running has improved, I don’t ache like i used to, my boner is hard as steel, me and the wife are busy being 18 again, I can work clearly all day long, the brain fog is all but vanished (still get groggy at times) and I’m dropping fat and adding muscle but not working out EVERYDAY. 

    Next appointment is in August. 

    Good luck, guys.

    PS: my insurance company defines the medical need for T replacement by ED symptoms which I have; also, my wife can remove the IUD as I am sterile…the Endo asked if I wanted to have more kids and that if we did he would provide the fertility treatment…yes, my nuts are shrinking..no, I don’t care! SOMETHING happened to my pituitary gland…just don’t know what…stay tuned

    cheers

    splatt

  52. TRT Man Says:

    Hey Splatt,

    That’s good to hear about the new type of test. I didn’t care that much for transdermal testosterone systems, and prefer the injections. But everyone is different and we all just have to find out what works for us. It’s good to be feeling back to normal isn’t it!?

    Take care,

    TRT

  53. stldrgnrdr Says:

    I been on the TRT for 2 years. Started out with total T of 87!. Tried  Adnrogel, Striant, TC injections. Now using compounded cream. Looking into sublingual drops. Would love to get off this stuff and go natural. May TT levels are in the upper 300’s free in mid range. Found this site ooking for info on Clomid. Symptoms lessed for about a year, now I feel back to square one! Really would like natural approach but not finding much luck with that google searching. My boys are withering away. This sucks!! Will keep watch of this blog for sugestions and give any help I can

  54. JM Says:

    I haven’t updated on this blog in a while so I thought I would post an update. If you’ve read through my previous posts you know that I’ve been a quite a roller coaster ride with TRT for a few years now. Back in Dec-Jan timeframe I attempted to restart my natural test production but wasn’t successful so I went back on TRT. I didn’t want to go back on Androgel again so I thought I would try Testim. Have to admit that I do like Testim better then Andro mostly due to the quicker absorption rate (2 hours vs. 6 hours). After about two weeks I started feeling ok again and continued to feel good for the next few months. However, about a month ago I started down that say path of again of feeling terrible about 2 – 3 hours after I would apply the gel. Like before the gel seemed to mostly be converting to Estrogen rather than giving me a test boost. Not sure what the problem is as I know most men tolerate TRT and realize good benefits from it but for some reason no matter what I’ve tried (Test Cyp, Andro, HCG & Testim) it just doesn’t work for me.
     
    I was originally diagnosed with Idiopathic Secondary Hypo (meaning of unknown cause) so I’ve always questioned whether I really had an underlying problem which was causing the low T or not. Back when I got diagnosed I was suffering from sleep apnea so I was not sleeping well and I was drinking too much which could have contributed to my low test levels. Both issues are behind me now.
     
    Looking back when I attempted to restart in Dec I think I was taking way too much Clomid and I gave up too soon. Well I’m attempting to go natural again but this time I’m only taking .25mg of Clomid daily. I’ve been off the gel and on Clomid therapy for two weeks now and I feel much better. My plan is to continue to take the Clomid for another week or two and then stop taking ANYTHING! I’ll probably wait another 30-days after my last dose and then go in for testing.
     
    My levels after I tried to restore natural last time were actually in the normal range but just above the lower limit. At this point I would rather be in the low normal range with natural production then at any level on TRT…that’s just my personal opinion.
     
    JM  
     

  55. TRT Man Says:

    Good luck JM. I’m sorry this hasn’t worked out for you. If you ever do go back on I’d recommend paring your testosterone injections (definitely injections) with an aromatase inhibitor like Arimidex if you think estrogen conversion is your problem. But I hope you can get into reasonably normal levels of testosterone naturally.

    An update on me: After having my thyroid removed and adjusting dosages of thyroid hormone (synthroid) twice, I am in normal TSH ranges and feel like my old self. My testosterone ranges from about 600 to 800 depending on when in the week I’m checked, and that is a level that makes me feel normal without any noticeable side effects, nor a raging sex drive. I feel like I’m balanced right now and will continue on current doses for another six months just to make sure this is where I need to be. I may do a “blast” once a year with slightly higher doses of testosterone just to get in really good shape, but otherwise I’m going along as planned.

    Thank you for your update and I wish you the best of luck on your journey.

    Cheers,

    TRTGuy

  56. daniel Says:

    Howdy folks. Especially you, TRTMan. It has been wonderful to read all your comments on this blog. I am in the same boat of looking at TRT the rest of my life. Probably wouldn’t have commented except that I noticed that TRT Man has had some problems with your thyroid? Just wondering if you have any extra information about the connection between your thyroid, testosterone production, and the pituitary gland. I am particularly interested if you know how to determine if you are primary or secondary hypogonad.

    Little bit about me, just so you know where I am coming from…

    Age 13: gynecomastia began, told by doctor that it would go away on its own.

    Age 16: benign tumor found on one half of my thyroid, 1/2 of thyroid was removed.

    Age 17: thyroid hormone replacement therapy started. helped greatly in my concentration ability.

    Age 17.5-19.2: slowly weaned off thyroid medication. lab numbers revealed that the one half seemed to have been working alright without the other half.

    Age 19.5: started trt after labs showed my t to be under 200. on 5g androgel.

    Age 20.3: had gyne surgery after years of frustration. somewhat frustrated with the results, too, but trust me, it’s much better.

    Age 21: lost my health insurance a few months ago when I turned 21 so I switched to a compounded cream. much much much cheaper than androgel.

    That brings me to the present. I am 21 and (this is the honest truth) i have unfortunately not grown AT ALL since I was 16 and they removed half the thyroid. AT ALL. I have gained about 15 pounds since then but as far as height goes it has been 0 change and muscle mass has been extremely minimal, at best. i am living in a 16-17 year old’s body but I guess I have gotten used to that. The only thing that I am still frustrated about is my inability to sleep. I have very poor sleeping ability and usually get 5 hours or so. Not enough for me to feel truly refreshed. About one day every two weeks when i get super tired i finally get a good night’s rest and feel great, which is how i wish i could feel every day. anyways, just posting an option that i am very heavily considering switching to after hearing many great stories. weeks between shots is old news. if you’d like to hear more of the science behind it i can provide that information but for now, here’s what the top in the field are recomending – a weekly cycle. It is very close to what Ken was recommending above.

    Day 1 (ie Monday):      100 mg cyp, .25 mg Arimidex
    Day 5 (ie Friday) :        .25 mg Arimidex
    Day 6 (ie Saturday):     250 iu hcg, 
    Day 7 (ie Sunday):       250 iu hcg
       (start over)

    Just thought I’d share my story and potential plan. I have been on the compounded cream for about 8 weeks now so I am scheduled to go get the following tests done:

    t3
    t4
    tsh
    estradiol
    free t
    total t
    lh
    fsh

    this should give me an idea on my next step and may also shine some light on whether i am primary or secondary and may also tell me if i need to go back on thyroid medication. o boy. i’m younger than you and already feeling the pain of being on 1 (or more) medications for a lifetime. yay. but it’s better than feeling like CRAP like i did before i started TRT. I am really thankful that we have scientists that discover all this stuff.

    one more thing: DO NOT LET YOUR DOCTOR TELL YOU THAT THE NORMAL RANGE OF TESTOSTERONE IS FROM 300-1100 LIKE I LET MINE TELL ME FOR TOO LONG. After doing exhorbitant amounts of research (like I did, you really have to be your own doctor if you are serious about feeling better) as well as experimenting on your own as to your dosages (as I also did until i felt better), you really need to consider the healthy range of total testosterone to be 650-900 ng/dl. Seriously. You will feel loads better once you get above 600 or even 700 as Ken stated above.

    Hit me up with comments or questions. I’m not trying to say I know everything, I am seriously looking for opinions because I’ve heard great things about the above method and just wondered what you thought since it appears you have done a lot of learning and researching on TRT yourself. Researching TRT has over the past few years become a hobby. If I spent as much time playing my guitar as i spend reading and asking questions about TRT, maybe I’d actually become that rock star I’ve been wanting to be 🙂

  57. TRT Man Says:

    Daniel,

    I feel for your brother. It sounds like you’ve been through hell. For what it’s worth, the older you get the more you’ll appreciate looking younger. 😉

    I’m not sure about your weekly cycle, but can’t claim that I know a lot about that sort of thing. Is seems to me that taking Adex only twice a week is strange, but I also know that killing off ALL estrogen can be unhealthy too.

    I totally agree with what you say about testosterone ranges. My normal is not someone else’s normal. And I didn’t feel “normal” until I was above 600 ng/dl.

    Although our entire endocrine system is connected in many ways, I don’t think my thyroid problems had much to do with my testosterone problems (I was secondary, but have all of this TRT I’m sure I’m primary now too) as it was more to do with the benign tumor than the pituitary gland. Of course, I could be wrong, and even endocrinologists don’t have a full comprehension of how intricate the system is so… who knows.

    Keep in touch and let us know how things progress for you.

  58. JM Says:

    TRT Man & Gents,
    I went to see another endo about two ago to get a second opinion on what’s causing my low T levels and why I seem to be having so much trouble with side effects from TRT. This endo actually works out of a diagnostic facility along with many other colleagues of other disciplines. Well he did a very thorough exam and tested me from A – Z. 7 different vials of blood samples along with urine.

    Came back for a follow-up last Friday and he shared with me that all of my levels were in the normal range. Therefore, he concluded that I was misdiagnosed with Secondary Hypo 4 years ago. Mind you I have not been on any testosterone or Clomid for the last 90-days prior to my labs. My Test Serum was at 295 and Free LH is at 14.5. My thought was that even though my levels at 295 were slightly above the low end of the normal range that still seems very low for a 38 yr old man. He explained that the more important measure to see if your pituitary is working properly is the Free LH measure which is actually closer to the middle of the range at 14.5. He also tested 3 other measures related to my pituitary (not sure what they were) and he said all were within normal range as well. 

    Now this is all good news however, it doesn’t explain why I was still feeling tired low energy and somewhat depressed. His answer was that after being on TRT therapy for 4+ years it’s going to take time for my body to return to normal function, it may take as long as 7-8 months until I feel completely normal again. He also said that the pharmaceutical companies that are producing the gels and other tests products are selling Dr’s on the fact that TRT is the answer for anyone with low test level. Therefore, there are many DR’s that just prescribe Androgel or something else without really digging into what the underlying cause may be. With that said I know that there are many of you who have a legitimate medical need to be on TRT and that your experience may be positive with the therapy. My situation was unique (I think) and thankfully I found an Endo that really took the time to try and diagnose my issue. 

    So my focus at this point is to eat right, exercise and try to get my body back to good working order. I actually started the P90X workout program last week which I think so far is awesome.
    I will continue to post my progress to this blog. Best of luck to all of you! Hopefully my experience might be helpful to some of you who may still be struggling with TRT!
    JM 

  59. TRT Man Says:

    JM,

    That’s good news I hope. My situation was very similar to yours. Some tests show I was borderline on several fronts, and others show I was slightly low. Given that I was in my early 30s at the time, I figured “borderline” was actually “low”. At any rate, I feel GOOD when on testosterone replacement – better than when not – and as long as the side effects don’t outweigh the benefits I’ll stay on.

    The real question is always going to be: How do you FEEL? If you feel good without it, don’t take it. Hopefully you can reach that level of comfort without TRT. It’s expensive and a pain in the ass. Literally.

  60. JM Says:

    TRT Man,

    I hear you, the most important thing is how you feel not how high your levels are unless of course they are dangerously low. As of right now I don’t feel that great but like I mentioned I’m going to be patient and work hard.

    As side note, my main issues with TRT were water retention and high blood pressure so I was meaning to ask my endo if a prescription diuretic would help alleviate the sides but when he said all was normal I kind of forgot about it. Have you heard of anyone having success with water pills to help with the sides I mentioned? 

    Who knows if I still feel like crap in 8 or 9 months from now I may be back on TRT.  

    JM

  61. KT Says:

    Great blog! I’ve been on TRT for over 2 years now and seem to be experiencing some of the same issues as JM. Been on Androgel and for the first few months it seemed to help but then I started to have issues with water gains and high blood pressure. I think part of the problem is that I’m not absorbing the gels very well so I was thinking about switching to test cyp injections. From what I’ve read on this site and elsewhere that seems to be the better option for TRT but I’m struggling with having to administer a shot every week. For those who are on test cyp or have tried it, how soon after your first shot do you start to feel the effects? What length of needle is required for a shot in the glutes?
    JM- good question on the prescription diuretics I’m wondering if that would help me with the water retention and HBP.
    TRT Man – Thanks for hosting this site there is a lot of good information here!      
    KT
     

  62. TRT Man Says:

    KT you should start to feel better within two weeks of starting the injections, probably sooner. The length of the needle depends on where you inject. You’ll probably want 1.5 ” to 2 ” needles for glutes (butt cheeks upper/outer quandrant) or 1″ to 1.5″ for thigh. I get 1.5 ” needles so I can use for both. I also draw the oil out of the bottle with an 18g needle and inject with a 23g needle. This keeps the injection needle nice and sharp since it doesn’t have to pierce the rubber stopper before I put I use it on myself and makes pulling the oil out much faster.

    Good luck!

    TRTGuy

  63. KT Says:

    I just started on test cyp injections last week and by day 4 I already started feeling better. My endo also has me on 50mgs of Arimidex 3 times a week. The first 3 days I really didn’t feel anything but I did notice some bloating so I took my Adex and than not so coincidentally I woke up the next day feeling better and the bloating has all but subsided. My endo has me on 100mg of test cyp every 7 days. However, I’ve read that if you take it every 5 days you can avoid crashing on day 6 and 7. I would like to avoid the fluctuation in levels but at the same time I don’t want to overdo it.

    TRT Man – If you don’t mind me asking what’s your dose and how often to you take your injections?

    KT
     

  64. TRT Man Says:

    KT are you sure you take 50mg of Arimidex 3 times a week? Do you mean .5 three times a week?

    I take 100mg of testosterone enanthate every Friday. From time to time if I feel like my nipples get a little sensitive or itchy I’ll take 10mg of Nolvadex for a few days. I’d prefer to take arimidex but haven’t talked my doctor into prescribing it yet and don’t like dealing with the black market or shady “HRT clinics” online.

    I feel great at that dosage. It’s high enough to keep me between 600 – 800 on the testosterone test scale, but low enough that I don’t experience side effects too much. No acne, no bloat… so far.

    By the way, I don’t feel like I crash on the 6th and 7th day. Once a week is plenty with a long-lasting esther like enanthate or cypionate. And it’s easier to remember to just take it every X-day rather than counting every five days. If you’re going to be doing this the rest of your life you might as well make it easy on yourself. But everyone’s different so I guess the important thing is that you’re doing what makes you feel better.

  65. KT Says:

    TRT Man,

    Yes I meant .5mg of Adex 3 days a week. I’m taking my injections once a week on the same day and it seems to be working well. I’m not feeling a crash on day 6 or 7 however, I do feel kind of a rush the next two days after my injections. It’s not necessarily a good rush though it kind of feels like my BP is spiking a little. Not to uncomfortable though. The rest of the week I feel 100% times better than I did on the gels. I’m sure over time my body will adjust and the spike in BP will subside.
    Last week I got my labs back and my test level was at 625!!! The highest I ever got on the gel was 405. The injections are proving to be a much better alternative for me. After the first couple injections I got used to administering the shots so no problem there either. 

    Thanks for the advice!  
    KT

  66. KT Says:

    This last week I noticed a bit of crash on day 6 and 7 and again a little uncomfortable rush the first day or two after taking the injection. At this point I’m wondering if I should split my 100mg dose in half and take twice per week. Take 50mg on Sunday and 50mg on Wednesday. That might keep me on a more consistent level. I really don’t mind administering the shots any longer so if that frequency would keep my levels consistent that I’m all for it. Has anyone tried splitting your doses and taking shot more frequently?

    KT

  67. CC Says:

    Thanks or taking the time to make this blog. I’m 38. I had a struggle with Peyronie’s when I was 31. It sucked. Just before Peyronie’s I was also diagnosed with an AZFc microdeletion. I went through a series of Verapamil injections and my Peyronies stabilized. Back then my FSH was high and LH was middle range and my testosterone was “normal range”. What I didn’t understand at the time was that the doc only checked for total testosterone, not bio-available. Fast forward to 6 months ago. Tired and worn down. No sex drive. Couldn’t concentrate. I decided to go see a doc that is well known as an anti-aging doc and specialized in TRT. My total testosterone was in good range as well as thyroid. But my bio-availble testosterone and other androgens were low. Also my FSH is now off the charts and LH is at the top of the range. My SHBG is extremely high. Additionally, my estrogen (sensitive E2) was low at only 10 (it should be 20-30). I have started treatment recently and am feeling better already, mainly because I think I’m on the right track. Keep up the comments. It’s good to hear what everyone is going through. CC

  68. TRT Man Says:

    CC I am convinced that there is a definite link between Peyronie’s disease and testosterone and related hormone imbalance. I hope to do some more research on the topic and write an article exploring it. Thanks for sharing your experience.

  69. Fred Says:

    Low b12, both natural varieties, can cause low testosterone.  As there are both functional changes and later damage, from b12 deficiencies, it is sometimestimes reversible with vitamin supplementation.  The two natural b12s, methylcobalamin and adenosylcobalamin are included in the foods that are part of the long traditional “tantric” meal used in vegetarian countries.  I have known folks who have recovered both testosterone levels and erectile function with the right brands and methods of taking mb12 and adb12 and cofactors.  The important ones are Jarrow or Enzymatic Therapy methylb12, Source Natural dibencozide (adenosylb12), Metafolin, b-complex, omega3 fishoil, zinc, potassium (can be critical), magnesium and the other usual vitamins and minerals.  The b12s need to be taken under the upper lip and retained fro 45-120 minutes or more to absorb a good amount.  If you are deficient you will likely notice an effect before they finish disolving.  Also, I had uncontrolled muscle atrophy that reversed when I added the mb12 and adb12 and my muscles have all grown back. The brands mentioned by name are critical as not all forms of mb12 are created equal.  Most brands are ineffective.  Chewing and swallowing the tablet is ineffective. Good luck.

  70. John Stevenson Says:

    Hi there

    I just got diagnosed with secondary and have started Depo T shots, and will soon be adding Arimidex and HcG as well this week (week 10)

    thanks for your experiences its all still one hellova shock to me cause I’m 30 years old and hearing your journey has helped and will help

    thank you

    John

  71. TRT Man Says:

    Hello John,

    Sorry to hear about your diagnosis, but glad you’ll be feeling better soon. Glad we can help with our stories too. One thing I want to mention is that you may feel like a human pin cushion after taking depot shots every day or every other day for the rest of your life. I prefer a longer-lasting testosterone esther like Cypionate or Enanthate so I don’t have to inject as often. Once a week is plenty for me!

  72. AE Says:

    Hello,

    Thank you for having this forum. I’m writing to hear your thoughts on an HCG, T, Aromasin protocol. I’ve been diagnosed with primary hypo-g. It started two years ago when I noticed testicular shrinkage and lethargy. For my annual physical I had the clinic test my T. It was at  200 something. They checked on me 3 mos. later and it was just over 100.

    So the doc started me on pills, and then moved me to Androgel after I told the doc that long terms pills could be unhealthy for the liver. I’ve never had much body hair but after three months on Androgel my skin became rough as (what I believe) hair follicles started sprouting. Now I have stomach hair and a rough chest. I didn’t like this and the daily gel applications and switched to cypionate injections which I liked much better.

    So now I have convinced the doctor to prescribe me a-dex (moving to aromasin shortly) after my fingers and face became puffy and have seen a reduction in puffiness. Having read about the benefits of HCG I convinced the doc to give me that too and they complied.

    Currently on:
    2 shots a week @100mg (.5ml of 200mg cyp per 1ml=100mg right?)
    .25 mg aromasin daily
    500 mg HCG daily

    What potential side effects are there on this protocol? I was worried that I could develop secondary hypo-g with HCG. I know they are working on regrowing testicles and it would be a bummer to still be stuck in the same boat when/if this arrives because of the therapy.

    Thanks,
    AE
     

  73. TRT Man Says:

    AE,

    You are taking too much testosterone. No wonder you are aromatizing some of it into estrogen and thus experiencing estrogen related side effects and having to take aromatase inhibitors. Add HCG to that, which raises your testosterone levels even more, and you are on a low dose cycle, not testosterone replacement.

    100mg per week is PLENTY, especially if you are taking HCG too.

    Potential side effects short-term are probably limited to gyno, bloat, and maybe some aggression and scabs on your penis from chronic masturbation. Long term though, and you’re looking at far more serious and potentially life-threatening side effects. I don’t want to scare you though. By long term I mean years.

    TRT Man

  74. JCM Says:

    Ken is reassuring, since he is a long time user.   That is the thing.. newbies read a lot from short term users but these T blog sites rarely have much from 10 year plus users.

    I first was diganosed three years ago.  Took me another year to get a doc to prescribe T cyp to me.  Then I panicked and freaked out about long term dangers and general dependancy to scripts, docs, and a shot to preserve feeling good.  And did not start. so, I have now gone on three years feeling weak and depressed becasue I don’t want to start a dependancy to a shot.

    Now 43 – still conflicted and anxious about starting.  I think my low T is part of my problem in making this decision and feeling confident about moving forward.  Crazy the thing I need to treat is clouding.. blah blah blah – you get the idea.  I read all these blogs and hear good then bad stories and gyrate back on forth on what to do.  Then to do shots or pellets… kinda have already ruled out gel.  

    totally understand TRTMans concern about stockpiing.  I fret what if I lose my job or go broke and cant keep up with meds… i do all this worst case scenario thinking.. ffing wearing me out.

    Great blog.  Lots of good comments.  Thanks to all.

     

  75. Fred Says:

    HI JCM,

    I have been on TRT for 11 years, one of the long term users.  I’m on 140mg/week of IM injection.  It works well and has for 11 years.  The injections, when prescribed, cost $25-$50/monthy depending upon availability, which is sometimes difficult.  I had to drop back to 100mg/ml from 200mg/ml a few times in 8 years becasue of availability problems, and it cost the same per ml.    As far as long term effects, I’ve had none.  I tried a very slow withdrawal schedule as suggested in some literature as a way to give one’s own T production to increase, it didn’t.  In the withdrawal I did find out where the effective level was, 120mg/week.  At 120mg/week night time erections start getting erratic.  At 100mg/week they are non-existant.  At 140mg a week everything works well.  The prescribed amount by the doc based on test results that are checked every 6 to 12 months, is 140mg/week.  The side effects from larger amounts are something I don’t want to have to deal with.  So basically I take the minimum that is consistently effective.  I started out on Androgel.  It got very expensive and started affecting my skin where it was applied. 

  76. TRT Man Says:

    FRED thanks for sharing your story. It is rare to hear from someone who has been on TRT for over a decade. I would love to have you post a your whole story on here some time if you’re interested. I can email you with how to get in touch if you are.

    As for the dosage, if that’s what works for you then that’s what works. But for others I would suggest that 140mg could be more than is needed. I do very well on 100mg per week myself. My first doc was only giving me 50mg per week and it wasn’t enough.

    Thanks again for sharing!

  77. FTcyclist Says:

    Great blog, nice to see this information. If anyone else has longer term experience please post. There is limited literature regarding the long term use of testosterone replacement. I am torn as I am not sure I want to be on testosterone for the rest of my life.

  78. AE Says:

    Thanks TRT man,

    I will get tested and see what the levels are at! So far I feel better than not being on the hormones but like you mentioned it’s the long term consequences that I have to watch out for. 

    Best,
    AE

  79. Fred Says:

    For me at least, being on T for the rest of my life is not any different than being on the thyroid hormone I have to take every day for the rest of my life, or the pain meds I’ll be on for life, or the vitamins absolutely needed for my good heallth that I will be on for life.  If I was ever in a situation where my various meds couldn’t be continued I would decline very rapidly.  The only thing keeping my neurology functional is daily methylb12 injections and daily Metafolin.  So the prospect of adding 1 injection per week to the 60 tablets a day and 3 injections per day I already take isn’t all that forboding.  I have been taking thyroid hormones for the past 55 years.  There is no alternative if I want my body and mind to function pretty well.

    If there are undiscovered side effects from long term usage I imagine I might be up at the front end of that.  Of course there are a lot of cancers that might be casued by faulty DNA replication which can occur becasue of shortage of methylb12 and/or methylfolate.  So maybe I’m protected from those by taking those vitamins.   There are a whole lot of unanswered questions.  So far I just feel better and have the best health of my life.

    For you YOUNGER guys, low methylb12 can actually cause low testosterone.  I have known some guys in their 30s that have had testosterone production restored with these vitamins so that might be something tried before going to the testosterone supplementation.   B12 deficiency is known to cause low libido, ED, low intensity of orgasm, no orgasm, low sperm, poor quality sperm, reproductive failure in general.  gOOD LUCK.   

      

  80. JM Says:

    TRT Man,

    Well I tried Clomid therapy in an attempt to restart naturally for roughly 5 months with little to no success. I was able to get my test levels into the low 300’s about 3 months ago but sense then I’ve been back down in the low 200’s and more importantly I feel like shit. I’ve gained about 20 lbs and it’s all right in my belly where my abs used to be. At this point I’m almost 40 yrs old so I’m finally coming to the conclusion that I need to on TRT.

    I went to see a cardiologist the other day about my elevated BP and heavy edema. He said my heart checked out but he was concerned about the high BP. He also thought I should get back on TRT due to my low test levels, weight gain and lack of focus and drive. He said that he is seeing a lot of guys lately with elevated BP that are on TRT as well. He prescribed me a beta blocker for my BP and a diuretic for the edema (not to be taken together). 

    I started back on TRT two weeks ago and choose to go with test cyp injections. I started feeling better within two days of my first injection so all is good so far. This time I am going to be incredibly focused on taking my injections on the same day around the same time for better consistency. Taking 100MG a week every Wednesday morning with .25mg of Adex three days a week. 

    My question is do you or does anyone else know how long the needle needs to be to effectively reach the muscle in your glute? At this point I’m about 25 lb’s over weight and body fat is at 24%. I’m using a 23G 1.5″ needle. It seems plenty long but I just can’t tell if I’m getting into the muscle or not. I know the thigh is an option too but I would really like to keep the injections in my glutes if at all possible. 

    Also, I know it’s only been two weeks however, both times when I get to day 6 it almost feels like I’m getting a flood of test which is causing my BP to rise quite a lot but I would have thought my test levels would be at its lowest at that point. Maybe I’m sort of crashing a little on day 6 which is causing the negative feelings. 
     
    Thx,
    JM
             

  81. TRT Man Says:

    Hello JM,

    I’m glad to hear you’re on the road to feeling better. The .25 Adex might be fine for right now, but you don’t want to add anymore LIFE LONG medications than you have to. I’d say you could see how you feel when you’re not taking that after a few months. I think most men can handle 100mg of testosterone per week with very minimal aromitization. I don’t take Adex or Nolva or anything for estrogen unless I’m on a “blast” cycle where I’m taking more than 100mg per week. But we’re all different and you know your body better than anyone so if your nipples feel itchy or puffy then you should take the Adex. Some guys will take HCG to maintain the size and functionality of their testicals. I don’t take that either since I don’t care about the size and we’re not having anymore kids. Orgasms feel just as good as ever; has nothing to do with testicular size.

    You need to watch BP on test, but in my experience my BP and lipid levels have always been perfect. Much of that is genetic though. Again, if the testosterone and a good diet with plenty of exercise (now that you have your motivation back) can take care of the BP then you can toss out the beta blocker and have one less medication to take every day.

    The needle size is fine for your glutes. It’s getting in there just fine, I’m sure. Also remember that even sub-Q injections into fat will still find their way into your blood stream. A lot of doctors these days actually tell patients they can take testosterone Sub-Q in the stomach fat, which makes injecting much easier for them. I do mine intramuscularly in the glutes like you do.

    Testosterone Enanthate and Cypionate are long-lasting esthers so it could very well be that day 6 is your peak day, but in my opinion it sounds like maybe you’re dipping a bit since you have “negative feelings”. A wee bit of extra testosterone isn’t going to give you negative feelings. My advice as another patient with no medical education would be to stick with it for at least a month, which will give your testosterone levels time to stabilize. If you’re still feeling a weekly dip then you should make an appointment to have your testosterone checked on that day. Then you’ll know for sure one way or the other; there’s no sense in guessing.

    Good luck!

    TRT Man

  82. JM Says:

    Anyone have any good information on the relationship between TRT and DHEA levels? I’ve been reading through a number of different sources on this topic and I keep finding very conflicting information. I understand that’s its commonly referred to as the “cousin” of testosterone in that it has similar effects on the body but is technically a different hormone. The reason I’m curious is mostly due to the fact that it sounds like there could be good benefits to adding DHEA supplements to your TRT regimen (improve your immune system, weight loss and anti-aging effects). I wouldn’t consider an OTC supplement but if my endo thought it could be beneficial and would prescribe it to me then it might be worth looking into. Although, I also read somewhere that’s it’s not even available for prescription use in the US yet so I could be way off here.
     JM    

  83. TRT Man Says:

    JM taking testosterone I think raises your DHEA a bit, but the thing you have to watch out for with DHEA is prostate hypertrophy and prostate cancer. I’ll stick with testosterone since that’s what my body wasn’t producing.

  84. JM Says:

    TRT Man, That makes sense, I was just curious.

    Thx
    Jm

  85. Rich Says:

    I’m so happy to have found this blog. I have been on HRT off and on for last 3 yrs. Every time I start I make a commitment to stick with it but stop because my nuts shrink down to the size of large grapes and my sac is flush with my body. I’ve asked my Dr. and he says not possible. I’ve tried patches, gels and compounded creams. The cream I have now has 20ML testoserone/Chrysin (2X) Progest 5ML. I was also instructed to take Endocarbenol, 2 tabs twice daily. I was in a car accident that left me with severe chronic pain and have been on narcotics and gapapentin for 12 yrs. Dr. says this has killed my nuts. I have good Med Ins., belong to a world renouned med center but the Endo will not even see a male patient unless testostone levels fall below 200. PERIOD! I have hot flashes, feel like shit, have gained 40 lbs. and when I ask my Dr. to do blood tests he says NO. Only every six months. I can’t go outside the system. He says I have no chioce but to be on it the rest of my life. Right now the only good thing I can say is that the customized cream is the best of all I’ve tried. It goes into the skin very fast and isn’t sticky at all. I hated andro gel, and I put one of the patches near my rear but still on the hip and it burned through three layers of skin. Since I have certain parts of my body that are numb I couldn’t tell it was burning. Took 4 months to heal. Anyone know if stem cell research to repair the nuts. I know there now doing it for breast tissue for women.(see good morning america) The beautiful blonde from Three’s Company. Can’t say her name. I would just like to feel and look normal. Don’t have to look like a porn star!

  86. Fred Says:

    Hi Rich,

    I’m on morphine for pain due to a car wreck decades ago.  I have a life back.  If you respond similarly to how I did, methylb12 (Jarrow or Enzymatic Therapy brands only) along with b-complex and other vitamins (Active B12 Protocol)   can heal the nerves and cut down the pain a lot and for me allowed a 40% reduction in morphine and a 100% reduction of Dilantin (an older drug instead of gabapenten) for nerve pain.  I also lost 85 pounds and, with dibencozide (adb12) and l-carnitine fumarate was able to start building muscles again.  I’ve been on testosterone since 2001.  I regained normal feeling in much of my body.  Some men on the active b12 prrotocol do regain the ability to make more testosterone if it was the deficiency in the first place that caused it to diminish.  Good luck.

  87. Boston Says:

    Glad to have came across this blog. I am a 27 year old diagnosed with Low T last year due to a Total T reading of 192 on approximately a scale of 220-1100 ng/dl. I was put of shots of test cyp and did that for a month. However, I began reading up on the effects that the exogeneous test could have on fertility and that was VERY concerning to me as my wife and I wanted to have another baby in the near future–we curently have a 15 mo old girl.

    I switched urologist as the other said he was not very aware of how the shors would impact my fertility (red flag!). The doc I am currently seeing wanted to put me on Clomid at 25mg ED to ensure my fertility while treating my Low T. I have been on Clomid therapy for about 6 or so weeks and recently got my blood results back. I was approximately 720 ng/dl which was great, but my estrogen was quite high at a level of 142 on a scale of around 40-120. I had been having some nipple irritation, so that may make sense. 

    My wife is actually 11 weeks pregnant right now, so fertility is not nearly as big of a concern as it was a few months back. The doc decided to take me off the Clomid and back on test cyp at 100mg EW. He also thinks this will help keep the estrogen levels down as well. 

    I would love some input from you guys as the internety websites are flooded with misinformation and many forums are saturated with guys looking to push their own agenda or business.

    Glad to be here.

                 

  88. TRT Man Says:

    Boston,

    It sounds to me like the new doctor is barking up the right tree for you. Clomid alone isn’t a long-term solution to low test because, over time, it may desensitize the leydig cells in your testes and make your problems worse. But as a short-term workaround while you tried to have a baby it was fine. Now you’re on 100mg per week of cypionate, which is what I’m on. It works well for me and I don’t need to take anything else at that dosage. Some may be more sensitive to estrogen or more likely to convert testosterone to estrogen (aromatization) so pay attention to symptoms and talk to your new doctor as necessary.

    Good luck and congrats on the pregnancy!

  89. Boston Says:

    TRT Man-

    Thank you for the feedback and the congrats! We are excited about the pregnancy, no doubt!

    I have heard about the desensitizing, but what-in simple man’s terms–does that mean exactly? I haven’t been able to get much out of what I’ve read online.

    Also-what sort of symptoms should I look for other than breast tenderness? I have begun taking an OTC supplement, made by a company called physique enhancing science, called “erase”. It is supposed to act like an AI and I started taking that due to the high levels of estrogen discovered while I was on the clomid. 

    Again, glad I found your blog!           

  90. TRT Man Says:

    Boston,

    In simple man’s terms, the desensitizing acts just like anything else you build up a tolerance too. Eventually your leydig cells will build up a tolerance to the gonadotropins so then even what little your own body produces will be even less effective. That’s why I wouldn’t take HCG or Clomid long term. I’m not a doctor though, and this is far from a scientific statement. It’s just what I understand from my own research – HCG and clomid are short term ancillary drugs.

    Don’t take OTC aromatase inhibitors. Half the stuff out these days in that genre, as well as the pro-hormones and “natural stacks” advertised in bodybuilding magazines actually contain pharmaceutical ingredients or their precursors, which turn into the active ingredient once in the body. If you need an AI, talk to your doctor and get a real one so you know what you’re taking. If you don’t feel any tenderness in the breast area or ithyness or experience bloating in general, you probably have nothing to worry about.

    Good luck.

  91. Boston Says:

    That makes perfect sense. I appreciate you explaining it.

    When you have your levels check does your doc to a total estrogen test or an estrodial test? My doc seems to look at only total estrogen, and I have seen some information online that mentions needing to look at E2. I did not mention this to him, as I did not want him to think I was doubting his methods, but I am curious as to what others are getting checked.

    I agree with you on the OTC products. I bought the erase as I was having the sensitivity and tenderness, but the doctor felt my estrogen would straighten itsels out once I stopeed the Clomid. I guess I was afraid more than anything else that I would end up in one of my sifes bras! He didn’t want to prescrive anytjhing just yet.

           

  92. JM Says:

    TRT Man,
     
    I’ve been experimenting with splitting my dose of 100mg test cyp twice per week to see if I could even out the highs and the lows. I’ve been doing this for a couple months now and it really doesn’t seem to be working well. I typically experience a rise in BP and heavy bloat for the first couple days after taking a shot so I thought perhaps I wouldn’t feel as many side effects at lower dose injections. However, what’s happening is I’m still feeling the sides just now I feel them more often considering that I’m taking the injections more frequently.
     
    I understand that test cyp is a slow release longer lasting therapy so I’m wondering if more frequent injections are actually counterproductive against the design of the medication. Have you heard that as well or do you take 1 shot 100mg per week more as a matter of convenience and for consistency? Would welcome any perspectives on this topic as well from other readers.
     
    Thx,     

  93. TRT Man Says:

    JM I don’t know if more frequent than once-weekly injections of cypionate is “bad” but I’m pretty sure that it isn’t really helping much more than a once weekly shot would.

  94. Fred Says:

    Hi JM,

    I’ll address that issue.     My dose originally was 200mg/10-days, the last 3 days of that were bad.  My doc changed it to 20mg/day so its 140mg if 7 days apart, 100mg of 5 days, etc. Seven days works great, 5 is no different. I have written some serum level emulators that merely need dose and frequncy and half life of the drug to simulate it.   The more frequent the dose the lower the peak and higher the trough serum levels. 

  95. TRT Man Says:

    Fred, We’d love a link to one of your serum level emulators. If it’s not “online” maybe we could help with that?

    Your dose sounds about what I’m taking so it is good to hear you’ve been happy with it for so many years.

  96. Fred Says:

    Hi TRT man.

    It’s not on line.  Also I need the info needed to derive an absorbtion profile.  Each drug goes through a series of tests in which the serum level is plotted by whatever intervals are used.  So it might start out with each 4 hour serum levels for some number of weeks.  I need that table of values or a decent graph of it.  From this, with the serum halflife interval which can vary depening upon concentration and so forth.  In any case in a long absorbtion medication this is critical information.  The FDA’s “Orangebook” might have it or it is somewhere.  A place to start is often the trials leading to FDA approval of a medication.  Wiuthg this ingo I can then produce graphs with any redose intervals and customize the serum halflife to a particular person based on their own response chracteristics. using the changes such as I had after 7 days.  This is one of the programs I have slated for conversion to a smartphone or tablet function.  If the information is rounded up I can create the model and run a series of graphs that could be posted, etc.

  97. JM Says:

    TRT Man,
     
    It’s been a while I hope you’re still active on this site. I have a questions for you that I was hoping you can answer. I’m still on test cyp which by in large has gone well but it has taken a while to get to the levels where I feel comfortable. I’m noticing that I feel much better and are much more lean towards the end of my injection cycle. I’m  on a schedule of taking a 75ml shot every 10 days and when I get to day 8 and 9 I feel much better than I do on day 2, 3 or 4. At the end of the day I’ve realized that I function much better when my test is in the low 400 range.
     
    My questions is do you know what’s more important in terms of test levels between test serum or free test? The reason I ask is I’ve noticed that even when my test serum levels are on the low side (350) my test free was at 18.5 which is on the high end of the scale. And I took my last labs on day 9 so I was at the end of my cycle. I’m wondering if this is why I function better at lower test serum levels because my test free is always normal to high side.
     
    Thanks,
    John
     

  98. TRT Man Says:

    John you are asking a very good question that I think is above my paygrade. It should be asked of an endocrinologist with experience in testosterone replacement, or a veteran steroid user. I remember researching once and reading about how that (low serum, high free) means something, but I don’t remember what. I think I was trying to find out at what point in my hypothalamus, pituitary, testicular axis (HPTA) the breakdown was happening and maybe it had something to do with that. An endocrinologist might be able to tell you. Perhaps the free testosterone isn’t being made bio-available, or is getting turned into something else (like estrogen).

    For me I think the most important thing is how I feel. I know my body and I know that 100mg of cypionate or enanthate once per week by injection keeps me the most level and healthy with the least side effects. When I take it up there are sides. When I drop it there are sides. I don’t mean you should do what I do, only that you know your body and if what you’re doing is working that’s all that matters.

    Good luck!

  99. Fred Says:

    All I can tell ypu is that on 1 ijection per week of 140mg, is my optimum by how I feel and effecrtiveness.  At 200mg each 10 days, days 8, 9 and 10 are downhill and increasing pain and fatigue.  I got good muscle growth when I added all the needed nutritional items, mostly the Deadlock Quartet; AdoCbl, MeCbl, L-methylfolate and L-carnitine fumarate.

Leave a Reply