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Notabodybuilder

low test. and HRT

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Hi everybody, new to this forum, and am looking for some feedback on low T. and HRT. so I thought I would put this out there:-) I have been struggling with depression and anxiety and chronic fatigue since April last year (am currently taking medication, and have no problem continuing with that for now). I have had several episodes like this in the last 15 years. I have never been a "big" person but am almost two metres tall. When I have been well my max weight has been about 74kg (and I eat a lot!) but I have always felt fit and active and plenty of energy. Also during my depressive episodes i tend to lose weight (don't have a lot to lose), but medication has worked eventually. So lately been feeling really exhausted, foggy (i have just recently completed a bachelors of Science so I really know when my concentration and thinking is off) , achey, weak and tight muscles (especially hamstrings) and current weight 69kg. Also experiencing frequent episodes of weepiness. Really feel like I am not recovering Had blood test for everything, so far looking good, but have come back with low testosterone (around 250-300 i think). GP has said I "need more calories" because my body is starving and basically need to eat more, which is why my t. is low. I can't help but think if the problem was that simple I wouldn't still be where I am at now. She has sent me for more blood tests for cortisol, estrogen and other related things. She has referred me to an endocrinoligist to look into the low t. , seemed reluctant to prescribe anything but did give me the option of gel patches. I've decided I would rather do anything like this under the supervision of an endo. I guess I am beginning to think maybe my test. has always been on the low side (also I only have one testicle), hence my recurring bouts of depression and anxiety and weight loss (and low weight in general), and the fact that I have always been quite skinny, and now that I am getting older (49) it may be becoming more of an underlying problem.  Have also read a few things pointing out a correlation between low test. and depression and also chronic pain. Would really appreciate anyone with any thoughts giving me some feedback about my situation, what I could expect when seeing the endo. etc., questions to ask etc. I have recently moved to Opotiki so I think will be going either to Whakatane or Tauranga. I'm wondering if even TRT doesn't make things 100% better, it might give me a bit of a push over the hump that I can start feeling like I am at least on the road to recovery. I also realise HRT could be a long term option, so want to make a very considered decision before heading down that road. Looking forward to any feedback :-)

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Hi There... Depression, weight loss, lack of motivation can be symptoms of low testosterone/estrogen..

Your blood testosterone is on the low side, and could be reason for your symptoms..

Obtaining a good Endo seems to be a bit of a lottery according to comments from dissatisfied members here over the years..

If you are not happy with their treatment options you can always shop around for another endo more inclined to your preferred method of treatment.. 

 

Generally some form of testosterone replacement therapy is advised, from creams, gels, patches, and weekly/fortnightly/ monthly injections.. 

Gels and creams seem hit and miss from a bioavailability perspective (difficult to acquire correct dose, and it can rub off on partners with surprising results)..:-D

Patches seem to closely replicate endogenous production patterns, from available research..

Testosterone injections ideally should be low dose twice a week to keep blood plasma levels as stable as possible (good luck getting a nurse to pin you twice a week for life, unless you learn to do it yourself).. It's easy we can guide you through the process..

 

TRT, should prove beneficial to your quality of life, if you can obtain the right treatment for you..

 

 

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Thanks for that great info, will keep updated with progress. I guess also the other thing to check is whether it is a pituatary problem, I think some of the extra blood tests I did may be looking into that. Hopefully not too long to wait to see endo.

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50 minutes ago, Notabodybuilder said:

Thanks for that great info, will keep updated with progress. I guess also the other thing to check is whether it is a pituatary problem, I think some of the extra blood tests I did may be looking into that. Hopefully not too long to wait to see endo.

 

Generally there is one of two options, primary hypogonadism (testicular failure), or secondary hypogonadism (hypothalamic, or pituitary failure)..

Very little you can do about either for initiating endogenous testosterone production over the longer term, Clomiphene, Triptorelin, hCG, hMG can induce temporary restart but only lasts for duration of treatment, depending upon condition (primary or secondary).. 

 

 

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That's good to know, to be honest, I'm not expecting a miracle overnight, but even to feel 50% better than I do at the moment is something I would be happy to commit to lifetime therapy for. I'm generally a fit person, was walking 10-15km a day on field trips this time last year, now I feel like I've run a marathon after being on my feet for 20 mins. From what I've seen here it can take some months for HRT to make a real difference? Happy to be patient too if there is a light at the end of the tunnel.  Oh yeah, one other thing, I've had a yeast infection for the last month or so which I would say is making me feel pretty crappy, I wonder if the two are connected.

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For endogenous testosterone synthesis to take place they should be enough dietary precursors, are you eating enough fats, animal fat from meat/fish, nuts seeds, avocado, olives/oil..etc.. 

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7 minutes ago, Notabodybuilder said:

yep, doing my best!

 

People too often think jumping on drugs is the answer when correct nutrition plays a huge factor in the health of human biological systems, poor dietary choices can lead to possibility of inducing many chronic illnesses..

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4 hours ago, Daz69 said:

 

People too often think jumping on drugs is the answer when correct nutrition plays a huge factor in the health of human biological systems, poor dietary choices can lead to possibility of inducing many chronic illnesses..

I agree, and also sometimes you need a balance of both. I'm a pretty healthy eater, off the booze and coffee at the moment, no junk food etc. Doing my best to get plenty of sleep at the moment too. Sometimes though if your body needs something it just cannot make for whatever reason..... As I said at the moment I'm just considering my options and trying my best to make a considered educated choice. Reading about peoples experiences on this forum has been a real help, and your feedback :-)

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7 hours ago, Biggerbythedaynz said:

Daz knows his stuff! Helped me heaps, educated a few endo's along the way too@

 

How is your condition, have you got treatment that you find acceptable and are happy with..

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Hi everybody, I've been referred to endo in BOP but could be a bit of a wait :-/ I'm trying to get hold of results of my last two blood tests from GP so I can have a look at what's what, and if my test. levels have changed between the two . 1st was around 12pm, 2nd was around 9.00am. Not much else is news, just hanging in there :-)

I'm interested to hear how you are getting on too Biggerbythedaynz

On 1/14/2018 at 9:52 AM, Daz69 said:

 

How is your condition, have you got treatment that you find acceptable and are happy with..

 

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On 14/01/2018 at 9:52 AM, Daz69 said:

 

How is your condition, have you got treatment that you find acceptable and are happy with..

Hi Folks, Still having a hard time with endo's. Have other small issues that are being dealt with. I did get on to trt eventually had to run the gauntlet with patches/ andriol caps then finally sus250. Im around 130kg (fluctuate 2kg either way) and find the 1 x shot every 4 weeks kept me borderline low on lab results with no increase to doses or frequency. With Daz's help in educating me I have challenged two different endo's and basically theyve conceded that I am correct (Daz is lol) but would still not change to fortnightly. First 6-10days great then crash quite badly and im clutching at straws by week 4. I will add at this point and emphasize that my issues are medically related not caused by androgenic experimentation and to move things along medically have been paying private consultation fees at $495 a consult,couple reasons for that, time in waiting for govt system and also wanting to be helped quickly eliminating the public funded consults and med cost. Im around 18months into this scenario and not much better off. My ideal scenario would be legit medical professional help but have come to the conclusion that most of them either dont know how to help or if they do just dont that may be because of regulation or just because they feel norderline low is good enough. I dont advocate this and of course dont want to be on the wrong side of the law but at this point my opinion is to self medicate with small accurate doses more frequently to keep myself stable and in the mid-high normal range as Daz has mentioned in numerous other threads, thereby avoiding peaks and troughs.  *small problem i have at present is im under specialist supervision and 'supplementing' my own health requirements will be noticed. So i shall wait till thats over and tend to myself. Hopefully NZ will catch up with the rest of the world in terms of TRT for valid and sincere medical issues. I imagine that all of the bro-science guys who have fried their nuts on cycles or johnny bravo's trying to abuse and get 'legal pharma grade supply' from the medical system may contribute to the difficulties we face. OP - I dont know Daz personally other than his shared wisdom on here but can vouch that Daz knows his stuff,hes helped educate me tremendously. Good luck with everything, hope it works out for you. Share with us how you get on, ill do the same and as always Daz thanks for being legen....wait for it....dary!

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Hi There, you might also find 250mg in one injection is far too much.. You could probably split the dose into 4 equal amounts, with an injection frequency of once every 3-4 days, although this could be an issue if your sustanon comes in a single 1ml breakable glass vial.. Or is injected in a medical facility via nurse appointment..

 

Your endo should be aware that a single dose of 250mg will push you over normal physiological levels in week 1, with a subsequent crash of the decanoate ester in weeks 3 & 4, yielding less than only 2mg/day down to 1mg in the last week..

 

You might wish to check whether this peak of almost double normal range is ethical, as the drugs prescribed within my own authority to practice are heavily regulated as far as dose is concerned..?

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On 1/20/2018 at 1:23 AM, Biggerbythedaynz said:

Hi Folks, Still having a hard time with endo's. Have other small issues that are being dealt with. I did get on to trt eventually had to run the gauntlet with patches/ andriol caps then finally sus250. Im around 130kg (fluctuate 2kg either way) and find the 1 x shot every 4 weeks kept me borderline low on lab results with no increase to doses or frequency. With Daz's help in educating me I have challenged two different endo's and basically theyve conceded that I am correct (Daz is lol) but would still not change to fortnightly. First 6-10days great then crash quite badly and im clutching at straws by week 4. I will add at this point and emphasize that my issues are medically related not caused by androgenic experimentation and to move things along medically have been paying private consultation fees at $495 a consult,couple reasons for that, time in waiting for govt system and also wanting to be helped quickly eliminating the public funded consults and med cost. Im around 18months into this scenario and not much better off. My ideal scenario would be legit medical professional help but have come to the conclusion that most of them either dont know how to help or if they do just dont that may be because of regulation or just because they feel norderline low is good enough. I dont advocate this and of course dont want to be on the wrong side of the law but at this point my opinion is to self medicate with small accurate doses more frequently to keep myself stable and in the mid-high normal range as Daz has mentioned in numerous other threads, thereby avoiding peaks and troughs.  *small problem i have at present is im under specialist supervision and 'supplementing' my own health requirements will be noticed. So i shall wait till thats over and tend to myself. Hopefully NZ will catch up with the rest of the world in terms of TRT for valid and sincere medical issues. I imagine that all of the bro-science guys who have fried their nuts on cycles or johnny bravo's trying to abuse and get 'legal pharma grade supply' from the medical system may contribute to the difficulties we face. OP - I dont know Daz personally other than his shared wisdom on here but can vouch that Daz knows his stuff,hes helped educate me tremendously. Good luck with everything, hope it works out for you. Share with us how you get on, ill do the same and as always Daz thanks for being legen....wait for it....dary!

Hey there Biggerbythedayz. Having multiple issues can suck eh. One thing I've learnt in dealing with multiple episodes of depression and chronic fatigue is patience. I'm not sure if we are allowed to post links, but this caught my eye in the guardian today. Not making any judgements, but...... amazing these guys are taking all this stuff basically to look good, otherwise generally feel okay, while some of us just need it to feel halfway normal apparently.  Anyhoo, have been doing plenty of research, and think I am getting some ideas about what I need to approach the endo with before we even start, all asked very politely of course ;-)

How much experience do they have with TRT?

If it's a given that I need it is the goal going to be just to get my levels just back above normal, or to get them up to a higher level where I actually start feeling something long-term?

If it's working and I'm happy to stay on it permanently will they be ok with that, especially given it looks like I may have a medical condition?

What approach are they going to use to keep my levels as stable as possible and not up and down between doses?

If I decided to go for regular injections and didn't want to do it myself would I be able to do it through the nurse in Opotiki (5mins drive away).

Will they be monitoring other hormones while I am on therapy?

Are they happy to monitor my blood levels and if there is an issue resolve it over the phone so I don't have to travel to Rotorua for every little issue?

Oh yeah, one other thing, has anyone else experienced excessive sweating from low T. I know this hot muggy weather hasn't been helping, but it's driving me nuts!

If anyone else can think of anything it might be useful to ask them that would be cool :-)        https://www.theguardian.com/society/2015/jun/19/anabolic-steroid-use-leaves-britain-facing-health-timebomb

 

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Hi there, your question strategy is good. In my case i had initially expected the 'specialists' to know what they are doing and it became apparent some dont. Maybe lower numbers in nz mean less exposure to these cases and in so saying less experience? One question may be added, self administration. This is probably frowned on but in my recent experiences the med centres ive been to three different ones, believe it or not - i had to explain to the nurses the draw procedure as they hadnt done so before and request multiple times for a thinner gauge  needle for injecting but also to slowly inject. After them blatantly not doing so and having a small or maybe even most of that 1ml leak out, they will not reissue a script and re-inject you. This means that if you got some in great if not tough. I also fing that they will give you in my case a 1ml 250mg sus shot every 4-6 weeks. I crash really badly after the second week and am then hanging on in desparation. As Daz suggested you can try split doses, really tough when it comes in a 1ml vial at a time. Do your homework on the doc youre seeing. Try find references/threads or anything in favor of or against. We are behind on trt in nz, the rest of the world, usa in particular seems more 'jacked up' on the subject. I hope you have better outcomes than i have

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wow, that sucks what you have had to go through. In my case it's more of a matter of seeing who I can out of necessity. It's up to four months to see the endo at Tauranga, so I'm going private to see one in Rotorua and make an appt.for the first of February. He's also a lot cheaper than others, I could go up to Auckland but I would prefer not to at this stage.

Hmmm, reputation, well I found one comment on a med thread that someone was really pissed off about some paperwork. Not a good look. Anyhoo, I figure at this stage I haven't got much to loose, if he is not that clued up, hopefully he will be willing enough to listen to sensible suggestions. I wonder if it would be kosher to ask anyone on here if they have dealt with him? Also I saw another discussion somewhere someone mentioned there is a TRT protocol document in the US which has got some quite useful information on it. Does anyone know where I can find that?

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Are you thinking of the Dr Crisler one? I reckon ask mate, only bad question regarding your health is the one you dont ask.I went private too in the hopes that itd be better and the logic would be expected in terms of being more open to suggestion. At $490 a consult lets just say 'suggestions' were not well received by mine. Even once proven otherwise mine still didnt want to accept it. We are no longer on speaking terms after things that have happened with me. For younger guys reading this thread, if you have low T and are considering TRT it may pay to cryo freeze some cells for later use if you are wanting to join the ranks of fatherhood or have another one. This is not discussed by endo's or even suggested by them here.

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Thanks for that advice, one less thing to for me to worry about, we have never wanted to have children, and certainly don't think we will be changing our minds at this stage :-) Will let you know how I get on. I reckon I will get a pretty quick idea of whether the endo is onto it or not. Thanks for sending the message. Will have a look at it, going into the GP tommorrow to pick up my latest blood test results.

Sorry you've had such a run around, hang in there and hopefully things will get resolved.

 

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On ‎14‎/‎01‎/‎2018 at 2:21 AM, Biggerbythedaynz said:

Daz knows his stuff! Helped me heaps, educated a few endo's along the way too@

I've had to do some endo education as well, their knowledge is quite limited in some aspects

 

My endo tried to tell me we don't even need to test for E2 because TRT wont affect estrogen levels so yeah.. also told me that if you just stop trt your sperm count will go back to normal within couple months

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7 hours ago, Detonate said:

I've had to do some endo education as well, their knowledge is quite limited in some aspects

 

My endo tried to tell me we don't even need to test for E2 because TRT wont affect estrogen levels so yeah.. also told me that if you just stop trt your sperm count will go back to normal within couple months

They say you will return to normal, but they cant gaurantee it or how long it would take, read up.on Daz's posts regarding leydig and sertoli cells its an eye opener. Also youll find clomiphene needed to 'kick start' your bollocks ;) lol. Your e2 levels will be higher on trt but they thing its not worth keeping an eye on and as such dont give any AI. Ive checked myself and my estradiol has been mid 350's not near the expected 75. Itching and feeling like stuffs crawling on me. Dude at gym gave me 2 x asin caps one to take and another 3days later and itd been the first time in a couple weeks i had relief.

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Hi guys, just wondering is E2 the same as Oestridol?

Anyhoo I have had a look at my last two bloods.

 21st Dec. my T was 5.2 nmo/L

 

10th Jan  T 6.3 nmo/l; FSH 51.8 U/L (I think that is telling me the problem is down below, not with the pituatary); Progesterone 1.0 nmo/L; Prolactin 89 mU/L; Oestriadiol <200 pmol/L; LH 7.2 U/L; Cortisol 253 nmol/L

 

I also notice on 21st December I had Free T4 9.0 pmol/L; and TSH 1.61 mU/L

 

 

So I'm off to see endo. in Rotorua next week, please feel free to comment on those readings.

 

I guess I may be making things simpler for myself in that I don't need to stay fertile, and I don't really care about sperm.  Had a chat to my GP yesterday, she said endo will probably put me on patches as that is the simplest most efficient way. I have heard it is good way of staying level, (though possible issues with skin irritation?) Also I'm not looking for any body-building enhancements, just want to get some energy back into my system so I can get physical again without feeling I am going to pass out. If there is anything else in that list of blood tests you think I should ask to get tested by the endo please let me know. If he does not want to do ongoing monitoring I'll probably politely suggest to him that maybe my bloods should be checked again after six weeks, and then how regularly do you guys think?

Anyhoo, thanks for the support, glad I found this forum :-)

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6 hours ago, Notabodybuilder said:

Hi guys, just wondering is E2 the same as Oestridol?

Anyhoo I have had a look at my last two bloods.

 21st Dec. my T was 5.2 nmo/L

 

10th Jan  T 6.3 nmo/l; FSH 51.8 U/L (I think that is telling me the problem is down below, not with the pituatary); Progesterone 1.0 nmo/L; Prolactin 89 mU/L; Oestriadiol <200 pmol/L; LH 7.2 U/L; Cortisol 253 nmol/L

 

I also notice on 21st December I had Free T4 9.0 pmol/L; and TSH 1.61 mU/L

 

 

So I'm off to see endo. in Rotorua next week, please feel free to comment on those readings.

 

I guess I may be making things simpler for myself in that I don't need to stay fertile, and I don't really care about sperm.  Had a chat to my GP yesterday, she said endo will probably put me on patches as that is the simplest most efficient way. I have heard it is good way of staying level, (though possible issues with skin irritation?) Also I'm not looking for any body-building enhancements, just want to get some energy back into my system so I can get physical again without feeling I am going to pass out. If there is anything else in that list of blood tests you think I should ask to get tested by the endo please let me know. If he does not want to do ongoing monitoring I'll probably politely suggest to him that maybe my bloods should be checked again after six weeks, and then how regularly do you guys think?

Anyhoo, thanks for the support, glad I found this forum :-)

 

Bloods suggest leydig cell issues in the testes not producing enough testosterone.. LH & FSH seem ok..

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On 1/25/2018 at 5:20 PM, Daz69 said:

 

Bloods suggest leydig cell issues in the testes not producing enough testosterone.. LH & FSH seem ok..

Cool, i think that suggests it is something that will be fairly straightforward to fix with TRT? I guess it makes sense too if I only have one testicle, half the neccessary cells. But may only be becoming a problem now that I am getting older (49)

 

I have a couple of questions re patches Daz69.

 

Does one still possibly reach a point where endogenous production of T shuts down before your exogenous supply is up to a good level, thereby having a bit (or a lot) of a slump?

Also with patches is it still important to monitor E2 levels to check they are not going up, or is that not such an issue since it the doses are closer to endogenous production?

I noticed you said here and on another thread patches are the closest to replicating endogenous production, so really hope they are an option for me. As far as I can tell their only common drawback seems to be skin irritation.

 

Thanks for your feedback :-)

 

 

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