New on TRT

[Bulldog]

Hi,

I just started TRT a week ago. My Dr. has me on a Test compound that I believe is supposed to deliver 60 mg of Test per day. Once I started TRT I started looking on the net for info and found this great site. It sounds like SWALE knows what he is doing. Anyhow, I have a couple questions.

1. Is there any problem with testicular atrophy other than asthetics if you remain on TRT? And if I go off TRT will the Testicals start working again on their own or will I need to use HCG now to keep them functioning? I don't want to have problems later if I have to go off TRT and haven't been using something to keep them functioning.

2. Is there any alternative to HCG? I'm not real fond of needles and I'm not sure if I could do the shots myself. But I would really like to keep the natural levels flowing.

3. My Dr. isn't doing my first follow up labs until I've been on TRT for 2 months. And from what I have read hear that seems like it is too long. Should they be done sooner?

4. I'm curious if anyone has a "going off TRT" plan?

Thanks in advance.

[pmgamer18]

TRT is for life if you feel you don't want to be on it you should not be doing it. If you stay on it your testis will stop working and get small. You need to post your blood test with the rages for us to help you out here. Dr. are not doing a good job finding out why one had low T levels. There are a lot of things that cause this and going on TRT with out knowing why you are low is very hard to find out why later.
Phil

[Bulldog]

I'll have to get a copy of my blood work from my Dr. so I can post some info.

The only reason I'm worried about what happens if you have to go off is in case I were to lose my insurance for some reason. If that were to happen I would never be able to affoard to continue TRT.

How long does it usually take for your Testis to quit working?

[pmgamer18]

If you are real low on T and the tests show you are primary they can already be smaller. Primary means your testis get the message from you brain to make more T by sending LH and FSH to your tests. But if your testis are not working good they can't make T and they can start to get smaller before one goes on TRT. Then the other one is called Secondary this means the testis are good but there is something wrong with the brain and it is not sending the message to make more T. So this is just two resions why one could have low T there are a lot more like an infection, Tryroid problems, liver, using drugs and drinking are just a few.
Phil

[Bulldog]

Like I said, I'll have go get a copy of my lab work. But I believe my Bioavailable T was right around 285 ng/dL and I don't think they tested for Estradiol or Cortisol in my initial labs but I'll have to wait until I get a copy of the labs to know for sure. I do know that my Thyroid was low though. If Thyroid is low should that be treated before Test? For some reason my Dr. wanted to start me on Test and see if my Thyroid was normal at my 2 month follow up labs. I guess I didn't really think about that at the time.

As far as the testis size....no size problems prior to starting TRT last week. Maybe I'm secondary? What is the main course of treatment for someone who is secondary? From what I have read here it seems like everything has said that if you only treat secondary most people end up in a primary state? I guess I need to do some more research.

I've only been on the Test cream for a week. Is that too long to just stop using it without any special treatment? I'm kind of having second thoughts about this right now.....not sure my Dr. is taking the right approach.

I wish there was a Dr. with SWALE's knowledge in my area.

Thanks for the info.

[ASaxon]

Originally Posted by Bulldog

It sounds like SWALE knows what he is doing. Anyhow, I have a couple questions.

He definitely does! There’s a lot of good information on this side so educate yourself as you are going to be your own best advocate for your treatment.

Originally Posted by Bulldog

1. Is there any problem with testicular atrophy other than [aesthetics] if you remain on TRT? And if I go off TRT will the [Testicles] start working again on their own or will I need to use HCG now to keep them functioning?

Yes. Although testicular atrophy is a concern it’s more of a cosmetic concern to most people. I personally wouldn’t want my “dudes” shrunken up to the size of grapes. I already have one atrophied testicle I wouldn’t want them both to be.

One additional potential problem with TRT is that in some cases it may increase the chance of infertility. If you don’t plan to have children in the future then this isn’t likely to be a concern. However, if you do want children then there are a few things to consider. If you have Primary Hypogonadism then it is probable that you will eventually loose fertility anyhow. In these cases TRT will usually bring on infertility faster and it may never return as the condition that brought on the Hypogonadism progresses. If you have Secondary Hypogonadism then any infertility that may occur can likely return if you come off of TRT and/or start using hCG. Fertility can be maintained with the use of hCG while on TRT.

Finally, hCG also has other physiological effects on the Hypogonadal man. Apparently there are hCG receptors in many body tissues and thus many men on hCG see significant symptom improvements when using low dose hCG than when they were just on TRT alone. So hCG appears to be useful for some people and not just for testicular function alone.

Originally Posted by Bulldog

2. Is there any alternative to HCG? I'm not real fond of needles and I'm not sure if I could do the shots myself. But I would really like to keep the natural levels flowing.

Not that I know of. Also, one thing to consider, the generic hCG formulas don’t appear to be the same as the name brand ones as people on this board have noticed that generic hCG doesn’t work nearly as well as the named brand “real” hCG.

Originally Posted by Bulldog

3. My Dr. isn't doing my first follow up labs until I've been on TRT for 2 months. And from what I have read hear that seems like it is too long. Should they be done sooner?

After about two weeks of Gel application you should reach a relatively steady level of T in your blood. However, it could take much longer before you notice symptom improvements. It’s all very individual, some people notice significant improvement within a week while others take months. Perhaps your doctor set two months because he’s looking for symptom improvement and not just T levels. So he’s trying to get a gauge on how you are feeling not just what your T levels are.

Two months may be too long but two weeks might be too short. My doctor is waiting a month for follow-up although he said I can do the blood tests at any time after two weeks and before my appointment with him.

Originally Posted by Bulldog

4. I'm curious if anyone has a "going off TRT" plan?

Usually people don’t come off of TRT unless the cause of the Hypogonadism was caused by a condition that could be corrected in some way. Usually people are on TRT because they’ve had a failure somewhere in the HPG axis and if they have, it’s unlikely that it will ever change. Very few people that have Hypogonadism will ever be able to be cured. It does happen but not very often from what I understand.

Cheers!

[Bulldog]

I finally got a copy of my lab results. I stopped using the Test cream after a week...which was about a week ago. If anyone has any input on this feel free to post.

Detroit Bio-Medical Laboratories, Inc.
------------------------------------
TSH, 3rd Gen 2.480 uIU/ml 0.270-4.200
T-3 Free 4.6 pg/mL 2.80-7.10
LH, Serum 4.3 mIU/mL 1.7-8.6
Testosterone 349 ng/dL (don't know reference range)
Free Testosterone 12.30 pg/ml 8.7-25.10
SHBG 20.00 nmol/L 7.00-50.00
Bioavailable Testosterone 222 ng/dL
Albumin 5.0 g/dL 3.6-5.6

My main physical symptoms are cronic fatigue and brain fog.

Thanks.

[ASaxon]

The only thing I can see on those numbers is that your Testosterone is lower than what would be considered optimal and may be the cause of your symptoms. I just started TRT (Androgel 5g QD) about a month ago and I still have the brain fog although perhaps not as severe as before.

Recent talk on this has got me thinking. I'm just curious, have you tested for Sleep Apnea Syndrome? How well do you sleep? Do you remember dreaming every night or is dreaming rare for you? Do you snore? Has anyone ever noticed whether you stop breathing when you are sleeping? Both those symptoms you mention can be the result of sleep deprivation as a result of Sleep Apnea (OSA). And you should know that OSA has been shown to cause low Testosterone and your levels do seem low, albeit low-reference range. Something to look into if you haven’t already. And you should also know that a good 40% of people with OSA are not overweight so it’s not just a fat person’s disorder. Of course that means 60% are overweight.

[Bulldog]

Thanks for the comments ASaxon.

I don't snore very often and as far as I know I don't have Sleep Apnea but I have never been checked out for it. But I also don't remember dreaming very often and I usually wake up at least 3 times every night so I do think I would fall into the sleep deprivation category. I'm lucky to get 5 hours of sleep per night and it is never 5 straight hours. And I usually wake up at least once each night to take a leak. Sometimes I have to go as many as 3 times in a night. My Dr. says no UTI or prostate problems. And my PSA was only 0.44 mcg/l and should be less than 4.0 so no problems there.

I had another visit with my Dr. yesterday and we agreed that I should work on cleaning up my diet and getting back on a good workout program (it's been a while since I've hit the weights so I'm not in the greatest shape) and then we would recheck my Testosterone in 6 months. I guess I'll just have to wait and see what happens. Hopefully getting back on a good workout schedule will get things back on track.

[pmgamer18]

Your LH being that number and your T being that low I would get an MRI done on your brain to be sure you don't have a Pituitary problem.

[Bulldog]

Could you please elaborate on why you recommend that? I don't know enough about this yet to know the relationship between the Pituitary, LH and Test.

Thanks.

[pmgamer18]

I made a mistake sorry your LH at that number means your testis are not working that well and you could be primary not secondary. Here read this.
http://www.aace.com/clin/guidelines/hypogonadism.pdf

[Bulldog]

Thanks for the info.