Low t levels, possible side effects of trt treatment?

[Alexw80]

Hi there, was wondering if I could pick your brains, so to speak lol. Sorry if it's a long one but it's something that's really bugging me.

I've recently been diagnosed with possible Hypogonadism. I've had 2 blood tests by my GP for T levels, first came back at 4.4 and the second, 3 weeks later, came in at 7.5, I don't have the other numbers, I forgot to ask for a copy of the results, but my GP said everything else was in the normal range. Was referred to see an Endo at the local hospital. he checked me over, testicles are normal size so assuming it's not primary Hypogonadism. He asked me questions and agreed that everything pointed to low T levels, did another blood test to make sure, still waiting on those results, including a PSA test. Booked in for an MRI to check the Pituitary gland, just in case.

He said if all tests come back the way he's expecting them to, he'll put me on Testogel. Didn't go through the side effects with me, which concerned me slightly. I've since looked online to see what could happen. Most of them I can live with, except the one that keeps popping up. Which seems to be Testicular atrophy. I'm 35, don't have kids but would like the chance to have them in the future. Plus, I quite like having normal size plums, in fact, wouldn't mind them slightly bigger tbh, but that's just aesthetics.

So my question to anyone out there that can help is this. How likely is atrophy on Testogel, can it be reversed, or better still can it be avoided. I've read that people use something called HCG to fix this, but I'm in the UK and I doubt the NHS would provide this, or at least, I've not read of anyone getting it. Plus I'm not keen on adding even more medicines to the mix if possible.
I've read that Clomid is an alternative to standard TRT and would avoid atrophy, but that it isn't perhaps as effective as other TRTs. Does anyone in the UK have experience with this on the NHS. Does it work, and if so, how effective is it?

Thank you for reading.

 

[sangheili90]

Your body will shut down its own testosterone production whenever exogenous testosterone is supplied to the body, regardless of the dosage at hand. What this means is that since your body no longer needs to produce its own testosterone the testicles no longer need to perform their function and will shrink, I cant specifically say how much, and your sperm count will go down, there is a lot of push for using testosterone as a male contraceptive because of this. If you want children consider storing your sperm, I was considering getting having my sperm stored so I could get a vasectomy and not have to worry about accidental pregnancies.

Clomid will keep your natural testosterone production up but their are a host of potential issues that may be at play, not long I ago I read that their was some evidence showing long term use of this drug put men at risk for cognitive decline later in life. If you are looking to keep your testicle size purely out of cosmetic concerns I do not think you should resort to adding this drug to the mix.

You will put on muscle mass while on TRT, even if it keeps your testosterone at a physiologically normal level, your overall energy will improve, sleep etc. However, have you addressed any particular issues with diet, sleep or exercise? Because improving upon these factors can make a huge difference, just something you might want to consider. I personally think lack of sleep is a major contributor to the low testosterone epidemic of the developed world, it is common medical knowledge that sleep deprivation, just a few hours per night, shows a significant drop in baseline testosterone levels. Lots of stuff to consider before jumping on the TRT wagon, especially since you will be on it the rest of your days, which is why I think its important to do some research on your own.

 

[tasty9]

HCG is the hormone your body uses to tell the testes to produce testosterone. If you take it when supplementing testosterone, it will prevent testicular atrophy by keeping the testes producing testosterone. The HCG production system also can degrade over time during supplementation, but from what I've heard it's less of a concern.

I agree with sangheili90 it's best to find a natural solution instead of going right for TRT. Increasing sleep and exercise can help, so can cutting out things (like coffee) that might be suppressing production. Or you may have a simple deficiency of Zinc or Vitamin D. You might also look into botanicals like maca powder to help boost your levels. Just do some googling and read a bit, you'll see there are a lot of options available - TRT should be one of the last things you try, not the first.

 

[sangheili90]

HCG is the hormone your body uses to tell the testes to produce testosterone. If you take it when supplementing testosterone, it will prevent testicular atrophy by keeping the testes producing testosterone. The HCG production system also can degrade over time during supplementation, but from what I've heard it's less of a concern.

I agree with sangheili90 it's best to find a natural solution instead of going right for TRT. Increasing sleep and exercise can help, so can cutting out things (like coffee) that might be suppressing production. Or you may have a simple deficiency of Zinc or Vitamin D. You might also look into botanicals like maca powder to help boost your levels. Just do some googling and read a bit, you'll see there are a lot of options available - TRT should be one of the last things you try, not the first.

Unfortunately the doctor probably didn't bother to see what the OP's general lifestyle is like, since its all about profit.

 

[Alexw80]

Thanks for the advice, it helps to see things from others eyes.

From what people have said online, Clomid isn't always a long term thing. Some mention that a course of 6 months or so helps kick start the body into producing more naturally. How true that is I don't know. But seeing as it doesn't replace your own supply of T, rather tricks it into making more of it's own, would it be a simple case to come off it if it doesn't work. My concern with TRT is, if I do start it, but decide to stop, would my system kick back in and start running normally again (I use the term "normally" here to reference how it was pre TRT, not to imply normally as in everyone else). So if all that being true, would Clomid be a safer starting point than TRT?

As for my lifestyle, I don't get the best sleep, but usually get 6-7+ hours a night. I don't smoke/drink, my diet isn't the best and I do lack exercise although my job can be physically hard, I'm a delivery driver shifting anything up to 2 tonne of goods a day by hand, although usually less. The problem with getting more exercise is this, I'm always tired, thanks to low T, sometimes extremely so. The way I described it to my friend the other day was this. You need petrol in your car to make it go, so you need to fill it up at the station, but you've not got enough in the tank to get you there to fill it up, so what do you do? Perhaps not the best analogy, but the only one I could think of at the time.

As for the GP not being interested in my lifestyle because of "profits", seeing as this is the NHS, that's not really an issue, the advantages of social health care I suppose lol.

 

[girthyoldguy]

More sun/ vit C are supposed to help. You should also take DHEA which is a precursor to testosterone which can help boost t levels. I myself am on trt and its great. However Im 60 and nothing worked other that replacement therapy. Only real side effect is higher red blod cell count which I control with blood donations every 2 months. Does make you horny as shit.

 

[girthyoldguy]

I ment vitamin D!

 

[pwrdick]

There's no reason to stay on Clomid for a long time period - the drug's approach is to re-activate testosterone production after something had shut it down (in my case, it probably shut down as a result of HIV-related wasting). Once it has been re-activated you can go off of it. I probably stayed on it much longer than I needed to because I moved cross country soon after I had been put on it and my new doctor really didn't follow up on my testosterone tests. But it is now three years since I was taken off of it and my testosterone levels remain at appropriate levels.
By the way, prior to Clomid I had been using Androgel for years. It did boost my testosterone levels but it had to applied daily and I hated knowing that it would keep my balls small. Clomid was much more of a permanent 'cure', was far cheaper and it was easier (and more comfortable) to have an oral pill than a gel that had to be smeared over me. The only side effect I had after starting Clomid was discomfort in my balls as they regrew back to their original size.

 

[itsabiggy]

I suggest you see a endocrinologist. I also started TRT at 35 and been happier since. I feel so much better. I have 3 kids so being a dad for the 4th time is not a concern. My balls did shrink. But for everything else It makes up for it. Small price to pay. It's not an easy decision but it was in my best interest.

 

[Alexw80]

The TRT was suggested by the Endo, he agreed that everything pointed to low T and asked if I would be ok going on the gel. Just waiting for the last set of blood tests to come back, plus an appointment for a MRI scan and then will take it from there.

I work outside, so get all the sunshine I can, which isn't easy in the UK lol. Tried going down the supplement route, made me feel a little better but didn't get rid of the symptoms completely, hence getting a referral to an Endo. Think I'll wait for the results to come back, the book in to see my GP and mention to her about the Clomid and see what she says. Maybe she can discuss it with the Endo and see what they come up with. Other than that, I'll just have to avoid the treatment altogether for the time being. Just not sure I can deal with not being able to have kids just yet, not quite old enough of give up on that dream just yet. Plus I think I'd miss my balls too much lol

 

[AgTraveler]

This is a GREAT article about TRT: www.t-nation.com: The Complete Guide to T Replacement | T Nation

 

[AgTraveler]

This is a GREAT article about TRT: www.t-nation.com: The Complete Guide to T Replacement | T Nation

 

[technopeasant]

I am going to add my two cents worth to the discussion I have this problem as well. I have only one testicle and in my thirties my testosterone production was below 100, why I don't know. I had been recently off of it for a year because of insurance problems. I finally got that straightened out and got a test before going back on the level was over 300 and my testicle had returned to normal size. My LH and FSH were all high in my thirties now I am wondering should I go back on "T" considering that 300 is not a bad level for a 63 year old. Back in my 30's I would have liked to have had another kid but now who wants one at my age. I had a friend when I was in collage who was 22 and his father was 65 when he was conceived at 22 he was loosing his father to heart disease and felt a little robbed. (Off subject) Anyway I wonder if I should be taking "T" at my age I get rather tired applying it everyday and forget half the time anyway. I am considering having my FSH and LH checked again. before going back on. Any views on that. "T" is a big bother and I wonder what does it do for a 63 year old anyway. I lost my prostate about a year ago to BPH, and before some of you say it, it was necessary back pressure was causing me to loose kidney function now my creatinine is around 1.7. Anyway I don't shoot now and I am just starting to think just enjoy what sex is left and forget it.

 

[sangheili90]

I am going to add my two cents worth to the discussion I have this problem as well. I have only one testicle and in my thirties my testosterone production was below 100, why I don't know. I had been recently off of it for a year because of insurance problems. I finally got that straightened out and got a test before going back on the level was over 300 and my testicle had returned to normal size. My LH and FSH were all high in my thirties now I am wondering should I go back on "T" considering that 300 is not a bad level for a 63 year old. Back in my 30's I would have liked to have had another kid but now who wants one at my age. I had a friend when I was in collage who was 22 and his father was 65 when he was conceived at 22 he was loosing his father to heart disease and felt a little robbed. (Off subject) Anyway I wonder if I should be taking "T" at my age I get rather tired applying it everyday and forget half the time anyway. I am considering having my FSH and LH checked again. before going back on. Any views on that. "T" is a big bother and I wonder what does it do for a 63 year old anyway. I lost my prostate about a year ago to BPH, and before some of you say it, it was necessary back pressure was causing me to loose kidney function now my creatinine is around 1.7. Anyway I don't shoot now and I am just starting to think just enjoy what sex is left and forget it.

Well, you only have one testicle, its expected for your production to be lower in this case. No one can tell you if you should be taking it or not, personally I am planning on going on the TRT when I get older, but that is an educated decision that I have made for myself.

 

[sangheili90]

This is a GREAT article about TRT: www.t-nation.com: The Complete Guide to T Replacement | T Nation

Decent article overall, though you should be careful with a site that advertises bogus supplements and is widely known to be pro steroid use.

 

[marinera]

Clomid is the best option IMO; it is a safe drug, the two major complications are eye flashes and bad mood (the latter doesn't happen if you tak it 1 or 2 hours before bad, but never take it if your are going to be awake, it can transform you in a psycho). As pwrdick said, it's not required to be on it forever. The reason why docs don't prescript it in case of low T is that clomid has only been approved as a pregnancy drug for females.

Novaldex is less effective than Nolva, but less expensive and with less severe side effects.

Testosterone supplementation in the long course could cause your testicles to stop forever, depending on a number of factors, so it should be the last resort.

 

[marinera]

...
Novaldex is less effective than Nolva...

I meant 'than clomid', of course.

 

[rock26]

I appreciate you getting opinions but there is so much mis information and although some posts may seem to answer questions you really should be asking these exact questions to your doctor because many answers here are not accurate.

TRT therapy is complicated and there is much more involved here than in this thread. It is therapy and in most cases is used to bring your T levels up to a level that is reasonable and is working for you. If used and applied appropriately your balls will not shrink away and you will not be sterile. Working with your doctor for the first 6 months is important so everything can be dialed in to best suit you. Everybody is different.

Instead of assuming what you think you already know or what other people may think they know you might ask people on here what are some questions I should ask my doctor before I start TRT.

I'll start with a couple:

Will TRT raise my estrogen levels?
Will a rise in my estrogen negate or hinder my desired result?
Ask your doctor if he has had much experience in this therapy...ask for a referral if not.
What does a higher red blood cell count mean to me and how can it affect me?
Will my sperm count decrease and if so how does this reduce my chances of having kids?
Is there a solution for this and still stay on TRT?
If I experience atrophy of my testicles is there a solution? Is it permanent?

Like any drug you must weigh the perceived outcome vs risk.

The biggest failure for TRT therapy is abuse...more is not always better and seeking treatment from a doctor who is not experienced.

 

[rock26]

A couple of follow ups.....

Should my estrodial or estrogen be checked before I start TRT for a baseline?
What is the difference between the two?
Is there a solution to increased levels of estrogen while on TRT?
What is my free T level? What is the difference of my free T and my total T?
What is an aromatase inhibitor?
Is this an option to try first?

i gotta go eat...mealtime!

 

[marinera]

A couple of follow ups.....

Should my estrodial or estrogen be checked before I start TRT for a baseline?
What is the difference between the two?
....

I'd say you should start your own thread if you have questions instead thani hijacking this.