Treatment options for Hypogonadism

You can bring this to your doctor: Normal Testosterone Levels In Men: Average By Age Chart

Your total testosterone level is less than the average for a 85 year old male. How old are you?

The rest of that web page is a good reference that you should read and you should also read this thread. Decide on what is more important right now, PE literature or getting well? This is your life we`re talking about and not a quick fix by getting a pill from the doctor that you don`t even know what is doing. TRT is for life and you need to learn at least the bare minimum.

Chances are you should find another doctor, since if he does not want to treat you with your current levels, he probably does not know what he`s doing even if you can convince him that your levels are low sorted by age.

There are basically two types of hypogonadism, primary and secondary. With primary, your testicles are not working properly and as far as I know, injecting exogenous testosterone is the only solution.

With secondary, the problem is elsewhere in your HPT axis, in the hypothalamus or pituitary. For some reason, your testicles are not receiving the necessary signal hormones from your brain that tells them to produce testosterone. With this condition, it is possible to treat it by SERM therapy, which stimulates your pituitary to produce LH. This is different from exogenous testosterone therapy, since it stimulates your body to produce testosterone on it`s own. Another option is HCG therapy, a LH analogue that stimulates your testicles directly. Another option that some people have success with is herbs like Tongkat Ali, Maca, Ginkgo Biloba, D-aspartic acid, etc.

Finally, low testosterone can be a symptom of something else going on, so a thorough diagnosis is very important. It could be hemachromatosis or thyroid issues. Also, if you have a shitty lifestyle with lots of stress, bad foods, no training, little sleep, etc, that alone can explain your low testosterone and the real cure is to get your life together which WILL boost your levels.

I`ll be happy to answer any questions to the best of my knowledge, but you need to learn this for yourself.

Regards,

Renholder

How much do you weigh how what is your %bodyfat ?

I am 52 and have been on T injections for 8 months now. I have had problems in the past due to what the doctor said was damage to my testes from 9 months of chemo (interferon) for hep c. In the past my levels were low normals. About 12 years ago I was prescribed Androgel for 6 months, then off for 3 months and back on for 6 months. I noticed a little bit of a difference, nothing major though. I quit shortly after for sometime. I went back several times in the following years and basically did same treatments until I got tired of it because of the lack of major results.

8 months ago I went back to my Doctor complaining of no libido, erection problems, foggy head, lack of ability to concentrate, fatigue, all the classic low T symptoms. He did a whole series of test and my T came back at 104, which is extremely low, and I also had a under active thyroid. This time he put me on injections which he seemed to think works better. After about a month I started feeling a lot better all the way around. Almost all my symptoms were gone, other then some depression. I’m not horny all the time like a 16 year old but I would say it hits me pretty strong at least every 7 to 10 days on average. Sometimes I have longer gaps, and sometimes I will feel that way for 2 or 3 days in a row. I am pretty happy now considering what I have been through and my age. The thing is he claims I will have to be on it for the rest of my life. That has me kind of worried. It sounds like from what you guys have been talking about that as long as I am taking the TRT my body won’t start making it’s own. I am wondering if this is primary or secondary Hypogonadism? If I am doing the right thing or not.

Another thing I have mentioned in another thread is poor flaccid size now. I take some other meds which could be causing it though What do you guys think of my situation?.

Did you have your LH and FSH levels checked before commencing on TRT? The levels of those tests would be a good indicator of whether you’re primary or secondary. In my case, I had a testicle removed due to cancer. 3 years after I noticed that my remaining testicle was becoming smaller and I started with the low T symptoms. Did you notice any changes in the size of your testicles?

Has your libido and erections come back? The reason why I ask is, I’m also 52.

Yes my libido and erections are good when I’m feeling good. If I’m not feeling it I need half of a Viagra, and have to deal with the mood part. I think I’m going to start limiting myself for sexual activity if I am not in the mood at all.

With what we know today and barring any new discoveries and medicine, TRT is most likely for life in your case. In Europe we do have something called Nebido, which is long-acting testosterone that is injected only every 9-12 weeks. Hopefully it can come your way some day and make your life more practical.

If you have suffered damage (permanent?) to your testicles, your condition is most likely PRIMARY testicular failure. With testicular failure, I believe the only treatment is exogenous testosterone like you`re receiving now.

With SECONDARY hypogonadism, the problem is in the hypothalamus/pituitary and not in the testicles. For those who suffer from this, there are alternatives to exogenous testosterone which have been spoken about many times in this thread, but a lot of people still end up getting treatment with exogenous testosterone since the alternative treatments are not always successful.

What other medications are you taking that could cause it?

You really need to be asking your doctor these questions or get a better doctor. It`s not as simple as injecting testosterone and then things will get well on it`s own. You may have high or low E2, both which will affect libido. Maybe your dose should be adjusted. For high E2, the solution is usually to add an aromotase inhibitor like arimidex.

Even if you`re primary, I still think you can benefit from adding HCG to your regime. Sta-Kool on this board felt even better after he added this to his protocol and he has primary hypogonadism, so it`s not just for those who are secondary.

For your flaccid size and general erection quality, I would recommend daily use of Cialis instead of Viagra. Take a very low dose every day, if you don`t have any health issues that says you should not. Consult your doctor first. There are studies that suggests Cialis is beneficial for increasing testosterone and reducing E2 as well and not just improving the circulation in your penis. It was posted a few pages back.

Good luck!

Well I got my 3 month lab results in the mail today and everything is good other the my T is at 1009. Doc wants me to switch to 1ML every 3 weeks instead of every 2. I take methadone which being a opiate is also known to lower T levels. I am weening myself down on it because my work has changed and I don’t have near the back pain anymore.
I also have hep c which could be causing problems. No way to know for sure though, and I do not have any other problems from it.
What is the HCG, or I can look it up as. Also interested in messing around with some PT-141. It sounds interesting and kind of fun for special occasions. Oh, I also have a under active thyroid that I’m taking meds for, and I take Klonipin occasionally for anxiety and mild panic. Of course Viagra occasionally. Hell that is quite a list when you think about it. That is why I’m hesitant to start a antidepressants, plus I have had bad luck with them. I have done the small doses of Cialis daily before and it does help. I think I will switch back to it. I like to rotate between the two anyway so I don’t build up a strong tolerance.

Since this discussion is about hypogonadism, here’s a good flow chart for the hormones:

There’s a little popup button at the bottom of the chart that will blow the chart up so it’s ledgeable.

I don’t claim to know much about what’s going on here, but what I do know is all the hormones originate from cholesterol (top left). If you follow the arrows the chart shows how the major hormones are produced and how they can splitter off into less desirable pathways, for example DHEA (mid way down left margin) can go towards both testosterone or estrogen production.

The are some guys on other forums that are really good with this sort of stuff.

Thanks for the chart. It’s too complex to view well on my phone, so I’ll check it out on a bigger screen tonight.

HCG is mentioned in this thread several times and sta-kool reaped great benefits from it after he started using it along with his existing TRT-regime.

HCG is an LH analogue that keeps your testicles functioning after your HPT axis gets supressed from using exogenous testosterone. It`s not only for maintaining testicular size, since there are other hormones produced in your testicles as well.

I understand your hesitancy about taking anti-depressants and I would not do it personally.

Renholder

Yes I am going to print off one that sta-kool posted from KSman at T Nation. It is the one with the protocol for TRT. I am hoping the Endo I go to is up to date, or willing to be a pioneer. I am not excepting the old methods of treatment. If he won’t work with me I will find someone else that will. I am tired of feeling like crap both mentally and physically.

I’ve been going to a Low T center to get treatment for my hypogonadism. I’m currently doing 280 (unsure measurement) of Test weekly, followed by .5 mg of arimidex 48 hours later, with 50 units of HCG on days 3 and 5 of my week. Unfortunately, I am still waiting for my Test to get dialed in so that I feel consistently better. I’m not there yet, so I can’t say that this dosing schedule is necessarily the way to go.

There is much to know about TRT protocols regarding dosage, dosing frequency, AI, and HCG. I know the posts above yours are six years old, but there was one guy who’s doc was taking him from once every two weeks to once every three weeks dosing which is disastrous.

In your case Ronin 280 mg/wk is a very high dose, so you can expect your doc will most likely lower it in the future. The AI at 0.5 adex per week is probably about right, but will need to be dialed in via blood testing - and then once he lowers your test dialed in again. HCG is a great idea, would be good if you find out how many IU you are taking - 50 IU is a super low dose so makes me wonder - more typical is 250 IU 2x per week.