Frienly Urologist tip for young 'uns

[thebigbus]

Just saw a teenager last week for decreased libido, ED. I saw that he was coming in for that and thought "sure...".

He took some type of prohormone back in May. Didn't tell me which one.

Lab results?

Testo was near castrate level. FSH and LH almost zero. Prolactin a bit elevated. Estradiol tanked as well.

Moral of story? Let's be sure and keep encouraging our young guys NOT to use exogenous hormones. This guy's fertility may be permanently screwed if we can't restimulate his HPTA.

I'm all for "do what you want", so we have to at least keep educating them on the long term possibilities if they use. If someone is dedicated to making a living at bodybuilding, etc, then fine, but they have to accept the consequences. A lot of young guys are getting horrible advice from the typical gym "bro".

So when guys approach me in the gym, many eventually want to talk about hormones, and I try and educate as much as I can about this stuff.

I used way too young...I know that...and I started TRT at 34 yrs old and was prob low for quite a few years before that.

end public service announcement

 

[Michael30]

Just saw a teenager last week for decreased libido, ED. I saw that he was coming in for that and thought "sure...".

He took some type of prohormone back in May. Didn't tell me which one.

Lab results?

Testo was near castrate level. FSH and LH almost zero. Prolactin a bit elevated. Estradiol tanked as well.

Moral of story? Let's be sure and keep encouraging our young guys NOT to use exogenous hormones. This guy's fertility may be permanently screwed if we can't restimulate his HPTA.

I'm all for "do what you want", so we have to at least keep educating them on the long term possibilities if they use. If someone is dedicated to making a living at bodybuilding, etc, then fine, but they have to accept the consequences. A lot of young guys are getting horrible advice from the typical gym "bro".

So when guys approach me in the gym, many eventually want to talk about hormones, and I try and educate as much as I can about this stuff.

I used way too young...I know that...and I started TRT at 34 yrs old and was prob low for quite a few years before that.

end public service announcement

I completely agree, the amount of Young guys at my gym that are using AAS has increased dramatically in the last 5 years. Last week i heard a group of five 20 year olds talking in the locker room about what they were running and it was scary at how little they knew.

 

[letmeinagain]

Sort of on subject, I was put on hrt June 2001, the same month I turned 31. My testosterone levels had tested at 199 two times so the urologist the USAF referred me to put me on 400mg every three weeks. My sex drive went down from that point on. I didn't complain then because the woman I was married to then was rarely in the mood and the shots made my workouts better than ever.
In 2009 I was sent to another base and the urologist I started seeing there put me on 300mg every two weeks. Even better for my workouts, still no sex drive, but within 6 months my H&H went high. That doctor just had me give blood and life went on.
Retired from the military and June 2012 decided to get a yearly check up with my new pcm. H&H was in the 18's again and this new doctor just took me completely off!! 6 weeks later she checked me again, this time my H&H had gone up to 19.2 even though my testosterone was 54!!
Got put on androgel, back to giving blood, life went on.
2014 and I decide to move back to my home town after being gone 21years.
Well, new town new doctors plus found out the state I moved back to won't take my blood when H&H is high.
So the new doctor can't see past testosterone as the cause of my elevated H&H, plays around with the dosage for a few months and finally took me off again 6 weeks ago! So here I go again.
Anyhow, my question is, why is my sex drive low while on testosterone and since I can't seem to find a knowledgeable doctor around here, what are the chances that at 46, having been on trt over 15 years, I will see any start up in my body's natural testosterone production? I am at the point where I am just done dealing with the doctors I have a choice of and after having one knee and both shoulders operated on since getting into my 40's, I really don't care to have testosterone levels on the high side since I can't put the effort into my workouts like I used to.

 

[thebigbus]

Sort of on subject, I was put on hrt June 2001, the same month I turned 31. My testosterone levels had tested at 199 two times so the urologist the USAF referred me to put me on 400mg every three weeks. My sex drive went down from that point on. I didn't complain then because the woman I was married to then was rarely in the mood and the shots made my workouts better than ever.
In 2009 I was sent to another base and the urologist I started seeing there put me on 300mg every two weeks. Even better for my workouts, still no sex drive, but within 6 months my H&H went high. That doctor just had me give blood and life went on.
Retired from the military and June 2012 decided to get a yearly check up with my new pcm. H&H was in the 18's again and this new doctor just took me completely off!! 6 weeks later she checked me again, this time my H&H had gone up to 19.2 even though my testosterone was 54!!
Got put on androgel, back to giving blood, life went on.
2014 and I decide to move back to my home town after being gone 21years.
Well, new town new doctors plus found out the state I moved back to won't take my blood when H&H is high.
So the new doctor can't see past testosterone as the cause of my elevated H&H, plays around with the dosage for a few months and finally took me off again 6 weeks ago! So here I go again.
Anyhow, my question is, why is my sex drive low while on testosterone and since I can't seem to find a knowledgeable doctor around here, what are the chances that at 46, having been on trt over 15 years, I will see any start up in my body's natural testosterone production? I am at the point where I am just done dealing with the doctors I have a choice of and after having one knee and both shoulders operated on since getting into my 40's, I really don't care to have testosterone levels on the high side since I can't put the effort into my workouts like I used to.

Sorry to hear you've been through all the mismanagement. TRT every 2 or 3 weeks is absurd.

Hard to say about the sex drive without knowing estradiol and prolactin, and any other medications you might be on.

You could try kickstarting things with clomid 25 or 50mg daily, but that can take 6 mos to 1 year to see if gonna truly help.

I would find a GOOD doctor who understands TRT who advises MINIMUM of weekly injections.

As for you H&H, they need to make sure it's not some bone marrow source. If you can't donate then they can set you up for every 3 month phlebotomies to keep the Hb lower.

 

[thethinker48]

Is fertility really an issue in this case doc? A ton of people conceive while on exogenous hormones, and Dante's protocol for fertility has a crazy accuracy rate for success. I've always seen it the in sense that people who have trouble conceiving after taking steroids/being on would usually have the same problem had they not done it previously.

Obviously I'm not smart enough to know the intricacies behind this, so it's wise getting your opinion

 

[thebigbus]

Is fertility really an issue in this case doc? A ton of people conceive while on exogenous hormones, and Dante's protocol for fertility has a crazy accuracy rate for success. I've always seen it the in sense that people who have trouble conceiving after taking steroids/being on would usually have the same problem had they not done it previously.

Obviously I'm not smart enough to know the intricacies behind this, so it's wise getting your opinion

Just gonna depend on if we can restart him with proper protocol, so I agree with you. This kid is no longer on anything. He's shut down from prohormones done back in May. Nuts!

I would bet right now that his sperm counts would be low. Obviously one can still conceive if they're making ANY sperm, but it may not be via conventional means if counts are super low.

 

[Michael30]

Sort of on subject, I was put on hrt June 2001, the same month I turned 31. My testosterone levels had tested at 199 two times so the urologist the USAF referred me to put me on 400mg every three weeks. My sex drive went down from that point on. I didn't complain then because the woman I was married to then was rarely in the mood and the shots made my workouts better than ever.
In 2009 I was sent to another base and the urologist I started seeing there put me on 300mg every two weeks. Even better for my workouts, still no sex drive, but within 6 months my H&H went high. That doctor just had me give blood and life went on.
Retired from the military and June 2012 decided to get a yearly check up with my new pcm. H&H was in the 18's again and this new doctor just took me completely off!! 6 weeks later she checked me again, this time my H&H had gone up to 19.2 even though my testosterone was 54!!
Got put on androgel, back to giving blood, life went on.
2014 and I decide to move back to my home town after being gone 21years.
Well, new town new doctors plus found out the state I moved back to won't take my blood when H&H is high.
So the new doctor can't see past testosterone as the cause of my elevated H&H, plays around with the dosage for a few months and finally took me off again 6 weeks ago! So here I go again.
Anyhow, my question is, why is my sex drive low while on testosterone and since I can't seem to find a knowledgeable doctor around here, what are the chances that at 46, having been on trt over 15 years, I will see any start up in my body's natural testosterone production? I am at the point where I am just done dealing with the doctors I have a choice of and after having one knee and both shoulders operated on since getting into my 40's, I really don't care to have testosterone levels on the high side since I can't put the effort into my workouts like I used to.

I'm just going off my personal experience. I've been on TRT for 10 years. My Dr is not very knowledgeable at TRT. It's just my GP that prescribeds it. Anyways I'm prescribed 400mg every 2 weeks. When I first started it helped my sex drive but after 6 months not at all. I started experimenting myself. Now I take 50mg every mon, wed, Fri SubQ (150mg wk)along with none prescribed aromasin and HCG. My sex drive has been perfect(and at times to high according to my girlfriend) the last 6 years I've been taking my TRT this way. So my advice would be if and when they put you back on it to try 2x or even 3x aweek shots for more stable blood levels. If you don't want to inject I'm that often try SubQ shots. I no longer do it in my stomach. I do my SubQ shots in my upper thigh. Anyways I'm sorry your going through this I hope you fine a good dr and get things figured out.

 

[letmeinagain]

Thank you for the quick replies. To add to the long story, after I had tested at 199 twice in 2001, once by the military doctor once by the urologist, the urologist gave me a HCG shot. I remember it clearly, about a day and a half later I felt like a teenager again, which lasted 4 days. Had labs a week and a half later, testosterone was in the 260's! That was when I was put on 400mg every three weeks. He said he expected to see levels close to 500.
I am actually married to a NP now but she specializes in dermatology. She is who referred me to a hematologist last May, my H&H was really worrying her. The hematologist is who had me play with my dosage until 6 weeks ago. I tested negative for all the blood issues which could cause my high HH. So with her being out of ideas I was referred to another urologist. I haven't been seen by a urologists in a few years, my pcm had been prescribing the test.
I first saw the new urologist the middle of November. She tested fsh, lh, psa, and prolactin. Fsh and lh were almost zero but prolactin and psa were normal. Didn't test estradiol and she forgot to check test levels. I am doing labs for test and HH this Thursday. I know the test will be low and figure the HH will still be high.
Unfortunately the new urologist said she only likes the gel and when I mentioned HCG she seemed clueless. Well, maybe not clueless but like HCG isn't something used anymore? I loved how I felt the week after the HCG shot. Why can't a doctor prescribe a weekly shot of it? Is it too costly or worse than taking test the rest of my life?

 

[Turkishexpress]

Like you I had to get on TRT in my early thirties. I try to educate the youngins as much as I can but they rarely listen unfortunately. Experience seems to be the best teacher. Hopefully they don't hurt themselves while gaining that experience.

 

[maldorf]

As for you H&H, they need to make sure it's not some bone marrow source. If you can't donate then they can set you up for every 3 month phlebotomies to keep the Hb lower.

Great advice. I see an endocrinologist now, have been for 8 years since my blood clot/heart attack, and every 3 months I get checked to see if I need a phlebotomy. I just went today in fact and my hemoglobin was 14.8, so I didn't need one. I was very happy about that! He keeps mine at 15 or less. I am also on Coumadin now for life and that will keep things in check since I have the prothrombin mutation.

He also did a bone marrow biopsy to make sure there wasn't something wrong and that tested normal.

 

[sazo75]

Messed around with them a few times around 18 ish, didn't do anything ED wise until I started getting a bit older and continuously messed around with them. Hopefully he can recover.

 

[TODouble2]

I wish I would have read this post years ago. I've been trying to regain fertility for a long time now. Hopefully I bounce back eventually


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[nothuman]

I wish I would have read this post years ago. I've been trying to regain fertility for a long time now. Hopefully I bounce back eventually


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Why not try Dante's protocol?

 

[TODouble2]

Why not try Dante's protocol?

I remember seeing it somewhere, but it just seems like one of those things that takes a long time for some people. All these protocols are just different timing and dosages of the same drugs. I finally go my doc to prescribe me some FSH along with my HCG and clomid regimen.

Following dantes advice though, I've been taking Taurine. I'm also taking royal jelly since I saw a study on that showing it to prevent desensitization from big doses of HCG. And I take zinc and maca root and stuff like that as well.

So yes I've seen his protocol, I just don't remember exactly what it is... but I'm already 8 months off steroids so I didn't want to start a new protocol. I figured stick with the plan.

 

[saudades]

I can go into my gym and point out numerous kids who are "on the sauce." I've heard a few talking about it, and I've jumped into a couple of conversations, suggested they educate themselves and even get on this board. When I would follow up on it, they'd say they hadn't looked at anything. They always think they know what they're doing, trust their own knowledge or their bros' knowledge more.

Sort of on subject, I was put on hrt June 2001, the same month I turned 31. My testosterone levels had tested at 199 two times so the urologist the USAF referred me to put me on 400mg every three weeks. My sex drive went down from that point on. I didn't complain then because the woman I was married to then was rarely in the mood and the shots made my workouts better than ever.
In 2009 I was sent to another base and the urologist I started seeing there put me on 300mg every two weeks. Even better for my workouts, still no sex drive, but within 6 months my H&H went high. That doctor just had me give blood and life went on.
Retired from the military and June 2012 decided to get a yearly check up with my new pcm. H&H was in the 18's again and this new doctor just took me completely off!! 6 weeks later she checked me again, this time my H&H had gone up to 19.2 even though my testosterone was 54!!
Got put on androgel, back to giving blood, life went on.
2014 and I decide to move back to my home town after being gone 21years.
Well, new town new doctors plus found out the state I moved back to won't take my blood when H&H is high.
So the new doctor can't see past testosterone as the cause of my elevated H&H, plays around with the dosage for a few months and finally took me off again 6 weeks ago! So here I go again.
Anyhow, my question is, why is my sex drive low while on testosterone and since I can't seem to find a knowledgeable doctor around here, what are the chances that at 46, having been on trt over 15 years, I will see any start up in my body's natural testosterone production? I am at the point where I am just done dealing with the doctors I have a choice of and after having one knee and both shoulders operated on since getting into my 40's, I really don't care to have testosterone levels on the high side since I can't put the effort into my workouts like I used to.

Thank you for the quick replies. To add to the long story, after I had tested at 199 twice in 2001, once by the military doctor once by the urologist, the urologist gave me a HCG shot. I remember it clearly, about a day and a half later I felt like a teenager again, which lasted 4 days. Had labs a week and a half later, testosterone was in the 260's! That was when I was put on 400mg every three weeks. He said he expected to see levels close to 500.
I am actually married to a NP now but she specializes in dermatology. She is who referred me to a hematologist last May, my H&H was really worrying her. The hematologist is who had me play with my dosage until 6 weeks ago. I tested negative for all the blood issues which could cause my high HH. So with her being out of ideas I was referred to another urologist. I haven't been seen by a urologists in a few years, my pcm had been prescribing the test.
I first saw the new urologist the middle of November. She tested fsh, lh, psa, and prolactin. Fsh and lh were almost zero but prolactin and psa were normal. Didn't test estradiol and she forgot to check test levels. I am doing labs for test and HH this Thursday. I know the test will be low and figure the HH will still be high.
Unfortunately the new urologist said she only likes the gel and when I mentioned HCG she seemed clueless. Well, maybe not clueless but like HCG isn't something used anymore? I loved how I felt the week after the HCG shot. Why can't a doctor prescribe a weekly shot of it? Is it too costly or worse than taking test the rest of my life?

You sound like my own case. Put on HRT when I was 30, and I was put on 300mg every 2 weeks. Fast forward to today, I've been on for 17 years, always have had problems with keeping sex drive up. Only one doc I've had gave me HCG--felt great on it, all the others either don't know anything about it or won't give it to me. I'm guessing when you say H&H that you're referring to hematocrit and hemoglobin (or similar) and, I'd also guess that even though you've been tested for "blood issues," you haven't been tested for iron or the hemochromatosis genes. I only found out myself in the last year that this was my problem. No one had ever tested for iron/ferritin and the gene before, but my current doctor after listening to my description of symptoms did those tests which came back positive for the hemochromatosis genes and high iron/ferritin. You sound like you have the same problem, and I would suggest you get tested asap because this is what causes my hemoglobin/hematocrit to constantly go high.

I'm now on 400mg/weekly (really), 200mg twice a week to keep my levels at the point to keep my sex drive up, and I have been on this treatment for 3 years now. My levels will peak at a higher point then come down to about 600-800 at the trough. This is the key here. You don't want levels to bottom out below the lower limit when you hit the trough. Most urologists/endocrinologists will only put you on enough to peak at about 700-800 then let you fall way too far down. Normal men don't experience this. Their levels remain more or less constant. So it's no wonder that most guys on HRT still complain about libido issues--they don't get proper treatment!

 

[thebigbus]

I can go into my gym and point out numerous kids who are "on the sauce." I've heard a few talking about it, and I've jumped into a couple of conversations, suggested they educate themselves and even get on this board. When I would follow up on it, they'd say they hadn't looked at anything. They always think they know what they're doing, trust their own knowledge or their bros' knowledge more.





You sound like my own case. Put on HRT when I was 30, and I was put on 300mg every 2 weeks. Fast forward to today, I've been on for 17 years, always have had problems with keeping sex drive up. Only one doc I've had gave me HCG--felt great on it, all the others either don't know anything about it or won't give it to me. I'm guessing when you say H&H that you're referring to hematocrit and hemoglobin (or similar) and, I'd also guess that even though you've been tested for "blood issues," you haven't been tested for iron or the hemochromatosis genes. I only found out myself in the last year that this was my problem. No one had ever tested for iron/ferritin and the gene before, but my current doctor after listening to my description of symptoms did those tests which came back positive for the hemochromatosis genes and high iron/ferritin. You sound like you have the same problem, and I would suggest you get tested asap because this is what causes my hemoglobin/hematocrit to constantly go high.

I'm now on 400mg/weekly (really), 200mg twice a week to keep my levels at the point to keep my sex drive up, and I have been on this treatment for 3 years now. My levels will peak at a higher point then come down to about 600-800 at the trough. This is the key here. You don't want levels to bottom out below the lower limit when you hit the trough. Most urologists/endocrinologists will only put you on enough to peak at about 700-800 then let you fall way too far down. Normal men don't experience this. Their levels remain more or less constant. So it's no wonder that most guys on HRT still complain about libido issues--they don't get proper treatment!

Great points. Most docs are supremely ignorant when it comes to hormone replacement. Dosages are different for everyone, and symptom alleviation is different for everyone at different levels.

I start my patients out on 100mg/week, but they know we will likely have to adjust based on their symptoms. I've had some guys get mid injection levels of over 1000 on only 100mg/week, and some not get above 700 on 200mg/week. So much variation.

Most docs are terrified of getting anyone's peak over "normal". Also, unfortunately, most insurances will start giving docs hell when they get people feeling better on "outside the norm" dosages.

It's a screwed up little game.

 

[nothuman]

Great points. Most docs are supremely ignorant when it comes to hormone replacement. Dosages are different for everyone, and symptom alleviation is different for everyone at different levels.

I start my patients out on 100mg/week, but they know we will likely have to adjust based on their symptoms. I've had some guys get mid injection levels of over 1000 on only 100mg/week, and some not get above 700 on 200mg/week. So much variation.

Most docs are terrified of getting anyone's peak over "normal". Also, unfortunately, most insurances will start giving docs hell when they get people feeling better on "outside the norm" dosages.

It's a screwed up little game.

Well I'm glad there are people like you that help fight the good fight. I just wish there were more like minded MD's out there that we could trust.

 

[letmeinagain]

Well, I guess I am losing my memory also! Today is 5 weeks since my last shot not 6 weeks. To continue adding details to my story, September through October I was taking 120mg weekly and had H and H tested the last week of October. It was still mid 18's on that dosage. I was scheduled to see the hematologist the first week of November. I knew my results the next day since my wife can log in and check labs. Since I knew it was high I took a 200mg on 1 November. Because I was going back to biweekly shots. I know weekly are better but I get tired of injections, especially after 15 and a half years of them.
I saw the hematologist a couple days later and that is when she said she wanted me to see an urologist and to stop the shot, but I had already taken the 200mg.
Since my wife is friends with a urologist I got seen the end of the second week in November. I see her and of course get the same initial questions I got from the hematologist, why are you on it, who told you to be on it, if you look like you workout in the slightest and you tell a doctor that you are on testosterone, they always think you are lying about it being prescribed!
The urologist didn't even seemed concerned about the H and H levels, she checked me over, gave me the rubber glove test, and gave me a lab slip to check for fsh, lh, psa, and prolactin. Seemed odd no testosterone check. I had that lab drawn the next week and was to see her 9 December.
Well come the end of November I felt like crap and I knew I had a busy December ahead. So 1 December I took a 300mg shot since I figured the urologist would set me up on a new protocol in 9 days.
Well, I see the urologist on the 9th, goes over my low fsh, lh, and normal psa and prolactin, then ask where are the testosterone results! I told her she hadn't mark the paper for that test. Found out she had wanted to test my testosterone since she knew I had taken a 200 shot on 1 November and the first labs would have been about two weeks after it.
So there I was having just taken a 300 shot 8 days earlier and she hands me a new lab slip for testosterone. That is when I decided to go off the rest of the month and I will have testosterone checked tomorrow. Also my wife gave me a slip to have H and H, fsh, lh, prolactin, and estradiol checked while I am at it.
It's weird but I felt like crap last week but last Saturday through today so far, I have felt pretty darn good all of a sudden but test levels should be super low. I have been having tingling/ weird sensations in the nads and they seem to have gotten fuller all of a sudden! I am pretty sure I couldn't have rebounded this quickly or at all but I feel good and have had strong workouts this week.
I do the labs tomorrow and should have the results by Saturday or Monday, maybe Friday. I will post on here how they turn out for anyone who is interested.
I have been tested for iron and the hemochromatosis genes. They were normal, jack 2 mutation or anything but, I will add that my dad had a minor stroke in 2013. I found out his H and H was borderline high and he doesn't take anything or smoke and drink! Hopefully some day someone will figure me out.

 

[letmeinagain]

Had the labs done this morning and the wife logged in and checked them a few minutes ago. For some reason the testosterone level test wasn't there but the rest were. Surprisingly my hemoglobin was down to 16.4 and hematocrit 48 something. The hematologist did have me give blood in her clinic a month ago but my levels haven't been below the mid 17's and 52 since 2008. It didn't go down the last time I went off testosterone for this amount of time.
My fsh was 2.1 up from.1 in October and the LH was low normal also. Prolactin and progesterone were normal but estradiol was almost 0!
Hopefully they didn't forget the testosterone test and I will have that soon.
I really didn't expect my fsh and lh to have jumped up at all after being on testosterone for 15.5 years. I have been feeling good since Saturday so maybe I am miraculously rebounding after all these years. That would be nice!

 

[graybass]

Like I'd ever listen to a doc again! I've been self prescribing HRT for my self for over 15 years. These docs have not a clue for hormones. I cruise at 200mg a week then blast to 600mg for 6 weeks a couple times a year. I'm over 50 and I have 2 girlfriends in order to keep up with my sex drive. I do full blood work ups twice a year and I look fine, except test is a little high lol! You guys can flame me for my attitude but it's about MY quality of life not quantity. I don't need to be a little old man of 90.