Testosterone recovering after a prolactinoma

[Systemlord]

That result is pathetic as we see guys coming in here with low T symptoms at those numbers, you need to increase dosage. How do you feel?

 

[CoastWatcher]

I had my testosterone checked on January 5. It's up to 464 ng/dL now (Nov 7 test was 51, first shot Nov 17). That's doing 100mg once a week.

I have ordered HCG on my own and am waiting on that, but I'm going to see a urologist in early February and see if I can get it prescribed and also start monitoring estrogen levels.

At the very least, you should be injecting twice a week, possibly more frequently (and possibly with more testosterone). I'd argue that 60mg twice a week should be tried for six weeks. We regularly see members injecting frequent, small amounts (I inject 16mg every morning) of testosterone achieve splendid results. Remind me, what is your SHBG?

 

[madman]

That result is pathetic as we see guys coming in here with low T symptoms at those numbers, you need to increase dosage. How do you feel?

I would not say pathetic if he is only injecting 100mg once weekly and if 464 ng/dl is his tt (TROUGH)..............sure it is still low and needs to be brought up if he is feeling no improvement in low t symptoms/overall well being.

Now if 464 ng/dl was his peak than I would say that is pathetic!

 

[madman]

I started my trt at 100mg once weekly every Friday morning of Depo-Testosterone (cypionate) sub-q (abdominal injections) at 8 weeks my trough (following Friday am before next injection) was only 495 ng/dl.

Throughout the 8 weeks I noticed mild improvement in energy/libido/mood/slight strength increase weights (all my lifts)/improved recovery which was a big change from pre-trt but I felt shitty by the end of the week and could tell my testosterone levels needed to be improved dose increase and also injection frequency to keep blood levels more stable.

My dose was increased to 150mg/week which I split into injecting 75 mg every 3.5 days and 8 weeks later total t roughly 1200 ng/dl (trough), free t almost double top end of the reference range and overall I noticed a huge improvement in my energy/libido/mood/strength and recovery.

Do not use (a.i) or (hcg).

 

[perryw]

At the very least, you should be injecting twice a week, possibly more frequently (and possibly with more testosterone). I'd argue that 60mg twice a week should be tried for six weeks. We regularly see members injecting frequent, small amounts (I inject 16mg every morning) of testosterone achieve splendid results. Remind me, what is your SHBG?

I actually did just a half dose Saturday morning and was going to start the every 3.5 days thing. It seems like I was feeling better overall, but I could notice a drop off at the end of the week. Also, my quads are sore for a couple days after IM injections, so I got some 27ga syringes and injected into my abdomen. I gotta stick with this total weekly dosage until I see the urologist.

The only SHBG test I've has was in May and it was 19 nmol/L, range 11-80.

 

[OMI100]

If you did not see this post:
https://www.excelmale.com/forum/sho...-You-Be-Injecting-Testosterone-Under-the-Skin

 

[Systemlord]

I actually did just a half dose Saturday morning and was going to start the every 3.5 days thing. It seems like I was feeling better overall, but I could notice a drop off at the end of the week. Also, my quads are sore for a couple days after IM injections, so I got some 27ga syringes and injected into my abdomen. I gotta stick with this total weekly dosage until I see the urologist.

The only SHBG test I've has was in May and it was 19 nmol/L, range 11-80.

That's the same SHBG level as myself, I spent 17 weeks on 75mg weekly and things progressed very slowly, even 50mg twice weekly showed slow improvements. It wasn't until I started injecting EOD that my symptoms really started progressing faster, my muscles have been sore since July and I've felt a new level of soreness switching to EOD injections.

The point is if you are excreting most of your T and you are not injecting frequently enough you will not feel your best and recovery will progress slowly. You can also inject in your shoulders to give your quads a break.

 

[CoastWatcher]

I actually did just a half dose Saturday morning and was going to start the every 3.5 days thing. It seems like I was feeling better overall, but I could notice a drop off at the end of the week. Also, my quads are sore for a couple days after IM injections, so I got some 27ga syringes and injected into my abdomen. I gotta stick with this total weekly dosage until I see the urologist.

The only SHBG test I've has was in May and it was 19 nmol/L, range 11-80.

With that SHBG, under 20, you are typically clearing testosterone quickly; a once-weekly injection is not going to get you where you want to go. Give the twice a week (every 3.5 days) six weeks - you may well notice improvement.

 

[perryw]

I saw the Urologist's PA today. He's having me quit the testosterone cypionate and switch to Clomid. Doing this because while I don't have plans to have a kid, I am also not planning on not having kids. He'd rather try to raise my testosterone with clomid to maintain fertility, just to avoid having to spend thousands of dollars down the road in case sperm production is shut down. I was given the choice, and agreed with that rationale.

Then he goes on to prescribe an AI, 1mg per week. He said I look like a dude with high estrogen, so he didn't feel the need for a blood test right now. And a prescription for HCG. I'll try all this junk for 3 months and see how I feel, and if the testosterone levels aren't looking good then we can reconsider going back to testosterone cypionate.

I told him about the every 3.5 day thing I'd been doing and he said out of however many thousands of patients that he can count on his fingers the number of guys that need to do that.

Oh, he's going to take over monitoring my prolactin level so I don't need to go back to my endo.

 

[FeelingLost]

I saw the Urologist's PA today. He's having me quit the testosterone cypionate and switch to Clomid. Doing this because while I don't have plans to have a kid, I am also not planning on not having kids. He'd rather try to raise my testosterone with clomid to maintain fertility, just to avoid having to spend thousands of dollars down the road in case sperm production is shut down. I was given the choice, and agreed with that rationale.

Then he goes on to prescribe an AI, 1mg per week. He said I look like a dude with high estrogen, so he didn't feel the need for a blood test right now. And a prescription for HCG. I'll try all this junk for 3 months and see how I feel, and if the testosterone levels aren't looking good then we can reconsider going back to testosterone cypionate.

I told him about the every 3.5 day thing I'd been doing and he said out of however many thousands of patients that he can count on his fingers the number of guys that need to do that.

Oh, he's going to take over monitoring my prolactin level so I don't need to go back to my endo.

Hi Perry, I know this is a pro TRT site but I have to say if you think you might want a son or daughter in your future you have choosen an excellent path to try.
If it fails you always know your way back to TRT. It sounds like your new doc really cares about his patients and thinks of their future..

 

[CoastWatcher]

I saw the Urologist's PA today. He's having me quit the testosterone cypionate and switch to Clomid. Doing this because while I don't have plans to have a kid, I am also not planning on not having kids. He'd rather try to raise my testosterone with clomid to maintain fertility, just to avoid having to spend thousands of dollars down the road in case sperm production is shut down. I was given the choice, and agreed with that rationale.

Then he goes on to prescribe an AI, 1mg per week. He said I look like a dude with high estrogen, so he didn't feel the need for a blood test right now. And a prescription for HCG. I'll try all this junk for 3 months and see how I feel, and if the testosterone levels aren't looking good then we can reconsider going back to testosterone cypionate.

I told him about the every 3.5 day thing I'd been doing and he said out of however many thousands of patients that he can count on his fingers the number of guys that need to do that.

Oh, he's going to take over monitoring my prolactin level so I don't need to go back to my endo.

He told you that you "looked like a dude with high estrogen"? You found the one medical professional who can diagnose elevated estradiol in men based on sight alone - that's amazing! Seriously, if that practice isn't going to monitor your estradiol, invest a small amount of money and do it yourself via www.discountedlabs.com. You don't want to crash your estradiol - a world of hurt it is best to avoid.

An amazing guy this PA who diagnoses on sight and has less than ten patients injecting small amounts of testosterone more frequently than once weekly. Contrary to - essentiallly - every member of this site (across multiple practices and various countries).

 

[perryw]

He told you that you "looked like a dude with high estrogen"? You found the one medical professional who can diagnose elevated estradiol in men based on sight alone - that's amazing!

Gynecomastia is his basis I imagine. Couple years of super low T, super high prolactin, and shit happens. Estradiol will be checked when I go back in 3 months, just didn't check it today.

 

[perryw]

And I'm done with Clomid. I took the first pill on Sunday the 11th, and one each day after. By Sunday the 18th I had an all day headache. Called the office Monday and they had me cut down the frequency, so I had a pill on the 18th and the next on the 21st. By Friday the 23rd I felt like I was having some blurry vision. I was willing to fight through the headaches for a bit, but the vision stuff is a deal breaker. Got ahold of the office today and I can't get in until the 21st first March.

Thankfully, I still had a vial of testosterone and a refill left from the endo, so I'm just switching back to that until the appointment. Come to find out, pituitary tumors are a contradiction for Clomid so I'm not even sure I was a good candidate to begin with.

I was thinking of going to see my Primary Care PA and asking for a sleep study, so maybe I'll ask him if he can manage all this for me. I can see him next day.

edit found this study that makes me think Clomid is ok with my tumor. https://www.ncbi.nlm.nih.gov/pubmed/19359408

 

[Dr.V.P.C.]

Clomid is an excellent drug in paper and to restore numbers, but unfortunately very frequently the lab numbers show a beautuiful panel but the man really feels like crap . Crazy drug .

 

[Gman86]

HCG shuts down your natural LH and FSH. They will both show either zero or very close to zero on HCG.

On 2,000iu's of HCG mono therapy per week my testosterone level came back at 1200. So if 2,000iu's/ week isn't raising testosterone levels where you want them, it's highly unlikely 3,000iu's/ week is going to do much better.

Usually doctors are hesitant to prescribe TRT when someone is less than 30. I'm very surprised your doctor is hesitant considering you are 39. Most doctors would feel quite comfortable prescribing TRT to someone your age.

Considering everything you have told us, I think the answer is pretty clear. Find a new doctor asap! lol. HRT is extremely safe when being managed by a good doctor. Under a doctor's supervision that doesn't know what they are doing it is the opposite. You can do more harm than good

 

[Dr Justin Saya MD]

Gman is absolutely correct.

HCG stimulates the bottom half (the testes), but suppresses the top half (the hypothalamus-pituitary).

 

[CoastWatcher]

You wrote that your doctor doesn't want me on shots and blood tests for the rest of my life...but I assume he wouldn't hesitate to prescribe injections - for life - if you presented with a diabetic condition that responded to insulin shots. This isn't "vanity medicine," hypogonadism is a genuine medical condition that impedes, it can actually destroy, one's quality of life. A shot is a small price to pay to having your life restored.