Total testosterone of 290 at 21 years old. Options?

B-P- Tony: Yes, I workout. I’m 73 inches at 175 pounds right now although my body fat level is kind of high at 15% (not great I know, I need to lower it), I still have a V-cut and raised veins on my calves. I’ve been taking D-A-A for the past several months and I’ve tried m-you-c-you-n-a in the past unfortunately. I’ve also tried Long-jack and horny goat weed. In my opinion herbs are a scam because I didn’t feel any different on them. I don’t remember if I was taking them for the test in 2013 but I know I was taking D-A-A and Long-jack for the January 2015 test.

AFAIK weight training actually decreases T levels probably due to the recovery process, except for a very short time post workout. Also, I remember reading testosterone can be about double (wow?) after 7 days without ejaculation. I’m not an expert but you might look at some studies because I think testosterone can vary a lot even in the same individual based on environmental factors. Also I’m sure stress is a killer too.

I’d suggest finding a urologist who treats low testosterone.

One thing doc will figure out is whether your suffer from primary or secondary low testosterone

- Primary: your testicles are not working
- Secondary: testicles are functional, but the pituitary gland or hypothalamus aren’t sending the right signals to them

If you are Primary your treatment will be testosterone
If you are Secondary your treatment will be low dose human chorionic gonadotropin (HCG)

If it is primary, I don’t believe any doctor these days will prescribe injections right off the bat, because that is considered outmoded treatment. The goal these days is to give you a steady testosterone level, and injections just don’t do that. You will have to try the newer methods first.

For example, I was eventually prescribed injectable testosterone after first trying

- Androgel
- Striant buccal patch

Those methods did not work for me at all. Gel didn’t do anything to raise my levels, and the buccal patch made my levels go even lower down into the basement.

On the other hand, gel works great for most men.

How many times a week do you inject? I read stable levels can be achieved through multiple injections a week. I’m going to see my primary care doctor and if he wants to play ball then I’ll stay with him and if he refuses I’ll just walk out then find a urologist. I’m only going to be home for the summer from late May to mid August so I need to get a fix in that span otherwise I’ll have to start over in the fall when I go back to school. I don’t really care what I have to do to fix my level because all I want is to feel like a normal 21 year old male. :(

For what it is worth, this is the most comprehensive list of the symptoms of low testosterone I’ve seen. For anyone reading, only a blood test can determine whether or not you suffer from low test

From the book:
“The Testosterone Syndrome: The Critical Factor for Energy, Health, and Sexuality ” by Eugene Shippen, MD

Questions for Treatment:

Do you currently have or ever had any of the following symptoms?

Sex Function
Decrease in spontaneous early morning erections.
Decrease libido or desire for sex.
Decrease in fullness of erections.
Decrease in volume of ejaculate or semen.
Decrease in strength of climax or force of muscular pulsations.
Difficulty in maintaining full erection.
Difficulty in starting erection‐or no erection.

Mental Functions
Spells of mental fatigue or inability to concentrate; feeling burned out.
Tiredness or sleepiness in the afternoon or early evening.
Decrease in mental sharpness, attention, wit.
Change in creativity or spontaneous new ideas.
Decrease in initiative or desire to start new projects.
Decreased interest in past hobbies or new work‐related activities.
Decrease in competitiveness.
Change in memory function; increased forgetfulness.
Feelings of depression.

Musculoskeletal Condition
“Sore‐body syndrome”‐aches, joint and muscle pain.
Decline in flexibility and mobility; increased stiffness.
Decrease in muscle size, tone, strength.
Decrease in physical stamina.
Decrease in athletic performance.
Back pain; neck pain.
Tendency to pull muscles or get leg cramps.
Development of osteoporosis or inflammatory arthritis.

Metabolic or Physical/Disease Problems
Increase in total cholesterol or triglycerides.
Decrease in HDL cholesterol.
Rise in blood sugar level diabetes onset.
Rise in blood pressure/ diagnosis of hypertension.
Unexplained weight gain, particularly in the midsection; “beer belly”.
Increased fat distribution in breast area or hips.
Development of chest pain, or diagnosis of heart disease or blockage of arteries.
Shortness of breath with activities; worsening of asthma or emphysema.
Lightheadedness, dizzy spells, ringing of the ears; new onset of headaches.
Poor circulation in legs, swelling of ankles, varicose veins or hemorrhoids.
Changes in visual acuity focus reading fine print.

I split the weekly dose in half and inject on Mon and Thurs. Yes that works pretty well,

Your primary care doc can refer you to a urologist.

“I don’t really care what I have to do to fix my level because all I want is to feel like a normal 21 year old male.” Yeah thats the thing. Long story short, my first doc just wanted to hit a number on the lab report. My second doc wanted to make me feel normal again. So we adjusted dose until the symptoms went away and I felt normal again.

Thanks, I hope I can find a good doctor. It’s kind of funny my dad who’s in his mid 50s has a higher testosterone level than me (his is 417). Sadly I feel like I have most of the symptoms you listed out with the majority being in the first three categories. I’m just happy I’ve finally found the cause of my libido and erection issues. I’ve been trying everything I could and nothing has really worked. I know I don’t have a venous leakage due to how hard they can get and I credit PE for allowing me to be decent. Even ED medication didn’t change my erection frequency beyond once a day so it must be arousal.

I don’t think any responsible doctor would prescribe you TRT. TRT will shut down your endogenous production transforming a light, and maybe temporary, problem, in a worse and chronic one. Remember that you are still growing, maybe a tiny bit, but still. Anyway, Docs will know better than us.

Testosterone injections will shut someone down if they only take testosterone. Taking H-C-G in addition to the testosterone would ensure I keep my testicle size and fertility as well as produce some testosterone. My level is currently at 290 which isn’t even the average for an 80 year old. Even my level of 400 which I tested at 2 years ago is too low for a 21 year old. I’m more concerned with permanent erectile damage due to low testosterone levels leading to tissue damage from a lack of erections. I’m currently 73 inches tall and I haven’t grown a single inch in five years.

It doesn’t work that way TM. Nothing can avoid that you are shut up, and taking HCG could make the recover harder in the long run. I heard HCG is not even used anymore in PCT by many athletes on steroids. Better that you leave that to your docs.

Actually H-C-G completely prevents the shrinkage and reduction in both fertility and endogenous testosterone production when used in low doses. H-C-G is in the same class of substances (called Gonadotropin - Wikipedia) as L-H and works in the same way so injecting H-C-G is identical to endogenous L-H. H-C-G is never ever used in post cycle therapy because it suppresses the body’s own production of L-H. H-C-G is only used during a cycle to prevent the shrinkage of the Leydig cell - Wikipedia (using a link because spell check flags the word and I can’t post it) cells in the testes. When someone takes a large quantity of gear they must also take H-C-G or once they start post cycle therapy their testes ability to produce testosterone will be zero. H-C-G is never used in post cycle therapy and using it during that time is actually counter productive because the goal is to increase endogenous L-H production.

If my doctor and the tests I get done are unable to determine the root cause of the low testosterone level then possible recovery from stopping testosterone injections and H-C-G would be irrelevant because obviously if the problem can’t be fixed I’ll have to inject for life. The prospect of being dependent on injections for life is actually a relief in my opinion when compared to living with a testosterone level of 290 at 21 years old. How many erections have you had over the past week? I’ve had zero. Past month? Less than 10. Past year? Try ~100. These are erections not orgasms.

‘As for hCG, I don’t understand why anyone would want to create another level of suppression in their HPTA? There is really no use for hCG, it desensitizes leydig cells in your testes to Leutinizing hormone so that when you eventually cease using hCG it takes a while for your testes to become sensitive to your own body’s natural LH, thus prolonging your recovery. The use of hCG in males is limited to increasing fertility in HRT such that guys have enough viable sperm for their partners to conceive. When you are “shut down” your testes actually become more sensitive to LH due to receptor up-regulation. All that hCG will do is prolong your recovery.’
http://www.blue light.org/vb/th … t-effective-PCT

’ Quote Originally Posted by realgains89 View Post
Then if this is the case what the hell would be the point in taking HCG throughout cycle if it doesn’t help prevent shutdown? and make recovery easier?

You will get shutdown no matter what you do’
http://www.uk-m uscle.co.uk/ste … ilst-cycle.html

Supposed ‘evidence’ that HCG would stop suppression was flawed and based on low T supplementation (around 250 mg per week); a lot of people don’t get shut down from such levels of T.

HCG also aromatize and cause gynecomastia, so you could end with lower T levels than before and higher estrogens than before. I think you should join some TRT/steroid forums and study this topic for some months before making any plan to fix you problem. Or leave it to your Doc, as said.

http://anabolic minds.com/forum … nting-shut.html
The H-C-G prevents a shutdown of the testes from occurring so a person still produces testosterone but as I said the pituitary still shuts down and stops the production of L-H. The pituitary is faster to recover than the testes so someone only needs to increase their L-H production instead of reversing testicular atrophy and increase L-H production. In terms of a therapy application the shutdown of L-H from replacement therapy isn’t really an issue since H-C-G acts like L-H. I mean if my doctor is unable to find the cause of the 290 testosterone level and I get on replacement therapy it’s not like I’m ever going to go off of it. But yes taking anything long terms means a long (and only partial) recovery but I’d never want to recover my own L-H production if I start replacement therapy.

Application of hormonal treatment in hypogonadotropic hypogonadism: more than ten years experience
H-C-G then H-C-G plus H-M-G increased testicular volumes "after 6-18 months treatment, from 2.0 ± 1.1 to 6.8 ± 3.2 m-L and 2.1 ± 1.1 to 8.8 ± 3.9 m-L, respectively."

HCG & testicular aromatase
H-C-G doesn’t directly convert to estrogen but it increases the action of a-r-o-m-a-t-a-s-e inside the testes. This is easily fixed with an a-r-o-m-a-t-a-s-e inhibitor.

The reason why I’m so set on replacement therapy is because to be quite honest I don’t know what I could change about my life to raise my testosterone level. I’ve never done drugs, I never drink alcohol, I get at least seven hours of sleep a night, eat a minimum of 200 grams of protein, eat enough fats (especially saturated fats), take zinc + magnesium + a multivitamin, I walk at least five miles a day, I work out in the gym 3 days a week for 40 minutes each time, I’m not obese, I’m not even fat (~15% body fat), not stressed out, and the list goes on. I also have two tests at 400 from April 2013 and January 2015 then of course the latest is 290 in April 2015. Even a level of 400 for a healthy 21 year old male isn’t normal (let alone a 19 year old) and it should be about 800 to 1,100 considering my lifestyle. A level of 400 would make sense if I was a morbidly obese type 2 diabetic who laid in bed all day eating chips. It makes me wonder if it’s really just genetic considering the time frame I have tests for. I’ve read about taking c-lo-m-I-p-h-e-n-e (c-l-o-m-I-d) to "jump start" the testes into producing more testosterone but I think it’s unlikely I’ve had a temporary problem for the past two years based on test results and for the past 5 years based on symptoms. I supposed it could be caused by a tumor but considering a lack of other symptoms a pituitary tumor seems unlikely and I have a lack of tissue build up or lumps in my balls so a testicular tumor also seems unlikely. The only thing I can come up with that seems reasonable is that my maximum testosterone level is at 400 (which is low) but due to some circumstances the level has either temporarily or permanently been lowered to 290. Although why it lowered I’m not sure which leads me to believe it might just be genetic. I mean since my symptoms started when I was around 16 years old I think it’s safe to say that something regulating puberty messed up and caused a severe reduction in testosterone levels because when I look back I was perfectly fine in the first half of high school but in the second half I had the low testosterone symptoms. So I suppose it’s possible the same thing happened again now that I’m 21 where my body cut testosterone production again.

This is of course all speculation but I think it’s reasonable when considering what I said above. If I go the "natural" route then I see the "best" possible outcome of getting my level back up to 400 which would help out some of my symptoms but my symptoms would still be very bad. Then there’s always the possibility that if my lifestyle falls apart once I graduate college my 400 level will drop back down into the 200s. I’m sorry but the prospect of improving my level from horrible to bad just doesn’t seem like a good idea. Then of course my level will go down as I age so getting on testosterone therapy will need to happen at some point in the future. Why suffer at a level of 400 now for a few years just go finally get on it and feel great later? The way I see it is I’ll be throwing away the best time of my life where I’m supposed to be full of energy. And for what, just so I don’t have to inject or so I remain "natural"? There are only two real solutions to my problem. 1) There’s some simple underlying issue that’s wrong and if it’s fixed my levels will return to the normal level of a 21 year old (around 800). 2) Testosterone replacement therapy combined with H-C-G and possibly H-M-G. I find hoping for solution one to along the lines of hoping to win the lottery because like I said I’ve had symptoms for five years now and through my search on the internet I’ve been unable to find a cause which could be a possible fit. So therefore unless the doctor can "win the lottery" it seems like testosterone / hormone replacement therapy is the only option.

My only real concern at this point is finding a doctor who will be willing to prescribe me testosterone injections, H-C-G and an a-r-o-m-a-t-a-s-e inhibitor. I would also require the ability to do the injections myself at home because I’ll be going to back college in August (after the summer is over) and I’m not going to waste hours every week walking to some office to get an injections. It’s pointless and a waste of time. I’ve also read most doctors won’t even treat a male under 40 years old and the others won’t treat a young man with a level higher than 300. Because of these facts I’m worried if when I get tested again the level will come back at 350 and because of that fact the doctor would most likely refuse treatment because I’m “normal” even though a level of 350 would only be normal for a 60 year old obese diabetic (assuming the obese diabetic is still alive at 60….). Again the reference range of 250 to 1,100 (2.5 percentile to 97.5 percentile) is for all men regardless of age or health. Therefore I think it’s reasonable to have a level of 1,000 to 1,100 as a 21 year old male who’s active and healthy. This brings me to my other concern is that even if I find a doctor who will prescribe the correct treatment option he may want my testosterone level to be 500 to 600 and not the 1,000 to 1,100 that it should be at. But I’m more worried about doctors who flat out refusing treatment as I’ve read so many stories of other guys who have been abused (with criminal intent in my opinion) by doctors. This one “doctor” refused to treat a 19 year old male because his testosterone level was at 260 which is above the bottom of the reference range of 250 (in my opinion she needs be charged with malpractice and her license to practice medicine should be permanently revoked). A level of 260 isn’t even normal for any age group. This was of course after many appointments and time wasted. Don’t worry, the 19 year old ended up having to self-medicate which worked out well for him and he gets blood tests done by another doctor regularly. My main fear is having my own story end up like the story of the 19 year old above. I was hoping to find someone where who has been or is in a similar situation as mine. Having to live with erectile problems, low libido, fatigue, etc sucks and I just want to be a normal 21 year old.

In your case, admitting the low T levels were confirmed, I would give clomid (clomiphene) a try. This is just what I would do though, I am not a doctor and even if I was, giving advice without direct examination is a no-no, so take it just as suggestion to do further researches.

I will see what the doctor says when I see him in a few weeks and go from there. Thanks.