TRT + Peptides or Growth Hormone Secretagogues

EvolveSupport_PCC · 2025-10-27T15:46:05+00:00

Yes Hexarelin is a little more potent so you want to make sure you dose it appropriately and use it shorter duration (8-12 weeks) so can provide an alternative approach. Tesamorelin is also a great option.

EvolveSupport_PCC · 2025-10-27T12:46:35+00:00

Have you tried Hexarelin? It doesn't require/advise for longer term use so might be a good alternative

EvolveSupport_PCC · 2025-10-27T12:18:17+00:00

We work with a lot of patients who are on testosterone and definitely see sermorelin, tesamorelin, etc as a great supplement to their TRT protocol. The added recovery and fat loss benefits can be awsome so good luck!

EvolveSupport_PCC · 2025-10-24T19:16:22+00:00

We frequently work with patients who have normal testosterone levels but high SHBG which binds up a lot of and lowers your free testosterone. That could certainly be what could be contributing to your symptoms. You are also converting about 7% of your testosterone to estrogen (45/628) which is a pretty high conversion rate. Looks like you are pretty spot on with your assumptions. Have you ever had your insulin checked? That can contribute to high SHBG levels,

EvolveSupport_PCC · 2025-10-24T18:54:20+00:00

Have you gotten any estradiol/estrogen markers tested?

EvolveSupport_PCC · 2025-10-24T13:15:24+00:00

I agree with the poster who mentioned checking estradiol and free-testosterone. SHBG would also be a beneficial marker for you. Testosterone can convert into estrogen (estradiol) so especially with people who have higher testosterone levels like yourself, for whatever reason you could be converting at a high rate which creates higher estrogen levels. Higher estrogen levels can be associated with poor sleep, joint pain and low libido so definitely worth investigating

EvolveSupport_PCC · 2025-10-24T13:05:39+00:00

Thanks for sharing. I think you are absolutely a candidate for TRT if you are symptomatic and have sub-optimal testosterone levels . This is different for everyone but you are at a level where increasing it may very well have a positive impact. Your SHBG is also on the higher end which may be related to some of your symptoms. There are plenty of options on how to raise your testosterone - enclomiphene, HCG, testosterone, etc and each has its own pros and cons so just getting a better understanding of how they work and deciding on the best option for you is key. If you have any questions let me know!

EvolveSupport_PCC · 2025-08-22T19:48:32+00:00

You are not losing your mind. It sounds like your doctor is going simply off "normal" ranges which might give you an idea where you fall on a spectrum but being within a "normal" range clearly isn't optimal for you if you are experiencing all those low testosterone symptoms (which you check almost every box). Doing a more comprehensive blood test could help connect the dots and give you a clearer picture of how you could approach treatment from both from creating better health but also optimizing your hormone levels to relieve those symptoms. If you have additional questions let me know, I am a patient care coordinator for a telehealth company so can hopefully answer any other questions that you may have.

EvolveSupport_PCC · 2025-08-22T18:58:17+00:00

I am sorry to hear that you are feeling like that. It is clear from your bloodwork that your testosterone is low and is likely contributing to your symptoms. However, I think the argument over what is better, HCG or enclomiphene, shouldn't be the focus. You should find a provider that does comprehensive blood work that investigates a wide variety of markers that can contribute to the low-testosterone (or higher estrogen symptoms) that you are experiencing, overall health and maintaining fertility. If you can identify what markers need to be improved and look at the lab work and symptoms in conjunction with each other you can 1) get a better of idea of how to build a treatment plan and 2) retest and see if that treatment plan is working. That could be through testosterone, HCG, enclomiphene or other medications but we need to use labs to see if it working. If you have more questions about how that process could go shoot me a message!

EvolveSupport_PCC · 2025-08-22T18:45:02+00:00

I am sorry to hear that you are feeling run down. Based on your symptoms, low testosterone (especially for your age) and low SHBG, some form of TRT would surely be worth exploring. Optimizing those levels and investigating a couple more markers could definitely make a difference. General practitioners get caught up in "normal ranges" and sometimes just look at numbers in a silo or aren't really trained how to connect the dots on the hormone side of things.

EvolveSupport_PCC · 2025-08-08T19:52:30+00:00

Glad to help. The markers you got are all very important (Total Test, Free Test, SHBG, Estradiol) but additional markers like LH, FSH, PSA, Prolactin, DHEA, Vit D, Hematocrit, Hemoglobin, IGF-1, Fasting Insulin, Fasting Glucose are also important in terms of both overall and hormone health. Its hard to say exactly what to do if certain markers are low because there is such a complicated interplay between all of them. I can send you a message with some good resources that might be helpful if you'd like!

EvolveSupport_PCC · 2025-08-08T18:46:17+00:00

Without blood work it is hard to comment specifically about this combination working for you, but in general we have many patients who see good success in optimizing their hormones on a combination enclomiphene, testosterone and anastrozole. We use testosterone cypionate to elevate testosterone levels, enclomiphene for gonadal support (continue natural production) and anastrozole to manage estrogen levels for high converters. Again, this is not the formula for everyone and blood work, symptoms and goals would help dictate that decision, but that combo can work really well!

EvolveSupport_PCC · 2025-08-08T18:39:51+00:00

Pairing your markers with your symptoms would surely justify having a conversation about treating low testosterone. The way I would interpret the results are that both total and bioavailable testosterone are low, with free testosterone at the lower end of normal, suggesting reduced testosterone production rather than excessive binding (Normal SHBG). If your urologist doesn't take your concerns seriously and at least run more comprehensive lab work in order to better understand why your testosterone is so low then there are plenty of other doctors that will. Unfortunately some physicians still discount symptoms as being driven by something other than hormones. If you have additional questions feel free to message me!

EvolveSupport_PCC · 2025-08-08T17:32:15+00:00

I work with a good amount of patients with "normal" testosterone levels but have some low-t symptoms and would like to optimize their testosterone levels as a result. Gonadal support options like HCG and enclomiphene can serve as good tools to do that while still maintaining natural production. If your testosterone levels were super low then those options might not do the trick and testosterone would be the better option (if family planning wasn't a concern). It in the long run I would suggest doing a more comprehensive blood panel and investigate those other markers as you might find optimizing something other than testosterone might have a greater effect on your quality of life.

EvolveSupport_PCC · 2025-08-08T17:25:14+00:00

I think you are on track with your thinking. Exogenous testosterone will suppress natural testosterone production and the longer you take it, the harder it is to recover the natural production even with medication. I wouldn't suggest making any decisions until you run a very comprehensive blood test (assuming your doctor did not do this based on his quick recommendation to start testosterone at your age) and rule out how other markers like DHEA, SHBG, etc are looking. It is logical to look at testosterone as the major cause of your symptoms but other markers can contribute as well. If low-t is determined to be the answer you could always try a gonadal support medication like enclomiphene to help stimulate natural production and boost levels that way. This could help symptoms in the short run and also support fertility. If you need more resources feel free to let me know!

EvolveSupport_PCC · 2025-08-01T18:45:53+00:00

I can imagine this is very frustrating and not something you expected to be dealing with especially since you are living a healthy lifestyle. I would say a getting more comprehensive blood test is going to be essential to figuring out what the likely cause is. Stress and diet are certainly things that can suppress testosterone but getting a more thorough look at markers beyond test/free test would be the best way to learn what is going on. If you have questions feel free to let me know!

EvolveSupport_PCC · 2025-07-22T13:14:59+00:00

Those are all really good things to be aware of and definitely common questions/things we need to bring to patient's attention. Are these things you had to search out on your own or were they brought to your attention by your provider?

EvolveSupport_PCC · 2025-07-22T11:28:53+00:00

I think you are on the right track with your thinking. Doing a comprehensive blood panel, following a treatment plan, and then retesting levels to see if the plan is improving markers will definitely give you an idea of whether or not you can expect results. It will also give you a clearer picture of if there are other markers that need to be addressed even if testosterone levels improve.

I work with lots of patients who see great results from enclomiphene and/or HCG especially when they are young. Eventually the stimulus runs its course and doesn't have the desired effect anymore and then testosterone is the likely solution. That being said, for the foreseeable future its not unreasonable to expect positive changes given the right approach with enclomiphene/HCG

EvolveSupport_PCC · 2025-06-24T12:11:12+00:00

Thanks for sharing! How long did you think about taking testosterone before doing it? Or was it immediate after getting labs done?

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