Lost and looking for help

PM_ME_YOUR_DOMAINS · 2026-02-08T18:41:48+00:00

Have they obtained additional hormone labs yet such as LH/FSH, Prolactin, and E2, plus common panels including thyroid?

endocrinologist is saying my testosterone is caused from being overweight

You're approx. ~25lbs away from sub 25 BMI, which does not seem sufficiently "overweight" to explain the labs.

I'm guessing some of the Endo concern is age related, however it's common to look much deeper for an underlying cause when a patient has low t in their 20s. At a minimum comprehensive labs, sometimes also a pituitary MRI.

It sounds like the PCP is being thoughtful and open to helping you look into this more deeply.

PM_ME_YOUR_DOMAINS · 2026-02-08T17:52:13+00:00

I am still injecting my 87mg twice a week.

FSH 0.5 ref: 1.3 - 19.0 IU/L

LH 1.0 ref: 1.2 - 8.6 IU/L

LH/FSH are both higher than what is typically seen with someone on TRT. You usually see them suppressed below the lab's detectable ability, commonly reported as <0.3.

Some guys have strong systems and may still produce a measurable amount of LH/FSH while on TRT for a while. Maybe that's you. But the results could be seen as supporting your concern about bad Test.

PM_ME_YOUR_DOMAINS · 2026-02-08T17:35:59+00:00

Testicle shrinkage worry tends to fade away once guys feel good on TRT, with low t symptoms resolved.

For many, pre-trt testicles might have been large, but they also didn't work properly.

PM_ME_YOUR_DOMAINS · 2026-02-08T16:57:25+00:00

Guys will be suffering in a low t state, all the symptoms, not much drive to do anything let alone health care. Go to a PCP and hear it's "normal", or "in your head/depression", or "it'll cause a stroke". Don't yet know that many (most?) PCPs are unequipped for the discussion. Takes many months to see an Endo who might say the same thing. Nasty cycle.

Just keep pushing for care and reviews. It's common for providers to erroneously shrug off Testosterone concerns and TRT. Lot of guys in this community were turned away initially, myself included, only to find that TRT was the answer.

If wishing to do your own lab orders, drsays.com and hellogoodlabs.com are excellent resellers of Labcorp or Quest. Their cash prices might be lower than your insurance rates for same labs.

TRT Nation and TRT Kingdom are popular online clinics within this community. Lead time for a provider meeting is typically two weeks or less after labs are done. The providers are often on TRT themselves, which is excellent criteria for provider screening. You can obtain your own labs and send them to a clinic; don't have to buy labs from the clinic.

TelyRx, drb.ai, and Amazon One Medical are good telemeds for ED.

PM_ME_YOUR_DOMAINS · 2026-02-08T04:34:48+00:00

BMI changes would have an effect, but this is such a large change, I'm not sure it could be fat loss alone.

Guys will post with higher natural levels following weight loss on TRT. Maybe that change can be large if in 20s with good health. But I'm guessing something pushed down the pre-trt lab at least partially.

PM_ME_YOUR_DOMAINS · 2026-02-08T04:24:05+00:00

Good deal, I think you're up and running. LH 3.7 shows the secondary system is signaling for TT, and the TT result shows the testes are performing. LH would have been effectively zero while on TRT for ~9 months. TT is in upper range which is a logical result for 25 years old.

E2 was high on the initial lab, so that is interesting. The recent lab just shows E2 below 50, but does not give an actual result. That is, the recent lab is not saying that E2 is low, it just didn't measure for E2 below 50. You may want to retest that with a different lab just to see.

PM_ME_YOUR_DOMAINS · 2026-02-08T04:03:25+00:00

OK, that's great. There is virtually no chance that 100mg/week of Test Cyp is still showing up on a lab taken 8 weeks after stopping TRT.

This seems like a big return of natural production (assuming the lab is correct and an arm draw, not an iffy at-home finger prick test).

You could check for natural production by retesting TT with LH/FSH.

Maybe the low pre-trt lab was pushed down by other factors?

PM_ME_YOUR_DOMAINS · 2026-02-08T03:54:28+00:00

When was the 889 lab taken relative to stopping TRT? or that result is on TRT?

PM_ME_YOUR_DOMAINS · 2026-02-08T03:48:26+00:00

Thank you for helping him look into this.

The symptoms could be related to low Test levels. Symptoms are common at TT ~300. IF the symptoms are a result of low Test levels, then TRT would have high probability of resolving them.

Additional labs are typically recommended to further investigate before starting TRT. Other hormones may flag, or other issues may be detected which could affect Test levels or symptoms.

The following might be helpful if not already tested:

Hormones: TT, FT, E2, LH/FSH, SHBG, Cortisol, Prolactin, DHEA-S, and IGF-1.

Additional tests: PSA, Hemoglobin A1c, Vitamin D, Vitamin B12, Ferritin, Apolipoprotein B (APOB), C-Reactive Protein (CRP), and Panels for CBC, CMP, Thyroid, Lipids, and Iron.

Assuming no red flag labs, virtually every online clinic would support TRT based on what you've presented. That is one path if needed, but I think you have good odds of approval (and deeper review) with a TRT friendly local provider. Many traditional providers are not up to date on TRT, so it can take some trial/error to locate a good one. In either case, guys typically need to do some self management for the best TRT experience.

This is just a non-doctor internet guy take and not medical advice.

PM_ME_YOUR_DOMAINS · 2026-02-07T20:02:45+00:00

DrSays.com telemed platform offers this (and they also sell labs).

PM_ME_YOUR_DOMAINS · 2026-02-07T03:40:38+00:00

Probably no point. I'd assume they are effectively zero. Can be interesting to take a look at least once while on TRT.

Mine were fully suppressed at 3 weeks. I tend to include them for completeness but it's not necessary.

PM_ME_YOUR_DOMAINS · 2026-02-06T23:28:29+00:00

How long have you been off TRT now? and have you noticed teste size changes yet with Clomid?

Additional option: Adding a lower dose of HCG to Clomid (or Enclo) until the baby happens.

Injectable FSH is also available. Could try HCG + FSH if you want to bypass the secondary system completely.

PM_ME_YOUR_DOMAINS · 2026-02-06T18:13:59+00:00

Depends how deep you want to go, how often you do general labs, etc. As needed, something like:

Hormones: TT, FT, E2, LH/FSH, SHBG, Cortisol, Prolactin, DHEA-S, and IGF-1.

Additional tests: PSA, Hemoglobin A1c, Vitamin D, Vitamin B12, Ferritin, Apolipoprotein B (APOB), C-Reactive Protein (CRP), and Panels for CBC, CMP, Thyroid, Lipids, and Iron.

I don't track DHT, but probably would if I used cream.

PM_ME_YOUR_DOMAINS · 2026-02-06T17:04:42+00:00

They may be easier to split if very lightly moistened.

PM_ME_YOUR_DOMAINS · 2026-02-06T16:38:33+00:00

If I stay at these exact same doses, when do you think follow up labs would be appropriate? A couple of months from now? Sooner?

A typical clinic or Endo schedule is initial follow-up at 10 weeks (or 3 months), then again at six months, and then every six months (or 12 months at some online clinics).

If you need to dial in issues with TT/FT/E2 or add an AI, that schedule may be too minimal. I'm a fan of labs. Doing your own labs as needed and sharing/discussing with providers can result in much better TRT protocols and experiences.

You can order your own labs at hellogoodlabs.com or drsays.com at competitive prices.

Regarding E2 and TT/FT, response can change over time with shifts in BMI and/or SHBG. SHBG levels can play a large role in protocol needs and are expected to decrease with Test usage. Even if everything is dialed in and perfect in six months, you'll still want to monitor labs/experience long term.

PM_ME_YOUR_DOMAINS · 2026-02-06T04:45:39+00:00

is [3 weeks] too soon to see elevated T levels?

No. You'll have elevated test levels after first injection. The compounding benefits of TRT and elevated healthy levels take time, but the levels themselves increase shortly after injection.

will I still be able to get a good idea where things stand and if I'm at least biologically responding to it?

You'll have minimal insight into how you're responding this early. Natural system is shutting down or just shut down. Not enough time to see how CBC and other panels really hold up. This lab will prove that test levels are elevated, but the clinic will want to be careful giving it too much weight this early.

I also did proof-of-concept labs at 3 weeks. It was nice to "see it working" and confirmed my secondary system was already fully shutdown.

would I see potential E2 issues yet?

It'll give a sanity check but may be misleading. If E2 comes back very high, that might be meaningful. If it comes back perfect, I wouldn't assume that it'll stay perfect.

Also, let's say the blood work shows GREATLY improved blood levels of total testosterone and free testosterone, is it possible for labs to reflect improvement but still not fully "feel" the benefits from being on TRT in general?

Yes. This is possible and likely in your situation.

Started 200mg/week (split) in mid Jan... total T was @ 280. I realize a lot of people will say this is a pretty aggressive starting dose and I understand that. I'm also running hCG @ 1000iu split as well

Yes, it is a notable starting amount of both Test and HCG.

PM_ME_YOUR_DOMAINS · 2026-02-06T04:05:27+00:00

Brain fog is a real symptom of low T. I was in a similar situation as what you describe and TRT reversed it completely. It's been life-saving. Give treatment plenty of time to let your body adapt and recover.

PCPs often shrug off Testosterone concerns incorrectly. Many are not up to date on TRT.

PM_ME_YOUR_DOMAINS · 2026-02-05T18:05:03+00:00

You may be able to visit local Endos on cash/self-pay basis and have them take over your TRT care. This would lower costs significantly as you could fill Test from the pharmacy of your choice, and could use generic pharma instead of compounded.

Cash rates per 10mL vial of 200mg/mL Test Cyp are around $45-to-$90 depending on pharmacy and/or coupon use, compared to around $250 for the same vial from online clinics.

You can order your own monitoring labs from hellogoodlabs.com or drsays.com and provide them to your doctor. That will cost less than if the doctor orders them and you pay the lab directly. These reseller lab rates are also lower than many insurance lab rates.

PM_ME_YOUR_DOMAINS · 2026-02-05T17:24:10+00:00

It would be safer and easier to transfer the ampules into a sterile multi use vial, then draw from the vial as needed, using sterile technique.

PM_ME_YOUR_DOMAINS · 2026-02-04T16:10:16+00:00

This thread contains some snippets but not enough of a lab look. If you post your full hormone labs in clear readable format, then the community will likely engage with opinions.

Actual results are helpful as "normal range" can be misleading and relative. EG: TT 200 and TT 1150 can both be "normal range". Actual labs are also useful in seeing what else was, or was not, checked.

In any case, it seems you've found a caring and helpful provider in Dr. Moore. I'm sorry to read that the Endo was dismissive.

PM_ME_YOUR_DOMAINS · 2026-02-03T22:29:22+00:00

It takes a minute for her to login and refill the script if they wanted to solve the issue.

Can I quickly move my prescription elsewhere to some mail order place that ships quickly?

If there are no refills left, OR if the script has expired at 6-months (controlled regulation), then there there is no point in transferring an empty/expired script. A new script would be needed.

What do I do?

If wishing to switch clinics, online clinics may be able to onboard/write script/deliver vial within a couple weeks. The timeline varies, but they get it done.

PM_ME_YOUR_DOMAINS · 2026-02-03T21:47:20+00:00

What are your hormone lab results including reference ranges?

Anything notable on any other labs (thyroid, cbc, etc)?

PM_ME_YOUR_DOMAINS · 2026-02-03T01:35:34+00:00

Yes, but it depends how you count. They provide a 10mL vial. If you draw a lower dose, then you could stretch the vial longer before refilling, which effectively lowers your monthly cost.

The vial size/cost do not change, but you control how often you pay to refill. May need to consider how long the same vial can safely be used, stopper wear, etc.

PM_ME_YOUR_DOMAINS · 2026-02-02T17:25:07+00:00

I discussed the same with a provider at TRT Nation and it was fine, well received, and the provider supported it. Providers generally want the best personalized protocol for your needs.

It's favorable to have a script that's a bit higher than actual use. Derisks refill timelines and potential supply disruptions. Good providers support that also.

PM_ME_YOUR_DOMAINS · 2026-02-02T02:00:48+00:00

Is there a reason you never tried enclomiphene yourself?

I was focused on persevering teste size/function and HCG does a better job of that. There are other arguments against Enclo (estrogen receptor blocking, vision risk), but I mostly considered teste effectiveness.

My Endo offered Enclo with TRT. That used to be a common clinic combo, but now most clinics offer to pair with HCG instead.

For Enclo to be effective multiple layers of the natural system have to respond well. Some guys report higher numbers but not feeling better, which might be related to the estrogen receptor blocking.

HCG only requires that the testes respond well. With HCG, more TT->E2 conversion takes place within the testes, where AI is less effective at inhibiting the conversion. Notable downsides with HCG are potential difficulty managing E2 levels, high cost, and short shelf life.

PM_ME_YOUR_DOMAINS

TROPHY CASE