My triptorelin log for secondary hypogonadism

[Testiclats]

Hello all! Below is my experience so far with triptorelin for secondary hypogonadism. I will keep this thread updated as time goes by.

My lab rat is 34 years old, 5'11", and started at 252 lbs. Lab rat has NEVER used artificial steroids. Cause of hypogonadism is unknown.

Two years ago my lab rat got the following test results:
Glucose - 125 mg/dL (did not fast)
Albumin - 4.7 g/dL
T3 Uptake - 32.6%
T4 (Thyroxine) - 8.7 ug/dL
TSH - 2.4 mU/L
T7 Index - 2.8

FSH - 1.8 mIU/mL
LH - 2.8 mIU/ml
Testosterone, total - 272 ng/dL
Testosterone, free - 52.1 pg/mL
Testosterone, % free - 1.91%
Estrogen, total - 55 pg/mL

Based on these results my lab rat was assuming secondary hypogonadism.

On 1/11/2013 at 9:00 AM lab rat had total testosterone evaluated again, with the following results:
275 ng/dL (normal lab range 348-1197 ng/dL)

Doctor's opinion (he is a GP only, not an endocrinologist) is that the lab rat's testosterone levels are not low enough to warrant medication, and that his levels are caused by obesity.

Decided to try triptorelin and see how it goes.

 

[Testiclats]

On 1/12/2013 lab was administered a single injection of 100 mcg triptorelin intramuscularly. No other research chemicals or supplements are being used at this time.

On 1/16/2013 at 8 AM (4 days post-injection) new labs were performed. Result:
Total testosterone 465 ng/dL

So as of 4 days post-injection, total testosterone has increased by roughly 70%.

This leads me to believe that the source that the triptorelin was acquired from is legit (I have seen posts implying this supplier was bunk but I doubt it based on these results).

What do you think so far? Comments and advice are appreciated. Would this increase fall into the intitial "flare" effect? Is total testosterone likely to be more than this or less than this as more time goes by?

We will run new labs after maybe a month or so and see how things go. I believe for one thing, that the lab rat has some level of testicular atrophy and shrinkage from the chronically low GnRH levels. Would you recommend in the future (4 months or more later) that maybe the lab rat should go on HCG for a while to bring testicle volume up to higher levels before hitting it with Triptorelin, for better results?

Any advice is appreciated. The lab rat is also doing a carb cycling diet and an exercise program to lose weight, to test the theory as to whether obesity is the cuplrit. If the subject still has low testosterone after the obesity has been resolved (and after the effect of the triptorelin has had time to wear off), then an endocrinologist will be consulted to try and determine the root cause of the hypogonadism.

We would go to the endo sooner but now that triptorelin has been administered, it seems like we need to ride that out before doing more tests. Does that sound correct, or would it be advisable to go to the endo sooner?

 

[Michael Scally MD]

What were FSH & LH post-Triptorelin ?

Did you do a prior SERM challenge?

Where did you obtain the Triptorelin?

 

[Testiclats]

I will get a copy of the post-triptorelin FSH and LH levels from the Dr. today and post them. The Dr. is not too pleased about me administering the triptorelin but he is at least willing to order labs. However, he does not believe that low testosterone should be treated at all if it's over 200 ng/dL. He may not be super helpful in the future and I'm thinking an endo is a good idea at some point.

No prior challenge testing was done and no other substances have been tried yet before the triptorelin.

The triptorelin was purchased from an "extreme peptide" website, are we allowed to post a link?

I have clomid on hand if that would benefit the lab rat. But it has not been used so far.

 

[cvictorg]

You are basing your use of Triptorelin on a SINGLE study that used 1 injection of 100 micrograms on 1 man with no long term followup

There are NO other studies that I could find and there was NO long term follow-up to this study that I could find.

Single dose of triptorelin gets bodybuilder
Anabolic steroids purchased on the Internet as... [Fertil Steril. 2010] - PubMed - NCBI
https://thinksteroids.com/community/threads/134305905

Triptorelin - Professional Muscle
And lets take a look at the only study that's ever supported a one low-dose injection of tripto theory....

From the full study:
- A study of one man.... real reliable
- His cycle and PCT looks a bit strange... either the man's an idiot or poor documentation by the doctors.
- Before treatment he suffered only from mild testicular atrophy and semen analysis showed he had a normal count and had no spermatogenesis dysfunction. (79 × x106 spermatozoa/mlmL). His only problem was a lack of energy and libido...
- The study made no effort to explain how long he had been off his cycle, only reporting "for a couple months". and did not explain if he had been on or off cycle during either of the blood tests.
- LH and FSH were within normal range (albeit lower range) in the last blood test done before treatment.
- Report fails to show blood test results after treatment, only reporting that the patient felt better and that serum testosterone was 7.0 ng/ml after 10 days... and that's as far as they tested.
- My favorite is in the discussion... where they discuss nothing about the case report and instead focus on performance doping in ancient civilizations, consumption by students, the trade of AAS online, and the science behind clomid.
- All of his values were in the process of recoverying from Sept to February.

Doping involves the use of artificial means or substances with the specific aim of improving performance, despite well-known adverse effects on health (1). This practice has spread to the general population, in particular to young adults, along with the exaggerated ideals of body image portrayed by the mass media (2), (3) and (4). Over the last few years, Internet marketing may have played an important role in increasing consumption of anabolic drugs such as anabolic androgen steroids (AAS) and clomiphene citrate (5). We describe the case of a young male with prolonged hypogonadotropic hypogonadism due to ongoing consumption of various doping drugs purchased over the Internet, where they are readily available.
Case report
A 34-year-old man presented to our department in September 2008 for loss of libido and energy and for mild depression. He was a computer programmer and a nonprofessional bodybuilder with an unremarkable personal medical history. He admitted to having used doping drugs since he was 21 years old. More specifically, he would perform cycles of intramuscular injections of nandrolone (25 mg) and stanazol (25 mg) daily for 8 weeks, followed by mesterolone (50 mg/day) for 15 days. Then he would then take clomiphene citrate (50 mg/day) for 1 week, followed by an injection of human chorionic gonadotropin (2,000 IU) three times in 1 week. He had repeated these cycles from 1995 to 2005. From 2005 to August 2008, to his nandrolone and stanazol cycle he added an intramuscular injection of boldenone (50 mg) daily for 3 weeks. He said he had bought all the drugs on the Internet.
The patient was 175 cm tall and 80 kg, and he appeared very muscular and toned. His blood pressure and pulse rate were normal. Examination of his heart, lungs, and abdomen were likewise unremarkable. The physical examination showed normal secondary sexual characteristics, but the genital examination revealed bilateral testicular atrophy (volume 2.9 mL and weak consistence). Despite his testicular atrophy, the semen analysis revealed a normal count (79 × x106 spermatozoa/mlmL) and mild morphology derangements (between 46% and 58%). The blood count and chemistry were normal, but his level of creatine kinase was 454 IU/L (normal range: 20–170 IU/L), alanine aminotransferase 61 IU/L (normal range: 5–50 IU/L), and aspartate aminotransferase 23 IU/L (normal range: 5–50 IU/L). The endocrinologic investigations are reported in Table 1.
Table 1. Serum hormone profile in a man with hypogonadotropic hypogonadism due to the chronic abuse of anabolic steroids.
Hormone September 2008 February 2009 Normal range
FSH (mIU/mL) 1 2 1.5–13.0
LH (mIU/mL) <0.5 2 1–8
HGH (ng/mL) <0.1 <0.1 <0.4
IGF (ng/mL) 241 — 109–307
TSH (mIU/L) 1.249 1.345 0.270–4.200
FT4 (pg/mL) 7.9 — 7–18
DHEAS (pg/mL) 2.2 — 0.80–5.60
E2 (pg/mL) <10 — 11–45
T (ng/mL) 0.3 1.7 2.7–10
PRL (ng/mL) 14.7 13.5 3.0–23
SHBG (nmol/L) 8 21 13–71
Note: DHEAS = dehydroepiandrosterone sulfate; E2 = estradiol; FSH = follicle-stimulating hormone; fT4 = free thyroxine; HGH = human growth hormone; IGF = insulin-like growth factor; LH = luteinizing hormone; PRL = prolactin; SHBG = sex hormone-binding globulin; T = testosterone; TSH = thyroid-stimulating hormone.

In February 2009, the patient continued to report loss of libido and great tiredness. A second physical examination was performed. His levels of alanine transferase and creatine kinase were all within the normal range, but the endocrinologic investigations were still abnormal with the exception of sex hormone-binding globulin level (see Table 1). Because the situation had persisted for months after ASS withdrawal, we administered a single dose (100 ?g) of triptorelin (triptorelin test), which showed a normal response (Fig. 1). Ten days after the triptorelin test, the patient reported a great amelioration of energy, and his serum testosterone was 7.0 ng/mL. One month later, his serum testosterone was within the normal range, and he reported a return to normal libido and energy.


Full-size image (15K)
High-quality image (81K)

Figure 1.
Triptorelin test showing a normal response.

Discussion
Despite the perception that doping is a modern phenomenon, there are many examples of substance use by ancient civilizations, including extracts derived from plants or animals. Historically, the use of drugs in sports can be traced back to 776 B.C. One of the earliest reports describes the use of a diet of dried figs to improve the performance of Charmis, the Spartan winner of the stadium race at the Olympic Games of 668 B.C. (6). Later, Roman gladiators also used unspecified stimulants to overcome fatigue and injury (7). Amphetamines, the first “effective” performance-enhancing drugs, crossed over into sports in the early 1950s. These drugs, nicknamed la bomba by Italian cyclists, minimize the uncomfortable sensations of fatigue during exercise (8). Since then, many other substances have been used to improve athletic performance.
Epidemiologic data on the use and abuse of doping drugs are notoriously difficult to obtain because the drugs are illegal. Nevertheless, the use of these substances appears to have become widespread, ranging from the domain of elite athletics to the general community in many countries (5), (9), (10), (11) and (12). The popularity of doping drugs seems to be due to the large diffusion of print media, sports and bodybuilding magazines, advertisements, and television (5). Our patient reported over a decade of chronic consumption of a cocktail of doping drugs, mainly androgens, which caused his prolonged hypogonadotropic hypogonadism; all were purchased on Internet sites.
The side effects of the use and abuse of high doses of anabolic steroids have been well documented. After the first report, a fatal heatstroke in a cyclist in 1967 after abuse of amphetamines (8), many other reports have described the side effects of doping drugs (13), (14), (15), (16), (17), (18) and (19). Because they derive from testosterone, anabolic steroids have pronounced effects on the male pituitary gonadal axis, affecting the regulation of production of serum luteinizing hormone (LH) and follicle-stimulating hormone and inducing a state of hypogonadotropic hypogonadism characterized by decreased serum endogenous testosterone production and impaired spermatogenesis, often reversible with withdrawal of the drugs (19). Another consequence of ASS abuse is the reduction of sex hormone-binding globulin, which will continue long after ASS withdrawal (20).
Our patient showed no spermatogenesis dysfunction, even though he had used anabolic steroids for over a decade. This could be explained by his periodic self-administered treatment with clomiphene citrate and human chorionic gonadotropin between the cycles of steroids. Clomiphene is a selective estrogen receptor modulator that blocks the feedback inhibition of estradiol at the level of the hypothalamus, thus increasing pituitary release of both LH and follicle-stimulating hormone (5) and (21). In addition, clomiphene decreases the conversion of androgen substrate to estrogen by aromatase inhibition (22). It is this ability to block estrogen that leads to its postcycle use by bodybuilders to reduce the development of gynecomastia after self-administration of androgen drugs. Clomiphene is extensively used in the induction of ovulation (23), but it has also been used to reverse hypogonadotropic hypogonadism in many conditions like falciform anemia, uremia, and alcohol abuse, and it stimulates gonadotropin secretion in patients with sulpiride-induced hyperprolactinemia and gonadotropin suppression (24).
Moreover, clomiphene and LH (LH–RH) have been successfully used to treat severe hypothalamic-pituitary dysfunction due to anabolic steroid abuse. Van Breda et al. (17) reported that supraphysiologic doses of LH-RH restored normal pituitary–testicular axis interplay, and Tan et al. (25) used prolonged clomiphene citrate treatment to cure symptomatic hypogonadism in bodybuilders. The cycles of pituitary stimuli with clomiphene and human chorionic gonadotropin could also explain why our patient did not exhibit the hypothalamic-pituitary dysfunction that had been clinically evident previously.
The most important information relevant to the present case, in our opinion, is the apparent ease with which one can purchase these substances on the Internet. Indeed, very recently, Melnik (5) condemned the “role of the World Wide Web” in illegal drug marketing, reporting more than 47,500 new steroid-related cases in 2006, for an increase of 400% since their debut in 2002 (26). Many online bodybuilding stores also give information on the use and combination of drugs, their dosages, and their side effects. We have personally purchased stanazol, nandrolone, and other doping drugs online, confirming how easy it is to obtain these drugs over the Internet. Even though it has been largely demonstrated that more than 50% of illicit androgens are made available to the fitness community by licensed health-care providers (5), in our opinion the Internet may have played an important role in the increasing consumption of anabolic drugs, especially among young people. Population studies have documented widespread androgen abuse among students all over the world in places such as South Africa, the United Kingdom, Scandinavia, and Australia (27) and (28). Moreover, a recent investigation of Polish adolescents revealed doping drugs abuse by 6.2% of young men and 2.9% of women (11).
Although the World Anti-Doping Code, adopted in 2003 and effective as of 2004, has proved to be a very powerful and effective tool in the harmonization of antidoping efforts worldwide, it has not been sufficient to tackle this illegal phenomenon. For this reason, we believe that it is necessary to increase monitoring and adopt more severe sanctions, particularly with regard to Internet sites.
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23 S. Palomba, R. Pasquali, F. Orio Jr. and J.E. Nestler, Clomiphene citrate, metformin or both as first-step approach in treating anovulatory infertility in patients with polycystic ovary syndrome (PCOS): a systematic review of head-to-head randomized controlled studies and meta-analysis, Clin Endocrinol 70 (2009), pp. 311–321. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (6)
24 J.T.T. Bjork, R.R. Varma and H.I. Borkowf, Clomiphene citrate therapy in a patient with Laennec's cirrhosis, Gastroenterology 72 (1977), pp. 1308–1311. View Record in Scopus | Cited By in Scopus (3)
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[Michael Scally MD]

I will get a copy of the post-triptorelin FSH and LH levels from the Dr. today and post them. The Dr. is not too pleased about me administering the triptorelin but he is at least willing to order labs. However, he does not believe that low testosterone should be treated at all if it's over 200 ng/dL. He may not be super helpful in the future and I'm thinking an endo is a good idea at some point.

No prior challenge testing was done and no other substances have been tried yet before the triptorelin.

The triptorelin was purchased from an "extreme peptide" website, are we allowed to post a link?

I have clomid on hand if that would benefit the lab rat. But it has not been used so far.

Yes.

 

[Testiclats]

The source of the triptorelin was ExtremePeptide

I had read some say that this was a bunk source. But they said that about clenbuterol which I have no interest in. I never heard any testimonials about their triptorelin, but so far it seems to be effective. I suppose the full hormone results will help determine this. I should be able to post them tonight. The doctor just called today saying the results were in and I have not gotten a copy from him yet.

I didn't know there was doubt as to the authenticity of this source until after I had ordered and administered the triptorelin, or I would have probably gone elsewhere.

 

[Testiclats]

Well I will try to provide more information than that other guy did including full hormone panels when available and longer-term results.

 

[Testiclats]

Latest labs:

Total Testosterone: 469 ng/dL (range 250 - 1100)
Free Testosterone: 57.2 pg/mL (range 35 - 155)
FSH: 2.2 mIU/mL (range 1.5-12.4)
LH: 4.4 mIU/mL (range 1.7-8.6)
TSH: 2.75 mIU/L (range 0.45-4.50)
Vitamin D: 22.8 ng/mL (range 30.1 - 100.0) LOW
Creatine Kinase: 891 IU/L (range 44-196) HIGH
*Note: (this is what Dr. wanted to see me about but I think it's just from the exercise I'm doing, we re-tested it today after 4 days of rest)

One thing I notice is LH only increased by 22%, whereas LH increased by 57%. Does this seem consistent with the effects of a GnRH agonist, or could this have been fake? (perhaps HCG rebadged as Triptorelin)?

We are going to run new labs in approx. 30 days.

I was also told my vitamin D was too low and to start 1000 IU tabs daily.

Is the relationship between LH and testosterone non-linear? I ask because while my LH levels were about 57% higher, total testosterone was closer to 70% higher.

My normal Doc. was out of town today so I saw a different doc. Had to explain again what I took and what it does. She wasn't sure what Triptorelin was and looked it up. I think they have been pretty patient so far with me, nobody has scolded me yet for self-medicating with a research chemical. I kind of expected a lecture at some point but nope.

 

[vooch86]

I did Triptorelin back in April of last year, it worked for a while but after a month and a half or so I came back down. My suggestion would be to get everything else inline and then attempt a restart byt everything I mean your weight, excercise regimen, diet, Vit D, iron, thyroid and anything else that could be causing low T, then give it a shot. I'm sure someone more knowledgable will chime in.

 

[hardasnails1973]

Since we are so.focused on hormones did any one notice Tsh level. Correcting vitamin d in some cases raises testosterone level and appears to make.clomid and hcg to work.better. May be evaluating thyroid.proper and getting vitamin d up may all.be needed.to restore hormone function. Next is how you sleep? Just because a person sleeps eight hours does.not.mean its restorative. Many cases correcting sleep.hygiene resolves adrenal and.hormone issues in men <35

 

[Testiclats]

I sleep OK but I really have to work on it. I have to keep myself in the dark a few hours before bedtime and do things that calm me down. I have something called DSPS, Delayed Sleep Phase Syndrome, it's like permanent jet lag. My body produces melatonin later in the night so that my natural tendency is to go to sleep around 2 AM. This doesn't work with my job schedule.

So far I've been able to control it pretty well by keeping myself in the dark 3hours before bedtime and avoiding bright TV screens and monitors and fluorescent lights etc, and trying to relax. Also no caffeine after lunch. Then in the morning I have to expose myself to bright sunlight.

The sleep specialist tried putting me on Ambien and other sleeping pills but nothing helped me get quality sleep. The Ambien was just forcing me to sleep but it wasn't restorative. The best improvement I've seen has been from what I described above about being careful with sleep hygene, light exposure, etc. Taking oral melatonin also helped but I avoid it now because I don't want to shut down natural melatonin production. I find I can get to sleep naturally if I really work at sleep hygene.

The only problem I have had recently is since starting my exercise program, I have primarily been exercising at night, and it's too close to bedtime. Sometimes it makes it hard to sleep. Sometimes I wake up in the middle of the night and my heart is beating fast for no apparent reason. I suspect it's related to the workout. I think I am going to try changing my schedule to do the workouts in the morning before work instead of at night, to help get better quality sleep. That, or at least do them earlier in the evening so that I'm done working out at least 3 hours before bedtime. Finishing a workout right before bedtime seems to screw up my sleep.

 

[Testiclats]

Which thyroid tests would be needed for a proper thyroid function assessment?

 

[Testiclats]

Another thing to keep in mind, since it is suspected obesity might be a cause for my low T levels, and losing weight is by no means an easy fix, shouldn't a 70% increase in testosterone, even if it's only for a month or so, be a pretty helpful leg-up / boost to my weight loss plan?

I already feel a lot more energetic and my workouts are much better. Is it psychological? It feels real. I'm already achieving good progress in my weight loss.

Also wanted to mention, my primar Dr. is considering ordering a head MRI to check for any pituitary abnormalities. Since I have hormonal issues, and sleep issues, it makes sense to check this. I hope I can convince him to order the MRI as soon as possible. I have never had a head MRI, who knows what they might find.

I think I have had low testosterone all my life. I don't grow much of a beard, not a lot of body hair, below-average penis size, etc.

I also have been diagnosed with Tourette Syndrome and ADHD, and have always had issues with anxiety and stress-related issues. I've also had lots of problems with my spine, herniated and bulging discs, and fibromyalgia.

 

[Testiclats]

Just an update, 10 days after the injection, balls feel... I'm not sure, maybe not bigger, but heavier, like they are hanging down lower and heavier. They don't look bigger but they feel rounder, maybe more swollen.

Stamina feels improved. Exercising more often than usual now, and with more intensity. Getting more pumped when exercising. Definitely feel different.

 

[Testiclats]

Getting some unexpected effects. Not sure if related to the diet and exercise routine or the triptorelin. My blood glucose levels have been pretty low lately when i diet. Today I was feeling really tired at work and when I got home I checked my BG and it was at 69. I used to do the same diet as I'm doing now and my BG didn't go that low.

Blood pressure is also down, 120/80 today, at the Dr. it's usually like 145/95 or so. I was on blood pressure medication originally but I have stopped taking it (120/80 reading is after not taking the meds for a few days).

I'm still fat though, about 237 pounds today and obese but gradually losing weight.

 

[Testiclats]

I'm having some issues with hypoglycemia. Maybe my diet is too low-calorie and I need to adjust it? At night sometimes my blood glucose falls to around 65 to 68 and I start feeling heart palpitations. Tonight I woke up at 2 AM becase my heart felt uncomfortable like it was palpitating and when I checked, my blood glucose was 67. I ate about 140 calories of almonds and then my heart stopped hurting a few minutes later, and when I checked my blood glucose had gone up to 71.

I guess I don't understand why my body isn't just using more fat to increase the blood glucose levels when necessary.

On the positive side, my balls are hanging lower and flaccid penis looks larger lately instead of shriveled up. Could that be from the increase in testosterone? My penis and balls also look more red than before.

 

[Testiclats]

Hello everybody! I have an update with new labs!

Date collected:
3/07/2013

Total T: 800.7 ng/dL (range 196-782)
Free T: 28.2 ng/dL (range 5.2-18.0)
Bioavailable T: 557 ng/dL (range 119-470)
Percentage free T: 3.5 (normal 1.5-3.1)

FSH: 2.91 mIU/mL (range 0.95 - 11.95)
LH: 10.89 mIU/mL (range 0.57 - 12.07)

Estradiol: 33 pg/mL (range 11-44)

Vitamin D: 24 mU/mL INSUFFICIENT (range 30-100)

SHBG: 17 mmol/L (range 12-59)
AST (SPGOT): 39 U/L HIGH (range 5-34)

BUN/Creatine Ratio: 8, LOW, range 12-20

DHEA: 549 ug/dL, HIGH, normal range 120-520

TSH: 2.34 mIU/mL (range 0.35 - 4.94)

So, aren't these results quite interesting? My testosterone is now MUCH higher, but I'm not sure why. I have lost about 40 pounds so maybe that's why. Not sure about the other numbers, but testosterone looks MUCH better.

Your thoughts? I wonder what the heck is going on here.

 

[Michael Scally MD]

How many times have you done Triptorelin?

 

[Testiclats]

How many times have you done Triptorelin?

Just the one time

Though I've been taking vitamins, exercising, and done low carb, high protein, restricted calorie dieting, very strict. I lost over 40 lbs already. I just recently crossed the line to where I'm not classified as Obese any more

Also for a few weeks I was taking Ostarine and GW-501516 every day to aid with weight loss / exercise.