T Nation

1 Year of TRT


#1

I'm starting this thread because I need opinions and suggestions to what I have discovered in this one year journey. I'd like to hear from others with similar experiences and some of their solutions or ideas I can apply.

To do a quick recap of my story I suspected and later discovered low T at age 19 with a total level of 236. A test a year later revealed 330 total T with 16 pg/ml free with low SBGH. Digging further, I narrowed it down to secondary hypogonadism and then with willing doctors after 3 years of hassling for tests and treatment, to a microprolactinoma. I became a regular here in the TRT section, but haven't been here much during this time.

April 2013

My first experiment with an open minded doctor was to try 300 iu HCG EOD and Cabergoline.

Result: This increased mood, libido, and, aggression hugely, but then began to taper off.

Labs: Prolactin 0.4 E2 25.6 Free T 15.1 SBGH 19.3

Here I realized my T did not improve much with HCG alone.

June 2013

Step two we added 140mg of T per week divided in EOD dosing and 1 mg Anastrozole to the HCG Cabergoline regimen.

Result: Not much of a change, but noticed increased confidence and finally for the first time in my life, good muscle gain, I went from 180 at 6'3 to 205 in about 6 months.

Labs: Testosterone 761 348-1197 ng/dL Free Testosterone 29.1 E2 not detectable.

August 2013

I begin noticing body acne, and hair loss which does not run on either side of the family and I had never had before. I dropped T dose to 80 mg a week and stopped anastrozole. Additionally, I begin to get severe depression after taking cabergoline so I also stopped that.

Protocol 80mg of T divided in EOD dosing, 300 IU HCG

Result: Hair loss stops, muscle gains slow, severe depression stops.

Labs: Prolactin 14.8 E2 36 Total 548 free T 20.0 pg/ml 9.3 - 26.5
DHT 41 ng/dl 30-85

September

Attempt Cabergoline again, but severe depression begins again. Had to stop.

December 2013

Donated blood no HCG until mid January experience atrophy.

February 2014

209 pounds starting to get big. :slight_smile:

Partially tear my rotator cuffs. :frowning:

May 2014

Protocol continues as 300 iu HCG EOD 80 mg of T in EOD dosing.

Labs:

Testosterone 475 348-1197 ng/dL Free Testosterone 11.5 9.3-26.5 pg/mL
Prolactin 8.3 E2 9.7

June 2014 upped dose to 140 mg of T

Result serious hair loss.

July 2014

Gave my scalp a chance to recover and I am attempting HCG monotherapy 150 IU per day.

Result: Hair is regrowing and shedding stopped. Able to hit high singing notes again, enjoy people's company and socializing. Bloated cheeks is fixed. Fordyce dots are not expanding. BP is 115/75.

The bad, Muscle and weight loss, high cortisol and wrinkles, less energy and concentration. Low libido and no morning wood.


KSman is Here
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#2

With TRT

Cons

Liver markers and SBGH increased.
BP is high 140 to 150 - Donated blood, but did not help much.
I don’t care to socialize don’t enjoy it as much
Hair loss which doesn’t run on either side of the family in the frontal area.
Bloated cheeks and gut
Aggravation of fordyce dots.
Cannot hit high singing notes.

Pros

More Energy
Strength and muscle gain.
Lower cortisol
Increased Libido
More aggressive
Thick body hair


#3

How much caber? I was under the impression that 0.5mg/week was effective. When prolactin goes down, dopamine is meant to increase and that would then be expected to increase mood. I find that caber is a mood brightener in the context that I seem to otherwise have lower dopamine levels.

So what is dragging you down when on TRT? When your E2 is really low, you can be more emotionally detached and more analytical. We know that TRT can be a problem if the adrenals or thyroid are a mess. What is going on with body temperatures, iodine and thyroid labs? Maybe high cortisol wears you out?

Bloat on TRT sounds like E2. More E2 should lead to more SHBG.

High BP: What was hematocrit level? If not high, that implied that BP was from tension in the arterial muscles.


#4

[quote]KSman wrote:
How much caber? I was under the impression that 0.5mg/week was effective. When prolactin goes down, dopamine is meant to increase and that would then be expected to increase mood. I find that caber is a mood brightener in the context that I seem to otherwise have lower dopamine levels.

So what is dragging you down when on TRT? When your E2 is really low, you can be more emotionally detached and more analytical. We know that TRT can be a problem if the adrenals or thyroid are a mess. What is going on with body temperatures, iodine and thyroid labs? Maybe high cortisol wears you out?

Bloat on TRT sounds like E2. More E2 should lead to more SHBG.

High BP: What was hematocrit level? If not high, that implied that BP was from tension in the arterial muscles. [/quote]

Thanks KSman,

I was taking 0.5 mg in divided doses of caber per week. I don’t know what it is about my brain chemistry that doesn’t go well with caber basically all it takes is one bad emotion while on caber to put me in severe depression for weeks. I can get somewhat irrational on it for some reason.

My E2 was low when I was on adex and I over responded I stopped taking. On TRT I had full chunky cheeks, I don’t know if this was bloat or a result of higher T, body fat was 19% at 205lbs at that time. The emotional detachment while on TRT is strange and also feels like I have lower dopamine or serotonin while on Test for some reason.

Thyroid labs and temps have always been good TSH has always been near 1 or slightly under with good free T3 and T4, my usual temp is 98.6

Latest thyroid lab:

TSH 0.75

Free T4 1.4

Pre TRT hematocrit was 42 and it reached 48 on TRT before I donated, but donating only lowered the BP to 140.

Recently it went back to 47 while on TRT, but about two weeks after switching to HCG monotherapy the BP went down to 115/75 and 120/80 on average.


#5

Your body is reacting oddly.

Some relative emotional detachment with more T and lower E is normal for some males.

Mood and brain issues: Might be a period of adjustment is needed to establish new thought processes/patterns. The BP increase suggests a nerve component that is affecting the arterial muscle tone. Could you be magnesium deficient? If you get muscle cramps, you probably are. If TRT potentiates that, it does not make TRT the cause, but the revealer.

At this point, I am guessing as your symptoms and labs do not fit with what I know.


#6

[quote]KSman wrote:
Your body is reacting oddly.

Some relative emotional detachment with more T and lower E is normal for some males.

Mood and brain issues: Might be a period of adjustment is needed to establish new thought processes/patterns. The BP increase suggests a nerve component that is affecting the arterial muscle tone. Could you be magnesium deficient? If you get muscle cramps, you probably are. If TRT potentiates that, it does not make TRT the cause, but the revealer.

At this point, I am guessing as your symptoms and labs do not fit with what I know.

[/quote]

Thanks KSman I learned a lot over the years from reading your advice to others and it also didn’t add up to me. The emotional aspect on T is subtle, but it’s there, now that I’m experimenting with HCG only, my mood and motivation are significantly better. However, I’m sure my T is probably low because I’m in a catabolic state (muscle and collagen). I have tried magnesium, before, but not while on TRT, I’m going to start loading up and taking it consistently. I will probably be back on TRT if my T levels are as low as I suspect.

The main issues I need to solve to make this work:

Negative personality and emotional changes.

Non genetic and non MPB hair loss. I don’t know what is safe to stop this.

BP issues.

Fordyce spots grow.

Where can I learn more about nerve influence on cardiac muscle tension affecting BP? I tried researching it, but all I find is influence of stroke volume on arterial pressure.

Thanks.


#7

Fordyce spots are normal in the population. Increased T will tend to support the processes that are involved.

T lowers BP, in normal guys, as it facilitates muscle relaxation after contractions. You can see how that is fundamental to BP and the magnesium connection.

Please see my notes in the advice for new guys sticky concerning endothelial dysfunction. There are suggested supplements etc.

Thyroid also has effects on skin and hair. But you indicate that all is well there. Your hair lost pattern, while not expected, might still be DHT driven.


#8

Update.

I’m going to try a restart. I’m just not sure how to do it. I got 30 tabs of 20mg Nolva from a trip to Mexico. And a little bit of arimidex left.

I have always used HCG while on TRT except for a period of one month due to pharmacy errors.

What’s a safe restart and how long is it run? steroid PCT’s sounds like overkill IMO.


#9

You can be on hCG and the testes are in good shape from that. Then stop hCG and start SERM. Stay on SERM for a while and the top end of the HPTA should be working. Then taper. Good idea to be on 0.5mg/week anastrozole during hCG and cruse on that after to avoid estrogen rebound.


#10

Ok so I’m on day five of restart at 12mg of nolva a day. Nuts are sore not full size yet, I feel really low on T should I just tough it out another three weeks or can you add a small amount of T during the first weeks of restart?

Thanks guys.


#11

T during this does no harm. You don’t want T at the taper because of induced estrogens. However that can be blocked by an AI. So this can be done right but can also be done wrong.


#12

I have finished nolvadex at 11.5 mg a day for 4 weeks and then tapered off.

Here are the results after 9 days off of nolva. I’m honestly worried as I have always appeared to be secondary.

Any thoughts guys?

Labs:

lh 11.9
fsh 5.5
total t 380 ng/dl 348 - 1197
free t 12 pg/ml 9.3 - 26

tsh 1.2
free t4 1.4
free t3 3.3
prolactin 1.6 > taking 0.25mg a week of caber

hematocritic 44.5
glucose 97
hga1c 6.0
creatine 0.81
ast 27
alt 40 > this has been coming back high after I started TRT, not sure what it means.

cholesterol 172
triglycerides 101
hdl 44
ldl 108
vdl 20

THANKS!


#13

updates ?


#14

lh 11.9
fsh 5.5
total t 380 ng/dl 348 - 1197
free t 12 pg/ml 9.3 - 26

Looks like a degree of primary hypogonadism. FSH is probably a good indicator of overall LH status and high LH then suggests a strong and health pulsatile LH release which is more associated with youth. Perhaps testes will improve.

Whats up re BP and pulse?

ALT=40? Any sore muscles from training at time of labs?

How are you feeling? Physical and mood…


#15

My average pulse is 80 bpm.

BP is usually 125 to 135 over 80.

Feeling and mood, I’m a mess, I don’t have much energy and feel very fatigued. My motivation is messed up, my memory is erring, I’m acting very socially awkward and getting social anxiety. I noticed I feel detached and unmotivated. I’m trying to return to college after working a lot of crappy jobs after high school and finding it hard to push through.

I’ve lost like 10 pounds and haven’t been lifting as much, physically I feel quite frail.

The ALT started to come back highish for about a year now usually at 35. I wasn’t sore when doing labs. I’m not heavy drinker either so that is a red flag.

Thanks man.


#16

Thyroid numbers looked good. Do you still have good waking and mid-afternoon body temps.

Concerned that your stress might now be an active variable.


#17

Yeah, temps are good, I seem to have figured out how not to get sever depression on caber, I lowered the dose in half and this still keeps prolactin low.

What I’m starting to miss is the energy TRT gave me, especially for the gym, but I want to give testes some time to get LH and FSH. And I need to find a doc who will refill my HCG and AI.

What do you think of the ALT?

From doing some research it sounds like possibly fatty liver specially with my blood work suggesting I have a degree of insulin resistance.


#18

Are you getting fish oil and other healthy fats?
Doing anything to improve cell wall permeability and insulin sensitivity?
Ultra sound to image liver?

ALT from sore muscles?


#19

Are you getting fish oil and other healthy fats?

Avocado and nuts yes, fish oil could be dosed higher.

Doing anything to improve cell wall permeability and insulin sensitivity?

I don’t lift as much due to less energy and muscle performance, but I have a relatively clean diet and have added some jogging. What else can I try?

Ultra sound to image liver?

Will push doc for that.

ALT from sore muscles?

No, I wasn’t sore and this is the third time ALT comes back elevated, but not AST.


#20

Try a complete Vitamin E supplement for the hair loss.

Taking Zinc and Magnesium might help you with the acne. Epsom salt baths are great for helping with Magnesium. A lack of magnesium can also affect the brain and the skin.

For your mood/depression…I highly recommend Brain Candy. I have some brain damage (literally) and I’m pretty healthy with Brain Candy. I’m a mess without it. That supplement is a part of my life and is not something I can live without.

How is your oral health? Do you floss? Do you use toothpaste with Flouride? If you don’t floss, start. If you use flouride, stop. Try to buy a water filter that takes flouride out of your water also.