T Nation

2 Weeks in to TRT, Sore Nipples

T Replacement
#1

All,

Got my blood work done two weeks ago. I can provide other numbers if it helps, but here is what I think the main important ones are for help:

Free T3- 3.7 pg/ml (2.3 - 4.2)
Free T4- 1.32 ng/ml (.73 - 1.95)
TSH - 2.2 (.3 - 5.1)

EStradiol - <10 (up to 56.0)
Dhea Sulfate - 214 ug/dl (103-446)
Testosterone - 419 ng/dl (241 - 827)
Sex Horm Bind Globulin - 32 NMOL/L (13-71)
Free Test - 8.7 ng/dl (6.0 - 27.0)

Doc gave me 100 mg. Test cyp 1 shot per week for the past 2 weeks, and now I’ve had sore nipples for the past 4 days. I told him and he ordered up a Free Test/Estradiol test asap.

Could only 2 weeks of such a low dose cause E2 to shoot that far up to cause this? Maybe I’m just sensitive?

I’ve read the Estradiol sticky and I’m ready to go with Adex if I need to, but man being under 10 I thought I at least had some room to play with.

Thanks for any info!

#2

Estradiol test is probably incorrect. It looks like they did not do the test that needs to be done for men (i.e. ‘sensitive’, not ‘ultra sensitive’). You need to get tht tested again, because you have symptoms of high E2.

Also, a TSH of 2.2 indicates a probable thyroid issue.

Edit: also, highly recommend moving to EOD or E3D for shots (obviously, you need to break up the dosage so it evens out - for example, if you did Wednesday evening and Sunday morning, your 100mg/week would turn into 50mg/twice weekly). Ask your doc to show you how to do them on yourself, no reason to waste time and/or money having him do them - it’s really easy to do yourself (I do them in my thighs, which seems to work best).

#3

Estradiol test failures also generate a <n result.

Please use the edit function in the lower right of your post above and add lab ranges.

Age?

Check body temp when you first wake, write it down, collect for a few days and report.
Do you get cold easily?
Using iodized salt or iodine in vitamins?

How stressful is your life?
How do you react to major stress?

Cholesterol numbers?
Ferritin?
RBC?
Hematocrit?

Everyone is different. You may be more sensitive to E2 than others.

#4

Edited above post with ranges…hasn’t populated yet I guess.

39 years old
BF % - Low 30’s

I sometimes do get cold easily
No iodized salt or iodine to the best of my knowledge

Life has bouts of stress. I own a rapidly expanding business. Reaction to stress is usually to get pissed off, aggravated easily when stressed. The past 3-4 years I would say Moderate to high stress, particularly this past year. Trying to fix that now.

Cholesterol:
Total 190 mg/dl ( <200)
HDL 51 (>39)
LDL 128 (<100)
Risk Ration LDL/HDL 2.50 (<3.55)
Tridlycerides - 57 mg/dl (<150)

RBC - 5.48 M/UL (4.10-5.70)
Hematocrit - 46.5 % (37.0 - 49.0)
Ferritin - Don’t see on here

Thanks much for the help!

#5

[quote]Akaji wrote:
Estradiol test is probably incorrect. It looks like they did not do the test that needs to be done for men (i.e. ‘sensitive’, not ‘ultra sensitive’). You need to get tht tested again, because you have symptoms of high E2.

Also, a TSH of 2.2 indicates a probable thyroid issue.

Edit: also, highly recommend moving to EOD or E3D for shots (obviously, you need to break up the dosage so it evens out - for example, if you did Wednesday evening and Sunday morning, your 100mg/week would turn into 50mg/twice weekly). Ask your doc to show you how to do them on yourself, no reason to waste time and/or money having him do them - it’s really easy to do yourself (I do them in my thighs, which seems to work best). [/quote]

Thanks, I’ll do this. I do have everything ready at home to do them myself. Likely the results won’t return by the time to do my next shot. I guess keep going with the Test right?

#6

you really need to test for RT3, 8am Cortisol, and ferritin.

your T numbers weren’t horrendous to begin with and if you have a low cortisol issue then adding extra T will just cause even higher E2.

#7

[quote]PureChance wrote:
you really need to test for RT3, 8am Cortisol, and ferritin.

your T numbers weren’t horrendous to begin with and if you have a low cortisol issue then adding extra T will just cause even higher E2.[/quote]

Did you mean a high cortisol issue? Or are you thinking it could be low due to adrenal fatigue?

#8

could be either, but I have never seen anyone post on any forum with 8am Cortisol test results with cortisol above 20. Most are usually around 10 or lower. 15-20 is ideal.

also adrenal fatigue is misleading. adrenal insufficiency or imbalance is more accurate.

#9

Just got my latest results back, any input greatly appreciated:

Estradiol - 41 ( up to 56.0)
Test - 651 (241-827)
Free Test - 14.3 (6.0 - 27.0)
Cortisol 5 ug/dl (2 - 25)

How does one go about raising cortisol? And I’m thinking Adex pronto?

#10

If thyroid hormones are low because of an iodine deficiency, you would treat with iodine, not drugs. Where are you located. Some regions have little iodine in the soil and food grown there can lead to goiters.

Some meds, Rx and OTC can increase E2 by reducing the liver’s ability to clear E2. Liver conditions can do the same. Do you have CBC results?

What did you get for fasting serum glucose?

You have low cortisol and your stress reactions and daily stresses sound like adrenal fatigue.

No quick fix for adrenal fatigue as you will read. However, cortisol labs will really improve life. You do not want to get into a replacement program, more supplemental. When reading the book, you might have some “that’s me!” moments.

RBC and hematocrit appear to me to be indicating that ferritin is not low. Others may have a different opinion.

%BF, elevated E2 and low thyroid hormones would be consistent. While your fT3, fT4 appear to be good, very often, low cortisol will increase rT3 levels which block fT3 from docking with thyroid receptors, which can create a functional state of hypothyroidism [symptoms].

What vitamins and supplements?

#11

KSman,

Funny you should mention that book as I just bought it last night! Took the test with the questions in there and failed miserably. My “That’s me!” moments were too many to count. I’m fully convinced, as I’ve been redlining it for quite a while now.

Left my results at my office so I’ll have to get those posted on Monday.

I live in Austin, TX. Vitamins and supplements include: Whole foods Multi (150 mcg Iodine), B-Comp, Adrenal Support by Gaia herbs, Lipoic acid, Garlic, Digest Gold before each meal (A must as my digestion is also in the tank). Also, food and environmental allergies (cedar fever) are off the charts lately. I did read in the book that was a symptom of adrenal fatigue.

Thanks again for the help to everyone. Time for me to definitely chill out, and likely drop the replacement program for now and focus on regaining some peace.

#12

read the adrenal section on stopthethyroidmadness.com and thyroid-rt3.com

those have great information. I am on Hydrocortisone (prescription only) and my wife is taking Isocort (herbal OTC) to treat our cortisol issues.

assuming your blood draw was at 8am - a 5 result is like as near to a system shut down as you can get without being dead.

get your cortisol fixed up first, then work on your thyroid if needed, then your other hormones.

#13

Digestion problems can lead to mal-absorption. B-12 is the poster child for that. That means that is can be hard to absorb as an oral vitamin in those cases. Sub-lingual is available. Some will use B-12 injectables and co-inject with things like hCG. You can get B-12 tested as part of blood work. Taking anti-acids or proton pump inhibitors can cause low B-12 levels. With age, stomach acid levels go down and B-12 problems are typical.

Most need vit-D3 supplements, high dose. Amount in vits can’t do the job. You can test for Vit-D25, which is an active steroid hormone [non anabolic]. Many are taking 4000-6000iu per day. Body stores Vit-D3, you can take a week’s worth all at once. Those further north have lower Vit-D levels, but Vit-D deficiencies are found in the southern states as well. Those with darker skin at at higher risk.

Fish oils are needed because it is very hard to get enough EFA, in ones diet.

Some one else here may be able to speak to increased food sensitivities etc. Getting T, thyroid and cortisol levels might be quite helpful.

Glutamine can be useful for gut problems: http://www.google.com/search?hl=&q=glutamine+gut+permeability
Note leaky gut syndrome where food components get into the blood stream.

#14

What KSman said, can get a stool test to check for any gut infection etc Saccharomyces boulardii and probiotics can help, google these for more info. As for raising cortisol, transdermal pregnenolone i have found helpful. Elevated LDL can be a sign of low pregnenolone as well.

#15

Well you all have been awesome and thank you for the time you took to respond. I’m chomping away bit by bit here on this (a bit of info overload), however I can honestly say I do feel much better. I got on a few of Dr. Wilson’s formulas, started supplementing with Iodoral as well as some other supps. I did a salt water drink today of 1/2 tsp. Celtic sea salt in warm water followed by 16 oz. of regular water. I wanted to try this as after a few days on the Iodoral I ended up sick with a head cold and body aches. I did read of some detox, however I’m only at 12.5 mg/day.

It came to my mind though, as I got my wisdom teeth out a little while back, and all I was consuming were canned soups. After a week (recovery was brutal) I was peeing like crazy and leaner than I had been in months. It was like my body completely re-adjusted. Common sense quickly told me that salt was bad. Now however, that got my thinking perhaps I need extra sodium? I do recall a poster who mentioned the moment they started adding 1-2 tsp per day of sea salt everything seemed to normalize. Anyway I tried this drink this evening, and immediately started passing a great deal of gas, which is something I normally almost never do. I also started peeing again like crazy. Any thoughts?

I also added liquid anastrozole at 3 drops eod, with plans to increase. I have taken this about a year ago and remember dipping in to the other side at 6 drops eod (moody & depressed).

Another question I have is, how long after one starts Adex is a blood test accurate? I thought I’d wait 2 weeks, but then again that would only make sense if I kept the dose the same. Any input on this is also greatly appreciated.

Again thank you for the responses. With so much advice coming in, along with just simply attempting to feel good and make things happen through the busy day, it would be awesome if someone could just provide the next rational steps that I might take. The great news is, I’ve settled down tremendously and not nearly as stressed as I was. Workouts are great, strong as a beast lately. I always knew I was “off balance” somehow with water retention and fat deposition.

Thanks again.

#16

salt can help regulate electrolyte balance. too low salt causes the body to retain water, mess with digestion by impacting stomach acid levels, increases blood pressure, and increases heart rate.

TMI warning - when I started sea salt, I started having multiple daily bowel movements. not so much anymore.

low salt indicates low aldosterone (which controls salt retention).
low aldosterone is usually associated with low cortisol (which is a know issue for you).

are you doing anything to address or treat your low cortisol levels?

low cortisol also results in higher aromatase of T to E2 (hence your use of liquid anastrozole). treating your cortisol should result in a drop in E2.

#17

Test in two weeks? -perhaps a bad idea.

Anastrozole serum levels take around 6 days to reach final values as an expected result of half-life. So you are not playing with a complete deck of cards for 1 week. Usefulness of lab results increases with more frequent injections.

Many feel a good improvement, if they are going to benefit at all, in 10-14 days and the improvements can build for some time. If you are feeling good and positive as a result of introducing anastrozole, you can enjoy that and do E2 testing at three weeks or longer. If you feel worse, you could be an anastrozole over-responder and you should be aware of the issues with that and recommended dose reductions. If anastrozole levels are very low and you feel like crap, the lab result will not be useful for a dose correction calculation. The best outcome is to do testing when you feel that the anastrozole makes you feel better.

Remember that anastrozole really cannot be dosed properly if T is injected once a week or longer and the outcome will never be very good.

#18

I’m going to switch docs and go with a wellness clinic here and attack the cortisol/aldosterone issues next week. My current doc is very liberal with dosages and prescribing things but lacks the true insight like most.

I did switch to injecting every 3rd day for the past 3 shots, which may have helped in my improvement. I’ll stay with that and 4 drops EOD of the anastrozole, along with my current supps. Despite being sick still and even losing my voice (first time ever in my life), I am leaner and feeling much better. My weight was about 238 at the start of this thread and I’m 229 now.

I’ll get on the cortisol asap next week and report back. Thanks again for all the help.

#19

Got my labs updated as I had switched to 6 drops eod about a month ago on the anastrozole. I’ve been feeling great on the following:

Test cyp - .35 on the syringe E3D
HCG - 250 iu’s EOD
Anastrozole - 6 drops EOD

Latest results:

Test total - 708 (241 - 827) Up from 419 initially
SHBG - 29 (13-71) Down from 32
Free Test - 17.0 ng/dl (6.0 - 27.0) up from 8.7
Estradiol - 24 ( <63) down from 41

I feel good, actually down 14 lbs of fat and gained 8 lbs of muscle. I’d like to increase Free T more and was wondering what I should increase the T dose to, and how much to increase the Adex in drops along with it.

Also, should I be looking to exceed the free test range of 27?

Thanks much for any feedback.