This post ended up getting real long, but I'd really appreciate it if you guys could read it in it's entirety. I've been fucked over by incompetent doctors for too long now and just want to feel normal again, I have nobody IRL to talk to about this so the support network here is invaluable to me. Thanks in advance.
Weight: 168 lbs
Body and facial hair:
Very hairy legs, stomach and chest. Arm and facial hair are both sparse, though have improved since starting TRT.
Describe where you carry fat and how it has changed:
From a young age I've always had very estrogenic fat distribution. This hasn't changed since starting TRT, though estrogen control has been an ever present an issue (more on this further down). I store all of my fat on my ass/hips, even at the end of my bulk where I got up to 22% bf I still had a perfectly flat stomach.
ADHD, low testosterone and x-linked juvenile retinoschisis.
Rx and OTC drugs, any hair loss drugs or prostate drugs ever
-- real dangers!
Concerta 18mg for ADHD, no 5AR inhibitors ever. I was considering starting finasteride since I'm rapidly balding at only 20 but have decided I do not want to take the risk.
Diet depends on whether I'm bulking or cutting but is generally clean either way. I'm currently running a 500 cal deficit on nSuns 5/3/1 LP, I've also recently moved over to a vegan diet.
Testes ache, ever, with a fever?
They don't ache, but ever since a testicular surgery I had when I was younger they hurt to touch. They were also significantly smaller once the swelling from the surgery went down. I believe the trauma from the surgery is what caused my low T at such a young age.
This is a strange one for me because I've never had morning wood once in my entire life. Even as a testosterone fuelled 14 y/o with severe acne and gynocomastia I never got them. My erections were always fine though as was libido (until the surgey). Haven't had morning wood while on TRT either.
I started TRT at 19 Y/O and have been on for the last 15 months. Things haven't gone well since starting due to a combination of a lack of bloodwork (resulting in poor estorgen management), ineffective medication and incompetent doctors. I've had constant erectile dysfunction, low libido, depression and a number of other syptoms for the majority of my time being on T.
The main issue is the lack of bloodwork. The doctor who prescribes me TRT is located four hours away because I had to go private in search of treatment (I'm UK based). My local GP refused to refer me to a urologist because I was still within the reference range. At 19 Y/O my pre TRT bloodwork was as follows (both tests blood was drawn first thing in the morning, and the two are two weeks apart):
Total Testosterone: 14.0 (10.0 - 38.0) nmol/L
SHBG: 25.2 (16.0 - 55.0) nmolL
Total Testosterone: 12.9 (10.0 - 38.0) nmol/L
SHBG: 24.8 (16.5 - 55.0) nmol/L
As you can see my pre TRT blood work was very limited. Because the NHS is undergoing massive cuts GP's are reluctant to put you in for bloodwork that they don't deem necessary. I requested estradiol, LH and FSH but because the first test showed that my testosterone was within range he refused.
After those results I met with my current private consultant who offered me a prescription based on my levels. I knew that I needed more bloodwork, but at the time I was just desperate to feel normal again and didn't know if I'd get another chance to start TRT. Since then blood work has been near impossible to get for two reasons.
The first is that my private consultant is located four hours away which costs me £80 on the train, and another £120 for the blood work/follow up appointment. I wouldn't mind paying this, but when requested he never sends me a copy of my blood work. I refuse to pay over £200 for bloodowork and take dosage recommendations from a doctor who has often displayed his incompetence (he prescribes E14D sustanon injections, 5000iu p/w HCG for testicular maintenance ect) without seeing the results myself.
I also couldn't get bloodwork closer to home because the GP refused. He says that I shouldn't be on, and that facilitating a dangerous and unnecessary practise would be 'unethical'. But apparently letting a 19 Y/O with bottom range testosterone with a history of testicular surgeries live with erectile dysfunction, little muscle mass and low libido is perfectly fine.
This has left me living with permanent erectile dysfunction and low libido for over a year now because I've been unable to manage estrogen. I'm a naturally heavy aromatizer (pubertal gyno, estrogeneic fat storage) and I started on gels which are notorious for raising e, and then moved over to Sustanon injections which also raise e due to the shorter acting esters. I've experienced early signs of gyno and other e related sides multiple times since starting. My doctor prescribe me anastrozole to try and control it, but without being able to get bloods it's been impossible.
However, I recently discovered that medichecks offer private bloodwork that isn't the unreliable finger prick tests. I am now able to order my own bloodwork and travel to my local hospital to have the blood drawn and send it off myself. I also managed to persuade my doctor to prescribe me test E instead of sustanon despite his reluctance. These two changes have allowed me to finally start making strides towards dialling in my protocol and feeling like a normal person again.
My protocol for the last four weeks was based on the sticky for beginners and has been as follows:
50mg Test E E3.5D
250iu HCG EOD
0.5mg Anastrozole E3.5D
I had bloodwork done at trough. The blood was drawn at 10am, and my next injection was due at 8pm the same day. The results are as follows:
Testosterone: *36.6 (7.60 - 31.40) nmol/L
FT (calc): 0.918 (0.30 - 1.00) nmol/L
17-Beta Oestradiol (standard assay): 93.1 (0.00 - 191.99) pmol/L
SHBG: 28.46 (16.00 - 55.00) nmol/L
Prolactin: 211 (86.00 - 324.00) mIU/L
PSA: 0.979 (0.00 - 1.40) ug/L
TSH: 2.06 (0.27 - 4.20) mIU/L
FT4: 14.7 (12.00 - 22.00) pmol/L
FT3: 5.08 (3.10 - 6.80) pmol/L
Haemoglobin: 168 (130.00 - 170.00) g/L
HCT: 0.500 (0.37 - 0.50) L/L
RCB: 5.43 (4.40 - 5.80) x10^12/L
MCV: 92 (80.00 - 99.00) fl
MCH: 31.0 (26.00 - 33.50) pg
MCHC: 337 (300.00 - 350.00) g/L
RDW: 11.9 (11.50 - 15.00) %
White Blood Cells:
WBC: 3.7 (3.00 - 10.00)
Neutrophils: *1.90 (2.00 - 7.50)
Lymphocytes: 1.35 (1.20 - 3.65)
Monocytes: 0.33 (0.20 - 1.00)
Platelets: 153 (150.00 - 400.00)
MFV: 10.1 (7.00 - 13.00) fl
Creatinine: 103 (66.00 - 112.00) umol/L
Alkaline Phosphatase: 81 (40.00 - 129.00) IU/L
Alanine Transferase: 29.6 (10.00 - 50.00) IU/L
Creatine Kinase: *402 (38.00 - 204.00) IU/L
Gamma GT: 19 (10.00 - 71.00) IU/L
Total Protein: 75.1 (63.00 - 83.00) g/L
Albumin: 46.5 (34.00 - 50.00) g/L
Globulin: 28.6 (19.00 - 35.00) g/L
Ferritin: 99.83 (30.00 - 400.00) ug/L
Triglycerides: 0.83 (0.00 - 2.30) nmol/L
Cholesterol: 3.51 (0.00 - 4.99) nmol/L
HDL: 1.29 (0.90 - 1.50) nmol/L
LDL: 1.84 (0.00 - 3.00) nmol/L
Non-HDL Cho: 2.22 (0.00 - 3.99) nmol/L
Heart Disease Risk:
HDL % of total: 36.75 (20.00 - 100.00) %
The first is how my TT so high considering I'm on a conservative protocol. My test dose is only 100mg p/w, and I wouldn't expect the HCG to be making much of difference as I suspect that the cause of my low T is primary from the surgery I mentioned previously.
I've been on this protocol for four weeks now. The first three I had strong, consistent erections with high libido, but the last week I've had erectile dysfunction and no interest in sex.
How is that possible with testosterone so high and estradiol in check? My only idea is that with the assay being standard my estro is actually off, but since sensitive isn't available in the UK I have no way of knowing.
My creatine kinase is double the upper end of the reference range...
From what I've read it indicates muscle damage. The night before the blood was drawn was a heavy deadlift session working close to my training max. Is it possible this is the cause?
I've also read that it can sometimes indicate an issue with the heart. Lately I've been experiencing chest tightness/sensations, though blood pressure and HR are in check (I average 125/70 and 65 BPM). I chalked it up to my moderate anxiety anxiety but now I'm concerned.
I also started the medication conerta on Monday after being diagnosed with ADHD. I'm not sure if that could have had an effect (heart sensations were present before starting the conerta). I know nothing about the liver so hopefully someone more knowledgeable can shine some light on the situation.
My RBC's are starting to get on the high side so it's time to donate blood. Problem is I'm on anastrozole, and you're not allowed to donate blood if you take it. Anyone got any ideas for that?
My while blood cells are all on the low side. This has been like this for years now but doctors don't seem concerned. Figured I'd mention it in case anyone has any ideas.
That's about everything I think. Damn, that's the first time I've been able to fully explain my current situation alongside supporting bloodwork. It feels good to have somewhere to get it all out since nobody in my life has the first clue about any of this.
If anybody has any suggestions about my current situation, my most recent bloodwork and the actions that I need to take to improve I'd really apreciate the advice. Thanks for the help.