T Nation

27 on TRT Log

T Replacement
#1

Decided I wanted to start my own thread after learning so much from reading others. I also wanted to thank KSman for the wealth of knowledge he has provided here.

27
5’9
42" waist
250lbs
-minimal body hair patchy facial hair
-Carry majority of fat in spare tire region and on my chest
-No Rx Drugs (before TRT)
-describe diet: changes alot; never a starvation diet.
-describe training: Lift heavy 3-4 times a week and either play basketball or football 1 or 2 days a week
-testes ache, ever, with a fever? Slight ache from time to time.
-how have morning wood and nocturnal erections changed: Before TRT very sporadic

Background: Used to be in fantastic shape, I am a far cry from what I looked like in my profile pic. Over the last few years I have continued to put on fat. I have trained pretty consistently but diet admittedly has been very hit and miss. The last 2 years have hit me hard. Extreme fatigue, decreased sex drive, and a real loss of motivation. I used to look forward to my workout all day, now I have to drag myself to the gym. Had some blood work done last year, showing T in the 200’s but my doctor said to lose weight. Lost 20lbs which was REALY hard to do and had more blood work done showing T in the low 300’s going off memory. Doctor said I was just outside of normal ranges and due to my age wouldn’t do anything. So after a year of struggling and gaining back those 20lbs plus another 10 I found myself the most out of shape I had ever been all while training 4-5 days a week. Got tired of trying to convince my doctor something was wrong and got my own bloodwork done:

Testosterone, Total, LC/MS 374.9 348.0-1197.0 ng/dL BN
Free Testosterone(Direct) 8.5 LOW 9.3-26.5 pg/mL BN
LH 6.0 1.7-8.6 mIU/mL BN
FSH 3.2 1.5-12.4 mIU/mL BN
Estradiol 23.6 7.6-42.6 pg/mL BN

I knew these #'s were not optimal for an active 26yo male. Almost went to the darkside to treat myself, but for the sake of my relationship I found a subscription based service that referred me to doctor willing to look into treatment. Latest blood work to follow:

#2

New doctor who is unfortunately out of state requested blood work. The results:

Testosterone,Free and Total
Testosterone, Serum 229 Low ng/dL 348 - 1197 01
Comment:
Adult male reference interval is based on a population of lean males
up to 40 years old.
Free Testosterone(Direct) 7.4 Low pg/mL 9.3 - 26.5 01
FSH and LH
LH 9.4 High mIU/mL 1.7 - 8.6 01
FSH 3.5 mIU/mL 1.5 - 12.4 01
Prostate-Specific Ag, Serum
Prostate Specific Ag, Serum 0.5 ng/mL 0.0 - 4.0 01

Had a good 30 minute discussion with her about results and treatment plan. She decided to prescribe:

100mg test cyp 1x week
.5mg anastrazole 1x week
350iu hcg 2x week

I take my 3rd T shot tomorrow.

I asked to split T shot to bi weekly. She said she we would reevaluate after the 6 week blood results. She also said I was estrogen dominant but only prescribed .5 anastrazole a week. I have requested again that that dose be increased and am waiting to hear back. Taking AI once a week doesn’t seem right. If she increases to 1mg I will split it myself into .25 4 days a week. She informed me I have freedom on when during week to dose my shots. So as of now I am doing the following:

Sunday night 100mg test c
Monday afternoon .5 anastrazole
Friday morning 350iu HCG
Saturday morning 350iu HCG

#3

To compound my issues, I dont think my thyroid is functioning correctly. I am working on finding a new local GP doctor and plan to get more blood work done for thyroid with or without a new doctor. After reading through the thyroid sticky I realized I had no routine source of Iodine the last few years. I have since started supplementing with kelp pills every day starting about 2 weeks ago. Just starting this week I have began logging my temperatures when I first wake up and when I get home from work. My Avg morning temp last 3 days is 96.7 and none of my afternoon temperatures have broke over 98. According to everything I have read, this is a pretty big red flag. This could explain why it is so hard for my weight to go down when in my early 20’s I could drop 15-20lbs quite easily. I just want to get back to how I used to feel and look. The journey continues.

#4

Starting week 3 took my 3rd shot of 100mg test cyp last night. Things I have noticed so far.

1.Energy levels starting to pick up (dont feel like death in the afternoons)
2.Libido starting to creep up some
3.Acne, have noticed acne on back of my shoulders nothing terrible tho.
4.Weight is slightly down but my moobs look the same if not bigger. I sure hope its pecs building under there and im not just growing tits.

Still waiting to hear back from doctor on uping Ai dose, she said e-mail was best way to contact her. So far she hasn’t proven that correct.

Going to deadlift today, haven’t had the energy to do a good deadlift day in a couple months. I know I have lost a bunch of strength.

Still looking to find a decent doctor…(this may never happen)

#5

Maybe someone with more experience can chime in here. If taking 1mg anastrazole and 100mg of test a week would it be best to split the aromasin throughout the whole week or load in the days after the shot(when T levels should be at their highest)?? This is what I was thinking.

Sun night 100mg test cyp
mon-wed .25mg aromasin every morning
friday .25 mg aromasin and 350iu hcg in morning
saturday 350iu hcg in morning

Am I over thinking this?

#6

Please read the protocol for injections so I do not repeat my self.

If you need a 1 gram iodine replenishment, how long will that take with kelp caps?

TRT + thyroid problems can make some feel worse.

Aromasin or anastrozole?

You appear to have primary hypogonadism. Get your testes examined? Any pain there?

DHEA-S next labs.

#7

[quote]KSman wrote:
Please read the protocol for injections so I do not repeat my self.

If you need a 1 gram iodine replenishment, how long will that take with kelp caps?

TRT + thyroid problems can make some feel worse.

Aromasin or anastrozole?

You appear to have primary hypogonadism. Get your testes examined? Any pain there?

DHEA-S next labs.[/quote]

After doing the math and re-reading the thyroid sticky, I will most definitely be looking into getting some Iodoral.

Will also add Dhea-S to my next bloodwork up. Think I will just pay out of pocket and get it done soon.

Anastrozole Sorry for the confusion.

As for the testes examination, the doctor felt on them and around my groin area on my first visit to her said everything was fine. As for pain I only have a slight ache and I may notice it once a month.

I promise you I have read the stickies, the retention of all the information is my problem. I will continue to study up.

Thanks again for everything you bring to this forum.

#8

Have ordered thyroid labs and the DHEA-S. I will post up results when I get them. Thinking back to my old doctor its quite funny. The only supplement he ever suggested I try was DHEA… but never tested my levels. I’m gonna wait to order the iodoral until I get results back from blood work.

#9

Lab work is in.

TSH 2.67. .45-4.5uIU/ml
T4 free 1.11. .82-1.77ng/Dl
T3 free 3.1. 2-4.4pg/ml
Dhea sulphate 342.6 138.5-475.2 ug/Dr

Nothing flagged as high or low…time to read more and truly decipher the #'s

#10

So after reading awhile my TSH is far from optimal. Should have iodoral arrive in a couple days. Will continue to monitor my temperatures daily.

#11

Doctor is still not responding to me. Have upped anastrazole dose to 1 mg a week last week and this week. My T to E conversion is still scaring me. I am down approximately 7 lbs since starting trt 4 weeks ago but my man tits are larger than ever…multiple people other than myself have noticed. Not good at all!

I’m supposed to get blood work in approx 2 more weeks but may get my own sooner to check E levels. Very frustrating.

#12

Doctor said no go on upping anastrazole dose to 1mg weekly. Wants to see what blood levels look like at 6 weeks at .5mg a week. So next 2 weeks I’ll ride it out at .5mg to get reading and see what happens.

Still waiting for Iodoral to arrive. Morning temps still routinely under 97.

The saga continues.

#13

You have had someone else hit 98.6 on that thermo?

Your fT4 is a bit low and fT3 is good. So temperatures would not be expected to be low. In this situation one can suspect that rT3 is blocking the effects of your fT3. From there the conversation gets into your med history, accidents, infections, stress etc which can increase fT3 and lower cortisol and adrenal fatigue [AF] can describe this collection of problems. AM cortisol lab, done at 8AM and rT3 would be a good start. You cannot fix AF with a pill. At that point I suggest that one get Wilson’s book on adrenal fatigue and see if you find that book seems to be talking about you - avail at amazondotcom

#14

I do believe the thermometer is inaccurate. I have had my girlfriend test it multiple times and although she has routinely tested higher than me she has not got above 98.6. I will be buying a new one.

I have asked to add AM Cortisol and Vitamin D to my 6 week TRT blood draw which will be coming up soon. Depending on how I feel/results I may order a 4 panel saliva test for cortisol levels throughout the day.

I have also purchased Dr wilson’s book and skimmed through it this weekend. LOTS of information and lots of things that are sounding familiar. I will read in detail throughout this week.

#15

Going to get 6 week blood work…actually it will be the day before my 6th shot. Will be testing:

Testosterone
Free Testosterone
Estradiol sensitive
Vitamin D
Cortisol AM

After reading some of Dr wilsons book. I’ve been trying to cut back on my coffee/caffeine intake and drink more filtered water instead. It’s a work in progress as I have been a VERY HEAVY coffee drinker. I’ve also started taking licorice extract and ashwagandha to see if I get any positive effects.

I am feeling better than pre TRT but still dont think im getting the most out of it. I will definitely request to do my shots twice a week instead of once, and depending on blood work may try to increase dose. Also need to make sure in estrogen levels get dialed in. Who knows how long doc will take to get back to me after blood work since it took two weeks to answer a simple question.

Also just this week I have noticed i’m recovering from workouts slightly better(faster) than I had been pre TRT but still a far cry from how I was training/recovering 5 years ago. Still got 50lbs to drop… weight is SLOWLY coming off.

Also took 1/2 a iodoral tab most days this week and have started to hit 98.6 on my thermometer that i previously never got close to on these last few days. Still need to buy a new one.

#16

If self injecting, you can inject twice a week on your own.

#17

Was waiting for after my 6 week draw results, which i ended up doing this morning. Will see what doctor has to say (hopefully by end of week but doubt it). I know she was open to twice weekly dosing when we first spoke but wanted to try 6 weeks of 1 shot a week. Will switch to twice weekly regardless starting next week.

#18

Better to have labs based on injecting twice a week and do labs 1/2 way between. Labs based on steadier levels are better than a random snapshot of something that is peaking and falling.

#19

.

#20

[quote]KSman wrote:
Better to have labs based on injecting twice a week and do labs 1/2 way between. Labs based on steadier levels are better than a random snapshot of something that is peaking and falling.[/quote]

I agree, I will most certainly be getting even more lab work done after a couple months of new injection protocol. I seem to be spending a small fortune but am willing to do so to get back to “living life”. Having said all of that latest lab results are in.

Blood was drawn 8:15am before my weekly T shot.

CBC With Differential/Platelet
WBC 5.3 x10E3/uL 3.4 - 10.8 01
RBC 4.61 x10E6/uL 4.14 - 5.80 01
Hemoglobin 13.6 g/dL 12.6 - 17.7 01
Hematocrit 41.2 % 37.5 - 51.0 01
MCV 89 fL 79 - 97 01
MCH 29.5 pg 26.6 - 33.0 01
MCHC 33.0 g/dL 31.5 - 35.7 01
RDW 13.9 % 12.3 - 15.4 01
Platelets 190 x10E3/uL 150 - 379 01
Neutrophils 51 % 40 - 74 01
Lymphs 38 % 14 - 46 01
Monocytes 7 % 4 - 12 01
Eos 4 % 0 - 5 01
Basos 0 % 0 - 3 01
Neutrophils (Absolute) 2.7 x10E3/uL 1.4 - 7.0 01
Lymphs (Absolute) 2.0 x10E3/uL 0.7 - 3.1 01
Monocytes(Absolute) 0.4 x10E3/uL 0.1 - 0.9 01
Eos (Absolute) 0.2 x10E3/uL 0.0 - 0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 01
Immature Granulocytes 0 % 0 - 2 01
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1 01

Testosterone,Free and Total
Testosterone, Serum 281 Low ng/dL 348 - 1197 01
Comment:
Adult male reference interval is based on a population of lean males
up to 40 years old.
Free Testosterone(Direct) 6.4 Low pg/mL 9.3 - 26.5 01

Vitamin D, 25-Hydroxy 41.1 ng/mL 30.0 - 100.0 01

Estradiol, Sensitive 8 pg/mL 3 - 70

Cortisol - AM 15.0 ug/dL 6.2 - 19.4

Results of T were as expected based off how I had been feeling at end of weeks previous. Estrogen was kind of low but I suppose with such low testosterone it is expected. Will have to research further into the Cortisol and Vit D levels to determine optimal. Not sure what all to be checking for on the CBC but everything came back within range.