T Nation

28 On TRT need guidance

My Official Case:
28 Y.O.
Height: 5-10, Waist: 33in, Weight: 165lbs
Always been on the lean side. Currently losing muscle size, strength, tone.
Have body hair but not a ton, slightly receding hairline, always been active but less active the past two years. Right now I ride my mountain or road bike about twice a week. Not currently doing any weight training.

Alrighty guys - I think my original post was too wordy and overwhelming.

I need some help and guidance.

About 6 months ago I thought I was starting to die. I had no energy, no drive, lost majority of my muscle, moody, depressed, anti-social, and aches so bad I could barely get out of bed sometimes.

I have always been active and relatively healthy. Able to work long days, and focus on things when I need to. I cant do that at all anymore.

I am 8 weeks from my bachelors degree but its almost impossible for me to study, focus, or even have the desire. - This is my biggest concern right now - the mental stuff. I need to get through the last two months of school.

I started TRT 8 weeks ago. About week 4&5 felt great. I could concentrate and really get things done. At week 6 I started going down hill.

I fortunately have a good doc who will work with me (has so far)

The doc prescribed me 100mg test Cypionate every 10 days. I halved the dose and do it every 5 days to avoid such drastic peaks and valleys.

I have an appointment tomorrow and will be asking about my high E2 and asking for an AI.
I also am going to bring up HCG because I’m worried about my boys.

How do I know if I’m going to be on this forever or temporarily?
Can adrenal fatigue cause low T?

Thyrotropin 2.0
ESR 4.0
Hydroxyvitamin D3, D4 37.0
Prolactin 11.0
Testosterone 1098 (up from 193) (Range 280-1100)
SHBG 22.0 (range 13-71)
Free Testosterone 303.1 (range 47-244)
%Free Testosterone 2.8 (range 1.6-2.9)
Bioavailable Testosterone 772.8 (range 131-682)
Alb 4.1 (range 3.3-4.8)
LH <0.1
FSH <0.1
IGF 227.0
Estradiol 50.4
Estrone 38.5
Total Estrogen 88.9

Is an E2 of 50 high? This needs to be closer to 22 right? Will this help with my brain fog?
Anything else that causes alarm or I should look into with these labs?
I have a Dr. appt tomorrow.
Feedback/guidance is appreciated.

Im anxious/desperate to figure this out so I can finish school and keep my job/wife.

Thanks in advance.

…this post is still way long. My estrogen is obviously way too high. Heh.

your story sounds like most here. Good to start then a crash when your system can’t handle the extra T or the wild swings.

yes. your Estradiol is an issue.

yes. you definitely need to test your TSH and 8am cortisol at a minimum along with multiple other tests per the blood test sticky.

Agree that E2 is likely a huge cause of your issues. Since you are relatively lean (I presume from your height/weight/waist) your body is probably not used to high levels of E2. Most fatter guys have gotten used to E2 and tend to do a little better with a bit higher (but not 50 levels!). But for someone like yourself, this should definitely be addressed.

I would look at addressing it first with your T dosage. Your Free and Bio T are above the range high. If you felt great at these levels, I would say this is not a bad thing (assuming your liver/CMP markers are ok). But since you are having issues, it could be too high for you.

The only outlier here is 100 mg every 10 days is a fairly small dose, so its weird that your T levels are so high. Were you on the E5D protocol when this lab was taken? How many days after your last 50 mg injection were the labs taken?

You should also supplement Vit D–it is on the lower side.

Are you having crashes mid day? Are your nuts shrinking and scotal sack pulling up tight to your body? If answers to both of these are no, you probably don’t need hcg.