T Nation

3 Months on TRT. Starting to Doubt my Dr.


#1

HI Guys. Thanks for the all the help a few months ago before I started trt. I have been on 3 months or so now and it has changed my life for the better. I have able to drop one of my depression meds and I no longer have to naps in the middle of the day. I truly feel like I am getting my life back. With that said I am trying to get my Test and E dialed in and I am starting to feel like my Dr. doesnt know what she is doing.

I was started on trt at 2mg E10D. I knew that wasn’t a good idea but I tried it. On day 8 I felt god awful and injected again and had been injecting 150mg e7d. After 5 weeks I had blood work the day of my next injection but prior to doing it. So 7 days since my last 1.5mg injection. Here are my results.

Test serum 373 Range 348-1197
Estradiol 37.1 Range 7.6-42.6
SHBG 21.3 Range 16.5-55.9

After this test the Dr. moved my test to 200mg Every week. When she did that I started injecting every 3.5 days.

I have started to have tenderness in my nipples and my ED has come back somewhat. I asked her about this and the response was she won’t give me an AI because my Estradiol isn’t too high. And that my nipple tenderness was caused by the test and not a higher E level.


#2

[quote]agentjoedirt wrote:
HI Guys. Thanks for the all the help a few months ago before I started trt. I have been on 3 months or so now and it has changed my life for the better. I have able to drop one of my depression meds and I no longer have to naps in the middle of the day. I truly feel like I am getting my life back. With that said I am trying to get my Test and E dialed in and I am starting to feel like my Dr. doesnt know what she is doing.

I was started on trt at 2mg E10D. I knew that wasn’t a good idea but I tried it. On day 8 I felt god awful and injected again and had been injecting 150mg e7d. After 5 weeks I had blood work the day of my next injection but prior to doing it. So 7 days since my last 1.5mg injection. Here are my results.

Test serum 373 Range 348-1197
Estradiol 37.1 Range 7.6-42.6
SHBG 21.3 Range 16.5-55.9

After this test the Dr. moved my test to 200mg Every week. When she did that I started injecting every 3.5 days.

I have started to have tenderness in my nipples and my ED has come back somewhat. I asked her about this and the response was she won’t give me an AI because my Estradiol isn’t too high. And that my nipple tenderness was caused by the test and not a higher E level.

[/quote]
Hi,

As far as estradiol not being too high, that’s because your blood test was 7 days after your last injection. Those are trough readings. You are getting high estradiol symptoms when E2 peaks. Which is right after Test peaks. I’m saying this because I had the same issue. Before going on an AI, my trough E2 level was in range. But then I explained to the Dr., that my high E2 symptoms came about 36-48 hours after injection. She understood, and gave me a prescription for anastrozole.

Try to explain that to your doctor.


#3

While your E2 might be acceptable per the labs, it is my opinion that it is too high. I believe KSMan will weigh in and confirm this, but I believe he has found 22 to be optimum. In my experience, I feel best somewhere in the high teens but have never been above 24 in any of my blood tests - I’m on 150mg of test cyp E7D and I don’t use an AI with the exception of Grapeseed extract and am not even sure if that has any effect.

I think your concerns about your doctor may be valid. Look around for some information regarding ideal E2 levels, print it out and give it to your doc and see what happens. If she refuses, start shopping.


#4

I have scheduled a blood test tomorrow at 2:30 that will be about 30 hours my last injection. I am having them check TT E2 SBHG. Anything else. I should add to the test?


#5

I should also mention last week I had some edema issues mid week. Hand and feet mostly. Not terrible but I had to loosen my shoe laces. Diet hadn’t changed. They swelling seemed to go down by sat. Also noticing some slight feeling like you get when something goes to sleep in my hands. Not see if it related to the extra water or not. They started about the same time. Nipple tenderness as well has been going on the last few weeks.


#6

Your doc is an idiot.

Please read these stickies:

  • advice for new guys
  • protocol for injections
  • finding a TRT doc

#7

“”"
Thanks KSMan. Yeah I have read all the stickies multiple times. That’s what called me to question my DR and made them do another blood test. So my blood work from yesterday came back.
I injected on Mon 7am 100mg. Blood work was at 230 tues. last week I injected 200mg total

TT 1351. Range 348-1197
Estradiol. 82.9. Range. 7.6-42.6
Shbg. 23. Range. 16.5-55.9
"""
Stop creating new threads where I have to go on an easter egg hunt for you details!

You have not learned anything from the protocol for injections sticky and I will not repeat here.


#8

Nice douche bag response. I was thanking you for advice and posted it actcidentally started a new thread on my phone.


#9

My dr has now prescribed me Adex and suggested 1/2 tab 5 days a week. My plan is to use 1 pill per week split to take every other day. Will my test levels change being on an AI or does it just make what I am taking more available? I was thinking of waiting 5 weeks and running another blood test to see how things are doing. Did you guys change dosing after starting AI?


#10

AI will not affect T levels in TRT guys because the HPTA is not functional. It will lower E2 and improve T actions at the receptors and in gene expression. Mood can become greatly improved, along with libido and mental energy. Some feel more analytical and less emotional.

Fat patterns can improve and stubborn fat areas can lean out. So the fat losses of T only can be improved upon with more favorable E2 levels.

[hCG can increase T levels a bit in some older guys, more so for younger;who are not primary].

Please understand the issues re anastrozole over-responders, signs and what to do if you land there.

Yes, that Rx for anastrozole is nuts.

Sorry for the offense, I need to herd cats and track many threads for weeks. I direct people to the stickies to reduce the time needed to make these points.

You are injecting once a week and T levels are all over the map and the meaning of any lab work is then limited, all the more if not presented with lab timing.

Anastrozole is a competitive drug, competitive with free and weakly bound [bio-available] T. Your T levels are all over the map. Dosing anastrozole to a moving target is simply wrong. Inject twice a week and take AI then, or T and AI EOD.

Now you are injecting twice a week. By taking anastrozole at the same time, they will both roughly peak and trough together which works well for many.


#11

Thanks, yeah I feeling pretty good overall. Every 3.5 days with the T works well. I travel a lot but I have just started taking everything with me. No airport issues at all. I was wondering about the dosing on the AI. I will start doing half pill with each injection which makes a lot of sense. Crazy how we have to come to the Internet to find out how all this works and then press our Dr’s to do it right. I even asked my Dr for 1mg of AI per week and she prescribed me 2.5mg per week. Never did a peak blood test and wasn’t going to test me for a year after my initial… I am however very thankful she made the prescription. I already feel 100% better. I plan on doing blood work every 5 weeks or so until I get it dialed in. Then I will maybe go to every 3 months.

Thanks again