T Nation

37 y/o New to TRT. Labs and Questions


#1

age: 37
height: 5’9
waist: 36
weight: 220
describe body and facial hair: Like a sasquach since about 16…
describe where you carry fat and how changed: beer belly
health conditions, symptoms [history]:history of hypertension. Doctor diagnosed as “essential hypertension” meaning there no cause, it just is. Fatigue, lack of energy, insomnia, depression, anxiety.
Rx and OTC drugs, any hair loss drugs or prostate drugs ever:
Currently Test Cyp 150mg once E7D
Anastrozole 1MG E3D after Test Injection
HCG 4000UI @ 25 units daily

Hi guys, new here and hoping to get some advice about where i should go from here.
When i first got out of the army in 2008 i started experiencing the symptoms of low T. My doctor at the VA ran me through a gambit of tests and every time my blood work showed my Test was low. They were very hesitant to treat it, and ended up never wanting to address the issue. During that time I had no idea what “low T” even meant.

Fast forward to today and I am still experiencing a lot of those same symptoms. Fatigue, lack of energy, loss of muscle mass, increase body fat, depression. I start to hear adds on the radio about low T so I go to a clinic to get checked out about 3 months ago. I do not currently have a copy of the labs on hand but i remember my Estradiol was at 77 and my Test was at 137.

The doctor put me on a protocol of 150mg Test Cyp once a week, and because my estradiol was so high he advised i should take an extra dose of Arimidex. So for 3 days after my injection I take a 1MG tab each day. I also opted to take HCG as this is new to me and I wanted my body to continue to produce in case i decided to jump off.

It’s only been just over 3 months now and some times i feel great. I have a lot of energy, i walk around with a spring in my step and confidence and just a general sense of well being and it’s amazing. Other times i feel like I’ve been hit by a bus and like total shit. Almost like i’m sleeping off a hangover, and my energy will be low, and I could stay in bed all day and I would be OK with that. I’ve kind of narrowed it down to the middle of the week when i take the Arimidex is when i start feeling shitty. Libido has not, and continues not to be an issue.

I’m not supposed to get labs with my doctor for another 3 months and I was not satisfied with that. So i decided to go to private med labs and get the hormone panel for females. I take my Test injection on Mondays and I take the Arimidex on Tuesday, Wednesday, and Thursday. These labs were done yesterday on a Thursday. I don’t know if that was the best time but I wanted to get an idea of what is going on with me mid-week.

I can see right off the bat from the labs my test is very high, and my estradiol is almost non existent. I hope someone can chime in and help me decide what to do next, and where to go from here. My initial reaction is maybe lower my dose of Arimidex? I appreciate any feedback.

CBC With Differential/Platelet
WBC 6.7 3.4-10.8 x10E3/uL
RBC 5.69 4.14-5.80 x10E6/uL
Hemoglobin 17.3 12.6-17.7 g/dL
Hematocrit 50.8 37.5-51.0 %
MCV 89 79-97 fL
MCH 30.4 26.6-33.0 pg
MCHC 34.1 31.5-35.7 g/dL
RDW 13.9 12.3-15.4 %
Platelets 195 150-379 x10E3/uL
Neutrophils 57 %
Lymphs 30 %
Monocytes 11 %
Eos 2 %
Basos 0 %
Neutrophils (Absolute) 3.7 1.4-7.0 x10E3/uL
Lymphs (Absolute) 2.0 0.7-3.1 x10E3/uL
Monocytes(Absolute) 0.7 0.1-0.9 x10E3/uL
Eos (Absolute) 0.2 0.0-0.4 x10E3/uL
Baso (Absolute) 0.0 0.0-0.2 x10E3/uL
Immature Granulocytes 0 %
Immature Grans (Abs) 0.0 0.0-0.1 x10E3/uL

Comp. Metabolic Panel (14)
Glucose, Serum 89 65-99 mg/dL
BUN 10 6-20 mg/dL
Creatinine, Serum 1.22 0.76-1.27 mg/dL
eGFR If NonAfricn Am 75 >59 mL/min/1.73
eGFR If Africn Am 87 >59 mL/min/1.73
BUN/Creatinine Ratio 8 LOW 9-20
Sodium, Serum 141 134-144 mmol/L
Potassium, Serum 4.1 3.5-5.2 mmol/L
Chloride, Serum 98 96-106 mmol/L
Carbon Dioxide, Total 27 18-29 mmol/L
Calcium, Serum 9.5 8.7-10.2 mg/dL
Protein, Total, Serum 7.6 6.0-8.5 g/dL
Albumin, Serum 4.5 3.5-5.5 g/dL
Globulin, Total 3.1 1.5-4.5 g/dL
A/G Ratio 1.5 1.2-2.2
Bilirubin, Total 0.4 0.0-1.2 mg/dL
Alkaline Phosphatase, S 70 39-117 IU/L
AST (SGOT) 29 0-40 IU/L
ALT (SGPT) 46 HIGH 0-44 IU/L

Testosterone, Serum
Testosterone, Serum >1500 HIGH 348-1197 ng/dL 01

Comment: Comment 01
Adult male reference interval is based on a population of lean males
up to 40 years old.

Luteinizing Hormone(LH), S
LH 0.1 LOW 1.7-8.6 mIU/mL

FSH, Serum
FSH 0.6 LOW 1.5-12.4 mIU/mL

Estradiol
Estradiol 5.2 LOW 7.6-42.6 pg/mL 01
Roche ECLIA methodology


#2

Do not test LH/FSH on TRT as they go to zero.

Anastrozole dose was insane!

Inject 75mg subq twice a week.
0.5mg anastrozole at time of injections
250iu hCG subq EOD, more is not needed
Adjust later to get near E2=22pg/ml on labs.

Stop anastrozole for 1 week then restart at then dose.

Always do labs halfway between injections to reduce effects of lab timing. Time of office visits can be wrong.

Do not be dehydrated for your lab work.

Watch RBC, you do not want it higher, else may need to reduce T dose and/or donate blood. Avoid iron fortified foods, rice, flour, breakfast cereals, rice, bread. Vitamins should not list iron - men’s formula.

If hCG is 1000iu/ml, 0.25mg or “25” on an insulin syringe is 250iu hCG.

T can be low from low LH/FSH caused by blows to the head, blasts etc. Pituitary gets damaged.

Low thyroid function can also make you fat. Please see last paragraph in this post and post your oral body temperatures.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.