In your case/thread opening post:
Slender build, bit soft in the middle
Low and falling T (~300 total last test before TRT begun), long-standing fatigue issues
Fairly recently decided to give HGH a try to address fatigue and aging. Pre-HGH TSH level was in range (no other thyroid values available pre-HGH). Started taking 3.3 IU jintropin daily, but no significant impact on energy or physique. A few weeks in, bloods came back with below-range T4 (4.3 ug/dL), normal TSH (2.260 uIU/mL), normal T3 uptake (27%) and normal free thyroxine index (1.2). In response, started taking T4 (Thyroxine sodium) 100 mcg. More complete thyroid bloods pending (going to order FT3, FT4, rT3). Not sure HGH is doing much of anything (may have increased shoe size by 0.5)
Even more recently found a doc (urologist) willing to give TRT a go.
Doc (urologist) first prescribed Arimidex alone to raise T (from low 400s). Prescribed 0.5mg EOD. Went well at first (started feeling less lethargy), but within a few weeks my joints were so achy I felt 100 years old. Suspected too-low E2, ran my own bloods (in connection with HGH testing) and got back well-below-range Estradiol level of 5.9 pg/mL.
Complained to doc, who instructed me to stop Arimidex, and prescribed high-dosage progesterone cream (?) from compounding pharmacy. Applied nightly for one month, never felt much effect on lethargy, joints got slowly achy (not as bad). Follow-up bloodwork by doc showed total T falling to ~300. Doc prescribed 100 mg Test-Cyp 1x week, 500 mL HCG 2x week.
Happy to have Rx, and feeling a bit frustrated with the slow pace, I over-indulged and ran 125 mg Test-cyp 2x week (250 mg weekly) with the 500 mL HCG 2x weekly for the first three weeks. Also added Proviron (mesterolone) 50mg / daily to increase free-T and hopefully keep E2 in-range. Started feeling better, gaining weight (180-190, not noticably fatter, though - suspect water weight). Ran my own bloods, got out of range (> 1500) total test (expected closer to 1100, cutting back to prescribed dosage in anticipation of Dr.-ordered bloodwork), elevated out-of-range prolactin (~17 ng/mL), very high free T (~45 pg/mL - hooray Proviron!), and sky-high estradiol (~90 pg/mL). In response to high E2, resuming the .5mg Arimidex EOD.
My concerns are:
1- Where did the elevated prolactin come from? Doesn’t seem high enough to be a prolactinoma (this is my first prolactin test, in response to hearing the doc indicate that prolactin could be an issue we’d test for some day if the T didn’t help — I’m impatient and couldn’t wait to test). Does it rise with exogenous Test? Don’t think I pet any puppies or had any orgasm the day before the test.
2- Lab results for liver enzymes were very high: AST ~170 IU/L, ALT ~140 IU/L (reference ranges 0-40 and 0-44, respectively). This could arise from a few things, according to what I’ve read: liver damage (I hadn’t cut back on my 2-3 alcoholic drinks a day, but prior to HGH and TRT, my AST and ALT were within range at this level of drinking; Proviron/mesterolone is not 17a-alkylated, supposed to have low hepatoxicity; had been taking a single dose of NSAIDs every day for back pain), or possibly vigorous exercise causing muscle breakdown/repair (I’ve been lifting, but at a beginner stronglift 5x5 level, nothing impressive or even close to overtraining). In response to these numbers, I’ve cut out alcohol and NSAIDs for now, and dropped the Proviron (just in case). Will run these bloods again after taking a few days off of exercise to see what happens.
3- not too concerning, but other lab values out of range were platelets (high @ ~410 x10E3 /uL), Bun/creatinine ratio (low @ 8, Bun in-range @ 9, Creatinine in range @ 1.16 mg/dL), potassium serium (high @ 5.4 mmol/L), in case these are relevant.
Grateful for any input from the community on these issues (prolactin, liver enzymes) and suggestions for what other tests might be worth pursing (currently planning on getting a thyroid panel with free&total T3&T4, rT3 and TSH) and probably another lipid panel (have always been right at the very top of the total cholesterol range, a little above range on LDL).
Despite sky-high total and free T, didn’t feel much more energy than before. Maybe due to high E2?