T Nation

6 Months of TRT


#1

I am 41, 5' 8" and weigh 240. I was 200lbs in February 2014 and this time last year, 215lbs. I started to carry visceral fat more noticeable than ever, not much in the way of subcutaneous. Started having a hard time maintaining an erection, was tired, have insomnia, moody and really started struggling with building muscle which is why I went to have my testosterone levels checked.

In 2011 I had pain in the right testicle so severe that it hurt to sit and walking was unbearable. I had an ultrasound and saw two urologist who couldn't give a diagnosis but it subsided in a couple of weeks. Every once it a while I'll have a pain or dull ache but it doesn't last very long. I've always been in good health and I've got back into lifting for the last two years.

I lift three days a week for usually 1-1 1/2 hrs each session. My strength has steadily increased but knee and lower back injuries hampers my squat and deadlift.

Had blood work done on 12/24/14
Total test: 184 ng/DL (340-1050)
Free test: 3.7 ng/DL (9-15)
SHBG: can't remember

Put on androgel 1% @ 2 pumps daily. Felt better for 2 weeks and then felt worse. Androgel 1% was discontinued so, I went back after 1 month and the doc did more tests.
Total test: 113 ng/dl (340-1050)
Free test: 5.3 ng/dl (9-15)
SHBG: can't remember

Was put on androgel 1.62% @ 2 pumps daily and told to come back in a month. Got another round of tests after 6 weeks.
Total test: 187 ng/dl (340-1050)
Free test: 4.5 ng/dl (340-1050)

I was starting to get frustrated by then cause the androgel wasn't working and was told estrogen wasn't a problem and no need to test it. Androgel was increased to 3 pumps daily and was referred to an endocrinologist. The Endo is really an Endo but a PA and got all suspicious when I asked about injections and asked about clomid to help restore testicle size. He said I wasn't at that point yet. Said testicle size was "appropriate " to which I said, not for me it isn't. He ordered more tests since my primary didn't send prior test results in time.
Free test: 123 ng/dl (250-1100)
Free test: 24.6 pg/dl (46-224)
Bioavailable: 50.5 ng/dl (110-575)
Albumin: 4.5 g/dl (3.6-5.1)
SBH: 16 nmol/l (10-50)

Prolactin: 5.2 ng/ml (1.8-14.4)
FSH: 0.7 miu/ml (2-17.7)
LH: <0.2 miu/ml (.9-10.6)

I was put on injections of 200mg of cypionate very 2 weeks, have had 2 injections thus far and feel slightly better until 4-5 days before the next injection. I wanted to question the endo about the LH results but he wasn't in the office. I was told over the phone that the pituitary hormones were "appropriate " but I don't see how a <0.2 is "appropriate ". I work in a lab and I know what a "less than" result means. I have an appointment scheduled for in the morning to see a different md at my primary physicians office. I'm tired of dealing with not getting any help and getting treated like I'm just want to get on gear for recreational purposes. I even went so far as to complain to the medical center the endo works for because of the "appropriate" test results and was told I couldn't see another doctor but feel free to go somewhere else.

Any help, additional info or knowledge of good doctors in the triad area of NC would be appreciated.


#2

We need more info. Please read the ‘advice for new guys’ sticky and see what is requested.

TRT takes LH/FSH to near zero. Should have tested that before any TRT.

Your inability to absorb transdermal T is also a symptom of low thyroid function which can be caused by not using iodized salt and an iodine deficiency.

Check your overall thyroid function:
Check oral body temperature when you first wake up AND mid-afternoon.
Should be 97.7 - 97.8 in AM, 97.3 is way too low. Need 98.6 in afternoon.
If low, read the thyroid basis sticky

Also read thyroid basics and finding a TRT doc. Your doc is normal, ignorant and stupid.


#3

Thanks for the reply!! I just edited my post two more times, it should update in a little while.


#4

So get your body temperatures posted and respond to the point about iodine - please

You need to self inject T, 100mg/week as 50mg twice a week. Probably need 1.0 mg anastrozole per week, 0.5mg at time of injection. Therapeutic target is E2=22pg/ml
250mg hCG SC EOD will prevent infertility and shrinkage
Please read the ‘advice for new guys’ sticky and ‘protocol for injections’


#5

Estradiol is probably the most important # to get in your case, especially since you are on some serious T… You’re probably way high.


#6

I went to see my primary last Friday to discuss other treatments and to review my labs. He flat out said he would not order an estrogen test, prescribe clomid or an aromatase inhibitor. He is referring my to another endo for a second opinion. I went Thursday for another injection and spent quite a bit of time discussing and educating the PA on additional options.

He also refused an estrogen test due to my “appearance” doesn’t indicate high estrogen. I asked about clomid and hcg. He said his supervising doctor doesn’t do off label use but he would do some research on it and on hcg. I’ve been checking my waking temp and it ranges from 97.0-97.4. I get busy and forget the afternoon check. Thanks for your help, I’ll keep updating as my situation changes. The struggle is real, lol