T Nation

80 Y/O Starting TRT and Could Use Some Advice


#1

I’m 80 years old and just started TRT six weeks ago with an anti-aging doctor here in central Mexico where I now reside. The protocol he put me on consisted of Sustenon 250mg once a week for three weeks and then Nebido 1000mg in the fourth week which is supposed to release gradually over 8-9 weeks. I tested Test Total and Free before I started and then again two weeks after the Nebido injection. These test results are as follows:

9/15 Test Total 524.61 ng/dl (Over 50 range 127.18-1020.36)
Test Free 4.00 pg/mL (Over 60 range 2.50-17.80)
Did not test for E2
This test was right before I started TRT

10/27 Test Total 1930.77 ng/dl (Over 50 range 127.18-1020.36)
Test Free (cFT) 35.5 ng/dL (range 7.2-23.0)
E2 Estradiol 28.0 pg/mL (range 11-44)
Same Lab so don’t know why the Free test used a different measurement.

I was quite surprised at the extreme jump in my testosterone levels, from pretty low to way above the range and hope someone will comment on this. I’m wondering if this means the dose the Doc gave me of Nebido was too large or if this much of a spike in the first two weeks is normal and that my levels will subside a lot over the next six weeks. I’m inclined to test again every two weeks until the Nebido runs out to see if I can chart a half life for this dosage in my body.

I did notice the effect of the TRT right away, within days. Much more energy, improved attitude and mood, better sleep and a sharp increase in libido including morning wood for the first time in some years. Too soon to tell about increased muscle mass but I have put on 6 lbs since I started the program and only some of it seems to be on my waist line. To date all the positive aspects of TRT continue and I’m not experiencing any negative side effects.

For some context….

I’m 5’11 and now weigh 156 lbs (up from 150 on 9/15). Body fat is just over 10%. I was a daily tennis player until a year and a half ago when my knees started giving me problems and I decided to quit while I could still walk. So as not to deteriorate any further I immediately I embarked and a health and fitness program that involved a Primal diet, heavy supplementation, lifting heavy at the gym two days a week and doing HIIT on a stationary bike, walking, swimming, qigong on the other days. I have generally been feeling pretty good for some time but decided to try TRT to see if I could get my body back up to a higher level… So far it seems to be helping.

Although Nebido once every couple of months would be convenient I do like the sound of the protocol recommended on this forum and definitely need to immediately add Arimidex and hCG to my program. Not sure exactly how to dose the Adex with my Test so far above the range. I could use some suggestions on that. And at my age I’m certainly not concerned with fertility but see the value in hCG for it’s other benefits.

So that’s my situation and I would appreciate any comments.

Thanks for reading.


#2

Nebido really suck because you can’t fine tune your levels. It’s also dangerous because you’re injecting a huge amount of test, doctor’s must know what their doing in case if a severe reaction right after injection.


#3

Yes, I understand that problem now. If I had discovered this forum before the Nebido injection I would have opted for another protocol. However, it’s now in my system and will releasing for another six or seven weeks. It will be interesting to see how I feel during that period and I am going to test every two weeks to see how quickly my test levels drop. Living in Mexico I can order the tests myself and the cost is only about $30 for Total Test, Free Test and Estradiol. I can also get Adex and hCG through my local pharmacy easily without a script.

So far, however, I am feeling great. The only slightly negative effects are that I am waking up very early after about 6 hours of sleep, full of energy, and find that my appetite has increased and that I am putting on a few pounds.

I’m going to pick up some Arimidex today and get started with that while I wait for some hCG I ordered to be delivered. Since my Estradiol is not that high and I feel fine I think I’ll start with a small dose of Adex, maybe 1/4 mg twice a week and see how that works while I monitor my levels of test and E2.


#4

Forgot to mention if the dose ends up being too much for you and you get side effects, there’s little you can do about it. When was on 200mg weekly I realized I was in over my head real fast and there was little I could do about, I was forced to ride it out. These Nebido injections brings the doctor more money since they have to be trained on how to administer it. I think it should be against the law to give an 80 year Nebido, the risk is too high!


#5

Thanks for your comments, systemlord. Since my last post I tested again on 11/9 (two weeks after the prior test) and found my readings had dropped sharply. TT down from 1930 to 1064 ng/dl (range 127 to 1020), Free T down from 35.5 to 21pg/ml (range 2.50 to 17.80 and E2 down from 28.0 to 16pg/ml (range 11-44). I had taken only 3 .25mg doses of Adex during the 10 days before this test. No more Test and no hCG. I was, and still am, waiting for the shot of Nebido 1000mg I got on 10/13 to wear off.

So…it’s clear, as you suggested, that I got a sharp upward spike in the week or so after the injection and then the levels started swinging lower in the second two weeks. I have not been feeling recently anywhere near as good as I did right after the injection and plan to test again next week (six weeks after the shot) and suspect my levels will be much lower yet. I have not taken any more Adex since 10/25 as I don’t want to drive my E2 any lower while my Test levels are dropping.

Depending on the results of next week’s testing I hope to start the protocol suggested here around the 1st of Dec which brings me to my question for today.

SL, I have seen you mention in other threads that levels of SHBG can be used to determine the best frequency of dosing with Test and I’m going to add SHBG to the tests I order next week. What levels of SHBG (both high and low) would indicate that I should deviate from the suggested protocol dosage of 50mg of Test E3.5D? I think I’m understanding that very low levels require smaller, more frequent doses of Test so does that mean that very high SHBG levels would indicate a higher, less frequent dose of Test? Say 100mg or more once a week? I’d like to be clear on this before I start self injecting and would appreciate your thoughts. Early in January (after about six weeks on the new protocol) I’m planning to order a full battery of blood tests so I can check the levels of all the important markers. I typically do this twice a year.

Thanks for your help.


#6

Respect! At 80 you have body composition, fitness routine, and hormones many guys 30-40 years younger are struggling to achieve. With the good advice above you are well on your way to getting the ‘T’ side of the equation dialed in too. What are your typical lifts/work set poundages?

Keep us posted.


#7

Thanks birdman03. When I got back into the gym last year after a five year break from lifting I started off with the Stronglifts 5X5 program. Five compound exercises (squats, deadlifts, bench press, OH press and bent over rows), 5 sets of 5 reps each, split between two days a week…in and out of the gym in less than an hour. As my knees, right shoulder and elbow had been pretty well trashed by many, many years of tennis on hard courts and hitting thousands of tennis serves I started very light and have gradually increased the poundage as my joints have recovered some strength. Weights I’m using are still not very impressive (only 155 for squats, 175 deadlifts and much less for the presses due to my weaker right shoulder) but heavy for my old bod and my priority is to very gradually gain strength without getting injured. As my Free Test has been very low until just recently and HGH probably non-existent the going has been slow but I’m making progress. I’m hoping this TRT program will help me to put on some more muscle and speed up the repair of my damaged joints. My plan is to fine tune the TRT into next year, then add some HGH and then see how far I can go.


#8

Excellent! I found that TRT helped to heal tendonitis in my left shoulder after about 4 weeks or so. Shoulder was always sore and weaker than the right one.

On the workouts it sounds like you have a great plan featuring compound lifts and keeping sessions short but intense. I am doing Grow Ectomorph Grow 531 plan from this site which is similar. TRT is helping me sustain progress that I could never achieve before. Avoiding injury and starting low to allow room for progression are key.

At lower weights such as with Overhead Press going up 5 or 10 lbs when you are doing 70 or 80 can be too much. I use 1 lb plates to limit additions to less than 5% and keep form honest for all reps.


#9

Latest update and a question…

At 7 weeks after my first Nebido 1000mg injection latest lab results are showing Total Test 785 ng/dl (range 127 to 1020), Free Test 9.73 pg/ml (range 2.50-17.80), Estradiol 20 pg/ml (range 11-44) and SHBG 77.6 nmol/L (range 11.20-78.10). This is the first time I’ve tested SHBG.

During the 7 weeks Total Test went from 524 before TRT, to 1932 two weeks after injection, then down to 1065 4 weeks after injection and now down to 785 at 7 weeks. Free Test went from 4 to 35.4 to 21 and now 9.73. Estradiol went from 28 after two weeks to 16 after 4 weeks and now back up to 20. I took three .25 mg doses of Adex in the ten days before the 4 week test but have taken no more since.

So…Nebido is working as predicted. A large initial spike followed by a more gradual slide that will probably end up back where I started within a week or two. I have been feeling good in all respects during these 7 weeks and do still but in order to avoid the large swings that result from the massive Nebido doses I’ve been planning to switch to the protocol recommended here of 100 mg Cyp per week split E3D along with hCG EOD starting next week. I’ll check Estradiol frequently and add Adex if it starts climbing near 30.

My question is this…In view of the very high SHBG level should I take the 100mg Test Cyp dose in one injection per week rather than splitting it into two? Or…should I consider even a higher dose to hopefully bring down the SHBG level?

Also wondering if the very high SHBG reading could have resulted from having the blood for this test drawn right after I finished a hard, two hour gym workout. I’ve read that stress can raise SHBG and my body was probably pretty stressed when the blood was drawn.

I’d sure appreciate any thoughts or comments on this. Thanks.


#10

The only way you’re going to bring down your SHBG and to allow for more useable free T is larger weekly doses, slow acting esters are pretty much useless for guys with high SHBG. You could try two larger doses per week or one large dose, everyone is different. Your dosing should focus around your SHBG level down as close to the 30’s as possible as long as TT is within range. An AI will be more important with these larger doses. However I’m uncertain how high a TT is safe for an 80 year old.


#11

Thanks SL. I think I’m going to have to experiment and test frequently until I find a dose that makes me feel good and also starts bringing down SHBG.

Do you think working out hard right before the blood was drawn for the last test could have distorted my SHBG?


#12

Working out will only improve your situation. It’s encouraged since the effectiveness of TRT is determined by how often you work out. It’s the only way to reap all the benefits of TRT.


#13

Update on my progress and changes I have made to my program to address the bizarre thyroid numbers that showed up in my recent blood test of Nov 28th.

Range		Results

TSH .27-4.2 uui/ml 38.05
Free T4 .93-1.7 ng/dl 0.82
Free T3 2-4.4 ng/dl 1.87
Reverse T3 9.2-24.1 ng//dl Not Tested

Testosterone Total 2.8-8.0 ng/ml 7.85
Testosterone Free 2.50-17.60 pg/ml 9.73
Estradiol 11-44 pg/mL 20
SHBG 11.2-78.0 nmol/L 77.6

This test was done about 8 weeks after the one injection that I received of Nebido 1000mg and it should have just about worn off. I decided to immediately start with the protocol suggested here and am about two weeks into that. The first week I injected 50mg of Test C on Monday morning and Thursday evening along with 250iu of hCG on the same days and no Adex. I felt no beneficial effects from that dosage.

As my SHBG tested so high I decided to up the Test C dosage to 90mg on each of two days this week along with the hCG and added .25mg Adex the day after each injection. My energy level, mood and general feeling of well being notched up a little after the larger doses and I got a half hearted woody two mornings. A good sign but as my SHBG was SO high I suspect I may need even a larger dosage of Test to see much change and to bring down the SHBG that is binding up my Free Test. May go up a bit more in the coming week. I’m injecting SQ into my abdomen using 29G ½ in needles in 5ml syringes. I warm the vial of serum in a water bath before loading the syringe. Loads easily. Shots are completely painless and have had no problems.

I was really surprised at the ugly thyroid numbers as I had not noticed any recent symptoms of being Hypo. During the last half of 2016 I had tested low for Free T3, slightly high for TSH (like 6) and also high for RT3. I started Iodoral 12.5 mg daily with 200mcg Selenium and experimented with various thyroid meds…mostly Novotiral, a synthetic available here in Mexico that simulates the balance of T4 and T3 in Natural Thyroid. I continued the thyroid meds for several months but discontinued them when my thyroid numbers and temperatures came up but I started not feeling well at all in late 2016. Never did start the thyroid meds again until this week but I did continue the Iodine supp daily for about 15 months until just last week.

A recent post on this forum regarding the possibility of having EXCESS Iodine in one’s system caught my eye last week. (Thanks KSman) I was not aware that excess Iodine could be a problem so I immediately did a little research and started wondering if what I’m experiencing at the moment could be Iodine Induced Hypothyroidism resulting from taking 12.5mg of Iodine daily month after month. On the off chance that this may be the case I am discontinuing the Iodoral for a least a month or until my next blood test to see if that makes a difference. I may resume then with a much smaller, maintenance dose.

I also started checking my temps again after receiving these test results and found that they were quite low again. Five days ago I started taking 25mcg of straight T3 (Cynomel), daily, half AM and half PM. The last two days my mid afternoon temps were back up to 98.6 and 98.5 so it appears these meds are helping. I did not test for RT3 this time as the test is quite expensive here and I had no idea that TSH would come back so ridiculously high. Hell, I had no idea that it COULD get that high! I will include RT3 in the full battery of tests I plan to order in mid January and will continue taking straight T3 meds until then. It is my understanding that the best way to treat high RT3 is with straight T3. We’ll see….

I’ll post another update in a month or so after I get a full set of blood tests. In the meantime I’m going to follow the protocols I’ve mentioned to continue trying to optimize my Test and normalize my Thyroid numbers.

I always appreciate any thoughts or comments.