I started testosterone replacement therapy back on 11/13/2019 and just had my 90-day labs drawn. I have a review scheduled with my doctor in 4 days, but I wanted to get some input from the members about some of my concerns here so I can better understand things and know how best to move forward.
My relevant numbers are as follows (start-finish):
TT: 244 - 486 (Range: 264-916 ng/dL)
FT: 10.8 - 27.4 (Range: 8.7-25.1 pg/mL)
E2: 13.3 - 40.7 (Range: 8.0-35 pg/mL, Sensitive)
LH: 3.4 - Not Measured (Range: 1.7-8.6 mIU/mL)
TSH: 1.97 - 2.78 (Range: 0.450 - 4.500 uIU/mL)
DHEA: 356 - 478 (Range: 138-475 ug/dL)
IGF-1: 285 - 251 (Range: 98 - 282 ng/mL)
SHBG: 24.2 - 12.6 (Range: 16.5 - 55.9 nmol/L)
Prolactin: Not Measured - 31.7 (Range: 4.0-15.2 ng/mL)
PSA: 1.0 - 1.1 (Range: 0.0 - 4.0 ng/mL)
Cholesterol: 276 - 246 (Range: 100 - 199 mg/dL)
Triglycerides: 168 - 176 (Range: 0 - 149 mg/dL)
HDL: 44 - 44 (Range: >39 mg/dL)
LDL: 198 - 167 (Range: 0 - 99 mg/dL)
T. Chol/HDL Ratio: 6.3 - 5.6 (Range: 0.0 - 5.0 ratio)
Test-C 200mg/ml - .25ml Subcutaneous - E3D, or 150mg/week
HCG 250iu Subcutaneous - E3D
Anastrozole 0.125m 2-3/week, if needed
Dosing worked out to be 150mg Test-C weekly, or .25ml/50mg E3D
Reasons for starting:
Experienced the following symptoms since my early 20’s, yearly testing had always returned bottom of the range numbers for testosterone since I was about 23. Never went higher than 351 even at my youngest labs around 23. After realizing that my doctors continually saying “everything looks fine” despite me not getting or feeling any better might mean the doctors actually didn’t know what they were talking about, I decided to do more focused research and more comprehensive labs and obviously came across testosterone replacement.
*Chronically low energy
*Difficulty increasing muscle mass
*Difficulty decreasing bodyfat
*Difficulty maintaining erections or achieving erections, felt like a gamble whether my dick would work or not
Personal review of the first 90 days:
Let me start with an important point, I initially did the math wrong and ended up dosing .25ml/50mg EOD instead of E3D from start, 11/13/2019 - 1/15/2020. I didn’t realize until I did some mental math and realized that at the rate I was going, I would run out of my vial of test before it would be renewed. Once I noticed, I switched to E3D on 1/15/2020 and continued that since then. In other words, my initial 9 weeks I was actually injecting 200mg weekly thanks to the EOD schedule. I intend to bring this up to my doctor based on my notes below and since I was just an idiot who read their instructions wrong.
I didn’t really notice anything except for high libido and better erection quality until about the 6th or 7th week, around 12/25/2019-1/1/2020. From there, I started feeling several of the more proclaimed effects of TRT such as higher energy, better mental acuity, and an overall increased sense of well being.These effects continued to increase in a positive way including increased motivation and drive and maintained themselves at that state until roughly the end of January, or the 10/11th week. From the end of January until now (the 13th week), effects leveled off and then actually somewhat pulled back in the last 1.5-2 weeks.
I would say my original problem symptoms saw improvements by at least 30-40% overall until more recently when they started getting worse by a small amount, roughly 10-20%.
- Starting near the middle to end of January, I noticed a little bit of sensitivity around my left nipple. I don’t know how to describe it really except it’s a very subtle burning or throbbing maybe?
- I haven’t noticed any major changes in mood but there have been some days I just wake up feeling off. Again, I’m not sure how to describe it or if it’s even related to the medication, but there are just some days in the past 2 weeks especially where it’s like I woke up on the wrong side of the bed and can be irritable and grumpy.
- Despite taking HCG, testicles have become smaller, which kind of sucks since I naturally never really had large testicles. They will now recede quite a bit during sex and during orgasm and sink back down afterwards, but overall the testicles and scrotum have gotten smaller/tighter.
- The last 3-4 weeks my appetite has been all over the place. I have had a few nights where I jokingly said I must have synced up with my roommates periods because I was craving boatloads of chocolate. Before this I didn’t really notice a terrible difference in eating habits.
- No other notable sides that I can think of.
Nipple sensitivity - given this symptom and my lab results showing pretty high E2 as well as prolactin, would this count as a good time to start dosing the Anastrozole twice a week? I’m naturally concerned about gyno as it seems my body is reacting poorly there. I’ve just been hesitant so far because I wasn’t fully confident in how to spot high E2 symptoms or if I’m just being a hypochondriac about my nipple.
Normal Testosterone, High Free Testosterone, High E2, and Low SHBG - Given all of these measurements from my labs, it sounds like I’m what I think you guys call a hyper-secretor. I hope that’s the right term. From everything I’ve read here, I think that means I may be better off either dosing more frequently, or lowering my dose so that I don’t have as much free testosterone floating around to turn into estrogen, or possibly just relying on dialing in my AI, Anastrozole, to keep my E2 levels in a better range.
Testosterone levels and symptoms - Although this is the first time in my adult life that I’ve gotten into a more normal range with my total testosterone, I’m still concerned that this number seems low despite the medication. Additionally, although I’ve seen nominal improvements in my symptoms, it’s not to the extent I’d hope for. Put simply, this is the first time I’ve ever found something that seems to actually be helping my symptoms of the last 10 years. However, I want it to help more than 30-40%. In my simple guy logic, that means take more testosterone and treat the low SHBG, high E2 sides with an appropriate amount of AI. Is that the right approach? Why or why not?
Dosing - Clearly, I think it’s safe to assume there is some correlation between my dosing schedule and symptoms. It seems that when I was accidentally dosing EOD, or 200mg/week, I saw better and more consistent improvements of my symptoms. That being said, since it seems I am a hyper-secretor, doesn’t that mean that a higher dose of test, despite more frequent dosing, could lead to more free test floating around able to be bound up as estrogen? Forgive my ignorance, but that’s my understanding so far. Could that not simply be countered by an AI in minimal required dosage? Also, I’m aware that I may have been riding a honeymoon period for those first 9-10 weeks, so I’m not ruling that out completely.
I’m 30, 6’4", 215lbs, 27% bodyfat as measured by DEXA scans (lost 3% since starting). Moderately active in gym, bicycling, and hiking, and slowly increasing the frequency of those activities. Generally eat a balanced diet, but consume 12-18 drinks of alchohol, mainly beer, per week. Supplement fish oil, vitamin D, niacin, and ZMA. Also take Wellbutrin and Gabapentin for depression, anxiety, and nerve pain, although they’ve obviously never done much for the depression, hence why I tried TRT.
I look forward to hearing your thoughts and I appreciate your time and help on this!