T Nation

About to Start T Cyp Injections - Would Like Second Opinion


#1

Hi Everyone,
This forum has played such an important role informing me on my TRT journey. I’m about to begin T Cyp injections (more below) after a failed Clomid regimen, under the direction of a very well known Dr but before I do that I’d like some second opinions. I’m a bit bothered that the cause of my relatively low LH/FSH is unknown. Also confused if I’m primary or secondary (since the testes didn’t have much response to the increased LH/FSH from the Clomid).

Slightly concerned that the low LH could indicate pituitary issues (growth, etc), though the Prolactin from May didn’t raise any flags.

-age
37
-height
6’3"
-waist
40
-weight
255
-describe body and facial hair
Fine body hair, patchy facial hair (can do goatee but not beard)
-describe where you carry fat and how changed
stomach (gut) upper arms, love handles. Hasn’t changed.
-health conditions, symptoms [history]
Hypertension, depression, gout (all treated)

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
Valsartan 160mg/day (Hypertension), Prozac 10 mg EOD (mild depression) - note have been on some form of SSRI for 25 years), Allopurinol 300mg/day (Gout). No hair loss/prostate drugs.

-lab results with ranges

First test 5/15/17 Non Fasting PM:
T - 268 (250-1100)
FT - 57 (35-155)
Prolactin (don’t recall but know 100% was low normal).
PSA - .9 (< or = 4)

Second Test (still no treatment, just new dr) 6/2/17 Fasting AM
Glucose - 94
AST - 18
ALT - 22
Total T - 334 (250-1100)
FT - 68.8 (35-155)
TSH - 2.16 (.4-4.5)
Hemoglobin - 14.4 (13.2-17.1)
Hematocrit - 41.3 (38.5-50)
DHEA -S - 308 (106-464)
LH - 3.4 (1.5-9.3)
SHBG - 12 (10-50)
E2 Sensitive - 22 (< or = 29)

Third Test (after 8 weeks clomid 12.5mg ED) - Fasting AM
T - 367 (250-1100)
FT - 89.5 (35.0-155)
LH - 5.5 (1.5-9.3)
FSH - 5.4 (1.6-8.0)
E2 Sensitive - 40 (< or = 29)
A1C - 4.9 (<5.7)
Insulin serum - 5.7 (2-19.6)

-describe diet [some create substantial damage with starvation diets]
Effective June, Low carb, high protein, high fat. Before and after June, heavy use of alcohol (30+ drinks per week mostly spirits…just being honest here). Trying to lose weight but even watching all macros, working out and reducing alcohol doesn’t help me lose any fat or weight.

-describe training [some ruin there hormones by over training]
Stronglifts 5x5 3x per week starting in June

-testes ache, ever, with a fever?
No
-how have morning wood and nocturnal erections changed
Since Fall 2016 increasingly low libido, less morning wood (though that was fairly infrequent anyway).

Recommended regimen (to begin next week) will be:
48mg T Cyp, MWF
250 IU HCG, MWF
.125 mg Anastrozole, MWF

Thanks for any insights, opinions, etc.


#2

Blood is a bit thin for your T levels.
Any food allergies or digestive issues?

Your anastrozole dose would be way to little for most guys on that T dose, but OK for those that are anastrozole over-responders. Please commit doc to testing E2 after 2 weeks.

Your meds may be partly to blame.

TSH=2.16 is too high. Should be closer to 1.0
This can be from not using iodized salt and/or vitamins listing 150mcg iodine. Please eval further via oral body temps as suggested below.
Low thyroid function slows done every cell and organ in your body.
Thyroid lab ranges are mostly useless so docs do nothing…

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.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.