T Nation

Androgel Over 1 Yr, Going to Shots

T Replacement
#1

so my endocrinologist just told me in 2 weeks I have to have the nurse teach me to inject myself with test. I have been on androgel for over a year but my levels are still low according to recent labs. this is all covered by my insurance company thank goodness. im not sure exactly what dose he is prescribing, but I know its test cypionate.

I had gastric sleeve done in april this year and have gone from 472lbs to 302 today. I have loose skin and lost a lot of strength. I am looking to add muscle and gain some strength back. before mr dr swithed my meds I talked to royal mens and they suggested the test and added hgh. I need opinions on the best way to get to the goal of gaining muscle. any help is appreciated!

#2

You need to make sure that you eat some protein rich foods.

Please read these stickies:

  • advice for new guys — note first paragraph — provide more info about you
  • things that damage your hormones
  • protocol for injections

Labs:
TT
FT
E2
LH/FSH - must be done before TRT
prolactin if -35 YO
PSA if +40
fasting glucose
A1C
fasting cholesterol
CBC
hematocrit
CRP
homocysteine if high blood pressure or other CV risks
AM cortisol
Vit-D25
IGF-1 to eval GH status
TSH
fT3
fT4 [please not T3, T4]

Inability to absorb transdermal T is a symptom of low thyroid function.
You can eval your overall thyroid function by checking oral body temperatures:

  • when you first wake up, should be 97.7-98.8, higher is OK, 97.3 is a problem
  • also check for 98.6 mid-afternoon
    Thyroid function can be from not using iodized salt and/or vitamins listing iodine+selenium
    If body temps are low, read the thyroid basics sticky.

Your protocol should be:
50mg T cyp twice a week
0.5mg anastrozole at time of injection
250iu hCG SC EOD to preserver testes
You can inject T with #29 1/2" 0.5ml insulin syringes. Get ReLion house brand at Sam’s or Walmart for ~14 per 100.
Inject hCG with #31 5/16" 0.5ml [ReLion]

Do not accept injections at doctor’s office, you need to self inject frequently. Injecting every two weeks is bad and so is once a week.
E2 management can be mission critical.

#3

I will read up right now. thyroid is acting up some. I am 41. was severely obese at 472lbs before gastric sleeve. doing great now, all labs were normal except test being low. I will post the lab numbers shortly. injections will be done at home as my wife is a nurse…

#4

[quote]brianbgboy wrote:
I need opinions on the best way to get to the goal of gaining muscle. any help is appreciated![/quote]

Then take a look at the hundreds (or thousands) of nutrition and exercise articles on this site.

#5

I am 41. 6’6" light moustache and goatee. thinning hairline. was severly obese until gastric sleeve. lost 170 lbs so far and currently 302lbs. most of my weight was in my midsection. I feel great, just get tired kind of fast. libido has increased since androgel, and test numbers have increased from 280 to 315, so dr. recommended injections. of the results of labs, here they are…

tt=315
ft=40.6
lymph=37.0
psa=2.0
fasting glucose=91
fasting cholesterol=139
wbc=3.85
rbc=4.52
platelets=128
hematocrit=40.3
vit d-25=27
tsh=0.891
morning oral temp=97.5

#6

Hematocrit is quite low. Need to watch that this increases with TRT. We see low hematocrit with GI problems with GI bleeds that can be detected with an occult blood test [poop smear on a test card]. Any digestive problems or food sensitivities?

Cholesterol is to low. Cholesterol is the foundation of all of your steroid hormones, including cortisol and Vit-D.
Are you using statin drugs? Eat some cholesterol rich foods and more fats.

Vit-D25 is low. Suggest 5,000iu per day. Take 25,000iu for first 5 days. Do not take this or other oil type supplements with high fiber foods.

Please see [edit] in lower FH corner of your above post and add lab ranges to lab data.

TSH looks great. Please get those oral body temperatures.

Insurance company will vigorously oppose GH unless really low via IGF-1

Please explain: "thyroid is acting up some"
Are you using iodized salt?

#7

on the vitamin d, the dr evidentally called in a prescription for it @50,000iu daily for 10 days and then 5000 per day after. I just got the email from my pharmacy sayint it was ready for pickup. what I meant on the thyroid acting up was because based on the dr.examination, my hair loss was worse, fatigued, dry skin on face and in my ears and I have been getting cold easily which is not like me because I love the cold. the low cholesterol is coming from the bariatric diet I was on for the last 6 months. I have started back eating more whole food and fats but I am having to ease into it as my digestive system is fighting it from only having liquids and mushy type food for so long. like I said, I have lost 170 lbs and feel great, but not where id like to be. I will add the other labs in the original post when I get them. thank you so much!

#8

i have been incorporating iodized salt back in my diet for the last few weeks as well.

#9

Hematocrit is quite low. Need to watch that this increases with TRT. We see low hematocrit with GI problems with GI bleeds that can be detected with an occult blood test [poop smear on a test card]. Any digestive problems or food sensitivities?

Please see [edit] in lower FH corner of your above post and add lab ranges to lab data.

Please get those oral body temperatures.