T Nation

Considering Stopping TRT After 1 Year

30 year old male, been on 100mg of test cyp injected twice a week. Also taking HCG 250IU once a week.

My levels prior to TRT were low 300s and had all the symptoms…I have since felt slightly better but not much. Nice increase in strength ( i train 6 days a week, great diet etc)

My issue now is kids are around the corner having just got married although i kept this in mind with running HCG while on T. My main issue is my horrible body acne that has developed from the T. This may be due to high E2 at 54? I have been taking minocycline no results also taking DIM plus, no results. I cant take the boils on my chest and back anymore and doc wont prescribe anything else but T.

What should i take to stop the acne or should come off the T?

here are my levels i just got done:
TESTS RESULT FLAG UNITS REFERENCE INTERVAL LAB
CBC With Differential/Platelet
WBC 8.0 x10E3/uL 3.4 - 10.8 01
RBC 4.90 x10E6/uL 4.14 - 5.80 01
Hemoglobin 15.4 g/dL 13.0 - 17.7 01
Hematocrit 44.9 % 37.5 - 51.0 01
MCV 92 fL 79 - 97 01
MCH 31.4 pg 26.6 - 33.0 01
MCHC 34.3 g/dL 31.5 - 35.7 01
RDW 12.8 % 12.3 - 15.4 01
Platelets 234 x10E3/uL 150 - 379 01
Neutrophils 57 % Not Estab. 01
Lymphs 33 % Not Estab. 01
Monocytes 8 % Not Estab. 01
Eos 2 % Not Estab. 01
Basos 0 % Not Estab. 01
Neutrophils (Absolute) 4.6 x10E3/uL 1.4 - 7.0 01
Lymphs (Absolute) 2.7 x10E3/uL 0.7 - 3.1 01
Monocytes(Absolute) 0.6 x10E3/uL 0.1 - 0.9 01
Eos (Absolute) 0.2 x10E3/uL 0.0 - 0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 01
Immature Granulocytes 0 % Not Estab. 01
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1 01
Basic Metabolic Panel (8)
Glucose, Serum 85 mg/dL 65 - 99 01
BUN 16 mg/dL 6 - 20 01
Creatinine, Serum 0.92 mg/dL 0.76 - 1.27 01
eGFR If NonAfricn Am 112 mL/min/1.73 >59
eGFR If Africn Am 129 mL/min/1.73 >59
BUN/Creatinine Ratio 17 9 - 20
Sodium, Serum 141 mmol/L 134 - 144 01
Potassium, Serum 4.3 mmol/L 3.5 - 5.2 01
Chloride, Serum 96 mmol/L 96 - 106 01
Carbon Dioxide, Total 29 mmol/L 18 - 29 01
Calcium, Serum 9.7 mg/dL 8.7 - 10.2 01
Hepatic Function Panel (7)
Protein, Total, Serum 7.3 g/dL 6.0 - 8.5 01
Albumin, Serum 4.7 g/dL 3.5 - 5.5 01
Bilirubin, Total 0.4 mg/dL 0.0 - 1.2 01
Bilirubin, Direct 0.11 mg/dL 0.00 - 0.40 01
Alkaline Phosphatase, S 48 IU/L 39 - 117 01
AST (SGOT) 37 IU/L 0 - 40 01
ALT (SGPT) 37 IU/L 0 - 44 01
Testosterone, Serum 1260 High ng/dL 264 - 916 01
Adult male reference interval is based on a population of
healthy nonobese males (BMI <30) between 19 and 39 years old.
Travison, et.al. JCEM 2017,102;1161-1173. PMID: 28324103.
Estradiol 54.7 High pg/mL 7.6 - 42.6 01
Roche ECLIA methodology
Testosterone, Free, Direct
Free Testosterone(Direct) 30.5 High pg/mL 9.3 - 26.5 01

Please do TRT as suggested above before you give up. Your TRT is not been properly managed.

You need a new doctor and there is a sticky for that. Most doctors are clueless and dangerous.

You might find liquid anastrozole on the internet, depending on where you are located. This is preferred for find dose adjustment over Rx pills that have limited pill splitting options. Some dissolve pills in vodka 1mg/ml and dispense by volume or by the drop.

You should be trying to get near E2=22pg/ml and you will need anastrozole to do that.

Suggest:

  • inject 50mg T, subq not IM, twice a week
  • 0.5mg Arimidex/anastrozole at time of injections
  • 250iu hCG SC EOD - a proper LH replacement dose

E2 management is mission critical and high E2 can:

  • cause gyno
  • lower energy
  • cause intolerance and general bitchiness
  • contribute to acne
  • promote prostrate problems
  • contribute to endothelial dysfunction - aka heart diseases
  • lowers libido, sensations and sexual performance
  • caused adverse fat patterns
  • increases SHBG

A few guys have hCG promote high E2 levels from high testicular T–>E2. We can only surmise this after changes and more lab work.

hCG once a week is not good enough to protect fertility and testicular form and function.

Please also test SHBG. With high E2 your FT:E2 does not seem to reflect expected increase in SHBG and SHBG might be low.

This should not be forever: https://en.wikipedia.org/wiki/Minocycline#Side_effects

Age=30
Height
Weight
Waist size

Please post: - if available
fasting glucose
fasting cholesterol
A1C
pre TRT LH/FSH

Labs needed:

  • prolactin - pre TRT results will do

E2 that high might reflect impaired E2 liver clearance.

You can inject T subq with #29 1/2" 0.5ml insulin syringes. Do not use 1.0 ml. Slow to fill but injection time is decent. Try belly fat and over upper legs.

You need steady T levels, once a week is a high peak then it drops. Your lab results are then mostly determined by lab timing. Anastrozole needs to match serum T levels, so it needs steady T levels and so does your brain and skin [acne].

Most guys here have some thyroid problems, often from not using iodized salt --> thyroid deficiency. Please see "oral body temperatures below and report your AM and mid-afternoon body temperatures.


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 numbers 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.

Why is that, fellahs? Personally, I use a 25 gauge 5/8 inch with a 1 mil, subQ into belly. What are the disadvantages to a 1 mil?

Your doctor has no idea what he’s doing and is afraid to do anything other than what he was trained to do which is nothing, they don’t teach male hormones in med school or residency.

Most doctors are too damn lazy to even attempt to figure it out and do a little research, so they do nothing and offer no solution. You need to find a doctor that became what he is out of passion, one that wakes up in the morning to get people healthy again or maybe he himself is on TRT and living proof that it works.

With #25 no problem. With #29 you need high pressure to inject the T and the larger plunger of 1.0ml lowers pressure. Simple hydraulics.

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Nice hammer on nail!

Also, get the correct E2 test before you make any adjustments or take arimidex. You risk crashing your E2 and being in the 5th ring of hell. I know. I’ve been there. I’ve got a little shack in the 5th ring of hell I lived in for a while. Don’t visit. Get the E2 Sensitive test and adjust your T dose DOWN from there. Your way to high on Total and Free. Get your bloodwork keyed in. Train right and eat clean. Your body will make the appropriate adjustments itself from there. Btw, if you haven’t already… Get a body wash with salysilic acid for the acne.

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Actually, most doctors work exceedingly long hours to pay bills. The bills they have to pay include huge student loans, rent, malpractice insurance, billers, clerks to deal with excessive paperwork caused by federal regulations and third party payers, to name a few.

I have several friends that are MD’s, and none of them could be categorized as lazy. I realize this is anecdotal, but I think calling them lazy is a disservice and inaccurate.

Just one man’s opinion.

They are part of a broken system and are complicit in it, true that are a lot of intelligent doctors being turned into lab chasing robots and their critical thinking and reasoning are being overridden by a broken system, they have a choice and those leaving the sick care model are waking up and have my utmost respect.

Not really concerned with the healthcare system or needle sizes I’m well aware. I’m on the brink of ending TRT due to acne and fertility unless someone has some solid advise on what I need to add to my regimen to help.

I’d stay on hCG but go to EOD protocol as stated above. Drop test for now. Get follow-up labs after a couple of months to see where your numbers are and have time to see how you respond regarding the acne. Maybe consider semen analysis also.

You need to lower your dosage, you are not alone in that most men will have the issues you are having in those ranges without an AI. There aren’t many men who can handle 200mg weekly, inject 50mg twice weekly as this should get you to well above midranges. Maintain HCG dosing and monitor E2 levels 4-6 weeks after the change in protocol.

Don’t give up on TRT just yet, I’ll bet you find yourself feeling even better than before.