T Nation

First Labs Since Beginning T-Cyp

T Replacement
#1

Background:

  • Began TRT in 2008 at 28 years old. Symptoms were brain fogginess, low energy, terrible sleep, ED, and no zest for life. Doctor ordered multiple testosterone tests and my numbers usually came back between the 200 - 300 range.

  • Tried a clomid restart and failed, had an MRI of the pituitary, and had a full range of blood tests for thyroids and everything else. Everything came back within normal range other than Test, LH, and FSH. They were all low.

  • My endo started me on a HCG only regiment. While on the HCG only my body responded great to a very low dose of HCG (only 180 IU) and this brought my TT up to the mid 500 range. Coming from where I started (200-250 range) it made a world of difference.

  • Continued on the HCG only (180 IU) regiment for almost 2 full years before all my original symptoms returned (brain fogginess, zero energy, low libido, ED, etc). Got more blood tests done (got lazy with testing regularly since labs always came back fine for the previous 1.5 years) and my TT was back down to pre-HCG totals of 226. Tried doubling the HCG dose to 360 IU to see if more would help and all that did was raise my Estradiol while having little-to-no effect on my T (that went up to 306).

  • After all the above we began T-cyp shots (100mg weekly) with 250 IU shots of HCG on the 5th and 6th days of the week.

  • Age 31

  • Weight 215 (16% bodyfat)

  • Waist 34

  • Carry fat very evenly (lucky), but if I had to pick I’d say love handles and butt.

  • No other medication issues or allergies.

  • No statin drugs

  • No other drugs. Just caffeine-having pre workout supplements that I’ve been taking for years with no problems, multivitamins, and fish oil.

  • BP has always been fine

  • I lift weights 5 days per week and normally do 3-4 cardio sessions per week. Most times cardio is post weights but sometimes I will do it on its own day.

These labs were taken two days after my 3rd T-cyp shot of 100mg:

TT - 806 (241 - 827)

Estradiol - 54 (< 54)

Free T - 205.2 (35 - 155)

SHBG - 17 (8 - 48)

Pregnenolone - 10 (13 - 208)

Pregnenolone is a precursor to pretty much all hormones and it was low prior to starting T-cyp. We wanted to do 3 weeks of shots and have it rechecked before deciding if we were going to begin supplementing it. I am going to begin taking exogenus Pregnenlone as of today.

I feel great compared to before. All symptoms have improved and I’m waking up with morning wood a few times per week. I haven’t had that happen in 13 years or so.

Should I be worried about Estradiol of 54 since that is the exact high-point of normal? And is it strange that my Free T is so high off the chart since my SHBG and E2 are within range?

Sorry for the length of this post but hoping a few of you can offer your opinions. Thanks in advance.

#2

Read the stickies, if you haven’t already. Recommended dosing for T injections is every other day (EOD) or every third day (E3D). For E3D, 100mg/wk is about 40mg E3D (43mg/E3D = 100mg/wk avg). For EOD, 100mg/wk is about 30mg EOD (28.666~/EOD = 100mg/wk avg). This will keep you at a more even level of T, rather than giving you a huge boost at the beginning of the week with a major ‘trough’ at the end of the week, during which you’ll feel like crap.

Why did your doc have you do tests only two days after a shot? If you’re doing it weekly, it seems to make more sense to check TT near the end of the week. This also explains why your FT is out of range - the 100mg shot gave you a massive boost that will last for part of the week, then taper off and likely leave you hypo by the time your next shot is scheduled.

E2 is definitely high. “Carry fat very evenly (lucky), but if I had to pick I’d say love handles and butt.” This may be related to E2, actually; high estrogen levels cause fat to be distributed in a more feminine manner (evenly, as opposed to in your gut, with concentration in thighs/butt and possibly breasts).

“I feel great compared to before. All symptoms have improved and I’m waking up with morning wood a few times per week. I haven’t had that happen in 13 years or so.” This is probably most important. If you’re feeling good, it may be a risk to change too much. Bringing E2 down (target=22) and increasing frequency of injections are probably safe to do, though.

#3

Thanks Akaji,

I didn’t want to add all of this in the original post as it would be that much more to read and it was a lot to begin with, but I have read all the stickies and made some changes since that last test.

I began doing two shots per week after that test. My doc prescribed me to do 100mg per week, for 3 weeks, and then get the first blood test 48 hours after the 3rd shot. I already had it in my mind before the blood test that I was going to switch to two shots per week, but I wanted to do what he said for this first test so when he received the results they were what he wanted to see.

I have been doing two shots per week the past two weeks and still feel good. When I was doing the one shot per week I was doing the 100mg as prescribed. Since I began doing the two shots per week I upped it to 60mg per shot rather than the exact half of 50mg per week. So now I’m doing 120mg per week in two shots rather than 100mg in one shot.

Based off the numbers above, what would be your guess as to what this is doing to my numbers? I understand it would just be an educated guess. I’m assuming my T numbers are not getting as high (probably more like 600 rather than 800) but I’m hoping that it has cut my Estradiol in half or so as well (hopefully from 54 to somewhere closer to 30).

Is this a safe guess? Or is that just not how it works? My next blood test won’t be for another 1-2 weeks.

#4

You could increase frequency of shots which may help lower e2. The e2 test they did is invalid. Dr needs to do lab corp or quest senstive not the rapid. Your e2 levels may be fine, but false elevated in this test as I have seen many time. Dr needs to examine thyroid and adrenals through proper testing (refer to stickies). Since being on T your DHEA may lower which Dr should investigate. You still need to have a balanced nutritional basis, lifestyle, and mind set.

#5

While more frequent/smaller injections may keep E2 levels more normal, it’s still worth consideration. They may fluctuate less, but they might also be staying in the 45-60 range. I recommend having an E2 test done immediately before an injection to check - if your E2 levels are high then, it means that they’re high all the time, and you will want to advocate with your doc about getting on an AI.

Are you doing E3D, or are you doing exactly twice a week (e.g. Sunday morning and Wednesday night)? Is there a reason you’re doing 120mg/wk rather than 100mg/wk? The only labs you’ve posted are from shortly after a 100mg injection, but they show very good TT/high FT levels; 50mg twice/weekly may keep you in a reasonable range, so I’m not sure what your reasoning is for upping the dosage. This could also get you in trouble with your doc, as you may need a refill on your prescription earlier than expected (leading to concerns about abuse).

I strongly recommend sticking to 100mg a week for now, and talking to your doc if you don’t feel as good as you want to (or as good as you felt on average on 100mg/wk. - by ‘on average’, I mean how you felt on the middle 2 or 3 days, as the days on either end of getting the shot/approaching the next shot are going to be artificially high/low points).

#6

Yeah E2 seems pretty high optimal is at 22 - I’m having E related issues with an E2 of 35 but of course everyone is different and my weekly dosage is 200mg of T which puts me in the 800s. I’ve switched to EOD injections and added an AI. Might something to look into

#7

[quote]Hardasnails wrote:
You could increase frequency of shots which may help lower e2. The e2 test they did is invalid. Dr needs to do lab corp or quest senstive not the rapid. Your e2 levels may be fine, but false elevated in this test as I have seen many time. Dr needs to examine thyroid and adrenals through proper testing (refer to stickies). Since being on T your DHEA may lower which Dr should investigate. You still need to have a balanced nutritional basis, lifestyle, and mind set. [/quote]
My current tests are set up for Total Test, E2, Free Test, SHBG, and Pregnenolone. Are you saying I should immediately start testing for DHEA as well?

If so I can get that added that to the prescription.

#8

[quote]Akaji wrote:
While more frequent/smaller injections may keep E2 levels more normal, it’s still worth consideration. They may fluctuate less, but they might also be staying in the 45-60 range. I recommend having an E2 test done immediately before an injection to check - if your E2 levels are high then, it means that they’re high all the time, and you will want to advocate with your doc about getting on an AI.

Are you doing E3D, or are you doing exactly twice a week (e.g. Sunday morning and Wednesday night)? Is there a reason you’re doing 120mg/wk rather than 100mg/wk? The only labs you’ve posted are from shortly after a 100mg injection, but they show very good TT/high FT levels; 50mg twice/weekly may keep you in a reasonable range, so I’m not sure what your reasoning is for upping the dosage. This could also get you in trouble with your doc, as you may need a refill on your prescription earlier than expected (leading to concerns about abuse).

I strongly recommend sticking to 100mg a week for now, and talking to your doc if you don’t feel as good as you want to (or as good as you felt on average on 100mg/wk. - by ‘on average’, I mean how you felt on the middle 2 or 3 days, as the days on either end of getting the shot/approaching the next shot are going to be artificially high/low points).[/quote]
I’m currently doing my first shot on Wed, my second Cyp shot on Saturday, and my HCG on the Monday and Tuesday prior to the Wed shot. I usually do both the Wed shot and the Saturday shot in the morning. So there is 3 days between the first shot (Wed, Thurs, Fri) and 4 days between the next (Sat, Sun, Mon, Tues).

As for why I upped it a bit when I broke it in half is two reason: 1. Because the doc said I don’t have to do exactly 100mg every week. He said, “If you go a little above the 100mg and think you feel better because of it then it isn’t the end of the world. Just don’t go doubling the dose or anything crazy. Pay attention to how you feel. Too much is just as bad as not enough.” And 2. When I was on just the HCG shots, my dose was way too high in the beginning and my E2 went real high (like 88 or something like that) and I knew it. My nipples began feeling tingly and itchy, etc. So it was a physical sign I was feeling that my dose was too high. With the 100mg I was feeling good and did not have that feeling at all which told me that my E2 was probably not out of control so increasing the dose slightly was something I could probably safely do.

And as for why I got the test 48 hours after the shot, that is when I was advised to get it as he told me that 2 days after the shot is when Test and E2 would peek so we’d be checking each at it’s highest point. Is that something the board disagrees with? I don’t remember reading something different in the stickies but of course I could just not be remembering it.

Thanks in advance.

#9

[quote]Jax26 wrote:
Yeah E2 seems pretty high optimal is at 22 - I’m having E related issues with an E2 of 35 but of course everyone is different and my weekly dosage is 200mg of T which puts me in the 800s. I’ve switched to EOD injections and added an AI. Might something to look into[/quote]
What are the issues you’re having if you don’t mind me asking? In the past when I was on just HCG and my dose was too high my E2 shot up to close to 90 and I could feel something was weird. First sign indicator was my nipples were tingling and itchy. One google search will tell you that is a tell-tale sign of your estrodial being too high. At 54 though right now, I don’t feel anything like that.

Is there something else I should be looking out for?

#10

It sounds fine to up it, then - your doctor is aware, which is what’s important.

Personally, I don’t see a point in testing the highest point of T. That tells you where you’re going to get up to, but it doesn’t tell you how quickly your body is going to be getting rid of it. It seems to make more sense to me to test closer to the end of the cycle to see what level your T is getting down to. If you peak at 800 but valley at 300, you’re going to be feeling ecstatic for part of the week then absolutely horrible for the last part of the week. Regardless, it is still ultimately up to how you feel, and it sounds like twice a week is working great for you. “If it ain’t broken, don’t fix it!”

If you’re feeling good where you’re at, I wouldn’t worry about changing anything up. Even if E2 is high by the ideal=18-30 standard, everyone is different. If you start noticing E2-related side effects, look into it, but for now it sounds like you should stay where you’re at.

#11

[quote]Akaji wrote:
It sounds fine to up it, then - your doctor is aware, which is what’s important.

Personally, I don’t see a point in testing the highest point of T. That tells you where you’re going to get up to, but it doesn’t tell you how quickly your body is going to be getting rid of it. It seems to make more sense to me to test closer to the end of the cycle to see what level your T is getting down to. If you peak at 800 but valley at 300, you’re going to be feeling ecstatic for part of the week then absolutely horrible for the last part of the week. Regardless, it is still ultimately up to how you feel, and it sounds like twice a week is working great for you. “If it ain’t broken, don’t fix it!”

If you’re feeling good where you’re at, I wouldn’t worry about changing anything up. Even if E2 is high by the ideal=18-30 standard, everyone is different. If you start noticing E2-related side effects, look into it, but for now it sounds like you should stay where you’re at.[/quote]
Thanks for all the thoughts and time. You mention that you don’t see the point in testing the T at it’s highest point since you’re more concerned with where it is valleying, but I think what the doc is mainly after is keeping the E2 under control. I told him my biggest fear was getting “b1tch t1ts” and he said as long as we keep E2 under control it isn’t a concern. So that 54 score I got on E2 probably represents my E2 at it’s highest point (as long as everyone agrees that my Doc is right in saying it is at it’s peak two days after the injection).

The twice weekly injections have already fixed the problem of feeling great early in the week and crappy later in the week. I guess the only thing to really do is get another test in another week or two and see where the numbers are at.

Thanks again.

#12

Ah, that’s a good way of thinking about it, and it makes sense. Your doc sounds smart. I don’t suppose he happens to be in the Minneapolis, MN area? Not having much luck with docs, myself… also, LOL @ bitch tits.

Peak at ~two days after injection sounds about right, or close enough that it doesn’t matter.

Good luck!

#13

[quote]Akaji wrote:
Ah, that’s a good way of thinking about it, and it makes sense. Your doc sounds smart. I don’t suppose he happens to be in the Minneapolis, MN area? Not having much luck with docs, myself… also, LOL @ bitch tits.

Peak at ~two days after injection sounds about right, or close enough that it doesn’t matter.

Good luck![/quote]
Thanks. He is in Pennsylvania and I drive 2.5 hours from NJ once per year to see him. From there I can do a phone consultation with him at any other time throughout the year for $150. Wish I could find someone as good nearby but I couldn’t.

#14

do you mind posting your other test results?

doctors/labs idea of “normal” is usually far from it. I.E. - TSH labs range says .5 to 5.0 is normal, but we know that anyone with TSH > 1 has a possible problem, and > 3 equals a serious problem.

#15

[quote]PureChance wrote:
do you mind posting your other test results?

doctors/labs idea of “normal” is usually far from it. I.E. - TSH labs range says .5 to 5.0 is normal, but we know that anyone with TSH > 1 has a possible problem, and > 3 equals a serious problem.[/quote]
Sure, but this is the only test I’ve had since starting the T-cyp shots. All my other tests are from 2008 before starting any HRT (full hormone and thyroid test, test and estradiol test, etc.) or from 2009 and 2010 after starting HCG only (these tests are only Total Test and Estradiol).

Let me know if any of those would be of interest. And if so, anything particular as for example, the full hormone and thyroid test is a few pages long.

#16

some key results (like TSH) would be nice so that we can deteremine what your doctor considered “normal”.

HRT programs cn cause feedback issues with Cortisol and Thyroid. You should always continue monitoring your Cortisol and Thyroid levels while on HRT. i.e. T downregulates cortisol. too much T causes issues with your body needing more Cortisol - if your body can’t produce more then your thyroid might start producing more Reverse T3 to slow your overall metabolism down - and so on.

#17

[quote]PureChance wrote:
some key results (like TSH) would be nice so that we can deteremine what your doctor considered “normal”.

HRT programs cn cause feedback issues with Cortisol and Thyroid. You should always continue monitoring your Cortisol and Thyroid levels while on HRT. i.e. T downregulates cortisol. too much T causes issues with your body needing more Cortisol - if your body can’t produce more then your thyroid might start producing more Reverse T3 to slow your overall metabolism down - and so on.[/quote]
These tests are from 2008.

My TSH was 0.967 and two months later 1.355 (0.350 - 5.500)

Here is the 2 month separate scores of all other things in and around that area of the test:

Thyroxine (T4) - 7.5 then 6.6 (4.5 - 12.0)

T3 Uptake - 33 then 32 (24 - 39)

Free Thyroxine Index - 2.5 then 2.1 (1.2 - 4.9)

Total Test - 348 then 232 (241 - 827)

Free Test - 11 then 7.8 (9.3 - 26.5)

Thyroxine (T4) Free - 1.07 then 1.11 (0.61 - 1.76)

Estradiol - only test two 10 (0 - 53)

Prolactin - 8 then 5.7 (2.1 - 17.7)

LH - 1.1 then 2.4 (1.5 - 9.3)

FSH - 0.4 then 3.0 (1.4 - 18.1)

#18

[quote]Mman wrote:

[quote]Hardasnails wrote:
You could increase frequency of shots which may help lower e2. The e2 test they did is invalid. Dr needs to do lab corp or quest senstive not the rapid. Your e2 levels may be fine, but false elevated in this test as I have seen many time. Dr needs to examine thyroid and adrenals through proper testing (refer to stickies). Since being on T your DHEA may lower which Dr should investigate. You still need to have a balanced nutritional basis, lifestyle, and mind set. [/quote]
My current tests are set up for Total Test, E2, Free Test, SHBG, and Pregnenolone. Are you saying I should immediately start testing for DHEA as well?

If so I can get that added that to the prescription.[/quote]
Dhea can drop in little as 6-12 weeks on TRT.

#19

[quote]Hardasnails wrote:

[quote]Mman wrote:

[quote]Hardasnails wrote:
You could increase frequency of shots which may help lower e2. The e2 test they did is invalid. Dr needs to do lab corp or quest senstive not the rapid. Your e2 levels may be fine, but false elevated in this test as I have seen many time. Dr needs to examine thyroid and adrenals through proper testing (refer to stickies). Since being on T your DHEA may lower which Dr should investigate. You still need to have a balanced nutritional basis, lifestyle, and mind set. [/quote]
My current tests are set up for Total Test, E2, Free Test, SHBG, and Pregnenolone. Are you saying I should immediately start testing for DHEA as well?

If so I can get that added that to the prescription.[/quote]
Dhea can drop in little as 6-12 weeks on TRT.[/quote]
Thanks, bro. I’ll have it added. I’ve been on TRT now for 6 weeks.

The only time I see my DHEA was tested was 2008 before I started any type of HRT:

DHEA Sulfate - 166 (110 - 510)

So it was on the low side to begin with even before any type of HRT/TRT. I’ll definitely have it added to my next round of tests. Thanks.

#20

Do not test DHEA, test DHEA-S