T Nation

Flatdanny’s TRT Log

Okay I finally decided to create a TRT log to keep track of my progress… Should have done this from the start rather than creating more topics. Its become quite confusing with all the info spread around different topics. So I wanted to tidy things up and have just one topic to keep track of my ongoing TRT journey.

Quick notes:

  1. I am self medicating. Though I managed to get a prescription in the UK for Sustanon and also HCG.
  2. I was diagnosed with juvenile scleroderma back when I was 17.
  3. Undescended testicles till 4 years old when I had an operation to bring them down.
  4. Lived all my adult life with joint pain, low libido, and low immune system leading to me continually picking up bugs/viruses.
  5. Just found out I have had hepatitis b in the past.
  6. The last two or so years my health has gotten much worse with new symptoms which have made it very hard for me to function normally. Fatigue, severe brain fog, zero motivation etc. Running my company is next to impossible feeling like this. And the business is suffering big time.

Full bloods for reference further down page!

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Bloods…

Total Testosterone: (Range: 9.00 - 31.00 nmol/L)

03/aug/2016 = 15.9 nmol/L
24/oct/2017 = 16.0 nmol/L
20/dec/2017 = 13.9 nmol/L
15/jan/2018 = 11.1 nmol/L
6/march/2018 = 14.4 nmol/L
9/april /2018 = 13.4 nmol/L
21/may /2018 = >52 nmol/L
4/july/2018 = 40.3 nmol/L
28/aug/2018 = 42.4 nmol/L
19/sep/2018 = 31.7 nmol/L
19/dec/2018 = 28.3 nmol/L

Free Testosterone: (Range: 0.30 - 1.00 nmol/L)

24/oct/2017 = 0.357 nmol/L
15/jan/2018 = 0.241 nmol/L
9/april /2018 = 0.291 nmol/L
21/may/2018 = 1.69 nmol/L
4/july/2018 = 1.26 nmol/L
19/sep/2018 = 0.70 nmol/L
19/dec/2018 = 0.89 nmol/L

E2/Oestradiol: (Range: 0.00 - 191.99 pmol/L)

03/aug/2016 = 26.9 pmol/L
24/oct/2017 = 48.1 pmol/L
15/jan/2018 = 21.5 pmol/L
9/april/2018 = <18.4 pmol/L
9/may/2018 = 105 pmol/L
21/may/2018 = 100 pmol/L
13/june/2018 = 122 pmol/L
4/july/2018 = 168 pmol/L (*one week took 2x25mg Aromasin)
24/july/2018 = 94.4 pmol/L
28/aug/2018 = 104 pmol/L
26/sep/2018 = 75.6 pmol/L
31/oct/2018 = 57.8 pmol/L
19/dec/2018 = 113 pmol/L

SHBG: (Range: 16.00 - 55.00 nmol/L)

24/oct/2017 = 27.7 nmol/L
15/jan/2018 = 28.7 nmol/L
9/april/2018 = 25.2 nmol/L
21/may/2018 = 20.0 nmol/L
4/july/2018 = 19.6 nmol/L
19/sep/2018 = 37.0 nmol/L
19/dec/2018 = 18.0 nmol/L

Prolactin: (Range: 86.00 - 324.00 mIU/L)

24/oct/2017 = 164 mIU/L
20/dec/2017 = 319 mIU/L
15/jan/2018 = 208 mIU/L
19/dec/2018 = 111 mIU/L

Thyroid TSH: (Range: 0.27 - 4.20 mU/L)

03/aug/2016 = 2.48 mU/L
20/dec/2017 = 3.07 mU/L
15/jan/2018 = 4.20 mU/L *Note: Did iodine replenishment for 14 days prior to this test.
4/july/2018 = 2.37 mU/L
28/aug/2018 = 3.43 mU/L
19/sep/2018 = 2.43 mU/L. *Note: Took Levo/T4 50 mcg for five weeks. (Felt really shit)
19/dec/2018 = 1.76 mU/L

Thyroid Ft4: (Range: 12.00 - 22.00 pmol/L)

03/aug/2016 = 16.49 pmol/L
20/dec/2017 = 16.50 pmol/L
15/jan/2018 = 13.50 pmol/L *Note: Did iodine replenishment for 14 days prior to this test.
4/july/2018 = 15.8 pmol/L
28/aug/2018 = 17.6 pmol/L
19/sep/2018 = 21.0 pmol/L
19/12/2018 = 17.5 pmol/L

Thyroid Ft3: (Range: 3.10 - 6.80 pmol/L)

03/aug/2016 = 5.02 pmol/L
15/jan/2018 = 5.91 pmol/L *Note: Did iodine replenishment for 14 days prior to this test.
4/july/2018 = 5.45 pmol/L
28/aug/2018 = 4.95 pmol/L

Thyroid Rt3: (Range: 10.00 - 24.00 ng/dL)

15/jan/2018 = 15.00 ng/dL

Thyroid Rt3 Ratio: (Range: 15.01 - 75.00)

15/jan/2018 = 25.65

*Note re Rt3 Ratio: The rT3 ratio measures the level of reverse T3 in relation to free T3 in your blood. A low ratio indicates that the balance is favouring rT3, potentially leaving you with insufficient levels of active thyroid hormones in your cells. Some practitioners believe that a low ratio will lead to symptoms of hypothyroidism even when thyroid hormones are at normal levels.

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Updated Bloods - 01 January 2019
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Five months into TRT… How I’m feeling???

  1. First three months or so felt really sick. Generally felt like I had a nasty virus or flu. Joint pains, swollen glands, bad tinitus, chest pain, low pulse, pins and needles. So basically feeling like shite! Think this was my body reacting to the hormone changes and the silly high dose I put myself onto after thinking I’m a hyper mataboliser.
  2. I’ve been lowering my dose over the last five months and gradually the flu like symptoms went away.
  3. Unfortunately for the first four months I’ve not really felt any positives improvements in how I’ve been feeling. Most of the changes in how I’ve been feeling have been negative. These include - feeling very sleepy and fatigued, loss of penis sensitivity, back acne, still pretty low libido, brain fog and low motivation and I’ve been getting itchy/tingling sensation in the chest area. (E2 got too high I think)
  4. The last week I think there’s been a slight improvement because I’ve actaully managed to get some stuff done around the house and work. Though I am still getting bouts of feeling extremely sleepy.

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What I think is going on and why I think TRT has not been very successful so far…

  1. I put my body under too much stress ramping up my test dose way to quickly. It could not handle the change.
  2. Think I may well be a hyper metaboliser, looking at the first five weeks blood results. (Levels went down from pre TRT levels)
  3. I think my thyroid is struggling causing me issues and buggering my TRT.
  4. I was sure I had a low cortisol issue because of how exhausted I am especially in the morning. (Takes me 2-3 hours to get up and going) In the past I had quite low 8am cortisol but I just did the saliva test and my levels seemed fine.
  5. I will be testing aldosterone soon as I suspect that could be low. Also be testing for electrolyte imbalance. (24 hour urine test for both)

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Some questions I still have…

  1. Should I change from Sustanon to cypionate or enanthate? I am only using Sustanon because that’s what my GP will give me at the moment. I’m injecting EOD as I’m working from the shortest Ester which is the propionate.
  2. Should I do trial of thyroid meds? If so which is best to start. I have T3 and T4 to hand.
  3. Anything I can do/take to make my libido better? Only time I seem to feel like sex is if Ive had a few drinks. Maybe I should just become monk or something ):
  4. My blood sugar feels like it spikes up and down throughout the day even though blood sugar tests I’ve done in the past were normal. Anything else that could give me this feeling of extreme sleepiness?

Hi there Danny brother, Enanthate is not Available at all anymore on NHS far as i am aware it was once i believe in Lloyds, but now Unavailable in zero pharmacies nationwide" Correct me if i am Wrong though on that ok.

However a registered NHS Doctor can still order it from Europe for you. there is European Pharmacies who can process U.K subscriptions provided your doctor will give Signature of course & if the doctor is seeing you for Hormone treatment, then that isn’t a problem and then you can get on Enanthate.

Sorry to hear about your Health issues too, Hopefully you’re Hepatitis B is cleared up, and your Brain Fog disappeared, but i suffer the Days of Brain Fog too, I think Neurological stuff can take months or a while to heal up.

Decent Protocol you have going at moment. Personally i would choose Enanthate any day over Sustanon though really, why you ask? i would rather 1 single ester in my system, than 4 esters all Going off at different times & leaving different times but all depends how you feel on Sustanon too. Wishing you the best brother.

Thanks for the reply Danny…

Hope its okay to tag a few of the regulars here, so hopefully I can get some feedback on where I’m at with my TRT journey. Still really struggling to get dialled in and would very much appreciate some help/advice (;
@physioLojik @anon10230041 @anon10035199 @systemlord @NH_Watts

I’d say based on those TSH numbers alone you should be focused on your thyroid for a bit. Are you seeing an endo? Those numbers should be closer to 1 optimally.

Your thyroid status is incomplete without AM and mid-afternoon oral body temperatures. fT3 is good, if body temps are low we suspect elevated rT3. If body temps are good, no reason to test rT3.

How do u treat someone with good ft3 but high rt3?

Nice to hear from you btw.

I have been MIA for various reasons. Guilty as charged.

To reduce fT4–>rT3 you take T3 only to suppress TSH then the thyroid produces less T4 and T4 levels are lower and there is less fT3–>rT3. In case of full blown adrenal fatigue, see the sticky, the objective would be to get TSH very low and that would be part of changes of lifestyle to remove situational and medical sources of stress on the adrenals. Wilson’s book is the best guide to understanding. There is no quick fix.

You can probably reduce your dosage a bit more. Your total t and free t are above range.

If still libido issue. Could be serotonin , dopamine issues.

With good TRT status, thyroid function can make or break libido.

Thanks for the reply, very much appreciated.

I have suspected for some time there could be an issue with thyroid. Would explain why I’ve not responded so well the the TRT. I know my ft3 and ft4 numbers don’t look that bad but considering my symptoms and the low rt3 ratio was thinking there may well be an issue.

I’ve seen an NHS endo but that did not go well. So I’ve been going it alone.

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Good to have you back on the forums KSman :slightly_smiling_face:

I have checked temperatures AM and afternoons on and off over the last 5 months… Though not done for a month or so. AM temps never over 97.3 and afternoon temps not getting over 98.3. * rT3 and rT3 Ratio bloods results above.

I’ve been reducing dose and have been on 120mg a week for the last month. Not done any bloods apart from E2 for about four weeks. And I suspect total and free t have dropped a lot. I think my E2 is a lot lower too because I’m having a number of low sides. Joints are wrecked, pissing a lot and very fatigued. I really don’t like Sustanon because it seems to take ages for levels to level out once dose change. I’m switching enanthate I think.

I was actually thinking there might be a serotonin/melatonin imbalance. Zero libido and feel really sleepy throughout the day. I was convinced it was a cortisol issue but the recent saliva test I ran looked fine. I then thought it could be a blood sugar issue because that was exactly what it felt like. Blood sugar spike and sleepyness. I’ve been monitoring blood sugar and it actauly looks fine. So could be serotonin/melatonin imbalance?

So would you recommend a trial of T3 KSman? I thought adrenals were the issue but cortisol throughout the day looked fine. I did read that book and have been doing my best to do what I can to de-stress. Also been taking a bunch of supplements and getting as much sleep as I can. 8-10 hours a night.

Any recommendations re thyroid then? T3 only trial???

Imo I would leave thyroid alone unless your rt3 is high. But it was 15 and that’s fine. Your temps in the pm are close 98.3 in the pm and that is fine.

What was you am cortisol? And acth?

Am not to knowledgeable about serotonin and neurotransmitters.
I read physio suggest licorice root tea in the am if adrenal fatigue. But u say am cortisol is fine.

Read more about dopamine and neurotransmitters. I know there are supplements. And know we all read to much. Sux to go through this process.

I would look into ferritin and a 4-point cortisol test, cortisol levels could be fluctuating throughout the day.

I just did the four point saliva cortisol test a few weeks ago and it came back fine. Results are above. (Last image posted) In my head I was sure it was a cortisol issue, so I was surprised it came back normal… I’ve done 8am blood cortisol tests in the past and it came back below range. But that was a couple of years back. Also Transcortin was above range then at 74 mg/L (20-50) which I thought might be a reason why my free cortisol was coming in below range.

I must have done ferritin tests in the past but can’t seem to find the results. I’ll be running some more tests in the next few weeks which include ferritin.

You might be right but I still think there’s something going on with my thyroid somwhere down the line. Would be good to get @physioLojik oppionion on poissible thyroid issue.

AM cortisol has been low in the past. But most recent 4 point cortisol tests came back fine. Re, ACTH; I’ve had a short synacthen test back in September and results said “test shows adequate adrenal response to synacthen with a basal cortisol of 459 and a 30 minute cortisol of 520.

Yes I have been drinking licorice tea, taking salt in water, supplementing with 3-5 grams vit c, b vits, vit e, magnesium, d3, selenium, calcium and ubiquinol.

Yes been reading a lot over the last year or so! Have been reading up on dopamine recently, but need to read more as I’m not entirely clear. Need to take a closer look at supplements. Are you taking any Charlie?

I take a multi, d3, zinc. That’s it. Vit c 500 mg once in a while.

You cortisol saliva tests look really good. Not sure if you should continue the licorice tea. Or all that vit c.

Btw u said you have scleroderma. Am sure you know it can affect sex.

https://sclero.org/scleroderma/support/emotional-adj/sexuality.html

I no longer drink the licorice tea now. And am taking a lower dose of vit c daily… Yes do know that scleroderma can cause issues with sex drive. I’ve nver had any ED issues so I should be great full for that. Was just hoping that I might get a libido boost with TRT. Maybe I’m expecting too much.

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I wondered if tamoxifen could be what’s making me so tired. Anyone else have sleepiness sides with tamoxifen?

I believe that is one of the listed side effects Danny.

I did read that too… Really hope it’s not the tamoxifen making me feel so tired because I need to take it because I’ve been getting quite a bit of itchiness around the chest area and really don’t want to develop gyno down the road. Think I’ll give it some time and see if this sleepiness gets better. I’m really only clutching at straws as to why I’m suddenly so sleepy, so would be stupid stopping the tamoxifen now.