I’ve been on Testim for 2 months and the last few weeks I’ve been feeling like crap. My numbers are way worst than before I started TRT. My Total T went from 296 to 164. Estradiol went from 23 to 34. Test Free went from 58 to 35.4. Here are latest labs. I’m currently on Testim 1 Tube a day, Statins-Crestor 10mg, and Tricor 145mg.
Quest Diagnostics
Estradiol 34 (11.6-41.2)
DHEA 427 (61-1636)
Test Total 164 (250-1100)
Test Bio 75.8 (110.0-575.0)
Test SHBG 14 (8-48)
Test Albumin 4.7(3.6-5.1)
Dihydrotest 19 (25-75)
Cholesterol 210
Triglycerides 176
LDL 142
HDL 33
Total PSA 0.4
Free PSA 0.1
% Free PSA 25
TSH 1.65
What gives? I’m feeling lousy, my cholesterol got worse even while on Statins.
Some do not absorb T transdermals. Some of those do not because of an underlying thyroid problem. Yes TSH=135 looks decent, but the non-absorption suggests a need to test fT4, fT4.
Iodine in your salt?
Checked waking body temps?
Asked these questions before? It would be better if you updated and continued your original posts.
Thyroid panels done in the past have never shown any red flags but I will request another one. My waking body temp is 97.4 used on 2 different oral electronic thermometers(not sure how accurate they are). I use sea salt from Trader Joes. I always thought I may have an undiagnosed thyroid problem for the last 6 or 7 years but Dr always brushed it off as anxiety. If I do have absorption issues then why did my Total T levels drop way below where I originally started at before applying the Testim. Would it be wise before I pursue any further TRT therapy that I get more testing done? I already stopped applying the Testim yesterday since it was making me feel worse.
For some, transdermals to not absorb well, but what does absorb can be largely converted to E2 in the skin, which acts as a negative HPTA feedback signal, reducing LH and T levels.
Sea salt looses the iodine in sea water. Sea salt contains no useful amounts of iodine unless the package states that it has been iodized. Few are sold that way, some are.
In your case, we see that guys in that situation seem to have no recourse other than T self injections. If you were a good transdermal T absorber, you would have a very likely high probability of needing hCG to prevent eventual testicular atrophy and failure. Thus you would have been needing to be injecting anyways.
Please read the ‘protocol for injections’ sticky and come back with questions. Sorry that that thread has been severely hijacked.
I’m meeting with Dr later today and will discuss T injections, HCG, and
arimidex. I’m confused about the HCG. What would be a minimum dosing amount to
just keep the testis from shrinking and staying active. Fertlity is not an issue
since I’m done having kids.
I just don’t want my nuts to shrink. Can I take HCG
once a week with T injections or do I have to inject more frequently? I did read the sticky on 250iu EOD but was wondering if there are other options.
250iu SC EOD was shown in research to be a replacement dose for LH. That is considered low dose. You could try a smaller dose and that might meet your objectives. I have never seen any discussion about the minimal dose to prevent shrinking. Where one is attempting to reverse shrinkage, it would probably be best to do that with 250iu EOD then lower the dose after size is restored. Also monitor firmness. Individual variations are significant in terms of shrinkage.
hCG half life does not support weekly injections from a HRT point of view. Would weekly hCG injections prevent or reduce shrinkage? Perhaps. You can work these things out and report. As the changes are slow, it will not be easy to know exactly what is going on.
Injecting hCG in a larger dose may not work as well as one might hope. You might try 500iu once a week, but I have to discourage doses larger than that. Again, the context here is only preventing or reducing shrinkage, not an attempt to maintain baseline testicular function.
[quote]oceanminded wrote:
Thyroid panels done in the past have never shown any red flags [/quote]
what were the actual results? just because it is in range does not mean it is good. Was it a complete panel?
Here is what I have saved in my folder:
You have a problem IF:
TSH > 2.0 uIU/mL
Total T4 < 8.0 ug/dL
Free T4 < 1.2 ng/dL
Total T3 < 100 ng/dL (this varies)
Free T3 < 340 pg/dL
Reverse T3 > 1/3 Free T3 (you probably have to multiple the RT3 value by 10 to get it into the same value range as Free T3)
RT3 cancels out Free T3. High free T3 and high RT3 = basically no free T3.
also check AM Cortisol & Ferritin (if they are low that can contribute to high RT3)
First off, thanks for all the info and advice this site offers. I would not have been able to ask the right questions without the knowledge I’ve learned from the members who contribute their valuable info on here. I had my first follow up appt with my Urologist after my dissapointing lab results.
He first gave me the option of applying two tubes of testim a day or going with the shots. I opted for the injections. He started me out on 200 mg of Test Cyp and said I could do weekly injections on 100 mg and self inject if I want to splitting the dose up twice a week. He also put me on 0.5 Arimidex EOD. He recommended the following suppliments. DHEA 50mg, resveratal, Arginine 1000mg, Vit D, Zinc, Fish Oil, CoQ10.
I asked him about HCG and even though he does have patients on it he doesn’t feel it is necessary for me right now. I’m sure down the line if I want it, I can push him into adding it. He did mention it was costly. So, I have a few questions.
They used a 20 or 21 Gauge needle in my butt which hurt and is still sore. How would I go about requesting smaller neddles and doing it SC instead of into the muscle.
Is 0.5 Arimidex EOD too much. Is there any way to tell if E2 levels drop too low other than a blood test.
Out of the supplements he listed or any other for that matter which ones are a must. I don’t want to take or spend the $ on all the ones he listed. Just looking for a few must haves.
After the 200mg of Test Cyp I felt a surge or heat like sensation that lasted a few days. I also had a hard time sleeping the first night feeling amped up. Is this normal. I now feel the affects wearing off. Does this mean I need another shot 3 days after the first one.
I guess thats all for now unless there is more info I should know. I still need to get a full thyroid panel done.
Take vit-D3, 4000-6000iu. Take ED or a weeks worth all at once. And fish oil. If taking a statin drug, CoQ10 is very important. DHEA is cheap. You need a high potency multi vit with a good spectrum of trace elements.
Read the protocol for injections sticky and note comments re insulin syringes for injecting T. In some states you do not need a script for insulin syringes. Get a box of 100. That will cost $12.60 at Walmart or Sam’s for their ‘Relion’ house brand.
Arimidex: Start with 1.0mg/week for every 100mg/week test cyp.
4000-6000iu per day, as per research that has surfaced in the last few years. Vit-D3 is converted to vit-D25, which is what one tests for one labs. Vit-D25 is a steroid hormone that is transported to the nuclei of the cells where it affects gene transcription. Lower vit-D status is associated with so many health problems that it may be safe to say that most functions in the body depend on vit-D to work properly.
After the 200mg of Test Cyp I felt a surge or heat like sensation that lasted a few days. I also had a hard time sleeping the first night feeling amped up. Is this normal. I now feel the affects wearing off. Does this mean I need another shot 3 days after the first one.
[/quote]
That is exactly the symptoms I had when I was getting injections every 3 weeks. The first two days I was wired (not in a good way) because of that huge surge of T. I also had trouble sleeping. Then, things got better during the rest of that first week.
But then the next two weeks were pure hell! Hot flashes like mad. That is when I found this site and started EOD injections myself, just like the Injection Protocol sticky. I can easily sleep at night and I don’t ever plunge like I did before.
Two weeks now into T injections. The Dr has me on 200mg Test Cyp once a week. I als take Arimidex 0.5mg EOD. Suppliments include 50mg DHEA, Vit D, Zinc, COQ10. After the injection I have terrible insomnia along with some anxiety. Should I jump down to a smaller dose of T. Also, when should I get the next set of follow-up labs.
if you need more than 100mg of test a week, then there is a very high chance that you have some other imbalance throwing your system off. Simply taking more and more testosterone won’t fix that other imbalance and will more than likely cause additional problems (excess estrogen, excess DHT, etc.) and side effects.
weekly shots = hormone rollercoast
100mg test = high % chance of other problem
1mg Arimidex weekly = trying to compensate for excess Testosterone aromatizing to Estrogen
have you checked your Thyroid, AM Cortisol, Ferritin, Vitamin D 25OH, B12, DHEA-S, Pregenolone, etc.?
[quote]PureChance wrote:
You have a problem IF:
TSH > 2.0 uIU/mL
Total T4 < 8.0 ug/dL
Free T4 < 1.2 ng/dL
Total T3 < 100 ng/dL (this varies)
Free T3 < 340 pg/dL
Reverse T3 > 1/3 Free T3 (you probably have to multiple the RT3 value by 10 to get it into the same value range as Free T3)
RT3 cancels out Free T3. High free T3 and high RT3 = basically no free T3.
also check AM Cortisol & Ferritin (if they are low that can contribute to high RT3)[/quote]
In this case scenerio I would love to have a complete medical bio going back to events that happened 4-5 months before you experienced symptoms to look for the under lying cause of the problem.
First step is address the adrenals and look for man source of the problem
Seeing this low T is usually due to elevated cortisol levels, high insulin, low LH
Vitamin D at ranges of 70-90 can stimulate LH in many cases to get testosterone going.
Just posting numbers I have found is almost like shooting darts at board blind folded. Fixing the numbers does not take care of underlying causes. IT may make on feel better but is only a short term solution. Many patients that come to us numbers look great and still feel like crap untill the real issue is uncovered which usually means digging deeper into the issue such as lifestyle, environmental exposure, biological and psychololgical stress, even hidden intestinal or systemic infections such as lupus, lyme, ebar virus, and other hidden factors. Simple changes in sleep patterns or even nutrients can through out the body chemistry. Its hilarous when people are threaten to sue me for recommending a person get more sleep, or examine their relationships. I just laugh. This did not occur over night and will not get resolved overnight either. That is the straight up facts.
Hardasnails,
Here are my original labs before I started on TRT. I first went on Testim which lowered my T even more. As far as my current T dose of 200 mg per week I’m still experimenting on which dose I need. It may be too much which means I can drop dose to 100mg per week as well as decrease Arimidex dose. I’ve never had Vit D checked and I am going to get a new Thyroid panel done.
Here are my labs taken before starting on TRT. Symptoms were/are tired a lot, mild depression and anxiety, diminished sex drive, belly fat, irritability, and high cholesterol. Here are my labs taken in morning about a year ago:
High cholesterol is 90% thyroid or insulin driven. 5% of people no responsive to life changes and nutritoinal intervention.
Most people need 80-150 mgs a week. If you do not feel good on your T then there are other factors that need to be explored mainly adrenals and thyroid. I see it all the time. With out knowing the whole story it makes it so much difficult to properly make recommendations. Client profiling is uptmost important to get a person on the proper path.
Hardasnails,
I’ve had cholesterol issues way before I even knew I had low T. Tried statins with little improvement. Diet is so so and I try and exercise regularly. I’ve had thyroid panel done in past when checking cholesterol and there were never any red flags.
I am going to get new thyroid info and will post labs once I have them. I’m hoping my symptoms are low T related and that my cholesterol will improve once I can get that in balance.
You need proper thyroid panel
total t3
total t4
ft3
ft4
reverse t3
tsh 3rd
tpo
TGAB
TBG
TSH is worthless in a stressed condition.
TRT can affect thyroid and adrenal function in people. After 10-12 weeks on TRT we chck thyroid and adrenal parameters to make sure its has not been affected.