T Nation

Got My T Results- Any Advice?

#1

Hello All,

I went to a PA who works with a MD here in the DFW area. The PA seems very aggressive in his HRT. He is a serious weight lifter and been using T for about 8 years himself.

I called the office today and got my results, total T 193, free T 32.3, estradiol 43 and total cholesteral 123. Everything else was in "normal limits". This is the first time I ever had this type of blood work so I have nothing to compare it to. Overall I am in excellent health and no significant medical history. I have an unbelievable family history of cancer, especially prostate and colon.

I am 45yoa 5'9" 200lbs about 16%bf. I work out 5 or 6 days a week. My weight is a little high due to a lax diet and a 3 month bulking program I just finished. I actually made pretty good strength gains, which surprised me when I saw my total T.

I am not "moody" but seem a little down, which may have more to do with a rough marriage. No ED problems but morning wood is certainly a lot less prevelent than it was 10 years ago.

I have an appointment with the PA tomorrow afternoon. I know he will prescribe T if I want it. He seems high on a topical that he himself uses.

I have done some research and read a lot on this forum. I plan on doing some more. However, I would be glad to learn from others who have been down this road. If any of you have suggestions or comments I would certainly welcome them.

Thanks in advance.

#2

Your Total T is low, your Estrogen is higher than optimum (43 in a range of 0-54) an better E2 number is more like 22 or 25. Do you have more comprehensive labs? Your cholesterol is potentially low (depending on the actual ratio of LDL to HDL), and low cholesterol usually also means low Testosterone too.

But not always;
Before I started on TRT, my Total T was was 105, and man did my life suck. Unlike you I was depressed and moody, fat, not interested in sex, forgot was a morning woody was like, and, you get the picture. Life is now pretty good, bf% is acceptable, I hold my own in the gym, and I’m always in the mood for sex. Like I said, life is pretty good…

#3

KNB

Thanks for the reply. I go see my PA today and will get my total blood work numbers and will probably start T therapy. I am going to ask about HCG and something to lower my E.

What other numbers do you want to see?

Congrats on your results. How much T are you taking, in what form? Are you taking anything else? How long ago did you start and what is your T at now?

I appeciate you taking the time to answer these. I am just starting out on this and learning as I go.

#4

We often see hypothyroidism and hypogonadism problems together. You should test for TSH, FT3, FT4. But as TRT can improve thyroid baselines, I recommend that this be done at a later followup lab.

Test PSA now and at 3 months. Test hematocrit.

You need to discuss your insurance coverage, deductibles, injections, self injections, A-gel [expensive], compounded T [moderate cost].

Your workouts and showering may create issues with transdermals.

Do not be misled by voodoo about bioidentical T as a reason to do transdermals. Injected testosterone esters are time release deliver systems. As the oil deposit is metabolized and test ester molecules become bioavailable, the ester group is removed yielding bio-identical T.

#5

Thanks to KSman and KNB for responding.

I saw the PA this afternoon and am going to do 1 month of twice weekly 50mg T cyp injections and Zinc AG orally. He anticipates this raising my total T to around 550 and dropping my E. I then do not use for a week and retest. My PSA was 1.1 and hematocrit was good. He was not concerned with my cholesterol, mainly because the ratio was very good.

He wants to start with the 100mg of T cyp because my T is so low it would take a long time to raise it significantly with transdermals. If after a month my T levels are acceptable he said we would then go on a maintenance dose that could be transdermal or the T cyp.

This all seems to make very good sense to me. Does anyone think I am on the wrong path or missing something?

#6

[quote]TXM3 wrote:
Thanks to KSman and KNB for responding.

I saw the PA this afternoon and am going to do 1 month of twice weekly 50mg T cyp injections and Zinc AG orally. He anticipates this raising my total T to around 550 and dropping my E. I then do not use for a week and retest. My PSA was 1.1 and hematocrit was good. He was not concerned with my cholesterol, mainly because the ratio was very good.

He wants to start with the 100mg of T cyp because my T is so low it would take a long time to raise it significantly with transdermals. If after a month my T levels are acceptable he said we would then go on a maintenance dose that could be transdermal or the T cyp.

This all seems to make very good sense to me. Does anyone think I am on the wrong path or missing something? [/quote]

50 mg twice/week sounds good. Did he mention anything about HCG? Also, I would look into getting some arimidex or liquidex for E2 control. I really doubt that frequent injections will be enough to stop E2 from becoming a problem. If you end up using transdermals, I would bet my bottom dollar that it will be a problem. E2 can really screw you up and with your family history of prostate cancer, I would keep a close eye on it.

Did your doc mention the reasoning why he would want you to go off treatment for a week before testing? Seems odd to me.

Your doc is wrong about injections getting your levels up quicker though. Transdermals will work in as little as a few days, if you are absorbing, where as cyp will usually take a few weeks to start to feel the effects.

#7

Thanks Caged

We did talk about HCG and he likes it. He did not think it was neccesary at this time, but I got the feeling he would prescribe it anytime I wanted it. Is it hard to find or very expensive?

As you mentioned I am very concerned about my elevated E and told my PA I would like to get it down in the low 20s. He agreed and recommennded Zinc AG. He is very high on this and it is what he takes himself. He did mention Armidex, liquidex and some others. I am sure if the Zinc AG does not work he will prescribe whatever I ask for. Although I think I saw where the Liquidex is non prescription.

Does anyone here have any experience with the Zinc AG?

I am not sure why he wants me to be off a week for the retest. Common sense says test while on it to see where I am.

I really do not know why he feels the way he does about transdermals not raising T fast. He is really high on them overall. I got the feeling from him I should notice a difference in just a few days not weeks. This PA has quite a reputataion among Cops, Firemen and Federal Agents as to really knowing his stuff. The fact that you and he disagree on a number of basic points is disturbing. I thank you for your time and knowledge. Even if I am now confused!!!

Anyone care to chime in?

I would be?

Thanks again Caged

#8

I had never heard of zinc as an aromatase inhibitor before. Did a quick search and could not find any definitive studies on it.

#9

TXM3,
There are couple of things you need to mention to your doctor, i.e. T-Cyp takes between 35 and 45 days to hit maximum blood level, whereas the trans dermals will get b/levels up quickly, but the hassle they create are too much of a pain; elevated E2, DHT, and poor absorption as well. Not every man has these issues but they are very common with gels/creams.

Here’s an idea: get your doctor to give you “gel” for two weeks while the shots are kicking in to get you on the right path sooner. HCG will usually raise T levels AND E2 levels, so w/o an AI HCG may be more of a problem than a help.

As far as being off a week from shots to re-test, your T levels will drop significantly after one week w/o a shot, and that is so your doc can actually prescribe the largest dose possible w/o having your b/w results be higher the scale on the tests being used. He’s doing you a favor if you haven’t figured it out yet…

He doesn’t get into DEA or Medical Board hassles, and your insurance won’t balk about your dosages if you are always “in range” when your blood is tested.

Liquidex is a research chemical, so it’s not prescription, but if you have insurance force your doc to give you arimidex, to save money if possible.
Keep us posted.

#10

Thanks for responding Gary and KNB.

I will call and speak with my PA tomorrow.

I understand what you said about letting the values drop then testing. However, my goal is not to take the max dose of T, but to raise it to a more moderate level. It seems if we always test after it has been used up I will never get an accurate reading. Does that make sense?

What you said about the HCG makes sense, I will ask if that is why he did not prescribe it.

He is very high on a certain transdermal that is absorbed in 15 minutes, then one can shower, workout etc. He did say not everyone can use it effectively. I can ask him again about why we started with the injections to raise the T level quickly. I know for sure he said in his experience transdermals raise it slow compared to injections. I can not see him reversing on that.

As I said earlier I am new at this and appreciate everyone who has taken the time to respond.

#11

The “maximum dose” of T is somewhat of a misnomer… You and I could take the same T-Cyp dosage and have completely different T numbers on our blood tests, so what would that prove?

Moderate (T level) compared to what? A professional bodybuilder, or a guy that wants to have “high normal” T levels?
If you had the opportunity to have the same T levels you did when you were in your 20’s, would that be too high, or would that be “moderate” even though for you personally, the T levels would be “normal”?
You see my point, right?

Some guys like their T levels right on the top of the curve (like me) and some guys like their numbers in the middle.
And w/o HCG you won’t have pregnenolone production anymore, and your mood may suffer. Not to forget to mention (as KSman did), the thyroid connection as well.

My thyroid numbers started to plummet after being on T shots for 4 or 5 months, so I got re-tested and got my thyroid meds adjusted. Not every guy on T shots develops thyroid absorption, but some do. It’s just something else to get tested for, and stay on top of. If you and your PA can get things worked out, your quality of life will improve so drastically you’ll be amazed.

#12

This will not contribute much but is more of a rant I guess. I am also 45 and have low T and finally starting TRT. I have been trying to get some help (TRT) for 2 years! Finally, my family Physician decided to administer the TRT himself as the Endo’s I saw were not willing to do anything. My T was consistently in the low 200s and free T was around 7 to 8 and I was symptomatic!

One Endo said he thought I was depressed. I said yes I was getting there because no one was willing to help me. Why are these doctors so opposed to hormone tratments? These treatments have been helping people for decades. I was continually asked if I were on steroids. I am decent size but nowhere close to looking like I’m juiced. The one doc asked me 3 times until I finally just left.

Anyway, if you are in this situation, keep pressing and don’t let someone discourage you. Rant over. Thanks to KSman and KNB for leads on info out there which has helped me persuade my doc.

#13

[quote]KNB wrote:
TXM3,
There are couple of things you need to mention to your doctor, i.e. T-Cyp takes between 35 and 45 days to hit maximum blood level, whereas the trans dermals will get b/levels up quickly, but the hassle they create are too much of a pain; elevated E2, DHT, and poor absorption as well. Not every man has these issues but they are very common with gels/creams.

Here’s an idea: get your doctor to give you “gel” for two weeks while the shots are kicking in to get you on the right path sooner. HCG will usually raise T levels AND E2 levels, so w/o an AI HCG may be more of a problem than a help.

As far as being off a week from shots to re-test, your T levels will drop significantly after one week w/o a shot, and that is so your doc can actually prescribe the largest dose possible w/o having your b/w results be higher the scale on the tests being used. He’s doing you a favor if you haven’t figured it out yet…

He doesn’t get into DEA or Medical Board hassles, and your insurance won’t balk about your dosages if you are always “in range” when your blood is tested.

Liquidex is a research chemical, so it’s not prescription, but if you have insurance force your doc to give you arimidex, to save money if possible.
Keep us posted.[/quote]

Hey KNB,
How much benefit do you think it would be to frontload the T-cyp on the first injection to get his levels up quicker?

I know steroid users do it often on cycle, and Dr. Crisler suggests it for his patients, but I wonder how much quicker you would “feel” the difference. Any experience in this with HRT doses?

#14

I have tried many different dosing schedules, and I also believe in front loading to help get numbers up sooner.
This is only a good idea if you have access to an AI, because the larger the shot dose the greater the potential to turn it into Estrogen.

Once upon a time when I didn’t have an AI handy and I was front loading to fix my low T problems, my Estrogen numbers went sky high. As in double the test range high. On a scale of 0-54, I came in at 105 and wondered why I didn’t feel like Superman if you get my drift… Once the Estrogen was in control if the wind blew I had a woodie, so I knew I was in the right range for me.

Anyway, I realize not every man that takes T shots will have Estrogen issues, but since most will have some problem, better safe than sorry.
If you don’t know where your E2 numbers are for some reason, but want to make the best of TRT; accepted dosing for adex is 1mg/week per 160# of body weight. Adex is a marvelous drug that as far as I know works for 80% or more of the people that use it. There are those it doesn’t work for, and there are those that 0.5mg/week is too much for their particular body. I used research chems in the early days, and had good results doing so.

#15

Thanks again to everyone that replied.

KNB and Caged I definately owe you guys a cold one if you ever get to the Dallas area.

I feel your pain J.L., as confusing and complicated as this is, I feel very lucky to have found a guy who is easy to work with and aggressive in his HRT.

I see by going back and reading my posts I did not mention the first dose I got, in his office, was 100mg. Then 3 days later(yesterday) I gave myself 50mg. The reason he gave me 100mg was to start with a front load dose. I am guessing you would have recommended a larger dose to front load? I have not felt much of a difference yet, but I did not feel real bad before I started.

I am very concerned with my E2 level which was 43 before I took anything. At my PA’s recommendation I ordered Zinc AG and am waiting for it to come in. He said he likes it more than liquidex and the others. He has been treating guys with HRT for over 8 years and currently has over 1000 men on HRT. He says he has not needed to use HCG in the vast majority of the cases. He says he does not think it is a good idea.

KNB, you asked a real good question; where do I want my T levels? I am not sure, I would like to get up to a mid range and see how I feel. I am the type of guy who almost never takes medicine. The idea of being on anything long term never mind for the rest of my life is certainly new to me.

I am going to follow his recommendations for a monmth and see how I feel and what my labs are.

Thanks again for your input, I value the opinions all of you guys have expressed. I will keep you updated and continue to beg for advice.

#16

[quote]Caged wrote:
TXM3 wrote:
Thanks to KSman and KNB for responding.

I saw the PA this afternoon and am going to do 1 month of twice weekly 50mg T cyp injections and Zinc AG orally. He anticipates this raising my total T to around 550 and dropping my E. I then do not use for a week and retest. My PSA was 1.1 and hematocrit was good. He was not concerned with my cholesterol, mainly because the ratio was very good.

He wants to start with the 100mg of T cyp because my T is so low it would take a long time to raise it significantly with transdermals. If after a month my T levels are acceptable he said we would then go on a maintenance dose that could be transdermal or the T cyp.

This all seems to make very good sense to me. Does anyone think I am on the wrong path or missing something?

50 mg twice/week sounds good. Did he mention anything about HCG? Also, I would look into getting some arimidex or liquidex for E2 control. I really doubt that frequent injections will be enough to stop E2 from becoming a problem. If you end up using transdermals, I would bet my bottom dollar that it will be a problem. E2 can really screw you up and with your family history of prostate cancer, I would keep a close eye on it.

Did your doc mention the reasoning why he would want you to go off treatment for a week before testing? Seems odd to me.

Your doc is wrong about injections getting your levels up quicker though. Transdermals will work in as little as a few days, if you are absorbing, where as cyp will usually take a few weeks to start to feel the effects.

[/quote]

KSMan is correct…T levels will take a few weeks to elevate if doing injectibles and when they do and you continue them you will have to watch your E2 levels. After experimenting with my T levels, I ended up at 200mg/wk. That got me to the high 700s and I had to start Arimidex to get my E2 lowered. It was only at 42 but I was getting gyno problems and after taking Arimidex for only a week it is much better.

#17

[quote]ChrisM wrote:
Caged wrote:
TXM3 wrote:
Thanks to KSman and KNB for responding.

I saw the PA this afternoon and am going to do 1 month of twice weekly 50mg T cyp injections and Zinc AG orally. He anticipates this raising my total T to around 550 and dropping my E. I then do not use for a week and retest. My PSA was 1.1 and hematocrit was good. He was not concerned with my cholesterol, mainly because the ratio was very good.

He wants to start with the 100mg of T cyp because my T is so low it would take a long time to raise it significantly with transdermals. If after a month my T levels are acceptable he said we would then go on a maintenance dose that could be transdermal or the T cyp.

This all seems to make very good sense to me. Does anyone think I am on the wrong path or missing something?

50 mg twice/week sounds good. Did he mention anything about HCG? Also, I would look into getting some arimidex or liquidex for E2 control. I really doubt that frequent injections will be enough to stop E2 from becoming a problem. If you end up using transdermals, I would bet my bottom dollar that it will be a problem. E2 can really screw you up and with your family history of prostate cancer, I would keep a close eye on it.

Did your doc mention the reasoning why he would want you to go off treatment for a week before testing? Seems odd to me.

Your doc is wrong about injections getting your levels up quicker though. Transdermals will work in as little as a few days, if you are absorbing, where as cyp will usually take a few weeks to start to feel the effects.

KSMan is correct…T levels will take a few weeks to elevate if doing injectibles and when they do and you continue them you will have to watch your E2 levels. After experimenting with my T levels, I ended up at 200mg/wk. That got me to the high 700s and I had to start Arimidex to get my E2 lowered. It was only at 42 but I was getting gyno problems and after taking Arimidex for only a week it is much better.
[/quote]

Sorry… have to give the credit to Caged for the Arimidex…both KSMan and Caged gave me good advice for my TRT issues…Good Luck!

#18

Hello All

I was going to let this post die but in the past 2 weeks I have been contacted by 4 different guys in the Dallas area asking about my PA or my results. So in an attempt to keep me from having to repeat myself I thought I would post my progress and see what some of the more experienced folks might recommend as a future course of action.

To recap my original test results on 3-27-09 were Total T-195 Free T-32.2 and E-43. I went on 100mg cyp a week divided in 2 50mg shots and taking one tablet of ZincAG a day to lower the E. On 4-27-09 I was retested and mt Total T-384 Free T-71.2 and E-42. So the T was up but no significant difference in the E. All other results were in normal ranges and not dramaticly different from the original values.

Following the recommendation of my PA we are now going to 150mg T cyp shot every 10 days and a compound transdermal 150mg/cc EMU CREA applied 1 ML daily. In addition doubling up on the Zinc AG. My PA believes this will raise my T levels and drop my E down in the 20s. I will have my blood tested again after about a month.

I have not noticed a large change in mood, sex drive or workouts, but I was not having problems before. The workouts seem a little better but I have just changed them.

Anyone in the DFW area feel free to contact me if I can help and I would again appreciate any comments or suggestions from the members here.

Thanks

#19

I know this might sound odd and weird -why stressing going to the Doc about all this. Do reaearch on some pro hormones - cheaper and easier I say. Alot of them do not aromatize like Test does so no need worrying about your E levels.

As a PCT use double dose of Novadex xt for 3 weeks or another like Alpha Male to jack up your own T levels again.

The reason I say this is 100 mg of cypionate a week is barely anything - most people need atleast 150-200mg a week to notice changes and then you have to worry about conversion and all the other side effects related to artificial T being introduced to your body and the remedies you need. let alone what is the time frame of your “cycles” ? Better be less than 12 weeks or you will shut down your own T levels even more when you come off .

Rant over.

#20

[quote]FISCHER613 wrote:
I know this might sound odd and weird -why stressing going to the Doc about all this. Do reaearch on some pro hormones - cheaper and easier I say. Alot of them do not aromatize like Test does so no need worrying about your E levels.

As a PCT use double dose of Novadex xt for 3 weeks or another like Alpha Male to jack up your own T levels again.

The reason I say this is 100 mg of cypionate a week is barely anything - most people need atleast 150-200mg a week to notice changes and then you have to worry about conversion and all the other side effects related to artificial T being introduced to your body and the remedies you need. let alone what is the time frame of your “cycles” ? Better be less than 12 weeks or you will shut down your own T levels even more when you come off .

Rant over.
[/quote]

MOst people need between 100-150 mgs which is TRT not steroid dosage. If you need 200 mgs you got other issues going on or have down regulation from prohormone or steroid use. Most of out guys are on max 150 mgs a week while managing esrodial and using hcg which reduces the amount of T that is needed. Prohormones are reason alot of guys are on TRT because these molecules we have not idea what there metabolites do to cellular tissues. I tell people to stay away from them with a 10 ft pole.