T Nation

Help for T Bloat

Preview:

57 yr old male here; after reading about T replacement, studying countless threads I was determine to take the plunge. Much to my surprise I live 32 miles from Doc John Crisler. Saw the doc long story short was on injectable cyp .5 ml once per week. For the first month, I felt like superman. In fact it was downright scary.

Workouts were a breeze, previous weight and rep schemes were blown away. I had energy like never before. Then came the bounce, the body adjusted and the superman feeling was gone.

I will fast forward to present day to spare those kind enough to read. After several labs (most were not performed correctly, another story) I am on sub Q .2ml cyp twice per week, anastrozole .5 mg eod and daily HCG (10 mark on a 1cc syringe, sorry the measuring scheme i find a bit confusing).

I have to say I feel better overall. I hesitate do only to the bloat. I still get the bloat gut and cannot seem to figure it out. Doctor Crisler tried lowering the cyp dose to .17 twice per week and it first the bloat was gone. Eventually, the body adjusted and the bloat came back even at the lower dose. The only way I can get positive results is during my weekly 24 hour fast.

I confess a lack of knowledge even after reading a great deal on the subject of T replacement. I also confess to missing the feelings I had during the first month where I felt invincible. Close exam of other threads warned of the superman feeling and then coming back down to earth. I guess I had to experience it myself.

If anyone with similar experience has any guidance on reducing the bloat I would very grateful. My fear is this is just the way it is for my body and replacement T.

Thank you for reading…

1 Like

Do you have labs you can post ?

How is your sodium intake ?
Do you eat a lot of processed food ?
How is your diet ? Do you eat a lot of grains ?

Crisler is in love with HCG, but it can have unintended consequences,
like e2 spikes that cannot be controlled with an AI.

I doubt it is dietary, or you would have had it before.

Bloat (facial or otherwise) is not an uncommon complaint of guys on TRT. In some cases it may have to do with too high E2 levels but it seems that often that is not the whole story. It seems that a too high T level can in itself cause bloat even if E2 is low. What is your T level on this regimen?

Also, edema (bloat) is a known side effect of arimidex, listed on the FDA insert, so it may even be due to your rather high dose of arimidex.

[quote]PKNY wrote:
Do you have labs you can post ?

How is your sodium intake ?
Do you eat a lot of processed food ?
How is your diet ? Do you eat a lot of grains ?

Crisler is in love with HCG, but it can have unintended consequences,
like e2 spikes that cannot be controlled with an AI.

[/quote]

I can and will post labs. No, I don’t not eat a lot of processed foods and overall I think my diet is pretty clean. I do not eat many grains, an occasional slice of bread. My biggest vice is a craft beer or two in the evening. The HCG does seem to restore the testicles somewhat, however, not all the way back to normal for sure.

The bloat gut is a bummer. I have tried most of what I have read; limit sodium, drink lots of water, but nothing seems to work. Sex drive is good, no nipple irritation. I have used the anabolic diet in the past with great results, but even when I cut back on the carbs it seems to have little impact on the bloat.

I will post labs tomorrow. Thanks

[quote]PKNY wrote:
Do you have labs you can post ?

How is your sodium intake ?
Do you eat a lot of processed food ?
How is your diet ? Do you eat a lot of grains ?

Crisler is in love with HCG, but it can have unintended consequences,
like e2 spikes that cannot be controlled with an AI.

[/quote]

Labs
I will note only “high or low” from the normal blood work and concentrate on estradiol and T

RDW-SD H 47.0
Platelet count L 139

ESTRADIOL (17B) 25 pg/ml
DHEA SULFATE H 428
SEX HORMONE BIND GLB 38
BIOAVAILABLE TEST 233.2
TOTAL TES 819
FREE TES 113.4
SHBG LC/MS/MC 36
ALBUMIN 4.5

I have a strange thing occurring during my subq T injections. I am using 26 ga needle and injecting into belly fat. I pull the skin sideways (as directed by Doc Chrisler) inject the T, pull the needle and let the skin slide back in place. As of late I have noticed a good amount of T coming back out of the injection site. This has happened a few times now and I have no idea what I am doing wrong. I have tried very slow injection thinking perhaps I was injecting too fast and somehow the T was under pressure and coming back out the injection site.

Have any of you experienced this before and if so, how did you correct it?

Many thanks for taking the time to respond.

Jeff

[quote]seekonk wrote:
I doubt it is dietary, or you would have had it before.

Bloat (facial or otherwise) is not an uncommon complaint of guys on TRT. In some cases it may have to do with too high E2 levels but it seems that often that is not the whole story. It seems that a too high T level can in itself cause bloat even if E2 is low. What is your T level on this regimen?

Also, edema (bloat) is a known side effect of arimidex, listed on the FDA insert, so it may even be due to your rather high dose of arimidex. [/quote]

I tend to agree it is not dietary, as I had no such problem prior to starting the T. As I said, my diet is not perfect, but pretty darn good. When Doc Crisler lowered the T dose, the bloat left like magic only to return after a few days. Doctor Crisler seemed puzzled by this and said "it almost seems like an allergic response of some kind).

The bloat has bad days and not so bad and I for the life of me cannot figure out what triggers either one, with the exception of my weekly 24 hour fast. When the bloat is bad I feel like someone pumped air into my stomach, uncomfortable and unsightly.

Thanks for commenting

RDW-SD H 47.0
Platelet count L 139

These two values suggest anemia.
Do you have the rest of the CBC section of the bloodwork ?
Specifically WBC RBC HEMOGLOBIN and HEMATOCRIT.
Also, do you have ALT AST #'s ?

I was thinking you had edema type bloat, I didn’t realize it was in your abdomen.
Does it seem like air, or water ?

Do you take any other meds ? Supplements ?

A few suggestions:

Stop using Hcg for two weeks.
a 250iu injection keeps my boys firm for several weeks. When I took it three times a week
I was all over the place #'s wise. *Crisler won’t like this as he believe the HCG is the be all end all
compound.

Change up your AI from Adex to Aromasin.

Long shot, but you should move the site of your Subq injections from your belly to
your upper leg. I do IM in the delt, but when I used to do subq I did the upper part
of my leg. If you are seated, on the top part of your thigh, just before your leg becomes
your upper torso usually has a decent skin/fat fold. You can do the injection sitting down,
and you don’t have to do the whacky skin stretch thing Crisler demonstrates.
Subq injections in that area didn’t leave that hard little nodule that I always got in my
abdomen.

1 Like

[quote]PKNY wrote:
RDW-SD H 47.0
Platelet count L 139

These two values suggest anemia.
Do you have the rest of the CBC section of the bloodwork ?
Specifically WBC RBC HEMOGLOBIN and HEMATOCRIT.
Also, do you have ALT AST #'s ?

I was thinking you had edema type bloat, I didn’t realize it was in your abdomen.
Does it seem like air, or water ?

Do you take any other meds ? Supplements ?

A few suggestions:

Stop using Hcg for two weeks.
a 250iu injection keeps my boys firm for several weeks. When I took it three times a week
I was all over the place #'s wise. *Crisler won’t like this as he believe the HCG is the be all end all
compound.

Change up your AI from Adex to Aromasin.

Long shot, but you should move the site of your Subq injections from your belly to
your upper leg. I do IM in the delt, but when I used to do subq I did the upper part
of my leg. If you are seated, on the top part of your thigh, just before your leg becomes
your upper torso usually has a decent skin/fat fold. You can do the injection sitting down,
and you don’t have to do the whacky skin stretch thing Crisler demonstrates.
Subq injections in that area didn’t leave that hard little nodule that I always got in my
abdomen.

[/quote]

WBC 4.6
RBC 5.36
HEMOGLOBIN 15.3
HEMATOCRIT 47.1
AST 30
ALT 28

Does the bloat feel like air or water? I am not real sure; I would say mostly air or gas. I have tried over the counter water reducers with no luck. I have tried drinking lots and lots of water no luck. The more I think about it I would have to say air.

I take a multi, occasional protein drink or protein bar. Crisler had me start on iodine selenium, B complex and C. I do not take the for mentioned every day.

I also tak Wellbutrin 150mg once per day and xanax 0.5mg (no more than 2 per day) for anxiety and depression. An occasional trazodone for sleep (very small amount 1/4 of a 50mg tablet. I have been on the xanax at small doses for a long time. I am very afraid of dependance.

I will certainly give your HCG dosage recommendation a try. There seems no harm is reducing to a bigger dose once per week. I am not sure about switching Aanastrzole, as I get that from a prescription from Doctor Crisler. I am not sure if he would agree to switch unless I know how to present the topic without offending him.

Thanks for the injection information. I was baffled about why this way happening and all my layman mind could come up with it that area of my abdomen is sort of a pin cushion and I have experienced the hard nodules you mentioned.

I appreciate your time, it is kind of you.

Jeff

It seems many patients of Crisler live in fear of him…pretty sad.
But he is pragmatic, and if he’s baffled to the bloat he should be open to suggestion
on the switch from Adex to Aromasin.

Your other blood #'s look fine as does your liver. You may want to consider b12 supplementation
though. There are some decent ones you can purchase otc that are sublingual and effective.

On the HCG, just ditch it for two weeks straight. If the symptoms don’t improve than you can
go back to your regular dosing schedule if it’s been serving you well.

I have no experience with Wellbutrin, but I do with xanax, and the sooner you can ditch it, the better.
Benzos are highly addictive, and slow down every process in the body. They have their
place for anxiety or panic attacks, but not daily IME. That is entirely up to you though.
Never took trazodone either, but I hear you on the need to shut your mind off occasionally to get
some sleep. I take ZMA nightly, its a combination of Zinc, Magnesium and B6…sounds goofy but
it works great and has zero side effects, except for vivid dreams.

Last suggestion for the abdominal bloat, have you tried probiotics / acidophilus ?
Its the bacteria used to make yogurt. It can really help to balance your gut bacteria and relieve
abdominal bloating. You can buy it at health food stores, and supermarkets that have a
health, vegan etc section. It will be in a cooler, be sure to buy it that way, and not one that is
on a shelf in a vitamin isle.

Good luck and let us know how you make out.

PKNY,

Thanks for all the tips very much appreciated. I have heard of probiotics, but always on the self never from a cooler. Is there a brand off the top of your head you could recommend.

I would ask the next question in a private message but thought was being a bit bold of me. Is what I initially experienced the norm for T replacement users, in terms of feeling so good and then coming back down? And if so, is it the result of a doubling of T suddenly in the body, what was being produced naturally and what was injected? And finally if all of this is true would it represent what an anabolic steroid cycle would be like?

This is a person with little knowledge and a touch of common sense trying to figure out why the huge addictive rush of strength, quick recovery and huge increase in energy for just a short period. Then once the body realizes it has more T then it knows what to do with it shuts natural production down?

Finally, at 57 years of age, there is little “I fear” in terms of interaction with people, in fact, it is what I do for a living. The Doc is a confident guy, but believe me I have encountered much, much worse. I could put myself in his place, as I too am considered an expert in my field. I don’t know how seriously I would take a suggestion to change my methods based on one of my students telling me “a guy on the net told me”. No offense to you at all you have been very helpful. But would an approach to this topic work better if I said something like “Doc, I am still suffering the bloat and have read where a switch from Adex to Aromason has helped many”?

Thanks again, if I come to a resolution I will let you know.

Happy Holidays!

1 Like

I don’t have any study to cite for this, but have seen it mentioned (by Dr Crisler online I think) that the initial good feelings from TRT may be due in part to its effect on brain dopamine. If that is true, then as with pretty much anything that increases dopamine (such as many addictive substances), after a while the brain builds a tolerance to increased dopamine and then it doesn’t feel as good.

I don’t know how seriously I would take a suggestion to change my methods based on one of my students telling me “a guy on the net told me”. No offense to you at all you have been very helpful. But would an approach to this topic work better if I said something like “Doc, I am still suffering the bloat and have read where a switch from Adex to Aromason has helped many”?

HA, I hear ya!
I’ve never interacted with Crisler personally, but I’ve read hundreds of accounts by former patients
of his that aren’t exactly flattering. However, I do respect the man for helping to
legitimize TRT. He seems to have a blue print for TRT that appears to be more of a one size fits all.
If it’s questioned by a patient it doesn’t work for, it’s met with disdain instead of an obstacle to over come,
and usually mixed with a bit of attitude. I know he’s an expert, but being a dick to people paying for
advice you gave that doesn’t work is BS. That said, easing the question to him is a good idea but be ready
for his dismissive attitude.

In his defense, I’ve seen varied protocols pushed by other leading TRT Dr’s around the country, each
with it’s own theory and few answers to those it doesn’t work for.

I realize that forums are full of half truths and bro science, but the collective empirical
data and first hand experience of men in the same boat is more powerful than you may give it credit for.

I’ll get off my soapbox now LOL.
WRT to the good feelings: Your total test # is good, but your Free is a bit low and SHBG at 38 is a factor.
You will need more T to raise your free T to the level that previously made you feel so good.
You will also need more AI to keep e2 in check. Of course, more adex could aggravate your bloating issue.

On the probiotic, I buy one of the cheaper ones by SOLGAR. They have really fancy ones that are expensive,
but the cheaper ones are just as effective IME.

PKNY,

Very cool of you to reply. I admit, I have noticed a bit of attitude from the Doc. However, he is calm compared to some I have talked with about T replacement therapy. Quite a while back before going on the T I exchanged a long series of emails with Ksman. I loved his quote about being your own doc, within reason ( I know I am butchering the quote forgive me Ksam if you read). I sort of feel that is where I am now.

Doctor John has more or less said “run for the next 6 months and come see me”. This troubled me some but then I figured the body needs to adjust. It is and has been very hard to keep track of all the details, but your comment on high SHBG rings a bell as far as where Doctor John started me. Meaning that was his concern also.

I do know I felt wonderful and would give anything to get that feeling back. Note; during the time I felt the best my protocol was one shot per week, with no anti E or HCG. I think the anti E probably should have been added earlier, as I had bad nipple reaction. The boys shrunk big time also in the first couple of months so I was an easy sell on HCG.

I think I might try boosting the T up a bit, turning the HCG to once per week as you suggested and keep the anti E where it is for now.

Sort of like chasing the dragon…

[quote]seekonk wrote:
I don’t have any study to cite for this, but have seen it mentioned (by Dr Crisler online I think) that the initial good feelings from TRT may be due in part to its effect on brain dopamine. If that is true, then as with pretty much anything that increases dopamine (such as many addictive substances), after a while the brain builds a tolerance to increased dopamine and then it doesn’t feel as good. [/quote]

seekonk,

I understand placebo effect and dopamine manipulation. What I experienced that first month or month and a half I feel confident in say was not either. The weight I would use for my workout seemed “light” it was much easier to do more reps without the effort. In fact, I remember thinking, you better back off, just because it seems easy you could hurt yourself.

I admit I don’t know, if I did I would not be posting. It does make sense (uneducated level) that natural T production plus injectable start to equal a Steroid sized dose, until the boys say whoa… and shut down internal production.

I hope and wish I am wrong in my elementary reasoning, because I would give anything to get that initial feeling back.

Thank you for you commenting

PKNY,

I thought I would let you know your recommendation to stop the HCG to stop the bloat worked like a charm. I have been bloat free for nearly two weeks and it is wonderful! I am concerned about re-introducing the HCG and wondered how you handle the dosing?

I sent a PM as well but was not sure it went OUT, sort of a strange message system used here at T-Nation.

Bottom line, big Thank you for your suggestion.

Jeff

Pardon for the noob semi-hijack…

Can you describe “the bloat”?

Hey Jeff, great news !

HCG seems to be a wild card for a decent % of TRT guys, myself included.
I’ve heard the explanation that intra testicular T production that is stimulated
by HCG can aromatize to e2 readily in that environment. No amount
of AI can help with e2 when it’s converted at that level.

I use it sparingly, usually just 1 250iu injection whenever I feel my boys begin to
get soft or if they ache. This is usually around every 12-20 days give or take a few.

Did you tell Crisler ? : )

[quote]PKNY wrote:
I’ve heard the explanation that intra testicular T production that is stimulated
by HCG can aromatize to e2 readily in that environment.

[/quote]

What’s the fallout from this?

Chaz, it’s different for each guy. But, it generally manifests itself as a symptom of high E2.
In Jeff’s case, it bloated him up, in my case it made me bitchy and moody. When it was
happening to me I’d take more AI.

The problem is the additional AI stopped conversion in my peripheral tissues, but had no effect
on the testis conversion. So I had feelings and symptoms of high e2, but the extra AI was setting me up for an E2
crash. Low E2 is worse than high E2 IMO, much worse.

[quote]PKNY wrote:
Hey Jeff, great news !

HCG seems to be a wild card for a decent % of TRT guys, myself included.
I’ve heard the explanation that intra testicular T production that is stimulated
by HCG can aromatize to e2 readily in that environment. No amount
of AI can help with e2 when it’s converted at that level.

I use it sparingly, usually just 1 250iu injection whenever I feel my boys begin to
get soft or if they ache. This is usually around every 12-20 days give or take a few.

Did you tell Crisler ? : )

[/quote]

PKNY,

Thanks for the suggestion. I will try 250 once every two weeks and see what happens. I won’t see Dr. John for another five months, as I started on his six month cycle between appointments last visit. All I can say it is so freaking nice not to feel like someone stuck an air hose in my ass. I can actually suck my stomach in now!

Thanks again,
Jeff