T Nation

Help with T Replacement Side Effects and Results


#1

age 52
-height 6’0"
-waist 36.5
-weight 202
-describe body and facial hair
Body=light
Facial=moderate

-describe where you carry fat
midsection

-health conditions, symptoms [history]
High Cholesterol
525 Total at highest 3 years ago
225 with a 85HDL currently with no medications

Head Trauma

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
No

-lab results with ranges
02.29.16 no medication
10.31.16 one month into clomid,
03.07.11 after 2 months of T injections and continued clomid
07.12.17 11 months clomid and 3 months Anastozole

                              10.31.16                                                  02.29.16

Growth Hormone** 5ng/ml* 0.19 LN
Somatomedin C (IGF-1)** 209 N > 200 ng/ml* 116 LN
IGF BP-3** 3630 LN 4000 ng/ml* 3100 LN
DHEA-S 276.8 HN ~255 ug/dl* 232.2 LN
Testosterone Free** 7.95 LN ~14 pg/ml* 8.92 LN
Testosterone Total 575 LN 690 ng/ml* 657 N
Dihydrotestosterone (DHT) 45.9 N < 55 ng/Dl* 43.7 N
Sex Hormone Binding Gb 59 HN < 45 pg/ml* 63 HN
Prostatic PSA <4.0ng/ml 0.789 N
Estrone (E1) 29.5 N < 60 pg/ml* 21.1 N
Estradiol (E2)* 16.4 N <25 pg/ml* 32.4 HN
Pregnenolone 110ng/dl* 35 LN
Progesterone 0.8ng/ml* .60 LN
FSH (infertile) 7 mIU/ml* 32.1 H
LH 5.1 mIU/ml 8.4 HN
Prolactin 14 ng/ml* 8.2 N
Zinc* 95 mcg/dL* 101 HN
Insulin < 25mIU/L 3.5 N
Vitamin D3** >60 ng/dl* 35 LN
TSH <2.5 mcu/ml* 2.29 N
T3, Free > 2.5 pg/ml 3.0 N
T4, Free > 1.5 ng/ml 1.34 LN
rT3 80-250 pg/ml 147 N
T3/rT3 Ratio >1.06 2.04 N
TPO <35 -
ACTH < 35pg/ml * -
Cortisol** < 15 ug/dl 24.5 H

Glucose (F) < 100mg/dl 101 H
Sodium (NA) 133-149 meq/L 141
Potassium(K) 3.5 – 5.5 meq/L 4.2
Chloride (Cl) 96-108 meq/L 101
Iron (Fe) 35-200 mcg/L -
LIVER TESTING Normal
SGOT < 35 U/L 20
SGPT < 38 U/L 19
Total Protein 6 – 8.4 gm/dl 6.9
Albumin 3.2 – 4.8 gm/dl 4.7
Globulin 2.0 – 3.7 gm/dl 2.2
Alkaline Phosphatase 30-125 U/L 40
Lactose Dehydrogen 80 – 225 U/L 146
GGTP 2 – 60 mg/dl 11
Total Bilirubin 0.1 – 1.2 mg/dl 0.70
BONE, JOINTS Normal
Calcium (Ca) 8.4 – 10.8 mg/dl 9.5
Phosphorus 2.3- 5 mg/dl -
Uric Acid 2.5 – 6.8 mg/dl 5.6
Magnesium (Mg) 1.5 – 3.0 mg/dl 1.9
LIPIDS -
Triglycerides (FAT) <162 mg/dl 50
Cholesterol < 200 mg/dl 211
HDL (Good) >45 mg/dl 70
LDL (Bad) <100 mg/dl 131
Cardiovascular Risk ¼ - 1/2 risk 3.0
RENAL FUNCTION Normal
Blood Urea Nitrogen 6 – 25 mg/dl 17
Creatinine < 1.0 mg/dl 0.8
GFR 108
BLOOD COUNT Abnormal
ESR 0 – 20 mm/hr 2.0
WBC 4.0 – 10.8 x103 2.7 L
RBC 4.0 – 5.4 x 106 4.78
Hemoglobin 13 – 17 gm/dl 14.1
Hematocrit 39 – 52% 44.4
MCV 80 – 99 fL 93
Granulocytes 45 – 75% 33.5 L
Lymphocytes 20 – 50% 51.9 H
Eosinophils 0-8% 2.1
Urine Analysis Normal -
CRP C-Reactive Protein 0.6 mg/L 0.0 - 8.0 mg/L

03.07.17
Testosterone Free 121.6 pg/mL 50.0 - 210.0 pg/mL
Estradiol 17 Beta 41 pg/mL pg/mL
Luteinizing Hormone 23.1 mIU/mL mIU/mL
Follicle Stimulating Hormone 51.9 mIU/mL mIU/mL
Prolactin 8.2 ng/mL 3.0 - 13.0 ng/mL
Insulin Growth Factor 1 135 ng/mL 50 - 317 ng/mL
Glucose (serum) 91 mg/dL 65 - 100 mg/dL
Blood Urea Nitrogen 21 mg/dL 8 - 22 mg/dL
Sodium 139 mmol/L 135 - 145 mmol/L
Potassium 4.7 mmol/L 3.4 - 5.3 mmol/L
Chloride 103 mmol/L 98 - 107 mmol/L
CO2 Venous 32.0 mmol/L 21.0 - 31.0 mmol/L H
Anion Gap 4 mmol/L 5 - 15 mmol/L L
Creatinine 1.1 mg/dL 0.7 - 1.2 mg/dL
BUN/Creatinine Ratio 19 Ratio 10 - 20 Ratio
Osmolality Calculation (serum) 280 mosm/kg H2O 275 - 300 mosm/kg H2O
Calcium 9.4 mg/dL 8.6 - 10.3 mg/dL
Protein Total Serum 7.1 g/dL 5.6 - 7.9 g/dL
Albumin 4.6 g/dL 3.5 - 4.9 g/dL
Result reflects use of Bromocresol Green Methodology.
Bilirubin Total 0.9 mg/dL 0.2 - 1.2 mg/dL
Alkaline Phosphatase 31 U/L 34 - 104 U/L L
AST (SGOT) 28 U/L 13 - 40 U/L
ALT (SGPT) 27 U/L 7 - 52 U/L
A/G Ratio 1.8 Ratio 1.0 - 2.0 Ratio
Globulin 2.5 gm/dL gm/dL
GFR >60 mL/min/1.73 sqm mL/min/1.73
Calcium, Corrected(Adj/Calc)Total 8.9 mg/dL mg/dL
Hgb 15.9 g/dL 14.0 - 18.0 g/dL
Hct 46.9 % 42.0 - 52.0 %
CRP C-Reactive Protein 0.6 mg/L 0.0 - 8.0 mg/L
Dihydrotestosterone 41 ng/dL 16 - 79 ng/dL
Sex Hormone Binding Globuline 46 nmol/L 10 - 50 nmol/L

Latest Labs July 12, 2017

SEX HORMONE BINDING GLOBULIN 68 Reference Range:10-50(nmol/L
FSH 59.4 Reference Range:1.6-8.0(mIU/mL
LH 37.5 Reference Range:1.5-9.3(mIU/mL)
ESTRADIOL 57 Reference Range:< OR = 39(pg/mL)
DIHYDROTESTOSTERONE 59 Reference Range:16-79(ng/dL)
TESTOSTERONE, TOTAL 666 Reference Range:250-1100(ng/dL
FREE TESTOSTERONE 81.3 Reference Range:35.0-155.0(pg/mL)
Prolactin 6.9 Reference Range:2.0-18.0(ng/mL

-describe diet
2500 calorie average
Real food
200 grams protein from grass fed beef, organ meats, fish, shellfish, poultry, whey
Small amounts of butter, Olive Oil
Lots of non starch vegetablres
Balance is Complex carbs, Beans, brown rice, potatoes, steel cut oats, seeds and fruit.

-describe training
531, 4 days per week
Prowler 1 or 2 days
Walk at least 5 miles a day (mostly work but some intentional with weight vest)
Bike 10 miles per week, mostly back and forth to work

-testes ache
recently, yes

ever, with a fever?
no

-how have morning wood and nocturnal erections changed
much less in the past month

I was prescribed Testosterone CP at 4 mg every third day. After a couple weeks I had a lot of fluid retention (gained 15#) and my blood pressure became elevated. I cut sodium in the diet but there was no effect. I stopped the T injections, blood pressure and weight returned to normal.
Dr. then prescribed Clomid at 50 mg three times per week and Anastozole (1mg but I need to check prescription to verify) three times per week on opposite days. Have been using Clomid for 8 months and Anastozole for 4 months.
Latest labs have desired effects going the opposite direction I want.

Are there any options that might help with fluid retention? Should I try the Test CP again?

Thanks for any help


#2

What is 4mg?
Report in mg’s, not ml’s

Need lab normal ranges, not L, LN, N etc
Do not have any units.
Please directly edit your post above and change to show lab ranges.

No blood work, CBC, hematocrit?

What labs were on T injections?
What labs were on Clomid+anastrozole?

Have you had your testes examined for vascular abnormalities or cancer?

Labs July 17: Looks like clomid and clomid dose is way too high, promoting high T–>E2 inside the testes, where anastrozole cannot work leading to very high E2=57pg/ml.

3mg/week anastrozole is insanely high.

Your testes are not working very well.

TSH=2.23 should be nearer to 1.0
Thyroid lab ranges are mostly useless.
Need thyroid lab ranges.
You may have iodine deficiency from not using iodized salt.
There is no useful amounts of iodine in sea salt, real salt or pink salts.
Please eval overall thyroid function via oral body temperatures, see below.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


#3

Thank you KSman.

Testosterone CP 0.20(40mg) every 3rd day.

Lab ranges added.
Blood work added.
02.29.16 and 10.31.16 labs were before T injections
10.31.16 lab was one month on Clomid

Tests examined and ultra sound.
Fertility issues, took a long time to have our daughter

Current clomid prescription is 50 mg 3 times per week.
I stopped a week ago

Current Anastrozole prescription is 1mg 3 times per week.
I stopped a week ago.

I did supplement with iodine for a time while regulating my thyroid and defective LDL receptors.
I damaged myself with a very low carb diet for a time. No longer do that and things have returned to normal.
now I eat salmon,scallops, and sardines 5-7 times per week.
open to iodine supplementation again.


#4

Barlifr

  1. do you have any hair loss? Prior to using clomid or prior?
  2. any prostate related issues?

#5

No hair loss prior or after.
No prostate issues.


#6

This is from holding your breath for the needle stick.

Hopefully SHBG will calm down.
03-17
IGF-1 down a lot. This is your GH status. Do not test GH directly
FT midrange, E2 high, SERM dose too high

You need to check body temperatures and selenium is not optional.

Get iodized salt and use it. Get vitamins with trace elements that also list iodine 150mcg and 150-200mcg selenium.


#7

Thanks for the information KSman.
I will start checking body temperatures.
I eat 2 Brazil nuts daily for selenium since I eat so much seafood.
I will add iodized salt or an iodine supplement. If supplement is there a recommended starting dose?
What is a typical starting dose for SERM that isn’t too high.
Would it be recommended to stop everything for a while and then restart after a couple months?
Thanks again.


#8

Stopping everything is misery.
SERM dose? See HPTA restart sticky for general issues.

See standard protocols.
T twice a week or E3D
0.5mg anastrozole twice a week or adjust to E3D
250iu hCG subq EOD to support testes, fertility not an issue at your age.

  • or 12.5mg Clomid or 10mg Nolvadex EOD

Some feel terrible with Clomid, Nolvadex does not do that.