T Nation

HRT... Bodyfat and Acne


#1

I've been thinking of going the HRT route after many failed attempts of trying to increase my energy, recovery ability, self-esteem, back pain, and depression through nutrition, supplementation, prescribed pharmaceuticals, and exercise, over the last 10 years.

My recovery ability is in the shitter as opposed to when I was a teenager. I no longer get much of a "pump" when training. I can only seem to tolerate working out twice a week for about an hour at a time now. It usually consists of 10 min. interval cardio, 40 min. weights, and 15 min. stretching. I have to keep my intensity of my workouts quite low as if I try to go too close to failure it tends to fry my CNS for quite awhile afterwards. Playing competitive volleyball for two hours seems to wipe me out much more that anyone else on my team. I'm usually exhausted for a couple days afterwards. I play volleyball once a week.

My diet is pretty clean consisting of a zoneish macronutrient breakdown; 300 grams protein, 300 grams carbs, and around 200 grams of fat. Yes, it's a lot of fat. :slightly_smiling: It seems to help me feel better though. I tend to not tolerate low fat diets very well at all. Same with very low carbs. I also don't have much stress in my life.

I tend to "look like I'm in shape". I'm 6'3 225lbs, at around 8% bf, 29 y/o. Bench: 325lbs, Squat(3/4): 385lbs, Deadlift: 415lbs.

The only relief I have gotten is from taking drugs/supplements that boost test and dopamine; Selegiline, Vitex, Redcat, and TRIBEX. Sadly though I tend to get a nice boost the first week with diminishing results afterwards with maximum suggested dosages.

Is it possible to have low testosterone, while having low bodyfat and problems with acne or are they mutually exclusive for the most part?

When my acne is the worst, my workouts, mood, and energy seem to be best interestingly enough. March/april and sept/oct also seem to be better months for me in that regard. Some kind of seasonal cycle, possibly hormonal.

I'm thinking of booking an appt with my doctor to get some lab results done or get a referral to an endo. I'm wondering though if they will dismiss getting bloodwork done if I appear to be in shape and have mild acne. I'm clearly suffering here.


#2

Hey guy,
The only way your going to know is to go to a qualified doctor, who treats low testosterone on a frequent basis,and have the doc test you.

You can be in good shape and have low testosterone. You'd just be in better shape with a good test level.

Before I got tested, I thought I must've had good testosterone levels because I have ALOT of body hair. Turns out, body hair is genetic, and you can have alot with low testosterone.

You're not fat because you don't consume more calories than you burn.

Women have low testosterone, and they can be not fat.

Bottom line is, go to a qualified doctor.

I recommend www.allthingsmale.com

Dr. Crisler is my doctor, he's really nice, and just a top notch guy.

You have to travel to michigan,though, for your first consultation. I drove 4 hours from Ohio, and if you can, it's well worth it.

Steve.


#3

I concur with the post above. See a qualified doctor. And get your blood work done more than once before starting HRT.
Levels can be low due to external conditions, and it would be a mistake to start HRT based on one reading.

Also, please don't take this the wrong way, but your numbers seem low for someone your size and age. At BW 198 and 42 years old I did similar, more in the squat. Could this be T related? Beats me.


#4

Acne is (believe it or not) an easy problem to solve.

Firstly you'll need a good gentle cleanser. You get the bodyshop in the US don't you? Go for anyone of their gentle cleansers, my preferecne lies with the vitamin E version.

Secondly you will need a product called Benzoyl Peroxide, you only need the 2.5% since it's much less harsh on the skin than the higher dosages yet will still clear acne as effectively. Most over-counter acne solutions may work a couple of times then stop working, this is because acne causing bacteria can mutate to be resistant to them; this is not the case with benzoyl peroxide. Over the counter acne washes nearly all contain hydrogen peroxide, or sallycic acid which are useless.

you can get high quality benzoyl peroxide cheap here : http://www.clearskinregimen.com/

Finally you will need a quality moisturiser. I reccomend "Bio-Oil"
http://www.bio-oil.info/
It really is a breakthrough and by far the most effective moisturiser i've used, it's also great at healing blemishes/ old scars.

You should use the three products in the order they are listed but wait for the benzoyl peroxide to dry before applying the bio-oil. It may take a few days for your skin to get used to the peroxide at first, red skin is normal in the beggining but this would be reduced by the bio-oil.

Don't get benzoyl peroxide in your eyes whatever you do, and don't rub your face all day.

Good luck
alstan

P.s, i'm allowed to know this since im metro.

Im also presuming the acne is on your face.

www.acne.org is a great site for acne info, and more or less backs-up what i said.


#5

Thanks everyone for responding.

I would definitely go to a doctor to get the proper blood tests taken. There's no doubt about that. I've researched all the options as well. I've read all the steroid related articles, and HRT related threads here, so I'm familiar with all your guys tribulations and such. I'm been reading this site since it's second year of inception.

As for my lifts, I'm not interested in powerlifting, more looking good naked and athletism per se. My recovery ability is absolute crap though which I'm sure hampers my workouts to some degree. I'm not interesting in getting any bigger, or stronger really, just more energy, recovery, and mood improvement. My quads are 26", arms 17" with pretty good vascularity. I get enough comments as it is regarding my size and veins. I've met my goals in terms of that. 15 years of experimenting with nutrition and workouts have allowed me to get a lot out of what I have.


#6

Thanks for the input. Yes the acne is on my face, and I'm quite familiar with all the products and websites you've mentioned except for the bio-oil.

Acne may be simple to solve for some, but I wouldn't say everyone. I've been on all the heavy hitting medications with limited success. Two courses of accutane, a few years of minocycline/tetracycline, salicylic acid, benzol peroxide, clindamycin lotion, vitamin A acid gels, and I'm sure I'm forgetting a few others.

I've been on so many cleansers I don't want to even bother listing. Vitamin B5 and copper seem to do an ok job. Vitamin B2 works great but it makes me feel like ass(depression and severe fatigue). Yeah I know weird. Tea tree oil, acidophilus, zinc, vitamins B3, biotin, C, E, and A aren't of much help either.

Now I know testosterone can exacerbate acne, and taking Vitex, TRIBEX, and RED KAT, all make my acne worse, and make me feel much better. It peters out eventually though and it's not a matter of taking a weekend off or a week off to get the magic back either. Usually a month or two off for 2 weeks of goodness isn't much to write home about. :slight_smile: I've read that dopamine agonists can cause downregulation over time. Perhaps this is the mechanism I'm experiencing at some level.

This is what happens to me, I'm not generalizing to anyone else. I've read others accounts that Alpha Male was efficatious for a long period of time.

I know I can have clear skin if I don't take any of the test supps, and take vitamin B2. I've done it before, but I feel like genuine ass. I'm guessing if I ever were to take testosterone supplementation my acne would get much worse. I was trying to research if B2 down regulates natural testosterone production. All I found is that it's involved in the conversion of testosterone to 5 alpha-dihydrotestosterone(DHT), which is an even more androgenic compound which wouldn't seem to support my theory.

Perhaps taking vitamin B2 in conjuction with the test would even things out somehow. It's all conjecture and speculation at this point, and this post is starting to get convoluted. :slight_smile:

I'm going to call for an doctor's appt now to move things along.


#7

For the acne, try tea tree oil. It's a natural antiseptic.

As for the doctor, you don't need a "qualified" doctor; all you need is a general practitioner who will order all the tests. If you've read the various threads, you should know what tests to get. Be sure to get the estradiol too, but make sure it's calibrated for men.
If the tests come back out of range, THEN you need a referral to an endocrinologist.

Also at 225 lbs, isn't 300g of protein a bit much? At 2 workouts per week, and only 40 minutes of weights, I don't think you need a full 1.5g per lbm.


#8

You couldn't be more wrong. A qualified doctor is definitely needed. Do you know what tests to order? To get all the information (which I certainly would want before I went on drugs/hormones for the rest of my life) you need to have a lot of tests done. Just testing your Total Test level doesn't say much. You also need your Free Test (much more important), your estrogen levels, dht, LH, SHBG, etc...If your estrogen levels are elevated, that alone could be the cause of lower test levels. But which estrogen? THere are three types in men but only one is of real concern. How many general practitioners do you think know all this? One in a million maybe?

THen, at best, you'll need to fall BELOW the reference range for Total Test to get a referral. And even if you get a referral, the average Endo won't give you a Rx unless you're BELOW the reference range. Well guess what? There is no reference range for a 29 year old. There's only a MALE reference range that was determined by measuring test levels of men between 20 and 80 yrs old. So if you're 29, you'd like to be on the higher end of the range, if not, you may have low test problems. But unless you have Test levels less than most 80 yr olds, your doctor or Endo probably won't prescribe test.

Besides, an expert doctor specializing in HRT will know all the tests and precisely what dosages of what drugs/hormones you need. I also HIGHLY recommend Dr. Crisler at allthingsmale.com. Once starting HRT (if you need it), he'll order bloodwork every 6 weeks and start you on the minimal dose so you find the exact, perfect dose for you with minimal or no side effects. He knows how to keep your estrogen levels down and with proper use of things like HcG, you won't become sterile or completely lose your ability to make your own test.


#9

I've been on HRT for several years, so I think I know something. And with most insurance companies nowadays, you can't get a pass for a "qualified" doctor, meaning a specialist, until you get past your GP. Maybe you should learn something about insurance.

A good GP knows just enough about endocrinology to get the information needed for a diagnosis and a referral to the specialist who has the specialized knowledge to treat it.

A good GP, like mine, will listen to your concerns, listen to what you've learned on sites like these and get enough tests done to make a diagnosis and refer you to an endocrinologist. NOT a urologist. The endocrinologist will then run the full battery of tests, including a pituitary CT scan if he thinks it appropriate. Why would you go to a urologist for an endocrinology problem? Just because the balls are close to the bladder?

If your GP won't listen, find a new a new GP.

The point being that you can go to your GP first instead of running around the country looking for specialist, unless of course you're a rich bastard and have a ton of money to throw at the problem. Don't make the solution so complicated.

On a final note, many endos spend so much time treating diabetes they don't know much else. I was lucky to find one
that also had a pretty good practice in HRT going. Just being a endo doesn't guarantee good HRT treatment,so don't be afraid to change endos if he/she doesn't work out.


#10

Well yorik,
I advised what would be IMO the best course of action for someone who wanted the BEST medical care, medical care where the doctor actually knows what he's talking about.
Not the least expensive medical care covered by insurance.
There's a big difference.
If you want to actually solve the problem, you have to go to a TRT doctor, not an Endo.
Steve


#11

Taken from my post up above...

"Tea tree oil, acidophilus, zinc, vitamins B3, biotin, C, E, and A aren't of much help either."

My protein intake will fluctuate between 200g to 300g depending on my goals or what I'm experimenting with at the time. I find it allows me to retain more lean muscle, and also helps to curb my appetite which I have a problem with sometimes.

From my learning thus far the tests I've read to be important are:

Serum testosterone(both free and total)
Estradiol
Prolactin
T3 and T4
TSH
LH

I had problems with gyno as a teenager. Whether it was due to progesterone, estrogen, or prolactin is unknown.

I also live in Ontario, Canada which obviously has a different healthcare structure than the states.

After reading a lot of your guys posts from other threads, if I do have low test, I think I would lean towards the injections with an anti-estrogen if needed. I really don't want to screw around with the gels or patches. Of course I'm getting ahead of myself. It's nice to theorize anyways.

I got a doctor's appt for tomorrow with my GP. He seems to be pretty open minded so I'm hoping he will order the tests for me or at least schedule a referral to an endo. The sad thing is I don't want to have to wait a few months to get an appt as it usually seems the case with specialists here in Canada.

I'm impatient as hell! 10 years of progressive deteriation is really wearing me down. I've gone through the anti-depressant route x 10 which really didn't offer much relief at all.


#12

Is DHT and SHBG really important? I thought you could indirectly measure SHBG levels by comparing the total test to free test.

A digital prostate exam and PSA test I heard are good ideas as well before starting therapy, although the PSA test is quite controversial.


#13

What do you guys think of the differences between once a week injections vs every three or four weeks?

Example: 100mg testosterone cyp. per week vs 300mg testosterone cyp. per 3 weeks.

I've read TC and I think Cy recommend that injections every three weeks allowed for more favourable conditions for natural test production. It results with a rebound test spike occuring after a couple weeks. Of course there's a negative with respect to greater peaks and valleys which isn't as favourable.

Ideas?


#14

Listen, if you've got low T, then get HRT. HRT is for life. If you're not producing enough Test at 29, you never again will. Don't think you'll go on for a little while to give your balls a break or jump-start your body or energy levels. HRT is for life. As my doctor says when asked can I ever get off of HRT, "sure you can go back to feeling the way you used to (read: miserable before HRT) anytime you wish."

As for the longer injections, it's highly NOT recommended. You'll feel great for a few days or a week - then you'll feel like crap for the remaining 2-3 weeks. Your test will not only be low the week or two before your injection, but it will be steadily decreasing. Both of those combined will make you feel worse than you do now. Plus, the side effects and health risks will be more pronounced. You'll have to take more test going over the high, healthy recommended test range and then you'll sink way to the bottom of the range later in the month. Not only will you feel like you're on a very bad rollercoaster, you may get bad acne, mood swings, sexual dysfunction and other more serious side effects from the hormonal swing of very high levels to very low levels.

Weekly injections are highly recommended and safest.


#15

I'm fully aware that HRT would be for life, and it doesn't bother me, assuming I do have low T which I am about to find out. I understand the physiological processes involved.

With respect to the longer injection protocol I misread Cy's quote. He is in favour of greater injection frequency i.e. once a week.

Here's Cy's quote I read:

"There's also a possibility of allergic reaction to sesame or cottonseed oil (solvents/vehicle) and supraphysiological peak concentrations, generally followed by subphysiological Testosterone levels prior to the next administration when 200-400 mg is administered every 2-4 weeks*. Once again, pharmacokinetic properties aren't conducive to mimicking the normal circadian rhythm.

*100 mg/week improves unfavorable pharmacokinetics."

This is what TC wrote:

"The advice Tim and I are giving to most docs is quite different.

We've found that 400 to 600 mg. every 3 WEEKS works quite well. Blood tests on several subjects have shown that in the third week--when Test levels should be leveling off--patients actually tested abnormally high; in the 700 ng/dl range.

What we theorize is happening is the the shots are far enough apart where you don't get any suppression. Your system simply picks off right where it left off while you're still benefiting slightly from the previous shot."

That quote was taken from two years ago. I wonder if he still feels the same way and what other authors like Anthony Roberts has to say. Perhaps I'll PM the both of them.


#16

I just remembered. If you were interested in Dr. Crisler's services, you don't actually have to travel to Michigan. You can go through your GP, and have Dr. Crisler serve as a consultant, all through your GP. I don't know how that would work with you living in Canada, but it's an ironclad way of utilizing a doctor who specializes in testosterone replacement. Dr. Crisler's website is www.allthingsmale.com
Give him a call,and see how you would work out the consultation through your GP.
Steve


#17

Thanks a lot Steve, I really appreciate the help!

The right doctor is so important for this kind of thing. Wish me luck tomorrow at my GP appt.

p.s. the link doesn't seem to work


#18

Just type in the url www.allthingsmale.com into your browser.
Steve


#19

Oh it that how it works? duh :slightly_smiling:

All I get is an index page, with dead links.

Here's a copy of the page.

Index of /
Name Last modified Size Description



Parent Directory 26-Apr-2006 10:48 -
_private/ 24-Apr-2006 16:33 -
cgi-bin/ 24-Apr-2006 16:33 -
images/ 24-Apr-2006 16:33 -
postinfo.html 24-Apr-2006 16:33 2k

----------------------------------------

Apache/1.3.34 Server at www.allthingsmale.com Port 80


#20

Hey guys,

Good news I guess. I just got back from my general practitioner appt and he's having me do blood work for:

Free testosterone
TSH
Prolactin
FSH
LH

I asked him about the total testosterone and estradiol but I couldn't sell him on them. I'd guess the total test isn't all that important anyway since it's the unbound test that's biologically active. What do you guys think?

He also prescribed another "anti-depressant" trazodone, although it's technically more of a sleeping pill. I told him I sleep great and have never had problems getting 8 hours in so I'm kinda lost on it. The fact that trazodone is a pretty weak antidepressant, when I've been on much stronger one's doesn't leave me very optimistic in that regard.

I'm glad that he didn't refer me to an endo. I don't feel like waiting till the end of the summer for an appt only to have him be a possible wanker. If I do end up testing low it would be nice to have my gp handle it all, if he can give me a sufficient dosages that is.