T Nation

I'm 50 on TRT 2 Years - Doc Not Helping


#1

Been on TRT for 2 years.
Age 50
Height 5’6”
Waist 32”
Weight 183LB
Normal facial hair
Thin hair line, lots of new hair in the last year everywhere but my head.
Fat is in my stomach.
Had high cholesterol but under control for the past 5 years with medication.
Had a one time AFIB episode and another time from heavy drinking. I really don’t drink unless I go to Vegas. I don’t think I have asthma, doctors say I don’t have it but some times I get whizzing and need to use Albuterol that I have prescribed.
No pains and aches, had constant back pain had to see chiropractor twice weekly in the past, but its gone since I started working out had no need for chiropractor.
When I started TRT my sex drive increased but not much going on in the past 4-6 weeks.
My Rx are:
25mg Atenolol
20mg Simvastatin
20mg Omeprazole
OTC I take:
81mg Aspirin
10mg Loradine
5000mcg B12
5000IU D3
1360mg Omega3
Smart Pants Adult Complete Multi Vitamins

Low carb, high protein 6 meals a day for 4 months, taking a break but still lots of protein low carb during the week except evenings and weekends pasta, pizza and hamburgers.
During this period my weigh has been fluctuating from 175-185Lb with not much change.
I work out 4 days a week with weights 1 1/2 hour with group training for the last year half, I’ve been building my strength very slowly getting good compliment from other trainers that I’ve been improving. I see it very slow and feel my gut is still the same and sometimes even bigger.
My TRT started almost 2 years ago from being in the low 258ng/dl.
The idiot put me on TC 250mg 1ml every other week with no change after 3 months to 250mg 1.5ml every other month, this worked well. Then after 6 month changed to Sustanon 250 1.5ml other week for 6 months still fine worked well I think. But hen he got lazy and I didn’t see him for 8 weeks felt bad, I tried to keep up the work out but really struggling.
Restarted 4 weeks a go, last dosage was TC 1.5ml and he just gave me a prescription for TE 200 and I have Sustanon 300. He said I can give my self a shot this week if I need it.
Very confused so I though I should get informed and do my own research but all is very overwhelming. Do I need to worry about E and my testcles?
I have an appointment next week don’t know what to expect then just another shot and go.
I’m very concerned that I’ve been relying on this idiot for my TRT for his financial gains at my health expense.

These are my last labs on 8/13/16
Sodium 134
Potassium 4.5
Chloride 101
Carbon Dioxide 27
Glucose 100
Urea Nitrogen 24
Creatine 1.0
Urea nitrogen/Creatine 24
eGFR, non-africana American 84.4
Calcium 9.5
Protein, Total 7.4
Albumin 4.7
Bilirubin, Total 0.80
Alkaline Phosphatase (ALP) 42
Alanine Aminotransferase (ALT) 26
Aspartate Aminotranferase (AST) (SGOT) 18
Albumin 4.7
SHBG 20
Testosterone >1,500
T Free >416


#2

Sounds like you, like all of us, need to take shit into your own hands. Do lots of reading of the stickies so you can answer your own questions and not have to wait or rely on others :slight_smile:

Firstly, can you clarify what your current dose is? Look on your prescription and find how how many milligrams per milliliter. It matters :wink: For example - if he has you doing Sustanon 300 at 1.5ml, that’s 450mg of T.

And also enter reference ranges for your lab work.

Worry about E? I would think so - especially when injecting large amounts of T like you are and with your sex drive and other symptoms of high E in men. Seems like your T levels are high and your dosage is very high, and TRT isn’t working very well so you are likely converting a lot of your T into estrogren.

Testes haven’t shrunk yet?

I would also worry about hematocrit levels. Recently read on another thread here about someone having heart issues.

I’m a noob but trying to be helpful.


#3

Here are the test results:These are my last labs on 8/13/16
Sodium 134 LOW 135-145 mmol/L
Potassium 4.5 3.4-5.3 mmol/L
Chloride 101 98-107 mmol/L
Carbon Dioxide 27 22-29 mmol/L
Glucose 100 65-140 mg/dl
Urea Nitrogen 24 High 7-18 mg/dl
Creatine 1.0 0.6-1.3 mg/dl
Urea nitrogen/Creatine 24 6.0-22.0
eGFR, non-africana American 84.4 mL/min/1.732
Calcium 9.5 8.4-10.2 mg/dl
Protein, Total 7.4 6.7-8.2 g/dl
Albumin 4.7 3.2-5.5 g/dl
Bilirubin, Total 0.80 .20-1.00 mg/dl
Alkaline Phosphatase (ALP) 42 42-128 IU/L
Alanine Aminotransferase (ALT) 26 5-30 U/L
Aspartate Aminotranferase (AST) (SGOT) 18 10-42 IU/L
Albumin 4.7 3.2-5.5 g/dl
SHBG 20 11-80 nmoI/L
Testosterone >1,500 High 300-890 ng/dl
T Free >416 47-244 pg/mL

My last shot was TC 250mg 1.5ml would be 375mg, not sure what my next shot would be.
Doc want me to bring my 2 vials of TE 200 and Sustanon 300, he usually gives me 1.5ml of one.
He gave me the vials and syringes to do my own shots when he not around.
He’s not doing anything about my E, I’m concerned I will read more about it, still learning all the terms.
Not sure about hematocrit, I will read more about it as well.
Thanks!


#4

Heart burn meds, PPI’s, lower mineral absorption. You probably need to supplement magnesium. Any leg cramps? Magnesium will help with blood pressure.

Tell doc that you want to:

  • sell inject 50mg T cypionate twice a week, 100mg total per week
  • get E2 labs and Rx anastrozole as needed to get near E2=22pg/ml, suggest 0.5mg to start at time of injections
  • always do labs halfway between injections to eliminate lab timing artifacts

The above will deliver steady T levels. If T levels are changing, the competitive drug anastrozole cannot work properly as it needs to match T levels. Getting near E2=22pg/ml will optimize fat loss and patterns, energy, anabolic effect, libido, mood.

Labs:
TT
FT
E2
PSA
fasting colesterol
fasting glucose
TSH
fT3
fT4 [please not T3, T4]

Eval overall thyroid function by checking oral body temps as per thyroid basics sticky.

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

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

#5

Glad to hear from you. I don’t have leg cramps however I did pull a hamstring 6 months ago but I fully recovered and don’t have high blood pressure. Whats the daily recommended dosage for magnesium?
The Atenolol was given to me because of the AFIB I had one time. I also did a stress test that resulted in me being low risk.
I will need to find a new lab company, was using Theranos that was very convenient and cheap.
What about the Sustanon? I have 2 vials. Can I take that instead until I’m out of it or I’m I being cheap and not thinking about my heath.
My testes normally where big, they have shrunken down at least 1/2, should I take anything for it?
My sex drive was going strong about 8 weeks ago but not much urge lately, could that be because I wasn’t consistent with the shots and different kinds of T?


#6

Update with new doc, staring fresh with new lab work, been off T for 2 weeks now.
My T looks really low, I think I will cut back on the B12.
Been feeling all these ups and downs lately want to get back on track.
Will start on T Monday.
1/30/2017
Test LowNormalHigh Reference Range Units
T4,Free(Direct) 1.13 0.82-1.77 ng/dL
Triiodothyronine,Free,Serum 2.7 2.0-4.4 pg/mL
Glucose, Serum 89 65-99 mg/dL
Hemoglobin A1c 5.2 4.8-5.6 %
Bun 21 6-24 mg/dL
Creatinine, Serum 0.93 0.76-1.27 mg/dL
Egfr If Nonafricn Am 95 >59 mL/min/1.73
Egfr If Africn Am 110 >59 mL/min/1.73
Bun/Creatinine Ratio 23 9-20
Sodium, Serum 144 134-144 mmol/L
Potassium, Serum 4.5 3.5-5.2 mmol/L
Chloride, Serum 103 96-106 mmol/L
Carbon Dioxide, Total 26 18-29 mmol/L
Calcium, Serum 9.1 8.7-10.2 mg/dL
Protein, Total, Serum 7.0 6.0-8.5 g/dL
Albumin, Serum 4.2 3.5-5.5 g/dL
Globulin, Total 2.8 1.5-4.5 g/dL
A/G Ratio 1.5 1.1-2.5
Bilirubin, Total 0.4 0.0-1.2 mg/dL
Alkaline Phosphatase, S 61 39-117 IU/L
Ast (Sgot) 16 0-40 IU/L
Alt (Sgpt) 20 0-44 IU/L
Vitamin B12 >1999 211-946
Vitamin D, 25-Hydroxy 68.5 30.0-100.0 ng/mL
Cholesterol, Total 164 100-199 mg/dL
Triglycerides 81 0-149 mg/dL
Hdl Cholesterol 38 >39 mg/dL
Vldl Cholesterol Cal 16 5-40 mg/dL
Ldl Cholesterol Calc 110 0-99 mg/dL
Ldl/Hdl Ratio 2.9 0.0-3.6 ratio units
Tsh 2.320 0.450-4.500 uIU/mL
Thyroxine (T4) 7.1 4.5-12.0 ug/dL
Triiodothyronine (T3) 99 71-180 ng/dL
Prostate Specific Ag, Serum 0.8 0.0-4.0 ng/mL
Insulin-Like Growth Factor I 140 67-205 ng/mL
Testosterone, Serum 181 348-1197 ng/dL
Free Testosterone(Direct) 6.8 7.2-24.0 pg/mL
Lh <0.2 1.7-8.6
Fsh <0.2 1.5-12.4
Sex Horm Binding Glob S 21.9 19.3-76.4 nmol/L
Estradiol <6.0 7.6-42.6
Wbc 6.3 3.4-10.8 x10E3/uL
Rbc 5.04 4.14-5.80 x10E6/uL
Hemoglobin 15.7 12.6-17.7 g/dL
Hematocrit 46.7 37.5-51.0 %
Mcv 93 79-97 fL
Mch 31.2 26.6-33.0 pg
Mchc 33.6 31.5-35.7 g/dL
Rdw 14.2 12.3-15.4 %
Platelets 247 150-379 x10E3/uL
Neutrophils 63 %
Lymphs 25 %
Monocytes 9 %
Eos 2 %
Basos 1 %
Neutrophils (Absolute) 4.0 1.4-7.0 x10E3/uL
Lymphs (Absolute) 1.6 0.7-3.1 x10E3/uL
Monocytes(Absolute) 0.6 0.1-0.9 x10E3/uL
Eos (Absolute) 0.1 0.0-0.4 x10E3/uL
Baso (Absolute) 0.0 0.0-0.2 x10E3/uL
Immature Granulocytes 0 %
Immature Grans (Abs) 0.0 0.0-0.1 x10E3/uL