T Nation

Introduction and Looking for Input

Just joined, and I’m looking for input.
I’m on 200 mg Test Cyp per week, 100 mg 2x week
Anastrozole is now 1/4 pill with each injection
I had/have a rare condition known as hyperparathyroidism hyperplasia, resulting in surgery last January. This means that all four of my parathyroid glands were enlarged, so they cut out three and a half and left me with half a gland.
I have a CPAP for apnea, which I hate passionately, it actually makes my sleep worse.
I am concerned that I am developing thyroid issues.
I had some blood work done and threw in a thyroid panel at my wife’s suggestion.
TSH 4.0 uIU/mL range 0.4 - 4.2
fT4 1.2 ng/dL range 0.8 - 2.0
T4 6.5 ug/dL range 4.5 - 14.0
fT3 2.9 pg/mL range 2.1 - 4.7
T3 1.1 ng/mL range 0.7 - 2.0

My waking temperatures from 12/ - 12/14 were:
I have plenty of other blood work from the last several years also.
I am on TRT because I went to an endo for the hyperparathyroidism and he wrote me a scrip for Androgel without blinking, all on his own initiative. I knew next to nothing about T levels prior to that point, but I did some reading and contacted a friend who does know.
It should be noted that I was a competitive amateur Strongman and I did some Highland Games, with a pretty low T level as it turns out. Would have been nice to know back when I was competing. I’m leaving a lot out, so ask any questions that need to be asked.

Just to add, my T is 833, with an E2 of 18.1 (not sensitive assay) at 200 mg Test C and 1/4 anastozole 3 x week. So I cut back to just twice a week with the anastrozole, but no new blood work since I made that change.
I am also diagnosed as ADD as an adult about 15 years ago, and I have Adderal for periods of high stress but generally do not use it.

When was the blood work drawn in comparison to the previous injection when you got that number?

Blood work is usually done on injection day, first thing in the morning before I take anything. The test/E2 level was done then, I inject on Monday and Thursday.
With 1 mg of anastrozole my E2 was 8. No sensitive assay available here, I’m in Central America at the moment, but everything is OTC here. Including Clomid and HCG if wanted,

Why did they start you with an AI right off? Were youre E2 readings really high pre TRT?

What is your body type? Fat %?

All these things come into play, but it sounds like starting an AI right off the bat is a little excessive. I would think that you would have had a blood test that showed a super high E2 (sensitive for males) before throwing that in the mix? If not… you might wanna hold what you got on your protocol for a bit and let’s work through this a little at a time.

You are most likely fine with the immunoassay. Here are a few examples of concurrent ECLIA and LC/MS/MS tests with numbers similar to yours:

IA%20LC%2021%2018 IA%20LC%2023-23 IA%20LC%2026-21 IA%20LC%2028-27

Thyroid does not look good. If I am you, I’m discontinuing the AI unless high E2 symptoms become an issue. You may not need it.

I blow up like a puffer fish without AI. It’s an overnight 20 lbs.
First go round I was told to go with 200 mg / week of cyp, so I bought it across the street (equivalent of $3) and opened up the box. One pin and one glass amp and one alcohol wipe all in the same box. I drew it up and then realized that it was actually 250 mg not 200 mg. I figured whatever and injected the whole 250. There were guys using as much as 12 grams a week when I was competing, so it didn’t seem like much of a difference.
My T went to 2150 and my E2 went to 112.6 by the following Monday morning (one week). So I bought some small pins and a box of alcohol wipes and several amps and preloaded some needles to 125 mg and switched to that dose. I just stayed like the Michelin man so I bought some anastrozole. It’s less than $2 a pill OTC here. I cut it up with a razor blade and started taking 1/2 EOD, and crashed my E2 like the Hindenburg. So I upped my dose to 200 a week and backed off to 1/4 AI 3 times a week. The E2 was still too low so I dropped to twice a week with the injections and I’ll see where that puts me.
I should note, hyperparathyroidism meant that my vitamin D was catastrophically low for quite some time, and my calcium was stupid high, and the endo simply gave me androgel and a digital exam and said good luck. No numbers for E2 or anything, even though they were taking 6 vials of blood every time I walked into a medical building. My T was:
Dec 12/2017 202
Dec 21/2017 277
Feb 5/2018 315 (post surgery)

I know that there are no nodules or visible problems with the thyroid, because the surgeon inspected it while he was in there cutting out the parathyroid glands.

Oh, my body type. I am too fat for my own good, some of that is from the hyperparathyroidism, some of it is being in my 40’s. It’s a work in progress. I’m 6’-0, 270 lbs. I competed from under 105 kg’s (which meant my walking around weight was 245 lbs) to 300 lbs. I am not a small guy in any sense of the word. Ideally I should be around 240-250lbs. It’ll take some work, but I should get there.

Looks like you may be be pushing too high of a test dose still. If I were you, I would drop to 150mg a week for about 3 weeks and take the AI at 1/4 pill once only if the E2 symptoms got unbearable. After running that for the 3 weeks or so, I would then drop to 100mg a week Test and try no AI at all for 6 weeks. Then get some recent thorough blood work done.

You never really established a baseline. You went all in based on some bad advice and are throwing stones at mountain. The goal here is to take only enough T to get your levels stable and get you feeling good, without needing an AI at all hopefully. Some guys will need it no matter what, especially if you are carrying a lot of excess fat, but that’s an issue that can be corrected as well.

You owe it to yourself to take as few drugs as absolutely necessary, and dial in the diet and exercise and trim down.

Why does my dose of test seem too high? 833 is not a high number. My T at 100 mg was 484, and without AI I aromatize like crazy - it’s a visible bloat that registers on the scale at even 100 mg. Cutting my dose to have a sub-par T level and the bloat of high E doesn’t make any sense.

You can’t chase a number bro. Have you stayed with one particular dose for at least 6 weeks without changing anything? If so, how did you feel and what was your SHBG, E2, Total T, and Free T after the 6 week stabilization period?

Total T means nothing other than for reference. What was your Free T? If your SHBG is low, your Free T could be through the roof, which could also drive E2 through the roof.

For example, my Total T is only 493, but my Free T is over the high side of the reference range at trough. My SHGB is obviously low. My Free T is where it needs to be, and I don’t take an AI at all and have no E2 issues.

No free T or SHBG tests available here. 200 mg a week with 1/4 AI 2/week feels the best so far, but that’s only been 2 weeks. Libido and morning wood are up at that dose and bloat is minimal or non-existent. I look like a Strongman, and am not really interested in looking much different, it just wouldn’t hurt to have a little smaller waist. My wife would like me to be able to wear a 36 again.
I also did a run of Sustanon every two weeks for a couple of months. Didn’t really get it for me and every week would have been a little too much I think.

My bigger concern is thyroid. Once my vitamin D builds back up and everything else normalizes I may or may not even need the TRT.

Man that sucks that you can’t get those test run. It’s going to be next to impossible for you to get it dialed in right without being able to “look under the hood”. The best thing I can offer under your circumstances is going to be (with my limited knowledge and experience), if you feel pretty good where you’re at, and you’ve been doing that for 2 weeks, then re-evaluate in another 4 weeks.

Not so much for looks, but just simply because you stated that you aromatase like crazy, I would try very hard to make losing as much excess fat as possible a priority. That’s a huge factor in your aromatase rate.

Whoa! In that case, never mind.