Quick background ... Using trt for about seven months. Started with androgel and quickly blew rit past the practical dosages. I now get 400mg testosterone cypionate every other week. I don't have my current labs, waiting on results.
I'm 35, have a lazy pituitary gland, and I am a long distance endurance athlete. I had a pretty major injury this summer that put me out of commission for a while and I'm getting back to serious marathon training now.
So, the problems... For the last several weeks i get a pump whenever I run or swim. The tibialis anterior (outside of shin) fills with blood and becomes really painful to try to run on. I can rest and massage it, and then it's okay for a couple minutes, but it always comes back. At first, I thought this was just tight legs from such a layoff, but I've never experienced it past two weeks. I'm a month into it now. Also, when I swim, I get a legitimate pump on. I hardly ever get a pump from swimming unless I'm doing sprint sets. Now, I get it from just regular old laps. Last thing, I've switched to a standing desk and I'm on my feet for a solid 6 hours of the workday now. Morning calf measurements show a .75 inch increase. This is a conservative measurement.
Does testosterone increase your ability to get a pump? Could this be causing the pain in my lower legs? I only started e cypionate about a 5 weeks ago so it coincides with the leg issues. I've also noticed the pump sensation in my forearms lately. Is this the cause?
I'm a newb testosterone user. I'm not trying to get bigger, in fact, I don't even lift with any regularilty. I just need to figure out what is going on and if I am potentially doing any damage. I'll talk to my doc in a couple days, just hoping for some points to go on.
I started TRT about six weeks ago, and the very first effect I noticed what that my arms were visually bigger after doing my physical therapy exercises than beforehand (rehabbing my shoulder). I actually measured it the second time I did the exercises and my arm was about 1" bigger, although my arms aren't the biggest to begin with, so drastic changes might happen because they had a lot of space to work with (went from 12.75" to 13.75"). It also happens when I work out other muscle groups, too.
But it's NEVER been painful, debilitating, or constricting in any way. Is your doctor ordering follow up labs? My doc ordered follow up labs for two months after starting TRT, but for reasons I won't get into because they are far too boring, I've had the labs done already.
While on TRT you have to regularly get Hemoglobin and Hematocrit labs done. With the extra T in your system your bone marrow MAY increase RBC production and you can end up with "sludge blood" similar to that of a cyclist that does regular "blood doping" (having a unit or two of blood removed a few weeks out from competition, then re-injecting said blood before the race to have more oxygen-carrying RBCs in their veins) which, if done repeatedly, leads to blood that is too thick. This is mentioned in one of the articles to which you linked.
Make sure you get the labs done as they are the only way to see if you are one of the "lucky" people who end up with this side effect.
48 hours later PEaks 3600 TT 7 days later - 1400 TT
This will most likely cause too much stress on adrenals, and thyroid they will go over time if these levels are maintained, possible put you at risk for thrombosis as well if you have any other hidden genetic clotting issues You are also on an estrogen rollercoaster ride
End up from one drug to potential 4-5.
I question medical ethics vs dispensing steroids here.
Honestly, there is simply too much info to try to read through it all. I would agree that for trt I have to be way up there. As I added androgel, my levels were bouncing all over the place, settling low after a month. I was at the max dosage of androgel and I was still below range. I would also agree that my doctor may not be the best one to manage this. I will talk to him about seeing an endo.
I've had monthly labs since the beginning, but they are not as complete as what other people post for structured steroid cycling. My doc bases most of his decisions on free testosterone. I have a new set that should be in now. I'll call.
I'd love the extra Blood count, as I have been slightly anemic all my life. As along as it doesn't pose a danger. Thrombosis scares the shit out of me.
yes it is a ton of information, but this is your one and only life... I think it is worth the investment of time to learn about what you are doing to your body.
(as covered in the sticky threads) lots of people have absorption issues with androgel - typically related to being hypothyroid - have you ever tested your TSH? I would hazard a guess that it is over 1 and most likely over 2 (possibly even 3) given your dosage of T-Cyp (and anemic issues).
but having absorption issues does not mean that you go from gels straight to 400mg biweekly...
biweekly shots = horrible hormonal rollercoster (stressing out your other systems) 400mg = massive dosage (stressing out your other systems)
btw, seeing an endo won't get you anywhere (as reference 100s of times in various threads and the stickies). except that the endo would take you off of the 400mg biweekly shots, but unfortunately would most likely just replace it with an anti-depressant. (please check out the finding an HRT doc sticky thread.)
Again, I appreciate the input.... I am/will continue to read through the stickies.
I have had my tsh tested and its in range, but you are right. It was 1.34 a year ago, and 1.21 four months ago. Those are the only results I have off hand. However, none of them have been tested since beginning with the T-cyp. I started the injections with 200mg, eow. I mentioned to my doctor before my second shot that I was feeling very low, so he jumped to 400mg. I received that amount twice, and had the draw before the second. When I went in for the third (last week) my results weren't back yet.
In the fall, I also had FSH and luteinizing hormones tested. Both were very low, and out of range. FSH - 0.3 and LH - 0.1. This is where he came up with pituitary disfunction. This is where I am wondering if a endo would be most helpful. Before this set of labs, I had not had FSH or LH tested, just prolactin and tsh. Prolactin was 3.2 in May 2011.
I'll call the office now and see if they can fax over my last set of labs. Honestly, this is starting to scare me a bit and I'm stressing out over it. Especially given the fact that its already in my body and I can't do much about that. I have only had a few tests for hemocrit and hemoglobin. Those were all low in range. But, those were all early in the process. Am I correct in saying that those tests are going to be the most relevant to concerns over thrombosis, elbolisms, etc.?
I have no idea on thrombosis, embolisms, except that HRT can result in increase hemocrit/hemoglobin levels which can have serious side effects if not monitored and treated.
the reason you were feeling bad on 200mg biweekly is because 200mg will spike your levels above your ideal levels for 3-4 days, keep you in range for a couple of days, and then leave you at below ideal levels for the last week. it will cause spikes in aromatase (higher estrogen) place increased demands on your cortisol leaving less to work with your thyroid, etc. etc. etc. I am sorry. I am normally not this blunt, but any doc who thinks that 400mg biweekly is a good treatment program is a moron.
increasing the dose to 400mg means you are spiking your levels even higher, placing greater demands/stressors on your system, and increasing your estrogen levels even more. Is the doctor testing for and monitoring your E2 levels? (I can already guess the answer.)
also he is also testing your blood at your lowest point right before your next injection when you are crashing and should have abysmal levels. if he tested at day 2-3 you could see levels at 2000+
you should self inject a smaller dose more frequently to maintain stable levels.... the starting norm is 50mg every three days (E3D).
Please dig through the stickies, there is a wealth of information there.
I've been reading mass amounts in the stickies and everything that you are saying is making sense. You are right, he is testing at the lowest, he is not testing E2. I'm not sure where to go with this. I guess I need a new doctor.
Also, I totally glossed over your TRT dosing. Good thing PureChance pointed it out.
Taking 400mg EOW is a REALLY hefty dose. Most TRT patients start at 100mg/week and work from there, and when you get over ~200mg/week (the max I've heard most docs will go on TRT) you are no longer replacing hormones but doing a really low grade steroid cycle.
According to this article 300mg will bring your TT levels to over 2000ng/dL, whereas 200mg will put you around 1200-1500ng/dL. Obviously these are averages, and every body is different, but I doubt that anyone taking a 300mg+ shot would not be way past the point of therapy and into the realm of performance enhancing.
According to www.steroid.com a Newbie's cycle would include 400mg/week of Test C, and Advanced Bodybuilders go as high as 800mg-1000mg a week (in addition to other T-products in the "stack")! So you getting 400mg EOW is less than what a bodybuilder would do, but it is in the same ballpark. I don't know much about T for bodybuilding, but I know that going near those levels is past the point of "replacement therapy". (Unless, perhaps, you are a horse. Then you will in fact need higher doses for Testosterone Replacement Therapy.)
I can imagine the swings you have, getting 400mg EOW. You probably feel like lifting or banging anything that gets in your way for days 1-6, and then less than crap days 7-14.
I haven't heard anything good about androgel, and absorption through the skin is crappy at best. The NIH's (National Institutes of Health) website on androgel says, "Approximately 10% of the applied testosterone dose is absorbed across skin of average permeability during a 24-hour period." That's 90% going to waste.
I'm not sure what the best course of action is at this point, as you have been on really heavy T doses. Were you ever on lower (more normal) doses of IM Testosterone?
Let the labs do the talking, and maybe even print out some of the stickies for your doctor to read. It's good that your doctor is on board for treatment, but apparently unsure of some of the finer points of hormone therapy. How on earth you got on 400mg EOW blows my mind!
Adjusting to smaller doses may be a bitch, I don't know. Maybe someone on here knows what it's like going from a high dose (400mg EOW) to a normal dose (50mg 2x week)? If not, try the Steroid Forums, and tell your story there. I'm guessing those guys know more about cycling off high T doses than us small-timers.
I stopped running completely for about four weeks. I still swam, and did a little lifting, nothing for the lower body though. I also stopped all T for three weeks, then started back with weekly 100mg injections.
By the time I stopped, I was breaking out something fierce and the side effects were undeniable. I was embarrassed to go to my massage therapist because my back had gotten so bad. (My opinion, wife said it wasn't THAT bad.)
So, of the three things that I pointed out earlier in the thread, the running, the T, and the standing desk, the desk was the only thing that remained. Over the course of the first two weeks, the pain subsided. Quickly at first, down a little nagging pain.
As I started back with the T, the side effects didn't get any worse, but they did continue. Mainly it was irritation of the back and skin. It has very slowly improved over the course of the last couple months and its basically all clear now. My regimen is still just 100mg per week, one injection per week, but I have gotten back to a regular swim and run schedule. Now that the spring is here, I'm getting back on my bike too.
My point in posting back to this old thread is in the event that others stumble across this with similar questions or symptoms. Like others posted above, I was getting TOO much T and it was not being mitigated with other drugs and was not being administered well. I took things into my own hands and I'm better for it.
In fact, my script is still the same as it was before, but I'm not using it all. I continue to lok for a quality endo around here, but its been a battle. I sought advice from a young Chiro that I know, not for the specifics of my case, but for a lead on who to talk to next. Even he has not been able to get a good local endo to talk to. So there search continues in that area.
Overall, I am back to endurance training, feeling healthy, and feel like I am back in control of my body. Thanks to those who helped.