T Nation

JayTuck's TRT Thread


#1

-age 41
-height 5'9
-waist 34
-weight 175
-describe body and facial hair Had to shave regularly since 13. Was 155 through high school and college until about 35, when I ate like a cow and lifted heavy and put on 30 pounds of muscle in 3 months. Basically reset my 'normal' to 175ish (plus I eat a high fat/high protein diet).
-describe where you carry fat and how changed Started with some but not much belly fat since about age 36.
-health conditions, symptoms [history] Ruptured disk l5-s1
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever Never.
-lab results with ranges - See below, doesn't seem to have tested for E/E2.

-describe diet Highish fat/protein calorie, primarily gluten free, sometimes some alcohol
-describe training Not much the last several years, shitty recovery and no drive
-testes ache, ever, with a fever? Never.
-how have morning wood and nocturnal erections changed - Function is fine, but morning wood etc basically dropped to 'rarely if ever' the last several years.


Hi all.

41 years old, never been particularly motivated or driven or aggressive, but always been easy to get in shape etc. The last several years have really noticed a drop in drive/desire to workout, partly because it's just 'too hard'. Recovery sucks, lots of soreness that lasts days, thus more time in between workouts which of course equals more soreness. Lifting the last couple years leaves me feeling 'defeated'. Like, 'fuck, does it -really- have to be so hard just to lift some weights?' I like lifting heavy, so really noticed that changed towards 'defeated'.

So am just starting TRT. On week 3 of of subq injections of test cyp in seasame oil, and hcg.

  1. RX 100mg of Test cyp/week = 1 injection of .5cc (which I've been splitting into two weekly injections of .25cc each).
  2. Rx 250iu of HCG 2x/week.
  3. I've been doing the T and HCG at the same time, subq. Support staff says I can combine into one injection but as it's subq it's been just as easy to do the as separate injections (and my ex ER nurse gf says they never mix/combine injections for a variety of reasons).

THE PROBLEM:

The first three injections (T and HCG) no problem. The fourth, no problem. I was alternating right and left side of belly, 3 and 4 days apart.

The day after 4th injection, BOTH sides of the belly started getting itchy, red, swollen, warm, hard. Slightly feverish with chills (though that could be because I just switched from warm to cold climate, could be my body responding to new amounts of T doing it's thing, but I'm leaning towards a big inflammation response).

This hardness, intermittent itchyness, mild pain, etc progressed for a few days, then maintained. Today is day 7 and 10 since last belly injections and they're just now starting to dial down.

I find it weird that both sides started at the same time even though they were days apart.

So for my 5th injection I did subq anterior aspect of thigh/quads, 5ish inches above knee. I kept the needle in for 20ish seconds after, then removed it and pushed down on the spot for a while, then rubbed it, then went for a long walk, then rubbed it off and on the rest of the day. All was good.

Next day, started to get red and hard. Next day, I have an 8ish inch curved line of redness, hardness, swelling (I'm assuming that's a lymphatic pathway that absorbed the injected fluid from the injection site dispersal). It's going to be another 10" day thing, it looks like.

So, wtf? And that's .25cc injection instead of the RX'd .5cc injection (hell no not going to do that).

Reading through these boards and chatting with support staff, it seems that I can be getting irritated by: the type of ester, the oil, too much BA (something acetate).
Support staff guy wants me to try an IM injection to see what happens before calling the pharmacy and having them switch esters (and oil I guess, and tell them to use less acetate etc). Says that it's trial and error, some guys are more sensitive/irritable in different locations (says he IM's in the glute because IM in the thigh gets him a reaction).

Really blows if I can't do subq. That's really attractive for a variety of reasons.

So I'll try an IM and see what happens, but not looking forward to this kind of reaction in the muscle (though my gf says in the hospital they shoot irritating substances into deep muscle instead of subq, so maybe it's different in muscle).

Questions:

  1. Should I expect an IM to have little to no irritation if my subq injections are so super irritable? A couple days is one thing, but 10+ days is not sustainable.

  2. Can I inject BA water into the T to dilute it? Asked another way, would injecting BA water into the T dilute it such that I wouldn't have such an inflammation response (I'm guessing not). Oil and water, I know, but if the water will help spread it out for better disbursement...though it's still a matter of injecting an substance my body finds very irritable.

  3. On a thread somewhere a guy said he took the top off his vial and put it in the oven at low temp to evaporate off the acetate? Is this worth researching more/trying? Heating the oil can't be that great an idea (makes it rancid and thus carcinogenic and in the short term possibly irritating)?

  4. How important is it to aspirate when doing IM in glutes (or anywhere else, really). I've been doing dry practice runs in prep for self IM in the glutes (GF not around for a month or so), and it seems...non-ergonomical.

First lab pre_TRT 8-12-13

CBC With Differential/Platelet; Comp. Metabolic Panel (14); Lipid Panel; Testosterone,Free and
Total; Luteinizing Hormone(LH), S; Prostateâ??Specific Ag, Serum; Venipuncture

TESTS RESULT FLAG UNITS REFERENCE INTERVAL LAB
CBC With Differential/Platelet
WBC 5.4 x10E3/uL 4.0 â?? 10.5 01
RBC 5.34 x10E6/uL 4.14 â?? 5.80 01
Hemoglobin 15.8 g/dL 12.6 â?? 17.7 01
Hematocrit 47.8 % 37.5 â?? 51.0 01
MCV 90 fL 79 â?? 97 01
MCH 29.6 pg 26.6 â?? 33.0 01
MCHC 33.1 g/dL 31.5 â?? 35.7 01
RDW 13.3 % 12.3 â?? 15.4 01
Platelets 250 x10E3/uL 140 â?? 415 01
Neutrophils 60 % 40 â?? 74 01
Lymphs 32 % 14 â?? 46 01
Monocytes 6 % 4 â?? 13 01
Eos 2 % 0 â?? 7 01
Basos 0 % 0 â?? 3 01
Neutrophils (Absolute) 3.2 x10E3/uL 1.8 â?? 7.8 01
Lymphs (Absolute) 1.7 x10E3/uL 0.7 â?? 4.5 01
Monocytes(Absolute) 0.3 x10E3/uL 0.1 â?? 1.0 01
Eos (Absolute) 0.1 x10E3/uL 0.0 â?? 0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0 â?? 0.2 01
Immature Granulocytes 0 % 0 â?? 2 01
Immature Grans (Abs) 0.0 x10E3/uL 0.0 â?? 0.1 01
Comp. Metabolic Panel (14)
Glucose, Serum 91 mg/dL 65 â?? 99 01
BUN 14 mg/dL 6 â?? 24 01
Creatinine, Serum 0.84 mg/dL 0.76 â?? 1.27 01
eGFR If NonAfricn Am 109 mL/min/1.73 >59
eGFR If Africn Am 126 mL/min/1.73 >59
BUN/Creatinine Ratio 17 9 â?? 20
Sodium, Serum 140 mmol/L 134 â?? 144 01

Chloride, Serum 100 mmol/L 97 â?? 108 01
Carbon Dioxide, Total 28 mmol/L 19 â?? 28 01
Calcium, Serum 10.0 mg/dL 8.7 â?? 10.2 01
Protein, Total, Serum 7.1 g/dL 6.0 â?? 8.5 01
Albumin, Serum 4.6 g/dL 3.5 â?? 5.5 01
Globulin, Total 2.5 g/dL 1.5 â?? 4.5
A/G Ratio 1.8 1.1 â?? 2.5
Bilirubin, Total 1.2 mg/dL 0.0 â?? 1.2 01
Alkaline Phosphatase, S 48 IU/L 44 â?? 102 01
AST (SGOT) 23 IU/L 0 â?? 40 01
ALT (SGPT) 32 IU/L 0 â?? 44 01

Lipid Panel
Cholesterol, Total 224 High mg/dL 100 â?? 199 01
Triglycerides 99 mg/dL 0 â?? 149 01
HDL Cholesterol 45 mg/dL >39 01
VLDL Cholesterol Cal 20 mg/dL 5 â?? 40
LDL Cholesterol Calc 159 High mg/dL 0 â?? 99

Testosterone,Free and Total
Testosterone, Serum 388 ng/dL 348 â?? 1197 01
Free Testosterone(Direct) 10.0 pg/mL 6.8 â?? 21.5 02

Luteinizing Hormone(LH), S
LH 6.4 mIU/mL 1.7 â?? 8.6 01

Prostateâ??Specific Ag, Serum
Prostate Specific Ag, Serum 0.7 ng/mL 0.0 â?? 4.0 01


#2

Partial converstion with a guy from support staff from the TRT program I went with. Curious of any comments on his commentary on Estriodol and hcg make up shot.

Me:
Sounds like an Estriodol level of 20-25 is the sweet spot. And Estriodol goes up as T goes up, in hindsight, I wish I knew my pre-TRT E2 level.

"I don't know what you mean by genital strength being gone or lacking. "
'Function' isn't my complaint nor has it been. Function has always been fine, though morning wood is a rare event the last couple years.
I've noticed more power/strength/umphf to erections and morning wood the last couple weeks until yesterday.
Yesterday and today that umphf is gone, and feels 'less' that it was pre-TRT. Partly I think that's because there's some noticeable difference going on in the testes as of yesterday. I don't usually pay attention to them, but feeling around last night I was 'holy shit, they're different/smaller/less dense'. Today it kind of feels like they're gone entirely. They're not gone, but they're definitely smaller/less dense and there's a subtle tingling feel, and the experience/feel is that 'they're gone'. I'm not panicking or anything, I'm just noticing what I feel, and there's definitely something going on/change happening.
I injected hcg today along with the IM Test in the glute. So I'll keep paying attention and see what happens.

Any reason not to inject hcg again tomorrow (or tonight) to make up for the hcg shot I skipped 3 days ago?


He responds with:
Optimal for estradiol is 20-30 but it's a very touchy range. For example, some guys start to have low estradiol symptoms when they're in the lower 20's but some feel great even in the low 30's. 20-30 is simply an optimal average. Everyone's different. For example, regardless of my testosterone dose, my estradiol stays in the high teens to low 20's, it doesn't really move so I've never had a need for an AI. I'd say around 30% of all men do not need an AI. Now I have used one in the past because I was under the impression that everyone needs one, but I was wrong. My estradiol dropped pretty low and I felt worse than I've ever felt in my life. Low estradiol can actually make you sick because estrogen is essential to your immune system.

As far as more testosterone equals higher estrogen, not necessarily. If that were the case I would have higher estradiol. But not everyone aromatizes testosterone significantly. And the reason we don't check estradiol on the first blood test is because if you have low testosterone you don't have enough testosterone for significant aromatization. For example, your initial blood test shows a Total testosterone of 388 and a Free of 10. The odds of high estradiol are a million to one with testosterone levels that low unless you're morbidly obese. Excess body fat can increase the rate of aromatization. But with our physicians, all they want to see is how your body is metabolizing the exogenous testosterone you're taking, that's what's important.

If you're having weaker erections, it may be an estradiol issue. Your 6wk blood req will be issued approximately 36 days after your initial doctors visit, so that should be generating pretty soon. It's recommended that you get it done between weeks 5-7 but if you feel you're having elevated estrogen symptoms you can get it done as soon as you get it.

As for your missed HCG shot, no I wouldn't take it in a way to make up for a missed one. The best thing you can do is to just get back on schedule. Unlike testosterone, HCG starts working very quickly. It won't take long for the effects to show.