T Nation

JR's Health - Advise Please


#1

I have been lurking around on this site for months and finally decided to join . Thank you all in advance to all that may contribute to my quest for better health .
My story is long but I will try to keep it as short as possible and not leave important detail out .

In 2010 my pcp referred me to an endo for high cholesterol issues . Said endo ran a bunch of test and placed me on statins . I tried Crestor and Lipitor and maybe another that I can't recall now . I could not tolerate any of them . I thought I was about to die on Crestor . Stopped experimenting with statins as I cannot tolerate .

Endo does more b/w and finds that testosterone is low , tells me I have hypogonadism , puts me on 100mg of T cyp once a week IM . As far as I know rembering back he did very little to find out why T was low . Not much thyroid test and no MRI . He just put me on T , then test TT and CBC once every six months .

About a year in I got him to check Vit D and it came back low . Now take Vit D 5000 ED and levels appear good . I tried lowering that to 2000 IU ED and it wasn't enough .
I continued to to take 100 mg of T cyp once a week IM , two 1gm capsules of Lovaza ED and Vit D 5000 ED for 18 - 24 months . I started to feel lousy at the beginning of 2013 .

I start doing a lot of research on trt and find this site , read the stickies over and over , read into a lot of other cases . Their is a wealth of knowledge here and I'm greatful to have found it !
After doing my research , I request the Endo to check my FT and E2 along with other blood work and he agrees to check FT but not E2 . So I have my pcp order the E2 test . I requested sensitive E2 and they did ultrasensitive , wrong test I know . The results came back high at 68 pg/ml with a range of < or = 29 . When I bring this to the Endo's attention he shrugs it off and doesn't want to discuss AI 's at all . I explain to him all of my symptoms , brain fog , memory issues , blurred vision , mood swings , aching testes drawn up tight to body . He is not sympathetic and does not offer AI's . Then I ask about Small doses of HCG to go with the T , explained to him I don't want to lose the boys and there hurting , we don't offer that here . WTF I'm thinking !

I decide to find another Endo that is more up to date on the life long treatment for hypogonadism . I called at least twenty different Endo's and asked them all the same question , do you treat side effects that come with TRT until I found a positive response . Had all info faxed to new Dr . . I had initial appointment and showed up with all my research . I requested some of the test from the stickies be done . Explained to him the protocol that I invisioned , T cyp , hcg and AI to keep E2 in check .

New Endo's response , split T dose up and inject twice / week , I had already started doing this . Get brain MRI , had done and nothing showed up . Ran a bunch of blood work that I will post below . E2 came back in range high . All thyroid test in range and he says is good .

Now I'm thinking we are on the same page he reluctantly agrees to the AI and HCG . I start injecting 300 IU EOD on may 11 along with my 100 mg T cyp in two divided weekly SC injections . Started Arimidex at 1/4 mg EOD . I found I'm an over responder to this so backed off and now do 1/8mg E2D .

My TT high out of range and FT are now double the quest in range high . TT is 1460 with range 250-1100 ng/dl . FT is 378.1 with range 35-155 pg/ ml .
Doc not happy ! Ask what I'm doing , I explain the above and he says I thought you were doing HCG only and nobody does them together ! I come back and say I thought we went over all of this . He fires , I fire back and you know who lost .

My levels are high and I would like to get things in range . Should I make up with Endo and try the Hcg mono thearapy ? My numbers suggest it could work .
but unsure of HCG mono therapy . My numbers point to it may work . Last blood test before this high test were , TT 761 ng/dl range 241-827 , FT 149.8 pg/ml range 46-224 . These were taken on 4/24/13 and high results were taken on 5/29 /13 . Taking the 300ius of HCG EOD really made my T numbers jump up . Could it have been the AI stopping aromatase giving me the higher numbers or a combo of both ?

If I were to stop taking the T and go HCG mono , how long would it take to get a reliable sample drawn ? Do you think T would drop fast and give me bad side effects ? Going to stick to the 300 IU EOD if I go this route . Doc prescribed 1500 IU three Times a week ?? I think this is way too high !?

Suggestions please ?

Latest T results ,
3/8/13. FT. 461 ng/dl range 250-1100 , TT 546 range 241-827

3/25/13 FT. 14 ng/dl range 9-30 , TT 451 ng/dl range 240-950

4/24/13 FT 149.8 pg/ml range 46-224 , TT 761 ng/dl range 241-827 these test are after splitting weekly dose .

5/29/13 FT 378.1 pg/ml range 35-155 pg/ml , TT 1460 ng/dl range 250-1100 ng/dl , these test are after the addition of AI started on 5/3/13 and HCG started on 5/11/13 at 300iu EOD

Age -44
Ht. - 5'10"
Waist - 40
Weight - 220
Balding , can grow goat t and stash but no full beard .
Carry fat in belly and love handles
Health cond . I've had knee orthoscopic twice , shoulder once , hand tendon surgery , gull bladder removed a couple years ago .
Symptoms before splitting T dose , tired , moody , not feeling well , testes ached and drawn up tight .
Symptoms a week to tens days after starting HCG and AI , brain fog lifted , more motivated , testes not sore and pulled up as close . Feeling good for a couple weeks .
Now feeling not right . Shaky , some headaches , I'm sure due to high T . Feel like I passed through the sweet spot .
Drugs , with all the surgeries and some teeth pulled their was opiates giving for pain probably used more than I needed . Other daily meds are losartan 100mg for blood pressure , Vit C 1000 , Vit A 10,000iu , Vit D 5000 , Florastor 250mg (probiotic) . Take whey isolate after work outs and do casein before bed on training and night shift days .
Diet , high protein low carb . Lots of fish , steak and chicken , Fruits and veg's . No white flour products or potato's .Changed to this way of eating in jan 13 , lost 30 lbs .
Body temps have been reaching normal at mid day , last time I checked . Morning lows 97.3 . Has been a month or so since I checked them .

Training , do cardio and some weights EOD for 45-50 min .

Testes ache , yes . Improved a lot after splitting T dose .
Morning wood , after current protocol yes and dreaming and remembering them . ED issues were showing up a couple months before I left the first Endo . Is what got me started more than anything into my research to feel and get better . ED got better after splitting T dose but not as good as now with AI and hCG .

I will post images of labs and it takes me forever to type .

Original T results from 6/2010
Testosterone 220.2 range 280-800 ng/dl
FT 5.5ng/dl range 5.0 - 21
Bioavailabile T calculated 128.3 ng/dl range 130-680

All blood test were collected as close to 42 hours after last T injected . It is rough keeping a regular schedule to take everything as I work 12 hr shifts and they switch between days and nights every time I'm off a couple days . This shift work is hard on me . It's like flying to China and back twice per week .

Please if Anyone knows a good TRT doctor near pittsburgh , pa please let me know .


#2



#3

what about iodine?

mid afternoon temperatures?
what was lab timing?
good hcg response might come with high E2
use less txt, use T to get target level
rndo's can be a poor option
with dragons muscle soreness is induced coq10 deficiency
where are you?

  • from my phone

#4

Read this... get your labs in the same units as it says here and see how you make out. maybe helpful.. check it out.www.stopthethyroidmadness.com/reverse-t3/


#5

Thank you for responding .

What about iodine ?
I am not supplementing with any at this time . I will start checking my temp's again . When I was checked last morning lows were 96.9 -97.3 and I was getting up to 98.6 mid afternoon . I just checked my temp at 10:30 am and it was 98.7 .

Lab timing -
My labs are in two different pictures above , ( I tried to post them together ) .

In the top photo everything but the estradiol was collected at 11 am , the estradiol was at 2:20 pm .

I had two estradiol ( quest 4021 ) test done , one before taking HCG and AI , and one after . Both test came back the same 37 with a reference range of < or = 39 pg/ml . Your thoughts on this ?

In the lower photo that shows up in another post , everything but the cortisol was collected at 11 am . The cortisol was collected at 2:20 pm . I was on night turn at this time and the timing to get labs was good for everything else . I gave this sample an hour after waking up , lab tech said that it still wouldn't count as an am cortisol test .

What are your thoughts on my lab results ? T4 , t3 , reverse t3 , cortisol , prolactin ? Does anything jump out at you ? Doc said everything looked fine , but you know how that goes .

My question is do you think the HCG mono therapy could work ? Should I give it a try and keep close eye on E2 levels .
Will switching to just HCG only with AI cause any problems besides lower T levels ? Do I need to taper off or just switch right over , if I chose to do so .

If I don't walk the line with the Endo I will be on my own until I can find somebody else . My insurance has been covering meds and testing . On my own ill be somewhat nervous , especially going to research product .

Anyone here tried or doing HCG mono therapy ?

With dragons muscle soreness is induced co q 10 deficiency ? Do not understand .

Where am I ? I live in the pittsburgh , pa area . I would consider going to Dr. Shippen's if I could get an appointment , not sure if he is taking new patients . He is located on the other end of the state , 5-7 hrs away . I will try to get in touch with his office this week .

What are your thought on my FT doubling with the addition of 300ius of HCG EOD ? Is it possible that prior statin use and opiates after surgeries just knocked my T numbers down . Could I not even have hypogonadism ? I do not trust the doctors at this point .

Another added health issue is sleep apnea . It is not confirmed , but the wife says I have it .

Thank you again for responding .


#6

It's very hard to read your labs try are sideways.

I left you a link on how to figure out rt3

Other thyroid labs that would be helpful before using iodine is

Tgab and tpo for hashimotos

Tsa for graves I believe but could be wrong. Look it up.

You have to learn a lot on your own to understand these things.

Do the math suggested in that site and you will find out if you have rt3 problems.

Research research.

List all your symptoms. Even the ones u don't want to.


#7

Sleep apnea with trt could be dangerous or trt induced! Did the wife notice this before you started?

Does your doctor know this?

300 eod is high I think read the protocol for injections sticky..

Read all the stickies lots of good info there


#8

Thank you IW84aces for your input . I will read into the information you provided . It may take a few days to get my labs change over .

I have to make a decision on continuing T , HCG , and AI while trying to tweak dosage , ALONE . Or , choosing T or HCG and staying with my Endo . He won't approve both together . It may not be the best thing to do , but to try HCG mono therapy and keep doc would be easiest . My T labs are high so I need to play ball to get more labs or find another doc that approves all three together soon .

Anyone know a good TRT doctor near Pittsburgh , PA ?

Again thanks for responding .


#9

It's only rt3 and ft3 that need to be in the same units bud. The math and the conversion factors are all on that page


#10

Let me try again:

Statin drugs interfere with liver's production of CoQ10. This can lead to muscle soreness, mental confusion persistent nagging cough. CoQ10 supplementation can fix that, Ubiquinol form has highest bio-availability.

Are you on statin's now? Exactly what?
What was total cholesterol before and now?
HDL?

Doctors: have you read the finding a TRT doc sticky? Endos can be the worst for TRT work and uro's are also mostly useless. An enthusiastic GP can be the best.

Snoring: Others in fire hall will also know.

Your thyroid panel is odd. Still need your history of using iodized salt. Have you used sea salt for a few years at any point in your life?
Read thyroid basics sticky

Your liver markers ALT/AST are high end of range. Might be from drugs or toxins.


#11

Thanks guys for responding . Sorry for the delay in getting back to you , been working .

Are u on statin's now ? No , has been about a year since last trying . Will get some coq10 .

What was cholesterol before and now ?
9/22/11 it was 249 mg/dl range 0-200
3/8/13 it was 244 mg/dl range 125-200

HDL
9/22/11 was 39 mg/dl no range
3/8/13 was 41 mg/dl range < or = 40

Doctor sticky , have read and tried . I thought I succeeded when I found the one I have . Was fooled into thinking he was actually listening when I spoke . Major let down .

Iodized salt ? I have always used , but cut back the beginning of the year . Blood pressure was creeping up , so backed off and started diet . I used Morton salt , unsure if iodized as we discarded empty can . Never on sea salt or sub salt only .

Liver markers . I do have a couple to a few light beers daily .
Some more current results and older ones .
9/22/05 AST 46 , range 11-42 IU/l
ALT 86 , range 10-60 IU/l

3/25/13 ALT 64 u/l range 0-50
AST 42 u/l range 0-50

I did check the RT3 ratio from the STTM formula and my result is a 16.7 . The book says it should be 20 -24 . Says probable low iron and or low/high cortisol ? Any thoughts ?
Some symptoms ,
Poor memory
Some brain fog even with the hcg
Hollow feeling at times , like I'm spent
Some dizziness when standing up at times
Feeling of just not feeling well , seem shaky on the inside at times
Feeling very poor and butt sweats minutes before am constitutional
Sometimes I feel as if kidneys hurt with dull ache , had them checked last year and they said good .
Some depression , never treated , self diagnosed
Panic attacks 10 years ago came back before I split my weekly dose of T up at the end of march this year .

Drugs or toxins ,
No street drugs . Have worked around insecticides and pesticides in the distant past . Welding / burning metal fumes .

Apnea , had consult with doc. Haven't had sleep test yet .

Dose for HCG , I did 300 IUs cause I was on trt almost three years without . Testes shrunk about half size and hurt . After some research And being a little over weight I figured the 300 EOD wouldn't hurt .

I haven't injected any T since 6/10/13 , still doing the HCG 300 IU EOD . Hoping I'm not going to crash ! I can feel T levels coming down as I don't feel as energized . Told doc yesterday I would do hcg mono . I'm somewhat interested to see where the T lab numbers end up . If I crash to hard or find a different doctor I'm going back to the T at 50 mg . a week and try that with the hcg .
I need doc at this point for labs and future med's , as he orders and insurance covers most .

Thanks for responding