Well, my new doc is trying me on compounded troches, and I am not sure what to think at this point. I got my labs(saliva) and he told me I had low cortisol, low progesterone, low free T, and my E2 was nearly non-existent.
I started using the troche on Thursday, but to be honest I'm already thinking of switching back to injections. My wife was with me at the doc, and together we decided I would try the troches. The idea is to have a more stable platform of testosterone by using these oral troches everyday. They are compounded with hcg and test. I know these are not a popular topic on here, and that's one of the reasons I am thinking of switching back to injections. My free t was low on the saliva test, but the test was done 8 days after my last 200mg shot. I feel like I would have more success with 100mg a week divided Into 2 shots, with hcg, and an AI like arimidex.
Along with the new troches I was prescribed Cortef for the low cortisol level, and he gave me some progesterone cream. I am also slowly coming off of Celexa, and I am taking 100mg of 5htp each night to help wean off of the Celexa. I really don't like doing all this stuff at once. I feel like shit today, and I'm feeling way to much of the emotional stuff that comes with depression.
What would you guys do in my case? My new doc likes to use saliva testing for hormones, and from what I've read, they just aren't as reliable as blood for free test, TT, and E2.
I’ve tried the troches as a supplement to androgel as the primary source of T before morning exercise and before I put on gel. They did give me a little added “umph” for my morning workouts. Troches have a very short half life due to the delivery method being sublingual and would need to be used multiple times a day. This reason alone would deter me from using them as the primary TRT.
If your doctor is attempting to use the progesterone cream as an aromatase inhibitor, in addition to you have low progesterone, I can tell you from experience that it will not work. Also from experience, if I’m feeling a little emotional or depressed, it’s always been because my E2 was out of control and I needed to reel it in a bit. You need a real AI to control E2.
You are also adding/subtracting several things at once without giving your body time to adjust and yourself time to differentiate between what is causing what. I generally wait one month between changing or tweeking things.
It sounds like you are seeing an anti-aging doctor with all of the medications being thrown at you at once. This can get very expensive very quickly. Read A LOT on here. It will save you money.
Blood testing is still the most accurate and still considered the gold standard, but salivary testing has shown to be very accurate as well. Bottom line, if you’re low, you’re low. If your FT was low, your SHGB was high, and lowing E2 with an AI will lower SHGB and raise FT.
I just read Crislers view on troches also. He does not recommend them as sole trt, but for a boost of test only. I told my wife I would give these a 2 week trial, but I think I’m going to call the doc on Monday, and see if he will switch me back to injections. I’m afraid if I don’t get back on injections I will crash from low T.
Btw, you guessed it, he is an anti-aging Doc.
Back in January I saw an Endo, and he had me stop taking my test cyp injections to do some blood work. At the beginning of the 4th week without testosterone shots I crashed hard. I did my blood work for that idiot, and I went back to my doc. He told me to go home and do a 600mg shot of test, and a week later do 400, and then the following week just go back to my 200mg shot per week.
6 days after the 600mg shot I finally felt a lift in mood and energy, but it was short lived because I was not on an AI. By the time May rolled around I was so depressed I had to leave work. I couldn’t function at all. My doc did an estrogen check, and my total came back at 325. He did not do a sensitive test. He gave me letrozole, and told me to start taking it everyday at first, and then every other day after that.
I switched docs in the middle of June, and when I did the saliva test I was still on letro and feeling horrible. That explains why my E2 was so low on the saliva test.
I really think I could feel a lot better if I do t shots with some arimidex to control the E2. I will be calling my doc on Monday to tell him I want back on shots, and I will see if be will prescribe me arimidex. I may have to switch back to my old doctor for the arimidex and actual blood work. This time I will tell him I need a E2 sensitive test. I really wish I had been on this forum a year ago.
You’re here now. Welcome, by the way. We all stumbled upon this place in search of answers. You will find plenty here.
Not sure what he was attempting to accomplish with the 600/400/200 front-loading phase. Blast your T (and E2) way out of range for…? Anyway, I’m sure you know by now estrogen control is very important. Low estrogen feels almost as bad as elevated estrogen.
Most here find the balancing easiest with the every other day (EOD) injection routine, and taking hCG and arimidex at the same time. Using liquid arimidex and having corresponding blood tests will allow you to tweak things down to the drop to find homeostasis.
My trt journey actually starts back quite a few years. I accidentally posted my initial post in the over 35 lifter area. It’s titled my journey through hell.
Thanks for the input guys. Last Saturday I actually did my first SQ injection in my right thigh, and I was surprised at how painless it was. That was going to be the start of my twice a week injection protocol. But I saw the Doc on Monday, and he was really pushing the troches. I am going to call him on Monday and see if I can get switched back to injections. If not, I’m going back to my old doc loaded with the info I have about hcg, E2, and at least twice a week injections.
I will also be asking for some lab work so I can get it posted up here.
Last year I was started on 200 mg test cyp injections, which I now know is kind of high for TRT, but could have been manageable with a good AI. Do you guys think I should start with 100mg a week in 2 doses, and ask for arimidex, and should I also ask for HCG to be included?
I need all the help I can get to find a good protocol. I have read a lot on here, but just want to be sure I do this right this time.
If I were you and I wanted help from the guys on the board I would make a new opening post thread list all available blood work prior to trt and then list labs after trt.
The protocol for injections sticky tells you what you might want for a protocol and I didn’t do it that way but most of the gentlemen here do try and do it this way. I think a lot of things come into play. I hated the idea of always doing a shot. I couldn’t even handle twice a week. I myself have made the choice to stop everything and try to get my body working properly again as I don’t feel the issues were addressed properly and I didn’t get to the root of the problem which I may have made worse by listening to uneducated doctors.
I am not saying to do this and I haven’t seen your lab work prior to trt but we here try to find out what is causing the issue and as a last resort end up on trt.
Were lh and fsh tested prior to trt
Do you have E2 labs prior
In the lab work sticky it gives you a good idea of what should have been tested and what you should be testing now
Please post everything you have and make a new thread and guys here may be able to set you in the right direction!
I will post my most recent blood work. I really think that there were not enough labs taken prior to going on trt. Like most docs, mine only looked at total T, free T, and I think psa.
I wake up with this nervous/anxious feeling everyday for the last several months, and I hate it.
Injected T is time release bio-identical T as the ester groups are removed.
If you inject T SC EOD, T levels are very steady. Problem solved. You can try that with #29, 0,5ml[50iu] 1/2" insulin syringes. Then you can switch back to twice a week if that feels better.
Total E is not the lab to get, get E2. And labs need to have ranges!!!
This is standard advice maintained here:
There is a huge amount of knowledge in the stickies. Please study these. Start with the advice for new guys sticky.
There is a lot to read there, so read carefully. There are suggestions for things that are root causes of low testosterone [T]. Low T is a symptom, not a root cause itself. But low T itself is a root cause of many of the symptoms one experiences. Note that other things cause the same spectrum of symptoms, so do not have T tunnel vision. Many docs are guilty of that and they only treat the symptom [low T] and do not attempt to find the real problem. If you go to a clinic that specializes in low T, you will get T tunnel vision for sure.
Post info about yourself as suggested in the above sticky. We need labs, almost all of your labs, not just hormones. We also need the lab ranges.
We see a very high number of thyroid issues in the population of guys that show up here. So there is a strong focus on that. Most people are iodine deficient to some degree. Your history of iodine intake from iodized salt and vitamins that list iodine is important. If you become iodine deficient, the RDA [recommended daily allowance] is inadequate for recovery of iodine stores. Please see the thyroid basics sticky for more information.
You do not want to suffer from subclinical hypothyroidism or get Rx thyroid meds to treat iodine deficiency.
If you are injecting T or contemplating that, read the protocol for injections sticky.
There are stickies for finding a TRT doc, estradiol [E2] and lab work.
Do not place your history or treatment details in the stickies! That belongs in your thread. Keep all of your posts in your thread so we can have a clear picture of your situation and needs.