T Nation

Long Term T and Pec Tear

Never used any floroquinalones. I think overtraining and a freak accident caused this. Anyone out there make full recovery from pec tear. I’m gonna be pretty nervous lifting again. Still waiting on my labs

Read the finding a TRT doc sticky and explore the suggestions there.

You seem to arguing to talk yourself out of doing what is known to work:

  • men on TRT mostly have E2 levels that are too high.
  • AI lowers E2 levels
  • Low dose AI effectively modulates E2 levels
  • E2=22pg/ml is known to be a good target levels, because guys report that they feel better
  • The side effects of AI are from E2–>0 which by definition does not occur with the above
  • testes ache for many, wither and die on T without hCG, smells like organ failure to me
  • above caused by LH–>0 from TRT
  • low dose creates the same LH receptor activity as baseline LH activity, define HRT

I can’t believe that that I have to repeat this to a doctor. Stop looking for reasons that you cannot, and get motivated. You only need to find a doc who will script off-label use of drugs that are documented as safe.

We know that dealing with endocrinologists is mostly stupid. Welcome to our world.

BTW, a year or so ago, a doctor was here [Florida] who was looking at what was going on. He studied what is here then did his own research. Then he started PM’ing me and stated that he had changed his medical practice. He was no longer satisfied treating people’s diseases. He wanted to be in health management, not disease management. He modelled his new practice based on the protocols recommended here. What he found, and what he read that I wrote, made a lot of sense to him. You might compare and contrast your thinking to that professionals epiphany. And note that this type of thing is practised by a large number of physicians, however, they are a relatively rare. And they are making a lot of money as well.

You think that someone is going to do hugely expensive combined double blind medical trials to verify that these things work? How about a study of T without AI where men go postal and grow tits? And T without hCG where men, some young men, will go sterile, testes become irreversibly tiny, crashed pregnenolone and DHEA levels, and scrotums that pull up tight and make men look like prepubescent boys.

Internet clinics are a huge rip-off. And they have a opportunity to make money, and over prescribe, because the rest of the medical community to address these problems effectively.

I do not hesitate to call out doctors. Do not take this personally. I am, in my own way, trying to help you in the best way that I know. Yes, I get angry with doctors who are idiots, welcome to my world.

i dont take it personally at all. and as ive said i actually am willing to explore these options. but i have yet to find a doctor in portland who does this and knows what they are doing. my search continues. i run the biggest practice in my county and its hard to find time but im going to continue for sure. and i agre the internet thing seems like a money machine. and i agree that this should be looked into by the medical community at large with viable research. and im nit talking myself out of anything at all. understand all this has been quite traumatic. been a bad year. i dont know you or your backround but yes i understand physiology and everything you say makes sense. and i appreciate that you are passionate about the topic and are trying to help people you dont know. your a saint for doing so. i should be paying for your knowledge.

just a couple things you should know about “doctors” i treat my entire practice like they are family. i bleed for them. most of my co workers do as well. medical community has some of the highest suicide rates of any profession. and its no way to get rich. believe me. average doc comes out of school with 300000 in debt payed back over ten years so you have to love what you do and love people. and hers the problem. being a “pioneer” and using stuff off label can and will get you sued. and if something happens you have no leg to stand on, period. and remember, whatever you do doesnt necessarily have to have caused the problem. you just have to have a good enough lawyer and doctors for the plaintiff convincing enough to pursuade the jury you did something wrong. and then guess what. your fucked. you can be perfect at what i do, someone can die and your fucked. period. welcome to america. and no tort reform.

i and my cohorts wish it was that easy to always do what we feel is best but its not always possible. having saud that i want to feel better. im going to find someone and give this a try. and if i cant find anyone ill do it myself with expensive internet stuff.

dont stop helping me. dont give up on helping others. just try to see the other side of things as well. and recognize that not all of us are bad, oney grubbers, lazy, stupid, etc. in general we are really compassionate people sometimes shackled by our training or lack thereof. rememebr, i have to do my best to know everythign about everything, lol.

again, thanks for your help and my test results will go up soon. where are you from?

Two sides to every story.
Well said Doctor…and good luck!

I understand what you are saying.

More doctor abuse ;}

Lol. And the other end is there is some good to restrictions. Some of my counterparts are fucktards. Wouldn’t want them doing whatever they wanted. Best to have us all under some level of control .

I love your sense of humor. Reminds me of Monti Python’s abuse skit.

Oops, wrong door!

Labs hopefully in tomorrow Ill expect recommendations and evaluation dr kswan! You still haven’t told me your background. How did you get so knowledgeable on these topics!!! I’m clearly the fucktard on the topic of hormones but you had to have some training

Some labs in. Estradiol level high at 44. Total t 740 two days after injection. I’d .3 of a 200 per ml twice weekly. Magnesium normal. CBC fine. Lh and fsh quite low of course. Expected. Waiting for ACTH and igf

One other thing. If your take hcg aromase and t how do your levels not go through the roof.

I have two degrees in Mechanical Engineering. I have read medical, nutrition and science issues for decades. I suspected I had low T many years ago and started researching that. When I located an age management doc, part way through our 2 hour consult, he said that I knew more about the issues than almost all doctors. For me, its all cause and effect, lending itself, at least for me, to a systems approach.

I have done this work here for years and when guys come up with new issues, I research them. And as we build up this body of knowledge which gets indexed by Google, we have more guys landing here that match what we already have. This seems to create storms of new guys, for example, we current have a swarm of young men with problems. And what I can’t understand how the forum is selecting for cases where thyroid issues are found!

I have read books about adrenal fatigue, thyroid issues, hormones of course with a few books centered on male health, female hormones, books on the rolls of neural transmitters and steroid hormones on the male brain and the female brain. I read Masters and Johnson books when I was in high school.

I have also worked with a few women on hormone problems. I am convinced that most female cancers are caused by estrogen dominance, brought on by normal age related decline in progesterone; or by progestins that depress progesterone levels. So I recommend that all women use the 2% OTC progesterone cream that is readily available.

[quote]Cstamata wrote:
One other thing. If your take hcg aromase and t how do your levels not go through the roof.[/quote]

If you reduce E2 and thus reduce feedback on the HPTA, the HPTA is still shutdown. So no LH, but hCG fills in that gap. 250iu hCG SC EOD does increase T, if the patient is not primary. With older guys, hCG might increase T levels 15-20% above levels not using hCG. With young men who are secondary, their young testes may produce enough T from hCG to be a satisfactory monotherapy.

So, AI use does not increase T when on TRT.
hCG can create varying levels of T, T dose refinement takes care of that variable.

Many age management docs aim for TT in the 900-1000 range for older guys as their receptor response may be age limited, or some other weak link. SHBG increases with age, so you need more TT to get high normal FT. Note that lab ranges for FT are age adjusted. We want to refer to the levels of young men, not old men.

Some age management docs will take TT to 1500 or above. Whatever works for the patient. I recommend that levels not be higher than what is needed to achieve a strong libido, as one should reserve the dose headroom for needs that arise as years go by.

When a man has his libido go through the roof, this can be disturbing to a woman. Some of that increase in libido is transient and a once in a lifetime situation that wives should accommodate if they are informed about what is going on. Note that libido can be shut down in a few weeks if E2 is not managed. And later if elevated E2 is taken near E2=22pg/ml libido can bloom again.

When some women go to an age management doc and get their hormones fixed, including T, they will drag their husbands into the doctor’s office and say “fix him too!”.

Ok. Perfect. I’m going to get the remaining labs soon. Pass them along. Then get a good idea from you how to dose. I’m still probably going to end up getting things through mail order if I can’t find a good t doc but sure do appreciate the help. Now i think only issue will be whether or not to include hgh based on igf numbers. I had problems with acne trying to run at 1000. Suggestions my friend. Really amazing your crusade. I’m humbled

I see some ACNE as a welcome sign that ones metabolism is closer to the state when we were young and had pimples.

Can you give me the skinny on pregnenolone? How that is effected and its role ? I assume you are doing triple t therapy. Can you speak to how it’s made you feel compared to just straight t therapy?

Hey Doc thought I would throw in my .02 on your situation. Everyone poo poos the online clinics as just a rip off. but they are out there for a reason, they serve a niche. Look through this site and look at how many people complain about their doctor or how impossible it is to find one that prescribes the right things. These places will get you what you need and do it within the legal system, sure its going to cost more but some things are worth paying for including the convience. They aren’t all outrageous priced and no one says you have to follow their overprescribed protocol, follow the one you find on here. I have researched many and know of at least one that is about $600 per protocol, but that protocol would cover at least 5 months at a conservative 100 mg per week level. Many guys at TRT age like myself have reached a level in life where they can afford a little extra to get what they need without hassle. Also I am not connected with a clinic, but have talked to many. Just seems to me these guys should not be automatically eliminated in the decision making process but evaluated with all options.

2006:
A blast from the past: http://tnation.T-Nation.com/free_online_forum/sports_body_training_performance_bodybuilding/my_hrt_story_cyp_im_every_day

Others have reported an improvement in mood with hCG and this is a transient effect, most good things are!

From there I did T+hCG SC both EOD.

Later added anastrozole. I had E2=37pg/ml and I had libido issues, moody, intolerant if sudden noises, short tempered. I think that for some, E2 rots the male brain; leading to mental confusion. In one week of 1mg/week anastrozole in EOD divided doses I was really noticing that I was feeling better. More energy, libido back very strong, less emotional and more of my typical analytical self. Nothing gets under my skin now.

We have referred to T+hCG+AI as the tripod. And E2 management is mission critical for libido and QOL. Unfortunately, there are some who have trouble getting that dialed in.

Pregnenolone: http://en.wikipedia.org/wiki/Pregnenolone

Made in the mitochondria everywhere. But it is thought that this activity is strong in the gonads. As you can see http://en.wikipedia.org/wiki/Steroid_hormone pregnenolone is the basis for the cascade of steroid hormones, so it makes sense that there would be origination in the testes. As shown in the link, pregnenolone is the substrate for conversion to DHEA in the adrenals. From there, in men and women there is some DHEA–>E2 and DHEA–>T inside the adrenals, outside of the HPTA/HPOA/HPGA control loop. In the testes/ovaries, DHEA is converted to T and E2.

When I started TRT, my DHEA-S level dropped, which is explained by reduced pregnenolone from the testes. By the time I had that lab work, my testes were quite small and mushy. It is thought that hCG supports pregnenolone production.

Given the roll of pregnenolone in the brain, it is not so surprising that guys who are shutdown feel better when hCG is introduced. Some times guys with low T can feel a boost from hCG alone.

And note that pregnenolone is the foundation for cortisol and the other related hormones.

I did try pregnenolone oral, 100mg/day. It absorbs very poorly and my lab work did not show much benefit. Pregnenolone in caps does not need an Rx. However, if made into a cream, the FDA considers that product a medical drug and it must be Rx. With either one, I did not notice it. But somethings are really hard to judge that way. Others on other BB’s have reported good results and have seen pregnenolone lift DHEA levels.

Maybe we need pregnenolone cypionate.

I do not use pregnenolone now.

Jesus. Thanks so much guys. Thanks wt. ACTH 17. Igf1s. Slightly high at 249. And again. Test level 740. Very low oh and fsh. Estradiol high at 44. Any other labs to draw?should I try hgh as well? Other advice? Could I trouble k for a list of what doses to start with. Had no libido issues on the t. Have after surgery but that’s expected and going away. No gyno. Was rock solid before the tear. Did get muscle pain though. Especially if I didn’t exercise. You guys have been so much help

I certainly wouldn’t be happy with that estradiol my chest and nips would drive me crazy at that level. Since you are already injecting twice a week u would probably benefit from an AI.