T Nation

Looking to Put Tired Behind Me

After being tired of being tired I finally decided to talk to some people about it; these people put me in contact with a TRT/HRT company that seems reasonable. They required me to get a panel (see below) which I thought was good and even though they want to sell me a dozen things I’ve started only a TRT treatment course for the next few months.

First the background: chronological age 43; lots of miles on the system though; 72", 190#, 14-16%BF (5 bodPods), 33/34 waist, seem to be able to grow a full grey bread quickly. Resistance train 4 times a week (used to split that between full-body lifts and running but have since focused more on weights); never looked to be ‘big’ but high strength to weigh ratio is useful in my sport/hobby; so 4-5 set of less than 8 reps. I think most people I exercise with would serious doubt I have low T but this fall I was surprised my bodPod indicated a % loss in lean muscle and noticed I was more tired and it was more difficult to recover. Had the opportunity to add in some crossfit classes in December and I’ve never been more sore and tired; part of that is to be expected but this was something worse that I think the ‘new’ exercise just illuminated.

Here are the labs from the end of Jan with the companies desired range and the LabCorps values.
Total Testosterone 385; CompXDesiredRange750 -1150; LabCorpRange348- 1197
Free Testosterone 8.4; CompXDesiredRange >16; LabCorpRange8.7 -25.1
Sex Hormone Binding Glob, Serum 50.2; CompXDesiredRange20-39; LabCorpRange16.5-55.9
FSH 3.1; CompXDesiredRange3.5 - 8.6; LabCorpRange1.7 - 8.6
LH 3.0; CompXDesiredRange3.5 -12.4; LabCorpRange1.5 -12.4
Cortisol 16.1; CompXDesiredRange2.3-14; LabCorpRange2.3 - 19.4
Estradiol 21.9; CompXDesiredRange13-20; LabCorpRange7.6 - 42.6
IGF-1 214; CompXDesiredRange180 -250; LabCorpRange71-250
DHEA 105.4; CompXDesiredRange275 -416; LabCorpRange102.6 - 416
Vitamin D 39.4; CompXDesiredRange50-80; LabCorpRange30-100
TSH 2.450; CompXDesiredRange0.450 - 4.5; LabCorpRange0.450 - 4.5
Thyroxine (T4) 6.6; CompXDesiredRange4.5-12.0; LabCorpRange4.5 - 12.0
Triiodothyronine (T3) 122; CompXDesiredRange71-180; LabCorpRange71-180
Prostate-Specific Ag, Serum 0.5; CompXDesiredRange0.0-4.0; LabCorpRange0.0 - 4.0
Vitamin B12 730; CompXDesiredRange700-946; LabCorpRange211-946
Cholesterol, Total205; CompXDesiredRange70-199; LabCorpRange100 - 199
Triglycerides 68; CompXDesiredRange0.0 -149; LabCorpRange0.0 - 149
HDL Cholesterol 62; CompXDesiredRange>39; LabCorpRange>39
LDL Cholesterol Calc 129; CompXDesiredRange0-99; LabCorpRange0-99
Glucose, Serum 92; CompXDesiredRange65-90; LabCorpRange65-99
BUN (Kidney) 14; CompXDesiredRange6.0-20; LabCorpRange6.0-20
BUN/Creatinine Ratio 15; CompXDesiredRange10.0 - 15; LabCorpRange8.0-19
Creatinine, Serum 0.95; CompXDesiredRange0.6 - 1.3; LabCorpRange0.6 -1.3
Bilirubin, Total 0.6; CompXDesiredRange0.0 - 1.0; LabCorpRange0.0-1.2
AST (SGOT) 95; CompXDesiredRange0.0-30; LabCorpRange0.0-40
ALT (SGPT) 50; CompXDesiredRange0.0-30.0; LabCorpRange0.0-44
RBC 4.73; CompXDesiredRange4.14-5.8; LabCorpRange4.14 -5.80
Hemoglobin 14.3; CompXDesiredRange14-18; LabCorpRange12.6- 17.7
Hematocrit 42.6; CompXDesiredRange37.5 - 51; LabCorpRange37.5- 51

So not crazy low totalT; but low free T; fairly high SHGB; low DHEA. They offered to treat me and it seems fairly aggressively. Here is the part of the protocol they offered that I accepted:
200mg/ml T-Enanthate (inject once a week)
1mg AI 3 times a week (EOD)
HCG 500 units SQ on days 5 & 6 following testosterone dose
Danazol: 75mg (only for first 7 week cycle)

I realize (per the sticky) that I should inject 0.5 ml twice a week as opposed to the once a week treatment (and once I get used to the injections I will probably pursue this course) and that this amount might be a little high; and that the AI dose at present seems higher than the forum generally recommends.

Just a couple questions:
(1) How long into the treatment do you think it will be until I feel ‘full’ affects; I don’t feel much after 10 days (didn’t expect to) but just curious other experience. I’m sure my system is adjusting do to the exogenous T.

(2) Does the recommendation seem reasonable as a first cycle? I intend to get key labs done toward end of cycle to make adjustments and will expect to be off Danazol at that point.

I take s few supplements: 1000 ui D3, C and FishOil, BComplex, 100 ui Q10, and those values are fine but I also added 50mg of DHEA as well per the recommendations.

This is mostly to document my progress but advice from those with direct experience will always be considered and appreciated.

So starting the 3rd week, after getting more educated, I started to inject twice a week and also split the prescribed AI into half pills 6 days a week as opposed to MWF. Since the beginning all has been getting better, and is still good. I’ve still been going to the gym 4-5 days a week and certainly recover faster, had a little body re-comp (maybe 5# heavier but same if not thinner waist), and made some moderate strength gains were I was previously stagnant. I think a lot of my symptoms, like tiredness, have also diminished even with my slight increase in training schedule and morning wood has returned as well!

To get an update on my state I got my TriCare docs to runs some tests for me (I use an outside doctor for my scripts); so around the 6 week point I got some tests done. These tests were pulled the morning of the day that I would inject (later that day); so I would think this would be the ‘low’ point although with higher frequency injects I assume the ‘low’ point is less low. Here are the highlights…

Dehydroepiandrosterone: 154 mcg/dL [normal range: 110-424]
Total Test: 1173 ng/dL [normal range: 348-1197]
Free Test: 45.2 (H) pg/ml [normal range 6.8-21.5; my PA seemed to think this might be an error]
Estradiol: <10.0 pg/mL [no normal range indicated but PA mentioned the low end was 7…]

I only include the DHEA since I started supplementing with 50mg daily and it seems to be slowly working (105 to 150) so I will continue. My TriCare PA seemed to think the Free test was wrong but perhaps not since I was on Danazol to reduce SHBG (which they forgot to test) and I imagine that was effective. Actually about 10-14 days before this test I started to cut Danazol dosage in half (EOD) since I started to feel it was drying my joints out which was a tip from a previous user that it was getting too low.

So I’m waiting to hear from the Anti-Age clinic (just sent them the results) but I’m fairly confident I’m going to cut off the Danazol for a while (should my SHGB rise in a few months I’ll have a means on hand to knock it back down) and then obviously reduce the AI that was prescribed. I was thinking about not taking any for this 3.5 day ‘cycle’ and then reduce it going forward to 1.5 mg per week as opposed to the 3 mg they had prescribed (figure I’ll just take a 1/4 pill 6 days week).

Anyone have an idea how quickly Estradial will rise pinning .5 mg of 200TE twice a week without any AI?

Update…finished out my first 10 weeks on TRT. Didn’t take the doctors advise after week 5 labs to keep taking the danazol and 3mg per week of the AI; stopped taking the danazol after 5 weeks and reduced AI to just 2mg per week.

Since I was at the 10-week point I decided to get a bodpod again. I had one done a year ago and was running alot for a climb (25 miles/wk and 2 full-body sessions/wk) so I was down to 185#, 14.5% BF…and I was pretty happy with that. Then last fall, after working out fairly consistently over the summer I took 5 over the course of 2 weeks. All were consistent, 190# and 16% BF. Not happy but not surprised since I was tired a lot…

I didn’t repeat just before starting TRT but I think i was in the same state as last fall. Now after 10 weeks, 200#, 13% BF. No real change in diet, certainly worked out more since I recovered better and had more energy, but also I really have not done cardio during this time. I have occasionally done some CF metcons (maybe 1-2 times a week) but nothing consistent. So for anyone out there that is questioning the benefits of TRT, I think those numbers speak for themselves (keep in mind this is a 43 year old body with lots of miles on it)

I assume the body changes will be a little slower from here but we shall see what a little more discipline can do. I’m reduding the dose to 180 per week so I don’t run out after 9 weeks and reducing the AI to 2 mg per week but we will see how the next 10 weeks go…

Had a yearly physical and got the doc to run some numbers to see if my subtile changes were affecting the numbers. These were taken just before my next injection on day 4.

PSA went from 0.5 to 0.83 but if I think that could be due to the previous nights activities.
Estradiol: 20 pg/ml which I think is better considering I was <10 last time.
TestTotal: 1237 ng/dL ref range 348 - 1197
TestFree: 36.7 pg/mL ref range 6.8 - 21.5
SHGB: 36 nmol/L ref range 16.5 - 55.9

Cholesterol also decreased slightly to 191, which is a record low for me.

My dose that lead to this was 80mg every 3-4 days (depends on my schedule); 0.5 mg AI starting about 12 hours injection and then another .25mg the next day; 500ml HCG the day before the next injection. At the 80mg (.4ml) dose twice a week my 10 ml vial will hopefully last all ten weeks. We shall see.