Male, 38 y.o, on T-replacement for 1-year

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Doctor is Stingy with Test Results - Testosterone Replacement - Forums - T Nation

The above message appeared on my thread, so if it’s ok I’d like to start a new thread.

-age: 38
-height: 6’
-waist: 34"
-weight: 180lbs
-describe body and facial hair: Hairy all over (including my goddam shouilders). Decent beard (when I grow it), but patches where my moustache should connect to my beard.
-describe where you carry fat and how changed: Carry fat on my hipbones, toward the back.
-health conditions, symptoms: heart murmur, but was never a problem.
-Rx and OTC drugs, any hair loss drugs or prostate drugs: been taking Viagra for a year.
-lab results with ranges:

5 Tests Done so far. The first three are covered in my old thread:
http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/doctor_is_stingy_with_test_results?id=4043076&pageNo=0

  1. JUNE 2010 (before T-replacement)

  2. JULY 2010 (during Dr-prescribed 250mg every 2 weeks)

  3. OCTOBER 2010 (after three weeks of NO injections)

  4. MARCH 2011 (four months of T protocol, as outlined in the sticky)

  5. OCTOBER 2011 (11 months of T protocol, as outlined in the stickies)


  1. MARCH 2011 (four months of T protocol, as outlined in the sticky)

Free Test: 22.8 (8.8-27)
Testosterone: (RIA) 8.6 (2.62~15.93)
E2: 27.2 (7.6-42.6)
Free T3: 2.7pg/mL (2.0-4.4)
Free T4: 1.01 ng/dL (0.93~1.70)
Prolactin: 3.35ng/mL (4.04-15.20)
PSA 1.0ng/mL (0-4)

  1. OCTOBER 2011 (11 months of T protocol, as outlined in the sticky)

Testosterone (RIA): 15.92 (2.62~15.93)
E2: 41.1 (7.6-42.6)
SHBG: 42.3 (10~73 nmol/L)


-describe diet: low fat, small meals.
-describe training: full-contact martial arts (received some KOs) for 20 years. Now, just light training, 3x per week.
-testes ache, ever, with a fever: no teste ache
-how have morning wood and nocturnal erections changed: morning wood, but not too hard. And not with the arousal it used to give me.


I got the most recent test done because for about 2-3 weeks my erections have been slow to appear, and then quick to fade away (a couple times during goddam intercourse). Popping Viagra, which usually makes me rock solid, instead made me capable (but just barely).

So, it seems my T is high, but so is my E2. Can that be giving me problems with libido and erections?

EDIT: btw, as I mentioned, I’ve been following the injection protocol as outlined in the sticky.

Link to your old thread or PM a moderator and ask them to unlock your old one and delete this one. Too many case threads to give meaningful advice.

[quote]VTBalla34 wrote:
Link to your old thread or PM a moderator and ask them to unlock your old one and delete this one. Too many case threads to give meaningful advice.[/quote]
I linked to my old thread, thank you.

Maybe I should up my dose of Anastrozole?
I’ve been at 250iu EOD.

My E2 is at the very high end: 41.1 (7.6-42.6), and my T is at the high end: 15.92 (2.62~15.93)
I want to keep that T where it is, amd get the E DOWN!

[quote]Helper wrote:
Maybe I should up my dose of Anastrozole?
I’ve been at 250iu EOD.

[/quote]

No you haven’t

[quote]VTBalla34 wrote:

[quote]Helper wrote:
Maybe I should up my dose of Anastrozole?
I’ve been at 250iu EOD.

[/quote]

No you haven’t[/quote]
My mistake. .250mg EOD

Your E2 was at 41 while taking .25 mg EOD? Yeah I’d talk to my doc about increasing it. Are you using scripted adex or research? May be tricky to fine tune your dose with pills (without dissolving in alcohol and dosing more precisely).

Formula is New Dose = Current Weekly Dose * Current E2 / Desired E2

Current Weekly Dose = 0.875
Current E2 = 41
Desired E2 ~ 22 (somewhere between 20-30…I use KSMan’s number)

So New Dose = 1.6

If doing pills, best approximation is 1.5 mg/week. Easiest way to do that is 0.5 mg (half pill) on MWF.

If that still doesn’t leave you at the desired level (too high), then add an additional quarter pill on Friday.

[quote]VTBalla34 wrote:
Your E2 was at 41 while taking .25 mg EOD? Yeah I’d talk to my doc about increasing it. Are you using scripted adex or research? May be tricky to fine tune your dose with pills (without dissolving in alcohol and dosing more precisely).

Formula is New Dose = Current Weekly Dose * Current E2 / Desired E2

Current Weekly Dose = 0.875
Current E2 = 41
Desired E2 ~ 22 (somewhere between 20-30…I use KSMan’s number)

So New Dose = 1.6

If doing pills, best approximation is 1.5 mg/week. Easiest way to do that is 0.5 mg (half pill) on MWF.

If that still doesn’t leave you at the desired level (too high), then add an additional quarter pill on Friday.
[/quote]
Thank you very much!
I’m taking liquid, so I think it’ll be a little easier. I’m really hoping this gets me back on track!

Btw, for E2 levels to come down, are we talking days, weeks or months?

Days…its very quick…

Nice. Thanks!

Well, today I got the results of my latest blood test.

Please look at my E2, cholesterol, and SHBG…

BLOOD TEST RESULTS FROM FEBRUARY 8, 2012

  1. Testosterone (RIA): 11.38 ng/ml (2.62~15.93)
  2. Free Testosterone: 0.133 ng/dL = 1.17 %
  3. E2: 39.3 (7.6-42.6)
  4. Prolactin:
  5. DHT:
  6. PSA: 1.47 (0.16~0.4)

Alubin: 3.8 (3.5~5.0)
SGOT: 33 (5~40)
SGPT: 31 (1~40)
-GTP: 21 (7~50)
Total Bilirubin: 1.0 (0.2~1.2)
T. Cholesterol: 122 (130~220)
Tryglyceride: 45 (10~190)
HDL-chol: 26 (35~85)
Blood Sugar: 83 (110)
CBC
WBC Count: 5.81 (4.5~10.5)
RBC Count: 4.98 4.00~6.00)
Homoglobin: 16 (11.0~18.0)
Hematocrit: 46.8 (35.0~60.0)
MCV: 93.9 (80.0~99.0)
MCH: 32 (27.0~31.0)
MCHC: 34.1 (33.0~37.0)
Plt Count: 182 (150~450)
PSA: 1.47 (0.16~4.0)

SHBG: 64.8 (10~73 nmol/L)

*0.285mg test, EOD injections [EDIT: 28.5mg EOD]
*0.300iu HCG, EOD injections
*0.40mg Anastrolzole (EOD, raised from .25mg EOD because of high E2)

My cholesterol is non-existent. I’m not taking any drugs to lower it.
My SHBG is too high.
My doctor told me that these two things are the causes of my low libido and erection problems.

symptoms?

[quote]VTBalla34 wrote:
symptoms?[/quote]

  1. Haven’t been able to get a decent erection in 6 months. Viagra allows me to “get the job done”, but just.
  2. Very sensitive to heat in recent months. After sex, my body is too hot and I can’t sleep for 2-3 hours.
  3. Sleep in general has been very poor lately.
  4. I don’t know if this is a sypmtom or a cause, but I’ve been feeling REALLY stressed lately. Things that I could live with before are now unbearable. It feels like a band of stress is wrapped around my torso.

After some more research, I’ve decided upon these solutions:

  1. Low HDL: More running, adding more seafood to diet, niacin, flaxseed oil, MORE omega 3 (I already take 2,400mg nightly).
  2. High SHBG: Apparently controlling estradiol will lower SHBG. If there is still a problem, I will try stinging nettle root.

As for my ongoing high E2 levels, 0.25mg adex EOD didn’t work, 0.4mg EOD didn’t work, let’s try 1.0mg EOD.

Thoughts?

Definitely think you need to lower your E2…you can start by reducing your hcg dosage to 250 iu twice a week (I assume you meant youre at 300 iu thrice weekly currently). This is where I would start if it were me.

Why are there no values for prolactin or DHT? those two are 2/3 of the key ingredients for libido (E2 being the third).

You need to get your units straight. I have no idea how to interpret “0.285 mg test EOD”. Are you trying to say 28.5 mg? Have no idea how you would measure this in an insulin pin. Are you sure you know waht you’re doing?

I assume in your later post you meant “Low HDL” instead of “Low LDL”…those are good options…CoQ10 with ubiqutol (I misspelled that but you can figure it out) will help with mitochondria function and conversion to HDL.

Keep in mind that for some people (namely myself) arimidex tanks libido…no clue why, but it sucked for me even with normal E2…when I switched to Aromasin, my E2 stayed the same but didn’t have the same issues.

Thanks for taking the time to weigh-in on my issues.
The results for prolactin and DHT are missing on my blood test results, so I’ll be getting in to see the doctor again on Monday afternoon.
I’ll lower my HCG injections and take all of the rest of your advice and try to make positive things happen.
Oh, and sorry about confusing the units (again). Luckily I don’t confuse them when I’m injecting :slight_smile:

Thank you

VTBalla,

I hope it is ok to ask this question within this thread, In here you wrote the following:

"Why are there no values for prolactin or DHT? those two are 2/3 of the key ingredients for libido (E2 being the third). "

I know that E2 can be controlled with AI and adjusting HCG and testosterone, How do you control Prolactin and DHT up or down to work on libido issues?

Thanks,

[quote]tuscans wrote:
VTBalla,

I hope it is ok to ask this question within this thread, In here you wrote the following:

"Why are there no values for prolactin or DHT? those two are 2/3 of the key ingredients for libido (E2 being the third). "

I know that E2 can be controlled with AI and adjusting HCG and testosterone, How do you control Prolactin and DHT up or down to work on libido issues?

Thanks,

[/quote]

Very difficult. There are drugs that can control or improve both (caber or bormo for high prolactin or A5RI for high DHT or proviron or similar for low DHT). Not really had anyone that required these specific treatments though (except for the guy that had a pituitary andenoma that secreted prolactin)…but it is very imporant tot know where these labs are at in order to assess from an overall viewpoint

As you can see above, my E2 in my February blood test was 39.3 (7.6-42.6), EVEN THOUGH I WAS TAKING 0.40mg Anastrolzole (EOD)!
So, I decided to take 1mg EOD for a few weeks, and then get tested. I dropped my E2 to 11.14 (7.6-42.6), which may sound great, but I still felt terrible. I’m assuming because of my ridiculous SHBG level, combined with my non-existent cholesterol level: last blood test was HDL-chol: 26 (35~85)

LATEST BLOOD TEST RESULTS (March 7, 2012)

  1. Testosterone (RIA): 11.14 ng/ml (2.62~15.93)
  2. Free Testosterone: 0.152ng/ml = 1.36%
  3. E2: 11.14 (7.6-42.6)
    (Lowest ever. It took 1mg Anastrozole EOD to get there.)
  4. Prolactin: 5.75 (4.04~15.2)
  5. DHT: didn’t test. Doctor said the test was not available.
  6. PSA: 1.31 (0.16~0.4)

SHBG: 80.4 (10~73 nmol/L)
***Sept 2011- 42.3; February 2012- 64.8 It seems to rise when I up the Anastrozole.

Protocol leading up to latest blood work:
*28.5mg test EOD
*0.200iu HCG, EOD injections
*1mg Anastrolzole (EOD, raised from .25mg EOD, then .40mg EOD because of high E2)

I’ve been on a wild ride since September 2011. Back then I was simply following the protocol as outlined in the stickies. My results weren’t bad, but my E2 was TOO HIGH. Trying to lower that has led me to other difficulties (higher SHBG, lower cholesterol)

Since the latest blood test, I switched from Anastrozole to Aromasin. I’m taking 12.5mg EOD, but may up it to ED.

MY GOAL:
Lower SHBG, higher HDL, and return of boners.

PS Sorry in advance for all unit mistakes and overall ignorance. I’m no rocket scientist.