I am 48 yr old male at 6’2", 240 lbs. I recently went to my doctor regarding symptoms of low Test including depressed attitude, sex drive, etc. He ordered a blood test which came back as:
Sex Hormone Binding Globulin 26.0 range nmol/L 13.0-71.0
Testosterone 11.60 range nmol/L 5.80-28.00
Free Androgen Index 43.9 no range given. Free testosterone is no longer avaiable and has been replaced with Free Androgen Index which is a better measure of the bio-availablity of testosterone, says the report.
Unfortunately, he did not order the estradiol bloodwork. He did feel the Test level was at about average for the range.
As a starting point he has me on Test E (Delatestry 200mg/ml) at 1ml/month injection. Started the first shot Friday May 22, self injection. My next appointment is Sept.
My questions are can the injections be more frequent with less volume such as .5ml/2weeks, or .25ml/week? Is there a concern with the peaks and valleys of a once/month injection? Would such a small amount/week be as effective? Even though it is a low dose of Test, I was considering going to a small dose of an AI. Is that a benefit considering the circumstances? Any thoughts would be greatly appreciated..
[quote]KSman wrote:
Your doctor is yet another idiot. You need 100mg/week and that should be as two injections per week. You need E2 management and 250iu hCG SC EOD.
T+AI+hCG
What are your cholesterol, PSA and serum Glucose numbers?
Where are you located?.. lab units are not typical for USA.[/quote]
I’m in Western Canada, I was going to mention that but forgot. Ttl Chol is 4.50 nmol/L range 3.8-5.2, HDL is 1.07 range 0.9-1.6, and LDL is 3.26 range 2.0-3.4. Glucose Fasting is 6.1 mIU/L in a range of 0.30 to 5.50. PSA is 0.38 ug/L 0.0-4.0 range.
I almost feel I should do my own TRT with frequent blood tests. The doctor seems fairly open minded on things. He considered hormonal rather than the depression route. Ill have to figure out the next plan of action. Again, any comments and suggestions would be appreciated. Thanks for you response.
[quote]KSman wrote:
Your weight and glucose suggest insulin resistance. How much fat and how to do carry it? Waist size?
Some drugs can increase E and lower T, at at 48 your levels seem typical.[/quote]
I don’t know my bf% but I carry most of the fat in my waist/belly. My waist is 41 inches at this moment at the belly button. Interesting comment about the insulin resistance, I guess it’s time to cut some weight and also focus on insulin resistance. I thought I wasn’t doing too bad as my carb intake is moderate at around 200 gr/day, 1/2 that post work out. I am on a mass gain phase since Sept 08 and would like to stay that way if I could. I have been weight training for 7 years consistently.
Appreciate your thoughts and any more ideas anyone has. I’m coming up with more questions than answers however.
So going back to my first post, should I switch to once/week injection or is it even worth it? Considering it’s 200mg/month is 50mg/week going to be of any benefit? Since I did the one shot just Friday is a 50 mg shot going to keep the Test levels higher if I do a 50mg shot this coming Friday?
On the insulin resistance, I have done most things in my power to manage insulin through diet and post workout nutrition. If I wasn’t doing those things I suspect my blood glucose would look much worse than it is. I do the 7 meals a day, low glycemic carbs unless peri and post work out along and in the last 3-4months ago added a cup of rice or pasta at supper time probably about 150 to 200 grams of carbs a day. Also at about 3800 to 4000 Kcals with approx 360 gr of protein and the rest fats. What am I missing or doing wrong if anyone can point me in the right direction. I’ve been following CT’s and others articles and posts since Ive joined. Thanks.
TRT, done properly, can improve insulin resistance. You may have syndrome-X aka metabolic disorder. The spectrum of problems seems to be associated with estrogen dominance. Tell your doc what you want.
TT near upper range, FT the same or at.
Manage serum E2 to get near E2=22pg/ml.
250iu hCG SC EOD to prevent damage to the testes and loss of pregnenolone production.
Ask for 100mg test ester per week and inject that your self as 50mg twice a week.
Supposedly if you inject the same amount 2xwk (50 x2) you would get a higher value than if you shot just a 100 x1wk. This was brought up by my endocrinologist when I was arguing that there was no way that 100mg a wk should be the most a person should get.
He said 100mg wk was recommenced max and I pointed out that that that there were other experts Rx’ing 300mg twice a wk… This actually makes sense especially when it’s known that increases wk to wk to not give a equal increase in tt.
I was able to get to see the doctor today to ask about E2 control and HCG. He is totally unaware the role E2 HCG has in the scheme of things. His only goal is to bring my test levels up to the upper range, nothing else matters. He feels E2 will have no significant role at my current level, whatever it is, or with the new test treatment. He would not entertain a prescription for an AI such as Arimidex. It’s for women and besides E2 only elevates in sgnificantly overweight males. I did tell him I was going to weekly injections on the Test but he didn’t want me to go as high as the 100 mg/wk. I also left him some copies on male hormone treatment from LEF and Mens Health(Dr Crisler) websites.
I will have to look at other options such as another doc, but my time is really limited to do that. For the AI I suppose there’s the RC route, but I don’t know who to trust. I have been looking around but who is legit. PM me if you can help point me in a good direction.
Since my first injection was Friday May 22 any recomendation on when I should start the weekly ones? So far I’m feeling better since the first treatment but my anxiety is over the AI and HCG is higher. Any other ideas?
Here’s an idea: read the insert that comes with the testosterone, then read it to your doctor in his office. It will say something like "average dosage is 200 to 400 mg’s every two weeks. That should make it easier to convince this guy to up your dosage since that is what the medication “says”. If he won’t budge, get rid of him as he isn’t doing you any favors at 200mg’s a month. You will probably feel good for a few days, then feel like crap from the E2 spike.
If I knew of any RC’s in Canada, i’d PM you but I don’t. If you want a US based RC, PM me.
[quote]KNB wrote:
Here’s an idea: read the insert that comes with the testosterone, then read it to your doctor in his office. It will say something like "average dosage is 200 to 400 mg’s every two weeks. That should make it easier to convince this guy to up your dosage since that is what the medication “says”. If he won’t budge, get rid of him as he isn’t doing you any favors at 200mg’s a month. You will probably feel good for a few days, then feel like crap from the E2 spike.
If I knew of any RC’s in Canada, i’d PM you but I don’t. If you want a US based RC, PM me.[/quote]
I’ll follow that up. Thanks. The only thing I could see on the insert is 200mg/ml solution for intramuscular injection. Feelings were like you said. Good for a few days but I haven’t felt too bad since considering some of the stress recently. Thanks for the suggestion.
Ksman said it best just another dr that does not know proper TRT.
One can not blame it on the DR, but rather they are taught in medical school. There are alot of good dr’s in oregon and seattle area. One of them is Dr John wright in tacoma washington. I would check him out.
[quote]Hardasnails wrote:
Ksman said it best just another dr that does not know proper TRT.
One can not blame it on the DR, but rather they are taught in medical school. There are alot of good dr’s in oregon and seattle area. One of them is Dr John wright in tacoma washington. I would check him out.
[/quote]
I must have missed your post before now. Thanks for the advice.
I had a follow up visit with the Doctor. I think he was waiting to see what I was going to do with the Test E. He said he knew the once/week injection would likely not be enough and more frequently would be better. After telling him how I reacted to the injections he upped the dose and suggested more frequent. He even went as far to say to experiment(within reason) with the dose over the next several weeks to see where the best level may be. He will do more blood work when he is back in Sept.
However, he still is uncertain about estradiol and an AI but he did read the literature I gave him about it and is looking at it. He has another doctor filling in for him while he is away so I will get him to do the bloodwork sooner. I increased to 100mg/week composed of twice at 50mg. I am contemplating EOD dosages. Thanks to those who replied and those who I pm’d for you advice.
When it comes to blood work, there are two schools of thought: one is always get your b/w done mid week between shots, and the other is to wait until after your b/w is done to give yourself your shot.
The reason why I prefer the “other” way is blood levels of T will be at the lowest point right before the next shot, as opposed to the mid week “average”.
When I was on twice a week shots, I did Monday morning and Thursday afternoon because it was convenient.
I now do my HCG EOD, and my T shots EOD as well. Because I don’t like having large E2 spikes, that’s why the EOD shot protocol.
What the heck… if doc says “experiment”, why not experiment up to 200mg’s/week if you can? I am one of the guys that the more Test I do, the more calm and focused I stay. I have never had androgen rage in the last 3 years, and I don’t think I’ll start now.
My doc has me on Test Cypionate and Nandrolone Decanoate for my joint pain issues. I just started on the Nandrolone last week, so I don’t know if the joint pain will go away or not, but only time will tell.
Good luck and keep us posted.
[quote]KNB wrote:
When it comes to blood work, there are two schools of thought: one is always get your b/w done mid week between shots, and the other is to wait until after your b/w is done to give yourself your shot.
The reason why I prefer the “other” way is blood levels of T will be at the lowest point right before the next shot, as opposed to the mid week “average”.
When I was on twice a week shots, I did Monday morning and Thursday afternoon because it was convenient.
I now do my HCG EOD, and my T shots EOD as well. Because I don’t like having large E2 spikes, that’s why the EOD shot protocol.
What the heck… if doc says “experiment”, why not experiment up to 200mg’s/week if you can? I am one of the guys that the more Test I do, the more calm and focused I stay. I have never had androgen rage in the last 3 years, and I don’t think I’ll start now.
My doc has me on Test Cypionate and Nandrolone Decanoate for my joint pain issues. I just started on the Nandrolone last week, so I don’t know if the joint pain will go away or not, but only time will tell.
Good luck and keep us posted.
[/quote]
At first he said 100mg every 10 days to get to 300 mg/month so I thought I would start with the 50mg twice a week as the experiment as the every 10 days, I felt, was a stretch. I’ll see how things go from here. Might try EOD comparison as well as a slight dosage increase comparison over time and plan it in with the blood work.
I am on the same boat as you are BB. I just started 200mg a month. 1 shot. After three months she wants me to take another blood test 4 weeks after my last shot. I imagine my numbers will be real low after the shutdown and 4 weeks of halflifes whittling down to nothing. My Doctor also took another blood test and said the second test (before I started TRT) my numbers were all in the normal range. She said if she knew that I was in the normal range she would never had started me on test. Her action is to know go more on how I feel and try to get my numbers into the normal range. I too would like 400mg a month/ 100mg a week. Why the hell are these doctors so stingy with this?
[quote]IKIMURA wrote:
I am on the same boat as you are BB. I just started 200mg a month. 1 shot. After three months she wants me to take another blood test 4 weeks after my last shot. I imagine my numbers will be real low after the shutdown and 4 weeks of halflifes whittling down to nothing. My Doctor also took another blood test and said the second test (before I started TRT) my numbers were all in the normal range. She said if she knew that I was in the normal range she would never had started me on test. Her action is to know go more on how I feel and try to get my numbers into the normal range. I too would like 400mg a month/ 100mg a week. Why the hell are these doctors so stingy with this?[/quote]
You get getting injected at the doc’s office? Ask to self inject 50mg twice per week. Explain that once a month is not natural.
[quote]KSman wrote:
IKIMURA wrote:
I am on the same boat as you are BB. I just started 200mg a month. 1 shot. After three months she wants me to take another blood test 4 weeks after my last shot. I imagine my numbers will be real low after the shutdown and 4 weeks of halflifes whittling down to nothing. My Doctor also took another blood test and said the second test (before I started TRT) my numbers were all in the normal range. She said if she knew that I was in the normal range she would never had started me on test. Her action is to know go more on how I feel and try to get my numbers into the normal range. I too would like 400mg a month/ 100mg a week. Why the hell are these doctors so stingy with this?
You get getting injected at the doc’s office? Ask to self inject 50mg twice per week. Explain that once a month is not natural.[/quote]
KS can you point me twards some articles, web links or literature that I can show her?