T Nation

Midsection Fat Gains on TRT?


#1

I've read that being Hypo and starting TRT can and likely will reduce fat around the midsection. Well, it has been about 3 months since I started weekly injections (and started working out again) and I know I have gained a good amount of fat in my midsection. I have also gotten good gains in muscle as well. My diet hasn't changed much at all - I would describe it as semi-healthy.

I started out with about 1/4" of fat around my belly button, now I am at about 1/2"-3/4" of fat. Thing is, I wasn't working out prior, and I am now working out almost every day with a decent amount of cardio every workout (20min-60min on an elliptical). I am sweating a good amount in my workouts, I wouldn't say excessive.

Started TRT due to no libido and ED, but prescribed by my oncologist (because I have an unrelated blood disease that has to be monitored monthly or EOM). I don't have much other bloodwork related to HRT other then a few TT and one e2 test:
Started: 270 TT (250-837)
Now: 830 TT (but probably higher since I take my weekly injection just after the blood test).

Just got my first e2 and it was 46 (20-43).

Currently at 160mg/weekly inj. test cyp. More to my story and dosing, but it is probably more then is needed so I left it out.

Any help on why I could be gaining fat?

I have my first appt with an Endo (referred by my oncologist), but it isn't until the end of February (endo's are in demand in CO)- and I'm not positive this endo will know much about male HRT.

Thanks!


#2

Please read these stickies:

  • advice for new guys ---- post more info about you
  • protocol for injections
  • finding a TRT doctor

Your problem is from the high E2

You need to self inject T at least twice a week.
Should be using anastrozole to reduce T–>E2 aromatization
Use 1.0mg of anastrozole per week for ever 100mg T per week in divided doses.
Take at time of injections.

When you inject once a week, your lab numbers are greatly a result of when you do the lab work.
Proper results with anastrozole need steadier T levels.

Understand “anastrozole over-responder” and know what to do.

You may have higher E2 because your liver is not clearing E2 properly. This can be from the liver having to metabolize your other medications that make same demands on the same enzyme pathways that clear estrogens.

Endo’s are as a group, the worst option for TRT. Get a referral from: http://www.collegepharmacy.com/index.php?/patients

Labs:
TT
FT
E2
LH/FSH - cannot do that now, something that needs to be done before TRT
prolactin
CBC
hematocrit
TSH
fT4
fT3
DHEA-S
AM cortisol [ do at 8AM]
fasting glucose
fasting cholesterol [could be too low]
PSA if over 40
DRE if over 40

Do labs always half way between injections and not at doc’s office


#3

Ok. I have some more info.
Filled out the referral request several days ago - no reply as of yet.
My current protocol is 100% doctor driven, since he is the prescribing doc, and I have to see him every month or so. It started with 100mg inj a month. Increased quickly to every 2 weeks. Then finally, self administered 1x a week about 3 months ago. I have had to push him pretty hard to get where I am (1 inj a week, self administered), but recently requesting a microdose of anastrozole put him over the edge and he referred me to an Endo.

I have a blood disease that causes clotting (over-produce blood platlets), I have always been on the high end for Hematocrit: 51 (40-54). Since starting my TRT, my Hematocrit has not increased at all. Because of my treatment, my platelets are now almost down to the just exceeding high range, which is huge: 429 (140-400). I used to be at about 800-900.

Where can I do blood tests you suggest outside of Doctors visits?

Although I am a bit aprhensive, I will try doing 2x a week injection in the thigh (currently 1x in the glute by the wife). I also went to BlueSkyPeptide and ordered some anastrozole - hopefully they are reputable. Knowing either of these was happening I believe would cause my doctor to stop prescribing. I have asked about going to 2 times a week in the thigh, and he said he didn’t do it that way because thigh inj cause more problems - so he wants me to stay in the glute.

Current daily meds:
Hydroxyurea
Asperin
Vitamin D

Also on daily Tramadol (pain) for Degenerative Disc Disease - but working to try and remove that completely. Not sure it is possible, but with my increasing core strength, I might accomplish a reduction.

All of the bloodwork - I just don’t have, he never did that kind of work, only TT got checked because of my symptoms. Here is how it worked out:

Symptom: Low Libido. Tested on the low end for TT - refused TRT. TT: 269 (250-837)
Month later
Symptom: Low Libido, Erectile problems. Given a 100mg Test Cyp Shot. For 2 days I had erections.
Month later
Got another shot 200mg. Lasted 5 days or so: erections, good libido.
2 weeks later
Got another shot 200mg. Lasted a week. Asked to home administer weekly. Denied.
2 weeks later TT: 289
Got a shot for 300mg. Lasted a week or longer. Asked again for home administration. Denied.
2 weeks later TT: 359
FInally approved for 200mg/wk home administration.
Continued on 200mg/wk for 2 months, then tested at TT: 929 (250-837). Self reduced to 160mg/week. Useable erections, and a decent libido.
Last test TT: 830, E2: 46.

I should state that my erections have seemed just a bit soft, and a bit numb since my very first 2 shots (which were rock hard, but only for a few days). At least I can now get them.

Thinking of dropping to 70mg 2x a week (from 160mg 1x a week), but I like the gains in the gym. Or maybe 80mg 2x and a bit of Anastrozole could get me where I want to be?


#4

Inject in quads or vastus lateralis with #29 1/2" 0.5ml [50iu] insulin syringes. At Sam’s or Walmart ask for their Relion house brand. ~$14 per box of 100. No script needed in most jurisdictions.

Thigh implies inner leg, never do that!

Is your serum iron or ferritin at an odd level? You do have iron losses now.

Fix E2 and life will be a lot better. Try 1/2mg at time of injections. You may need more.

lef.com has blood work product page, there are other companies that may be better depending on how much you are doing.


#5

[quote]KSman wrote:
Inject in quads or vastus lateralis with #29 1/2" 0.5ml [50iu] insulin syringes. At Sam’s or Walmart ask for their Relion house brand. ~$14 per box of 100. No script needed in most jurisdictions.

Thigh implies inner leg, never do that!

Is your serum iron or ferritin at an odd level? You do have iron losses now.

Fix E2 and life will be a lot better. Try 1/2mg at time of injections. You may need more.

lef.com has blood work product page, there are other companies that may be better depending on how much you are doing.

[/quote]

Sorry - I meant to say quads - I’ve watched a video on how to do it online.

What do you mean “You do have iron losses now”? I haven’t had any specific IRON tests (that I know of), but low iron would cause anemia, and I have high RBC - it has always been on the higher side: 5.6 (4.2-5.8).

Also, picked up the syringes just now.

I just checked out lef.com. Pricey. Might see if I can get my oncologist to pull a full set, as I might get a better price.

Thanks!


#6

I was assuming that you were having blood removed to manage RBC.


#7

No phlebotomy as of yet. Doc says if I go higher, then I will need to go in and donate.

Couple of questions:

  1. These needles are tiny! Any issues with leakage in the Quad? Is there a thread around for best technique?
  2. My prescription consists of mini vials (1ml per vial: 200mg/ml). Since I am now taking less I have several little vials with .2 ml in them. Is there any problem with using one of these syringes to draw out the .2’s and combine by pumping them all into one vial? Say if I wanted to have a little extra for a later time? I didn’t think there would be a problem if I am careful, but thought I would ask.

Thanks!


#8

“because I have an unrelated blood disease”

  • you should not be donating blood

yes, you can collect T from the vials
So you can’t get a 10ml multi-dose vial? - would be less cost too

Back pain:
For my arthritis in my hands, I found that 15mg meloxicam once a day worked a lot better that 6 naproxen which were affecting kidney lab profile. Might be helpful in getting off of or reducing Tramadol. $10 for 90 days is very cheap, I pay cash prices and don’t run it through insurance.


#9

[quote]KSman wrote:
“because I have an unrelated blood disease”

  • you should not be donating blood

yes, you can collect T from the vials
So you can’t get a 10ml multi-dose vial? - would be less cost too

Back pain:
For my arthritis in my hands, I found that 15mg meloxicam once a day worked a lot better that 6 naproxen which were affecting kidney lab profile. Might be helpful in getting off of or reducing Tramadol. $10 for 90 days is very cheap, I pay cash prices and don’t run it through insurance. [/quote]

DAMN - I wasn’t even thinking about not being able to donate because I have the high platelets - I know I have discussed it (donating platelets and blood) several times with my doctor (and I hear my doc is a well renowned hemo-oncologist). I just googled and found the problem might be more that the anti-cancer drugs that I take can be harmful to others (not necessarily the blood or platelets). I will have to bring that up.

ON that subject - I can’t donate blood anyhow because I travel to regions of the world to scuba dive which then prohibit me from donating blood. SOOOO… is there a way to do a phlibotomy without the donation aspect? Where and how? I would assume may on gear would have to plibotomize, but their blood is too tainted for donation. So, how is that done, and how much does it cost?

I asked for the 10ml, and they refused - not sure why. It would cost me about 30% less, and I wouldn’t have to worry about the ‘bits left over’. I think they are worried about abuse, and they are somehow controlling it, but I lowered my own dose on my own accord to get within the range - so maybe they will reconsider. Again, another reason I need to find a good doctor - still trying - in CO (if someone wants to give me a tip :slight_smile:

I have to be careful with NSAIDS. I broke my back in 2 places when I was a teenager, and I have degenerative disk disease. I have some pretty bad pain. Overuse of NSAIDS over the years has torn apart my stomach. The aspirin-a-day I am prescribed to reduce the thickness in my blood is all I can handle. I am currently trying to wean down my dosage of tramadol (which I can do), but I think the only way to get off them completely is if I have another series of epidural injections, or surgery. Surgery is out because I haven’t met 1 single ‘lower’ back surgery patient that is symptom free, and many are worse off. I’ve been avoiding more epidurals because a recent rash of people instantly dying from them.

Honestly, you wouldn’t look at me and think I am in as bad of shape as I am. 6’4" athletic build, 220lbs - much better shape (muscle-tone wise) then most 43 year-olds. Thing is, the only time I don’t really feel pain is when I am exercising. But if I don’t move for a few hours (think: working at a desk), I am literally debilitated from pain. It has gotten much worse over the last few years - hopefully this shot of Test will help me out. Seems to be working so far - I think I am just a bit high on E2, so waiting on the AI to arrive. Moving to 2x weekly inj in the outer quad (per your inj protocol thread)- just freaking out over the reports of problems. First one is tomorrow morning. Wish me luck.


#10

The nice thing about meloxicam is that the drug load is only 15mg per day. Somehow I think that that reduces risks to the stomach.


#11

With respect to donation, or other options, I believe you can obtain therapeutic phlebotomy with a script. My clinic offers it and it should be covered. I also believe many Red Cross centers offer it, but I am not positive.


#12

[quote]The Myth wrote:
With respect to donation, or other options, I believe you can obtain therapeutic phlebotomy with a script. My clinic offers it and it should be covered. I also believe many Red Cross centers offer it, but I am not positive.

[/quote]

Good to know - thank you!


#13

[quote]KSman wrote:
The nice thing about meloxicam is that the drug load is only 15mg per day. Somehow I think that that reduces risks to the stomach. [/quote]

I will check into that at my next GP appointment. Thx!

Also KSman - did my first injection about 10 minutes ago following your protocol. In the lateral vastus with a .5" 29 guage insulin pin. Was a bit shakey, but I used the ‘z track’ technique I found online, and no pain, no blood, no leakage - beginning if I actually did anything! Thanks for the info!

Now, my liquid adex should be showing up today. Is there someplace that states how to store/dose that? Is it supposed to be refridgerated? Also, I saw to mix it with vodka, is there someplace that spells that process out for dummies?

EDIT: I think I found that I can dose with a syringe dropper - don’t think vodka is necessary. Refridgeration? ALSO, could someone please vouch for BlueSkyP please?


#14

Purchased liquid adex should not be refrigerated. Dose into a shot glass, add water, drink, repeat water and drink.

Alcohol is use to make your own liquid from tablets.

Z-track has no benefit. Leakage does not happen. Press on injection site after injecting for 10 seconds to allow damaged blood vessels to seal off and prevent blood bruising.