T Nation

My TRT Journey and LOG

I read the sticky on new posts, and some stickies by KSman, so I am starting my own thread for my “case”. Per the advice, here’s what I have:

Age: 54 years

Height: 5 ft 11 inches

Waist: 31 inches

Weight: 172 pounds (naked)

Body/Facial Hair: Still pretty “heavy”. Increasing near wrists (which I think is a result of TRT).

Body Fat: 9% before beginning TRT March 15 2013. Don’t know current BF %. Appears to have not changed much. Carry on waist, mostly around back, very little noticeable “love handles” up front, more dominant on back around waist.

Health Conditions: Low T (see lab results below), high “normal” cholesterol.

No Rx, except for T pellets and anastrozole (both from a compounding place used by my BodyLogicMD doctor, who I don’t think is an idiot, see more on that below). The anastrozole, right now, is .25 (one-quarter) mg twice a week. First, and only so far, insertion of 1200mg T-Cyp pellets on March 15 2013. Due to go back June 24, 2013. No OTC, not even ibuprofen, ever.

Supplements:
Acetyl-L-Carnitine: 2 gram ED.
Vitamin E: 800 IU ED.
Omega 3: 2250mg ED. EPA: 1500mg ED. DHA: 750mg ED.
NAC: 1200mg ED.
NOW Super Enzymes: 3 Caps ED (Amylase: 20k USP, Protease: 20k USP, Lipase: 3400 UPS. Betaine HCL: 200mg. All per capsule).
Niacin: 1500mg ED (flush free!).
NOW ZMA (ZMA 2400mg, B-6: 15 mg, Magnesium: 450mg, Zinc: 30mg).
Iodoral: 1 tablet ED (Iodine: 5mg, Iodine as potassium salt: 7.5mg).
Resveratrol: 2 ED (2 caps provides: trans-Resveratrol: 400mg, Polyphenols: 160mg).
“Rosavin Plus”: 2 caps ED (each cap provides 150mg standardized 3% Siberian Rhodiola); I plan to stop this (too costly, and I honestly don’t know if it is beneficial).
R-Lipoic Acid: 200mg ED (I’ve read this form is more bioavailable than ALA).
CoQ10: 800mg ED (includes 10mg BioPerine ostensibly to aid in absorption).
DHEA (Spray; Nature’s Plus “Lipoceutical Delivery System”: 2 sprays ED providing 25mg DHEA total.
Vitamin B complex (“B-Bright” from Jarrow Formulas): 1 cap ED.
Vitamin D: 10k IU ED.
Vitamin K2 (as MK-7): 100mcg ED.

My BodyLogicMD doctor prescribed the DHEA, Vitamin D, Vitamin K2, and the anastrozole, all from the compounding firm he uses. I discontinued all because of pricing, especially the anastrozole which I was paying $20/mg! (Nine .25mg capsules for $45!). I now get all those elsewhere. I have a rather urgent question about the anastrozole I have purchased elsewhere as a “research chemical”. More on that later (below my lab results).

Lab Results: My doctor had me take a blood test, it seemed like they took a quart for all the tests he ordered! Below is a partial summary. If you need more please ask! NOTE: These are results BEFORE beginning TRT on March 15, 2013. I have marked out of range with a *.

Estradiol, Ultrasensitive: LC/MS/MS: 27 pg/mL. Range: < OR = 29 pg/mL.

LIPID Panel:
*Cholesterol, Total: 231, Range: 125-200 mg/dL
HDL: 51, Range > OR = 40 mg/dL
*LDL: 145, Range: <130 mg/dL
*Triglycerides: 177, Range <150 mg/dL
CHOL/HDLC Ratio: 4.5, Range: < OR = 5.0 (calc)
NON HDL Cholesterol: 180, Range: mg/dL (calc) “Target for non-HDL cholesterol is 30 mg/dL higher than LDL cholesterol target”

Cardio CRP ®: 0.5 mg/L, Range: none given but note that for > 17 years age that <1.0 (which I had) is “lower relative cardiovascular risk”.

Metabolic Panel:
Glucose: 86, Range: 65-99 mg/dL
Urea Nitrogen (BUN): 22, Range: 7-25 mg/dL
Creatinine: 1.18, Range: 0.70-1.33 mg/dL
Sodium: 145, Range: 135-146 mmol/L
Potassium: 4.1, Range: 3.5-5.3 mmol/L
Chloride: 105, Range: 98-110 mmol/L
Carbon Dioxide: 25, Range: 19-30 mmol/L
Calcium: 9.6, Range: 8.6-10.3 mg/dL
Protein, Total: 7.6, Range: 6.1-8.1 g/dL
Albumin: 4.5, Range: 3.6-5.1 g/dL
Globulin: 3.1, Range: 1.9-3.7 g/dL (calc)
Albumin/Globulin Ratio: 1.5, Range: 1.0-2.5 (calc)
Bilirubin, Total: 0.7, Range 0.2-1.2 mg/dL
Alkaline Phosphates: 91, Range: 40-115 U/L
*AST: 56, Range 10-35 U/L
ALT: 39, Range: 9-60 U/L
Hemoglobin A1c: 5.5, Range: <5.7 % of total Hgb “decreased risk of diabetes < 5.7”

Vitamin D, 25-HYDROXY LC/MS/MS:
*Vitamin D, 25-OH, Total: 27, Range: 30-100 ng/mL
Vitamin D, 25-OH, D3: 23, Range: none given
Vitamin D, 25-OH, D2: 4, Range: none given

TSH: 1.36, Range 0.40-4.5 mIU/L
T4, Free: 1.2, Range: 0.8-1.8 ng/dL
T3,Free: 3.1, Range: 2.3-4.2 pg/mL

Dihydrotestosterone, LC/MS/MS: 36, Range 16-79 ng/dL

CBC (includes DIFF/PLT)
White Blood Cell Count: 9.6, Range: 3.8-10.8 thousand/uL
Red Blood Cell Count: 4.68, Range 4.20-5.80 million/uL
Hemoglobin: 15.6, Range: 13.2-17.1 g/dL
Hematocrit: 45.7, Range: 38.5-50.0 %
MCV: 97.7, Range: 80.0-100.0 fL
*MCH: 33.3, Range: 27.0-33.0 pg
MCHC: 34.1, Range: 32.0-36.0 g/dL
(And much other CBC stuff of you want it.)

DHEA Sulfate: 73, Range: 25-240 mcg/dL
Insulin: 11, Range: <23 uIU/mL

LH: 1.8, Range: 1.5-9.3 mIU/mL
Prolactin: 6.0, Range:2.0-18.0 ng/mL
PSA, Total: 0.8, Range: < OR = 4.0 ng/mL

Testosterone, Total, LC/MS/MS: 527, Range: 250-1100 ng/dL
Testosterone, Free: 55.1, Range 46.0-224.0 pg/mL
Testosterone, Bioavailable: 120.4, Range: 110.0-575.0 ng/dL
Sex Hormone Binding Globulin: 44, Range: 10-50 nmol/L
Albumin, Serum: 4.8, Range: 3.6-5.1 g/dL.

Why my BodyLogicMD doctor is not an idiot. He took one look at my SHBG, my Free and Bioavailable T and said “you need help!” He said he wants my Free near 220, near top of range, and my Bioavailable much higher too. My E2 looked “in range” but he knew once I am on TRT it could increase, but since it was not above the high, he put me on a, in my opinion, very low dose of anastrozole. My LH was “almost” low, and IMO it is certainly not optimal. I suppose now that I am on TRT it may get lower, but don’t care as long as my Free and Bioavailable T get much higher, and my E2 remains where it is or lower.

I have been doing a lot of reading here, and as far as E2 is concerned, it seems I should go by how I “feel”, and adjust through lab results thereafter. And that’s what I need help with. I found just through internet searching a place where I bought 30 mL, at 1mg/mL strength, anastrozole as a “research chemical” . However, I do not know yet if its real or not. I’ve been taking it for about a week.

I know I should not, and therefore will not, post where I got it from. What I need help on is if any of you experienced guys can help me with if this place is legit or not, or even better, who is a legitimate place from which to purchase. That means a PM or something like that because I have no intention of “publicizing” from where I purchase currently.

I am due back in my non-idiot doctor’s office June 24, and I’m not sure yet if it’s for another insertion, or to schedule tests to see “where I am at”, I think the latter and I will call. It seems like four months would be at the very end of the usefulness of the pellets in me now.

As soon as I get more results I will post an update on this thread of mine. I am particularly interested if KSman would spend some of his valuable time with me.

Thanks Very Much in advance for any helpful suggestions or “nice” flames!

[EDIT on Hair]: I have almost NO HAIR below my knees. I thought it was from wearing socks! However, I read KSman sticky and noticed this was one of them.

[EDIT on symptoms]: Before TRT I had very low libido, would “get up but not stay up” many times. That changed for a while, about 4 weeks, since 2 weeks after beginning TRT, but now has returned, but to a lesser degree.

Based on the above recent events, I am worried my E2 is not where is should be.

30 drops = 1mg, so that is 1/30 mg/drop. Based on KSman recommendations found in sticky, I am going from 0.50 mg/week to 1.0 mg/week. I plan on takilng 0.133mg ED (4 drops) for a total of 0.933 mg/week. However, I have seen KSman recommend 8 drops (0.267mg) EOD. If so, then I would do 8 drops Sun, Tue, Thu, Sat for 1.06mg/week, and just start over on Sunday (not adhere to the EOD once a week). Is that more efficacious than 0.133mg ED, other than the fact of the difference between 0.933 versus 1.06 mg/week? I am basically asking is there some kind of “threshold” generally observed below which anastrozole is not effective?

I forgot to post my Cortisol. It is saliva: morning, afternoon, evening, and just before bed:
(before beginning TRT pellet therapy).

Morning: 6.6, Range: 3.7-9.5 ng/mL
Noon: 2.4, Range: 1.2-3.0 ng/mL
Evening: 0.9, Range: 0.6-1.9 ng/mL
Night: 0.9, Range: 0.4-1.0 ng/mL

The times on the day the saliva samples were collected:
06:50, 11:50, 18:25, 23:20.

Your doc should do LH&FSH as LH is pulsatile and has a short half life. FSH is more indicative of your status. But no need to test now.

TRT may fix up your cholesterol.

Have you been able to loose weight?

Can you post body temp and iodine data? [thyroid basics sticky]

Waist size is a very important indicator.

Anastrozole dose needs to be proportional to serum T levels, specifically bio or free. With pellets, your levels are changing, so E2 management will always be a crap-shoot.

You are quite technical. But how do you feel? How have you changed emotionally?

KSman: Thanks Very Much for your attention.

I thought I ought not worry about LH/FSH now that I’m on TRT, as you wrote also.

I did not realize TRT could fix up cholesterol. My doc suggested Niacin 1g ED, so I went for 1.5g ED. My father (deceased at 74, with two infarctions and three multiple by-passes under his belt) had high cholesterol and took it from 250 to 180 by taking 5g ED. He did not do TRT, and he was a doc (ophthalmologist). My mother, still alive and very well, apparently, also has high cholesterol (around 230) and does not take any statins (I believe that’s correct). Neither do I. My GP idiot prescribed Crestor which I terminated 3 days in due to severe joint discomfort. My GP absolutely refused to even listen to the possibility of TRT since my total T (he did not even get FT or Bio-T tested, nor E2) was “normal”, that lab test (different from the reported lab results above) showed my TT at 364, with Range 344-1250. So, according to him I was “normal”. Too bad, since everything he could have prescribed would have been covered by my insurance (very little is covered from my BLMC doctor, he’s “out of network”).

I started out back into weightlifting in late October 2012, after discovering the most traumatic discovery I have ever had to endure, and still am, but I am recovering. It has been an emotional hell storm. I won’t get into details, but suffice it to say sometimes it is difficult to sift through my emotional state and separate out what would exist if I was not experiencing what one doc called PTSD, and the emotional lows induced from low T. I will say this though: I feel less depressed having started TRT, but I am dedicated to my recovery, so don’t really know how much of the lessening of my depression is due to TRT and how much is due to working ‘through’ the stress (basically transforming pain/anger instead of transmitting it).

Anyway, I started lifting at a weight of 145 on a 5’11" frame. Before I even started TRT, mid March this year 2013, by that time I was at 9% body fat and 162 pounds, but I did do three bottles in Indigo 3G while stuffing quite a bit of carbs, but with finding out my low T, I had to discontinue I3G due to cost, even at the auto-ship rate. I think there is really something to I3G and may perhaps pursue it again in the future. So I have been pretty good at gaining weight, which I desire, of course without gaining any or very little fat.

I will get right on monitoring my temperature. I just know I don’t eat much salt at all (little to no processed foods in my diet and no added salt to anything, except my pre-workout drink, where I dose about one gram), along with about one-half gram potassium, and other goodies such as highly branched cyclic dextrin at 40 g, hydrolyzed casein at 30 g, creatine malate at 5 g, and citrulline malate at 7 to 11 g. Post workout (within and hour of last rep) consists of 30 g hydrolyzed whey isolate, another 40 g highly branched cyclic dextrin, about 15 g of maltodextrin, and 5 g (net) leucine peptides.

My waist size has remained right at 31", no change since at least December 2012. I did notice a substantial loss in waist fat and waist size while on I3G from October to December 2012, and it has remained off, even though I ceased I3G quite some time ago.

My BLMD doc told me pellets would serve up T “on demand”. Is that what you are referring to regarding my T levels. With pellets, will my T levels be pulsed, or slowly (and perhaps not so slowly) declining? I don’t know because I have not done a lab since starting TRT one and a half months ago. That is really disheartening to learn my anastrozole will be a crap shoot.

I have decided to quit entirely Adex for this week and see how I feel. My muscles were really sore this past week, but I did a killer, for me, leg workout at the beginning of that week, and even stayed sore for four days after, very unusual for me currently. However, my joints are not bothering me, which I thought was one hallmark of too low E2. My right collar bone has been broken twice and can give me trouble occasionally, so I discount always any pain it gives me, and it is very rare now anyway.

As I alluded to above, it is very difficult for me, currently, to take my emotional temperature and discern what is contributing how much to my lows, the PTSD, low T, high E2? I do go through some pretty disparate moods, but nothing like manic/depressive, just really, really low sometimes and the other, I guess you could call them “relatively” highs are just normal, not ultra-low. When first exposed to the trauma I was a total wreck for the first month, crying and sobbing, heaped up in a corner, and the next hour I was on a mission to spew my venomous anger. That has passed, however, and now the lows are mostly having to accept I will not have a better past and I had better move my ass on and not get stuck in it.

KSman,

I just read elsewhere in this TRT forum where you recommended one does not want carbs post workout if one is looking for enhancement of GH response. My post workout drinks have always consisted of some high glycemic index (GI) carbs, currently maltodextrin (about 30% of the total carbs in that one drink), because I desire a pretty significant insulin dump. I get flamed about that a lot. But the bulk of the rest of the carbs are this “new” highly branched cyclic dextrin. The hype is that form is quickly gastrically emptied and allows for quick absorption in the intestines, without being high GI.

Anyway, you wrote on that other thread in this forum your comment was not really meant to be discussed in that thread and would be better served discussed separately; so I’m asking what your take is on post workout meals/supplements. Pehaps when I execute workouts with high reps (20+ reps) for a few sets on a few exercises, which I consider a GH producing workout, and perhaps post those type workouts I should adhere to what you wrote recommending low (or no?) carbs. Just wanted to know why you have that position.

Thanks,

Since I am on pellets, and KSman indicates it is a “crap shoot” to control E2, I thought I would order several salilva test kits for only E2, and monitor once every two weeks. The saliva test I found is $35 and there is another for TT for $35, but TT would not be ideal to test, or would it when combined with E2 test? I am very concerned my E2 will not be properly managed with simply the BLMD doctor’s directions of 0.25mg twice a week. I cannot see how it is possible he knows my reaction well enough, and understand it is a starting point, but I think unless I regularly monitor E2 I will not have a clue how I should dose anastrozole on the next round. Testing E2 with this frequency I believe is better than nothing, even if my next round is a higher dose (I received 1200mg of T-Cyp on March 15, 2013), and so far I have not heard anything from my BLMD doc regarding follow-up until four (4) months after the implantation, which I think is the end of that “cycle”. So I am a bit skeptical about my BLMD doc not scheduling a lab panel before I am due back to see him June 24, 2013.

Please give me your thoughts on my idea of testing only E2 every two weeks, and if saliva test for E2 would even be a good idea (is at accurate?). I suspect it will not be “ultra-sensitive” like my first BLMD lab tests, so I could not compare the first E2 saliva test with that result, and would have to wait for the second to start garnering a trend.