T Nation

New Doc, New Labs, New Questions


#1

Hello, I will try and be brief. You can find the backstory here:


and here:

But the summary is, just got a new doc because old doc only gave injections in the office and was giving me 500mg every 3 weeks and I was crashing hard. So I self supplemented with test gotten somewhere other than my normal pharmacy. I realized that was F-ed up and decided to find a new doc.

I visited my new doc and got labs:
Lab - result - range
HDL Chol - 48 - >39
Calc LDL - 136H - <100
PSA - 0.62 - <=400
TSH - 1.58 - 0.4 - 4.1
Vit D - 29.4 - 20 - 82
Estradiol - <17.0 - <=60.7
Progesterone - 0.32 - <.15
Testosterone - 179 - 300-890
Sex Horm Globulin - 39.6 - 16.5-55.9
Calc free testosterone 3.0 - 4.8-25.7

These results were 7 days post injection of 150mg of cyp. I was surprised how low I was, because in the prior 3 weeks I had gotten 500mg (doc), 150mg(self) and 150mg (self), respectively. Guess it goes to show that my previous Dr’s regime of 500mg every 3 weeks was crashing me hard. I had also been taking Clomid 3x per week each week.

So new Doc wants me to come in for 140mg Cyp/250mg HGC injection 1x per week for the next 4 weeks and do another set of lab tests on day 5 after the 4th injection. From there, he said he will prescribe me home injections which I will break up and do 2x per week rather than once. He also prescribed me Chrysin 500mg 2x per day.

What do you all think of this course?

Also, I have some extra cyp and I would like to add in 75mg mid week for the next two weeks and keep taking the clomid, then for the last 2 weeks stay strictly on Doc plan. If I do that, will it skew my lab results after the 4th shot?

Thanks


#2

If you add your own T, your doctor may reduce T based on labs results.

Clomid 25mg? -please be dose specific

Base on info so far, you may be a T hyper-metabolizer and often then 300mg/week is required and because of the short effective half-life, dose needs to be split to EOD dosing. Probably very few doctors have run into this.

You need to write out your desired treatment plan and put in front of your doctor’s face. Docs will not read anything that too long. Do not wait for doc to guess what you want.

Anastrozole 1mg/week is cheap and effective. Chrysin is not. Chrysin is not a ‘drug’ so its out-of-pocket as far as drug plans are concerned.

Calc FT as extremely low. So FT–>E2 generation is then very low and E2<17 makes sense. With ample T dosing, E2 will increase.

Vit-D=29 is not good enough, please take 5000iu/day Vit-D3.

Do not know what to make of progesterone.
LH/FSH untested.

As E2 is low and SHBG=40, we can assume that you might have higher SHBG on TRT. But high-normal T levels can suppress SHBG is E2 is lower. Desired is E2=22pg/ml.

Please do not create any new topics for your case!

Still need your oral body temps to eval thyroid function which has a huge effect on energy levels, metabolic rates and fat gain/loss. NOT OPTIONAL


#3

Thanks. I will do the Thyroid temp tests and report back, and I will start the vitamin D.

Clomid is 50mg 3x per week.

So two weeks on Doc’s protocol won’t be enough to baseline?


#4

re Vit-D3

The amount of Vit-D3 in multi-vits is quite low and the RDA has been based on what it takes to prevent bone deformities in children. The need for more Vit-D3 has taken a long time to be recognized.


#5

Okay comma I have taken my body temperatures first thing in the morning and the results are 96.9, 97.4, 97.7.2.

I am following the new doctors protocol of the single 125 shot per week to get my Baseline level. I feel great the day I get the shot and the next day but can feel the taper off almost immediately and then I feel like shit for the next five days.

I double-checked in the salt I’m using is not iodized, but my men’s multivitamin does have 150 mg of iodine which it says is 100% of the RDA.

I have two more weeks on the docks protocol until I get my next set of labs. It is really hard not to add in some extra tests or at least Clomid to try and feel better.


#6

RDA assumes that you are getting iodine from other sources. Do not minimize this.

Do not mess with other meds as your doc might reduce your dose.

“I feel great the day I get the shot and the next day but can feel the taper off almost immediately and then I feel like shit for the next five days.”

  • please read again my prior posts re recommendations and having what you want written to show your doctor.

#7

Visited today for lab follow ups. I reported that I could feel the weekly shot wearing off.

My total T was up a bunch - 552 (300-890). My free T was kind of low at 10.5 (4.8-25.7) and my Globulin was 40.2 (16,5-55.9).

Interestingly, my estradiol was undetectable. Results have a note that says threshold is 17.

So doc wrote me 140mg/week, .5 anastrozole and 250 HGC. Almost exactly what I wanted.

I asked for 200mg/week and he said first we wants me to try the pfizer brand (they were giving me the generic) because he said it is more effective and will be just like upping the dose. Told me a story about a guy that he switched over to it and his T went up 120 points.Said that if I felt good before the dropoff, we needed to address the dropoff first, and said Pfizer would be more stable in my system. He said that if in 4 weeks I wasn’t feeling an improvement in the dropoff, he would up me to 200mg and I could inject 2x per week.

So I definitely have a better doc, but I don’t get the no detectable estradiol (and I never filled the Chrysin he wrote the first time) or the comment about using the pfizer T. Any thoughts?


#8

I have been reading more, should I be concerned about the very low estriadol levels? Do I need the anastrozole? What are the effects of Low E?


#9

The <17 lab report is indicating that the lab selected is not sensitive enough for male TRT use. Some labs read well below 10pg/ml.

So your level could be E2=16.5 pg/ml, does not sound the same as undetectable.

pfizer T may be 100mg/ml, a pain to inject, you need 200mg/ml, ask before you purchase. Pfizer may get raw T cyp from china like so many other companies. Potency cannot be different, that is a major FDA violation. I think that your doc is making things up. In any case, you can use any product and do labs and correct levels with any product.

“and his T went up 120 points” is easily the result of lab timing changes.

This is still my best recommendation:
Base on info so far, you may be a T hyper-metabolizer and often then 300mg/week is required and because of the short effective half-life, dose needs to be split to EOD dosing. Probably very few doctors have run into this.