New Guy - Blood Work Results and Initial Protocol

Pharma / TRT Testosterone Replacement
1

Have been educating myself with review of Stickies and posts…Thanks to all for the info! Will try to keep it to the point. Will update periodically for benefit of others in similar situation. Looking for comments, suggestions and constructive criticism.

Had T levels tested approx. 10yrs ago as a result of fertility issues (never any AAS use). Was informed that levels were bordering low normal (did not retain specific results). Re-tested 10/2012 (levels listed below). Have several symptoms identified in KSMan’s lab work sticky (things you can determine w/out lab work).

Visit to GP for latest lab work. Was very receptive to potential use of TRT based on results of pending labs. Lab work came back, and was prescribed (1) 200mg injection every 3 weeks (Watson 200mg/ml). Initially no AI or HCG, but willing to revisit after 6wks on current protocol.

Based on review of stickies and posts, I have decided to go with an injection every 4days (.2ml/40mg). Trying to stay around 200mg/3 weeks dosing prescription. 1st injection - 10/15/2012 (.2ml/40mg - subQ w/ 29g/.5in/ 3/10ml insulin syringe).

Seems pretty conservative, but willing to see how it progresses. In it for the long term.

Following are lab work results and additional info:
10/5/12 (Ref Range)
Test - Total (LC/MS/MS) 474 ng/dL (250-1100)
Test - Free 57.3 pg/mL (46.0 - 224.0)
Test - Bio Avail 120.4 ng/dL (110.0 - 575.0)
Albumin, Serum 4.6 g/dL (3.6 - 5.1)
Sex Hormone Binding Globulin 37 nmo/L (10 - 50)
Estradiol 21 pg/mL (< or = 39)
Vitamin B-12 557 pg/mL (200 - 1100)
PSA 0.3 ng/mL (< or = 4.0)
DRE normal/negative
TSH (3rd generation) 1.42 mIU/L (0.40 - 4.50)
T4 (direct analysis) 1.6 ng/dL (0.8 - 2.7)
T3 (free “Q” - Q34429) 3.2 pg/mL (2.3 - 4.2)
Cortisol (8am) 12.9 mcg/dL (n/a)

-age (43)
-height (6ft)
-waist (36)
-weight (225-235)
-describe body and facial hair (dense)
-describe where you carry fat and how changed (ass, spare tire)
-health conditions, symptoms [history] (generally healthy)
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever (no RX in past 5yrs, no OTC, no hair loss or prostate ever)
-lab results with ranges (above)
-describe diet [some create substantial damage with starvation diets] (lean proteins, green veges, complex carbs)
-describe training [some ruin there hormones by over training] (4-6x/week, light cardio, bench/squat/deads/military)
-testes ache, ever, with a fever? (occasionally ache, no known fevers)
-how have morning wood and nocturnal erections changed (morning wood has disappeared, low sex drive)

2

57mg[.26ml] E4D=100mg/week

Should have tested LH/FSH, too late now.

3

Tomorrow is 2wks since beginning injections. Sub-Q injections are no problem w/ 3/10ml, .5in, 29gauge insulin syringe. Observations so far…“Brain Fog” seems to have lifted. More willing to engage in social situations. Energy level seems better. No apparent physical changes. Interested to see new bloodwork in about a month.

4

11/04/2012 - Starting wk 4 of injections…continuing .2ml/40mg Test Cyp E4D. No AI or hCG. No overt physical effects so far. Overall mental state feels improved, subjective, but noticeable. Energy is good, motivation to train is better than before injections.

5

You are taking 70mg/week, can you get to 100mg/week? That is more of a youthful amount of T.

Rational: 100mg T ester per week yields around 70mg/week bio-identical testosterone. Young normal virile males produce around 10mg/day, or 70mg/week.

Normal males release T all through the day. Injecting E4D is not very natural and injecting every three weeks is a practice that predates disposable needles and self injection. You doctor needs to be educated.

6

KSman - Your responses and input are much appreciated. I began EOD injections = 100mg/wk yesterday.

Overall mental state has continued to improve, noticeably during this past week (prior to switch in injection protocol). The change in dosage is minor (80mg/wk vs. 100mg/wk). I’ve had no negative symptoms, and have had no difficulties with injections.

7

Currently taking 100mg T Cyp/wk. EOD injections alternating .24mg and .26mg.

New bloodwork results: TT - 980; Estradiol - 47. Complete labs being mailed, will post when received (same lab and parameters as previous test).

Dr prescribing Arimidex. Picking it up tomorrow.

Overall feel good, but think I passed through sweet spot about 3-4 weeks ago. Libido has gone down noticeably, itchy nipples, cramping in calves.

Should Arimidex be taken EOD with injections? Also was reading posts in Estradiol sticky, and noticed dosage can be calculated taking into account weight (1.0mg x current weight/160). This would put dosage at 1.5mg/wk (1.0mg x 240/160). Does this seem like a good starting point.

8

You may need the weight adjusted dose. However, given what we have learned about anastrozole over-responders, you should start at 1mg/week and see if you are an over-responder or not. If not, you can continue at 1 mg/week for 2-3 weeks and eval how you feel. Then you could try 1.5mg/week and see what that does. When you feel that things are good, do E2 lab work and see whats up.

With E2=47, you should feel a lot better.

Arimidex is not a generic in the USA. Brand name will cost more.

1mg/week is difficult EOD. 1.5mg/week could be .5mg three times per week. Liquid products are needed for fine incremental dose control.

9

New labs: 12/20/2012
Test - Total (LC/MS/MS) 980ng/dL (250-1100)
Test - Free 164.2 pg/mL (46.0 - 224.0)
Test - Bio Avail 351.9 ng/dL (110.0 - 575.0)
Albumin, Serum 4.7 g/dL (3.6 - 5.1)
Sex Hormone Binding Globulin 30 nmo/L (10 - 50)
Estradiol 47 pg/mL (< or = 39)

All CBC tests fell well within normal ranges.

Previous labs: 10/05/2012
Test - Total (LC/MS/MS) 474 ng/dL (250-1100)
Test - Free 57.3 pg/mL (46.0 - 224.0)
Test - Bio Avail 120.4 ng/dL (110.0 - 575.0)
Albumin, Serum 4.6 g/dL (3.6 - 5.1)
Sex Hormone Binding Globulin 37 nmo/L (10 - 50)
Estradiol 21 pg/mL (< or = 39)

Dosage with 100mg T Cyp/wk subQ seems to be right on time as far as raising TT into high normal range. Don’t really know how to interpret Free Test and Bio-Avail Test #'s, but those also seem to have been raised significantly. New labs were drawn a.m. after regular EOD injection.

Started generic anastrozole this a.m. Have a good pill cutter, was able to split 1mg tablet in half easily. Took .5mg this morning with regular EOD test injection. Going to experiment with splitting pill in 1/4’s. If that works, then I would be able to take .25mg EOD with test injections. If not, then plan on .5mg 2x/week.

I’ve definitely noticed a change for the better since beginning TRT. Mood, cognitive awareness, energy levels, training strength and intensity have all moved in a positive direction. Elevated Estradiol has been a little noticeable the past 3-4 wks, but hopefully that will improve with anastrozole. Thanks again to all who post on topic with relevant info…Thanks KSman for input.

10

E2=47 is really limiting your QOL [quality of life]. Looking forward to your anastrozole reports. Will take 7-10 days to get most of the effect, but brain changes/patterns take longer.

Serum anastrozole levels need to match T levels, injecting once a week makes that impossible.

11

Actually I’m injecting T EOD to = 100mg/wk, that is why I’m happy that TT levels are at 980. I think that must mean that my T levels are fairly stable in that 900+ region, as my last labs were taken the morning after my EOD injection.

Getting E2 down is next project. My first dose of anastrozole (.5mg) was taken with my last T injection (yesterday). At that time I split a 1mg pill in half. Since then I’ve been successful in splitting 1mg tablet in 4 equal pieces (.25mg doses)…good pill cutter helps!! From this point forward was planning on taking .25mg anastrozole at same time as EOD T injections (next dose tomorrow .25mg at same time as T)

12

01/01/2013 - Been having what I think is mild allergic reaction after my last 3 injections. ~ 24hrs after injection been having localized itching, puffiness and redness at injection site, very similar to a small bug/mosquito bite. Currently have one spot on my abdomen and one on my rt glute from last two injection days. Not painful, but definitely noticeable and aggrivating.

Have been giving sub-Q EOD injections of T Cyp since 10/2012. Rotating sites (abdomen, hip area, glutes). Nothing about my injection protocol has changed (same hygiene routine, same vial of T, same lot of syringes).

Anyone had similar issues and found a resolution? Thinking that I will try to make next injection a shallow IM in quad or delt to see if I get same type of reaction.

13

Mark injection site by pressing a tube or pen cap on skin.
Swab there, rubbing vigorously. You may see skin pigment color on swab.
Inject as the marked location.
As you pull the needle out, press on the injection site for 10-15 seconds to prevent bleed-bruises.

14

Ah…relief…last 2 injections in quads with no reaction. I think anastrozole is working too. Noticed less water retention, libido has returned.