T Nation

New to TRT/HRT

Hey guys,
Here’s my background info:

-age: 33 later this month
-height: 6’2
-waist: 44 1/2
-weight: 280
-describe body and facial hair: plenty of body hair and facial hair
-describe where you carry fat and how changed: mostly in my stomach, but I need to drop my bodyfat down obviously.
-health conditions, symptoms [history]: Some depression and anxiety the past few years.
-describe diet: Mostly the see food and eat it diet.
-describe training: Getting over an entrapped nerve in upper back, but mostly bodybuilding type splits.

  • Other symptoms: Lower sex drive, anxiety, depression, low energy.

I just had blood work done, and an appointment with a local BodyLogicMD doctor. Here were the results:

Lipid Panel:

Cholesterol Total 212 mg/dL (reference range: 125-200 mg/dL)
HDL Cholesterol: 49 mg/dL (reference range: > or = 40 mg/dL)
Triglycerides: 98 mg/dL (ref range: <150 mg/dL)
LDL-Cholesterol: 143 mg/dL (ref range: <130 mg/dL)

Chol/HDLC Ratio: 4.3 (ref range: <or = 5.0)

Cardio CRP: 6.4 mg/L (ref range: <1.0 lower cardiovascular risk)

Vitamin D: 47 ng/mL (ref range: 30-100 ng/mL)
TSH: 1.09 (ref range: .4-4.50 mIU/L)
T4, Free: 1.4 (ref range: .8-1.8 ng/dL)
T3, Free: 3.8 (ref range: 2.3-4.2 pg/mL)
Total Testosterone: 318 ng/dL (ref range: 250-1100 ng/dL)
Free Testosterone: 51.1 pg/mL (ref range: 46.0-224.0 pg/mL)
Bioavailable Testosterone: 118.4 ng/dL (ref range: 110.0-575.0 ng/dL)
Sex Hormone Binding Globulin: 23 nmol/L ( ref range: 10-50 nmol/L)
Albumin, Serum: 5.1 g/dL (3.6-5.1 g/dL)
Dihydrotestosterone: 16 ng/dL (ref range: 16-79 ng/dL)
DHEA Sulfate: 221 mcg/dL (ref range: 110-370 mcg/dL)
LH 2.5 mIU/mL (ref range: 1.5-9.3 mIU/mL)
Prolactin: 6.1 ng/mL (ref range: 2.0-18.0 ng/mL)
PSA, Total: 0.6 ng/mL (ref range < or = 4.0 ng/mL)
Insulin: 14 uIU/mL (ref range: <17 uIU/mL)
Estradiol: 59 pg/mL (ref range: < Or = 29 pg/mL)

Cortisol Morning (saliva): 4 ng/ml (ref range: 3.7-9.5 ng/mL)
Cortisol Noon (saliva): 2.6 ng/ml (ref range: 1/2-3.0 ng/mL)
Cortisol Evening (saliva): 1.1 ng/ml (ref range: 0.6-1.9 ng/ml)
Cortisol Night (saliva): 0.7 ng/ml (ref range: 0.4-1.0 ng/ml)

I don’t have the exact dosages, but I will post them as soon as they come in the mail. The doc wants to put me on clomid and arimidex, both 3 times per week. They also want me to focus on adaptagenic herbs as well. Diet wise, I’m going to stick to the guidelines that John Meadows espouses, focusing on organic, grass fed foods, reduced carb intake, increase in healthy fats. Any input and advice you guys have is more than welcome, thanks so much.

Do you need to eat at night a couple of hours after dinner and also have heart burn? If so, this could be a hiatal hernia where acid reflux is misinterpreted at heart burn. This feeding pattern can tip the scales, was not intended to be a pun, but there it is.

Please read these stickies:

  • advice for new guys
    – note thyroid and adrenal issues
    – come back here with lots more information!!!
  • there is an estradiol sticky

SERMs increase E2, but a proper dose of Arimidex/anastrozole will deal with that.

Clomid has severe estrogenic side effects for some guys, makes them feel horrible. Nolvadex will do the same job without those problems. The medical community is in a rut with clomid.

If the SERM dose is too high, a lot of E2 can be made in the testes and anastrozole cannot control that at all. So one can have a situation where no amount of anastrozole can bring down E2 levels.

Your thyroid levels look great. But just to rule out a complication with rT3, check and report your body temperatures as per the “thyroid basics” sticky.

LH is not enough, always need FSH too. With next labs on the SERM, get both LH and FSH done.

Your LH and FSH is probably substantially repressed by E2=59. Getting E2 in the lower 20’s will be very helpful.

Do you have CBC data? AST? ALT? If your liver is not able to clear E2 properly, E2 goes up and T then goes down. Liver function is critical.

You need to find the problems and fix them. What the docs are trying to do is a good recovery attempt but does not identify or treat underlying causes.

Hey KSman,
No heart burn issues at all, fortunately. I will try to locate the numbers, they did do CBC. The doc said everything checked out fine with my liver. I will also find out the dosage for the meds, I just know that I am taking them each 3x per week. If this protocol doesn’t do the trick, he said the next thing he’d look at adding in is HcG. He isn’t keen on putting me on TRT right away, as he feels at almost 33, I am young enough to get this on track with just modifying my nutritional habits, along with the protocol he’s prescribing.

[quote]KSman wrote:
Do you need to eat at night a couple of hours after dinner and also have heart burn? If so, this could be a hiatal hernia where acid reflux is misinterpreted at heart burn. This feeding pattern can tip the scales, was not intended to be a pun, but there it is.

Please read these stickies:

  • advice for new guys
    – note thyroid and adrenal issues
    – come back here with lots more information!!!
  • there is an estradiol sticky

SERMs increase E2, but a proper dose of Arimidex/anastrozole will deal with that.

Clomid has severe estrogenic side effects for some guys, makes them feel horrible. Nolvadex will do the same job without those problems. The medical community is in a rut with clomid.

If the SERM dose is too high, a lot of E2 can be made in the testes and anastrozole cannot control that at all. So one can have a situation where no amount of anastrozole can bring down E2 levels.

Your thyroid levels look great. But just to rule out a complication with rT3, check and report your body temperatures as per the “thyroid basics” sticky.

LH is not enough, always need FSH too. With next labs on the SERM, get both LH and FSH done.

Your LH and FSH is probably substantially repressed by E2=59. Getting E2 in the lower 20’s will be very helpful.

Do you have CBC data? AST? ALT? If your liver is not able to clear E2 properly, E2 goes up and T then goes down. Liver function is critical.

You need to find the problems and fix them. What the docs are trying to do is a good recovery attempt but does not identify or treat underlying causes.[/quote]

Doing a SERM increases LH and that stimulated the LH receptors in the testes, hCH stimulates the LH receptors as well. Over stimulation from the combo, or too much of either can create the the unmanageable T–>E2 rates in the testes and can also down regulate the LH receptors which is a total FUBAR when you try to get normal. Search for “HPTA restart”.

Please do not miss any of my prior points, -thanks