T Nation

New to TRT Need Help


I felt tired listless poor energy. ED as well, morning wood but hard to perform for any time. 54 male 6’5" 200lbs
Got my blood work done and asked for T levels
Total was 417 but Dr did not get free T done
This was last year. I got a new Dr and got blood done
And naturally got my T level to 631 ng/dL total and free T was 111 pg/mL
Got a Dr on the side not my primary Dr to address T levels
Started TRT 7/5/2016 all blood work is by Quest
Topical application he has compounded by a Pharmacy himself. I used 3 clicks as each click despences a given amount.
New blood 2 months later showed
Total T 1167ng/dL normal Ranges 250-1100
DHT 319 ng/dL. 16-79
Estradiol 58 pg/mL. < or= 39
Free T 220 pg/mL. 46- 224
T,bioavalable 442 ng/dL. 110-575
Globulin 29 nmol/L. 10- 50
Albumin 4.4 g/ dL. 3.6 - 5.1
Got new blood work and went down to two clicks
Total T now 943
DHT. 371
Estradiol 50
Free T 144
T Buoavalable 290
Globulin 34
Albumin 4.4
So now I started 2 days ago
Armidex 1/2 of a 1 MG pill daily
Finasteride 1/4 of a 5 MG pill daily
And my PSA is 0.7
What’s right and what’s wrong in your opinion


DHT is very high but I guess that’s why you added Finestride? DHT can have negative effects on prostate size so keep that PSA monitored. Also, you need to lower that E2 which is why I see an increase in Arimadex. Sounds like you should get new labs in a bit to see how your adjustements worked.


New labs are to be done in 2 months. Getting a full blood panel with T levels and PSA. In your experience is that DHT level of over 300 doable on will the meds pull that down or just protect the prostate?


They should have had you on Adex from the start. Anyway, your E2 is high but should come down with the Adex. I’d re-test in a month or so.

Also, transdermal is ok but injections are optimal. Not everybody responds to transdermal and your application areas can get desensitized to it and you have to move your application sites around.


I do move application sites around. My Dr says I’m a cheap date at the rate I absorb the topical. Cost is 40 bucks a month. And at that over 900 T level is good. My question is does every one get a DHT that high, in other words is that to be expected? And medication pulls it down?


Once my prescription deductible is met one month of testosterone cypionate is only $7. High DHT levels are typically the result of high FT. It’s not a bad thing with the exception of hair loss susceptibility if already present in your genes. I’ve also heard that topical T has higher conversion rates to DHT but do not recall why.

Your concern needs to be your e2.


I wouldn’t say DHT is no concern. That’s over 3x the highest amount and long term it’s no good for prostate. Finestride or progesterone will lower DHT.


If that were fact 18-25 year old men would have the highest incidents of prostate issues. Prostate issues more than likely requires high e2 as well and high dht.


18-25 year old men don’t have levels above 79 in that range. His are at 300+. During puberty the prostate is enlarged purposefully by these hormones and doubles size. After 25 any abnormal enlargement is BPH or cancer. Most consider DHT the cause along with estrogens.


I had nearly the exact levels you had pre - and post TRT and I’m close to your age and bodyweight. I’m actually attempting a restart myself - but as for you - your Estradiol is high (mine was 60 on HCG and some Androgel). You need Arimidex as others have stated. That should knock that down fast. The high DHT tends to arise from topical gels/creams. Should you switch to injections it should alleviate that problem but let’s see what others are saying about this.


I’ve started the arimidex 3 days ago. Using 1/4 of a pill once a day. What is a restart?


Restart is when you attempt to bring back your own natural production of testosterone after a cycle of steroids, or coming off TRT There’s great information on this in the stickies – by KSman - and I am following a modified form of that protocol. I have a log running as well – and will be posting new blood soon after doing three weeks of hCG and a month of Clomid.

By the way – your information intrigue me immensely – as I had almost the exact same numbers as you as I mentioned (E.g. Total test 425 - then a year later posted 660 ng/dl). For a 49-year-old, at the time – a score over 600 would be considered relatively stellar – and you had similar numbers in your 50s. So, I’m just curious as to why you were Dr. recommended TRT. For me, I had to rely on an old college buddy, who is also my cardiologist – that saw a lot of benefits from people on the therapy in terms of improving lipid profile, and reducing cardiovascular risk – which it did for me. However, I was still not 100% convinced that I should start a life long program taking these meds - so I did the restart protocol – and just want to see where I end up naturally. However – I felt a lot better taking the Testosterone – so I may have to wind up going back on


I did it for the same reasons. I wanted the lebido back and to feel better, not so tired at the end of the day, and energy during the day. I have a couple of friends that are doing TRT. They recommended me to a Doctor Who believes it and has a practice this sort of specialize in it. He looked up my entire blood work and said it would be reasonable for me to run a total testosterone of in the 900s and get that Pop back. I’ve only been doing it since July and I do feel better I wasn’t fat I’ve always been very athletic but I have lost some of the fat around my waist which is very little and as far as exercise I swim doing 25 and 50 yard sprints using different strokes and at the end of the routine I’ve done a mile. I do this three times a week. 33" waist now was 38 and 47" chest now. I was doing the swimming over a year before the TRT. That’s how with diet and Supplements, I got my total T from 411 to over 600. I felt good. I, like you am still thinking is the TRT worth it? How long were you on it and how did you feel?


Same here - diet, specifically giving up soy products and eating more meat, as well as high intensity training jacked my T-levels and got me in great shape. However, the gains came at a price - I had to kill myself to get sub 10% BF and stay lean - a big difference from when I was in my 20’s and early 30s. Plus, I was tired, cranky, libido wasn’t there, etc. I wound up turning to SARMS - to build some muscle - which it did - but shut down my natty test levels to <100 ng/dl. Even after running some Nolvadex - I was only up to 175 plus my lipids were in the gutter. My buddy - cardiologist who is a huge proponent of T replacement - came to the rescue and prescribed me some HCG (which I took and got my T-levels up to over 900 and Free T over 250 (yeah baby!!) - and then cut back the dose and added Androgel. adding the Androgel made a huge difference - I felt phenomenal - and was making gains fast and hard. My doc saw no reason whatsoever to come off - but I felt kind of like a science experiment chasing the proper protocol (E too high - up the Arimidex… then - wait, E2 crashed, don’t take so much, change the HCG timing, etc.) All the while (at least in the beginning - I was having some anxiety and restlesses until the protocol was somewhat dialed in. I was only on a little over a month. I was also concerned about the sustainability of this - meaning - what if insurance changed the plan, what if I was hospitalized (they would never give me the T) and I would crash badly. So - just like that - I decided to run some Clomid an see how I feel overall and where I end up. Will post back on my log I’m running with results soon.


Why do you suppose that prostate cancer and bph are primarily attributed with older men who also typically have low dht levels?


That’s a different circumstance where I agree its likely a cause of hormonal imbalance. You can become a novice on this subject with 15 minutes of google searching. A lot of recent studies think older men having a high ratio of estrogens to androgens cause it. However in this circumstance we are dealing with DHT levels that are 4x that of the highest range which could create a condition of enlarged prostate similar to the early development when hormones are highest.


Update: I’ve been on Arimidex .5 one half of a pill for 5 days now. My estradiol was 50 as shown above. What should I feel and how soon? Also from what I have read is that a big dose? as I see some are using .25 or less.


If you are doing .5 mg ED than that is a huge amount. Generally I’ve seen .5 EOD or E3D while running Test and assess from there. There is no way to assess E2 levels without a blood test - however some things to look out for:

  • good morning wood means Estrogen may be dialed in and cut back the dose a bit
  • joint pain = Estrogen too low - cut back a few days
  • water retention / bloating - Estrogen too high. Up Adex