T Nation

On TRT - Without Enough Info

Hello, first post… hope I don’t get bashed for being an uniformed newb… lots of great info within, but I have read till my head hurts and still am confused as it relates to me… I sucked in biology, so here it goes…

  • 37 yr old
  • 6’2"
  • 33" waist
  • 192 lb
  • normal beard / body hair
  • 9-10% BF- pretty lean
  • moody, tired, lack of zeal & energy, low libido, sex - take it or leave it… (but great once
    i get going)…
  • slight male pattern baldness going…have tried rogaine liquid and foam yrs ago… was
    allergic to it… also took finasteride for short period… I still use Nioxin shampoo &
    conditioner
  • labs - TT - 386 & 340 (that is all I have had except total blood counts and PSA, which I
    requested, I hadn’t read the forums at the time)
  • diet - typical high protein…cycle calories to keep low BF… high days 3000++, low days
    2500 +/-, many more high days than low just to maintain 10% during summer…
  • vasectomy a year ago
  • train 3-5 days a week… typical BB splits / routines, steady (aggressive) for 2 yrs… most
    of my substantial gains came first 6 months… SLOW go after that- about the same time as
    vasectomy (correlation?)… I take time off and I dont think I overtrain…
  • my left nut use to hurt often several years ago… not so much anymore…
  • morning wood - not often - more so now with TRT

I went to my primary and ask for a T test b/c I always feel tired and bithcy, (unless I am hyped up on caffeine or Preworkout), I have a hot wife that I am hardly interested in unless its been like 2 weeks or more since we got frisky… … my gains in the gym suck even though I bust my ass and eat decent…(I’m ripped I just don’t put on size or strength)… so the tv commercials say my T must be low… 386 bingo…anyway… primary told me to go see the urologist who cut the boys last year… he gave me a second total T test that came back 340 and sample and a RX of Axiron… been on it 3 weeks now… I can’t tell much of a difference… EXCEPT… my prostate is slightly hurting, a pressure feeling like I am constipated or something… and I am having unusual carb cravings… other than that, libido still sucks (unless I get myself worked up)… energy sucks and I still feel straight up bitchy, like everyone annoys the shit of me, maybe its Estrogen overflow from living with 4 women (I have daughters)… the gel sux too because inevitably one of my daughters wants to hug daddy right after I rub that shit on and it drips down my armpits…

anyway, apparently from what I am reading I should have gotten some more tests done to try to figure out why the T was low range before jumping into this… my dr., while he is a cool guy… he’s probably a dumbass like the rest of them when it comes to TRT… he told me to use the Axiron and come see him in 3 months…

So now what? I am self employeed and my insurance sux, so I am going to go next week and do the privatemdlabs deal and get the female panel to see what my total T is while on this stuff (and estridol) then, since this drug feels like it is doing something to my prostate, and I don’t feel like superman as I had hoped, i am going to jump off the Axiron, let it clear…go back to the dr. for a follow up… to see if I am shutdown from a month of TRT…

obviously I dont know what i am doing…and neither does the doc…any advice? Thanks in advance for any help (and for not chopping my nuts off for making uniformed medical decisions )

This is just my opinion, but I would get off the gel (and by that I mean figure out how to taper off of it and make sure you have everything necessary to get off it, like you might need medications that “jump-start” you as bodybuilders do post-cycle - I don’t know gel that well so I can’t advise you on that) wait a few weeks, and get all the tests done that are outlined in the sticky “Labs” on the main page.

If you get labs now you won’t have an accurate picture of what is going on inside you. You need to figure out if you have Primary or Secondary hypogonadism. This is important because the treatments for the two, while they overlap, can be worlds apart. You need to figure out if there is anything else going wrong with you that could be causing your low T such as thyroid, pituitary, etc.

Labs are pricey if you don’t have insurance, but TRT is for life - you might as well make sure you have a complete picture before diving in. Having only total T scores tells you so little about what needs to be done.

Gel sucks, is expensive, and as you mentioned cross-contamination worries are something to consider. Many men opt out of the gel for that reason, and the makers of the gel had to update the warning label just this year to make it clear that your kid could end up getting exposed and may hit puberty before they hit double-digit age!

So, I’d talk to your doctor about the best way to discontinue the gel in the interim, wait for your system to return to “normal” (“usual” I guess) and get a bunch of labs done. You don’t want to start a lifelong treatment if you don’t even know what is wrong.

Good luck!

thanks catsrophe, the prostate pain / pressure is the biggest concern for what the gel may be doing… and the fact that my mood is definatley worse on the gel… I am going ahead and getting the hormone panel ran just to see what the Gel did with my T levels over the last 3 weeks… then I will take a week and taper off as you reccomended… run some tribulus and orchex (bull balls supplement that my Chiropractor recommended) let things settle down for a few weeks and then retest everything… I suppose if I shutdown, I’ll have to look into clomid or another PCT regimen to hopefully get things going back to at least the mid 300’s I was at when I started… I know nothing about PCT or primary / secondary hypogo… guess I should not have went into this so half cocked… it is what it is, I’ll regroup and hopefully with the help of you men, figure this shit out… speaking of… if anyone else that may have some experience (VTBALLA, Hardasnails,KSman) care to offer up some advice… I am all ears… thanks in advance… I will post up some labs when I get 'em… BTW - I am looking into getting mercury fillings removed… I have a ton of those things… and I grind teeth at night… so they need to go. later men.

Please don’t listen to anything your chiropractor recommends, especially for hormonal issues. Ask the doc that gave you the gel about the best way to get off of it without loosing your mind. We all make mistakes, take bad advice from doctors who don’t know too much, and end up in weird situations like yours. Don’t feel bad about it; Just think of it as a learning experience. TRT is a big deal since you’re on it FOREVER. It’s best to do a ton of research before going on it, and continue learning afterward. It will help you talk to your doctor, and will generate good and interesting questions and dialogue.

In the mean-time: We need some labs! We can’t tell you what’s going on without some numbers. Post them as soon as you get them. Get all the labs done that are outlined in the Sticky and we can go from there!

ctastophe pretty much said what I would.

I would not get off the gel immediately though. Get your hormones tested on your protocol and see what’s up. Most of the time if one is not feeling good on a T protocol, they are either not absorbing it or their estrogen is too high. There are ways to mitigate both.

If you are concerned about transferring the gel to your family you absolutely need to get on shots man. There is little around it (unless you want to go the pellet route, which I don’t recommend especially if already having E2 issues).

Got my test back while on the Gel

T Total- 585 (348-1197) (up 200+ from last 2 test)
LH - 2.4 (1.7-8.6)
FSH - 1.8 (1.5-12.4)
Estridiol - 28.5 (7.6-42.6)

Other things that stood out high on the Metabolic panel -

BUN- 21 (6-20)
BUN/ Creatinine - 21 (8-19)

I just got these and haven’t had time to research the implications… any advise greatly appreciated… I will be tapering off the Gel this week… how long should I be off the T completely before I re-test for a baseline? Thanks Men.

[quote]LowfatMatt wrote:
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I wanted to PM ya VTBalla and ask you how long you think I should run stock before re-testing for a baseline… but the site wouldn’t let me…obviously I’ll have to keep it public to gain privileges…

so what do you men say… is a couple weeks off long enough to have a good baseline on the recommended tests… (mainly LH & FSH i suppose?) or do I need months removed from 3 weeks of Gel to get an accurate read?

(wish I had gotten my bases before taking the Gel) goal is to explore why the T is low and see if I can get it up (no pun intended) naturally, or without TRT… before hitting the doc up for shots…

A month to six weeks sounds about right. It is highly individual. But you shouldn’t have done much to your endogenous levels after 3 weeks, I wouldn’t think.

Thanks VT… I will wait it out…

I often wonder if I am over supplementing … I mean, I am not competing at anything other than life and business? but since I got back hard into the iron game 2 years ago… I have added supplementation and now I?m up to taking several handfuls of pills per day…should I really be taking all this stuff… could it do more harm than good? Here is the list:

Multi-Vitamin- 3-6 pills a day ( ON Optimum or Controlled Labs Orange Triad)
Fish Oil 2-3
Rohdilea 2 (roseroot, suppose to lower cortisol)
Calcium 1
Glucosamine 2 (joints)
V-C 500mg 1-2
Iodine 3 mg - (chiro and natural health doc rec. iodine for numerous reasons)
B-6 50mg/ niacin- (chiro recc. works with iodine on sinuses)
Fiber- 2 (just some extra to keep regular)
Tribulus 2 (now that I am off T)
ZMA 3 (I take this like every other night or so for better rest)
Melatonin- ( I take when I think I may have hard time resting ? 3 nights a week)
Protein 200-250g (I may get 1/3 of this from shakes)
BCAA’s- (who knows if it does anything, but it taste good to sip while training anyway)
Pre-Workout- (I cycle this stuff throughout the week, and mix brands up)

I know there is also some overlap, for instance B-6 straight, plus what?s in the multi, plus ZMA? etc. probably the same on other stuff I take?

As a side note? My chiro is not your ordinary quack, he is the chiropractor / kinesiologists for our local NFL team and a lot of the pro wrestlers…he works wonders on aches and pains and is very familiar with T cycles and such… he speaks our language?he recommended a product called orchex to jump start T… http://www.standardprocess.com/display/StandardProcessCatalog.spi?ID=115

he is in his early 40?s and said he boosted his T from 300?s to 500?s with orchex and trib? I hadn?t tried it (yet)

plus, there is other stuff I?d like to possibly try… CLA, DHEA, ALA, CoQ10, V-D?. Good grief… I may need to get help for this…ha

So, let me hear it fellas… is this normal supplementation?.. do I need to cut some of this shit out… or if I want to supplement, do some testing to get numbers on what my body really needs?

All ears? thanks…

Most of the stuff is pretty standard for anybody that lifts weights…maybe a few things you could do without, but probably not hurting anything…just a matter of what you can tolerate from a inconvenience and cost standpoint

Ok men - in my last post I was coming off one month of Gel (which sucked) and I posted my labs - that was back in July and I pretty much just let it go all fall - a guy has to bow hunt you know- so deer season is waning and I am back in pursuit of a better mood, more energy, sex drive, and maybe even a gain in the gym.

Went back to the doc and told him my story and asked for self injections… he was very reluctant… but as I told him about my problems, and reminded him I didn’t have the issues before he cut my nuts… he started writing the script… seriously. I was surprised.

So he prescribed 1 ML every 2 weeks of tes cyp. I picked up the single dose bottles (wtf) and syringes today… but I am not rushing into this without your guys advice. I still dont understand all the primary and secondary stuff… LH, FSH etc. etc… but I ordered labs today to get a baseline… and will post up my bone “stock” labs as soon as I get them done.

I suppose I should have some PCT gear before I start… obviously at the age of 38 I wont rock TRT forever without a break… but it will nice to see what > 360 T does for me… and then decide if it is worth the any sides / hassel / etc.

Counting on you guys to school me… I’m not to lazy to research… I have read to my eyes pop… but the more I read… the more confused I get.

Labs coming soon… you guys got me?

Ok Men - Got the Morning Fast Labs- (Not on TRT)

Total T - 622 (348-1197) not bad… up from 2 initial tests in mid 300’s - and mid 500’s while on axiron
LH - 6.4 (1.7-8.6)
FSH- 3.3 (1.5-12.4)
Estradiol - 32.8 (7.6-42.6)

and the kicker…

Free T Direct - 6.7 (8.7-25.1) flagged low! ( first ever Free T test)

Only thing I would add is I had the test in the morning… and by lunch I had came down with the stomach flu that my family had a few days ago… what timing… not sure if a virus would affect tests significantly.

So now what?? - I have 2 bottle of rx cypionate ready to go… I have had a PSA but no DRE. Havent talked to doc about what he will do in the case I need a estrogen inhibitor or meds to jump start Natty T if the cyp has side affects… or that other medication to keep your nuts from shriveling up… (can’t recall the drug names now, but you guys know what I’m talking about. The axiron made my prostate feel like a cantelope, main reason I quit it… plus the cost was going to be crazy.

What now guys? Shoot the cyp?? Go back to doc, get the DRE (uggh) and make sure he is on board for the full protocal if and when I need it? Try to lower E? More tests? Any and all advice greatly appreciated!!!

E2 is a major cause of prostate enlargement and cancer. Your E2 is too high now. If you get near E2=22pg/ml, T levels will probably increase.

Your low FT tells us that SHBG is elevated, so you get less FT and more SHBG+T which is not bio-available.

Higher estrogen levels causes the liver to produce more SHBG and vice versa.

Lower E2 and SHBG will go down and FT fraction of higher TT will go up, a double increase.

Suggest anastrozole, 0.5-0.6 mg/week in divided doses. The half life really needs dosing EOD [optimal].

Do not start injecting without anastrozole, because your E2 can only go up from here.

Try the anastrozole and see if you can refine your restart. It will make things better and will be healthier for your prostate. You will probably feel a lot better too.

ok, thanks… so E2 is my prob

I’ll go back to the Doc armed with info… not sure how receptive he will be to the Adex…

any idea why I would test sub 400 TT twice… then 500’s on axiron… then 620 bone “stock” 3 months later? makes no sense…

Could the axiron have jump started T? (or is that dumbass question… yes, I read all the stickies +++ and Im still confused)

I can tell E2 is high… b/c I do straight up feel like a bitch a lot of the time…

So what could be the culprit of high E2? - (living with 4 women maybe?? lol…)

If doc goes along with the Adex… how long should I run it before re-test?

Are there any other tests you guys think I need to baseline?

Does the LH and FSH above look good?

I suppose at 620 TT I am not “hypogonadal” after all??

apologies for all the questions… and big thanks for the help

I think that your HPTA has recovered and now it is been held down by high E2.

If you feel better on the adex, no need to rush into labs.

Ok, Got in to see the Doc today (urologist)… I took a stack of excerpts from the stickies & web to reference, knowing this was an uphill climb… he initially thought I was over analyzing… but he realized I had good info.

He’s never heard of Anastrozole before… (go figure) I brought info on the med in… but he wasn’t comfortable prescribing it… I respect that and didn’t push…because there still may be hope for treatment w him. (he did give the cyp. you know)

At first he wanted to refer me to an Endo… then he offered to consult with another Urologist that runs a small TRT group within the practice and get back to me… he said if he could get confirmation that the Adex was a good decision, he would call it in for me… so we will see.

He also did a DRE, my first, how fun… and actually pressed some fluid out the tip to test… said I have some inflammation as seen by the (white?) blood cells in the fluid… chronic prostatits… but said it was common in some guys and called it “boring”??

He is a cool Doc, and said maybe he could learn somethings if we worked through this together… that was good to hear.

So whats up with prostatitis?

I sure would like to run that cyp. (provided I could keep E2 down)… just to feel the T upswing in mood, bedroom and gym… workouts are stuggling… and I have lost quite a bit of mass.

prostatitis: use this site’s search and google

You never want chronic inflammation.

Do you have CBC lab data to see immune cell levels?

Yes, I have CBC’s from last week, WBC is 6.8 (4.0-10.5) ( I also had the stomach flu day of the test, but didn’t know it, not sure if that makes any difference)

I agree, chronic inflammation is not good. I started taking Saw Palmetto for the prostate, what else can I do? Now that I think about it, high caffeine, pre-workout drinks etc. seem to give me some piss symptoms, but I hadn’t been on those in a long while… workouts aren’t intense enough to need em.

Should probably try some zinc to lower E until I can get the Adex, the Doc neglected to follow up with me this week as to if he will write the script, and now he is out for Christmas… great, another week of feeling like crap.

Man, I want to just pin this Cyp. now… but I suppose I will wait… If you guys are familiar with the John Crisler’s TRT recipe (google it, best step by step read I have found on the subject)…he always waits to give an AI because some men’s E2 will actually go down once T is administered… even if the baseline is high. My luck E would shoot through the roof and I would wake up with man boobs…lol

If my total T hadn’t been in the 600’s on this last test, I would indeed throw caution to the wind and just pin the T… but I suppose I am still holding on to the thought that I can get free T up, symptoms mitigated and not have to be on TRT for life starting at 38… plus, I got no PCT if I wanted to stop… I guess I am really just scared that I don’t actually need the TRT… and I will be f’n up getting on it.

I’m still very unclear on WHY my T is jacked, why the totals were so low in the summer… then they came up now… and the free is in the gutter… thats why i asked you guys about possibly getting more tests… DHEA, Vit. D, Cortisol etc. Something that may diagnose why? The more I read and think I know… the more I realize I don’t know.

prostatitis: use this site’s search and google

Doc finally scripted me the A Dex. (great article on T nation btw…search - Your Doctor, Your Dealer)

now insurance co. Is questioning the script…if they don’t cover…it’s like $130 in generic… I’ve seen it for like $30 from Canadian pharmacies…but who knows if they are scams or the real deal…pls pm me if you guys have insight on that…