Protocol for Coming Off of TRT

Just curious. Why is the Nolvadex supposed to give me less E2 issues than the Clomid HAN?

[quote]KSman wrote:
Your testes were probably LH overloaded and making a lot of E2. Your T levels might have increased further over time as thirty days is not very long for the testes to recover. [/quote]

Any recommendations to the minimum amount of time to stay on Nolvadex and maximum dose/day to do before tappering off and testing levels to see if they hold. I’m thinking a low dose of 10mg am and pm would be good. After 30day’s I plan to have LH,FSH,TT, & FT tested to see if things are being stimulated and if they’re producing.

I’ll be starting my Nolvadex recovery on Saturday. I’m going to start with the 20mg AM & PM to see how it goes for 10day’s and test. I will need to watch for over stimulation to keep E2 levels down with as little Aromasin use as possible. I read a 20mg dose of Nolva is = to 150mg of Clomid (as far as stimulation goes)and it seems that 50mg of clomid may have been over stimulating me on my clomid test.
Hoping for the Best!

LH/FSH and E2 labs will take the guess work off the table.

Clomid has severe estrogenic sides for some. This can hurt libido and make one inappropriately emotional. There are many variations in things like enzymes that can have large effects. The most obvious example is how anastrozole is around 4 times more potent in some guys. Some of these effects will be genetics or variations in gene expression and there really is not much that can be done about that.

Please explain the anastrozole–>aromasin reasoning.

The lymph node issue: I would have expected this to be a normal response to an infection. Your tonsils are part of the Lymphatic system. Are they or the tonsil beds also enlarged? Anything in your CBC [or liver markers] that indicates that the immune system is activated? The liver removes estradiol from your blood. Perhaps the problem is impeded estradiol clearance, not excessive generation. I would review the effects of any supplements or drugs that could be loading up the same liver enzyme pathways that metabolize estrogens. While is might be very difficult to nail down a reason for increased estradiol generation, you might be able to get some clues about liver function that might be involved with estradiol clearance. If the liver cannot clear estradiol properly, one might find some other things elevated that would increase from the reduce liver enzyme functions or from the those enzyme pathways been overloaded.

Have another look at intestinal reabsorption and gut flora and probiotics.

Any other signs of inflammation? I don’t know if these problems can be created by longer term allergy response. Some of your symptoms might be consistent with infectious mononucleosis. [“the antiviral drug valacyclovir has recently been shown to lower or eliminate the presence of the Epstein-Barr virus in subjects afflicted with acute mononucleosis, leading to a significant decrease in the severity of symptoms” Aciclovir should be expected to do anything that valacyclovir because the liver converts it to Aciclovir which is not generic. Off-patent drugs are not researched as there is no payback.]

read the list of things that compete with estradiol for clearance.

Yes I thought the lymph node thing was an infection also. We tried 5 different stints of antibiotics and nothing.
I can’t explain it but when I upped the dose of Aromasin and continued it the swelling is now gone.

I’ve been told to tapper off of the Aromasin for this restart by HAN. We will be testing LH,FSH,TT,FT and E2 in 10 day’s. Not sure what other Blood tests he wants to do. I will request to have enzymes checked.
Also would it be a bad Idea if I was to start taking the herbal supplements I used to take to help with natural production of testosterone. The product I used contained Testofen (Fenugreek Extract.) Thanks for your input.

you do not want put NOTHING ELSE in the mix.
Nolvedex is used to lower estrogen at the receptors so it should not allow the problems with e2 issues of clomid.

40 mgs for one weeks Retest: 30 mgs for another 20 mgs for another week retest then 20 mgs EOD for 2 weeks retest (goal is TT 600-800 on your own)

[quote]oscar31280 wrote:
Yes I thought the lymph node thing was an infection also. We tried 5 different stints of antibiotics and nothing.
I can’t explain it but when I upped the dose of Aromasin and continued it the swelling is now gone.

I’ve been told to tapper off of the Aromasin for this restart by HAN. We will be testing LH,FSH,TT,FT and E2 in 10 day’s. Not sure what other Blood tests he wants to do. I will request to have enzymes checked.
Also would it be a bad Idea if I was to start taking the herbal supplements I used to take to help with natural production of testosterone. The product I used contained Testofen (Fenugreek Extract.) Thanks for your input.[/quote]

Well today was day 4 of the Restart. Currently on the 40mgs Nolva/day with no more Aromasin and while the lymph nodes that were swollen are back to normal and fatigue is a little better I’m loosing my libido fast. I can still get it up but it takes a lot of work to get there and even more to get enough feeling to get off. I hope its just do to the High dose and will get better as its lowered. Worse case scenario I can add some herbal supplements when treatment is done to aid in libido and estrogen control. Will test in 6 day’s.

[quote]oscar31280 wrote:
Well today was day 4 of the Restart. Currently on the 40mgs Nolva/day with no more Aromasin and while the lymph nodes that were swollen are back to normal and fatigue is a little better I’m loosing my libido fast. I can still get it up but it takes a lot of work to get there and even more to get enough feeling to get off. I hope its just do to the High dose and will get better as its lowered. Worse case scenario I can add some herbal supplements when treatment is done to aid in libido and estrogen control. Will test in 6 day’s.[/quote]

how old are you oscar?

thanks,
mk

I’m 31.

Today was day 7 on the restart and I’ve got the same symptoms back fatigue and swollen lymph nodes. They’ve been bothering me for 3 day’s now so tonight I choose to dose my Aromasin again. Libido is also in the toilet. Blood work Monday and drop the Nolva dose down.

With the lymphnoids swelling up all the time, has your endocronologist ruled out thyroid cancer through RAI?
THis needs to be further investigated as there tends to be some kind of immune reaction to any type of medication you try. I have been considering that dr’s tend to chase some thing that looks so obvious and tend not to take in the whole picture. After consulting with a few of my highly respected dr’s of mine about your case they all have concluded that the next proper steps is to rule out some form of thyroid cancer. The swollen lympnoids were a huge red flag when talking with them.

After long consideration looking at your labs which will deviate just ever so slightly can it make a person feel really that way. I am not refering to its in your head at all. There is something deeper at the root cause here and I plan on digging until I find it and i am coming to conclusion it is not e2 or total test seems to be the link. Out of all (5) the drs I talked to who I highly respect agreed 100% its something else. As you know I have been commited to helping you resolve your issues and I have the best resources in the world who I can turn to. Please reseach thyroid cancer swelling lymph nodes and you will see why they need further investigation…

The endo here will not see anybody without a refferal from a doctor on what he needs to be seen for. Would you call the office and refer me for an appointment.

[quote]oscar31280 wrote:
The endo here will not see anybody without a refferal from a doctor on what he needs to be seen for. Would you call the office and refer me for an appointment.[/quote]

Yes email me monday and I be glad to to do that for you.
Email me the contact information
Your GP will not refer you? Thats messed up…
How much coffe your drink or caffinated beverages.
I sent the nutra eval out should be there anytime.

Ok I will. No my GP will not in fact yesterday I had a huge argument with him and the practice manager about there principles. They were going to originally draw the blood for the nutra eval until I brought the kit in and they read the process. They told me they would no longer help me out because the process was time consuming and it was of no Benefit to them to perform it. No shit its a benefit for the patient. Basically we aren’t making any money off your illness so go away. I wish there was some way I could file a good complaint for being turned away.
Really the only caffiene I drink is whats in my preworkout drink so not much because it gives me the gitters.
Somethimes more this time of year when I try to cut some weight for summer but its only for 3 months at most.
I got both the nutra eval and adrenal kits and they will be done on Monday.

[quote]oscar31280 wrote:
Ok I will. No my GP will not in fact yesterday I had a huge argument with him and the practice manager about there principles. They were going to originally draw the blood for the nutra eval until I brought the kit in and they read the process. They told me they would no longer help me out because the process was time consuming and it was of no Benefit to them to perform it. No shit its a benefit for the patient. Basically we aren’t making any money off your illness so go away. I wish there was some way I could file a good complaint for being turned away.
Really the only caffiene I drink is whats in my preworkout drink so not much because it gives me the gitters.
Somethimes more this time of year when I try to cut some weight for summer but its only for 3 months at most.
I got both the nutra eval and adrenal kits and they will be done on Monday.[/quote]

Just to give you heads up all supplements other then medications have to be stopped 4-5 days prior before other wise you will get false readings on nutra eval.

nutra $169
adrenal stress $79

Call genova PLEASE MAKE SURE you are qualified for payed assure plan. I have not had any blue cross providers have any issues, but with the way the insurance company clamping down I tell every one to call and make sure. I can assure you I am doing everything to try to assist with you to the best of my ability even to bring in the my goto Dr’s when I need alittle reassurance or guidence. I do not know everything or claim to so I am not to proud to ask for the proper imput or help. That is why I am in process of creating a nation wide net work of dr’s that will provide a think tank for complex cases.

Please let forward me the information so we can get this taken care of for you this week.

Yes I read the guidelines for the test and will have no supplements in my system since Wednesday so testing on Monday shouldn’t be a problem.

[quote]oscar31280 wrote:
Yes I read the guidelines for the test and will have no supplements in my system since Wednesday so testing on Monday shouldn’t be a problem.
[/quote]

Just please read direction so you know what gets froze and what does not.

[quote]Hardasnails wrote:

[quote]oscar31280 wrote:
Yes I read the guidelines for the test and will have no supplements in my system since Wednesday so testing on Monday shouldn’t be a problem.
[/quote]

Just please read direction so you know what gets froze and what does not. [/quote]

Quest Diagnostics is actually going to let me bring the kit in and they are going to do it for $44.90.
Tomorrow is my first blood draw. Got my fingers crossed that the right signals are being produced.

[quote]oscar31280 wrote:

[quote]Hardasnails wrote:

[quote]oscar31280 wrote:
Yes I read the guidelines for the test and will have no supplements in my system since Wednesday so testing on Monday shouldn’t be a problem.
[/quote]

Just please read direction so you know what gets froze and what does not. [/quote]

Quest Diagnostics is actually going to let me bring the kit in and they are going to do it for $44.90.
Tomorrow is my first blood draw. Got my fingers crossed that the right signals are being produced. [/quote]

Let me know how it goes and email me that information,
So we can get a referral out to you this week or what ever needs to be done.

[quote]oscar31280 wrote:

[quote]Hardasnails wrote:

[quote]oscar31280 wrote:
Yes I read the guidelines for the test and will have no supplements in my system since Wednesday so testing on Monday shouldn’t be a problem.
[/quote]

Just please read direction so you know what gets froze and what does not. [/quote]

Quest Diagnostics is actually going to let me bring the kit in and they are going to do it for $44.90.
Tomorrow is my first blood draw. Got my fingers crossed that the right signals are being produced. [/quote]

The Quest I went to refused to do it since it was not a “Quest Diagnostics” kit (even though such a thing does not exist as far as I am aware)…

Did you have any troubles getting them to roger up?