T Nation

Sore Nipples Common on TRT & HCG?

Does the soreness mean you’re growing breast tissue?

Not necessarily. What are the details of your doses, how long have you been on it, etc.?

I’m 2 weeks into my new protocol so i don’t think it has normalized yet, but i have noticed sore nipples for months now off and on. Not bad. just noticeable. Previously i attributed it to my gyno surgery i did last year, but i shouldn’t be feeling anything from that at this point. I don’t want to have to do that again so i want to nail down a regiment that works well.I think over the last year, i may have gotten a little. I need to stop that form getting worse.

I’ve been on TRT for 2 years now, but 1 year with a clinic who knows what they’re doing. For the past 6 months i was on .23 ml of 200mg/ml test cypionate IM, and .35 ml of HCG SQ (the normal concentration, don’t know if off the top of my head) 3x/week. I take 2 .125 anastrasol at the time of my injection. But. i reported the sore nipples and was adding more anastrasol to try self-medicate (.125 the evening of a morning injection, and one the next day and i crashed my e2 or came damn close) so defy suggested i switch up the protocol to .21 test IM, .35ml hcg SQ and .15 deca which has less chance of converting to estrogen.

I had gyno as a kid, and initial T level without TRT/HCG was 299.

Here’s my recent labs, but they were taken 2 days after an injection, right before i was about to
dose again.

My goals: To put on more lean muscle mass and have an insane sex drive. A zero sex drive was the reason I started on TRT but muscles is why i’ll stay on it. I’m 6’ 185lbs at about 17% bodyfat now if i had to guess. i can see some abs.

Comments B0095768618^LAB: Cardiovascular Report, CBC With Differential/Platelet, Comp. Metabolic Panel (14), DHEA-Sulfate, Estradiol, Sensitive, Lipid Panel w/ Chol/HDL Ratio, Prostate-Specific Ag, Serum, Sex Horm Binding Glob, Serum, Testosterone,Free and Total, TSH

Diagnostic Test / Results Results Out of Range Flag Units Range Site Stat CBC With Differential/Platelet [Final]

Notes Fasting - No WBC 4.2

x10E3/u 3.4-10.8 01 F L RBC 5.59

x10E6/u 4.14-5.80 01 F L Hemoglobin 17.0 g/dL 13.0-17.7 01 F Hematocrit 48.0 % 37.5-51.0 01 F MCV 86 fL 79-97 01 F MCH 30.4 pg 26.6-33.0 01 F MCHC 35.4 g/dL 31.5-35.7 01 F RDW 12.9 % 12.3-15.4 01 F Platelets 126 L x10E3/u

150-450 01 F L Neutrophils 60 % Not Estab. 01 F Lymphs 30 % Not Estab. 01 F Monocytes 8 % Not Estab. 01 F Eos 2 % Not Estab. 01 F Basos 0 % Not Estab. 01 F Immature Cells NP 01 X Neutrophils (Absolute) 2.5

x10E3/u 1.4-7.0 01 F L Lymphs (Absolute) 1.3

x10E3/u 0.7-3.1 01 F L Monocytes(Absolute) 0.4

x10E3/u 0.1-0.9 01 F L Eos (Absolute) 0.1

x10E3/u 0.0-0.4 01 F L Baso (Absolute) 0.0

x10E3/u 0.0-0.2 01 F L Immature Granulocytes 0 % Not Estab. 01 F Immature Grans (Abs) 0.0

x10E3/u 0.0-0.1 01 F L NRBC NP 01 X Hematology Comments: NP 01 X Comp. Metabolic Panel (14) [Final]

Glucose 72 mg/dL 65-99 01 F BUN 20 mg/dL 6-20 01 F Creatinine 1.29 H mg/dL 0.76-1.27 01 F eGFR If NonAfricn Am 70

mL/min/1 >59 01 F .73 eGFR If Africn Am 81

mL/min/1 >59 01 F .73

Flag Legend: Flag Legend: L (Below Low Normal) H (Above High Normal) LL (Alert Low) HH (Alert High) < (Panic Low) > (Panic High) A (Abnormal) AA (Critical Abnormal)

Comments B0095768618^LAB: Cardiovascular Report, CBC With Differential/Platelet, Comp. Metabolic Panel (14), DHEA-Sulfate, Estradiol, Sensitive, Lipid Panel w/ Chol/HDL Ratio, Prostate-Specific Ag, Serum, Sex Horm Binding Glob, Serum, Testosterone,Free and Total, TSH

Diagnostic Test / Results Results Out of Range Flag Units Range Site Stat Comp. Metabolic Panel (14) [Final]

BUN/Creatinine Ratio 16 9-20 01 F Sodium 143 mmol/L 134-144 01 F Potassium 4.8 mmol/L 3.5-5.2 01 F Chloride 103 mmol/L 96-106 01 F Carbon Dioxide, Total 26 mmol/L 20-29 01 F Calcium 9.4 mg/dL 8.7-10.2 01 F Protein, Total 6.6 g/dL 6.0-8.5 01 F Albumin 4.7 g/dL 3.5-5.5 01 F Globulin, Total 1.9 g/dL 1.5-4.5 01 F A/G Ratio 2.5 H 1.2-2.2 01 F Bilirubin, Total 0.7 mg/dL 0.0-1.2 01 F Alkaline Phosphatase 66 IU/L 39-117 01 F AST (SGOT) 50 H IU/L 0-40 01 F ALT (SGPT) 38 IU/L 0-44 01 F Lipid Panel w/ Chol/HDL Ratio [Final]

Cholesterol, Total 173 mg/dL 100-199 01 F Triglycerides 147 mg/dL 0-149 01 F HDL Cholesterol 44 mg/dL >39 01 F VLDL Cholesterol Cal 29 mg/dL 5-40 01 F LDL Cholesterol Calc 100 H mg/dL 0-99 01 F Comment: NP 01 X T. Chol/HDL Ratio 3.9 ratio 0.0-5.0 01 F Notes

T. Chol/HDL Ratio

Men Women 1/2 Avg.Risk 3.4 3.3 Avg.Risk 5.0 4.4 2X Avg.Risk 9.6 7.1 3X Avg.Risk 23.4 11.0

Testosterone,Free and Total [Final]

Testosterone, Serum 1025 H ng/dL 264-916 01 F Notes

Adult male reference interval is based on a population of healthy nonobese males (BMI <30) between 19 and 39 years old. Travison, et.al. JCEM 2017,102;1161-1173. PMID: 28324103. Free Testosterone(Direct) 29.3 H pg/mL 8.7-25.1 01 F DHEA-Sulfate [Final]

DHEA-Sulfate 398.5 ug/dL 102.6-416.3 01 F TSH [Final]

TSH 2.180 uIU/mL 0.450-4.500 01 F Prostate-Specific Ag, Serum [Final]

Flag Legend: Flag Legend: L (Below Low Normal) H (Above High Normal) LL (Alert Low) HH (Alert High) < (Panic Low) > (Panic High) A (Abnormal) AA (Critical Abnormal)

Comments B0095768618^LAB: Cardiovascular Report, CBC With Differential/Platelet, Comp. Metabolic Panel (14), DHEA-Sulfate, Estradiol, Sensitive, Lipid Panel w/ Chol/HDL Ratio, Prostate-Specific Ag, Serum, Sex Horm Binding Glob, Serum, Testosterone,Free and Total, TSH

Diagnostic Test / Results Results Out of Range Flag Units Range Site Stat Prostate-Specific Ag, Serum [Final] Prostate Specific Ag, Serum 0.4ng/mL 0.0-4.0 01 F Notes

Roche ECLIA methodology.

. According to the American Urological Association, Serum PSA should decrease and remain at undetectable levels after radical prostatectomy. The AUA defines biochemical recurrence as an initial PSA value 0.2 ng/mL or greater followed by a subsequent confirmatory PSA value 0.2 ng/mL or greater. Values obtained with different assay methods or kits cannot be used interchangeably. Results cannot be interpreted as absolute evidence of the presence or absence of malignant disease.

Estradiol, Sensitive [Final]

Estradiol, Sensitive 20.7 pg/mL 8.0-35.0 02 F Notes

This test was developed and its performance characteristics determined by LabCorp. It has not been cleared by the Food and Drug Administration. Methodology: Liquid chromatography tandem mass spectrometry(LC/MS/MS)

Sex Horm Binding Glob, Serum [Final]

Sex Horm Binding Glob, Serum 26.1 nmol/L 16.5-55.9 01 F Cardiovascular Report [Final]

Most of the time nipple soreness is transient because your hormones are in flux for the first 6 weeks of a change in protocol and when levels stabilize the nipple soreness will more than likely subside, that is unless your levels are excessive.

It doesn’t appear children are one of your goals at the moment, if you not looking to have children at this time I would drop the HCG because it’s likely increasing estrogen and might increase your chances at an occurrence of a gyno if your glands weren’t removed.

You should have had the glands removed so a recurrence of gyno is not an issue.

This may force you to revisit your choice in protocols, TRT decreases SHBG in just about everyone so don’t be surprised is SHBG is <15 in your next set of labs. When SHBG decreases, FT increases and may convert more FT-> estrogen-> free estrogen and may make it seem like you’re not even on TRT.

glans removed? didn’t know that was an option. The doc said he leaves ~5% of the tissue so you don’t get that sunken in look.

I’ve had 3 kids and a vasectomy so kids are not a goal, but doesn’t HCG increase my total testosterone? my nuts shriveled up when i was on T alone and i didn’t like that, and wouldn’t want to drop it entirely. They said with this protocol, i should see my total t around 1500 and the estrogen should be easier to manage without the extra anastrazol pills i was taking before.

That e2 is already quite low compared to your T levels. I certainly wouldn’t try to lower it any further. I honestly think you’d feel better at higher levels but with gyno history someone more experienced with that will hopefully chime in.

You know glands are removed so a chance at another gyno flare up is not possible unless you want to return for another surgery one day. Your chance at gyno on hormonal treatments is more likely because after protocol changes hormone levels are all over the place, it’s great business for the doctor though.

Gland removal is more expensive, $5000-$8000 dollars.

Get prolactin tested.

I’m getting prolactin tested at my next labs. Not sure why they haven’t been doing them all along. need to pay better attention to what gets ordered when my labs are tested. also having them add DHT for libido monitoring.

They also gave me one of the deoderant sticks i can apply to the testes to see if that helps, but i don’t want to introduce that till i have a new baseline and can confirm the trt/hcg/deca combo is working right first.

I called my doc to ask if he removed the glands. He did. Said it should never come back, so that’s good news. So hopefully the sore nipples will stop after my hormones normalize. It was an awesome doc who ONLY does gyno on the border of CT and NY if anyone wants a recommendation.

Who is the dr and how much did it cost?

Dr Blau from white planes, NY performed the surgery. It was 8600 for just the gyno surgery. Awesome results.

If properly removed it cannot grow back again, right?

Sorry for the late reply. i’m rarely on here. But yes. If properly removed, it shouldn’t come back. I still get sore nipples every so often when i’m out of wack, but i don’t think anything will grow back.