T Nation

The New Guy's Story


#1

Hello folks! Am I ever thankful I found this website! Just wish I would have found it a few years before...would have saved me a bunch of time and cash. "Better late than never" my Pop used to say. Anyhow, here's a breakdown for you all...I am 6'4", 230 lbs. 30 years old (just turned 30, by the way). I started this whole trip because I was telling a dude I work with how crappy I was feeling. I was super lethargic, apathetic, I had a horrible memory, and did not want to do diddily shit at my job due to a kind of fogginess in my head (sorry, kind of hard to describe). I used to weigh 335, but I was able to lose 105lbs eating low carb.

He suggested I go to this clinic where they prescribe some bioidentical cream (testosterone/chrysin compounded) rubbed onto the inner thigh once daily when my test level was at 140 (should've been at about 700-900). That did not work at all, so I went to my primary care doc, who put me on androgel. Unfortunately, I had to take so much of it, I was bathing in it, which was ridiculous. Additionally, after being on it consecutively for 7 months, my level got to 367. The bad part is is that he felt this level was "perfect."

Then, my insurance changed, and the gel was going to become a ridiculous amount of money every month so my primary care doc gave me a 200mg injection of Test Cypionate, to be repeated every 3 weeks!!! Anyhow, I knew, just from my cursory research, that this was not right. Luckily, I work with two other gentlemen who go to a doc who is "in tuned" to the entire TRT process. This guy is legit! After his first session with me, he ordered a gallon of blood, to be tested for everything. After not having any test for 2 weeks, my level came back at 367 (yes, again). The following are the first set of labs:

                    Ranges
  • LH <.2 1.7-8.6 (mIU/mL)
  • FSH <.2 1.5-12.4 (mIU/mL)
  • DHEA 187.8 160-449 (ug/dL)
  • Test Serum 367 348-1197 (ng/dL)
  • TSH 5.820 .450-4.5 (uIU/mL)
  • Estradiol 22.6 7.6-42.6 (pg/mL)
  • PSA .2 0.0-4.0 (ng/mL)
  • IGF - 1 244 117-329 (ng/mL)
  • Vitamin D 13.9 30-100 (ng/mL)
  • Test Free 6.4 9.3-26.5 (pg/mL)
  • Progesterone .5 .2-1.4 (ng/mL)
  • Triiodothyronine, Free, Serum 3.1 2.0-4.4 (pg/mL)
  • Cortisol (AM) 24.0 6.2-19.4 (ug/dL)

Upon return to his office, he said, "your testosterone level is in the toilet." Music to my ears because he said it should be 800-900 at my age. He said it is currently in the "100 year-old man's range." The following regimen is what he placed me on eight weeks ago (I had bloods done at 6 and will update those changes following):

*Arimidex 1x weekly - estrogen blocker (.25mg per week)
*100mg Test Cyp IM injection 1x weekly (will probably go to 200 after first set of labs in 6 weeks)
*Armour Thyroid 30mg every morning (first two weeks then switch to 60mg every morning)
*.25mL HcG subcutaneous injection on day's 6-7 every week
*15mg's micronized Progesterone every night before bed
*12.5mg Iodoral daily
*150mg Zinc daily
*50mg DHEA every morning
*10,000 IU's Vitamin D3 every morning
*An entire boatload of Vitamin C (daily, seriously, about 4 grams daily)
*500mg of any OPC I can get (these are primarily antioxidants- Resveratrol, Noni, Acai, etc...)

After being on this regimen for 6 weeks, I had bloods taken again. I really messed them up, though, because I had the blood taken 8 days after my last Test injection. Doc chided me, said I should have gotten it taken 4 days after last injection. Regardless, Test was actually LESS than what it originally was at 307. I did, however, do my HcG injections 2 days prior to my bloods, and the injections had no impact on neither my LH or FSH, they remained undetectable. Doc said the few years I did of Androgel/Creams without HcG probably slaughtered my pituitary and thus, it may not work anymore. I can't find the updated results, but when I get them, I will update this OP.

Long story short, he bumped me up to 160mgs of Test Cypionate/weekly, broken down into 2x 80mg doses Monday mornings and Thursday evenings. He took the HcG out of the picture. He did ask me if I was certain I did not want anymore children, which I told him we were done with that.

I have always been relatively weak for a "big guy." I don't think my Test levels ever reached a peak where they were at 700-900. I have never really felt strong, not real confident in myself, etc...that is all changing now. I have recently started lifting weights for what is truly the first time. I have done it before with absolutely no success. My muscles would always fatigue immediately after a set or two. I would always get frustrated over this and I would quit. I have never been able to bench over 150lbs. I have never been able to do even 50 push ups. You folks see where this is going? It's pretty bad.

I have this bench press I bought 10 years ago that has sat in my garage collecting dust; it's a nice, sturdy "Olympic" set, not these dinky deals you get at garage sales that you can barely get your shoulders between. Well, the other day I went out and knocked the dust off of it. I figured, "fuck it," I need to start somewhere. Doc said lifting heavy weights will keep the Estrogen at bay too. Plus, he said, I should be knocking shit out as far as the weights go with the TRT. So, I threw on the 45's (don't laugh), I was expecting to lift them 2-5 reps (haven't benched in about 7 years)...lo and behold, I put all 135lbs up 25 times and could have done more, but figured, "shit, let's see what else I can do..." I had 175lbs on that damn bar within the next 10 minutes, put that up 8 times and could have done more, but I don't have a spotter (starting to see the necessity in that...never had to before). I know it's weak but damn I feel better! I actually feel like I could go out and put another 35-50lbs on that bar and throw it up a few times. The Doc told me that doing a lot of reps is not necessary, only that I lift "heavy weights" until "failure". Is that true? Is that what builds muscles? I thought it was about repetitions...oh well, thiese are the reasons I'm here, I suppose.

My apologies for the Russian novel-type post...I do believe the subject matter does warrant it, though. I am probably going to have a shit ton of questions as I already had. Before I go, I need to know one thing...I was taking the Armour Thyroid for about 2 months and I started getting heart palpitations. I was not taking the Iodoral (forgot about it) when I was taking the Armour, could that have been the cause of the palps? Any of you folks experienced this? Within 4 days of stopping the Armour, the palps went away. Do you think if I started back on it with the Iodoral, the palps would not return? Any info would be greatly appreciated. Thank you all for your time. I look forward to the information overload!


#2

Your doctor is an idiot for thinking that HCG would elicit some sort of LH/FSH response–it won’t. It mimics LH in your body, but does not actually raise LH. Your LH/FSH were suppressed from the test you were taking (more than likely, though its hard to tell since you never got these values tested before going on TRT in the first place). This is the first item of concern.

Second is that your TSH is sky high, warranting further thyroid testing. You need to get Free T3, Free T4, Reverse T3 (Optional) and Thyroid antibodies (there are two of these and they are not optional–they will tell you if you have Hashimoto’s). I suspect your thyroid issues are from your massive weight loss and not from Hashi’s, but you have to rule that out.

Third is that your Testosterone injection protocol is not optimal (twice a week, minimum) and the HCG injection frequency is just retarded (need at least 3x week based on HCG half life–once a week is asinine).

How much did your doctor charge you for this insane amount of drugs, if you don’t mind?

Go back and use the feature to edit your post to include the lab ranges for all values.


#3

damn, I hope I don’t have his information confused. I will clarify this with him further. He is actually pretty open, I think if I requested to get back on the HcG and to bump it up a bit, he may go with it. I was taking it 2x per week (on days 6 and 7 of every week, dose was .25mL’s for those days) is that a common dosing amount? Do you folks recommend that dose just more frequently, or do you recommend a higher dose than that more frequently?

Secondly, I did indicate that the Test injection protocol has now changed to 80mgs 2x per week, is that not sufficient? Should it be more frequent than that?

To be honest, the Doc didn’t charge me anything for these prescriptions. The HcG, Progesterone, Test, Arimidex and Armour Thyroid totalled up to 100.00/month. The vitamins and Iodoral were approximately 45.00 for almost 3 months worth. This is considered an “insane amount of drugs”? Damn, I thought after reading some of the info on here we were on the right track…are there changes to these you would recommend?


#4

I meant you need to spread your HCG dose out more evenly. It looks like he is following Dr. Crisler’s HCG and TRT protocol, which I never really understood. Much better to keep the testes stimulated consistently instead of once a week. 2-3x per week, spaced evenly (or almost evenly, MWF dosing is fine) is much better.

250 iu is a standard dose. I don’t know the concentration of your HCG, but shoot for this.

Switching to twice weekly T shots is fine, I missed that in your novella of a post.

It is a lot of drugs right out of the gate when all the proper tests were not performed. You really need to rule out and isolate thyroid issues before attempting to treat other things.

Also, a lot of those supplements I have found useless (iodine, progesterone, DHEA).


#5

Your on way too much shit with out laying the foundation first with proper T protocol. Typical throw shit against the wall and see if it sticks routine. Your DHEA low for a reason probably from hidden stressors. 30 years old, your dr should be looking for why you are low in the first place and find out if you are capable of producing it on your own with possible clomid.

As VT mentioned i agree 100% you do not know what is doing what. We take a layered approach with starting on thing at a time then measuring. This methodology your Dr is going to use is going to end up causing more harm then good. I see it on a daily basis trying to work with Dr’s to undo the damage from other incempetent Dr’s. If you get lucky now then it may only take you a month or so. On the aveage it take 4-6 month some times to get a person working back to a good baseline and some what balance.


#6

I looked for the layered approach you’re typing of, hardasnails, but I could not find it. Could you point me in the right direction?


#7

[quote]DullShooter wrote:
I looked for the layered approach you’re typing of, hardasnails, but I could not find it. Could you point me in the right direction? [/quote]

The layer approach is what individualized medicine is all about. There is no cookie cutter method. Each case is different.
Get T and E2 stablized before touching dhea, hcg or AI then when stable for 4-5 weeks then add in HCG, then retest, then DHEA then retest.
The whole process may take up to 3 months but in the end it will safe you months and years of possible head aches. Personally I would not have recommended HRT to Dr’s I am working with right off the bat till the underlying cause can be justified. Some many guys thinks going on HRT is going to solve all problems actually it can cause more problems in the long run since it may be masking deeper issues. Some people after doing it for 5 years, it gets old after a while. My self included…