T Nation

To T or Not to T – teste1 Log

DID I JUST MAKE ANOTHER BAD LIFE DECISION?

Sorry if this post is long, but trying to provide as much relative information as possible. I’m 6 weeks into TRT but now seriously concerned about recent heart issues and whether this is the right decision. I’m still reading through the stickies, so I apologize for any noobie mistakes this early on. There’s so much information to take in. I’m open to suggestions and will try to provide any and all info that may assist with helping make the right decision.

I went to a local hormone replacement clinic hoping to get my life back. See “symptoms” below. They put me on the below protocol.

160mg of test cyp per week split in 2 doses SQ (1st dose was full 160mg IM in office)

.25 mg of Anastrozole single dose per week

25mg DHEA ED

HCG (started on 2nd week) 1000ml per week split in 2 doses. **(Please verify my math. Directions say to mix with 6ML of bact water. Dosing “50 units twice weekly”. Also says “6000 units/vial”. So, half of an insulin needle twice a week.)

T+HCG Monday mornings. T+HCG+AI Thursday evenings.

Things were great the 1st 2 or 3 weeks. Started seeing improvements early on. Mood and confidence improved, was motivated to work out and get work/job done, started noticing girls again, noticed I started making eye contact with people, woke up a few times with raging wood that hurt like it used to…in a good way. But, around week 3 I started noticing my heart pounding. Not a change in pulse but beating very hard at times. Reduced T dose to 140mg/wk and stopped DHEA. Read somewhere it can counteract the AI. It got progressively worse till one night about 24 hours after a T+HCG+AI dose I was considering going to the hospital. I called the clinic and they suggested I give blood, which I did that very day. Felt good after with a boost of energy the rest of the day but crashed the next day. Also started feeling hot sometimes, waking up sweating. One morning I woke up and felt weak and clammy. BP and pulse seemed lower than normal. Had a couple days where I didn’t even want to get out of bed or the house. Symptoms seemed to be the worst within 12-36 hours after injections. It’s been 1 week since stopping everything. Currently sitting here with a Holter monitor on and other cardio tests scheduled in the coming weeks. Heart symptoms have greatly subsided. I’m now concerned about the possible crash coming from stopping cold turkey. Starting to notice a strength decrease, mood swings throughout the day, energy level down. I’m scheduled to go back to TRT clinic for them to test my E levels. My plan is to put TRT on the back burner until I get results from Cardiologist. Even though the clinic said “it’s bioidentical. You can just get off whenever you want”. Clearly that’s not true. And if this is a lifelong commitment, I’d like to exhaust all other options 1st. If this is the answer, then so be it. But I owe it to myself to do more due diligence before continuing.

Questions for now:

  • Should I consider PCT even though it’s only been 6 weeks, or just let my body recover naturally?
  • I know everyone is different, but what is typical time frame before body equalizes back to “normal” after stopping a short run on T?
  • What other potential diagnoses, issues or problems should I investigate that may be causing my symptoms?
  • TRT clinic wants me to come in to test E and I believe H&H. Should I request any other labs at this time?

Age - 44

Height - 5’8”

Waist - 28-29” (was 30-31 a year ago before changing eating habits and regular training)

Weight - 148lb

Hair - Can grow a full beard. Maybe not as full as younger years and not as fast. It may just appear thin from the grey. Hairy legs, arms, chest, stomach and back of neck.

Fat - Carry fat in front stomach near navel. Not a pouch but no 6 pack either.

Health:

-Symptoms- Libido 0.5 on 1-10 scale. ED. Originally started having ED issues in my 30’s. Blue pill helped but now does almost nothing. Coordination off/clumsy sometimes. No drive to get anything done. Tons of backlogged projects and “to do’s”. Used to be competitive and confident profession, but don’t even feel like getting the basics done. Having trouble multi-tasking like I used to. Short term memory sucks. By the time I get to the next room I’ll forget what I went there to get. Skin and hair not as oily as it used to be. Sometimes itchy all over after taking a shower. Tried the cold shower therapy and the itching after almost drove me crazy. Rash started 2 or 3 years ago on my face in mustache, beard and cheeks sometimes. Feels rough like sandpaper. Lack of emotional connection or able to bond. Feels like I’m here but not present…blah, numb. Sometimes wake up soaked from sweating at night. Sometimes wake up at 3 or 4am and unable to go back to sleep. Despite relatively strict eating and training, I’ve seen very minimal strength or body improvements; other than the waist size improvement, which I could usually do anyway by reducing food intake. Used to get severe headaches in the middle of the night. Seems to have mostly gone with current lifestyle changes.

-Possible pertinent history- Did 2 cycles around 30 years old. Don’t recall what it was or if I did a proper PCT. Drank often from teens to mid 30’s. Almost no alcohol now. Maybe avg 1 drink a month or 2. Use of “other” substances off and on from 18- mid 30’s.

Flipped car several times in 1990. Few broken bones. No seatbelt so almost ejected. May have been unconscious briefly or brain just blocked a portion of the memory. Not sure. Back was sore and hurt off and on for many years after.

Rear-ended in mid 2000s. Had severe headaches for about a year and a half after.

Varicocele diagnoses around 2006.

Worked several years for environmental spill response company. (fuel and oil spills, oil well blowouts, etc.)

Around diesel fumes often. 8 years on a commercial vessel.

-Rx and OTC drugs, any hair loss drugs or prostate drugs- Rogaine/Minoxidil for several months in the mid 90’s. Then again for a couple weeks several years later. **I noticed my hair loss was bad at that time then started to taper off till I wasn’t losing any some years later.

Presently taking daily: Allegra, multi-vitamin, D3 – 3000 IU. Recently started zinc – 50mg, Magnesium Glycinate – 400 mg. Sometimes fast dissolving Melatonin before bed.

-Diet-

Food - As of the past year I’ve cleaned it up considerably. Mostly lean meats, non processed carb and healthy fat in each meal. Supplement with occasional protein and frozen fruit shake; and protein or power bards. I try to completely avoid processed food or sugars. If I’m craving it or pressed for time maybe an organic peanut butter and jelly or honey sandwich. Obviously, there are exceptions outside of that like at restaurants, on the go or at friends, but even then I try to be smart about it.

Coffee – 1/3-1/2 cup on hard training days or when I’m really dragging. (no sugar or cream).

Hydration – Only drink water and Gatorade on hot days before or after training.

Rarely drink now. Usually a month or 2 between drinks. Even then it’s rarely more than 1. Anything more and I feel like garbage the next day.

-Training- Typical bro split type off and on when in my 20’s and 30’s. Stopped for several years but started again a little over a year ago. Originally 4-6 days a week but have learned to cut back and leave time to recover. Currently 4-5 days per week. 3 days custom programming of power building (hypertrophy and heavy main movements) then supplement with 1-2 days of crossfit metcons.

-testes ache, ever, with a fever?- Sometimes. Varicocele diagnosis around 2005. Was severe but eventually subsided. Currently have aching on left side near previous hernia repair. I thought maybe it had returned. Operating doc said I was “solid and good” and put me on Medrol for 1 week. Going to see a Urologist next week for 2nd opinion on that and TRT.

-Morning wood was virtually nonexistent the past couple years but started to get a rare one after starting to workout. Improved greatly 1st couple weeks of TRT.

-Body temps-
7-25-19
0600 – 97.7
1250 – 98.0

7-26-19
0700 – 97.9
2200 – 98.4

7-27-19
0720 – 95.9
Then – 96.5 (Immediately after. Was half awake and questioned how good of a reading I got. Woke up feeling hot.)
1045 – 97.5
1720 – 97.6

7-28-19
0650 – 96.7
1250 – 98.0

Switched back to iodized salt a couple days ago after reading possible issues on here. I live near the coast and eat shellfish somewhat often, so may not be an issue but why take a chance.

-lab results with ranges- I will attach 2017 (has total T) & 2018 wellness visit results and most recent May 2019 from TRT clinic.

It is more probable that you do not have enough lab testing and were put on the wrong protocol, everyone goes through a rough patch about 3 weeks into TRT, the surge in hormones can cause problems especially if on the wrong protocol.

You need a minimum Total T, Free T, SHBG and estrogen labs. If SHBG is on the lower end and estrogen on the higher end, then it’s not hard to understand why you are having problems. HCG increases estrogen and your large weekly dosage also increases estrogen, this is likely why you heart was beating so strongly.

You also started TRT with a bunch of other compounds, this rarely does anything except cause side effects, most men are not on HCG because of all the problems it causes, but brings in a lot money for theses clinics.

DHEA will also increase estrogen. Men on TRT usually do not need AI’s unless using HCG which increases estrogen.

You need to start TRT in isolation with no drugs, no HCG and dial in this way.