T Nation

TRT 11 Weeks into Treatment (1 year update)


#1

Long time lurker, first thread posted. I’m eleven weeks into my weekly injection of 100 mg tect cyp and hoped I’d be feeling amazing by now. I’m 41 yo, 5’-11", 180# healthy & in good shape besides being a few points above the low end of normal test before trt, lift weights 3-4 times a week.

My base line total test before trt was 30-40 points above the low scale and I had all the low symptoms for a few years. I finally found a Dr willing to treat me and 11 weeks in I thought I’d be feeling better. Dr started me out at 100mg test cyp weekly home injection. After 6 weeks I got lab work two days after injection (peak labs)

Total test: 1400 of 249-836
E2: 58 of 6-39
Hematocrit: 41 of 38-52 (actually 47, had wrong number)

Test was high along with E2 as I wasn’t started on an Ai protocol in the beginning. The Dr says I should feel amazing with that test level. I had a bit more motivation and energy but not a drastic change in symptoms as I was hoping for. My dose is reduced to 80mg test weekly and .25 anastrozole twice weekly. I’m now five weeks into the new protocol and don’t feel much better or different from original protocol or from before treatment. I’m not sure the Ai dose is enough and I’m not scheduled to get labs for another 6 weeks.

I was taking my Ai at 2 days and 5 days after injection and noticeably felt better after taking it. Dr said I could take it day of and then again 3 days after which I’m trying this week and don’t really like. I know it takes a while to get timing correct.

Finally my long winded question is should I try increasing my Ai to three times a week and see how I feel or get labs checked now via private lab to see what my levels are?

Thanks


#2

I would check labs before making another adjustment. Most members are on 1mg AI per 100mg test so you are under that but you may not need the full 1mg. Only labs will tell.


#3

With weekly injections you will be over-range at day two and should not down dose based on that.

Anastrozole is a competitive drug to T at aromatase reaction sites. Dose needs to match T levels, but a problem with changing T levels.

Suggest:
Inject 50mg twice a week
0.5mg anastrozole at time of injections

It takes a week for blood levels of anastrozole to get to final levels after a dose change. Eval at days 5-7.

Most normal anastrozole responders need 1.0mg for every 100mg T [cyp, eth].
Target is 22pg/ml

You can inject T IM or SC with #29 0.5ml 1/2" insulin syringes. Suggest SC.
~$14 per 100 at Sam’s/Walmart, ‘ReLion’ house brand made by BD.

Your E2 can also be high from poor liver clearnace, test AST/ALT.

Hematocrit [HTC] is too low VS TT=1400
Any digestive problems?
Could be blood loss via gut.
Ask for ‘occult blood test’, needs a smear of poop

Labs:
TT
FT
E2
PSA
CBC
hematocrit
fasting cholesterol
fasting glucose
TSH

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

#4

I agree I definitely need more labs. Some posters have mentioned getting tested when you’re feeling your sweet spot instead of chasing lab numbers. I can tell a difference in the reduced T dose even with the .5 mg week Ai. I have less energy and motivation.

I have no known digestive disorder or any other health issue I know of besides Low T. I struggle to gain muscle working out a several times a week and eating over 200g of protein a day.

That hematocrit result is lower than a lab I had prior to trt. I don’t have any dark stools indicating a bleed. I can’t imagine my iron is low although B12 could be. My last fasting glucose was elevated at 111, I’m usually right at 100. I’m going to have A1C tested to see what’s going on. My PSA was 0.7 at 6 week trt lab.
I haven’t had thyroid (TSH) tested recently. Would a whole thyroid panel be better than just TSH? I’ve read that monitoring my body temp will also indicate a tyroid issue.


#5

A GI bleed can be slight and not enough to be “dark”, so the blood is hidden and that is why the term occult is used.


#6

Update.
I posted the wrong hematocrit value, it should have been 47. I took the occult blood test prior to realizing the mistake and the test was negative.

Updated blood test
TT 355 taken at last day of weekly cycle on 80mg test C, increase dosage back to 100mg
E2 19, I felt like it was much higher but that’s near perfect range
Hematocrit 48 range 38-50
Vit D 38 range 30-100 low and started sup


#7

How do you feel?


#8

I am still looking for a boost in overall mood, energy level, motivation and any libido. I’m still at the point where I’m not sure this is all worth it w/o feeling much improvement.


#9

Gotcha! Well, you’ve already gotten this far so you may as well continue tweaking things. We are all different so I suggest you continue to read and make adjustments while getting more labs.


#10

I’ve read adding Proviron helps some with well being and libido, it apparently increases DHT levels.


#11

Did you read those stickies?

There, it is pointed out that you can eval overall thyroid function via oral body temperatures as per the thyroid basics sticky.

You need to be using iodized salt and/or vitamins that list iodine+selenium.

Thyroid has a huge impact on energy, libido and mood.


#12

Am body temp 97.4, afternoon 98.4
Suggested iodine dose?


#13

Levels are not bad.

vitamins that list iodine+selenium should be good to try
You can take some kelp supplements along with the above for a while and check body temps now and then. Selenium is important.

Note that high dose iodine will drive up TSH and TSH labs then are not of value.

HTC=48 is what is expected for your TT levels!

Vit-D3: Suggest 5,000iu per day, tiny oil-gel caps, take 25,000 for first 5 days.


#14

I’ve been taking an iodine supplement for a couple weeks with no noticed improvement. What dosage do you recommend KSman?

Also I started dividing my test dose into two weekly shots with insulin syringe. Smaller more frequent dosing is suppose to reduce estrogen from rising as much. I was taking .25mg anastrozle 2x week with one 100 mg ( .5ml) test shot. Should I cut back to one .25 mg AI a week now or make a solution taking .125 2x week?
Thanks


#15

I am not seeing the rational for reducing AI.

It has been a while, what are you noticing re energy, mood and libido?


#16

Rational: I’ve read several cases of switching to 2x weekly T dosing reduced the estrogen spike of single weeks dose. Originally I though my AI dose was too low at .5mg per wk but labs indicated E2 of 19 (6-39). I felt sluggish and unmotivated at that dose.

The 2x week dose does feel better, reduced my anastrozole to .125mg 2x week. I’m not sure .25 a week is enough but I feel like .5mg was too much. I’m getting labs next week so I’ll find out if it’s too small a dose.

Any advise?


#17

No advice, getting the labs is what is needed.


#18

Update:
Got some results from last blood test that were not available at my last visit.
DHEA(S) 84 out of 31-701. Is the optimal range 500?
Free Test % 37 out of 34-106

I believe the options to increase DHEA are through oral supplementation or HCG. I’ve already asked my Dr for HCG. Maybe I should just try it w/o a script.

What are the options to increase free test?


#19

I received my lab work at today’s visit, 6 months into treatment. Blood draw taken 4.5 days after (twice) weekly .25 ml test subq and .125 AI (at time of injection). My E2 tested even lower this time and I cut my anastrozle dose in half after my last labs.

Testosterone 249-836 428
% Free Test 34-106 51
Estradiol 6.7-38.7pg/ml 10.57
Hematocrit 37.5 – 51.0 46.3

It appears for me the (twice) weekly dosing has lowered my E2. Dr is increasing my test dosage to 140mg per week and wants me to maintain my AI dose. Think I’ll skip one AI dose to get my E2 back up though. I’ve read that some over responders switched to Aromasin as it doesn’t bottom out their E2 as bad?

Any advise?


#20

Protocol at 140mg wk test C (divided into 2 doses per wk) w/ 1 mg Adex wk divided into .33mg EOD dosage
finally got thyroid labs, TSH seems high with warm body temps, no thinning eyebrows, no multi vit, table salt used sparingly. Thoughts?

TSH 2.5 0.35-4.94
T3 free 2.8 1.7-3.7
T4 free 0.8 0.7-1.5