T Nation

TRT Consideration w/ Labs, Backstory

Hey guys.
Would like to introduce myself a little, and give a little information about how I think I ended up where I am today. Back in 2011, I had a TBI. Was in the hospital for 2 weeks, one of those being critical care. I fell and hit (I think) the back of the right side of my head. Knocked out cold. Went to ER the next day, they rushed me to a bigger hospital. I had two brain bleeds, one I remember was a surface brain bleed, and the other, was below the surface, whatever that is called. Sub-dural?

Ever since, I have had issues with depression, anxiety, cognitive difficulties, difficulty maintaining erection, loss of sexual interest, general confusion, insomnia, personality changes. Just, really nasty symptoms. Of course, to treat these symptoms, I turned to booze. When I couldn’t drink, I took Clonozepam. So needless to say, I just thought the symptoms I was having was attributed to the alcohol and prescription drug use, although I took my prescriptions as prescribed, the Clonozepam script was 3MG/day, which is pretty hefty. Took that for 9 years.

So, I got my shit together last year and quit everything. I was just tired of feeling like shit all the time, and felt like this would help. It did, somewhat. I’m much happier than I was. I have no desire to go back. I’m still tapering off the Clonozepam. I don’t want to have a seizure. I’m at 0.2MG/day, down from 3. Around this time, I got on a great insurance plan, and I started looking into a possible correlation of my symptoms with my TBI. The more I read, the more I suspected there was something going on with my testosterone.

I went to an actual TBI clinic, and was told that the injury happened so long ago, that the cells would have already regenerated and I would have healed. I can’t believe that! I walked out right then and there. This was a Brody School of Medicine doc as well, flanked by three students. Then, I saw a neurologist who wanted to refer me to an endocrinologist. That endocrinologist required supporting blood-work, so the neurologist had my A1C tested! For diabetes. Not an issue I’m having. That happened twice(!) Needless to say, both times my referral was declined because it came back normal. The neurologist did order a MRI, which came back normal.

So, I understood pretty quick that this was something I was going to have to learn about on my own. I was able to find a PCP that wouldn’t push back on the tests I asked for, although he expressed repeatedly he doesn’t know why I would need E2, fT3, LH, etc. Pretty run of the mill from what I have read.

So, this new doctor looked at a TT and FT test a previous PCP had dismissed as normal (311 TT, 67FT, (250-1100 ng/dL and 35.0-155.0 pg/mL respectfully) and said, essentially, here’s some Testosterone. Inject 400mg/2mL once a month. That’s how I ended up here. I took the injection, and despite learning afterwards that this protocol is horrible, I am wondering if I should not try to lift weights and get back naturally instead.

I work from home for a large tech company, so I sit in my office all day on the phone. Have done this for years. I don’t get out much. What if I just start going to the gym, modifying my diet, and perhaps take a few supplements? Should I try that first? I’m only 33 years old, and don’t want to be a slave to the T the rest of my life if it can be avoided. But on the other hand, I am desperately craving relief.

So, I don’t know what to do right now. If I decide to lift weights solely, how long until the 400mg Test Cyp is out of my system? What are your thoughts on me going this route? Futile?
I am really optimistic I can get a lot further reading on my own and with a little help from you guys. I appreciate in advance any advice/thoughts you may have.

Attached are all of the labs I have had done so far, with the exception of the FT and TT. That is listed in a paragraph above.

The ranges for the following are Lab Corp ranges.

5

I have several more labs that I guess aren’t finished yet. I will post them when I get them.

You certainly could try. It won’t hurt. Better to get some exercise and clean up the diet first and then see where you’re at.

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If you feel healthy enough that its not a big deal then try no TRT first. If it is imminent then take the next script and split 50 mg e3.5d or find another Dr. Preferably private

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Better stop right away with this crap protocol…1x every 4 weeks is the weirdest i’ve heard and will only give you mayor issues.
But dont worry on stopping right now, no harm done YET…and reading your story and especialy how you spend your time and work…this should all clear up once you start working out . Fitness/body building/ calastenics…this all promotes a healthy life style, better mood and better overall feeling. Once you start working on your body the rest will follow, food intake, rest ect…and once you start to see results it will give confidence, and you will keep on feeling better about yourself…so imo, first try everything to make most out of a healthy life style, and if that all fails…then consider other options. so get out there, work out, take walks in the sun, eat and drink the way your body needs…

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9 ng/ml is terribly low for vitamin D and b12 could be a bit higher too.

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There is no range with the Vit D, but it would certainly be super low. Vit D is produced by your skin when it is direct contact with sunlight. Direct being the key word. You cannot be behind glass or wearing any sunblock if you want to make Vit D. The alternative is supplementing. It is significantly healthier to just spend time outside every day with your arms and legs exposed. Sunblock is the worst snake oil out there, it’s killing people with the full support of the medical community and just compounds our modern sedentary working in an office health problems.

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I noticed Sex Hormone Binding Globulin was absent from your testing, if a doctor is going to put you on TRT this would be the most important test to order. SHBG binds testosterone, estrogen, thyroid hormones and even insulin. The higher the SHBG, the more will be bound to this protein and the less that will be free and bioavailable in the bloodstream.

Your protocol should be based off SHBG levels, lower values should seriously consider more frequent dosing. Your doctor didn’t put much thought into your protocol, you deserve better care. The sad truth is almost all doctors are just as bad since TRT is unpopular in the medical community, most doctors will refuse to prescribe TRT even to those who have a legitimate medical need for TRT.

Clonazepam is part of the reason for my low testosterone diagnosis, was on it for 30 years and when I started tapering off all my problems began and 10 months after withdrawal ended, testosterone was 120 ng/dL down from the optimal ranges. Medications like clonazepam (tranquilizers) sedate pituitary gland function and cases harm to brain function over time.

We are all guinea pigs who take these medications never truly knowing what they will do to us over the long haul. I can tell you clonazepam is known to deplete vitamins and minerals during withdraw, keep an eye out of all levels. The end of the withdraw would see a depletion in iron and vitamin D and my doctors never said a thing because they only have a plan that includes going on these drugs not off and offer no help at all.

You have to take charge of your own health because your doctors will not do it for you, doctors are overworked and overwhelmed and this leads to misdiagnosis and half ass care where doctors spend little time devoted to your case.

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Thanks for the input everyone. So, the plan is to start doing some cardio and calisthenics and change the diet up, and see how I respond to that. Any particular recommendations on diet? Currently I’m planning on ramping up my fresh fruit and vegetable intake, and cutting out all processed/frozen foods and sugars. I don’t want to go super far with it so it controls my life, but I can certainly stick to healthy foods only easily enough.

Also, I called my doctor to ask if he could call in a Magnesium test for me. I was looking in to that, and I have a lot of the symptoms. Especially when it comes to neuropathologies. Also, my muscles twitch a lot. I would start supplementing now, but then I would never have a baseline for what it was before I started supplementing.

Vitamin D has been addressed. Last it was checked, it was ~60 and rising. I can attribute that to the nature of my work and just not getting out a lot. I take 5000 units daily.

While I’m doing all of this, I will work on saving up a couple grand strictly to use for Defy or some other private service to handle possible TRT therapy, if it comes to that. I feel like I could easily become overwhelmed managing my therapy on my own.

Are their any natural substances you guys would recommend I look into to help with my hormonal system? Also, very important – would it be reasonable to get my T tested 2 months from now, or is 8 weeks not enough for the injection i took to not have any influence?

Thanks again, you guys are great.
@systemlord @hardartery @mr.inquisitive @max74 @jimmy401

You should lift weight if at all possible. I’m not saying that because I’m a meathead, I’m saying it because it has way more benefits than cardio or calisthenics. You don’t have to go heavy, but squats and some chest/shoulder work will do you some wonders in terms of hormone release and use of minerals. Personally, I find that when my dopamine is really off (ADD) and I’m depressed, some stupid heavy lifting resets my brain and I’m a new man for a while.

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Thanks man. That is good to know. I will be sure to do that as well. I was hoping i could avoid a gym membership, I live out in the country. I’ll look in to getting a weight set.

So, do you happen to know how long it takes approximately for Test Cyp to get to levels in my system that won’t affect labs? I can’t find any information other than the half-life. Thanks

Test Cyp has a half-life of 7-9 days, so after 3 weeks you have negligible amount in your system but if you shutdown you won’t yet be making your own. If you did not shut down, you will be almost entirely natty levels at that point, but probably lower than you would be in a month or two.

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You want to do lab testing after 6 weeks.

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The past few days my ED has almost disappeared. My libido is higher than I can ever remember. To the point where it’s kind of worrying, only because I didn’t know what that was like! Needless to say my wife enjoys it, so now I’m wondering if I should just stick with it. Question: Would every guy on T see an improvement like this, or just guys that are in need? If I go 6 weeks to see if this is for me, would that be hurting anything? Sorry I am vacillating here, but now that I feel like I’m seeing results, it makes for some damn difficult decisions.
@systemlord @hardartery

The only guy that would see improvements on TRT is those had a testosterone deficiency which is very common in those with TBI’s and those on long term benzodiazepines. If low testosterone is caused by the TBI or clonazepam usage, you can forget about fixing things naturally. I figured this is what you meant by damn difficult decisions.

I would hate to see you throw everything simply because you cannot expect that you require TRT for life do to a TBI and/or 9 year clonazepam usage which either can cause low testosterone.

If I have to do TRT for the rest of my life, I have to do TRT the rest of my life. I guess I am looking for “permission” to to go forward with 6 weeks of treatment, and evaluate it then, as opposed to holding off and possibly wasting more time just exercising. I’m going to exercise either way. Will I ruin any chance there was of me naturally getting my T back up with 6 weeks of treatment?

Yes, you are correct regarding the difficult decision. It just kind of hit me today that I’m seeing great results already, where as before I was not expecting that.

You won’t ruin anything, and you might decide just to stay on. If fertility is an issue, it can be handles while on TRT.

I stopped TRT 5 weeks ago and already my natural production is producing testosterone, I had been on TRT for almost 3 years. Countless men have stopped after 10 or more years and restarted their test production.

I would think seeing great results would encourage you to continue, imagine where you’ll be in a year. Maximum benefits is 1 year, but you continue to improve for years. I can only imagine what the future holds for someone that always has optimal testosterone, can only imagine what you will look like at 70.

Two options

  • TRT which leads to a high quality of life, high sex drive, high libido and strong lean muscle and therefore strong healthy heart and physically fit.

  • No TRT which leads down a path to depression, anxiety, cognitive difficulties, difficulty maintaining erection, loss of sexual interest, general confusion, insomnia, personality changes.

So, I have been taking 50MG of Cyp every 3 days, which works out to ~500MG/month. I talked to my doc before doing this, and he was okay with it. I just got some labs back after roughly a month of therapy. I feel like these values could be higher, at least on the T side. Labs were taken on the day I was due for an injection, but before the injection.

All LabCorp
Total T: 443ng/dL (Range 264-916)
Free T: 13.3pg/mL (Range 8.7-25.1)
SHBG: 18.2nmol/L (Range 16.5-55.9)
Estradiol-Sensitive: (Results not yet in)

My doc seems to be willing to roll with my suggestions, so I’m going to call tomorrow and ask him if it’s okay if I double my dose - or is that too much? I am really surprised that it’s not higher. But in regards to my doc, he had no problem running these 4 labs on my insurance. He doesn’t know much about TRT but he is certainly willing to help where he can. The first question he asked me is how I was feeling when I saw him last week and that speaks volumes.

Initially, I had much more energy and I was thumping like a rabbit. That backed off the further I got from that initial injection of 400mg. I started doing 50MG E3D 2 weeks after the 400MG injection.

My mind is a lot more clear, I feel more interested in stuff. I feel better, for sure, but not all the way better, if that makes sense. It’s like, okay, patched the leak, now I just gotta add air.

Speaking of air, I feel like I am growing a baby, I went from 163lbs to 171lbs in no time flat, like a couple of weeks. I feel like it’s all water. I’ll go to sleep at 171, when I wake up, after I’ve peed through the night, I weigh 166-167.

Your thoughts sure would be appreciated on this. I will follow up with the E2 as soon as I get it.
Thank you @systemlord @hardartery

I would go up by half first. 75 mg every 3 days, and see where that gets you. 200 mg is a lot more than 100 mg, it isn’t linear.

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