T Nation

TRT, Enlarged Prostate, Seeking Advice

Wondering if any of you guys can offer any advice?
I am 37 yrs old and have been on TRT (125mg Sustanon per week) for around 2 years now.
I ended up turning to TRT after foolishly using Propecia (finasteride) and later Saw Palmetto to block DHT. This had disastrous effects and I became a heavily effected ‘Post Finasteride Syndrome’ sufferer.
I had every symptom of low testosterone (more like NO testosterone) along with a plethora of other symptoms that did not lift in over 4 years before I turned to TRT.
Propecia also left me Hypothyroid which I am treated for (t4).
It wasnt until I began TRT that I managed to start getting my life back. Although still not completely over the issues I had from this drug, over the last 2 years the TRT has enabled me to get my life back. I have regained muscle mass (lost 12kg before trt), regained my sexual health, and mental health is a lot better. TRT in fact saved my life if Im completely honest.
Anyway, I am now experiencing frequent urination, weak flow, and post urination dribbling. My GP here in the UK gave me the dreaded digit examination and told me my prostate was slightly enlarged and has given me Flomax. Which I am reluctant to take after all the sexual health issues i previously experienced.

I have been doing my research and it seems it can be caused by E2 not being controlled. previously I took 0.5mg of Anastrazole every couple of weeks. but my E2 numbers were always pretty good.
I have just ordered new blood tests to check my levels of T/E2 and am waiting on the results. since the test I have now upped my dose of Anastrazol to 0.5mg once per week just after shot. I have been doing this dose for 3 or 4 weeks now but the symptoms are not relieved.

Can anyone offer any advice at all? …

My huge fear now is that I will have to stop TRT and go back to the misery I was living in before it, due to this prostate issue.

You should aim for E2=80pmol/L

Do you have E2 labs?

‘Most’ would need 1.0mg anastrozole per week to get in that territory.

Some products that help the prostate would be useful.

Cialis is used to improve BPH in USA and Canada perhaps, but NHS is an unknown.

Anastrozole is competitive with E2 and serum levels need to match T levels. With one T injection a week, T levels are changing. Better to inject T 62.5mg twice a week and take anastrozole 0.5mg at that time so both can rise and fall together.

Some prostate issues are expected with aging and you should not be thinking that there should be none at all.

TRT will make a prostate healthier and larger than a T deficient prostate, but then it knows what it is doing. When T deprivation is used to shrink/whither a prostate that is simply a reaction to lower T levels and same would happen to a younger health prostate.

Thyroid: Many?most who come here are hypo to a small degree and most times it is from iodine deficiency. In USA iodized salt is available, in Canada all ‘table salt’ must be iodized. In UK one can find iodized salt in a few shops. So you are on T4, see below ‘oral body temperatures’ to see what your thyroid function is now. There is only one active hormone, fT3 and often not tested at all. And some on T4 meds have poor T4–>T3 conversion. Your body temperatures can be a thyroid med dosing guide.

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

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
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Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re Thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number Aand ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


Firstly, thank you kindly for showing interest in my issue and replying to my post. It is your posts amongst others that inspired me to ask for advice on this forum.

Here is the new guy info I missed out:

Age: 37 Height: 5"9 Waist: 33" Weight: 80kg

Facial Hair: Full beard
Body Hair: Everywhere! Back, shoulders, chest, stomach & Male pattern baldness

Fat is around waist mostly.

Health conditions : Hypothyroidism, Low T (both post finasteride)
Drugs: Levothyroxine (t4) - 100mcg / 75 mcg alternate days
Sustanon 250 - 125mg every 7 days
Anastrazole - 0.5mg per week

Diet: Paleo diet (with some white potatoes and small amounts of dairy) through the week, with cheat day on sunday. Drink alcohol 1 “night out” every 2-3 weeks.

Training: gym 3 times per week, 30 mins cardio followed by 30 mins lifting.

Night time/ Morning wood: present but inconsistent currently.

Most recent labs from 12.02.2018, taken 7 days after my T injection and at around 2pm in the afternoon.

Test Patient Result Normal Range Units Comment
Liver Function
Albumin 41.9 35 - 52 g/L New range
Oestradiol L <18.4 41 - 159 pmol/L
Testosterone 15.5 8.64 - 29 nmol/L New range
SHBG 28 18.3 - 54.1 nmol/L New range
Free Androgen Index 55.4 24 - 104 Ratio
Free-Testosterone(Calculated) 0.358 0.2 - 0.62 nmol/L New range
Prolactin 228 86 - 324 mU/L New range
Cortisol (8-10am) L 151.0 166 - 507 nmol/L New range
Progesterone 0.2 Follicular 0.181 - 2.84 nmol/L

                                                                 Male <0.474

Then my last Thyroid test results were from Aug 2017…

TOTAL THYROXINE(T4) 109 nmol/L 59 - 154
FREE THYROXINE * 23.4 pmol/l 12.0 - 22.0
FREE T3 4.2 pmol/L 3.1 - 6.8
Thyroglobulin Antibody <10.0 IU/mL 0-115

Method used for Anti-Tg: Roche Modular

Thyroid Peroxidase Antibodies * 63.6 IU/mL 0 - 34

Thyroid microsomal antibody assays using
semi-quantitative agglutination titres are no
longer available, and the more specific and
quantitative assay for antibodies to thyroid
peroxidase will now be the only assay used.
These assays are clinically equivalent and have
been offered in parallel for several years.

REVERSE T3 * 40 ng/dL 10 - 24

would love to get your opinion on these numbers and how they relate.

Very interesting you mention Iodine. I had a brief and almost complete recovery when experimenting with iodine (after reading DR Brownsteins book) in 2014. I used 12.5mg of Iodoral for a couple of months, I used some selenium alongside, but everytime i took the selenium i felt like crap again and was beginning to feel great on Iodine alone. This resulted in me avoiding the selenium for the most part.
Anyway, just as I was starting to feel a near full recovery from the iodine, My thyroid swole up and I had to stop. I am interested in trying again, but so far everytime I have tried a very small amount i have swelling in my throat after a few days. very frustrating, as for a while in 2014 it really felt like it was getting to the route of my issues.
After discontinuing the iodine all of the sypmtoms returned. some worse. and that was how I stayed until I turned to TRT years later.

Hi Wez, I’m UK too, South England. I’ve got a couple questions, please

Does your doctor prescribe Arimidex & if so was it difficult to get it prescribed?

Does your doctor test for E2 or do you get private tests yourself?

How difficult was it to get the Sustanon regime & do they allow you to self inject?

My GP wrote to the local endocrinologist & the options were Testogel or Nebido (testosterone undecanoate) once per 12 weeks :open_mouth:


Hi Meeseeks,

I had the same experience with the NHS. Eventually I gave up and now pay privately for my TRT treatment. This includes paying for all meds and tests.
It is expensive, but I fear the restrictions of the NHS would always mean sub standard treatment.

If you need any more info, maybe send me a PM (is that possible on this forum?)
as to not de-rail the thread too much.

Thanks for your reply :slight_smile: There aren’t PMs on the forum.

I’ve not been able to add my email address either.

I see, if theres a way to chat off the thread Im happy to discuss my experience with you.

@wezman please see my thread and let me know if we had some similar side effects

Happy to hear your doing well