T Nation

TRT help and Finding TRT Doc in Hampton Roads VA

Newbie here.
Labs (Quest) from recent physical show TT @ 219, explains lack of motivation, etc…
My doc put me on comid and wants to retest in 3 months. Seems like a long wait… Thoughts?
From what I’ve read thus far I’m thinking I need to find a doc that will write me a script( insurance reasons- I’m broke) for some more blood work ( FT or bioT LH, FSH and E2) Did I miss anything?
Then assuming THT is appropriate I need him to write a script for Cyp, hCG and arimidex. Correct?

I’ve read the sticky about finding a doc and I plan on asking my pharmacist and a urologist I know, but thought I’d ask if anyone already knew of a good doc in the Hampton Roads VA area.

Deets and other lab results:
TT = 219 (241-827)
TSH=.81 (.4-4.5)
PSA = .3 (0-4)
Albumin = 5 (3.6-5.1)

Age= 45
No baseline T
Back surgery 3y ago, decreased: energy, stamina, motivation, persistent sciatic like pain in right leg and pain in right teste since injury/surgery.
No ED but no morning either

Current scripts/supplements:
Lipitor - current t chol= 148 from 307 18months ago
Iodine supp
B-12
MultiV
Comid - 3 weeks in no change

:frowning:

Update:
Week 5 on clomid 50mg daily
Week 2 IR therapy

Doc just called with lab results from last week. Hopefully, my coy will show up today…

Results via phone:
TT = 894
FT =194
E2 = 99 (seems too high to me, thoughts)
FSH = 19.6
LH = 17.7

Will post additional dets and ranges when I get my copy from quest.

I feel 1000x better than I have in years!
I assume most of my improvements are from the higher T but I was also unable to reach 98.6 or anything above 98.0 before I started IR therapy, so I assume my low iodine was also effecting my mood and energy level.

I

Cut your clomid dose by half, or take every other day. Your LH/FSH is too high, T levels in your testes is very high and T–>E2 inside your testes is raising your serum E2 levels to E2=99. Note that taking Arimidex/anastrozole will not lower E2 effectively with this LH overload problem. Your LH receptors may also become desensitized. Your doc will be clueless about these issues.

Please read these stickies:

  • advice for new guys
  • thyroid basics
  • protocol for injections - you may end up there, seems like you have reached the same conclusion

What was your clomid dose?

Lipitor:

  • dose is too high, aim for 180, 160 and below are associated with increased all-cause mortality.
  • any muscle aches or soreness?
  • persistent cough
    – above can be from statin induced CoQ10 deficiency
    – take Ubiquinol form of CoQ10

[quote]KSman wrote:
Cut your clomid dose by half, or take every other day. Your LH/FSH is too high, T levels in your testes is very high and T–>E2 inside your testes is raising your serum E2 levels to E2=99. Note that taking Arimidex/anastrozole will not lower E2 effectively with this LH overload problem. Your LH receptors may also become desensitized. Your doc will be clueless about these issues.

Please read these stickies:

  • advice for new guys
  • thyroid basics
  • protocol for injections - you may end up there, seems like you have reached the same conclusion

What was your clomid dose?

Lipitor:

  • dose is too high, aim for 180, 160 and below are associated with increased all-cause mortality.
  • any muscle aches or soreness?
  • persistent cough
    – above can be from statin induced CoQ10 deficiency
    – take Ubiquinol form of CoQ10

[/quote]

Clomid dose was 50 mg daily, pills are scored so will break and try 25mg daily
Lipitor dose was 80mg daily, will switch to EOD
Cough, muscle ache and soreness =Yes , will start ubiquinol tomorrow to address def.

How long should I wait to redo labs?
Thanks

Ubiquinol from lef.org works well. Have seen someone fix cough with that, then they tried from GNC and cough can back.

Please ping me from the KSman is here thread so I can see how the ubiquinol works for you. It is not cheap. 50mg may work. My other guy takes 100mg, he is on high dose Lipitor, but so are you!

TRT may lower cholesterol to some extent itself.

Test DHEA-S and supplement if below mid range.

[quote]KSman wrote:
Ubiquinol from lef.org works well. Have seen someone fix cough with that, then they tried from GNC and cough can back.

Please ping me from the KSman is here thread so I can see how the ubiquinol works for you. It is not cheap. 50mg may work. My other guy takes 100mg, he is on high dose Lipitor, but so are you!

TRT may lower cholesterol to some extent itself.

Test DHEA-S and supplement if below mid range.[/quote]

Ubiquinol definitly helped cough, 100mg
Hard to contribute anything else to it…

Got my copy of my labs today:
Estrogens total 99pg/ml. Range 130 or less
LH 17.7 mIU/ml. Range 1.5-9.3
FSH 19.6 mIU/ml. Range 1.6-8
Testosterone Total 894 ng/dl. Range 250-1100
Testosterone Free 194 pg/ml. Range 35-155

Have cut clomid and lipitor to EOD 4 days ago, will recheck labs in 2 months.
Also feeling overly emotional, def think its the E!
Should I ask for an AI?
My doc is planning on leaving me on clomid, from what I’ve read this is not “ideal” what is my argument against this approach?
Thanks

AI cannot control the testicular E2, but would reduce E2 made elsewhere. You might be better off with a a research chem product. You think that you doc will be receptive at all to Rx? [google (research chemical anastrozole)]

I agree that E2 is kicking your butt. The lower clomid will help.

Great news on the Ubiquinol. You will be looking for a smaller dose of lipitor. Later, you can see if 50mg will work. Let me know if muscles improve too.

Those T numbers are great, but E2, FSH, and, LH are way too high.

If it took that much LH to get your T to that level you might just be better off with full TRT.

At your age it wouldn’t be bad to look in to.

Was your FSH and LH ever tested before clomid?

Just to be safe a prolactin test and checking adrenals while you are at it would be good.

ACTH
IGF1
Cortisol
Dheas

TSH
FT3
FT4

Vitamin D

[quote]Tunapancake wrote:
Those T numbers are great, but E2, FSH, and, LH are way too high.

If it took that much LH to get your T to that level you might just be better off with full TRT.

At your age it wouldn’t be bad to look in to.

Was your FSH and LH ever tested before clomid?

Just to be safe a prolactin test and checking adrenals while you are at it would be good.

ACTH
IGF1
Cortisol
Dheas

TSH
FT3
FT4

Vitamin D
[/quote]

No pre-clomid FSH LH

Looks like I’m a over responder to the anastrozoles. Was feeling ache, muscle pain yesterday, and today it’s twice as bad.
Going to stop AI for a week and try a 1/4 dose EOD

Ok, I’m getting a bit nervous. I stopped the AI 5 days ago and I’m still ache in all my joints. If I do anything physical 5 minutes later my joints/muscles burn.
Is it normal for it to take a while (days) for my E to come backup, assuming I’m an over responder? My E was 99 prior to starting the AI, on clomid EOD, is it possible or does it make sense that the AI caused my E to bottom out which is causing my joint pain?
Thanks

Hey, I too live in Hampton Roads and I’m looking for a doctor who knows what the eff he’s doing. I just went to a Sentara family medical place and talked with the GP there and explained my situation. All the normal symptoms: complete loss of sex drive, lethargy, general terrible mood and outlook on life etc. and asked to be tested for low-t. I’m 29 (30 in Jan) and in relatively decent health. I have some weight to lose but I lift 4x’s per week. As soon as I said low-t and lift weights, the Dr. wrote me off. I don’t look like a meat head. I’ve been training for a little over a year, ANYWAY…

I asked for the full up low-t tests and he screwed that up. The blood work I got back only had total T levels which was 360 which is too low for a normal 29 year old male. I have no other levels of anything to compare/provide. Where were you able to find a doctor who was willing to work with you? Did you see an endo? I’m wracking my brain trying to find a solution here and getting past step one is seemingly going to be a challenge. Best of luck!

Update been running .5 e3d Cyp SubQ with .125mg arimidex e3d. No hCG, doc not comfortable with it.
Latest labs:
Thy-.92mcU/ml
Test- 600 ng/dl
Thyrox-1.4 ng/dl
Psa- .483
Cortisol- 9.28 ug/dl
Pot-4.7
Sod-143
Chl-101
Glu-89
Cal-9.9
Alb-4.9
Sgpt -10
Sgpt-19
Alk ph-31
Blood urea-13
Carb dio-27
Creating-1
Gfr>60
Glob-2.4
A/g rat-2
Tot pro-7.3
Anion gap- 15
Pregnenolone -20ng/dl

Thoughts?