T Nation

TRT Not Raising T


#1

I've been lurking this site ever since I started trt about a year ago. It's been a great place to find answers and even help me talk with my dr without sounding just as ignorant as I am to all of this. So thanks.

To the problem. As started I've been on trt for about a year now. I started with the testim gel for 5 months and my T actually fell 40points. I'd read here that that can happen with the gels and to low of dose so I started injections. .5ml/200mg wk. I did that for about 6months and went on back for to the doc.

Only to see a 20point rise in T. Which is still 20 off of where I started. Now with the injections I have seen some help with the areas of the issues but I know that I'm not getting what I'm paying for here. I'm curious as to if this happens to others and what I might do next.

This month I've been put on 1ml/200mg wk but if this doesn't take my dr will lower my does and just call it good. Please help me.


#2

How long have you been hypogonadal for?

Two hundred mg per week is twice the starting dose for injectable T.

Not everyone has success with gels simply because of variations in skin.


#3

Sorry for the delayed response.
I’ve been having symptoms for a few years (maybe 5) hard to say to be honest as the signs weren’t clear at first. I didn’t start learning about test until about 6 months prior to starting my treatment 1 1/2 yrs ago ruffly.

I did start on gel as stated and moved over to injections once we found that it wasn’t working for me. I started at a 100mg once on the injections but again that was raised again, as I had little to no reaction. So here I am at 200mg and concerned, mostly due to the lack of reaction from my body but also that I’m receiving the negatives of the drugs and feeling much the same.

I’ve been unable to find anything online about anyone having this problem at the doses stated even here on Tnation. So hoping for at least some I site.


#4

You’re going to have to post all your bloodwork, so these guys can get an idea of what’s off.


#5

You should be injecting two or three times per week. A few guys are hype-metabolizers of T and 300/week seems to be what is often needed for these guys.

Have you read these stickies?:

  • advice for new guys
  • finding a TRT doc
  • protocol for injections

Inability to absorb transdermal T products is a symptom of low thyroid function, but your dose requirements may have been from - see first paragraph.


#6

I figured that would be the case. I will need to go get a copy as I can’t find mine. So far I have only receive standard testing, test, psa, etc. I can have my DR write me up for anything, and that’s one thing I would like some help with. I.e. what to ask for, and I would be happy to post that once available as well.

I was hoping for some Insight into why I might not be going up in T so that I could bring that to the table as well.

My T to start was 380
Gel 340
Cyp 360 @ 100mg


#7

Thanks for joining in KSman. I read the stickies there was a lot of info there and sorry for my lack of information. I will update as soon as I have it.


#8

Check body temperatures and read the thyroid basics sticky.


#9

I left my page up and my lady beat me to the read lol. I checked it out but I didn’t see anything on checking the body temp. What am I looking for and what’s the protocol on this? Hourly,daily,weekly,etc?


#10

I was also curious on the subject you mentioned about hype-metabolizers. Although I’ve never heard the term this seems extremely likely in my case, as I have this same issue with any medication I take. I’ve spoken with my doc on this issue in the past but he brought up nothing of this sort.
In your “protocol for injections” post you talk about a basic setup for people starting trt.

  • 100mg test cypionate or ethanate injected per week with two or more injections per week.
  • 250iu hCG SC EOD [every other day]
  • 1.0mg Arimidex/anastrozole per week in divided doses.

If indeed this was the case for me (hype-metabolizer) would this still work in my case?

I’m sorry for all the directed questions but I really wanna take some knowledge back to my dr and get myself straight.
Thanks for the help so far


#11

100mg/week injected is simply not enough for you.
And injection frequency has to be high because your levels might drop 3x faster.

Check thyroid function via body temperature:

Check oral body temperature when you first wake up. Should be 97.7+, 93.3 is a problem.
Also check for 98.6 mid-afternoon

This was in the sticky:
"""""""""""“
Testing your body temperature: Get an oral “fever” thermometer. Do not test in your arm pit. Do not test soon after you have been talking, panting, drinking, eating, screwing, training etc. Check your temperature when you wake up, before you get out of bed. 97.3 F or lower is definitely a problem indicator. Ideal would be near 97.7 F and could be higher. We have guys who are below 97! I have added to this a check during the mid afternoon to see if you are getting to 98.6; if you can’t get there, that is a problem indication.
”"""""""""""""

To find, in a page, ^F then search for 98.6


#12

Thanks for the info on the body temps.
So I definitely run low.
1st morning/evening
95.3am 96.7pm
2nd done just Incase
96.1am 97.7pm (highest this week)
So low function I’m assuming is a good place to start.
We did test on my lady she runs a fine temp @98.5 so it works fine.

After reading a good amount of info both here and on google I’ve pretty much found I have every symptom of hypothyroidism. Including inability to absorb meds (life long issue) and and not getting sick. haha thought that meant I was healthy but only been sick twice in my life outside of stomach issues which goes right along with thyroid problems. Or so I’ve read. You guys are incredible with the amount of info you can provide and I’m smacking my forehead for not posting sooner. Thanks!

I have a Drs appt next week and will go over above. I’ve been trying to go threw everything I can to put together a good list of what I would like checked. Please add any advice you feel necessary.

FT
TT
T4
TT4
T3
rT3
rT4
DHEA-S
B12
Ferritin
Vit-d25
Cortisol
Prolactin
Aldosterone
Estradiol
Progesterone
SHBG
Lipid panel
Full iron panel
TPOAb
TgAb

I’m gunning for a complete overview here. Thyroid focused obviously, but am I missing anything important.

Also have former blood tests. However they don’t cover much in the way of what I see asked for here.
CMP,CBC,TT,TSH (only after starting TRT),CRP, and antibody test. I’m more then willing to post but only if you fellas see it necessary as it’s a lot to write in.

Any help is greatly appreciated!


#13

You been using iodized salt long term? - I did not review earlier posts

FT
TT
fT3
fT4 [ do not need T3, T4]
rT3
DHEA-S
B12
Ferritin
Vit-d25
AM Cortisol - do at 8AM !!!
IGF-1 to check GH status - if in doubt
Prolactin
Aldosterone
E2 - Estradiol
Progesterone
SHBG
CBC
Fasting Lipid panel
Fasting glucose
Full iron panel
TPOAb
TgAb


#14

Thanks I will revise the list.
No I have yet to add that to the diet. I currently use Himalayan salt and not sure of the properties.
I don’t supplement either but figured it would be something I should check just Incase. Still very much a beginner to blood work, hormones, and pretty much anything that has to do with taking care of myself if I’m being honest.


#15

Well they’re finally in, and my TT finally went into a nice range.

Cortisol:--------- 11.6 6.2-19.4
Prolactin: --------7.9. 3.5-21
B12:-------- 1038. 243-894
DHEA-S -------213.1. 160-449
CHOL/HDL ---- 3.48. 3.5-5
RT3. ------------ 12.4. 9-27
TSH. --------- 0.77. 0.27-4.2
FT3. ----------- 3.5. 2.2-4
FT4.---------- 0.88. 0.93-1.7
Anti/Thyroglobulin 90. 0-40. ------this has me worried
TPO. ----------- <10. 0-34
Vit D. ----------- 64.9. 30-100
Iron. -------------- 87. 59-158
E2. ------------ 57.7. 7.63-42.6. ---- this is quite high yes?
Ferritin. ----------- 37. 30-400
Progesterone -----0.8. 0.2-1.4
IGF-1. ----------- 168. 84-313
TT. ---------------- 921. 300-1080
FT. -------------- 23.3. 4.8-25.7
SHBG.----------- 29. 16.4-55.9
Aldosterone------- 7.4 ng/dl

My overall Cholesterol was pretty low which surprised me being that my diet is kind of crap right now. And thought it goes up with TRT. Not sure it’s important but just Incase.
Lipid panel:
Cholesterol. 174. — 100-199
Triglycerides. 76. ---- 10-150
HDL. 50. ---- 40-59
LDL. 111. ---- 0-130

Looking forward to your thoughts


#16

Not getting sick is not a symptoms of thyroid problems. There are some very ridiculous things people pulled out of their behinds on the internetz.


#17

Thanks for your reply. I do not remember the source, but the way they described it was that your body gets sick but isn’t able to regulate it thus you don’t feel the symptoms when the body does take it on. I was not clear and it may still be bogus. I try to find medical sites for everything I’ve been looking into and I can assume this was the case here but may be wrong.


#18

Glad your testosterone is absorbing now. How long after the last injection was the blood drawn? Since your current TT=920 ng/dL is a bit higher than it strictly needs to be, you have some room for reducing the dose of T-cyp to reduce your E2, which is a bit higher than normal, though if you feel good I wouldn’t bother too much. If you do want to address E2, reducing the T dose (since excess T converts to excess E2) is preferable to introducing something like arimidex (lots of guys never feel good on arimidex, either because they can never dial in the right dose or perhaps because of intrinsic side effects of the medication itself, so I like to stay away it myself; other members here feel different about this).


#19

Regarding body temperatures, Bill Roberts has a different take on them. You can try to do a search for his comments on the issue on this forum.


#20

I had the test after about 12 weeks at the new dose 200Mg. The E2 could be the reason ive been getting so bogged down and i will be meeting my new endo. This friday. I am also hoping to get onto HCG to turn my boys baxk on as theyre telling a story all there own. So the cyp. Is going to have to be addressed anyway. Although itd be great to stay at peek its not a must as long as i can feel good at the level i end with.

From what ibve read 700+ is a good area but only time will tell. Ive been feeling pretty shity maybe even more so then before i started trt but there are a few things that could be to blame. Fingers crossed for a good apt friday.