T Nation

TRT Still Struggling (Belgium)


#1

End 2012 (34 years old) I had an orchidectomy ( basicly removing the right testicle because of cancer, seminoma ). After that I had a single Carboplatinum Chemo dosis).

Awful episode, but they reassured me everything would be fine, with 1 testicle. to make a long story short, I had a TT of 192 ng/dL and I felt like a 80 year old person, tired and old, without energy or ambition, and my erection quality was getting worse.

After that I have been on hCG monotherapy, bringing the value to a 380 ng/dL and a FT barely in range. I still didn't feel really good. Energy was a bit better, but I felt bloated and I still had Erectyle disfunction. Libido was still very low. Also very emotional. Movies made me cry all the time.

Before the cancer, I never had any problems. I'm 37 years young, and used to have a healthy sexual life. I recently have a new girlfriend. Luckily enough she is very understanding.

I started with sustanon, ( now 4 weeks )

Every week I use 125mg of sustanon ( half ampoule)
I use every week 750 IU of Pregnyl ( half ampoule ) I hate to have a shriveled up scrotum and testicle
I use nolvadex 10mg ED to combat the gyno.

When I used hCG monotherapy, I also used Nolvadex, suddently my erection was good enough, sadly enough this only lasted a couple of days.

However this was a light at the end of the tunnel,giving me a clue there is hope!!

Now I went to another endocrinologic docter today with the hope that he would prescribe me some Arimidex to combat the Estrogen E2.

Basicly he was laughing in my face. Said my erection problem has nothing to do with the Nolvadex / Estrogen. He said I should stop reading on the internet and that I should go with my girlfriend to the a sex "counceling". He said I better use some aspirines, that it will have the same effect...

He said he couldn't give me the Arimidex because it's not approved and would break down my bones. He said there were sientific studies proving this.

He wants to put me on hCG monotherapy again. I'm very reluctent to do this....

I am so mad right now, and a bit hopeless. I posted my latest bloodwork,

I'm sorry the format is a bit messed up, it's basicly my blood value, the range and my last recent blood value, on one line to compare.

Analyse Result. Eenh. Ref.W. V.waarde V.dat.

BIOCHEMIE
Proteïnes [2]
Albumine 45 g/l 34-48 48 30/01/16

ENDOCRINOLOGIE
Schildklier [2]
TSH 3.18 µU/ml 0.27-4.2 3.22 30/01/16
FT4 (vrij T4) 15.0 pmol/L 13.1-21.3 14.7 30/01/16
FT4 (pg/mL) 11.66 pg/ml 10.00-17.00 11.42 30/01/16
FT3 (vrij T3) 6.4 pmol/L 4.1-6.7
FT3 (pg/mL) 4.1 pg/ml 2.7-4.3
Hypofyse [2]
HCG + 15.9 IU/L 0.00-5.00 + 28.0 30/01/16
LH - 0.130 IU/L 1.70-8.60 - 0.259 30/01/16
FSH - 0.389 IU/L 1.50-12.4 - 0.822 30/01/16
PRL 7.04 µg/L 4.00-15.2 8.79 30/01/16
Steroïden [2]
Oestradiol + 60.5 pg/ml 27.1-52.2 28.5 14/11/15
Cortisol 295 nmol/L VM 172-497
NM 74-286

  498	04/04/15

Cortisol (µg/dL) 10.7 µg/dl VM 6.2-18.0
NM 2.7-10.4

  18.0	04/04/15

DHEA-sulfaat* 354 µg/dl 106-464 376(1) 14/11/15
Testosteron + 38.9 nmol/L 11.4-27.9 + 40.7 30/01/16
Testosteron (ng/dL) 1120 ng/dl 1170 30/01/16
SHBG - 18.1 nmol/L 18.3-54.1 19.7 30/01/16
Vrij testosteron (c) + 34 ng/dl 4.5-25 + 34 30/01/16
Androstandiol Glucuronide* + 23.50 ng/ml 3.40-22.00

Thank you for your input !!

This really makes the difference between being happy and having a good life, or having almost no meaning of life!

Kind Regards

Elmar


#2

You're going to have really hard time finding a mainstream medical dr who is knowledgeable enough or is willing to give you what you need to get better. You should be prepared to take matters into your own hands.


#3

Studhammer; I agree with your opinion. But how can I get my hands on some Arimidex? I want at least try if this is a solution to feel good.

I could kill somebody to have that good erection feeling again :slightly_smiling: ( just an expression; no roid rage).

Ordering with the internet? Is that possible without prescription to deliver in Europe?

Or how do you mean?

Thanks!


#4

Endo's can be the worst.
See the 'finding a TRT doc' topic.

On TRT, E2=22pg/ml. 80pmol/L is your target.
I do not see a problem at all.

SHBG is also good as expected with lower E2 levels.

I see FT that is over range high.

I do see a thyroid problem.
TSH should be closer to 1.0
fT4 and fT3 should be mid-range or a bit higher.
Please check oral body temps as per the thyroid basics explained thread.
Check GF's temperatures too.
Stickies are now links in the 2nd post of the 1st forum topic.
Thyroid problems can explain your symptoms.
Have you always used iodized salt? Your GF?

Gyno:
E2 and prolactin [PRL] do not explain gyno.

hCG half life does not support injecting once a week.

http://www.thyroidclub.be/documents/btcnewstrategybe.pdf

Belgium is one of the Western European countries in which no program of iodine-deficiency correction using iodized salt has been implemented, in spite of well-documented mild iodine deficiency.
http://www.eje-online.org/content/143/2/189.full.pdf


#5

First of all I want to thank the people a lot, that are giving me advice, this is priceless.

@ KSman; I will read and study before replying on the thyroid subject.

About, the Estradiol being normal, I think it's not, but maybe I don't understand. Because the above format is confusing, I will repeat it here more clear to read. My Estradiol is actually 60,5 pg/ml , not 22,5.

Albumine 45 g/l 34-48
TSH 3.18 µU/ml 0.27-4.2
FT4 (vrij T4) 15.0 pmol/L 13.1-21.3
FT4 (pg/mL) 11.66 pg/ml 10.00-17.00
FT3 (vrij T3) 6.4 pmol/L 4.1-6.7
FT3 (pg/mL) 4.1 pg/ml 2.7-4.3
HCG + 15.9 IU/L 0.00-5.00
LH - 0.130 IU/L 1.70-8.60
FSH - 0.389 IU/L 1.50-12.4
PRL 7.04 µg/L 4.00-15.2
Oestradiol + 60.5 pg/ml 27.1-52.2
Cortisol 295 nmol/L 172-497
Cortisol (µg/dL) 10.7 µg/dl VM 6.2-18.0
DHEA-sulfaat* 354 µg/dl 106-464
Testosteron + 38.9 nmol/L 11.4-27.9
Testosteron (ng/dL) 1120 ng/dl
SHBG - 18.1 nmol/L 18.3-54.1
Vrij testosteron (c) + 34 ng/dl 4.5-25
Androstandiol Glucuronide* + 23.50 ng/ml 3.40-22.00

Sorry for the confusing format I posted before, hope this visualisation is better,

Thanks again,


#6

Thanks for that.
1.0 mg/week anastrozole in EOD divided doses would be helpful...

but...

Were you taking a SERM or hCG for that lab work?
That can lead to high E2 sometimes, depends on dosing.


#7

Thanks for the very fast reaction KSman, indeed, i am taking a SERM, Tamoxifen (= Nolvadex )

Dose is 10mg ED, It was not clear for me before if this would influence the lab work. So the weak nolvadex estrogen could influence the result....

And yes also the hCG every week, 750IU on tuesdays, blood was drawn on saterday.

I am afraid stopping the nolvadex just for the bloodwork because of the gyno

I want to get my hands on some Anastrozole but dont know how yet. Have to figure it out


#8

When LH receptors are over stimulated T-->E2 can be very high.
Anastrozole cannot control T-->E2 inside the testes.

You should never take any SERM [Clomid, Nolvadex] stacked with hCG!

SERMs create/restore LH and LH+hCG is too much.

Stop one or the other. Sounds like it will be the hCG that is stopped.

This is explained in the stickies.


#9

We 're not allowed to discuss sources on this board but there are pharmacies in places like Thailand that you can purchase a number of products from with out a prescription. They ship discreetly to your home.


#10

KSman, I take the hCG because this way my testis and scrotum don't shrivel up. If not I get major atrophy. So, this way I think I have to stop the SERM and switch to Anastrozole. Does that makes sense? Then carefully dose and go from there.

Thanks


#11

I fucking hate doctors.


#12

I did read the sticky a second time about TRT, it stays a very good reference document.
I will order myself some anastrozole and start taking that in combination with the hCG and the sustanon.
Because my FT is fairly high, and I need an injection tonight, I'm thinking about lowering my 125mg (0.5 ml Sustanon dose to 0.4 ml, what would be exactly 100mg). I have a nurse that comes to my house to give me the injection, so I will ask her to dose carefully. This should help already lowering a little bit, the amount of Estradiol. Till I get the medication by mail. Hope this sounds smart.

Kind Regards, and thanks for the replies already,


#13

SERM's cause the pituitary to release LH/FSH and then there is no need for hCG.

When you stop talking both, E2 should drop lower.

If you stop the SERM, with lower E2, amount of anastrozole needed is a question.

When taking the SERM, you need to test: TT, FT, E2 and LH/FSH. If LH/FSH are high, you need to reduce SERM dose.

If SERM alone does not maintain testes, then something odd is going on.

Right now, I don't think that anastrozole could get you near E2=22pg/ml - 80pmol/L.