T Nation

TRT, Very Disappointed

hello, I’m new to the site and really don’t have much time to go through all the stickies. just way too much info to absorb all at once. I’m 47years old 5’10" tall and 216lbs. my protocol is:
1cc testosterone cypionate compounded with .5 anastrazole every week
50 units of hcg on day of testosterone injection and 50 units of hcg 3 days after injection. I’ve been on this protocol for a little over 3 months now and feel like shit. brain fog, fatigue and severe anxiety. my initial labs had my total testosterone at 220 and E2 at 7. 3 month follow up my total testostereone was 1350 and my E2 was at 18. I don’t know why i’m feeling so bad. i’m trying to figure out how to upload my labs.

sorry about the way the pics came out. I just figured it out. first pic of labs are my 3 month follow up. last 2 were pre trt treatment

Thyroid lab ranges are mostly useless.

TSH=2.84 is way too high, should be close to 1.0

  • This may be from not using iodized salt.
  • Your thyroid cannot work right without adequate iodine.
  • Please provide long term history of [not]using iodized salt.
  • Iodine deficiency often affect everyone in a home.

You might:

  • gain fat easily
  • have low energy and mood problems
  • have sparse outer eyebrows or generalized hair thinning
  • anxiety

When TRT restores metabolic rates, if thyroid cannot keep up, things can be unpleasant some times.

We can get a good idea about your overall thyroid status via oral body temperatures. Please post oral body temps, see below. This is very important.

We need doses in mg’s and iu’s. Potency per ml is not standardized. When you state 50iu hCG I suspect that that is “50iu” on an insulin syringe, 0.5ml which would be 500iu hCG if mixed to 1000iu/ml.

If T is 200mg/ml you are injecting 200mg once a week which would be too much. And weekly injections create high levels then low. So then your lab results are more determined by lab timing and are thus rather useless.

Please try:

  • Injecting twice a week.
  • Take 1/4mg anastrozole at time of injections
  • Inject hCG subq at time of injections
  • Always do labs halfway between injections to avoid lab timing artifacts in lab numbers.

Then new labs for TT, FT, E2 in 3 weeks.

Anastrozole is a competitive drug with T and needs to match serum T levels. Your doc does not think about that. So you need smoother T levels. Please inject T with #29 1/2" 0.5ml insulin syringes, subq, not IM, over upper legs, pinch up a mound of skin and inject into end of mound with needle parallel to muscle below. You can select a spot where you cannot see surface veins and press with a syringe cap, swab the spot then you can see where prepped and inject there. With upper legs you can see what you are doing. Avoid decades of IM needle damage to muscles.

More labs: - all energy and vitality oriented

  • fT3 - the only active thyroid hormone
  • fT4 - a reservoir for T4–>T3 conversion
  • please not T3, T4 or indexes etc which are obsolete.
  • AM cortisol - at 8AM or one hour after waking up.
  • IGF-1 to eval GH status
  • [Thyroid auto-immune panel possible later if indicated.]

Your T and E2 levels really suggest that you thyroid is holding you down.
Your in-range thyroid numbers makes your doc think that things are great or perfect! [insert rant].

Action items:
get explicit with your doses
get the oral body temps ASAP
throw out non-iodized salt
high potency B complex multi-vits with trace elements including 150 mcg iodine and 200mcg selenium in a men’s product which means that iron is not an ingredient.

The stickies have to be that complete and complicated because doctors are typically uninformed, apathetic and dangerous. Guys need to learn these things in self-defense. If things were different, there would be no need for this forum.

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
  • finding a TRT doc

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 and 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.

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K Sman, thank you so much for the incredible amount of information you provided. you were spot on with my dosing sorry about the mix up. problem I have with trying to change the protocol is that my anastrozole of .5mg/ml is compounded in my testosterone. so knowing this would it be ok to inject 100mg of testosterone twice a week. that should break the anastrazole dose in half correct? also, I’ve used iodized salt all my life so assuming that that is not the issue how can I get these thyroid issues under control?

Body temperatures needed and also read the thyroid basics sticky re stress and adrenal issues also noting “rT3” to see if anything might apply.

fT3 regulates metabolic rate via body temperature acting on and regulating mitochondria. CoQ10 from liver enables mitochondria, fT3 regulates. Statin drugs can lower C0Q10 a lot in a few individuals.

I do not agree with T+anastrozole compounded because anastrozole cannot be changed. WTF, why a need to eliminate an oral dose? There is really no need for that combination other than the fact that compounding pharmacies are not allowed to make what is commercially available. So they can’t really sell straight up T and need to mix something. So the motive may be $$$.

ok, I have some oral body temp numbers.
5am wake up 96.8 F
9am … 97.5F
12pm… 97.7F
3pm… 98.6F
4pm… 98.1F

I already ordered Iodoral 12.5 mg supplements for IR and a high potency B complex with 200 mcg of selenium and 150 mcg of iodine for maintenance. any recommendations on how long I should do the IR?

Numbers are decent if you can repeat 98.6

12.5mg twice a day for two weeks then 6.5 per week for maintenance.

I would like you to be getting selenium for 5 days prior to Iodoral. This will allow any inflammation to calm down. You could wait longer if you like as your body temps are quite decent now.

Please note that taking large amounts of iodine increases TSH as an expected reaction which is harmless. That makes TSH lab work of no value for a while.

You did not explain your history of using iodized salt.

I got some more oral temps for today.
8am wake up 96.6F
10am 98.0F
12pm 97.3F
3pm 98.1F
4pm 98.3F

iodized salt history:
as long as I can remember my family has used iodized salt. my family also owned a seafood distribution company in key west since I was 6 years old. I was raised on a heavy seafood diet including fish, lobster, shrimp, conch, octopus etc. until they sold the business in my early 30’s. I’m 47 now and don’t eat the amount of seafood I used to. I do from time to time use sea salt and Himalayan salt on certain foods but still use iodized salt for other things. I have also noticed that my eyebrows are very thin on the outer edges. I will be using iodized salt from now on.

Obviously everyone is different, but I’ve found that of my e goes below 22 I feel terrible, same symptoms as low T, with sweating and muscle cramps thrown in.
Libido will disappear, and Ed will be total.
Having T over 1,000 and e under 20 would wipe me out.

I need to take tiny amounts of an ai to stop that happening, if I took 0.5 I’d be lucky to be able to get out of bed!

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Thanks for your input.