T Nation

TT = 3064, E2 <12... How Is This Possible?

Wow great call! I updated the lab post w/AST and ALT numbers while on TRT:

AST…17 (0-37) U/L
ALT…50 (15-60) U/L
ALP…126 (26-137) U/L

Elevated ALT and ALP. No more alcohol or Tylenol.

I do understand that normal T production stops while on TRT. I was asking about HPT feedback when not on TRT (i.e. before I started)… and if over-metabolizing T–>E2 could cause low T output. Clomid test shows that the testes can produce >700ng/dL of T, but E2 skyrockets.

Do you have any thoughts why the TT is low after being on TRT for 2 months? I’m injecting using a 29 gauge 0.5" needle into the side of the quad (vastus lateralis). Next ones might go into the deltoids or biceps as there’s more muscle definition there.

Adding HCG and a-dex EOD. I think 20 drops = 1ml, so 5 drops = 0.25mg.

I felt better within a couple of hours. Let’s see how the next few days go!

Update a month later…

Adding 250 iu HCG EOD reduces testicular pain and a little atrophy.

Setting the correct a-dex dose is challenging. Four drops EOD has excessive side effects the same day I take it. There’s a lot of digestive pain, like there is a gaping hole in my stomach. Coupled with that is bloating, and a constant feeling like I need to pass gas. Horrible, horrible feeling…

The lesson? NEVER TAKE TOO MUCH OF AN AI!!!

Current dose is three drops EOD, however that does not seem to be working out very well. My symptoms are very similar as to when I was not on an AI at all, and before I started TRT.

T-injections are at 60mg every 3.5 days, or 120mg/week. I’m using a #29 gauge 1/2" 0.5cc syringe. Perhaps this is not going deep enough into the muscle? Sticky says this size needle should work…

Either I am still not administering the injections correctly, or injections are not working… or the AI dose needs further refinement. Perhaps 2 or 3 drops ED?

I’m no pro but from what I read low E can feel very much like high E.

Without lab work it is tough but if your just looking for a thought.

Stop the AI for one week allow E to build and try again at a quarter of the dose and see how you feel. You may be an over responder

Get a good probiotic

You really should bite the bullet and get some labs

[quote]Master_P wrote:
Update a month later…

Adding 250 iu HCG EOD reduces testicular pain and a little atrophy.

Setting the correct a-dex dose is challenging. Four drops EOD has excessive side effects the same day I take it. There’s a lot of digestive pain, like there is a gaping hole in my stomach. Coupled with that is bloating, and a constant feeling like I need to pass gas. Horrible, horrible feeling…

The lesson? NEVER TAKE TOO MUCH OF AN AI!!!

Current dose is three drops EOD, however that does not seem to be working out very well. My symptoms are very similar as to when I was not on an AI at all, and before I started TRT.

T-injections are at 60mg every 3.5 days, or 120mg/week. I’m using a #29 gauge 1/2" 0.5cc syringe. Perhaps this is not going deep enough into the muscle? Sticky says this size needle should work…

Either I am still not administering the injections correctly, or injections are not working… or the AI dose needs further refinement. Perhaps 2 or 3 drops ED?

[/quote]

You definitely need labs or you’re just flying blind. I was flying blind due to my work schedule after trying a compounded cream, and it turned out I wasn’t even absorbing it.

Your 29 gauge 1/2" syringes are intended for sub cutaneous administration. Pinch your belly fat in the same way you should do your hCG shots and inject. This alleviates chronic muscular damage, although some report less “punch” with sub-Q shots. You can do it in the thigh fat as well. Also, some seem to be fast metabolizers of testosterone when administered sub-Q. 2x/week injections might work better if you do EOD injections. Just some suggestions. This is just speculation without labs to back it up.

Thanks for the replies guys. You’re right - labs are overdue after these changes. I will get them done.

One challenge is determining the time on a fixed hormone routine before getting BW. 2 weeks? 4 weeks? 6 weeks? If you observe a bad change and adjust a dosage/frequency, does the clock re-start to get valid data?

I’ve made small changes based on symptoms. I suspect that when E2 goes up, there’s lots of gas, feeling less “manly”, and if it gets really high - acne breakouts on my back/shoulders. Quite a bit of searching lead me to the conclusion that this was probably high E2.

Other symptoms I watch:

-AM oak (should be solid)
-libido
-digestive problems (appetite, bloating, etc.)
-concentration/focus during work
-feelings of drive/ambition… wanting to be my best vs. feeling apathetic
-memory
-fatigue

A-dex dosing is still challenging. Instead of 4 drops EOD and getting stomach pains, I do 2 drops ED in the morning. I am trying to adjust this to optimize the symptoms listed above with consistent test-c + HCG shots. This way, AI frequency/dose is the only variable.

Subject of needle size/injection site. This is what I was referring to:

Further searching helped me locate the vastus lateralis, and how to inject; however given the needle length, I’m unsure if the oil goes deep enough into the muscle to get absorbed properly.

As an experiment, this week I injected into each of my biceps, as there is zero fat there - so now I am quite confident that the oil is getting deeper IM. Hopefully T goes up, and I suspect E2 will as well.

I’ve also started adding ZMA at night too. My sleep quality the last two nights was very good.

Observation this week: My second test-c shot is Wed evening. Last Wed I forgot. On Thursday night I was ridiculously horny. Possibility is that E2 temporarily dropped to the optimal range.

Why are you trying to get in the muscle with a sub cutaneous injection?

The whole point is to not pole holes in your muscles, sub c is injected into the fat.

That is true. Before I go SQ, I need to research it further. Until then I’m sticking to IM with the smallest needle possible.

Reasons for using a smaller needle:
-less muscle damage = less pain/soreness and faster recovery
-higher injection pressure on delivery

From the stickies (see the section I quoted above), this needle should be the correct size/length at the quads, but in my case it may not be reaching deep enough… so either I use a longer needle (tough to find at this thin gauge), inject into a different muscle with less surrounding fat, or go SQ (discussed above).

Symptom note from this morning… morning oak was present but short-lived. Libido last night was present but weak. I’m already seeing concentration problems today. Suspicion is that the test-c from Sunday morning is absorbed, and E2 may be getting elevated. Still doing 2 drops a-dex in the AM. Will switch to 3 if it becomes necessary… but I need to figure out how long to stay on 2 drops.

My GP approved the BW. Maybe I should get labs drawn in the AM when I have massive oak and high libido to get an accurate baseline of my optimal E2 value??

The needle ur using is not for IM injections though and in the sticks he is referring to sub c,u understand that right?

After reading it again, I suppose it could be referring to SQ, although it is nebulous. Why specify the name of a quad muscle, if injecting into your gut is equivalent? SQ can be anywhere… it doesn’t need to be at the vastus lateralis.

Cause that’s where ksman likes to inject… No idea

Updated lab results - drawn on 8/2 around 9am (fasting)

Total Testosterone…3064…250 - 1100 ng/dL…H
Free Testosterone…1109.7…35.0 - 155.0 pg/mL…H
Estradiol…<12…0-39 pg/mL

FSH…1.0…1.4 - 18.1 mIU/mL
LH…0.1…1.5 - 9.3 mIU/mL

Total cholesterol…238…<200 mg/dL H
Triglyceride…111…<150 mg/dL
HDL cholesterol…29…>40 mg/dL L
LDL Calculated…187…<130 mg/dL H
Cholesterol to HDL Ratio…8.2…1.0 - 4.0 H
VLDL (Calculated)…22…5 - 40 mg/dL

So I’ve gone from getting very little T to ridiculously high levels, and now virtually no E2.
My liquid a-dex regiment for the past week was 2 drops ED in the morning. Assuming 20 drops/mL gives 0.1 mg ED, or 0.7mg/week.

Last week, I had really good morning oak from Tuesday through Friday (although it was a little weaker on Friday). The labs were drawn 2 hours after I woke up Friday. The goal was to see where my E2 levels are when morning oak is present.

This really high T level concerns me. Yet, I am not feeling angry, agitated, or like I’ll fly off the handle. My facial hair is not growing out at insane levels.

The HCG should stimulate LH activity, but that is not happening. I might have bought bunk stuff.

I am stopping all T injections and a-dex dosing for the time being.

HCG doesn’t stimulate LH, it simulates it. Your LH won’t increase when you use it.

There should be a huge banner at top of each page that reads “Low E2 will cause libido to behave similarly to high E2.”

At least you won’t be needing a bra with low E2, but it can affect you emotionally. It will crush your libido and make you cry, so always carry a handkerchief.

In other words it will kill your desire to rape and pillage. Well maybe not pillage.

Haven’t felt overly emotional at all. This afternoon I was started to get a little agitated with a co-worker, but it wasn’t that bad.

I’m also taking SSRI’s (noted on the first page) - Lexapro 10mg, Wellbutrin xl 300mg and Adderall 15mg. Those medications make it extremely difficult to break down in tears. I don’t know if a link exists between these meds and T or E levels.

The suspicion is that E2 will shoot up as T is converted, so perhaps I shouldn’t completely stop a-dex… maybe just wait another 1-2 days. If the bloating and gas returns, then try 2 drops EOD.

I don’t often post here, although I’ve lurked for years and have first hand experience, because I don’t have much to say that hasn’t already been said by the cadre of other well informed posters.

However, I don’t know if I’ve ever we’ve ever seen a TT level at 3,000+ on 125mg/weekly. I think that points to lab error (I’m unsure whether FT is an actual or calculated number. If actual, then that would point to a reliable lab result), or user error. What is the dosage of your Test C and how much are you administering?

Secondly, keep in mind the source of your AI. I’m assuming it’s from a research company because you mention drops. There is NO oversight in the manufacturing of these drugs. That’s not to say that I think they’re trying to poison their customers, but I wouldn’t always assume the chemicals are dosed properly, nor would I always assume they contain what the manufacturer says they contain.

Lastly, I sat down and read your entire post in one sitting. Your posts and methods come off as totally scattered. It culminates with you giving yourself injections in the biceps because you don’t understand that the VL injections called for are supposed to be SQ and not IM. Now, with TT levels that frankly I wouldn’t even trust, and taking an AI that may or may not actually be what the label says, you remark that you’re going to “stop all T injections and a-dex dosing for the time being.”

Take a deep breath, and double check your Test C dosing. Are you drawing the correct amount? Can you get an AI from a reputable source? I would rate an AI from an overseas pharmacy as more reputable than a research chem company, but you can come to a different conclusion. Is it likely that your lab results are correct? Can you confirm the results with another blood draw ASAP from the same or a different lab (eg Labcorp v Quest)? You’re dealing with multiple variables and changing them all at one time and it’s confusing the heck out of you.

Cheers.

<-------- Not an MD.

[quote]Dr. Pangloss wrote:
I don’t often post here, although I’ve lurked for years and have first hand experience, because I don’t have much to say that hasn’t already been said by the cadre of other well informed posters.

However, I don’t know if I’ve ever we’ve ever seen a TT level at 3,000+ on 125mg/weekly. I think that points to lab error (I’m unsure whether FT is an actual or calculated number. If actual, then that would point to a reliable lab result), or user error. What is the dosage of your Test C and how much are you administering?

Secondly, keep in mind the source of your AI. I’m assuming it’s from a research company because you mention drops. There is NO oversight in the manufacturing of these drugs. That’s not to say that I think they’re trying to poison their customers, but I wouldn’t always assume the chemicals are dosed properly, nor would I always assume they contain what the manufacturer says they contain.

Lastly, I sat down and read your entire post in one sitting. Your posts and methods come off as totally scattered. It culminates with you giving yourself injections in the biceps because you don’t understand that the VL injections called for are supposed to be SQ and not IM. Now, with TT levels that frankly I wouldn’t even trust, and taking an AI that may or may not actually be what the label says, you remark that you’re going to “stop all T injections and a-dex dosing for the time being.”

Take a deep breath, and double check your Test C dosing. Are you drawing the correct amount? Can you get an AI from a reputable source? I would rate an AI from an overseas pharmacy as more reputable than a research chem company, but you can come to a different conclusion. Is it likely that your lab results are correct? Can you confirm the results with another blood draw ASAP from the same or a different lab (eg Labcorp v Quest)? You’re dealing with multiple variables and changing them all at one time and it’s confusing the heck out of you.

Cheers.

<-------- Not an MD.[/quote]

Well said!!

Good post from Pangloss. I don’t post here much either but I would second this general advice.

First rule of anything chemically related—change only 1 damn variable at a time.

Second rule of anything chemically related—change only 1 damn variable at a time!!

You’re freaking out a little bit, and that’s understandable, but I would avoid changing everything up like you said in your last post about stopping all Test injections and AI. Don’t unnecessarily cause even MORE fluctuations in your hormone levels. Keep your test injections but do as Pangloss said and double check that you are pulling the correct volume out of the vial!! As has been mentioned numerous times, E2 levels affect mood as well as libido, etc. So the take home message from this is that moodiness, aggression, depression, etc. is a result of fluctuations in E2 levels, not necessarily very high T levels–in other words, you won’t Hulk out and go rage if you keep fluctuations minimal. If you did fly off the handle with high T for no other reason, every single person who ever ran a bodybuilding cycle would be a raging pile of homicidal rage with werewolf hair :). “Roid rage” is largely a myth, at least as far as testosterone itself goes (douchebags are douchebags, the whole “rage” thing is beyond the scope of this thread anyways). What you need to do is keep your head on and work the problem.

If you are not pulling the right amount out of the vial, or made a simple multiplication error, then you are in fact drawing waaaay too much and are essentially on an accidental cycle of Test.

I do not think if you got the HRT from a pharm company via prescription that they are mis-dosing their prescription drug–there are strict quality controls in place. This means either a) you are pulling the wrong amount out or b) you are intentionally cycling (not making a value judgement, but it changes the game a bit here).

Keep test injections the same but double/triple check the concentration the vial is at and how much you are pulling out and injecting. As for AI, consider halving the dose that had you at E2 = 12. An alternative consideration is that depending on the time that you dosed AI and how long you’ve been at that dose, you may not have reached a stead-state equilibrium concentration yet. Typically we consider 3-5 half lives as having reached steady state (Example—a prescription drug half live is 2 days, and you dose at 1 gram every day. This means that you reach equilibrium about 7-10 days later…ASSUMING you don’t change the amount or frequency of your dose! For every dose change there will be a time lag as blood levels stabilize to the new equilibrium—> this is why you don’t want to change things rapidly or change more than one variable at a time if you can possibly help it)

So in this alternative, you have changed your test injections and AI dose too recently (last week) to have reached a steady equilibrium and therefore see any sort of steady blood test result.

I am not going to give you any real specific advice, but perhaps think that if you still feel good currently–and you have morning wood–then perhaps you are doing ok. After all, the goal of therapy is to feel good :). I would still double check that you are pulling the right therapeutic dose for your injections though.

Thank you everyone for the replies. I appreciate everyone’s input in helping me get a grip, as I was really freaking out!!

Dr. P - thanks for taking the time to read my scatter-brained thread. I have ADHD. It’s an incredibly frustrating condition to manage. No matter how hard I try to focus, my mind quickly drifts away.

Aragorn - you raise a solid point w.r.t. changing one variable at a time. Question: What if the one change results in unbearable side effects before levels reach equilibrium?

I am confident that I’m pulling the correct dose. The syringe is 0.3cc. The test-c vial is 200mg/mL from a pharmacy. It is legit. I am drawing the full 0.3cc the syringe allows. That equals 60mg of test-c, taken twice a week, for 120mg per week.

The lab re-tested on Monday 8/5:
E2 <12pg/mL
TT 296… 250-1100 ng/dL
FT 61.6…35-155 pg/dL

Odd that the results go from 3000ng to 300 in ten days? Hmm…

This entire process has grown weary on me. I don’t mind the injections. It’s the constant struggle of balancing shit and dealing with side effects. My libido still sucks. That’s what I want to improve. I don’t believe exogenous testosterone is helping.

I think the next step is what I should have done initially - get off all the damn SSRI meds. This week I am stepping off Adderall. To help kick-start HPTA, I will talk to my PCP about clomid dosing for a few weeks.

[quote]Master_P wrote:
Thank you everyone for the replies. I appreciate everyone’s input in helping me get a grip, as I was really freaking out!!

Dr. P - thanks for taking the time to read my scatter-brained thread. I have ADHD. It’s an incredibly frustrating condition to manage. No matter how hard I try to focus, my mind quickly drifts away.

Aragorn - you raise a solid point w.r.t. changing one variable at a time. Question: What if the one change results in unbearable side effects before levels reach equilibrium?

I am confident that I’m pulling the correct dose. The syringe is 0.3cc. The test-c vial is 200mg/mL from a pharmacy. It is legit. I am drawing the full 0.3cc the syringe allows. That equals 60mg of test-c, taken twice a week, for 120mg per week.

The lab re-tested on Monday 8/5:
E2 <12pg/mL
TT 296… 250-1100 ng/dL
FT 61.6…35-155 pg/dL

Odd that the results go from 3000ng to 300 in ten days? Hmm…

This entire process has grown weary on me. I don’t mind the injections. It’s the constant struggle of balancing shit and dealing with side effects. My libido still sucks. That’s what I want to improve. I don’t believe exogenous testosterone is helping.

I think the next step is what I should have done initially - get off all the damn SSRI meds. This week I am stepping off Adderall. To help kick-start HPTA, I will talk to my PCP about clomid dosing for a few weeks.[/quote]

Valid question about the one change inducing horrid side effects. IMHO I would then change back immediately and wait for stabilization.

Well, E2 is very low, so that can be causing libido issues right there (see above on Pangloss I think, talking about how low E can mimic the symptoms of high E).

Now that we’ve ruled out use error :), my personal opinion is probably that you should reduce adex dose and/or increase the test dose. Obviously there are a number of problems here, but to my eye the most obvious are: 1) get adex dose sorted to get proper E2 levels (21 ish on your scale) and then 2) if that doesn’t help some of the libido issues, look at raising test levels to something resembling normal :). Obviously although I am academically educated on the subject I am not a doc, so grain of salt and all that.

Is Adderall the only other med you’re taking currently? Generally not prescribed as an SSRI… At any rate, I don’t tink stepping down with that at the same time as you are looking at adex doses is a big problem. I know I just contradicted myself, but it is highly unlikely to result in wild fluctuations. Still, I’d like to see some step down on adex before changing other hormones aside from adderall. Perhaps try 12 drops adex instead of 20.

EDIT–Wait, I am a bit confused on exactly what you are dosing adex wise…is it 3 ED for 21 weekly?