T Nation

What to Do Next? New to Low T Replacement


#1

Age 36
Height 5’11"
Waist 34"
Weight 214#
-Lots of body hair, a little patchy on facial hair
-Most fat is on my waist line. Was very skin up until 25 or so. Gain 60 pound in last 5 years.
-was diagnosed with anziety 4 years ago. But think it was other issues causing it.

  • took several different zoloft like drugs for anziety. Last used over a year ago. Currently on testosterone CYP IM 200mg every 14 days.
    -eat out alot but trying to eat better.
  • no training but work construction so up and down ladders all day.
  • testis hurt ocasanaly after sex but no fever
  • morning wood none existing since age 18
    Labs
    Before t therapy
    Tt= 251.70 range 259-836
    Tsh= 1.030mlu/l range .270-4.20
    Ft4= 0.96 range 0.78-2.19
    Very little testing before starting low t therapy

3 months after low t therapy and last day of 14 day cycle of course idiot says it is good…
Tt= 349.60 range 249-836
Ft= 80 pg/ml range 47-244
Bio available= 187.00 range 131-682
Sex hormone binding 17 10-57

I know i am missing alot… wondering what next step.should be. I feel better but still have low libido and election problems. I am thinking e2 needs test…


#2

Firstly, your protocol is terrible - one big shot every two weeks is ridiculous, but unfortunately is not uncommon.

Next steps - educate yourself by reading the stickies. In short, your need to adjust your protocol to inject twice a week, you need HCG to maintain testes, you need to measure and control estrogen, because it is AS important as T levels. I.e. You can have rockstar T levels but have no libido, no morning wood, and an inability to perform sexually because Estrogen (E2) is out of control.

You need to realize that it’s all on you - you’re unlikely to find a doctor that is really on point, so you have to take things into your own hands. You also can’t rely on anyone on this website or others to do things for you - you really must understand things and be willing to accept responsibility for yourself. You don’t need to be a chemistry or biology major - you just need a basic understanding of the hormones and their relationships etc.

For example - my clinic is just OK. They prescribe me the right meds, but the protocol is bad, and I was told to inject way too much T. These clowns don’t even include Free T on labs, nor do they check cholesterol, which is important to do. They DO a CBC, which is good. So I took matters in my own hands by:

  • getting educated
  • ignoring my doc’s protocol and going with the guidance in the stickies. For me this meant switching from one weekly 210mg dose of T to two doses of 67mg, totaling 134mg a week. Switching from twice weekly 500IU of HCG to 250IU EOD, and also modifying my anastrozole dose, as the dose they gave me crashed my E2 into oblivion leaving me a mess for a couple weeks.
  • doing my own blood work - every two weeks. Might be a little excessive, but it has help me dial in my dosage and correlate symptoms to lab numbers.

13 weeks on TRT now and I am starting to feel super good in all ways.

About the T Replacement Category1
Please read the stickies found here: About the T Replacement Category advice for new guys 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 bo…

Best of luck!


#3

FT4 is well below midrange. Last paragraph explains what you need to do to understand state of thyroid function.

With labs to weeks, results are useless as results are mostly a function of lab timing.

Doctors are the problem.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • 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.


#4

After reading suggested sticky… I am taking my temp and will post soon. I also forgot to put down some symptoms I have off and on.
Other symptoms

  • night sweets, these happen off and on. I wake up in the middle of the night sweaty and pillow and sheet moist but not soaked. Then have trouble going back to sleep. This started about 3 months after trt.
  • muscle tension and joint ache. I have always thought this was due to my anxiety… but not sure this is the case now. (Atleast this is what my doctor always said.)
  • sleep issues. I have found myself waking up more often in the middle of the night. This has been happening about the 3 month mark since starting trt. This also was part of my anxiety issue, but with the anziety I would wake up with racing heart and go into panic attack. Not the case here. Now I just wake up full of energy or wide awake most of the time it happens with the night sweets.

Again, I have read all sticky and have search this site about some of these symptoms. I have put an order in for arimidex today but am not for sure if I should get blood work on e2 first or wait and start arimidex then get blood work. Note: I will be paying for these test myself since my idiot does not believe e2 is affected by trt. I know that I should be looking for a different doctor, but I have not been able to find any one that seems to be a good fit and the one I have know atleast started me on trt. I have looked into men’s clinics and such and it seems they make you pay for all the stuff and turn it into your insurance after. I am not rich so it is tough to pay first and wait months for my insurance to pay if they even will. @KSman thanks for the advice.


#5

Update:
Thursday temps
Morning- 96.9
Afternoon- 97.9
Friday
Morning-97.2
Afternoon- 97.9

I relize these are low and have ordered Iodoral, i will start with the ir as soon as I receive it. I also recieved my Liquidex today… I think i am on the right track now. If I have missed anything please let me know @KSman