T Nation

Winny for TRT?


#1

Haven't been here in quite some time but I need your recommendations and insights for my latest labs please. I Finally recieved copys of my last test results.
,
My TRT protocal since mid April has been ;

.2cc test c 200mg EOD. =.7cc wk = 140mg/ml
250 ui HCG EOD. = 875ui wk
1 graim Westhroid daily
1 graim Phentermine daily

Dr prescribed changes (Recieved meds today)

1 Testosterone Cypionate 200mg/ml. 1.5ml/wk IM-----(Too much?)
2 HCG 1 500units/2x wk SQ -------------------------(Too much?)
3 Anastrozole 1cap/eod PO -------------------------(too much?)
4 Stanozolol 50mg 5troche/wk under tongue----------(Dangerous? check my hemo)

Fasting am 8/21/09

glucose,serum -----------------97 mg/dl -----65-99
bun----------------------------13----------- 5-26
creatinine---------------------.94
Sodium ----------------------136 mmo1/L --- 135-145
Potassium ---------------------4.9 --------3.5-5.2
Carbon Dioxide----------------- 21----------20-32
Calcium -----------------------8.7 mg/dl---8.5-10.6
Protein ----------------------6.1 g/dl----6.0-8.5
Albumine-----------------------3.9 --------3.5-5.5
Globuline----------------------2.2---------1.5-4.5
A/G ratio----------------------1.5----------1.1-2.5
Bilirubin total----------------0.6--------- 0.1-1.2

Lipids
Cholesterol ------------------245-- H---- 100-199
triglycerides -----------------71 ----------0-149
HDL Chol ---------------------28 ---L------- >39

Thyroid
TSH --------------------------1.350 -------0.450-4.500
T4 ----------------------------5.4-------- 4.5-12.0
T3 Uptake--------------------- 32----------- 24-39
Free thyroxine index---------- 1.7 ---------1.2-4.9
Free T3 3.3 2.3-4.2
Immunoassay
Prostate 0.4 0.0-4.0

insuline-like
growth factor I --------------79---- L ----81-225
Testosterone ----------------1752--- H ----241-827
Free T---------------------- 28.2--- H ----7.2-24.0
LH --------------------------<0.3--- L ----1.5-9.3
FSH------------------------- <0.3 ---L-----1.4-18.1
Sex horm binding --------------54 ---------23.0-116.3
Estradiol--------------------- 90 ---H ----0-53

I had been feeling so well that I hadn't donated any blood (high hemoglobin) since 3 months ago but did go again the day I had this test drawn.

CBC

WBC --------------------------------8.7-------------- 4.0-10.5
RBC -------------------------------5.69 -------H------- 4.1-5.6
Hemoglobin------------------------ 18.1------- H -------12.5-17.0
Hematocrit------------------------ 55.1 -------H -------36.0-50.0
MCV -------------------------------97 ------------------80-98
MCH -------------------------------31.8 ----------------27-34
MCHC ------------------------------32.8 ----------------32-36
RDW -------------------------------14 ------------------11.7-15
Platelets------------------------- 221----------------- 140-415
Neutrophils----------------------- 4.8 -----------------1.8-7.8
Lymphs---------------------------- 2.9----------------- 0.7-4.5
Monocytes -------------------------0.9 -----------------0.1-1.0

I'm thinking I should set a different protocal. The one he recommended sounds crazy to me.
Any suggestions? Should I follow his script?

What about.

.5cc test C a week
850ui HCG a week
.25 Anastrozole EOD (how could I split the caps?)


#2

REduce T doages to 120-130 a week
keep hcg 250 ius 2 times a week
keep adex .25 E3D

Retest 6 weeks
check on changes of thyroid and also cortisol levels as well

Pm me if you want to get this taken care of the right way LOL


#3

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#4

Ok Hans How about this? I will follow your suggested protocal for 6 weeks. I will then contact you in six weeks or so about getting the labs done and setting an appointment.

Do you have concerns about me using the Westroid?
I have concerns about my body temp falling again. It was at 95 before I started it. Now it hangs around 97.


#5

Hey CC,
Am I the only person to see your RBC, Hemocrit, and Hemoglobin were high? How about you go donate blood as soon as possible before you get anymore labs done? It looks like you may be headed for trouble regarding your blood pressure... Just my .02


#6

Back in April I was put on BP meds. I donated blood Started the posted protocals and within 2 weeks was able to give up BP meds. Since then it has been right on. I should have been donating more often and will do so from now on. Thanks

The RBC and Hemos are why I was shocked when the "clinic" scripted me the stanozolol.


#7

No doubt BBB Affording the benefit is anouther story but I'm playing the lottery now so wish me luck. :<)


#8

I would also be concerned about your lipids.
Lipids
Cholesterol ------------------245-- H---- 100-199
triglycerides -----------------71 ----------0-149
HDL Chol ---------------------28 ---L------- >39

You have high total colestorol and really low HDL(good colestorol)
these are all signs that you might be headed for heart disease.


#9

First time ever my HDL has been low. Gotta think my T count (1752) has something to do with it.


#10

Sent the following email to my clinic

Could you check with the Doc to see if he meant for me to get Danasol instead of Stanozolol considering my hemo numbers?
(RBC -------------------------------5.69 -------H------- 4.1-5.6
Hemoglobin------------------------ 18.1------- H -------12.5-17.0
Hematocrit------------------------ 55.1 -------H -------36.0-50.0 )
I would think that Stanozolol would be very dangerous for someone in my condition. Would the Pharmacy offer a refund or exchange?

Here was his responce.

"Stanozolol is strictly used to lower SHBG levels. You just gave blood for this bloodwork so all of your levels below RBC, Hemogolobin, and Hematocrit --are all back w/in range..that is how you get those #'s low. So they are fine. Testosterone is what increases these #'s anyways..the stanozolol does not."

Your all set --just listen to the dr. and you will be much better.

In Good Health,


#11

Re: Found this about Stanozolol


Stanozolol administration and dosage depends largely on what your reasons for taking it are. While intravenous method has an obvious edge, the oral version also has some advantages. For instance, it has been noted that the oral version may bring about a synergy of the drug with other steroids in the body. One such steroid is the Sex Hormone Binding Globulin (SHBG), which is a glycoprotein that the liver produces and which binds itself to testosterone and then makes it biologically unavailable to do the things we would like it to do, such as building muscle. Thus (SHBG) prevents testosterone from exerting its anabolic effects. So a very normal desire would be to counter this by lowering our (SHBG). Not surprisingly you can achieve just that by taking winstrol orally. Experiments have shown that an oral dose of Winstrol as low as 0.2mg/kg has been shown to lower the (SHBG) by 50 %.


#12

Sex Hormone-Binding Globulin Response to the Anabolic Steroid Stanozolol: Evidence for Its Suitability as a Biological Androgen Sensitivity Test*

http://jcem.endojournals.org/cgi/con...ract/68/6/1195

Also found

As discussed in the opening section of this book, the oral use of Winstrol depot (Stanozolol) can also have a profound impact on levels of SHBG (sex hormone-binding globulin). This admittedly is characteristic of all anabolic/androgenic steroids, however its potency and form of administration make Winstrol depot (Stanozolol) particularly noteworthy in this regard. Since plasma binding proteins such as SHBG act to temporarily constrain steroid hormones from exerting activity, this effect would provide a greater percentage of free (unbound) steroid hormone in the body. This may amount to an effective mechanism in which Winstrol depot (Stanozolol) could increase the potency of a concurrently used steroid. To further this purpose we could also addition Proviron (1 methyl-dihydrotestosterone), which has an extremely high affinity for SHBG. This affinity may cause Proviron to displace other weaker substrates for SHBG (such as testosterone), another mechanism in which the free hormone level may be increased. Adding Winstrol depot (Stanozolol) and Proviron to your next testosterone cycle may therefore prove very useful, markedly enhancing the free state of this potent muscle building androgen.



#13

Why does he want to lower the SHBG? Oxandrolone also lowers SHBG, but this causes a more rapid excretion of testosterone, resulting in lower testosterone and lessened libido

Low sex hormone-binding globulin and testosterone levels in association with erectile dysfunction among human immunodeficiency virus-infected men receiving testosterone and oxandrolone.
Wasserman P, Segal-Maurer S, Rubin D.

Infectious Disease Division, Department of Medicine--New York Hospital Queens, Flushing, NY, USA. pjw9003@nyp.org

INTRODUCTION: Men with acquired immunodeficiency syndrome (AIDS) wasting and hypogonadism are frequently treated with testosterone and oxandrolone, an orally administered anabolic-androgenic steroid hormone. We observed reductions in testosterone and sex hormone-binding globulin (SHBG) levels, in association with complaints of erectile dysfunction, after prolonged exposure to this therapeutic regimen. AIM: First description of an association between long-term receipt of oxandrolone with erectile dysfunction, low SHBG and testosterone. METHODS: Case report of three human immunodeficiency virus-infected hypogonadal male patients receiving treatment for wasting syndrome and hypogonadism, and highly active antiretroviral therapy. All three patients received long-term oxandrolone in addition to testosterone replacement therapy. RESULTS: Testosterone and SHBG levels for patients 1, 2, and 3, respectively: total testosterone 183, 71, and 151 ng/dL (260-1,000 ng/dL); free testosterone (not done for patient 3) 58.3 and 26.9 pg/mL (50-210 pg/mL); SHBG 6, 9, and 6 nmol/L (7-50 nmol/L). No other hormonal abnormalities were detected. Following discontinuation of oxandrolone, levels of total testosterone rose, consistent with increase in SHBG. One patient received repeat SHBG assay documenting rise in SHBG level. Patient 2 reported return of libido and early morning erections several weeks after discontinuation of oxandrolone. CONCLUSIONS: Patients had erectile dysfunction in association with low testosterone and SHBG, in spite of exogenous testosterone replacement. Discontinuation of oxandrolone led to the normalization or improvement of testosterone levels in all three patients with symptomatic improvement in one patient. First pass metabolism of orally administered oxandrolone may decrease hepatic synthesis of SHBG, allowing exogenously supplied testosterone to be excreted. Further work is necessary to elucidate the relationship.

PMID: 17961146 [PubMed - indexed for MEDLINE]

#14

"Why does he want to lower the SHBG?"

I'm not sure . I have read that the optimum level was around 25? All I was told was (from his email)

"Stanozolol is strictly used to lower SHBG levels. You just gave blood for this bloodwork so all of your levels below RBC, Hemogolobin, and Hematocrit --are all back w/in range..that is how you get those #'s low. So they are fine. Testosterone is what increases these #'s anyways..the stanozolol does not."

Your all set --just listen to the dr. and you will be much better.

I did donate blood at the Red Cross but not until I saw the labs.


#15

Oh. I need to do some reading on that. I just noticed your SHBG is right smack in the middle (not high at all) of the "norms", but I do realize optimal levels may not be the "norm".


#16

The test they use for igf-1 is a screening test (somatomedin-c), it's not indicative for growth hormone therapy. You can actually have a normal range but still be deficient for GH, like I said a low score doesn't mean you need GH but that they should consider further testing to see if you really are. Testing to determine a real GH deficiency, oral glucose tolerance with measurement of GH suppression, basically putting you into insulin shock and checking GH levels.


#17

Doc probably wants FT to go to mid 30's. Lower SHBG would do that. Stanozolol will lower SHBG and does that better oral vs injected suspension. It is liver toxic. So for TRT, continuous use, that can be dangerous. 0.2mg/kg/day [yes, low dose] will typically reduce SHBG by 50%. This drug can lower HDL which is already too low, and can also increase LDL.

Your high E2 and lowish SHBG is a bogus combination. Something is not right with the labs.

Your hematocrit contradicts increasing T.

You need some high dose B-vitamin multivits. Niacin, folic acid, B-12 and others will increase HDL. Take 5000iu vit-D per day, find oil caps that are bigger than 1000iu each. Take fish oil.

Low TSH, hypogonadism and low IGF-1 could be indicating some general problems with the pituitary gland. Any blows to the head or accidents? Any changes to peripheral vision or visual field? Might need a MRI.

Get DHEA-S tested.

Testing LH and FSH when on TRT is wasteful, stupid or simply running more labs to make more money.

Use anastrozole to lower E, do not increase T and do not use Stanozolol. See where SHBG and E2 go after you get serum E2 near E2=22pg/ml. Try 0.5mg anastrozole EOD. Test in 4 weeks then adjust dose again. Find dose change formula or PM me.

Review Rx and OTC drugs [and alcohol] for impact on P450 enzymes which increases E2 levels.

Get E2 under control and might need to reduce T dose.

Stay with 250iu hCG EOD. A higher dose will increase E2. Read "Protocol for Injections" sticky.


#18

Thanks KSman, No problems with vision (other than my arms got to short) No alcohol and no major head trama.

Dr suggested changes
1 Testosterone Cypionate 200mg/ml. 1.5ml/wk IM
2 HCG 1 500units/2x wk SQ
3 Anastrozole 1cap/eod PO
4 Stanozolol 50mg 5troche/wk under tongue

KSman suggested
.2cc test c 200mg EOD.= . which totals .7cc a week average.
250ui HCG EOD
0.5 anastronzolol EOD

JanSz suggests:
change to 0.18cc--->126mg/week)
250 ui HCG EOD.------(keep as is)
1 graim Westhroid daily(replace with 50mcgCytomelT3 + one drpper full of Lugol's solution)

Hans suggests:
REduce T doages to 120-130 a week
keep hcg 250 ius 2 times a week
keep adex .25 E3D
Retest 6 weeks
check on changes of thyroid and also cortisol levels as well

With no objections (I'll be the guinue pig) my new protocal for the next few weeks untill I get new blood work will be.

0.1cc test c 200mg-- EOD= ,35cc/70mg a week
10 units/syringe hcg EOD = 250ui / 875ui a week
.25mg Anastrozole -- EOD-
0.25mg Stanozol----EOD
1.0gm Westroid-----daily
1 gm Phentermine -daily

Plus the OTC supplies on hand.
1000iu D-3---------daily
1000mg Fish oil------daily
B-complex Sublingual daily


#19

JanSz: updated recommendations.


Somehwere here, on one of the slides I guess:
musclechatroom.com/forum/show...6&postcount=14
I found speculations on SHBG binding T & E2

Double whammy of high SHBG levels.
It accelerates, it becomes more exponential rather than linear
At given level of SHBG proportion/affinity of T/ E2 changes.
At higher levels of SHBG more T is bound, more E2 floats free.


So when in vicinity of ideal condition, call it
SHBG=20, E2=20, TT=1000

SHBG=60, E2 more than 60, TT more than (what!!) 3000

I wish someone would come with chart for E2/SHBG, similar to T/SHBG chart

Your SHBG=54, E2=90, you still need to knock E2 down, but easy does it.


This is a long way of saying that your doctor may be right when he asks you to do very high weekly testosterone dose.
But I still have a problem with once a week injections.
If you are looking for a change, change to daily injections instead of EOD.
I am afraid of Stanazol, mostly for what it will do to your blood and lipids.
I would give a ample time for this very high testosterone dose to work its way thru, good chance that it will push SHBG down.
Doc wants you on 300mg/week=300/7=21.4unitsED(EveryDay), make it 21units.
But my first choice would be if you stay on present 20units/EOD=140mg/week-average

About Arimidex.
First, you need to have high E2, just for the sake of getting your FreeE2
second, if you push E2 down (with Arimidex), you are not only going to have to little of FreeE2 but your low estrodial will be asking SHBG to go up.
This is last thing that you need.
=================================== ==================

With this high dose of Testosterone, you will be on a (small) bb cycle.
But, you will be using HCG
so you should be all right.
Make (twice) sure that your HCG is always fresh.
Make sure that you do phebotomies more often than you did so far.
================================== ==================


#20

Latest directions from Drs office

  1. the best route to get free testosterone levels up is not to increase amt. of testosterone necessarily. Reason being --the increase of testosterone will increase your Hemoglobin, Hematocrit, RDW, etc...Also increase estrogen levels being you are putting more testosterone in your body that your body cannot process and use. The proper way to get free testosterone level up is to lower shbg levels. Stanozolol is used to do so -- and there are no negative side effects when using the stanozolol for this situation.

Of course like anything else --if your shbg level was already low and you used major amt. of winstrol --there can be some mild side effects..but in your case....there will be no negatives at all. We see this situation all the time ..this is the reason Stanozolol is FDA approved and prescribed by physicians every day!!!

  1. I understand your frustration reguarding finding a dr. who specializes in this and you can find the proper treatment from just one physician. Dr. P is the best dr. ive ever had the opportunity to work with..Ive been in the industry now for 10 years and we have thousands of patients ---he does a great job and understands the doses and where levels need to be.

Every patient i deal w/ has 100% positives to report..never any negatives. I guarantee to you --if you follow his instruction at all time --you will see dramatic improvements in your health, & we will do follow up labs to show you the improvements...Ive worked w/ probably 15 different dr's over the years..Dr. P is by far the best!!!

Follow the exact protocol and you MUST stay consistent w/ it.
Testosterone: Take 1.5ml. per week. (same day of every week).
Anastrozole: Take 1 pill every other day.
Stanozolol: Take 5 per week. (2 days you do not take ---do not make consecutive) *take wed and sun. off for example is perfect.

HCG: Take 500units of hcg on days 5 & 6 following test inj.
*All 4 of these med's are supposed to be taking together.!! This is a 10 week supply. Once shbg levels are low --you will not need to take as much testosterone to increase your free testosterone level ---so dr. P planned to lower to 200mg per week of test.

*When taking stanozolol --makes sure you are taking hcg and testosterone and anastrozole consistently. So if you didnt start it..you need to complete it --but if you run out of test, hcg, arimidex 1st..you need to re-fill those med's..never want to take stano alone....

This is all we specialize in....I promise you success and better health..i see it every day w/ follow up labs..but consistency is everything and you must must follow the rx instruction!!!!