Was put on Androgel 5mg daily, felt nothing for a month, then started injections, Test Cyp 100mg weekly. Have done 2 shots so far…nothing, no response at all. Bloodwork done before starting shots:
Thyroid: T3 Free: 2.1 (1.2-4.9)
T3 Uptake: 32% (24-39)
T4 Total: 6.7 ug/dL (4.5-12.0)
TSH: 2.295 uIU/mL (0.350-5.500)
Comments: Adult TSH concentrations below 5.5uIU/mL do not rule out the presence of subclinical hypothyroidism.
CORTISOL: 7.5 ug/dL (3.1-22.4)
ESTRADIOL: 23 pg/mL (0-53)
PROLACTIN: 11.9 ng/mL (2.1-17.7)
LH: 1.3 mIU/mL Low (1.5-9.3)
DHEA: 570ng/dL High (131-538)
DHT: 78 ng/dL (30-85)
I will be getting more complete bloodwork in 4 weeks.
Would like your opinions on what you think is going on here. Looks like my own production is practically shutdown, LH=1.3. Estrogen, Cortisol, Prolaction are good. DHEA high? Test is working? DHT pretty high? From the absorption of Androgel?
PCP referred me to endo…first one I called doesn’t do TRT. Waiting for call back from another. I mentioned HCG to my doc, but that is beyond his domain. I think I need something to stimulate my natural production. Am tempted to do 200mg of Test Cyp when I’m due for my next shot. Just to see if I feel anything.
Would appreciate feedback from the guys here who know alot more than I do…thanks.
Have been thinking about this for the meantime: Getting a good trib product to try to get the LH going, and increasing to 150mg Test cyp weekly. Thoughts?
Try some high quality Zinc and eat up Liver a few times a week if you can stand it. Also have a TBSP of high quality Cod Liver Oil daily. Thats about the best you can do naturally for your T levels at the moment…
Your E, while not high, is quite high for someone with little T. This can make one estrogen dominant and the E can suppress the HPTA, sort of like getting stuck in a rut.
It is very strange that your DHT is high!!
DHEA is excellent. One would assume that you are supplementing.
Do you have any PSA lab numbers? You need that data. Any urine flow problems?
This is puzzling to me too…DHT is high, but no acne, no prostate issues, PSA taken before starting HRT was 0.6, DRE normal. This week I started taking GNC over 50 prostate formula, (saw palmetto, zinc etc.). Also, I am NOT supplementing with DHEA. Weird. I will try to set up appt. with an endo who treats hypogonadism with TRT asap. Still feel no different than when I started HRT over 6 weeks ago, but obviously something is going on. In addition to my LH=1.3, FSH is at 4.6 (1.4-18.1). I’d really like to do 150mg of t-cyp on Monday instead of 100mg. I’m thinking though, that a good endo will have me stop TRT for awhile to get good baseline blood levels and move forward from there. My “boys” don’t appear to have shrunk yet, but my libido, on a scale from 1-10, is about at 1. I don’t have ED, just no desire at all. I figured when I started all this, I’d smear on a little Androgel and presto, problems solved. Not so easy. Now I feel I’ve fallen into the black hole of HRT, trying to find a progressive doc who will treat me appropriately. Will continue to post updates. Thanks for your reply.
…this was after six weeks of Androgel correct? Just for comparison, after 40 days of doing 10g Androgel/daily my DHT went up to >8600 (860-3406). Completely off the charts…hebs
Saw endo today, gave me a very thorough exam. He said my total T was low, but that my free T was ok. He did say my testicles were smaller than normal and soft. He wants me to stop injections, I went for more bloodwork, LH, FSH, Total T, Free T, SBHG, Ferritin (iron), and I need to bring in a semen sample to the lab. In 4 weeks, I need to do the labs again, except for the ferritin and the semen. I will see him again in 6 weeks. He made it clear that he has no problem prescribing TRT and that he is not trying to hold it back from me. But it seems he is relying on that Free T #, 9.0 (7.2-24) more than anything else. I’ve decided to take a 200mg shot today, just to see if I feel anything, I have had no results up to this point. I am going to move my appt. to a week later (7 weeks from now), and do the next labs in 5 weeks rather than 4. Will a 200mg shot today have an effect on bloodwork done in 5 weeks from now? Thanks to all for replies.
Don’t play with your dose, you may make estrogen problems worse! Stick to your prescribed dose and get estrogen tested and controlled.
Your FT is also low and your symptoms are totally consistent with that. Lab ranges are only a statistical grouping and does not mean that you are in a normal state of well-being. You as an individual can have different T level needs than others.
Do not get prolactin tested after producing your semen samples as your prolactin level will be up and the labs will not be representative. Ditto for PSA as ejaculation creates a temporary increase in PSA.
Smaller and softer testes is consistent with HPTA shutdown and low LH prior to TRT.
Estradiol tested after 4 weeks of androgel, 5mg was 24, endo considered this good. Prolactin is not being tested, was done when estradiol was tested, prolactin=11.9 (2.1-17.7). PSA done before starting androgel, 0.6. Small, soft testes diagnosed after 4 weeks of androgel, and 100mg test cyp weekly for 2 weeks.
Endo did exam my nipple area, no problems. Aggressive (literally pushed me against the door), prostate exam, no problems.
Have taken the 200mg shot…will not take any others before bloodwork in 5 weeks, seeing doc again in 7 weeks.
Lab results from 4 months on androgel, 5mg, and 2 100mg test cyp shots:
T: 326 (241-827) up from 268 before treatment.
Free T: 16.1 (7.2-24.0) up from 9.0 before treatment.
FSH: <1.0 (1.4-18.1) down from 4.6 after 1 month of androgel.
LH: 0.3 (1.5-9.3) down from 1.3 after 1 month of androgel.
So it looks like the treatment is getting my T and free T up, FSH and LH down. Still feeling no significant changes. Am seeing endo in 6 weeks, blood tests in 4 weeks, no injections during this time. I would think that HCG might be needed to boost my own production. Comments, please. Thanks.
if you are needing TRT, hCG might be a small contributor of T. Example, 100mg/wk took me to 886, adding 250iu hCG EOD took me to 1025.
If you need more T, hCG will not make more changes. hCG is more to keep your testes alive. Yes, a younger normal guy given hCG would see a significant increase in T, but those guys are not needing TRT either. You do not want hCG while on your your 4 weeks of hormone starvation.
Your HPTA is shutdown, as expected. There is now no reason to do LH & FST tests again while injecting. Your endo probably wants to test for these after 4 weeks.
Your low LH and FSH are part of why your testes were soft and smaller.
When was the blood draw relative to your last injection?
Your T levels are still bad. Some guys, rare, have a problem where their body seems to eat T and their levels do not go up. In these cases, they may often need 200mg/wk or more to get levels that most achieve with 100mg/wk.
From a pragmatic point of view, I think that your endo is playing around the the therapeutic needs are already determined.
Thanks for your input, you are definitely more knowledgeable on this stuff than I am…
Endo will be checking FSH, LH in 4 weeks, I assume to see if my own production comes up without the injections.
The lab didn’t draw enough blood to check SHBG, I will be having that done early next week.
Blood draw was taken 1 week after my last 100 mg injection. After the blood draw I took a 200mg injection, (I know, I probably shouldn’t have done it, but my impatience for results got the better of me). That was on 5/12. I did start to notice some subtle reactions, more energy in the gym, (able to do additional sets), and a small increase in libido, had a few spontaneous erections.
When I saw the endo, the number he focused on was the Free T. I’m afraid if he is sees this elevated he may stop the TRT.
I don’t want to go this on my own without doctor supervision, so I may have to shop around until I find a doc who will treat me less conservatively.
My estradiol was at 24 after the 4 months of androgel. I don’t know if an AI is necessary or not.
When I see the endo in 6 weeks, I will try to convince him to at least try to continue the TRT for 4-6 weeks, perhaps at the higher dose, maybe 200 mg every 10 days?
Your blood draws need to be 1/2 way between injections… 3.5 days. And you need to always do that exactly the same every time. You want to see the effects of you TRT, not the effect of when you did the blood draw.
E2=24 was not bad, but your T levels were low and your T:E ration was probably quite adverse.
Stop T completely. FT will drop faster than TT. Your HPTA recovery will be delayed by the one 200mg dose. But perhaps that will play into your interests.
Secondary hypogonadism, low gonadotrophins from the pituitary while T&E are low.
FT is the diagnostic number to watch. It is the active form of T. When on TRT, TT is the guide to gauge drug delivery. But some will dose to FT numbers when on TRT and some will not even test for TT.
Testes might respond to hCG, but as you are in your fifties, I would not expect good T levels from that. As hCG supplies are not reliable, it would not make any sense to be totally dependant on that.
You did not respond well to the transdermal, however your DHT was maxed out. If you took enough Agel to get strong TT numbers, your DHT would be dangerous.
Injections will not drive up your DHT as much as [effective] transdermals can.
Saw the endo today. He’s putting me 250mgs test cyp once every 2 weeks. I asked him about peaks and valleys doing it every 2 weeks, but he said the half-life is 10-14 days. I’ll see how I feel and adjust if necessary. I am having complete bloodwork beginning of September, seeing him again on 9/16. He seemed unsure of whether I’m primary or secondary, at first he was going to order an MRI of my pituitary, but then checked his notes and saw that my testes were small. That made him think I am primary. Either way, I’m happy I am getting treated by a specialist who will monitor me correctly.
“The half life of testosterone cypionate when injected IM is approximately 8 days.”
and
“… and the free testosterone concentration will determine its half-life.”
After one week, your free T will be about 1/2. After another week, you loose half of that and will have 1/4th of the FT you started with [day 2 or 3].
Injecting every two weeks may have been a convenience for doctors, but is totally wrong.
Tell him that you want to self inject 100mg/wk. Ask him what harm this will cause. If it does no harm, he is running of of excuses.
I think that all of the test cyp inserts state the same thing as drug documentation is DFA regulated.
HRT is hormone replacement to youthful levels. Young men do not have testes which create T 1 day every two weeks.
The spikes of T from injecting like that are very high. This creates more E2 and that in turn creates more SHBG. You get less FT and more E2 that blocks the action of that FT.
KSman:
I am injecting at home, so that is not an issue. I’ll just do 125 mg weekly. When he told me the half-life, I believed he was wrong, but I wasn’t positive. What you are saying makes perfect sense, especially after reading Dr. Crislers’ protocol. I asked the endo about hcg, and he said, 1. it’s very hard to get supply, and 2.
If I’m not interested in having children, it’s not necessary. I also asked about an anti-aromatase, he said we should wait for the next bloodwork, since the last estradiol level was at 24. It seems he is using the condition of my nipples as a main barometer for E2 conversion, mine are fine. I’m taking a prostate support capsule, (GNC), twice a day. Your comments are always appreciated…thanks.