Case Thread for hankr

Pharma / TRT Testosterone Replacement
21

OK - He seems very enthusiastic last time I saw him, but now my doc hasn’t gotten back to me in a while, so I went ahead and bought some Arimidex myself. My understanding is that I need 1.0 mg per week in divided doses, but how many? Currently, I am dosing the test e3d, should I take the Arimidex at the same time?

I ma also a little cloudy on what my goal number should be. Although this is intensely personal, an how you feel is most important, I am guessing I want E2 @ <25, Total test would be nice to see @ 600+ (I am understanding that this is not the most important factor, though) and free test where? I am under 12 now, but I can’t find a solid range anywhere here on the forum.

Still no evidence that wife can see of shrinkage, or testicle aching. Libido is still quite good, but I seem to be having a little more trouble coming, esp when tired. 2 of last 3 times we stopped because she was getting sore. Obviously, I am glad she’s getting all she wants, but damn. Is this a side effect? My wiener has never been all that obedient :slight_smile:

22

FWIW - I take my adex EOD and also inject on Mondays and Thursdays. Makes Mondays not suck so much :slight_smile:

Numbers will vary from person to person - it is a lot of “feel”. I would shoot for more labs once you get on the adex for a week or two. You said you got it yourself - I’m assuming that means research chem. Get a 1ml syringe to use for measuring. Most of the RC stuff is 1ml=1mg, which is real handy. Use the marks on the syringe to find your divided dose. Personally I’m at .05ml EOD (I’m an over responder). If you get too low, stop for 5-6 days then come back at 1/2 or 1/4 dose. You’ll know if you are too low - ED, joint pain, etc.

Doc may just be busy, or thinking he has got you “fixed”. Just stay after him.

23

Arimidex finally came. Started today wiht 0.2 mg. Will do .2mg EOD for .6-.7 mg per week.
I want to see if I can “slide in” to the right level. The stories about guys over-responding freak me out a bit.
Will try to get levels done in about 3 weeks to see where I am at.

24

OK Update - 50mg test ethanate on Mon / Thurs, wife injects.
A-dex .2mg EOD for last two weeks.

Need to get some blood work done - Sex drive seems to be up even more with a-dex. Workouts are going well, when I can get to the gym - friends from overseas, parties every weekend last month or so - but they are gone now.

Still cannot get my weight to budge, but no doubt I am putting on muscle - clothes fit differently, still - diet must be off or something (parties, maybe? duh) because I keep the fat around the middle and hips.

I would like a little guidance on what labs I should have done at this junture.
Should I give the a-dex another week?

What should I look for now, aside from test, Free test, E2?

25

you really should at least test for testosterone, estradiol, TSH, free T3, and 8am Cortisol.

26

OK - Been on the Adex for 4 weeks or so. Feel about the same, balls are hanging higher, but seem about the same size, not a firm.

Libido is great, energy is great. all systems go otherwise. Ongoing problems staying asleep (early wakening insomnia) but I have had that for about 5 years.

Current protocol is 50mg Test E on Mon / Thurs., .25mg Adex EOD

Going in for labs shortly:

-TT: Total Testosterone (<500 is not good. 700-1000 is good)
-FT or bio-T : Free Testosterone
-E2 estradiol: use the basic LabCorp serum E2 test or Quest Sensitive 4021x. DO NOT USE Quest ULTRASENTIVE!
-Prolactin
-DHT
-PSA: Prostate-Specific Antigen
-TSH: Thyroid-stimulating Hormone
-Chemistry Panel (Metabolic panel with lipids)
-Complete Blood Count (CBC)
-8am Cortisol
-Homocysteine
-C-reactive protein (High sensitivity) - (high = cardio risk)

I am hoping to see my Total T >500 and E down to mid 20s. Also hoping that my diet has pulled down my scary high Triglycerides. Last minute suggestions to the test list will be appreciated.

27

D25-OH is always good to double check and the same with ferritin.

If your TSH has ever been above 1 then I would ask for Free T4 and Free T3.

28

OK - to recap this is several weeks ago:

6 weeks in and got my first numbers back. We’ve been injecting 50mg test ethanate twice weekly on mon and thurs mornings. No problems or site pain. Workouts going well. I seem to have more energy, and while I haven’t lost mush weight, I am definitely losing fat. Shirts tight, pants lose - confirmed by photos and tape measure, so I am happy with that.

Libido is back, and I am sleeping better, working harder. So far, so good. I have felt that my testes have shrunk slightly, wife says no, and my doc says he sees no change either. No acheing in testes or other evidence of any issues.

Numbers 6 weeks in:
Start: Test, free: 10.6 Ref range: 9-30 unit: ng/dl
Now: 11.03

Start: Test, total: 302 Ref range: 240 to 950 unit: ng/dl
Now: 400

Estradiol: 46.3

--------------- End recap

Today got my labs back after one month plus on A-dex - still 50mg test e Mon / Thurs, .25mg A-dex EOD

I am so confused! All the standard test are fine. No red flags anywhere, and I feel great. Been working hard, not working out last month, and eating everything in site - lost 3 pounds! Sex drive through the roof. Still having issues reaching climax - bothers wife more than me.

So - it would appear to be working, except for the numbers:

Test, Free: 15.68 Ref range: 5.00 - 21.00
Total Test: 326 ref range 240-950 unit: ng/dl
Estradiol: 16.6

They flagged % free test as high at 4.81% with a ref range of 1.50 - 4.20

Balls are def smaller - Dr has been reading a LOT and was much more knowledgable this time. He is open to starting me on HCG. Shrinkage is not that much - but they really ride high.

He started by asking me how I felt - I told him great, libido good, etc. Then he gave me the numbers - When I expressed my dismay at the low total test, he said “I treat people, not numbers, how you feel is what counts.”

He has a point, but I am still flummoxed by these results. I think this is just more evidence that Free test is what we should focus on. Dr doesn’t know where the test is going, and neigher do I.

Input would be appreciated…

29

Very odd indeed. That is great to hear you are feeling better though man–your doctor is right to chase symptoms and not lab numbers!!!

But that said, your shrinking balls seems to be affecting you mentally a bit, plus its probably not good to completely shut down your natural production, so I think hcg is well warranted. Did he end up prescribing it, or still willing to do so after your complained about your Total T?

Your Free T is great, and that is the key number. Total T is really useless as long as SHBG, E2, and Free T are in check. HCG will probably increase your Total T somewhat, not sure what it will do to Free T, and increase your E2 a tad (probably closer to E2=22). Sounds like a winner to me.

Where you at in VA btw?

30

I have to put together some documentation for him on HCG, but I have not been able to find anything here that refers to any sort of a study on HCG for this purpose. I think I need more than a forum post, so anyone that can point me to a medical reference or study, that would be greatly appreciated.

I feel like the HCG would be the last piece of the puzzle here.

I know total T is not the really important number, but it still bothers me, esp considering how I got it up to 600+ with Androgel a few years ago.

31

Check out Dr. Crisler’s Recipe for Success and HCG Update publications. I haven’t reread them in a while, but best I can remember his hcg protocol doesn’t jive with the one on here, and actually seems unnecessarily complicated. But if your doc gives you the green light to self inject, you could probably choose which protocol you wanted to implement if you deem it necessary–I think the overall dosing is about the same.

If they remove the link, let me know and I’ll shoot it to you in a PM.

32

Thanks VT - there is enough there that I can get the script I think. I will be running the protocol from here on T-mag. Simpler is better, I already have enough complex stuff in my life.

33

Yeah, I went back and reread his hcg protocol and now that I know a little more about things it makes more sense…

Basically he recommended using hcg on Days 5 and 6, with T injections coming on Day 7…this is for a once a week T injection protocol, and his line of thinking was to use the HCG on Days 5/6 to maintain high T levels as blood levels of T are beginning to drop (due to the ester half life)…This makes sense, if you are injecting once a week…

He goes on to say that he recommends an hcg protocol similar to the one here for his patients that are on androgel, meaning they are getting consistent dosing…this is more analogous to the the T-injection protocol here (end result to maintain more steady blood levels) so the hcg is used twice a week…