Doc Wont Prescribe hCG/Arimidex

Pharma / TRT Testosterone Replacement
21

Hello,

Thanks for the reply.

I went to a wellness clinic last week, I guess it’s somewhat equivalent to American anti-aging centers.
Long story short:
The doc wants me to quit the sustanon so that she can perform a whole bunch of special tests, including blood, homones, feces, 24h urnine, gut flora etc… All very expensive, so hopefully it is worth it. I have to wait another two weeks for the sustanon shot to be out of my system before doing the tests.

She told me that sustanon in combination with hCG is horrible for long term use, even with the suggested protocols here; Basically, the risk for prostate cancer in the long run would be very large. She suggested a special type of transdermal which I was not a fan of; I told her about absorption/aromatase problems and she was well aware that this could be a problem with the regular androgel/testim gels. However, according to her there are newer gels out there that don’t have these type of problems and also provide steady absorption levels throughout the day. There is only 1 manufacturer in my own country that produces the correct type of transdermal… Forgot to ask the name of the gels though. She also stated that HPTA shutdown is not an issue while using this type of transdermals (because of the constant steady T-levels, I guess?). LH/FSH levels should remain stable. She sounded very convincing while explaining all this and I actually felt that she seemed to know what she was talking about.

She told me the same thing that you said about probiotcs not being effective ; They will first try to find the root cause of the problem for the messed up flora and go from there. This includes special tests that measure the amounts of bad bacteria in my gut combined with a bunch of allergy/auto-immune tests.

According to her the gut problems are probably the cause of most of my problems (fatigue, severe muscle loss while cutting) since nutrient and protein absorption could be problematic. She noted that my low IGF-1 and FSH levels could also be related to this because both are indeed proteins… The levels will probably go up if the gut problems are fixed. If still deemed necessary HGH tests could be done afterwards and growth hurmone supplemenation could be prescribed.

She also noticed the stuff that you said about my thyroid and did a quick check ; My thyroid felt a little swollen and I also have a thyroid echo and/or ultrasound sheduled for this.

I have my next appointment in january. This includes a one hour presentation and a full followup with her and all of her team members to discuss the results and possible treatment. These follow ups and appointments are indeed quite expensive so I hope they can help me, especially with the gut/fatigue problems.

It’s unfortunate that I already had the first sustanon 250 injection, because now I have to wait until it’s out of my system… I hope I don’t get a dip because of this 1 injection around next week? I also can’t get the transdermal prescription until my next appointment in january, so I’ll have to wait a little longer for that as well.

I’ll keep you updated.

Thanks

22

Some of what she said is disturbing.

Do not loose sight of the iodine/thyroid and cholesterol issues, review the posts here.

With the stool testing, did they check for blood?

23

Hello,

Thanks for the reply.

Anything in particular that was disturbing? Her opinion that I wouldn’t suppress my own production maybe?

I assume that they tested for blood; it is not on the results explicitly but they checked “consistency” and “color”. This doctor didn’t let me take any tests yet, I just took the results that I already had to the first consultation last week.

I’ll keep the temperature/iodine issues in mind and I’ll ask for info about that next time. I won’t take extra supplements before my next baseline test in order not to skew results.

As for the cholesterol, The doctor said this was probably a genetic issue. She knows whole familys that have cholesterol levels around 90. Do you think it would really be a good ideo to elevate my cholesterol levels by eating a high amount of fats? It will return back to lower baseline once I eat less fats again?

I’m also not 100% convinced about the transdermal gels, to be honest.

Thanks

24

You tell me about iodine in your vitamins and use of iodized salt, YOU check your your body temperatures and post here. Throid swollen: that is a sign of iodine deficiency, a degree of goiter.

TSH: 1.42 (0.27 - 4.20) is not bad, we need body temperatures to see if there is a functional problem. You only posted one temperture reading. Please get more temperature data posted.

Low cholesterol can undermine your hormone levels. Yes, increase your cholesterol!!!

What was said that is bogus:

probiotics are not effective: well they are except in rare circumstances and probiotics are aways the first option, after that it is fecal matter transplant.

Bacterial problems in the gut often are a result of using antibiotics; which can kill of the friendlies and leave the bad bacterial to take over. These are not indepenant. The flora are their own ecosystem and you have a symbiotic relationship with the flora. The flora has profound effects on the body and your immune system [auto immune issues].

Why did you test gut bacteria? Can you tell us about your gut problems. It is no surprise that a family would have similar gut flora [and problems].

Stopping TRT: Your low FST tells the story.

Is this a typo? “SHGB: 48.4 (14.5 - 48.4)” If so, please edit the posting.

Do not treat an iodine deficiency with throid HRT.

dead wrong: “sustanon in combination with hCG is horrible for long term use”

“risk for prostate cancer in the long run would be very large” hCG has nothing to do with the prostate. T and DHT do not cause BPH and cancer, E2 and lack of ejaculation do.

“newer gels out there that don’t have these type of problems and also provide steady absorption levels throughout the day:” ask for the clinical evidence. What does she mean by steady?

“only 1 manufacturer in my own country that produces the correct type of transdermal” how convenient

“She also stated that HPTA shutdown is not an issue while using this type of transdermals” bull shit

“(because of the constant steady T-levels, I guess?)” totally wrong

“LH/FSH levels should remain stable” yes they will be stable, close to zero

I think that “her” gels do not have T in them.

Where are you located?

25

Hello,

My main multi-vitamine contains about 150 mcg of Iodine (from Potassium Iodide), it seems to be 100% of the necessary daily value. I also eat seafood every day, mostly salmon and Tuna.
My morning temperature stays around 36C (96.8), sometimes a little lower; I also had to fill in this information on a question list from the Healthcare center. It would be weird to have a deficiency in Iodine when I already eat enough through diet and supplemenation?

As for your other questions: I think that they let me test gut bacteria because I had increased eosinophils in the blood. SHGB values were not a typo, and I was born and still live in Belgium :slight_smile:

I received testresults from the tests that I took before taking my first sustanon injection last month. I ordered these tests myself, I still need to take the extended tests of the Healthcare Center next week and have a followup appointment in january. Some of the results are weird, because they are inconsistent with previous results. This was a fasted morning measurement. I will only post hormones, cholesterol and other readings that were out of range.

Hormones:
TSH: 2.37 (0.93-4.2)
Free Triiodothyronine: 3.9 (2.0-4.4)
Free Thyroxine (FT4): 1.5 (0.93-1.70)
Thyroid microsom. As: 13.2 (<34)
Thyreoglobuline As: 15.0 (<115)
Thyreoglobuline: 2.9 (1.4-78)

LH: 2.6 (1.7-8.6)
FSH: 1.8 (1.5-12.4)
Testosterone: 573 (218-905)
Free androgene index: 44.1 (14.8-95.0)
Sex Hormone Binding Globuline: 45 (13-71) – Note: Why is reference range different than last time?
Androstanediolglucur: 843 (100-2360) – Note: I wanted to get a DHT measurement but could only select this reading

Oestradiol E2: 24.20 (7.63-42.59)
Progesterone: 1.4 (0.2-1.4)
Prolactine: 19.20 (4.04 - 15.2) – Note: I assume this is a problematic value?
Cortisol 8am: 26.47 (6.2 - 19.4) – Note: I assume overtraining related? Will try deloading for a week.

DHEA-S: 531 (160-449)
Somatomedine IGF-1: 382 (116-359) – Note: I think this is weird. 230 last time?
IGF-1BP3: 6260 (3400-7800)
IGF-1BP3/IGF-1 ratio: 4.4 (3.5-10.0)

Cholesterol total: 123 (<190)
HDL Cholesterol: 67 (>40)
LDL Cholesterol: 41 (<110)
Triglycerides: 74 (<150)

Things out of range:
Red blood count: 5.82 (4.30-5.70)
Hemoglobine: 16.7 (13.2-17.3)
Hematocrit: 51 (39-49)

Eosinophils: 9% (0-7)
Eosinophils total: 0.63 (0.03-0.38)

Vitamine B12: 1467 (191-663)
Potassium: 5.4 (3.5-5.1)

Creatinine: 1.21 (0.70-1.20)
Albumine g/dl: 4.9 (3.4-4.8)

Note: I will also post serum protein values because they might be interesting in combination with the gut flora problems. However, everything seems to be normal:

Total eggwhite: 7.2 (6.4-8.3)
conc. g/dl: 4.3 (4.0-4.8)
Alfa-1 globulines %: 4.1 (3.8-6.1)
conc (g/dl): 0.3 (0.2-0.4)
Alfa-2 globulines: 9.8 (8.5-12.8)
conc: 0.7 (0.5-0.9)
Beta globuline: 11.2 (9.9-13.3)
conc: 0.8 (0.6-0.9)
Gamma globuline: 15.5 (11.5-17.6)
conc: 1.1 (0.8-1.4)
albumine/globuline ratio: 1.5
Albumine (g/dl): 4.9 (3.4-4.8)

IgG: 997 (700-1600)
IgA: 249 (70-400)
IgM: 133 (23-259)
IgG subclass 2: 360 (242-700)
IgG sublcass 3: 54 (22-176)
CRP: 0.1 (<0.5)
Haptoglobine: 75 (30-200)
Complement C3: 119 (90-180)
Complement C4: 24 (10-40)

Do you still think my Testosterone is low enough for supplementation; It seems to go up every time I do a test. LH/FSH seem to be very low this time, it’s my first morning reading. Last time my LH was still mid range (took test at 11.30).

Can high prolactin be the cause of my fatique and low(er) Testosterone levels? What is generally the cause and solution for high prolactine levels?

EDIT: Accidentally submitted before finishing the post.

EDIT 2: I just noted that a few of the readings (prolactin, TSH, LH, Total T) are much different than the 11am reading that I posted on the 27th of october. Is this normal or are there some possible measurement errors? Also… I assume that a 570 total morning T reading seems OK, but isn’t it problematic if it drops to around 380 by 11 am (test 27 oct)?

Sorry for this wall of text btw… Hope someone will take the time to read :slight_smile:

Thanks!

26

It’s amazing how so many of our stories are similar. My doc, who is quite young, has told me that HCG is never prescribed for long term use. He has also told me that unless someone is hoping to have children HCG will not be prescribed at all. Here’s the best one-He told me that AI’s are only used by bodybuilders.

It is also impossible to convince my Endo to test for estrogen levels let alone E2 even though I am taking max dose of Androgel (10g daily) and my TT is still below normal. The only thing he has tested in regards to my E concerns is Prolactin. I have held off on telling my own story until I have gained enough knowledge to understand the advice given by this great forum. I am also pretty intimidated by KSman (lol).

Thanks to those who take the time to help the less educated and experieced.

27

Cortisol: Did you work out prior to the 8AM lab work?

fT3 and fT4 are above mid range is good. Odd that your TSH=2.37
RDA iodine is not necessarily optimal.
What is body temperature when you wake up, before you get out of bed.
Does doc palpate your thyroid for size, symmetry and consistency [lumps]?

TT is not bad, but LH/FSH are low. This suggests that your teste are working quite well for that level of LH. E2=243 is quite good VS your TT level. So your LH/FSH is not pushed down by high E2.

Your total cholesterol is TERRIBLY LOW and is a major health risk. HDL is great. You need to increase your cholesterol levels. Eat beef, eggs and other ‘red meat’.

Not sure, but wondering if your high SHBG is related or caused by your low cholesterol. Your E2 does not explain the high SHBG. Despite your low cholesterol, your DHEA level is good.

You are making lots of GH!

Prolactin is not high, but not where we see most guys either. We know that LH/FSH are lowish and all three are in the pituitary.

Hormone levels do change and the results and ranges are different from different labs.

You do not need TRT, but there is room for improvement. Increase cholesterol, report waking temperatures, get recovery time into your training.

You need fT, not Free androgen index - Wikipedia

How many days apart were the two lab sets?

Do not eat large amounts of tuna, you get more mercury that way.

http://www.consumerreports.org/cro/magazine-archive/2011/january/food/mercury-in-tuna/overview/index.htm

28

Hello,

Thanks for the quick reply.

No, I did not work out before 8AM that day. I started a training deload today and will do so for the next week. The strange thing is that I do not really feel overtrained, and I still have progress with my lifts etc. I’ve always had some overall fatigue but I don’t have the feeling that it’s training related. I also do not have that much stress at work. I will take the next set of blood tests on wednesday next week so hopefully my cortisol levels will be lower by then.

I will measure my body Temperature before getting out of bed tomorrow and during the next days, hope I don’t forget. Doc performed a little examination last time and said my thyroid was swollen; I think that’s why she ordered the thyroid tests/scans. I’m taking that scan next weekend, so I have no results yet.

Thanks for the Cholesterol hint. I’ll add some more fatty cuts of meat in my diet and I’ll keep the egg count high. This is how the new nutritional shedule looks (on average):
Protein: 240 (30%)
Carbs: 350 (40%)
Fat: 108 (30%)
Kcal: 3330
Cholesterol already went up from about 100 to 120 during the last few months, but LDL stayed stable. Hopefully it will improve with this new diet.

Yes, IGF-1 was very high; I Still find it strange that it was 230 last time. The extended tests that I posted earlier were a few months old btw.

However, I still have another “free Testosterone” reading from october.
Total T: 5.40 (2.5 - 8.4)
Free Testosterone: 88.90 (57.0 - 178.0)

My total T was always “relatively OK” but free T is quite low, hence the TRT considerations from the doctors. What’s your opinion on this value? Even if I get Total T to around 700 with increased cholesterol then my free T will still be in the lower half of the reference range (<117)?

If my LH was mid range then my TT would indeed be optimal. Can low LH/FSH somehow be fixed?

Thanks for all your help!

29

Hello,

Quick followup on my previous post.
My total T levels might not warrant usage of TRT and I could indeed try to elevate Cholesterol levels first and then see what happens. However, according to me SHGB and hence my Free T levels remain problematic.

I’ve read up on some things myself and I think that the usage of proviron (1-Methyl-dihydrotestosterone or mesterolone) might be usefull in my own situation. It seems to bind with SHGB more aggressively than normal T, so that more of the T will remain Free. Also, it does not give any negative feedback on LH/FSH levels so that my total test levels should remain stable. Is the usage of only proviron without TRT a valid option or am I missing something? Should I suggest this to the doctor?

Some quotes and references:

“Mesterolone had no depressing effect on low or normal serum FSH - follicle stimulating hormone - and lh - leutenizing hormone - levels but had depressing effect on 25% if the levels were elevated” (The effect of mesterolone on sperm count, on serum follicle stimulating hormone, luteinizing hormone, plasma testosterone and outcome in idiopathic oligospermic men - PubMed)

“The use of mesterolone as a fertility aid is perhaps one of the most controversial indications for this drug considering that anabolic/androgenic steroids are generally linked to infertility. It is also a use of mesterolone that is quite often misunderstood by athletes. Mesterolone is applicable here because it is an effective androgen that offers minimal suppression of gonadotropins in normal therapeutic doses, not because it increases LH output.” (Source, Willam Llewellynn’s Anabolics. Information is this book seems to be validated through literature, references are often given)

“Lowering the level of plasma binding proteins is also not the only mechanism that allows for an increased level of free testosterone. Steroids that display a high affinity for these proteins may also increase the level of free testosterone by competing with it for binding. Obviously if testosterone finds it more difficult to locate available plasma proteins in the presence of the additional compound, more will be left in an unbound state. A number of steroids including dihydrotestosterone, Proviron®, and Oral-Turinabol
(chlorodehydromethyltestosterone) display a strong tendency for this effect. If the level of free-testosterone can be altered by the use of different anabolic/androgenic steroids, the possibility also exists that one steroid can increase the potency of another through these same mechanisms. For example, Proviron® is a poor anabolic, but its extremely high affinity for SHBG might make it useful by allowing the displacement of other steroids that are more active in these tissues.” (William Llewellynn’s Anabolics)

30

Proviron is not legal in the USA or Canada, cannot be prescribed. DHT can be prescribed, but there is currently no FDA approved supplier for US compounding pharmacies. There are a few prescribable drugs of this nature and they are, as with proviron, liver toxic. HDL can be depressed as well.

31

Your natural testosterone and estradiol levels were fine. One problem in cases such as yours is that it is unlikely that you will feel a big difference from TRT - it is mostly people who are really hypogonadal before starting who will feel a big difference. Another problem is that it is kind of unlikely that low T is responsible for your symptoms. You can certainly try to raise T with TRT and see if it helps, but it is likely that that will just be putting a band-aid on an unidentified underlying problem.

AIs have their own side effects and should not be used unless there is a problem with high E2, and even then they are very hard to dial in to the correct dose. Actually a better way of controlling E2 is to reduce the testosterone dose, but this is seldom preferred by patients, who tend to get a bit greedy w.r.t. T dose.

32

[quote]seekonk wrote:
AIs have their own side effects and should not be used unless there is a problem with high E2, and even then they are very hard to dial in to the correct dose. Actually a better way of controlling E2 is to reduce the testosterone dose, but this is seldom preferred by patients, who tend to get a bit greedy w.r.t. T dose. [/quote]

WRONG: Modulation of E2 with anastrozole is easy almost always in a TRT context. Read the stickies.

Start T+AI+hCG
100mg T cyp per week dosed at least twice a week
1mg anastrozole per week dosed at times of injection
hCG 250iu EOD or three times per week, unless total hypogonadism

Do labs half way between injections.

Adjust anastrozole:
-example: E2=28 and target is E2=22

new_dose = old_dose * [28/22] = 1.0 * 1.27 = 1.27mg

Getting control of the dosing requires a liquid anastrozole product, either a RC or hole made with tablets and vodka. Count the drops per ml and then do the math to get your dose. Dose increment is 1 drop.

For those that are over responders, stop for 5-6 days and resume at 1/4th of the expected dose, which would be .25 mg/week.

Anastrozole sides are typically the sides of too little estrogen when not dosed correctly. A few seem to have libido problems and some report that aromasin works better for them. Note that with anastrozole one uses 1mg/week and with aromasin, one might be using 10 or 20mg per day. There is cost to that.

33

With all due respect, I have known many who can never dial in their anastrozole dose so they feel consistently good and have consistent libido and erections, despite “optimal” E2 levels and even with respected TRT doctors. They get temporary subjective benefit from anastrozole but it doesn’t last. These guys are all over the TRT forums.

One problem with aromatase inhibitors is that they indiscriminately inhibit aromatase even where doing so may be harmful. For example, someone with more aromatization (because of body fat or because of too high a T dose) may use a certain dose of AI to get serum levels of E2 “right”, but serum levels do not truly reflect what is going on in individual tissues. That higher dose may inhibit aromatase just enough in fat tissue but at the same time it may over-inhibit aromatase in other tissues such as the bones or brain, starving them of E2 and potentially causing harm to bone density and mood/libido, for example.

For example, maybe all the excess E2 is from fat tissue but since we cannot control where the AI goes, we are now suppressing E2 also in the brain and bones, which is bad.

Also, aromatase affects other hormones besides estradiol. For example, it also transforms androstenedione to estrone, so using an AI to target E2 levels may conceivably lead to non-optimal estrone levels, for example.

For these reasons, as well as further documented side effects of AIs that may be unrelated to E2 inhibition (hair loss, edema, etc.), it makes sense that it is better to control E2 by reducing T dose, as long as sufficient T levels can be attained this way. I suspect in most cases this is possible but as I said people are greedy and want their T levels as high as possible, even when lower but still reasonable levels demonstrably work better for many men. The temptation of bigger muscles is too seductive.

34

Easy fellas’

You’re both right, Seekonk and KSman; while Seekonk’s example and argument fit best in a situation in which testosterone has been elevated to a supra-physiological level, I think we can all agree that in this case, specifically, SKman’s advice to begin E modulation with testosterone is optimal. We shouldn’t lose sight of JustMeOnTRT’s preliminary lab values, nor his follow-up posts.

Any news of your waking temperature(s), JustMeonTRT?

35

seekonk, good points, but we still see guys doing well on T+AI and suffering with 100mg T per week alone. So choose one. It is really about what feels better. yes, increased well-being and libido are transient, that is sort of the way our brains work.

When high LH or hCH pushes T–>E2 to extremes inside the testes, trying to manage that with high doses really does cause a concern with reduced local T–>E2 inside the brain. We are only guessing what that might mean. But in this case when serum E2 is uncontrollably high, again it is hard to believe that brain would be starved for E2.

As for bone loss, T is probably the major factor for that and as long as serum E2 is decent, should not be problem. Bone loss is also characterized by catabolic loss of the collagen matrix. Youthful levels of T will not allow that to happen.

If serum E2 levels are decent, I would also expect that tissues would be exposed to that reducing the effect of reduced local T–>E2. And 1mg/week anastrozole will not take local T–>E2 to zero in any case.

As for extreme things like hair loss, that would be data from women taking E2–>0, not applicable to E2 modulation.

36

Hello guys,

Sorry for the late reply, it seems that it’s more than 3 months ago since I last posted. I first want to thank you guys again for all the info that you already gave me; In hindsight, I guess I should have listened to the advice from the start… :slight_smile:

I will give a quick update on the situation and what has happened since then:
Around january I received my last bloodtest/hormone results and also the results of the feces test. Hormones/blood looked about the same as before, as expected. However, I will post the values again for clarity:

Glucose sober: 85 (70-115)
Insulin sober: 6.9 (2.6-24.9)

TSH: 2.27 (0.27 - 4.2)
Free T3: 3.7 (2.0 - 4.4)
Free T4: 1.44 (0.93 - 1.70)

LH: 3.0 (1.7 - 8.6)
FSH: 2.0 (1.5 - 12.4)
Testosterone: 530 (218 - 905)
Free androgen index: 40.8 (14.8 - 95.0)
Androstanediolglucur. 648 (100 - 2360)

Oestradiol E2: 24.70 (7.63 - 42.59)
Progesteron: 1.1 (0.2 - 1.4)

SHGB: 45 (13-71)
DHEA-S: 462 (160-449)

Cortisol 8am: 23.61 (6.2-19.4)
Transcortine: 51.3 (33-65)
Free cortisol 8am: 1.47 (1.1-2.2)

IGF-1: 389 (116-358)

Unfortunately I do not have the urine test results because they were not yet finished at the time of my consultation.

For the feces tests, I already knew that I had lowered amounts of “good” intestinal gut flora and that my gut Ph value was too high (7.5 (5.8-6.8)); I already added those results in one of my previous posts here. I was now tested for “bad” intestinal gut flora/viruses. They all tested positive:

catalase (positive)
hemolysis (positive)
coagulase (positive)
urease (positive)
gelatinase (positive)

secretorisch IgA: <277.5 (510-2040)
Beta-defensin 2: <10.0 (<23.0)

I was also tested for allergies; I believe that the numbers indicate the amount of antibodies for the particular food type, but I could be wrong:

Eggs: 18 (<5)
Milk: 74 (55-105)
Beef: 9 (<5)
Gluten: 7.0 (<5.0)
Union: 7 (<5)
wheat: 8 (<5)
Rye: 7 (<5)
Barley: 7 (<5)
Oats: 9 (<5)
Mais: 5 (<5)
Rice: 8 (<5)
Banana: 11 (<5)
Black Pepper: 25 (<5)

I will summarize in short, in my own wording what the doc said during the consultation: According to her a gluten intolerance/allergy can cause damage to the intestinal wall and this allows bad bacteria, unprocessed foods etc to penetrate. This in turn can cause auto-immune reactions and a constant inflammatory condition in the body. The intolerance to all the other food types are probably a result of the gluten allergy itself. Basically, my whole immune system is in overdrive and constantly working.

I am currently eating totally gluten free in combination with a gut “medication” protocol to clear out the virulent flora and repair the intestinal enterocytes. The bad intestinal flora seem to incapsulate themselves in some kind of protective layer. I first need to take a product to penetrate this protective layer after fasting for at least 2 hours, then 30 min later I take another product (To kill them?). 30 min later I take activated carbon to flush the bad stuff out. I follow this protocol daily.

She also told me to stop eating eggs/unions/black pepper, which I did. However, I added some eggs back in my diet recently because I thought it wouldn’t do any harm (since the gluten allergy was the core of the problem). However, I’ve been getting some bowel irritation because of it so I’ll stop eating them again. Hope I didn’t do any damage…

I believe this intestinal/allergy stuff is probably at the core of my health problem; I know this might not be the correct forum to discuss these issues.

However, I was also prescribed hormone replacement therapy, and this is also the part where I probably should have listened to the advice here. I was reluctant to start any HRT but I need this doc to fix my gut problems… so I followed her advice on everything she suggested. This is the HRT protocol that I’m currently on:

  1. Hydrocortisone: 3ml at 5% gel.
    I was actually thinking that my cortisol levels were too high before… apparently my free morning cortisol levels are suboptimal and should be around the 2 value. I am actually thinking about stopping the hydrocortisone treatment, unless someone can tell me that there are advantages taking it? As someone who works out I find it very strange to supplement with cortisol…

  2. Testosterone, some kind of gel 2ml, 2.5%. No Hcg, No AI…
    Already noticing some testicular athrophy/weakness from the start, but it has not gotten worse since then. I have no idea where I am at with E2 or DHT values right now. This could be a problem since the doc already mentioned something like “E2 is not a problem in men, since it is low anyway”…

  3. 50mg L-Thyroxine, went to 75mg a few weeks ago
    I had a new blood test after two weeks taking 50mg and my TSH went from 2.27 to 1.47 (t3 and t4 stayed about the same). I got a mail that TSH should be lower and am now taking 75mg (She actually charged me 20â?¬ for this mail…). I believe that she was aiming for a TSH of 0.4 for her patients, but I could be wrong. However, I googled it and optimal values seemed to be around 1?
    I also got some kind of weird explanation that a part of my thyroid was damaged/dead because of the auto immune reactions… I seem to be making antibodies against my own thyroid. I actually don’t know why she concluded this since the thyroid scan showed everything to be normal. I’ll ask next time.

  4. 1 tablet of metformine each morning during breakfast.
    I got some kind of explanation that the auto immune stuff also caused a mild form of insulin resistance. My value of 6.9 was a little too high and should have been around 4, if I remeber correctly. I also forgot to mention that I eat carbs right before bed. Could this be the reason that my insulin was still a little elevated in the morning? Is metformine really necessary/beneficial for me?

Last month I had some complete followup blood tests using no HRT supplements except for the testosterone which I had to take about 1.5 hour before taking the blood sample. I also did another feces/urine test including digestion tests and I’m still awaiting all those results; I will get everything back during the next consultation…

Well, I’m happy that someone is at least doing something now. However… the problem is that there seems to be no progression at all since january. Even today, I had to crawl back in bed this sunday afternoon because I woke up tired and couldn’t get through the day like that. When I sleep well (8 or more hours) everything is fine, but when I sleep less than 8 hours I wake up very tired and it never gets better during the same day. It’s also getting hard mentally since I don’t know what to expect the next day… can’t plan anything and have no social life because of it. I’m happy that I’m still able to lift weights; Even when I’m very tired I still go to the gym and I get an energy boost because of it. (I’m actually also concerned that the hydrocortisone will cause negative feedback on my adrenals and I will be unable to recover as well from the workouts…).

I am well aware that the intestinal issues could still last a long time, However I was also wondering if my DHT value (Androstanediolglucur.) isn’t too low? The doc’s goal was to keep my DHT value about the same, even with the TRT replacement. However, wouldn’t a higher DHT boost my current mental condition somewhat? Any opinion on this?

It’s getting late and this post is getting very long, so I will stop here.

Thanks for reading

37

Hello,

It’s been a while since I last posted.
Summary: I have been put on TRT (gels) for about a half a year now. However, it has since become clear that all my issues and problems are related to a whole bunch of immunity problems, not so much hormonal deficiencys. The underlying problems will probably take some time to resolve (months or even years). I will not get into the details here.

I am now thinking about quitting the TRT all together, so that my HPTA can recover. I think that if my underlying issues are resolved my TRT baseline will also improve. However, the longer that I continue with the TRT the more hpta suppressed I get. I am currently not using any hcg or AI’s and I am already experiencing a mild form of testicular athrophy. I basically want to quit the TRT immediately so that my system can recover properly without too much problems.

My question: Do I need any form of PCT or can my system still recover naturally in a timely manner without using extra medication? How long could the recovery take on average? I am thinking of quitting the gels today and do a baseline test next week to see where I am.

Testresults before TRT:
LH: 3.0 (1.7-8.6)
FSH: 2.0 (1.5-12.4)
E2: 24.7 (7.63 - 42.59)
TT: 530 (218-905)
FAI: 40.8 (14.8-95.0)
SHGB: 45 (13-71)
Androstanediolglucor.: 648 (100 - 2360)

Testresults after 3 months (blood drawn 2 hours after applying gel, am measurement)
LH: 1.6 (1.7 - 8.6)
FSH: 1.7 (1.5-12.4)
E2: 26.60 (7.63 - 42.59)
TT: 1017 (218-905)
FAI: 67.8 (14.8-95.0)
SHGB: 52 (13-71)
Androstanediolglucor.: 873 (100 - 2360)

I lowered the dosage after this.
Testresults after 4-5 months (blood drawn next morning WITHOUT applying the gel first, am measurement)
LH: 1.7 (1.7-8.6)
FSH: 2.0 (1.5-12.4)
E2: 20.20 (7.63-42.59
TT: 528 (218-905)
FAI: 42.6 (14.8-95.0)
SHGB: 43
Androstanediolglucor.: 1000 (100 - 2360)

After this last bloodtest I increaed the dosage, I am now using an amount between the first and second dosage.

Can I please get some advice on this? It seems that I am not completely shut down, so I am wondering if I need any form of PCT? If yes, what dosage and for how long?
I can probably get another doctor to prescribe me the medication, if needed.

Another important reason for me to quit the TRT is that I am finding it “more difficult” to get it up than before. For example, it’s summertime and I see some scarcely clothed girls walking around the street… My stuff basically got a life of it’s own and reacted automatically before the TRT (which was kind of a nice feeling…). Now, with the TRT this does not happen anymore.
Before the TRT, during intercourse I could go 3-4 times in a row without problems; Things just got going automatically. Now, while I’m on TRT I can go 1 time… and I’m basically done unless I wait long enough. Things are defintely going the wrong way in this department, this is not a nice feeling and I’m actually quite concerned about this. I don’t understand how this can occur while my Test (and DHT) levels are higher? Is there any explanation for this; Testicular athrophy perhaps? I hope this gets resolved when I go back to my original baseline without TRT?

Thanks!