Feel Terrible Need Some Advice on Lab Updates

Pharma / TRT Testosterone Replacement
1

Long post alert, a lot of info to digest, thanks in advance-
In your case/thread opening post:
-age 26
-height 6’2
-waist 34
-weight 210
-describe body and facial hair (Very hairy, face, chest stomach back legs etc)
-describe where you carry fat and how changed (only fat is waist, don’t carry any on arms legs back)
-health conditions, symptoms (diagnosed sleep apnea, had surgery and sleep with mask, if depression falls in that catagory, then I have suffered with that for multiple years, assumed due to sleep apnea, adrenal fatigue and other hormonal issues)
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever (heavy abuse of AAS, addiction to benzodiazepines, adderall use, alcohol, pre workout user for a series of years (NOTE that I have not drank, abused AAS, used pre workout or adderall in well over a year, still using .25 clonazipam dose before bed
-describe diet (breakfast is fruit, supplements, water, lunch is heavier, usually chicken rice beans, dinner is also usually heavier (burger/steak and occasionally a 4th meal, rough estimate of 3-3500 calories daily)
-describe training (I walk 3-6 miles per day, haven’t weight trained in probably 2 months, before that was just spurratic due to no energy and poor recovery)
-testes ache, ever, with a fever (No signs of that issue)
-how have morning wood and nocturnal erections changed On Trt wood was very very minimal, off trt first month wood improved, 2 months off trt, wood was on and off, 2.5 months (now) no morning wood due to T/E both being extremely low.

Recent blood work as of MAY 10, 2018, last test administered was 15 days before draw, 75mg (had new labs drawn yesterday to add once results are in)

TSH 1.4 (0.4-4.5)
T3 FREE 3.1 ( 2.3- 4.1
T4 FREE 1.3 (0.8- 1.8)
REVERSE T3 22 (8-25)
TOTAL TESTOSTERONE 293 (250-1100)
FREE TESTOSTERONE 60 (35-155)
ESTRADIOL 21 ( less than 39)
INSULIN 6.2 (2.0-19.6)
SHBG 19 (10-50)
VITAMIN D 45 (30-100)
AST 18 ( 10-40) note: first time both liver enzymes
ALT 43 (9-46) have been in range in over 2 years
CREATININE 1.28 (0.60-1.35)
SODIUM 138 (135-146)
POTASSIUM 3.8 (3.5-5.3)
CHLORIDE 101 (98-110)
TRIGLICERIDES 55
CHOLESTEROL 213
HDL 54
LDL 144
HS CRP .02 (less than 1= lowest risk)

With the objective info on the table, I’ll keep the subjective simple so it’s not too overwhelming. I used AAS extensively from age 20-25, running a self administered TRT dose between 150mg subQ up to 375mg IM with pretty poor results this past 12 months (estrogen/prolactin issue may have been the case). My total T level hasn’t come back on paper over 430 in the last year, many times the tests were weeks after last injection so it was a descending number. Currently I have been off testosterone for just over 10 weeks now. I actually felt not bad month 1 and 2 of being off. Very clear I am still shut down, joints and like glass, recovery is nonexistent, low mood/ energy, the usual low T symptoms.I stayed off hoping to balance my body out and be able to produce naturally, however, I am thinking of going back on test. I was going to do 75mg test prop 3x per week to get the body healing because my joint pain is beyond reason and sexual function is nonexistent. Previous issues in the past are/ were thyroid issues, adrenal issues, the whole 9 yards but this last test things were improving based on the numbers my doc and I are seeing. Side note I was addicted to xanax for about a year and as of now have managed to go from taking .5 mg every 6 hours to .25 clonazipam before bed so I feel like that issue has also been resolved for the most part. I don’t drink smoke or do anything that could compromise health, MY GOAL: I was hoping to regain natural function of my HPTA but so far there’s no signs of life. If I have to be on TRT I’m fine with it but want it dialed in because the last year was minimally successful. Eliminating all the variables was this years goal to start from a clean slate. Info will be appreciated, thank you.

2

The Klonopin/clonazepam will cause problems with hormone production by sedating the pituitary gland, the reason why you need it is because testosterone is low. It’s quite common to see guys using benzodiazepines that induce secondary hypogonadism, I took 2mg Klonopin daily for 30 years and it caused secondary hypogonadism.

Low SHBG guys need to inject smaller doses more frequently, preferably EOD. I don’t feel my best when not injecting 17-20mg EOD do to low SHBG. Large infrequent injections will drive estrogen production, larger the dosage, the larger the spike in estrogen.

You can check thyroid status by checking oral body temperatures morning (97.8) and afternoon (98.6). High Reverse T3 prevents Free T3 from soaking into your cells, Reverse T3 competes for the same receptor as Free T3.

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3

What was your injection schedule? It doesn’t sound right.

4

I was doing 125mg sustanon 2x or 3x a week, but when I did inject it would be Monday and Friday, or Mon Weds Fri. My labs were always 2 or more weeks after last shot so that’s why I think my total T was always shown as low.

5

Checked morning temp, 98.0 upon awakening.

6

If you’re injecting 2-3 times a week how could a test be 2+ weeks after a shot?

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7

You must choose either 2 injections a week or 3 injections a week, not both. You’ll never reach a stable state this way.

Why would you do TRT this way?

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8

My TRT has been great lately, have been on a roll for a few months with my workouts.

Took a trip to Disneyland with the family and I have terrible anxiety. I took a clonazepam, and my motivation, and that “confident, motivated, alpha” feeling instantly was gone, and took 2 weeks before I even felt “normal” again.

For me, clonazepam was the WORST for this. Im certain is has something to do with its 20+ hour half life.

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9

Klonopin has a 50 hour half life, much longer than Xanax. Taking it every 8 hours for 30 years provided a smooth, consistent stable state. The 50 hour half life makes for a long withdraw period.

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10

Potential for 20-60 hours.

The shorter the half life of a benzo, the easier I can snap back into the “physical” mindset.

I still use lorazepam, and don’t get that “days long” hangover effect from Cloanzepam…

Moral of the story. STOP TAKING BENZOS . (after you taper safely of course)

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11

I am on my way off of benzodiazepines for good it just takes a while, I’m finally going all day without them. I’ve been tapering down for about 5 months, down to the last .25 before bed. Cutting that down even further soon. I definitely feel more like a person, just a crabby ass person from having trashed hormones for the last year.

To answer the question about why my labs are low while injecting 3x a week, I was not injecting anything 2 or more weeks prior to testing just due to getting fed up with my poor results. Yea I know it makes no sense, while constantly under the influence I didn’t make many great choices but it’s a slow improvement.

My new labs should be done tomorrow to post for further consulting. Thanks everyone for different bits of info.

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12

Updated labs, I don’t even know what to make of this. But here’s where i’m at. Subjectively I feel like garbage, no sex drive, severely depressed and 0 motivation at this point. (It’s been 11 weeks off testosterone)
LH 4.6 (1.5-9.3)
FSH 15.2 HIGH (1.6-8.0)
AST 23 (10-40)
ALT 59 HIGH (9-46)
Aldosterone 7 (< or = 28)
Total Testosterone 296 (250-1100)
Free Testosterone 48.3 ( 35-155)
Estradiol 33 (15-39)
Prolactin 6.4 (2-18)
Cortisol total 13.6 (4-22)

Comments and thoughts welcome, any insight is appreciated.

13

Update: Hit the 3 month marker off test and also stopped benzodiazapines. I’ve been having symptoms that seem like high E, irritable, more depression, worsening body comp. Was hoping for some more thoughts on my recent labs.

14

A high FSH level in a male may mean the testicles are not functioning correctly. I would expect to see higher testosterone levels given your LH level, and together with your high FSH, it could be hinting at primary hypogonadism.

There is something going on with the testicles. The pituitary gland is sending large amount of FSH to the testicles as if the testicles aren’t receiving the message to produce sperm, similar to high LH to get the testicles to produce testosterone.

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15

As a heads up, there’s no need to edit the title for updates. Simply posting in the thread will bump it and members who’ve posted and have notifications on will be alerted to the new post.

Changing the title so long after it was started and after it’s been getting replies also makes it more confusing to follow.

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16

That makes sense. I figured with that kind of spike in signaling I would have a noticeable Increase in Testosterone. All I’ve really noticed is a worsening ratio of T to E. Starting to think the natural route isn’t going to cut it.

17

Oh ok I understand, thanks.

18

Update: Body Temp for the last week is steadily 97.8-98.1 upon waking up, usually 98.5-98.6 during the day so i’m thinking thyroid is functional. Adrenals/ liver are still questionable and T levels still feel low. been off everything besides daily vitamins for about 4 months. Energy/ recovery is extremely low most days. Working out seems like an impossible feat. At this point staying natural doesn’t seem like the best route.

19

A total T under 300 is abysmal. I know how you are feeling.

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20

are you still at that or have you done anything to raise it? Its freakin terrible.