I think you’re freaking out over nothing…your doctor didn’t give you any guidance on what to dose, so he is partly to blame for this…
Explain to him like an adult that you were following the exact literature that you showed him, and explain that it looks like you are more sensitive than average, then adjust your dose downwards…this is an art, not a science, and you are making a good faith effort to dial in your dosage with frequent blood tests and follow ups…
You are speculating that there is some high end number that if you cross he will pull you? That is weird if you haven’t, you know, ASKED HIM IF THIS IS THE CASE!
If I were you, I’d just be ready to go in there and explain what happpened and fix it…follow up in another 2 weeks with blood tests after dropping dosage…
If he tries to put you on 600 mg every 1.5 months, fire his stupid ass and find a new doctor…
The most suprising thing happened…he wrote a three month script for T cypionate (200mg/mL 10mL vial x3) and told me to dose it how I see fit. [/quote]
Rereading your post, are you sure you are dosing correctly (87.5 mg/week)?
You say a three month supply but it looks like you have enough T-Cyp to last you 68 WEEKS (assuming the “x3” indicates you have a script for 3 vials of 10 mL @ 200 mg/mL)!!!
Where is the disconnect between my math and yours?
Edit: Changed 100 mg/week to 87.5 mg/week to reflect his dose.
I plan on speaking with him on Monday about it. I’m sure that I am freaking out over nothing…but after dealing with these symptoms for so long, any risk of losing the little relief I felt is frightening.
We had decided on 200mg every 10-14 days…how much at a time and how often was up to me…as long as it equaled the 200mg every two weeks. I’m just concerned because it looks, at the worst, like I was being irresponsible with the script. At best, I lost some credibility with the doc and any ability to argue for E2 control (why would a guy need a woman’s breast cancer drug?)
Shopping for a new doc is expensive and time consuming. I finally found one to work with me, at least a little, on an effective treatment. Going to a new one would most likely equal stopping treatment all together…crashing and feeling like shit as everything gets cleared from my system just so the doc can get another baseline…figure out again that I am obviously hypogonadal…and then start treatment again. I’d rather just get healthy and stay that way.
It is a huge supply of T that he wrote. Maybe it shows on his part how inexperienced he is with TRT. I laughed when I saw how much he gave me but at the same time glad. My insurance, for whatever reason, wouldn’t pay for the T…super expensive but I’m set for over a year which is a huge plus.
I dosed it low so I wouldn’t be too high in his mind. He stressed that with T, just enough is perfect. In talking with him, I knew he had issues with a guy being around even 900 due to the risk of polycythemia and a plethora of other health risks. That is the reason for dosing it lower than normal.
Is it possible to be an over-responder to testosterone? This is probably the first time in my life that I’ve had anything above even a midrange T level. I’ve never had a huge sex drive even during puberty. (Bilateral undecended testicles until age 8 probably a reason for this).
some people are over-excreters (they clear things out of their system very quickly like me).
others are slow excreters (medications and such hang around and take forever to get cleared out)
seems like you would be in the second group - the good news is that you should need less T and you probably don’t have to inject as frequently.
OOPS, I thought that this was the “Stupid Things That Docs Do and Say” thread.
With your E2 injections, the high TT is not expected or explainable, unless you injected T into a vein. The major issue is your E2 level. You need anastrozole to manage that.
I always aspirate prior to injection to make sure I haven’t hit a vessel. Never had a blood return, so I don’t think an accidental IV injection took place.
I just spoke with the nurse. The doc looked over the labs and had said everything is fine. Even with the TT being elevated, he doesn’t want to adjust the dosage as of yet. I mentioned the nipple thing and that I had felt fine for a while and then it all went to crap. I had said E2 was elevated and that could be the cause of it. She relayed that to doc and he had said it shouldn’t be a cause of concern, but to keep an eye on the nipple issue and get ahold of them if it gets worse.
I want to give it a few weeks and get my own labs done. If it (the TT) hasn’t come down, I’ll adjust the dosage myself. But its the elevated E2 that worries me. I can’t sell him on an AI. I really don’t want it ruining my treatment at best or developing into full blown gyno at the worst.
I’ve done my reading on Arimidex and believe somewhere around 0.25mg EOD would start to fix it. He won’t hear of it though. Any ideas?
I figured I would post an update on my treatment. A few weeks ago I went in for my 3 month blood work…
Total Testosterone: 802
E2: 20
(drawn the day after my injection)
I ended up getting myself some liquid arimidex. I started at the recommended dose of 1mg/week and judged the dose on how I felt. I upped the dose every few weeks until I started feeling better. The E2 result is from my current dose of 1.5mg/week. The AI may be under-dosed or I am an “under responder” though I haven’t found anything to suggest that is something others have experienced. Either way, its working for me.
Sex drive still hadn’t improved. I had taken a week long class about a month ago and didn’t work out…sex drive came back. I started working out again and it was gone again. I was reading up on DHEA and decided to give it a shot at 25mg EOD. That did the trick. I do have a concern that it may screw up my E2 levels…so I am watching that.
So I figured I would just post that my treatment is working out for me. Blood levels are stable at my current dosing and I hope it stays that way lol.
But a question for anyone that knows it…would any possible conversion of DHEA into estrogen be handled by the arimidex? The blood test results I posted were taken before I started taking DHEA.
Hey man, that’s awesome that you are getting on track with your current regimen…I wish more people would log back in with good news stories like this to show that what we’re all trying to do here actually works haha
As for your question, DHEA doesn’t dump to E2 directly…but if it causes your T to rise higher than your body’s setpoint, then T could aromatize more into E2…not sure exactly the implications of this while you are using TRT, but I think it is definitely possible DHEA could cause your E2 to rise and you may need to adjust your Adex dose accordingly…I would probably track any symptoms/improvements after starting DHEA, get bloodwork done in a month, then adjust as needed…
DHEA can convert directly to Androstenedione and from there it can convert to Estrone and then to Estradiol. I believe that this is influenced or controlled by aromatase (but really that is just a guess).
Here is a detailed hormone pathway chart. Be warned, it is slightly complex.
genome.jp/kegg/pathway/map/map00140.html
If You want you can PM me I live in Illinois also.
I have a very good TRT doctor thats very well versed in all topics discussed here and takes insurance.