My Story for All to See

Pharma / TRT Testosterone Replacement
1

Greetings gentlemen.

I’ve read the stickies several times over and now I feel ready to share my story.

-age: 34
-height: 6
-waist: 32
-weight: 179
-describe body and facial hair: Not much body hair on the trunk. Normal arm and leg hair for a man. Facial hair can be shaved every three days.
-describe where you carry fat and how changed: I carry bodyfat in the general spare tire area.
-health conditions, symptoms [history]: Very healthy male with the exception of what is listed below.
Fatigue, Brainfog and racing thoughts, loss of muscle mass, horrific GAD (generalized anxiety disorder) with at least three panic attacks a day,
-Rx and OTC drugs, any hair loss drugs or prostate drugs *ever: Propecia for 6 years
-lab results with ranges
Attribute Value(Normal Range) Date
42 pg/ml (0-46) 5-Sep-12

.5 U/ml (0.0-5.0)	5-Sep-12
	
5 U/ml (0-99)

%B 0.8 % (0.3-2.0) 26-Mar-13
%B 1.2 % (0.3-2.0) 21-Dec-12
%B 0.8 % (0.3-2.0) 24-Oct-12

%E 5.2 % (0.6-6.0) 26-Mar-13
%E 4.1 % (0.6-6.0) 21-Dec-12
%E 4.6 % (0.6-6.0) 24-Oct-12

%L 38.9 % (10.0-58.5) 26-Mar-13
%L 35.4 % (10.0-58.5) 21-Dec-12
%L 37.3 % (10.0-58.5) 24-Oct-12

%M 9.1 % (3.0-14.0) 26-Mar-13
%M 10.4 % (3.0-14.0) 21-Dec-12
%M 11.6 % (3.0-14.0) 24-Oct-12

%N 46.0 % (42.0-72.0) 26-Mar-13
%N 48.8 % (42.0-72.0) 21-Dec-12
%N 45.7 % (42.0-72.0) 24-Oct-12

ALBUMIN 4.1 G/DL (3.5-5.0) 26-Mar-13
ALBUMIN 3.8 G/DL (3.5-5.0) 21-Dec-12
ALBUMIN 4.1 G/DL (3.5-5.0) 24-Oct-12

ALKALINE PHOS 72.0 IU/L (40.0-150.0) 26-Mar-13
ALKALINE PHOS 72.0 IU/L (40.0-150.0) 21-Dec-12
ALKALINE PHOS 73.0 IU/L (40.0-150.0) 24-Oct-12

ALT/SGPT 28.0 IU/L (0.0-55.0) 26-Mar-13
ALT/SGPT 30.0 IU/L (0.0-55.0) 21-Dec-12
ALT/SGPT 23.0 IU/L (0.0-55.0) 24-Oct-12

ANION GAP 10.0 RATIO (4.0-34.0) 26-Mar-13
ANION GAP 6.0 RATIO (4.0-34.0) 21-Dec-12
ANION GAP 7.0 RATIO (4.0-34.0) 24-Oct-12

AST/SGOT 23.0 IU/L (5.0-34.0) 26-Mar-13
AST/SGOT 22.0 IU/L (5.0-34.0) 21-Dec-12
AST/SGOT 19.0 IU/L (5.0-34.0) 24-Oct-12

BASO 0.0 10e3/uL (0.0-0.1) 26-Mar-13
BASO 0.1 10e3/uL (0.0-0.1) 21-Dec-12
BASO 0.0 10e3/uL (0.0-0.1) 24-Oct-12

BUN 27.0 mg/dl (10.0-26.0) 26-Mar-13
BUN 26.0 mg/dl (10.0-26.0) 21-Dec-12
BUN 25.0 mg/dl (10.0-26.0) 24-Oct-12

BUN/CREATININE 27.0 RATIO (8.0-36.0) 26-Mar-13
BUN/CREATININE 28.9 RATIO (8.0-36.0) 21-Dec-12
BUN/CREATININE 27.8 RATIO (8.0-36.0) 24-Oct-12

CALCIUM 9.7 mg/dl (8.8-10.4) 26-Mar-13
CALCIUM 9.2 mg/dl (8.8-10.4) 21-Dec-12
CALCIUM 9.4 mg/dl (8.8-10.4) 24-Oct-12

CHLORIDE 104.0 MEQ/L (94.0-112.0) 26-Mar-13
CHLORIDE 106.0 MEQ/L (94.0-112.0) 21-Dec-12
CHLORIDE 106.0 MEQ/L (94.0-112.0) 24-Oct-12

CHOLESTEROL 200.0 MG/DL (140.0-200.0) 26-Mar-13

CO2 26.0 MEQ/L (21.0-32.0) 26-Mar-13
CO2 30.0 MEQ/L (21.0-32.0) 21-Dec-12
CO2 28.0 MEQ/L (21.0-32.0) 24-Oct-12

CORTISOL 11.30 ug/dL (2.50-25.00) 26-Mar-13
CORTISOL 12.80 ug/dL (2.50-25.00) 31-Jan-13
CORTISOL 9.37 ug/dL (2.50-25.00) 24-Oct-12
CORTISOL 13.4 ug/dL (2.50-25.00) 5-Sep-12

CREATININE 1.0 mg/dl (0.6-1.4) 26-Mar-13
CREATININE 0.9 mg/dl (0.6-1.4) 21-Dec-12
CREATININE 0.9 mg/dl (0.6-1.4) 24-Oct-12

DHEA-Sulfate 176.8 ug/dL (160.0-449.0) 4-Feb-13

DIRECT BILI 0.2 MG/DL (0.0-0.6) 26-Mar-13
DIRECT BILI 0.3 MG/DL (0.0-0.6) 21-Dec-12
DIRECT BILI 0.2 MG/DL (0.0-0.6) 24-Oct-12

DIRECT HDL 60.0 MG/DL (45.0-70.0) 26-Mar-13

DIRECT LDL 124.0 MG/DL (50.0-130.0) 26-Mar-13

eGFR 91.5 () 26-Mar-13
eGFR 103.3 () 21-Dec-12
eGFR 103.3 () 24-Oct-12

EOS 0.3 10e3/uL (0.0-0.5) 26-Mar-13
EOS 0.2 10e3/uL (0.0-0.5) 21-Dec-12
EOS 0.2 10e3/uL (0.0-0.5) 24-Oct-12

ESTRADIOL 31.60 pg/ml () 27-Dec-12
ESTRADIOL 27.90 pg/ml () 25-Oct-12

FREE T3 3.830 pg/mL (1.800-4.200) 26-Mar-13
FREE T3 3.840 pg/mL (1.800-4.200) 31-Jan-13

FREE T4 1.290 ng/dl (0.800-1.900) 26-Mar-13
FREE T4 1.130 ng/dl (0.800-1.900) 31-Jan-13

Free Testosterone(Direct) 6.6 pg/mL (8.7-25.1) 4-Feb-13
Free Testosterone(Direct) 7.1 pg/mL (8.7-25.1) 26-Dec-12
Free Testosterone(Direct) 7.3 pg/mL (8.7-25.1) 26-Oct-12

FSH 2.730 uIU/mL () 26-Mar-13
FSH 3.080 uIU/mL () 27-Dec-12
FSH 3.020 uIU/mL () 13-Nov-12
FSH 3.50 uIU/mL () 5-Sep-12

GLUCOSE 90.0 mg/dl (70.0-100.0) 26-Mar-13
GLUCOSE 59.0 mg/dl (70.0-100.0) 21-Dec-12
GLUCOSE 86.0 mg/dl (70.0-100.0) 24-Oct-12

HCT 46.3 % (43.5-53.7) 26-Mar-13
HCT 47.1 % (43.5-53.7) 21-Dec-12
HCT 47.5 % (43.5-53.7) 24-Oct-12

HGB 15.0 g/dL (14.1-18.1) 26-Mar-13
HGB 14.6 g/dL (14.1-18.1) 21-Dec-12
HGB 14.9 g/dL (14.1-18.1) 24-Oct-12

INDIRECT BILI 0.3 MG/DL (0.0-1.0) 26-Mar-13
INDIRECT BILI 0.3 MG/DL (0.0-1.0) 21-Dec-12
INDIRECT BILI 0.4 MG/DL (0.0-1.0) 24-Oct-12

LH 1.710 mIU/mL () 26-Mar-13
LH 2.830 mIU/mL () 27-Dec-12
LH 2.070 mIU/mL () 13-Nov-12
LH 2.90 mIU/mL () 5-Sep-12

LYM 2.0 K/UL (0.6-4.1) 26-Mar-13
LYM 1.8 K/UL (0.6-4.1) 21-Dec-12
LYM 1.7 K/UL (0.6-4.1) 24-Oct-12

MCH 30.3 pG/cell (28.0-32.0) 26-Mar-13
MCH 29.3 pG/cell (28.0-32.0) 21-Dec-12
MCH 29.7 pG/cell (28.0-32.0) 24-Oct-12

MCHC 32.5 g/dL (32.0-36.0) 26-Mar-13
MCHC 31.0 g/dL (32.0-36.0) 21-Dec-12
MCHC 31.3 g/dL (32.0-36.0) 24-Oct-12

MCV 93 fL (80-97) 26-Mar-13
MCV 94 fL (80-97) 21-Dec-12
MCV 95 fL (80-97) 24-Oct-12

Mono 0.5 10e3/uL (0.1-1.1) 26-Mar-13
Mono 0.5 10e3/uL (0.1-1.1) 21-Dec-12
Mono 0.5 10e3/uL (0.1-1.1) 24-Oct-12

MPV 9.8 fL (0.0-99.8) 26-Mar-13
MPV 10.4 fL (0.0-99.8) 21-Dec-12
MPV 11.1 fL (0.0-99.8) 24-Oct-12

NEU 2.4 10e3/uL (1.8-6.7) 26-Mar-13
NEU 2.4 10e3/uL (1.8-6.7) 21-Dec-12
NEU 2.1 10e3/uL (1.8-6.7) 24-Oct-12

PCT 0.2 % () 26-Mar-13
PCT 0.2 % () 21-Dec-12
PCT 0.2 % () 24-Oct-12

PDW 23.0 10(GSD) () 26-Mar-13
PDW 22.5 10(GSD) () 21-Dec-12
PDW 23.7 10(GSD) () 24-Oct-12

PLT 157 K/uL (145-450) 26-Mar-13
PLT 166 K/uL (145-450) 21-Dec-12
PLT 153 K/uL (145-450) 24-Oct-12

POTASSIUM 4.1 mg/dl (3.5-5.5) 26-Mar-13
POTASSIUM 4.3 mg/dl (3.5-5.5) 21-Dec-12
POTASSIUM 4.2 mg/dl (3.5-5.5) 24-Oct-12

PROGESTERONE 0.3 ng/ml () 31-Jan-13

PROLACTIN 6.67 ng/mL (2.50-17.00) 24-Oct-12
PROLACTIN 7.7 ng/mL (2.50-17.00) 5-Sep-12

PSA 0.81 ng/mL (0.09-4.00) 31-Jan-13

RBC 4.97 M/UL (4.69-6.13) 26-Mar-13
RBC 4.99 M/UL (4.69-6.13) 21-Dec-12
RBC 5.01 M/UL (4.69-6.13) 24-Oct-12

RDW 12.9 % (11.5-14.8) 26-Mar-13
RDW 12.0 % (11.5-14.8) 21-Dec-12
RDW 12.7 % (11.5-14.8) 24-Oct-12

Sex Horm Binding Glob, Serum 29.9 nmol/L (16.5-55.9) 4-Feb-13

SODIUM 140.0 mg/dl (130.0-149.0) 26-Mar-13
SODIUM 142.0 mg/dl (130.0-149.0) 21-Dec-12
SODIUM 141.0 mg/dl (130.0-149.0) 24-Oct-12

T. TESTOSTERONE 318.00 ng/dL (270.00-1730.00) 26-Mar-13
T. TESTOSTERONE 229.00 ng/dL (270.00-1730.00) 1-Feb-13
T. TESTOSTERONE 337.00 ng/dL (270.00-1730.00) 21-Dec-12
T. TESTOSTERONE 421.00 ng/dL (270.00-1730.00) 25-Oct-12

TOTAL BILI 0.5 MG/DL (0.2-1.3) 26-Mar-13
TOTAL BILI 0.6 MG/DL (0.2-1.3) 21-Dec-12
TOTAL BILI 0.6 MG/DL (0.2-1.3) 24-Oct-12

TOTAL PROTEIN 6.8 G/DL (6.3-8.1) 26-Mar-13
TOTAL PROTEIN 6.5 G/DL (6.3-8.1) 21-Dec-12
TOTAL PROTEIN 6.5 G/DL (6.3-8.1) 24-Oct-12

TRIGLYCERIDES 75.0 MG/DL (30.0-150.0) 26-Mar-13

TSH 1.570 uIU/mL (0.400-4.000) 26-Mar-13
TSH 1.890 uIU/mL (0.400-4.000) 31-Jan-13

WBC 5.2 K/UL (4.5-10.5) 26-Mar-13
WBC 5.0 K/UL (4.5-10.5) 21-Dec-12
WBC 4.5 K/UL (4.5-10.5) 24-Oct-12

Uric Acid 5.7 md/pl (2.6-7.2mg/pl) 5-Sep-12

-describe diet [some create substantial damage with starvation diets]:I eat reasonably clean with ratios of 50protein, 30 carb and 20 fat.
-describe training [some ruin there hormones by over training]: What trainingâ?¦nothing these days
-testes ache, ever, with a fever?: There is pain occasionally, but no fever.
-how have morning wood and nocturnal erections changed: Off and on.

I have sitting in front of me a bottle of test cypionate and a 27 gauge insulin pin and Im instructed to inject 50ml sub q tomorrow and to be honest Im scared sh&*tless.

Not of the needles mind you, but of the potential side effects that could occur.

A few questions…

Why is my free T so stinking low?
My ACTH is high but cortisol looks decent, what are your opinions on that?
Is it a given that Hemocrit, RBC’s and Hemoglobin problems will arise?

Before you ask…body temps are steady at 97.7 (I’ve monitored for three months).

Ill be honest guys…TRT freaks me out, but if i get even a slim chance at being “normal” again, its a chance I must take for me and my family.

Thanks in advance for all of the responses!

2

Please add time of day for cortisol lab work. You can use [edit] to change your original post.

First 5 groups of lab do not make any sense.

TSH is elevated, temps are low, fT4 is lowish.

Your low body temps indicate a functional thyroid problem. Thyroid function is part of body temp regulation.

Need waking and mid afternoon temps…
Need your history of iodine intake using iodized salt and from any vitamins that list iodine.

Doc palpates your thyroid?
Your neck appears thick around your thyroid?
Looks or feels asymmetric or lumpy?
Dry or brittle skin, nails hair?
Feel cold easily?

T is low because FSH/LH are low. Those are low in part because your E:T ratio is poor, you are estrogen dominant. FT is even worse, indicating that E2 has increased SHBG and SHBG reduces FT.

When did these problems start? With the hair loss drug? You stopped that when?

You do not show any ATCH labs.

Suspecting thyroid/iodine problems and perhaps adrenal issues. We often see that low T has company. rT3 might be elevated, explaining the combo of low temps and elevated fT3.

Do you eat red meat?
Any food sensitivities?
HGB could be better.
Digestive problems or upsets?

How do you react to stress? Ever makes you feel unwell or drained/weak?

DHEA-S is low, start taking 25mg DHEA with meals that contain fats.

3

[quote]KSman wrote:
Please add time of day for cortisol lab work. You can use [edit] to change your original post.

First 5 groups of lab do not make any sense.
(These specific groups are part of the CBC panel and from what Iâ??ve read, they pertain to the percetages of B (basophil) E (Eosinophil) L (Leukocyte) and N (Neutrophil).)

TSH is elevated, temps are low, fT4 is lowish.

Your low body temps indicate a functional thyroid problem. Thyroid function is part of body temp regulation.

Need waking and mid afternoon temps…
(97.7 is my average waking temp. Midday is 98.1 and afternoon I can hit 98.7 with ease.
Need your history of iodine intake using iodized salt and from any vitamins that list iodine.
Since reading the stickies months ago, I ingest at least a table spoon of iodized salt daily.)

Doc palpates your thyroid?
(Nope all is clearâ?¦.no goiders.)

Your neck appears thick around your thyroid?
(Not at all.)

Looks or feels asymmetric or lumpy?
(Negative.)

Dry or brittle skin, nails hair?
(Yes for dry skin, but I attribute that to the North Texas Panhandle dryness. Hair is in the process of turning grey and turning loose but my nails can be trimmed weekly as they grow very quickly and are thick and hard.)

Feel cold easily?
(Yes and noâ?¦.I have my days.)

T is low because FSH/LH are low. (Now can you elaborate on E:T ratio influencing my pituitary secretions.) Those are low in part because your E:T ratio is poor, you are estrogen dominant. FT is even worse, indicating that E2 has increased SHBG and SHBG reduces FT. (I appear to be in normal range for both Estrogen and SHBG. How can a reversal be made from being estrogen dominant.)

When did these problems start? With the hair loss drug? You stopped that when?
(Yes our favorite hairloss drug Propecia was a big part of my life in my early 20â??sâ?¦.right about the time anxiety started. DHT lab results are due to arrive next week. I stopped the drug three years ago after loss of penile sensation and nipples becoming puffy.)

You do not show any ATCH labs.
(For the heck of it, here is Progesterone: 0.3 ng/ml (no reference range given)

Here are the results from the saliva cortisol test.

6:15 am 0.435 range (0.122-1.551)
2:00 pm 0.173 range (less than 0.359)
9:00 pm 0.115 range (less than 0.359)

I had my ACTH stim test this past Monday those results should arrive next week.

Something worth noting is that within 5 minutes of receiving the cortrosyn shot, I became very ill with extreme stomach pain and it felt like my kidneys were being pummeled.

I have been having tremors and shakes since Monday and ended up in the ER with low blood sugar of 60 and a blood pressure reading of 165/105 and Iâ??m never over 115/68 (usually lower). Something else worth mentioning is that in the past six months my blood serum cortisol reading has never been over 12.8…well in the ER the score was 25.5 (range 8.7—22.4). Im scared of taking testosterone for fear of bringing about an adrenal crash. Most dr’s treat Adrenal, Thyroid and Sex Hormones…correct?

Here is my ACTH test. ACTH 42 pg/ml (range 0-46))

Suspecting thyroid/iodine problems and perhaps adrenal issues. We often see that low T has company. rT3 might be elevated, explaining the combo of low temps and elevated fT3.
(I inquired about an rT3 test and we will have that ran in a few weeks.)

Do you eat red meat?
(At least four times a week.)

Any food sensitivities?
(Too many to nameâ?¦.but I do shy away from them)

HGB could be better. (Perhaps this is good because TRT can certainly raise it)
Digestive problems or upsets? (Not all, Iâ??m as regular and on time as Big-Ben.)

How do you react to stress? Ever makes you feel unwell or drained/weak?
(I donâ??t react to stress because Iâ??m constantly stressed. Oddly enough if there is a catastrophic event or accident, Im as cool as the other side of the pillow. In actual moments of crisis, its strange but I perform well. I usually donâ??t find myself in crisis very much so its fatigue 98% of the time.)

DHEA-S is low, start taking 25mg DHEA with meals that contain fats.
(Any recommendations?)

As always, thankyou for taking time to help complete strangers.[/quote]

4

DHEA-S is low, start taking 25mg DHEA with meals that contain fats.
(Any recommendations?)

  • get it where you buy vitamins?

Most docs do not know how to manage TRT and totally miss adrenal fatigue and subclinical hypothyroidism.

Your medical options are limited there?

That is a lot of salt. Iodine supps might be more agreeable. Assuming that you are using iodized salt.

You eat lots of red meat and labs suggest possible low iron. Explanation can be GI bleeds and food sensitivities are associated with some of that. A poop smear card from your doc, take it home and mess it up and mail it, doc gets results of the occult blood test. Note that low T can cause some of these issues and TRT can correct. If you do TRT, you can wait and see if blood labs look better and then do the occult blood test later if blood does not respond.

Your cortisol does not move much at all over the day. That does not seem right. Ask your doc if you can do a trial with a small amount of cortisol to see if you feel that it improves things. Tread carefully to see what this does.

5

Ksman, so much has transpired these past few weeks so much so that I’ve taken a medical leave of absence to begin the journey of recovery.

Today I started with 25ml of testosterone cypionate and I’ve been taking DHEA, Vitamin D, Vitamin C and Vitamin D.

I will go back to the dr this Friday for a follow up and more blood work.

My plan is to start slow with 25mg of test c every M W and F.

My question for you all is looking at my Hemocrit and RBC, do you guys think I’m at risk for “thick” blood?

I also plan to introduce an AI and topical pregnenolone a bit later should my levels continue to tank.

What can I expect my first week of therapy and is my strategy of slow and low a good strategy to adopt as this is my first time?

I truthfully worry at about week 5 or 6 when my own production is halted and how I will feel.

Can I use this thread to begin a log for all to share my experiences?

Thanks again for the responses!

6

Keep all of your posts in this thread and write away.

You may feel nothing for a while. Results vary. E2 management can be mission critical.

What is 25ml testosterone. That is almost an ounce. T can be 100, 200 mg/ml. So know your dose in mg’s and post that.

Please read the thyroid basics sticky.

7

I edited my dose measurement…my apologies.

I will reread the thyroid basics sticky and revisit “stop the thyroid madness.com”.

How soon can one suspect E2 and hemocrit/hemoglobin levels to rise?

I know testosterone cyp is a long acting ester and thus released slowly, but 12 hours after the shot I’m relaxed and can hardly hold my eyes open and usually I’m shaking from anxiety.

Any thoughts?

8

Day after…

Today as I expected was filled with anxiety (that is the one thing Im hoping trt remedies) but to no avail.

The day was filled with worry and trepidation as to what trt was going to do to me. So naturally I noticed every cool breeze on my face, every temperature change, every heart beat…NO EXAGGERATIONS HERE.

Maybe an unrelated symptom, but my sugar was extra low (65) and more fatigue than usual.

Macro nutrient breakdown are as follows…
200 grams of protein
175 grams of carbs
50 grams of fat

No sleep last night as my wife began to experience labor (our third soon should arrive this week).

No exercise today as I don’t have the strength or energy to do so as of yet.

Second sub Q injection (25mg) is scheduled for tomorrow morning.
Vit C, D and B12 and DHEA are to be taken as well.

Guys let me know what other information a good log needs and I will include it.

9

Four shots in and I’m so ridiculously fatigued and tired.

My legs are quivering and I could fall asleep at the drop of a hat.

Temps have averaged 97.8 in the morning rising to 98.8.

Blood sugar has averaged 88-95 and blood pressure has been averaging 118/73.

Why am I so sleepy and why am I having more panic attacks out of nowhere?

This is worse compared to pre trt and I know people saw give it a few weeks but I have a job I need to function at and this present state I now find myself in isn’t condusive to performing at peak levels.

Any advice…I follow up tomorrow with my Dr.

So frustrating.

10

I would say that your body is not able to deliver the restored metabolic demands of TRT. I have indicated reasons above or in the advice for new guys sticky. You have some mental aspects to deal with that may be beyond hormone balance. I have not reviewed everything above. You may need to reduce TRT dose while you deal with these other issues. Stress/anxiety seems to be a large issue now.