Hi all, I have been reading through this forum as well as a few others over the last few months and have found so much info here. I have been on trt for about six months now and I have definitely improved from where I was pre-trt.
My current doctor began my therapy with t-gels for a few months and a felt an improvement for the first few weeks and then everything went downhill. My TT at this time was barely over 400. He then switched me to 110mg test-cyp weekly and after a few weeks added in 300iu of Hcg (I was starting to suffer from a bit of testicular atrophy even during the second month of the gel).
This brought me up to a TT level of ~610 and e2 of 31. I did feel a great improvements in all areas at this time (energy, focus, greater sense of well being, etc.). Unfortunately over the last few months I have started to move backwards. I realize that this protocol is far from ideal because my doc has me come to the office every week for both injections at the same time.
I understand this will cause large fluctuations in test levels and is far from ideal. Since he will not allow me to self-inject I am stuck with this protocol. My estradial level is running into the low 50’s (sensitive e2 test) now along with elevated hematocrit levels. I do have access to anastrozole, but I would rather have a doctor that would be better able to manage a proper trt protocal.
I would give more blood test info but my doc wont even test for it ( shbg=?, free t=?, etc). Since I am a NYC resident I am unable to use private med-lab testing as it seems most of these private testing labs are not available to ny-nj residents. I am 37 years old, 5’9" 160 lbs and I do not smoke or drink. I exercise 5 times a week with a combination of weight training and cardio.
I have recently visited with a few urologists in my area but all they want to do is inject me with pellets (I am not really interested in testopel). I know about contacting compounding pharmacies and I am starting do do that now but I am hopeful someone here can recommend a good doc in the nyc region.
Why urologists? As a group, they are incompetent. An enthusiastic GP is best. Please see the -finding a TRT doc- sticky and if you have not already read, read the advice for new guys sticky.
You may have problems other than low T. If you go to a carpenter, you will get nailed. At your age, low-T can be a symptom of something else going wrong.
Self screen for thyroid by checking your body temps and iodines intake: thyroid basics sticky. Inability to absorb transdermal T is a symptom thyroid problems.
Get your labs and post all here, with ranges. Also need cholesterol if you have that.
Thanks KSman, here are the results of my latest blood-work.(last week)
wbc 8.6 (3.8-10.8)
rbc 5.17 (4,2-5.8)
hemoglobin 17.0 (13.2-17.1)
hematocrit 50.8 (38.5-50.0) flag high
MCV =98.1 (80-100)
MCH 32.8 (27-33)
MCHC 33.4 (32-36)
RDW 13.1 (11-15)
Platelet 204 (140-400)
MPV 9.8 (7.5-11.5)
Total Nuetrophils 63 (38-80) Absolute 5418 (1500-7800)
Total Lymphocytes 29.4 (15-49) Absolute 2528 (850-3900)
Monocytes 5.9 (0-13) Absolute 507 (200-950)
Differential 26 (0-200)
Iron 96 (45-170)
TIBC 344 (250-425)
Transferrin Sat. 28 (20-50)
Metabolic Panel
ALT 23 (9-46)
Albumin 4.7 (3.6-5.1)
A/G ratio 1.5 (1-2.5)
AST 18 (10-40)
Bilirubin .7 (.2-1.2)
Calcium 9.9 (8.6-10.3)
Carbon Dioxide 26 (19-30)
Chloride 102 (98-110)
Globulin, Calculated 3.1 (1.9-3.7)
Potassium 4.2 (3.5-5.3)
Protein 7.8 (6.1-8.1)
Sodium 141 (135-146)
Urea Nitrogen 29 (7-25) flag high
BUN/Creatinine 29 (6-22) flag high
Alkaline Phosphate 95 (40-115)
Glucose 92 (65-139)
Thyroid Stimulating Hormone
TSH third generation 1.48 (.4-4.5)
Most recent TT = 714
E2=51
KSMan, I will ask my GP to run any additional labs , when my thyroid function was checked right before starting trt I was told my thyroid was functioning fine.(sorry I dont have the lab numbers) My GP did prescribe clomid(clomophine) but it affected my vision and made me feel off so we discontinued its use. He then referred me to the uroligist I am currently working with. Thanks for your time, any additional advice is appreciated.
Your e2 is very high. I’d have boobs and mood issues at that level. Everyone’s different, but you might want to try 1mg/wk Anastrozole for a few weeks. I can almost guarantee you’ll feel better. Meanwhile, you can investigate your thyroid health.
Also, You can cross over the boarder into PA to get a blood test without a script. You don’t need to be a resident.
Thanks Surfer, I am going to take a small dose of the anastrozole and I will ask my pcp to run labs on my thyroid. However, I am a little worried now because I had thyroid labs run twice before starting trt and everything came back normal. Fist labs were run by my PCP and then a month later by an endocrinologist(who then sent me to my current doctor for trt).
The only things that I can recall that were flagged were total testosterone level. Unfortunately, both panels showed TT in the low 200s. I am not sure if this information is relevant but I also had a sleep study done to rule out sleep apnea. I must admit that the last few months have been a huge improvement compared to how I was feeling before treatment.
When I had my t-level checked last month with a TT of ~700 and E2 of 36 I still felt pretty good. I notice my E2 has been rising over the last few labs. Is it possible my current protocol is messing things up? I would definitely appreciate if anyone on the forum could give me a lead on a competent doctor in the tri-state area.
Many here have “normal” thyroid labs with functional hypothyroidism. Your TSH is in a range where we do see problems. And your transdermal TRT did not work.
“”“Self screen for thyroid by checking your body temps and iodines intake: thyroid basics sticky. Inability to absorb transdermal T is a symptom thyroid problems. “””
Read the thyroid basics sticky, eval your iodine intake and check your body temperatures the the times specified.
E2=51 is horrible. That can be the major cause of your not feeling right. Add thyroid problems to that and things can double up.
Hi all, things have really gone south for me in the last few weeks as you can see by my labs.
Lab results from a blood draw last week:
Thyroid
Free T4 1.2 (.8-1.9)
TSH 1.15 (.4-4.0)
Free T3 3.48 (1.5-4.1)
doc report states, “normal not borderline at all” and no treatment is necessary
I have split my shot to 60mg twice weekly and I have also started anastrozole at ~.1mg (a little less then 1/10th of a tablet) twice weekly and so far I have had a mild headache, brain fog, and just feel awful (probably a-dex over-responder). In addition my bp has spiked to 135-140/80-90 from where I am normally around 110/75. Honestly, this might be the worst I have felt in a long time. I am really worried about the high bp, should I consider reducing dosage or discontinuing treatment?
I have been going through some old posts on this and a few other forums and it seems that guys with lower levels of shbg tend to better with lower levels of total t which in turn brings their free t into the proper range. Upon further investigation this seems to be accomplished with smaller more frequent injections (eod, perhaps sub eq). Is their any validity to this?
Any advice would be appreciated, thanks in advance.