Greetings,
Thanks for the feedback. I hope everything works for you.
Stay strong
I have had 5 DVT blood clots and worry about Test causing blood clots, esp with my Hct getting up near 53. My libido is better but not great. I am sure it would be better with a higher Test dose, but worry about increased blood viscosity causing DVT with surgery.
Considering stopping Test before Surgery to decrease risk of blood clots.
Anyone have any thoughts or data to share?
Your surgeon will likely insist upon that or at least a normal CBC prior to surgery.
I may give blood a couple weeks before to decrease my HCT and some coagulation factors. Will taper down my Test a bit as well.
I have watched a couple lectures posted to this site that claim using test does not increase the risks of blood clots.
Any thoughts?
Iāve posted some of those. I sat in a room with 100 other doctors while Dr. Neal Rouzier asked if anyone had any published evidence that TRT caused blood clots, stroke or heart attacks. Silence. āIām waiting.ā More silence. āIām still waiting.ā Silence. āThere is none.ā
Iāve seen studies on people living at altitude with erythrocytosis and they live longer with a decreased incidence of heart disease. I donāt think thatās why they live longer, but it is not killing them.
However, your surgeon is going to want to see a normal CBC before proceeding. Nothing wrong with donating blood anyway. I do, but I always have. From an TRT perspective, I think each patient should be looked at on an individual basis.
Regarding your DVTs, has a cause been identified? Platelet level?
I have had a complete coagulation workup twice and no abnormal results. Platlets are always normal. Hemotologists think I must have some abnormality that they donāt have tests for yet.
So I am thinking about getting a IVC filter placed and then getting my low back and neck fused, then remove the filter once I am doing well, if I have not had any clots.
Then I will try to get my TRT dialed in. Still no adverse effects from no AI, just some very mild hand swelling. No lower leg edema or joint popping like when I first started TRT. I think I will need to increase my Test-C a bit to optimize.
Well my 3 level neck fusion is set for Sept 24,2020.
I just got some labs back after being on my new regimen for about 3 months.
My old regimen:
TestC 40 SubQ 2x / week Sunday am and Wed eve
HCG 333u 2x / week Sun/Wed
Amidex .15 mg 2x/week Sun/Wed
My new Regimen:
Test C 40 Sub Q 3x/ week ( MWF)
HCG 200 3X/week (MWF)
No Amidex
Labs:
Total Test OCT '19: 758 New July '20: 1127
Free T OCT '19: 25.8 NewJuly '20: 25.2
DHEA 36 - low 31.6
Estradiol 15 (7-42) 49.0
Estradiol Sensitive 18.2 (8-35) 38.9
Vit D 32 43
HCT 43 48
My libido is somewhat better, but not much. I am a bit bummed that my free T is about the same despite having a much higher total Test level. Also my estrogen is much higher without taking the AI. I seem to have a good energy level, it actually was great when off work for 4 weeks because of Covid shutdown ( more sleep vs new protocol?)
What can I do to increase my free Test and Libido?
Increase dose = more free T
Your estrogen is on the low side, bet thatās the reason for the mediocre libido.
Increase your dose. Iād increase VitD as well.
I think it increased with both methods, 15 to 49 and 18.2 to 38.9.
Yes my estrogen increased from 15 to 49 since stopping the AI.
I have increased my test C dose and my total test level is way up, but my free Test level is about the same.
Am I getting more Testosterone
bound?
I mean e2 comes from T. So if you have more e2 it has to come from somewhere. Whether thatās the reason or not, I donāt know, but itās probably a piece of it.
Well, I think I am doing pretty well, not concerned that perhaps my E2 may be too high. Should I do a trial of restarting my AI in low dose for a while to see if it has an effect on my libido?
Iād listen to @highpull first. Lowering e2 is not usually the answer to improving libido, esp at the levels youāre at
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If my total T increased, should my free T also increase - it has not.
Would an increase in total T usually give you a benefit, or should I only be trying to increase my free T?
Yes, it should. I donāt remember, has SHBG been checked?
I would increase total testosterone until I had free testosterone where it needs to be.