On The Right Path?

Pharma TRT
41

They are right about your T fluctuating more than your E2, E2 moves much slower and it also take the body longer to even notice the rise in E2. This also creates a problem with your T and E2 ratio, you feel the peaks and valleys regardless. When you take prescription medication you don’t wait for half of the medicine to clear otherwise you would be going through withdraw every day and that seems to be what endo’s just don’t understand.

My first endo was ok with my T levels peaking at 1200 and 10 days later at 400-600 since I was still in range without regard for how it made me feel. They look at it that 600 is alright, but going from 1200 to 600 feels terrible.

42

Don’t continue to make the mistake of taking an AI because you felt a couple symptoms. Been there, it only leads to crashed E2.

In the beginning, TRT made my feet get a little puffy after a shot, my e2 was in check, this has gradually gone away, I still get it very rarely.

43

Thank you guys! It really does go a looooonh way knowing I’m not the only one and that it’s not permanent or something worse.

44

Just to clarify…are you saying less frequent testosterone or more frequent injections are better for E2 levels? I was of the mindset that the more frequent the better for T and E2 and SC even helps a little more but I’m open to whatever will work to stabilize my system.

45

It depends upon the individuals SHBG levels. When I moved from twice per week injections to every other day my estrogen started climbing higher because my levels did not start dropping before my next injection. Injecting more often increased my testosterone and my estrogen.

46

Well I should have my new labs back by Monday and will definitely report them here. Hopefully that will give some insight as to what is happening.

47

I did confirm that they ARE running the Estradiol Sensitive LC/MS test along with the blood work tomorrow morning so that should give us some accurate numbers to work from.

Tomorrow will also be trough day as I won’t inject until after my appointment. Since I won’t have the results until Monday or Tuesday should I go ahead and take another 1/8th of AI as I did on Tuesday? I noticed my wood-o-meter wasn’t very good this morning so I’m curious but with actual REAL numbers to go off of I wonder if I should wait for those before doing anything?

48

So I’m perplexed by my blood work results…

Total T = 426 (range 264-916)
Free T = 16 (range 6.8-21.5)
E2 Sensitive = 10.2 (range 8.0-35)

I don’t understand how this could be. My symptoms point to high estrogen now (high BP, crazy bloat, anxious, etc.) and when I took 1/8th MG of Anastrozole it started to relieve them so I took .25mg with this most recent injection and now I’ll probably crash.

Plus now my ALT is high (45 range 0-44) my Globulin Total is low (1.3 range 1.5-4.5) and my AG ratio is high (3.7 range 1.2-2.2)

So I’m about to throw my hands up…this is far worse than I felt before TRT. Maybe one of you or @KSman have some solutions because my TRT clinic does not.

49

Do you feel hot or cold? For me feeling cold is always lower E2 while feeling warm is high E2. Your TT levels are low. In any case your AI is too high! Low/high E2 symptoms are very similar.

50

I flash hot to cold but my hands/feet have always been cold.

I know, right? It was my trough day but I would think my Testosterone levels should / would be higher. And now I realize my AI was too high too but all my symptoms are high E2 so that’s why I tried to reintroduce it. As soon as I started to the water weight dropped off - we’re talking 5-8lbs of water.

Last night was my best wood-o-meter to date too and I had taken .25mg of AI on Tuesday. I just don’t get it.

51

Repost your protocol. Helps so guys don’t have to read all the way up

52

No problem…

Test Cyp 200mg/ml - 0.4ml twice weekly (SC)

HCG - 0.25ml twice weekly (SC)

Anastrozole 1mg tablet - Take 1/4 tab twice per week*

*Obviously the AI was the original protocol.

53

Ok. So I went back through this entire thread to make sure I wasn’t losing my mind. When you started this thread you had low estrogen. Shortly after that your doctor gave you an AI and crashed you even harder. Now you have blood work again showing that you are crashed with less than ideal TT. I feel like there is a trend here. Mixing up the dosage on your AI isn’t a good idea. I’m no doctor but I would drop the AI.

54

I know and I feel like I’m chasing my tail here. Initially I did think I crashed my E2 but in the following couple of weeks with the crazy BP, heart rate and bloat (which I feel like the bloat is attached to the BP because they both decreased at the same time but could not be) along with the fact that I still had “lead in my pencil” lead me to believe my estrogen had shot up from the injections. And what’s with those other issues (ALT, globulin, AG ratio)?

55

Your issue is your AI dose was to high, you lost water weight and great erections within a small window and then your E2 continued to plummet, then you got labs showing low E2. Another thing you don’t realise is when your E2 changes you don’t feel the effects right away, it takes days or even half a week to actually feel it.

Your main problem is you making changes based off how you feel, guys that do this routinely crash their E2 levels.

56

@shltn, I don’t think I have seen anyone say this so far but imo… drop the AI all together. Insanely high estrogen does not seem to be the problem here. Low estrogen is a problem. It is more of a problem than high estrogen ever will be. Low estrogen in men accounts for a 300% increase in mortality. I’m not trying to scare you but that’s what the studies have shown. YOU NEED ESTROGEN. Based on all the test I’ve seen thus far you may not need an AI at all. Hell your TT is low and your Estrogen is low. At 160 mg a week I’m actually pretty surprised to see that. I’ve seen plenty of bloodwork from others on 100mg a week that are way higher than that. I’m not trying to tell you what to do but this is certainly what I would do. Drop the AI. Stop obsessing over your interpretation of “symptoms”. Let your treatment stabilize without the AI and see where your Estrogen falls. If your E2 is still low without an AI than a slight increase in Test might bring everything in range.

57

I agree with you (maybe we’ve been listening / reading the same info lately) but hindsight is 20/20 :slight_smile:

I guess another thing I’m curious about is how my Total Testosterone only went up 10 points and my Free 5 points on 160mg of Testosterone a week and 500iu of HCG?

So now I have to figure out whether to keep going because I obviously have some additional issues with TRT and if I have to take a million pills / supplements numerous times of day plus whatever else to try coax a few good days here and there to crash or have high BP then what’s the point? I can do all that growing old for free :slight_smile: and a few years down the road because I felt better pre-TRT…I’m longing for the brain fog and lethargy now :slight_smile:

58

Attached is my most recent blood work.

This week I travelled and met with another one of the leaders in this optimization / anti-aging field – this is my second attempt at a resolution.

My first attempt a couple of weeks ago was via phone consult to which I received “hmmm…that doesn’t make sense…why didn’t your testosterone increase from the injections…hmmm…well times up.”.

On this second attempt I was told that testosterone just wasn’t for me due to the way my body reacts to it…which is totally fine if that’s the case. I started TRT due to the symptoms I was having (lethargy, brain fog, low energy, etc.) and now I have those PLUS the high BP, heart rate, anxiety / adrenaline issues and my cholesterol actually went up.

Going into this meeting and with new blood work I thought, based on what I’ve read, that there is probably some underlying issue(s) that caused this reaction to TRT and THAT ISSUE was probably what was actually causing my original symptoms in the first place but they just so happen to overlap with “Low T” symptoms. Plus, I also have the low body temp, cold extremities, etc… so I honestly thought I had hypothyroid or adrenal fatigue or something along those lines and then the testosterone just blew everything out of whack.

But alas, I was told I do not… my thyroid and the rest “are fine” and that my body just cannot tolerate testosterone. That my original symptoms / issues stem from idiot GPs putting me on antibiotics for 6-8 months due to what turned out to be a botched root canal (long story that began in November 2016) and that I just needed up to a year to recover. I was given a Clomid script for PCT (not sure I needed it due to my only being on TRT for about 4-5wks and ran HCG throughout) and several hundred dollars worth of “pharmaceutical-grade” vitamins and I should only take their specific vitamins.

I just rolled with it in the office because I was desperate for some relief from these symptoms and didn’t really examine the “bill” until after I left but needless to say, I declined the monthly retainer fee for them to essentially “consult” me on vitamins each month. If “time” is really the only thing that is going to make me better why would I pay hundreds of dollars a month for someone to do nothing and buy way overpriced vitamins? In addition, I would be out-of-pocket for everything else due to the fact that they don’t mess with insurance in any facet – services, blood work or prescriptions.

So as a last ditch effort I thought I would post my blood work for everyone here and maybe you’ll see something, anything, that may be the root cause for my original symptoms – I think I just have to wait for the TRT issues to go away but I stopped those injections on January 12th.

Post-TRT-BloodWork-Jan2018_05
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59

TRT doesn’t work if you are hypothyroid, your doctors sound like complete idiots! For TRT to work you must fix your thyroids issues, often when a guy is hypo his thyroid cannot match the metabolic rate of healthy test levels and often a guy can feel worse than before TRT.

You need to find a doctor who will treat BOTH your thyroid and TRT protocol. The fact that you were started on TRT without having your thyroid diagnosed tells me your doctors are half hazard.

The notion that your body just doesn’t respond well to TRT is absurd, you body evolved over millions of years to process testosterone. How frustrating this must be for you. Doctors are worse than lawyers.

Reverse T3 is blocking fT3 thyroid hormone, how come your doctors don’t address it?

60

Do not test LH/FSH again.

Thyroid is NOT fine!

fT3 is the active thyroid hormone. There is no receptor for T4.

rT3 opposes fT3 and blocks fT3 at T3 receptors. rT3 is high so I expect to see that you have some hypothyroid symptoms:

  • low energy, lethargy and mood problems - brain is slowed done.
  • Low body temps because every cell in your body has slowed down. T3 is part of the body’s energy and body temperature control loop.
  • You need to check and post oral body temps as requested earlier - did I miss?
  • Outer eyebrows sparse
  • dry skin

fT3 is a bit above mod-range which can be a compensation for elevated rT3. As mid-range should support good body temperatures, if temperatures are low, we can strongly suspect rT3 as the cause. Similar re fT4.

So your low energy is your thyroid and few doctors will understand that ranges are stupid and the depth of complexity.

IGF-1 shows good GH status. GH should not be tested directly again.

If you were to take T4 only thyroid meds we would expect to see more T4–>rT3 and things get worse. See the thyroid basics sticky noting terms: stress, illnesses,inflammation, over training, adrenal fatigue and Wilson’s book.
You need to take time release T3 which is a USA compounding pharmacy only item. That will suppress TSH and then reduce T4 production in the thyroid.

Need time of day for cortisol labs!
Should be AM cortisol at 8AM or 1 hour after waking up.