I asked him for the full panel and he just ran Test and estradiol. I am going back on Saturday with a printed out list and flat out TELL him to run the full damn list!!!
That said…
Estrodial <10 is all it says, but the real bitch is my test. 223 ng/ml! OUCH! He says we are starting TRT immediatly @ 200mg per shot 1x per week for 6 weeks then test again. At that time he wants to figure out a ‘maintinance’ program.
Thoughts?
You will be ok. After you are on, the labs done then are what will be used to get things right.
200mg/wk is probably way to high.
Suggest that you get an E2 test at week three, then probably get onto arimidex. You will need hCG, there is no doubt about the outcome.
200mg in a weekly injection will spike your T and that will lead to higher amounts of E2 and SHBG. Better to inject twice a week.
I would recommend 200mg/wk for two weeks, then 150, then 100 and stay on that. Start arimidex [1mg/wk] after 1.5 weeks and test E2 at week 3, adjust adex to get E2 into lower 20s [0-53pg/ml]. Start 250iu SC hCG EOD from the get go.
T alone will mess things up, better to start with “maintenance” right now and not wait to develop problems from T alone.
If the 3rd week E test shows E2 too low, your may be an adex over-responder. Go to 1/4mg per week and see how that feels. Make small changes up or down and see how that feels. When things seem ok, retest E2. When E2 is too low, mental confusion, mood and libido problems result. If E2 is too high, reducing E2 will create a fast libido response. Libido can be your best guide for eval of adex dose.
A few [sort of rare] do need 200mg test cyp per week. Their bodies clear T and E out of their systems at a high rate.
Starting with too much T might feel great as first. But when your TT=1800, your doc will cut you back to 100 and you will feel a let-down and may feel worse that if you had started on 100mg/wk and not making your body accustomed to very high T levels. If you have to change your T dose, this will affect the amount of adex that you need. So you will not have a stable adex-E2 situation for a long time. With more/less T, you need more/less adex to get a given E2 result.
T+AI+hCG
Good info. Thank you.
I will have to check into him letting get some hcg. He wants to do the injections in office (at 30.00 each its tough to turn down 
His nurse said something about working down to a 1x per month shot which doesn’t sound right to me.
Nurse is an idiot, I guess she want to see YOU suffer through monthly cycles.
Fight to get self injecting.
Would that be office injections every week or every two weeks? At every week that is only $1560/year. My test cyp costs me $2.60 per week 100mg/wk , other typically pay around $5.00. Large needles cost around $20/100 if you buy a box of 100. Insulin syringes from Wal-Mart or Sam’s cost $12.60 per 100. Nice money maker for your doctor.
Yeah its 1x per week at 35.00 per shot. I don’t get the damn 1x per month either.
This is beyond frustrating
Welcome to the state of medicine. Unfortunately, your story is already quite familiar.
This is why we need to end up knowing more than doctors know, out of self defense.