Cholesterol increase is to be expected and TRT will reverse that.
LH/FSH is low and T is low, you have secondary hypogonadism. But getting on T then off can cause that as well.
Increase HDL with:
fish oil
high potency B-complex multi-vits
DHEA [if deficient, you are boarder line low]
TRT can lower fasting cholesterol, but typically has no effect on HDL
Fasting insulin?
Labs for A1C are needed. ?diabetes?
“low T/E/SHBG” - these are self-consistent to some degree.
"SHBG levels are decreased by androgens, administration of anabolic steroids,[19] polycystic ovary syndrome, hypothyroidism, obesity, Cushing’s syndrome, and acromegaly. Low SHBG levels increase the probability of Type 2 Diabetes.[20] "
?diabetes?
Low T increases insulin resistance in some cases and TRT can combat some of that.
Correct. All tests done in the morning and fasting.
Hemoglobin A1c 5.5 % 4.8-5.6
Haven’t been diagnosed with diabetes but clearly it’s boderline. I need to fix this asap.
My experience while on TRT was poor at best. I attribute that to the Dr. and being uneducated on TRT before going in. This is a long shot but would significant lifestyle/diet changes affect T at all?
There is one Dr. locally who just began HRT/TRT. I know nothing about her but I’m tempted to schedule a consult. At least now I can go in having experienced TRT. I guess it couldn’t hurt.
A1C is top range and fasting insulin was high; you have insulin resistance. TRT with controlled E2 will improve that and reduce cholesterol. You need to change diet to avoid simple carbs.
You have thyroid function issues with low body temperatures, so your mitochondria are running in low gear. Mitochondria burn fats and sugars in your blood and that is impaired and is probably part of your insulin resistance.
Any numbness or tingling in your feet?
Focus:
diet
TT, FT, E2
thyroid, iodine, body temperatures
Saw Endo last Friday. Thankfully I took with me the blood work I had done myself. Doc saw them and admitted I had low T. Started me on 25mg clomid everyday and wants me to come back in 3 months. He had another patient on clomid and that person saw good results so he was willing to prescribe it for me.
I’m about 10 days into clomiphene - 25mg every day. I’m not sure when/if I should begin to notice effects but the only thing I’ve noticed is that I’m absolutely exhausted during the day. Growing more and more frustrated.
I’m tempted to get a quick T/E lab done this week to see if I’m going in the right direction.
I didn’t want to start a new thread or hijack someone else’s so I’ll just update this one. I finally saw a “good” Endo, started me on clomiphene 50mg EOD, and I just got my labs back from being on it about two months.
I feel ok. Not great and not measurably better than before.
It’s been quite awhile but I thought I’d use this as a place to update my TRT situation. To pick up where I left off, I moved to a much bigger city with better doctors. After pellets I tried Clomid (no change improvement in symptoms), tried HCG (labs came back in normal range for T but no change in mood, sex drive, etc). Finally decided to get on T again via injection with HCG. I’m currently two injections in with Friday being one week on T/HCG.
Aside from the obvious low T symptoms, for the past year or so I’ve been experiencing what are basically hot flashes and would sweat like crazy. I went to see a dermatologist and was prescribed glycopyrrolate. I use it on days I have meetings and it works some of the time. I’m not sure if this is hormone related but it certainly wasn’t an issue a few years ago. Had an MRI done about 2yrs ago to rule out any pituitary issues. Results were negative.
The past two weeks I’ve noticed I have had headaches more often than usual. About two days post injection I feel not great and it mimics the “test flu”.
Current Weight: 260 (heaviest I’ve ever been and the fact that I’m closer to 300lbs than 200lbs is terrifying)
Daily meds/supplements:
Metoprolol Succinate 50mg x 1 daily
Losartan 25mg x 1 daily
Ubiquinol (lab test showed CoQ-10 deficiency) 100mg x 1 daily
Omega 3 EPA: 1250 DHA: 500 x 1 daily
Methyl Folate: 1000mcg x 1 daily
Vit D-3 5000iu x 1 daily
ALA 600mg x 1 daily
Chromium 200mcg (starting today. Lab test showed deficiency)
TRT:
0.3ml Testosterone Cypionate x 2 weekly
HCG 750iu/0.375ml x 2 weekly
Anastrazole 1mg weekly. Starting 0.5mg 36hrs post injections. Will revisit after labs.
Below are my labs one week prior to starting injections. I’m going to re-test this Friday which would be about 4hrs prior to my next injection. I’m aware the triglycerides are sky high. If this lab doesn’t show a reduction I’m going to speak to my GP.
Your SHBG is low enough to where you should consider injecting every other day or perhaps ever day. Reason being your low SHBG prevents you from holding onto your testosterone for long, I’m only a few points higher than you and I only respond to TRT strongly when injecting smaller doses EOD.
You just can’t seem to find a good enough doctor, you don’t take an AI once weekly because of the half life is only 2 days so by the end of the week it’s cleared out of your system. You need to at a minimum take the AI twice weekly. The dosage for the AI is too high, compared to my .125 dosage is just too much for most men.
Have your doctor write you a AI prescription for a compounding pharmacy so you can have access to compounded doses of anastrozole. Cutting up the 1mg tablet into quarters is next to impossible.
0.3ml Testosterone Cypionate from 200mg vial or 100mg vial? Big different in dosages. That’s either 60mg or 30mg twice weekly. Still using the wrong estrogen test for females, men require the sensitive E2 or LC/MS/MS method designed for men.
You can better control hematocrit injecting smaller doses EOD or ED, you will feel better because low SHBG men have a lot of free T and Free E2. That’s why you have to throw the AI at the problem. 20mg EOD is all that I need, still dosing the AI.
The SHBG was from previous blood work about 3yrs ago. I’m going to get it tested soon.
Sorry, I should have been more clear on the T dose. I’m on 0.3ML E3.5D and the vial is 5ML with 200mg/ML. I’m going to try a week of a set protocol to see what my numbers look like then I’ll adjust accordingly. FWIW, my Dr. did say I was free to adjust doses based on how I feel which was nice to hear. He’s younger and is on TRT/HCG as well.
The sticky for lab work says no to sensitive E2 testing while on T. Or is that not correct?
My hematrocrit was really high even before getting back on T so my Dr. has prescribed me to donate twice monthly but expects it to somewhat level out in a few months. I guess we’ll see.
I started checking my temps yesterday to look into any potential thyroid issue and this what I got. It might not have any relevance but I am constantly hot and sweating even when I shouldn’t be. I guess the next step will be labs to figure out what’s going on.
6:30am - 96
8:30am - 97.5
3:00pm after workout and shower - 97.9
5:15pm - 96.9 (checked three time, this was the highest of the three)
9:30pm - 98
You shouldn’t be checking morning and evening temperatures as they are both expected to be lower than your peak afternoon body temperatures. You need a thyroid panel checking Free T3, Free T4, Reverse T3 and antibodies. TRT may improve thyroid. You may just be iodine deficient.
So I’ve moved to .20ml T EOD as well as .25ml HCG EOD. As of now it seems my mood had stabilized a bit but my cravings have come back and the energy I had initially has subsided.
One thing I did notice the other day was about 4hrs post injection I got the best erection I’ve ever had. Now I’m scrambling to think of how it happened. I wonder if it was just a fluke or perfect timing of shot and E levels?
When you inject testosterone there’s a lag response, you’re actually responding to an injection days ago and not necessary the last one. It could even be the anticipation of your next injection, the body knows it’s about to happen, the reason is usually more than just one reason.
