TRT, 61Y/O, Prostate Cancer History

Pharma / TRT Testosterone Replacement
1

Looking to learn from this forum, will get this out of the way first.

61 yr old male, 6’0". 195 lbs. Prostate Cancer treated with Radioactive seeds in 2004. 2010 declared clean of cancer latest PSA <0.10 ng/ml. Oncologist grudgingly agreed that monitored TRT would be acceptable.

My T Levels vary according to time of day. As high as 550 if test taken in morning as low as 360 if taken in the afternoon. T has slowly degraded over the last 4 years.

No longer any morning erections or desire for sex to speak of. Brittle nails, carrying weight around midsection and back, lack of energy, not sleeping well.

I have had lots of blood work done over the last 4 years. These normally include CBC, CMP, Lipid Panel, PSA Diagnostic, Testosterone, TSH. All tests were within normal ranges. Estradiol levels were never requested in those blood tests.

“Normal” Range for Testosterone is 300 - 700 ng\dl per the docs, I have never felt normal at that low end, sometimes had hot flashes and sweating with the low numbers.

I have been to endos’ that tell me the T levels are normal, then shrug their shoulders when I tell them I am experiencing menopausal type symptoms. The doctors I have been to (with the exception of my current GP) just stare with a blank face when I speak of symptoms. To them, the number is the end all of it, and I am alive, how dare I complain. My current GP is a young guy, we have a good rapport and he knows what I am considering.

I have read some, not all of the stickies. At this point, the technical jargon is a bit beyond me.

Ready to take blood tests, what should be included outside of the above?

I have put up with these problems since 2004 and I am tired of it.

Thank you . Gary Moore

2

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

We often find issues in normal labwork. Please provide with lab ranges.

TT, total testosterone is not the whole picture as most of its T is T+SHBG that is not bio-available. Liver issues can impair T+SHBG clearance increasing TT. SHBG can be elevated leading to more T+SHBG

Read the stickies and you will know more than most doctors.

Brittle nails can also be from thyroid issues?
Using iodized salt to support thyroid hormone production?
Feeling cold easier that before?
Outer eyebrows sparse?
You cannot go on thyroid normal ranges or TSH alone.
Please check oral body temperatures as per the thyroid basics sticky. That is a good overall measure of thyroid function.

3

Labs - at your age:
TT
FT
E2
CBC
hematocrit
AST/ALT
DHEA-S
AM cortisol
PSA is known low
CRP general inflammatory marker
homocysteine - cardio specific inflammatory marker
If body temperatures are low:
TSH
fT3
fT4 - please not T3, T4

4

I have two sources of salt in the house, I find out now that neither has iodine. I would not have thought.

Have no issues with hair loss on eyebrows or elsewhere on body except mid thigh to ankles, no hair there. I may have lost this during cancer treatment due to being administered Lupron and Casodex, or possibly radiation therapy. I know for sure it has been missing for years and has never regrown. There were also other numerous urinary drugs administered during my cancer treatment, if you insist, I will list.

Current Prescription and OTC drugs taken = Prilosec 40 mg daily, Tolterodine Tartrate 4mg once daily for urinary urgency, Duexis (ibuprofen and famotidine)1600 mg daily
Currently using Minoxidil 5 percent 2 ml daily.

Up until May of 2016 I worked out regularly. Worked up to about 165 on bench, squats and deadlift about 215, about 9 sets of each per week. Tore a ligament in right elbow and stopped. Weight training gave me strength, but had little effect on muscle development and body fat.

Am I feeling colder? Yes, more than usual, especially of late.

I found the table of abbreviations, that will help a lot in my stickie reading.

Will get new labs soon and take temps.
Thank you. … Gary M

5

Thyroid basics sticky addresses iodine replenishment.

Anyone else living there who is iodine deficient?

6

That can lead to poor mineral absorption. If you get muscle craps, that is a magnesium deficiency. Look at ZMA sold by T-nation, Biotest branded.

7

Arthritis: I have OA in my hands. 6 naproxen per day did nothing. Now using Rx 15mg meloxicam, swelling and pain gone. Take once per day. 15mg is a very small drug load. $40 for 360 at Walmart, cash price.

I am concerned that you are taking two acid reducers!

8

Yes, I know what you are saying, I will stop the Duexis. I am recovering from surgery for a torn tendon in my arm and the need for anti inflammatory drugs are nearing the end anyway.

I have taken something for my stomach most of my adult life, I can go about 3 months without it and the reflux is back. Had surgery to rebuild stomach flap before the cancer and it worked great. Then during the PC cancer treatment, the drugs that were supposed to “settle my stomach” messed up the very effective surgery solution.

No one else in the house, so no other Iodine deficiency. I am looking at getting Iodine supplements and a good thermometer to take my waking and bedtime temps this weekend.

Getting all of the information together including the labs will take me a little time so please bear with me.

I am updating the original post as I go along. Is that an ok way to respond, or would you prefer that I respond in this thread with a new post every time I have something to add? Thank you for your responses.

9

Keep everything here in this thread, with new posts in this thread, so what is new is obvious. Later if you post something that needs reference to what has been posted before, we can scroll up for that context.

My answers can be a bit brief sometimes, trying to cover most threads.

10

I will do that, thank you for the help sir!

11

Checked temps, morning and evening 98.6.
Went on Iodine today.
Have straight Ibuprofen coming in tomorrow, getting rid of second anti acid.
I have a question about HPTA Restart.
Why would you want to restart if your T numbers were low in the first place?
Just to take a rest from the drugs?
Thanks. Gary

12

I have been told by people around me that If I am going to inject rather that use a cream or patch to use Testosterone Enanthate. Everyone I see on the boards are using Testosterone Cypionate. Why choose one over the other?

13

Started Selenium today. How much to take? 200 mg caps.
Iodine 12.5 mg caps. How much to take?
2 days in a row, body temps 98.6 first thing AM and Evening. No variation.

14

Appt with GP on Nov. 14th for labs and TRT Discussion.

15

Injected testosterone is testosterone altered to have an ester group attached [cyp, eth]. This is then oil soluble and 200mg/ml is typical. When injected, it is slowly absorbed and as the testosterone ester gets expose to processes in the body, the ester groups are removed and the end result is a time release bio-identical testosterone delivery. It does not matter if you use cyp or eth. Cyp is considered the generic in USA, Canada, UK and Europe mostly use eth.

Body temps are very odd at 98.6 in AM. Someone else gets <98.6 in AM?

200mcg selenium once a day is fine, with a meal. You can get similar in a multi-vit with iodine and other needed trace elements. Single mineral supplements are “not cost effective”.

A restart sometimes will reset the HPTA and get it working again and sometimes fixes low T.

16

Ok, different body temp readings. Still unsure about the accuracy of my thermometer, but since I started shaking it down better, temps have changed.
97 exactly this morning. Took temps yesterday evening before bed and it was 97.6.
Dr. Appt. Tomorrow. Get labs ordered. Going to talk the whole thing thru with him, give him some printed material that I have read. Not sure how this will go, but the guy seems to have an open mind. Hoping for a prescription and not to much resistance to my idea of an adequate test level. I found a lab that I believe was taken at one of my very first visits to the cancer doc on 09/04/2009 before any treatment. They show the below levels.

Bioav Test @ 442.00 range= 130.5 - 681 ng/dl
Free Test @ 20.20 range= 4.70 - 24.40 ng/dl
Total Test @ 800.00 range= 132 - 813 ng/dl

I felt good at these levels, would like to be somewhere near here in the end. None of the labs I have found tested estrogen levels.

17

Your situation sounds identical to mine, mine caused by propecia

Low normal T levels but all the symptons of Low testosterone

This doctor talks about a resistance to testosterone and trying super levels

I am trt creams and have seen a slight improvement, I will be trying cialis next. I had low estrogen to start strangely

18

I have never used Propecia, what a nasty side effect huh? I think most of my problems stem from cancer treatment drugs.

19

Which makes sense as propecia (finasteride) is used to treat prostate cancer / problems

20

Nope, was never given Finasteride, but the Lupron and the Casodex was nasty enough! I swear I went thru menopause, hot flashes, boohooing, the whole thing. Even with all that, I still was not the b**ch my ex was when she went thru hers.