TRT and Aromatase?

Pharma TRT
1

Hi

I have been reading this forum for a while and have a question concerning TRT therapy and estrogen.

I have been on test-cyp for about 6 months now. Was on gel for 1 year prior to that.

Test cyp was 150mg every two weeks, recently upped to 170mg every two weeks.

I was going over all my old test results and I could not find any tests for estrogen (prior to TRT or during TRT).

Is this something I should get my doctor to test?
Should I only concern myself with this if I am feeling the side effects of abnormal estrogen?
What are those side effects, besides the obvious gyno (which I do not have)?

2

The last month I have been feeling symptoms of a sort of depression but I would not call it depression because its more physical than emotional. The best way I can describe it is just feeling like shit, where it is an effort to get up to do anything. This caused the dosage to be raised from 150mg to 170mg (once every two weeks).

The feelings are not near the end of the treatment which Is strange because I would think it would be caused by the testosterone running out. Sometimes it happens only a few days after a shot.

I asked my doctor about this and commented on Estradiol (the only thing that we haven’t looked at before) and they replied:

[quote]Because your testosterone dysfunction does not originate from your testicles, it is not necessary to check your estradiol levels.
Your symptoms may more likely be related to your thyroid. I have ordered another testosterone level, a TSH, and Free T4 level for you.
[/quote]

FYI: I was also diagnosed with hashimoto’s thyroiditis for which I take levothyroxine 115mcg / day.

edit:
The reason they say that my testosterone dysfunction does not originate from my testicles is because I went on clomid for about a month and it caused my test levels to go from 100 to 400s, which I guess proves that the problem is in my pituitary gland. Other than this, and my thyroid issues, there is no other reason the endo can find which would cause low T.

3

Estradiol is VERY (can’t emphasize enough) important in how you feel. High E2 will make you feel like shit even if your testosterone is in the 1000’s. Low E2 is just as bad, with effect on joints, libido, blood lipids and well-being, so you should make your doc check them. Remember you are the customer, you have a right to know what you deem necessary, and no one knows your body like you do.

As far as the hashimoto’s, what were your thyroid antibody labs like? I recommend natural thyroid extract over synthetic hormones (levothyroxine, etc) for treatment. Even though T4 is a storage hormone, some people have poor conversion rate to T3.

Check www.stopthethyroidmadness.com , and read through everything, they have a lot of valuable info on people dealing with hypothyroidism and hashimoto’s, and even mild adrenal insufficiency, which can happen due to your wrecked HPTA.

Low T and hypothyroidism/hashi’s have very similar symptoms. Do you have episodes of hyperthyroidism between your depression bouts? If not, I’d be very careful about that hashimoto’s diagnosis.

Speaking from experience, increasing my thyroid meds has also skyrocketed my testosterone (and E2 along with it, necessitating an aromatase inhibitor to manage it). You might not get this effect from levothyroxine alone, if you don’t want to go the natural dessicated thyroid route, it’d be more beneficial to try a T3/T4 combo (cytomel and levothyroxine)than T4 alone.

If you want to try the dessicated thyroid, I recommend Thyroid-S from Thailand. Armour used to be good, but it went to shit after they dropped the pig glands and started doing it from plants (for vegans, I suppose, fuck that noise).

As always, gauge your progress by symptoms.

Take your morning temps, check your iodine intake (be very careful with supplementing iodine if you have hashimoto’s), and read the sticky for new guys.

Hope you recover.

4

[quote]Fingerstyle wrote:
Estradiol is VERY (can’t emphasize enough) important in how you feel. High E2 will make you feel like shit even if your testosterone is in the 1000’s. Low E2 is just as bad, with effect on joints, libido, blood lipids and well-being, so you should make your doc check them. Remember you are the customer, you have a right to know what you deem necessary, and no one knows your body like you do.

As far as the hashimoto’s, what were your thyroid antibody labs like? I recommend natural thyroid extract over synthetic hormones (levothyroxine, etc) for treatment. Even though T4 is a storage hormone, some people have poor conversion rate to T3.

Check www.stopthethyroidmadness.com , and read through everything, they have a lot of valuable info on people dealing with hypothyroidism and hashimoto’s, and even mild adrenal insufficiency, which can happen due to your wrecked HPTA.

Low T and hypothyroidism/hashi’s have very similar symptoms. Do you have episodes of hyperthyroidism between your depression bouts? If not, I’d be very careful about that hashimoto’s diagnosis.

Speaking from experience, increasing my thyroid meds has also skyrocketed my testosterone (and E2 along with it, necessitating an aromatase inhibitor to manage it). You might not get this effect from levothyroxine alone, if you don’t want to go the natural dessicated thyroid route, it’d be more beneficial to try a T3/T4 combo (cytomel and levothyroxine)than T4 alone.

If you want to try the dessicated thyroid, I recommend Thyroid-S from Thailand. Armour used to be good, but it went to shit after they dropped the pig glands and started doing it from plants (for vegans, I suppose, fuck that noise).

As always, gauge your progress by symptoms.

Take your morning temps, check your iodine intake (be very careful with supplementing iodine if you have hashimoto’s), and read the sticky for new guys.

Hope you recover.
[/quote]

Right now I feel good. That is what is strange about these symptoms, its on and off, goes from really bad to feeling really good.

To answer your question about my antibody levels:
Thyroglobulin Antibody 78.5 <60 - <60 Units/mL H
Thyroid Peroxidase A 5204.5 <60 - <60 Units/mL H

Here is the results from the blood test I got a few days ago (taken exactly half way between my injections) this test was taken during the time I was feeling like absolute shit.

Tsh 0.733 0.350 - 5.000 mcUnits/mL
Testosterone Male 616.6 280.0 - 1100.0 ng/dL
T4, Free 1.1 0.8 - 1.5 ng/dL

Other tests they ran:

AUTO HEMOGRAM/PLATE/DIFF
Wbc 5.9 4.2 - 11.0 K/mcL
Rbc 5.18 4.50 - 5.90 mil/mcL
Hgb 16.6 13.0 - 17.0 g/dL
Hct 46.1 39.0 - 51.0 %
Mcv 89.0 78.0 - 100.0 fl
Mch 32.0 26.0 - 34.0 pg
Mchc 36.0 32.0 - 36.5 g/dL
Rdw 12.3 11.0 - 15.0 %
Plt 136 140 - 450 K/mcL L
Diff Type AUTOMATED DIFFERENTIAL
Neutrophil 59 %
Lymph 33 %
Mono 7 %
Eosin 1 %
Baso 0 %
Absolute Neutrophil 3.5 1.8 - 7.7 K/mcL
Absolute Lymph 2.0 1.0 - 4.8 K/mcL
Absolute Mono 0.4 0.3 - 0.9 K/mcL
Absolute Eos 0.0 0.1 - 0.5 K/mcL L
Absolute Baso 0.0 0.0 - 0.3 K/mcL

COMPREHENSIVE METABOLIC PANEL
Fasting Status 10.5 hrs
Sodium 139 135 - 145 mmol/L
Potassium 4.4 3.4 - 5.1 mmol/L
Chloride 103 98 - 107 mmol/L
Carbon Dioxide 31 21 - 32 mmol/L
Anion Gap 9 10 - 20 mmol/L L
Glucose 83 65 - 99 mg/dL
Bun 19 10 - 20 mg/dL
Creatinine 1.08 0.50 - 1.30 mg/dL
Gfr African American >60 >59 - >59
Units = Ml/min/1.73m2
Gfr, Estimate >60 >59 - >59
Units = Ml/min/1.73m2
Bun/creatinine Ratio 18 7 - 25
Calcium 9.3 8.4 - 10.2 mg/dL
Total Bilirubin 1.1 0.2 - 1.0 mg/dL H
Ast/sgot 24 <38 - <38 Units/L
Alt/sgpt 36 <79 - <79 Units/L
Alk Phosphatase 74 50 - 136 Units/L
Total Protein 6.9 6.4 - 8.2 g/dL
Albumin 4.3 3.4 - 5.0 g/dL
Globulin 2.6 2.0 - 4.0 g/dL
A/g Ratio, Serum 1.7 1.0 - 2.4

I will try to read that thyroid site soon…

Thank you for your response

5

jdub- can I ask why you switched from gel to injections after a year on gels? Not getting the results you hoped for?

6

[quote]Cooper1test wrote:
jdub- can I ask why you switched from gel to injections after a year on gels? Not getting the results you hoped for?[/quote]

The Gels worked but only brought my levels from low 100’s to mid 300’s. They were also annoying to apply each day.

The injections were much better up until only about one month ago when these new issues arrived.

7

The depression lows are debilitating to the point it is interfering with my interactions at work. I would really appreciate some additional input.

I have a follow up appt with endo on april 15. Do I need to demand he check my e2 levels? Are there any other missing pieces?

8

Everything you need is in the stickies on this forum. If you read them, you should be able to pick up on why your current protocol is less than optimal.

9

[quote]dhickey wrote:
Everything you need is in the stickies on this forum. If you read them, you should be able to pick up on why your current protocol is less than optimal. [/quote]

I have gone through them before. I understand the dose and frequency of my shots is not optimal. I also understand the importance of testing for estradiol hence the topic of this thread.

I have called clinics who specialize in TRT administration who basically tell me exactly everything I have seen in this forum. The issue is that I am only 21 and they can’t legally treat me. They tell me that 99% of endocrinologists are nearly useless in TRT administration but that they are my only choice.

I have been to a different Endo before this one, one who was also only concerned with getting each hormone within range.

I am not really asking advice on what to do, but rather how I can do it. Must I simply demand to a medical doctor he take these tests that he thinks are non sense? How can I demand he give me more frequent, higher dose testosterone? He would see it as only trying to get PEDs(he knows that I actively weight train and I am not a small man).

I want to just fucking feel normal

10

You can do bloodwork on your own to get dialed in. Lef.org, private MD lab and others have cheap testing.

Do you self inject? If so, split it up into smaller bi-weekly shots.

If your stuck at every two weeks, it’s going to be really tough to get dialed in and you might consider trying HCG monotherapy or a SERM to get natural production going again. You can get these on your own from international pharmacies, along with the AI if you need it. Take a look at my thread on here to see what I did. It’s worked pretty good so far, just have to nail down E2.

11

No, I do not self inject. I’m pretty sure my insurance as well as the clinic are strict on getting shots done at the clinic. I would have to jump through hoops to be able to do them on my own plus I don’t know if I would be able to do that…

I’m going to wait until I see my doctor again in two weeks before I go that route and get my own labs drawn. In the mean time I will talk to other doctors to get information to bring to him.

I would also like to bring some studies that show the importance of monitoring E2 , free test, and free t3/t4. (He usually only tests for total )

I have been looking, but only could find a few articles that talk about aromatization of testosterone in the morbidly obese.

Could somebody point me towards some good articles?