TRT/HRT Guys, Questions

Bigger Stronger Leaner Over 35 Lifter
1

I have been hrt since late 05,I do self injections 2x a month at 1cc=200mg a shot. I am 38. 2CC a month 400ml

I felt initially great, I would actually feel muscle pumps/tight and more alert not even working out at the time as I was recovering from injury.

We played with the dosages and due to feeling tired, or poor erectile frequency went as high as 1.5cc eow/ 600ml a month.

MY blood then went crazy and my hemoglobin count skyrocketed, I produced too many red blood cells, and yes prostate enlargement, oh goody.

We dropped back down to 1cc eow…

All this having been said and 2 years later…

Now let me preface that I work nights and sleep is never as restful as it should be, and it is like running up hill with cement shoes carrying a truck to loose weight,it is almost friggin impossible, I have good runs then it just stops and comes back on.

I have absolutely NO hunger on or off feelings, I never feel particularly hungry, nor do I ever feel full after eating??? but not satiated… Is this messed up or what?

This time in I have crap for energy most of the time, I do not sleep well and am finding that like when my Test numbers took a crap in the beginning I have no ambition to do anything,  no motivation... I also take 1/4 of an arimidex tab every few days because I am very sensitive to the E sides, when my Test was normal it was very high since I was 13 or so, then I got a prostate infection WITH epididymitis at once out of the blue, that is when we found my test levels had just dropped to extremely low levels.

Was thinking about maybe going to the Gel instead?
does anyone know if this makes a difference?

I also am thinking about seing and Endo, there has to be more wrong with me than just Test levels, this is getting screwy…

What do the HRT vets think? Anyone experience this?

I will add that I have one of the best Urologists in the country, so I do not think it is a matter of quackery, just think there may be more to it all…

2

To be able to answer your questions appropriately we need to know the following:

Age. height, weight.

lab values for test and estradiol (E2).

You make no mention of taking an aromatase inhibitor. Are you taking one?

3

What about adrenal fatigue? Where are your thyroid levels?

In terms of the information you’ve posted so far, the twice a month injections could be improved by dividing up the dosage for every other day (EOD) injections. Guys have the best results and fewer sides by injecting smaller doses more frequently as this more closely mimics natural production. I do 25mg EOD.

Going to the gel wouldn’t help per se, but since gel is applied daily, you wouldn’t be spiking like you are now, but moving to more frequent injections would fix that.

Yes, he says “I also take 1/4 of an arimidex tab every few days” which is good, but I’d still want to see the numbers to know how this was going. Seems like Teufelhunden might be especially sensitive to meds and so the numbers would give an indication of where he’s really at.

4

Teufelhunden,

I am sorry to say that you are the poster child for TRT done wrong. You can make huge gains in well-being as outlined by happydog48 above. If I seem angry, its not with you, but with your doctor. What you are doing probably cannot be done worse. The problem is not injecting and the answer is not T gels.

Make the changes and see how your blood - hematocrit responds in time. Some need to have blood removed, or make blood donations.

Injecting every two weeks will create more T–>E aromatization and more E leads to more SHBG. SHBG reduces your free testosterone. Your T:E ratio goes to shit.

Even injecting T every other day (EOD) with high TT and FT numbers can be a total crock if E2 levels are elevated.

With injections every two weeks, as the T wears off, the E is still hanging around. You can feel terrible, worse that before TRT started.

You must inject at least once a week, twice a week would be much better. Your program is a complete mess and your doctor is what we term here … a complete idiot.

Your testicles are small and your scrotum is pulled up and tight? TRT shuts down your HPTA and there is no LH to keep the testes working. With the testes shut down, you loose most of your pregnenolone production which is important to the brain and is also the ‘feedstock’ for DHEA production.

Injecting 250iu hCG SC EOD will maintain the testes. Many report a fast acting improvement in mood with hCG… see pregnenolone above.

If you are injecting hCG EOD, you might as well be injecting your T ester EOD as well.

Estrogen can mess up your brain, mood, energy, libido and prostate if too high. Without lab numbers, you do not know what you are doing. Do you have and retain copies of all of your blood work? With T levels changing over two weeks, the correct amount of arimidex is not achievable. Too little E can also create probems with brain, mood, energy, libido. A few are over-responders to arimidex/anastrozole and must use 1/4 or 1/8th of the expected dose. Some who get good E numbers at first with 1mg/wk often later need to almost double that as some changes take place. You need the numbers.

Example:

250iu HCG SC EOD
.14ml test cyp (200mg/ml) IM EOD
1mg/wk Arimidex in divided doses

Adjust Arimidex to get a serum E2 number in the lower 20’s (0-53pg/ml)

When injecting small amounts of T esters (cypionate, ethanate) you can use a 1" #25 needles for the quads (vastus lateralis). If your skin/fat is thin, you can inject with .5" .5ml #28 insulin syringes. You do not need to use 1.5" needles in your butt.

You cannot understand any of the above? Research these items.

Getting TRT done right requires a good doctor… very hard to find. Most doctors have no idea what to do. Endos are not in any way particularly qualified to do any of this. Many GPs do a better job, because they are wanting to learn. Endo’s have been seen here to be, as a group, frequently stupid and have ego problems that prevent them from thinking that there is anything that they might need to learn. You need to understand what you want and need and fight to get it. You probably have to dump your endo.

Many of us here have been through all of this.

5

Trust me guys It is no problem if people get angry, it stands to reason that it is OUR bodies and well being and we should get angry when we are not being “heard” or payed attention to.

I will see if I can get my numbers for you in a few weeks as I have to go for my 90 day blood work and check up…

Yes I have had quite a bit of atrophy with my testicles since you asked and they do draw up frequently, and my ejaculate has dropped way off to very sparse as far as fluid production goes.

I am very sensitive to Estrogen, I retain water, my nipples hurt or itch beyond belief, but when I have not figured out how to dial in the Arimidex these things happen,

I get red and flushed feeling, loose libido to an extent along with erections. 1mg tab broken up into quarters.

Not enough I retain water and feel tired all the time.

I appreciate all feed back as usually the people whom know what is going on with the doctors, we are the ones whom suffer the problem, we do the research and ask questions.

Do not worry about sounding angry I can identify with the frustration.

This all came out of the blue one month and ever since nothing has been the same.

Give me a bit and I will get the numbers you ask, and I do think I will divide up my dosages as you mentioned, more shots but oh well if it leads me feeling better.

I am not looking to pack on 300lbs, I just want to work out and feel good again, I never had a problem with gaining muscle.

Thank you for the no holds barred answers I appreciate it…

Chris

out of curiosity, If I change this injection scheme, would this cause my testicles to get back on track to an extent?

And,
Would it be helpful to supplement DHEA along with pregnenolone?

Just curious…

If you wish to take this off board, you can PM me.

6

No. The only thing that will help your testicles is hCG. The fact that your testicles have atrophied is actually a sign that the testosterone is “working” and has shut your HPTA down completely.

Many of us take DHEA as part of a general hormone health program and while I find no dramatic effects, it seems prudent to supplement with it. Pregnenolone has too many questions associated with it for my tastes but it’s been a while since I did any research on it. If I remember correctly, it has pathways to estradiol that do not involve aromatase, so it could lead to higher E2 levels. KSman can probably enlighten us on this issue.

7

[quote]happydog48 wrote:
…out of curiosity, If I change this injection scheme, would this cause my testicles to get back on track to an extent?

No. The only thing that will help your testicles is hCG. The fact that your testicles have atrophied is actually a sign that the testosterone is “working” and has shut your HPTA down completely.

Many of us take DHEA as part of a general hormone health program and while I find no dramatic effects, it seems prudent to supplement with it. Pregnenolone has too many questions associated with it for my tastes but it’s been a while since I did any research on it. If I remember correctly, it has pathways to estradiol that do not involve aromatase, so it could lead to higher E2 levels. KSman can probably enlighten us on this issue.[/quote]

I take 50 mg DHEA and 50 mg pregnenolone (lef.org) every morning and would hate to think that the pregnenolone could contribute to higher E2 or SHBG levels. I would love for KSman to weigh in on this one. I am doing everything possible to encourage the highest possible free-T level using only DHEA, pregnenolone, anabolic diet, and recently avoiding flaxseed and sesame lignans.

I must say that in the several weeks I have avoided flax seed and sesame lignan, I have noticed a marked libido increase and robust fullness of the testicles. Morale has improved too. I was using approx 3 heaping tablespoons ground flax seed per day and ingesting sesame lignan from my lef.org super EPA/DHA Omega-3 caps.

Please note that elevated E2 has not appeared to be an issue for me in the past (blood levels tend to hover around lower ref range). I have struggled with elevated SHBG for at least 3 years however. Total-T hovers around the upper 3rd of the ref range and free-t clings to the lower ref range. I do feel that currently my numbers must be good (judging by nocturnal wood, morning wood, increased libido, engorged testes, improved morale) since eliminating lignans and I will get tested soon to confirm.

8

[quote]happydog48 wrote:
Pregnenolone has too many questions associated with it for my tastes but it’s been a while since I did any research on it. If I remember correctly, it has pathways to estradiol that do not involve aromatase, so it could lead to higher E2 levels. KSman can probably enlighten us on this issue.[/quote]

This is easy.

progesterone
?
pregnenolone

You are remembering things that you read about progesterone. Progesterone can also suppress the HPTA to some extent. Some steroids have progesterone related side effects that are not good. Men do have progesterone and progesterone tends to balance out or oppose the actions of E in men and women. As women age in their 30’s, progesterone levels drop and they become estrogen dominant, which leads to weight gain, PMS, bloating, mood swings, tender breasts, enlargement of the uterus, fibroids, ovarian cysts, breast cancer, cancers of the uterus [distinct from HPV]. I list these only to outline the the roll of progesterone. Some men as they age, get abdominal fat, blood sugar problems, low T and elevated E.

They also are at risk for CV and prostate diseases. These men can be come estrogen dominant and have higher E than their postmenopausal wives. They and their wives can often then have the same body composition and shape. In ‘normal’ men, E is relatively low and balanced by T to some extent. But as many of us have learned the hard way, high amounts of T cannot balance out the effects of E in the upper 30’s or higher. So even with high T, elevate E can have dominant effects on the mind and libido.

You can’t make DHEA without pregnenolone and you cannot make testosterone [or estrogen] without DHEA. Pregnenolone is vital.

9

Thanks for clarifying that. I am relieved.

10

Gentlemen,

As usual, KSman and happydog48 are right on. Let me recap a little and provide my own thoughts.

The following EOD regimen seems to be very effective and easy to track:
28mg testosterone injection EOD
.25 - .50 mg Arimidex EOD
250IU HCG injection EOD

My current regimen differs slightly - I am seriously considering adopting the EOD regimen in the near future.

I take 10mg Pregnenolone and 100mg DHEA tablets ED per my physician. My Preg & DHEA(Sulfate) lab results went from low to mid-range. I am happy with that.

Lab tests are everything and provide a road map to solve your problems. Needed lab requests can vary widely, depending on facts and circumstances. In most cases, you have to do your homework up front and demand appropriate testing from your physician. It seems most doctors do not order enough labs - certainly in the beginning I believe you need comprehensive labs to establish a history and identify issues. I look back on my history and am frequently disappointed when I see some tests were omitted when they should have been included.

At a minimum, I believe the following tests should be performed to determine inital therapy and annually thereafter (certainly I have neglected a few):

Testosterone - Total, Bioavailable, Free and % Free, Estradiol (E2) (request a sensitive assay for male patients, aka Estradiol by Extraction Method); SHBG; DHEA Sulfate; PSA; Progesterone; Pregnenolone; Cortisol (AM/PM); DHT; Prolactin; LH; FSH (3rd generation, ultrasensitive); Liver panel; Thyroid Panel (T3, T4, Reverse T3); Lipid Panel; ACTH; CBC; CMP.

After things are in order, one can reduce the number of labs during interim periods. For example, I am currently monitoring Arimidex/E2 and just did a solo saliva test for E2. (Saliva vs. blood testing is an entire topic in itself).

Do ALL the labs now. You will be glad you did.

Hope this helps.

11

[quote]luv2lift_temp wrote:
Gentlemen,

As usual, KSman and happydog48 are right on. Let me recap a little and provide my own thoughts.

The following EOD regimen seems to be very effective and easy to track:
28mg testosterone injection EOD
.25 - .50 mg Arimidex EOD
250IU HCG injection EOD

My current regimen differs slightly - I am seriously considering adopting the EOD regimen in the near future.

I take 10mg Pregnenolone and 100mg DHEA tablets ED per my physician. My Preg & DHEA(Sulfate) lab results went from low to mid-range. I am happy with that.

Lab tests are everything and provide a road map to solve your problems. Needed lab requests can vary widely, depending on facts and circumstances. In most cases, you have to do your homework up front and demand appropriate testing from your physician. It seems most doctors do not order enough labs - certainly in the beginning I believe you need comprehensive labs to establish a history and identify issues. I look back on my history and am frequently disappointed when I see some tests were omitted when they should have been included.

At a minimum, I believe the following tests should be performed to determine inital therapy and annually thereafter (certainly I have neglected a few):

Testosterone - Total, Bioavailable, Free and % Free, Estradiol (E2) (request a sensitive assay for male patients, aka Estradiol by Extraction Method); SHBG; DHEA Sulfate; PSA; Progesterone; Pregnenolone; Cortisol (AM/PM); DHT; Prolactin; LH; FSH (3rd generation, ultrasensitive); Liver panel; Thyroid Panel (T3, T4, Reverse T3); Lipid Panel; ACTH; CBC; CMP.

After things are in order, one can reduce the number of labs during interim periods. For example, I am currently monitoring Arimidex/E2 and just did a solo saliva test for E2. (Saliva vs. blood testing is an entire topic in itself).

Do ALL the labs now. You will be glad you did.

Hope this helps.[/quote]

Many will only need 1mg Arimidex/anastrozole per week. Ones dose may need to be increased over 6-12 months to get the same response. Why this happens is not understood.

For LabCorp, the basic serum E2 test works well.

Prolactin is released during orgasm. No sex or wanking before your labs or you will spoil the test. The test is looking for elevated levels, not you sexual activity. There are pituitary tumors that will release prolactin that then kills libido. I would skip this test and then consider later if TRT+AI does not yield a good libido. Dopamine, mood, libido, depression/mood are all interactive. TRT can change the game and some changes to prolactin and depression/mood can be expected. Some early testing will not be indicating a long term situation or needed interventions.

LS, FST are of some diagnostic value. But when TRT is started, these should not be routinely tested for as they will be close to zero from HPTA shutdown, a waste of resources.

TRT will change thyroid and adrenal functions. I suggest that one give the body 6 months to settle to find the its new baseline metabolism. Then treat based on symptoms and lab results. Early intervention might not be a good thing. If there are strongly indicated problems, that would be a completely different situation. Some problems are symptoms of hypogonadism, not root cause thyroid or adrenal problems.

What tests you will want will be different if you are paying for them out of pocket and are of a pragmatic nature.

Doctors and clinics make a lot of money marking up lab tests. When you can get the same tests from LEF.org and they cost around 1/2 of what your doctor or clinic charges, and the testes are from LabCorp in both cases… this can be a major amount of money. The point is that ticking off tests on a lab requisition form is often a driven by habit and motivated by profit… and your needs are not necessarily in mind. You should not be doing expensive tests for things that are not something that can be treated or changed. If high SHBG is found and E2 is high, then one should be treating the E2 directly with an AI. The SHBG is a symptom of high E2 levels. Later if TT is high and E2 is in the lower 20’s; if FT is low, then one would expect to see SHBG elevated. Testing for SHBG can be a waste of time and money. Testing for everything under the sun is not the mark of an experienced doctor/diagnostician.