TRT Injection Support Thread

Bigger Stronger Leaner Over 35 Lifter
81

I have the original copy it says:
Total Test 723
Adults 241-827

We just did peak and through(sp?) I will have those in the next few days.

Again, to me 723 is not high, just normal.
I emailed her and she said overdosing is not recommended. Going back to .50 from .40 is over dosing???

[quote]KSman wrote:
When did you get your lab work done? 3.5 days after your last injection? Important!!

Is your doctor mixing up FT and TT ranges?

FT: 7.2 - 24 pg/ml
TT: 700-1100 ng/dl is optimal [241-827 LabCorp range]

Is the original lab report seen or a med office transcription?

Often when the lab numbers are greatly unexpected, there is a lab error and there should be a retest.

Please post your labs with units and ranges. Get the original data from the lab. Get and keep copies of all lab work.

If you hit a vein with an injection, serum levels could be very bogus.

RhodeIslander wrote:
Ok,
This is what I fugured would happen. I finally got to 723 free T and was feeling great. My Dr calls and said, 723 is too high, reduce dose to .40ml weekly. I was at .50 or 1/2ml. This is week 3 at that level and one day before my sceduled shot and I felt like crap for the past 3 days. Horrible today, moody, no energy no morning erection. WTF, why can’t we just leave well enough alone? Now I know why people buy this stuff black market and self medicate.

Here is a funny view on all this:
My wife says" Well if you have a vagina, and wanted to be a boy, they would be tripping over themselves to give you all the Test you wanted and maybe go on Oprah."

She is right, whats up with that? I just want to feel good, not become a different gender? I get all this flak just for trying to feel OK?

Sorry for the rant, I’m just very pissed off, after feeling so good for so long.

[/quote]

82

[quote]RhodeIslander wrote:
I have the original copy it says:
Total Test 723
Adults 241-827

Again, to me 723 is not high, just normal.
I emailed her and she said overdosing is not recommended. Going back to .50 from .40 is over dosing???

[/quote]

You could use more, not less. Looks like you are using LabCorp there.

As guys age, there is a steady increase in SHBG that reduces FT. TT often needs to be at the top of the range to be effective. To maintain a FT level as one ages, one would have to be increasing TT to compensate for the SHBG. One needs to control E2 levels which also drive SHBG levels.

My doc thinks that TT=1100 is optimal and he is Cenegenics trained. Some docs go by FT or bio-T and do not bother to test TT. You need T levels that reverse muscle loss, fat gain and other physical a and mental problems. You do not want T levels that will maintain the current state of degeneration.

83

philzao,

I’m not sure if I can help you but I’m also in the Boston area and looking for a doc willing to try some of the things mentioned here. Please PM to get in touch.

For anyone else: it would be easier to convince my doc to try different things if there were studies or research to support them. Can anyone point to anything out there that supports the claim that E2 levels in the 20s is optimal for libido benefits, for instance?

Where is the data to back the assertions about E2?

If enough of you say you’ve benefited from lowering E2 to this range without any adverse effects, the anecdotal reports are good enough for me. Convincing my doc otherwise is another story…

I’ll post my whole story in another reply for anyone interested.

Mike

84

My story (long):

37 y.o. male 5’9, 170lbs, somewhat muscled (go to gym 4-5x per week) but not a bodybuilder.

Low libido complaints in Feb of '07 prompted my doc to test free T on two separate dates in Feb:

FT - 12.2 (13.5-39.1)
FT - 9.1 (13.5-39.1)

Wanting to know why the values were low rather than just jump on T as my doc wanted, I saw an endocrinologist and a urologist. Endo tested in May of '07:

Total T - 378 (270-1070)
Free T was calculated using a formula and was deemed to be in middle of the normal range.
LH - 2.7 (2.0 - 12.0)
FSH - 2.3 (1.0 - 12.0)

Endo tested a whole range of other values to rule out other conditions (Thyroid, etc.) and concluded nothing was wrong.

Urologist found similar values to the Feb '07 ones (indicating low free T and low-normal total T - don’t have the #'s handy) and also did a bone scan that revealed mild osteopenia. He recommended TRT. I started it in the form of low-dose Clomid every day.

That’s when my real problems began. A few weeks into Clomid I started to feel very uncomfortable. Sleepy during the day, depressed, ringing in my ears, tight in the throat, felt like it was hard to breathe. Also my scalp got very oily and itchy and my hair loss speeded up (I attribute this to DHT). My body generally felt “inflamed.” These symptoms continue to varying degrees to this day.

Levels were checked by the uro in Sept '07 and FT was around 26 (13.5-39.1), TT was around 1070 and E2 was at 79. I only got the E2 results recently after I asked for copies of my tests. At the time the uro said the E2 level was “very low.” I’ve since learned that while on Clomid you can’t get an accurate picture of E2 - which begs the question of why bother to test it… anyway…

I still felt like crap, but was getting morning wood and erections/orgasms were somewhat better than they’d been. I lowered my Clomid dose to EOD from ED. Felt a bit better but still quite uncomfortable.

Decided to switch to Testim in Nov '07 on the idea that maybe the Clomid just didn’t agree with me. After 2 weeks on Testim, got levels checked and TT was at 670 or so. Don’t recall FT and E2 was lower, maybe middle of the range. Was on Testim through this past winter but didn’t feel much better. Still had many days of struggling to stay awake, feeling depressed, ringing in ears, congestion.

Over the winter, went to specialists and ruled out: ENT issues, alleriges, and sleep apnea.

Had FT levels checked in March:

FT - 10.6 (13.5-39.1)

Uro said it probably meant the Testim gel wasn’t being absorbed. He offered me the option of going to shots or doubling the gel. I chose shots and have been on 200mg IM injections every 2 weeks administered at the uro’s office for about 6 weeks now. Just had my levels tested, but have yet to get the results. I’m feeling o.k on the injections, with more good moods in general, but nothing spectacular. Morning wood is more reliable. Libido is so-so.

I should mention that I used Propecia for about 5 years from 2000 - 2005 or so. I also have a history of depression, beginning from when I was a teenager, but have never taken meds for it except for a brief 2 month stint of Wellbutrin.

I know this was a rambling story, but I’m hoping some of you might have some insight on how I might get to feeling better.

My options as I see them:

  1. See where E2 is at now (I know they tested this a few days ago). If it’s over 30, try some DIM or I3C on my own – assuming my uro would veto arimidex. He’s basically said there’s no evidence that E2 causes problems when it’s in the normal range.

  2. Try an antidepressant, perhaps SAM-e. The daytime sleepiness and mood issues are my biggest concerns right now. Perhaps my depression has just reasserted itself coincidentally since starting on T treatments, or perhaps the T has just unmasked it somehow.

  3. Try to track down a doc willing to experiment with Arimidex and HcG. I’ve definitely noticed some testicular shrinkage. :frowning:

I know you guys will probably steer me to #3. I’m almost ready to jump on a plane to Michigan to see Dr. Crisler. But I’d welcome any perspectives on my lengthy story!

Mike

85

Clomid has estrogenic side effects. Nolvadex would have been better, less sides.

Many E2 problems occur in range, another doctor who pretends to know what to do. Optimal E2 is in the lower 20’s [0-53pg/ml].

Propecia is known to permanently trash hormones for some guys and generally aways kills libido at best. HDT is vital to well-being, using to avoid hair loss is nuts.

Tell us where you are, someone in your region might have a suggestion.

Clomid did product high TT, your FT should have also been over range. Your E2 was high, that increased SHBG and that kept your FT lower. Using adex with the SERM probably would have been a better situation. When you stop a SERM, you must taper off of it over two weeks. Doc did not tell you about that?

Labs two weeks after stopping clomid would not be right as the clomid effects

E2 control is absolutely a major part of ‘successful’ TRT/HRT.

Some do not absorb agel very well and some who do loose the ability to absorb later on.

Agel will produce more E2 than injections. Injections should be at least twice a week for the lowest E2 generation. Every two weeks is bad practice. Yes that is suggested in very old out of date literature for T ester injections.

86

mikemass, welcome to TRT hell.

Clomid can raise testosterone by blocking the suppressing effect of estrogen on the HPTA, but it does nothing to lower estrogen itself. As you have discovered, it’s a poor choice for TRT. As KSman said, in some tissues it is an estrogen receptor activator and so depression and mood problems are well known side effects.

Low T can also cause depression. I was depressed for 15 years and it cleared up rapidly as soon as I got my T and E under control.

If you’re going to self-medicate with DIM and/or I3C why not just get your own anastrozole and be done with it?

Don’t forget that T doesn’t do anything until it binds to an androgen receptor and that isn’t going to happen as it should if your E levels are high enough that a significant number of your androgen receptors have been blocked by E2. This explains the T to E ratio significance that we see time and time again. Healthy young male adults have T to E ratios in the 30:1 or 40:1 range. Personally, I didn’t start to feel much of anything until I got mine in the 15:1 range and things really got interesting once I got above 30:1 Add in some hCG and now we’re talking the shit. hCG isn’t just about stopping testicular atrophy. It really does smooth things out.

87

[quote]KSman wrote:
Many E2 problems occur in range, another doctor who pretends to know what to do. Optimal E2 is in the lower 20’s [0-53pg/ml].
[/quote]

Thanks for the reply KSman. Can you tell me how you came to know this about E2 in the 20s? Was a study done?

How is this known? What’s the source for this info? That’s quite a strong statement. I have had some good libido stretches post-Propecia, so I know my body is capable of getting back there. I’m just having trouble getting consistency.

I’m in Boston and have been exchanging email with someone else from this board. We actually have the same urologist.

Nope. He said I could just quit.

Please don’t take my asking for sources the wrong way. You may very well be right, but unless I can put something concrete in front of my doc (other than ‘some guys on the internet told me…’), he’ll be reluctant to try new approaches.

Thanks!

Mike

88

[quote]RhodeIslander wrote:
Ok,
This is what I fugured would happen. I finally got to 723 free T and was feeling great. My Dr calls and said, 723 is too high, reduce dose to .40ml weekly. I was at .50 or 1/2ml.

This is week 3 at that level and one day before my sceduled shot and I felt like crap for the past 3 days. Horrible today, moody, no energy no morning erection. WTF, why can’t we just leave well enough alone? Now I know why people buy this stuff black market and self medicate.

Here is a funny view on all this:
My wife says" Well if you have a vagina, and wanted to be a boy, they would be tripping over themselves to give you all the Test you wanted and maybe go on Oprah."

She is right, whats up with that? I just want to feel good, not become a different gender? I get all this flak just for trying to feel OK?

Sorry for the rant, I’m just very pissed off, after feeling so good for so long.[/quote]

If I were you, I’d use the half life calculator and do what I do; know exactly what my blood test results will be before I get them. That way you lower the dose (lol) like the doc says, come in with a really low number, and he boosts your dosage back up again.

At the moment you have to lower your dose, or you’ll run out too soon. Really short shoot before your next b/w, and the doc will give you back your original dose. Very easy indeed.

89

Thanks happydog,

I really appreciate your input. It’s hard to find folks knowledgeable about this stuff…

I’ll wait and see what my E2 results come back as. But even if it is highish I still need to convince my doc to give me a prescription. That’s why I thought of DIM.

Mike

90

HCG and FSH and LH Levels Question

Hi Everyone, please let me know if I should have tried to start a new thread for this question, or if this is the right place to post this.

I have been prescribed Androgel (Testosterone), Arimidex (Aromatase Inhibitor ? ) and HCG (Human Chorionic Gonadatrophin) to combat my low testosterone levels. I am wondering if anyone is knowledgeable enough about this stuff to let me know if they think this is going to help.

My lab work is as follows:

Total Testosterone 382 ( 241-1100 )

Free Testosterone 36.6 ( 46 - 224)

BioAvailable Testosterone 70.4 ( 110 - 575)

SHBG 56 ( 18-47 )

LH 8.4 ( 1.7 - 11.2 )

FSH 12.5 ( 1.7 - 11.2 )

Estradiol (E2) 49.1 ( 0 - 52 )

I havent taken the HCG injection yet. I am concerned that the elevated LH and FSH levels indicate testicular failure, and that the HCG won’t help at all.

I am 53 years old. 6’1 180. I feel like I am in menopause I swear.

Does anyone know if:

1.) It is true that elevated FHS indicates that HCG won’t help ?

2.) Will it hurt to try the HCG injection or should I not bother ?

3.) Is there any chance that injecting the HCG will make matters worse ?

4.) If the HCG won’t help, what might be wrong, and is there any satifactory treatment ?

My quality of life all around…not just sexually is pretty affected at this point.

Any Advice guys ?

Many Thanks,

Phil

91

[quote]philzao wrote:
HCG and FSH and LH Levels Question

Hi Everyone, please let me know if I should have tried to start a new thread for this question, or if this is the right place to post this.

I have been prescribed Androgel (Testosterone), Arimidex (Aromatase Inhibitor ? ) and HCG (Human Chorionic Gonadatrophin) to combat my low testosterone levels. I am wondering if anyone is knowledgeable enough about this stuff to let me know if they think this is going to help.

My lab work is as follows:

Total Testosterone 382 ( 241-1100 )

Free Testosterone 36.6 ( 46 - 224)

BioAvailable Testosterone 70.4 ( 110 - 575)

SHBG 56 ( 18-47 )

LH 8.4 ( 1.7 - 11.2 )

FSH 12.5 ( 1.7 - 11.2 )

Estradiol (E2) 49.1 ( 0 - 52 )

I havent taken the HCG injection yet. I am concerned that the elevated LH and FSH levels indicate testicular failure, and that the HCG won’t help at all.

I am 53 years old. 6’1 180. I feel like I am in menopause I swear.

Does anyone know if:

1.) It is true that elevated FHS indicates that HCG won’t help ?

2.) Will it hurt to try the HCG injection or should I not bother ?

3.) Is there any chance that injecting the HCG will make matters worse ?

4.) If the HCG won’t help, what might be wrong, and is there any satifactory treatment ?

My quality of life all around…not just sexually is pretty affected at this point.

Any Advice guys ?

Many Thanks,

Phil

[/quote]

This post could have been elsewhere or on its own.

It is rare to see someone starting T+AI+hGH. That is perfect.

Yes, your testes are failing and your LH and FSH tell the story.

You T is low, and your E is very high, expecially compared to your T.

The high E is causing the liver to make more SHBG because it is trying to clear it out. The higher SHBG is probably why your FT is as low as it is.

TRT should shutdown your LH and FSH. But your E2 levels should also be making those low now. So test for LH and FSH later on. If these are still high, you need to have someone check your testes and pituitary for tumors. If LH have been way higher earlier, this could have downregulated the LH receptors in the testes. If LH and FSH do not go down, then hCG should be stopped.

All of this depends on agel dose and how well you absorb that.

As long as injecting hCG is on the table, why not inject T?

If you started injecting T now, there would be no doubt about absorption. 100mg/wk testosterone cypionate would shut your HPTA down and then LH and FSH should be zeroing out. If that happens, no tumors likely. If the first post-TRT lab shows that T levels have not responded well with agel, then there would not be any reason to expect LH and FST to zero out. So the question of some other issues would not be resolved.

Your “case” is unusual and there are conflicting issues that need to be resolved.

Once your conflicting issues are sorted out while injecting, you might then be able to do agel if you really want. Many here would strongly discourage that. Injecting now will take agel absorption issues off the table.

That low T and high E would make any guy feel like his life had tanked.

92

This is a great and helpful thread.

I am frustrated with my endo who treats my type 2 diabetes. Great personable doc but my 423 TT (at age 57) reading didn’t move him to address my exhaustion and the other ADAM factors I brought up. Within normal range he said. And in my area I have tried to find an alternative doctor but the guy listed on A4m is not an MD or a DO from what I can see.
At a 423 reading I am thinking it is time to get an AI to boost the T levels. Hopefully it will make me feel better. My question is the impact of the AI on the metformin–will it negate the effects? Metformin from what i’ve read raises E. I’ve dropped my statin as it causes leg cramps and the actos as it causes bone fractures. It is hell to get old. I also ordered the Tribulus to see if it will help any.

93

[quote]Diabetic wrote:
This is a great and helpful thread.

I am frustrated with my endo who treats my type 2 diabetes. Great personable doc but my 423 TT (at age 57) reading didn’t move him to address my exhaustion and the other ADAM factors I brought up. Within normal range he said. And in my area I have tried to find an alternative doctor but the guy listed on A4m is not an MD or a DO from what I can see.
At a 423 reading I am thinking it is time to get an AI to boost the T levels. Hopefully it will make me feel better. My question is the impact of the AI on the metformin–will it negate the effects? Metformin from what i’ve read raises E. I’ve dropped my statin as it causes leg cramps and the actos as it causes bone fractures. It is hell to get old. I also ordered the Tribulus to see if it will help any.[/quote]

The leg cramps were from the reduced levels of CoQ10 caused by the statin drug. You could supplement with CoQ10 to manage that. Note that the heart muscles are also affected by low CoQ10. Your dose of statins might simply have been too high. Low T levels cause increases in cholesterol. FT/bio T might be the controlling factors.

Elevated E causes prostate enlargement. Any changes to urine flow?

Low testosterone leads to weak bones. But vitamin K, D, calcium, magnesium are also some of the factors.

You need a male panel blood work to see what is going on. Be proactive and order the test at LEF.org. Read about, male HRT, diabetes and heart/artery disease on that site. When you have the lab data, you can determine what is wrong and what you need. Then you can go shopping with that and explain what you think your situation and needs are.

E often increases with diabetes. I would expect that a more optimal level of E would improve insulin sensitivity. There are others things that you can do to deal with the root causes of insulin insensitivity.

Have your thyroid levels been checked?

Most need at a minimum 1000 - 2000iu of vitamin D every day.

What is “actos”?

TRT: improved lipids, improved insulin sensitivity, more energy, improvement in mood, improved endothelial function [arterial disease], stronger bones, loss of fat, increase in muscle mass.

TRT needs to include AI [Arimidex] and hCG would be good too. Control of E is essential. You need optimal levels, not normal or simply in range.

94

Many thanks, KS, for your reply.
Actos is another diabetes med similiar to Avandia, supposedly synergistic with metformin to reduce blood sugar levels. It costs a fortune and I have never had it act synergistically to show in lower A1c blood readings. My doc and I argue about its worthlessness a lot–he likes it for its carotoid artery benefit. PSA levels very low. Thyroid checks out fine also.
I see that I can get the “deluxe” male panel for 275 at lifeextension (with 1 yr membership). I will get that and then go shopping.

95

[quote]KNB wrote:
RhodeIslander wrote:
Ok,
This is what I fugured would happen. I finally got to 723 free T and was feeling great. My Dr calls and said, 723 is too high, reduce dose to .40ml weekly. I was at .50 or 1/2ml.

This is week 3 at that level and one day before my sceduled shot and I felt like crap for the past 3 days. Horrible today, moody, no energy no morning erection. WTF, why can’t we just leave well enough alone? Now I know why people buy this stuff black market and self medicate.

Here is a funny view on all this:
My wife says" Well if you have a vagina, and wanted to be a boy, they would be tripping over themselves to give you all the Test you wanted and maybe go on Oprah."

She is right, whats up with that? I just want to feel good, not become a different gender? I get all this flak just for trying to feel OK?

Sorry for the rant, I’m just very pissed off, after feeling so good for so long.

If I were you, I’d use the half life calculator and do what I do; know exactly what my blood test results will be before I get them. That way you lower the dose (lol) like the doc says, come in with a really low number, and he boosts your dosage back up again.

At the moment you have to lower your dose, or you’ll run out too soon. Really short shoot before your next b/w, and the doc will give you back your original dose. Very easy indeed.
[/quote]

Ok,
Did what you suggested and we are a go again.
I inject in my shoulder, sometimes some of the cyp leaks out? Is this Ok? Sometimes it bleeds a good amount as well. Any suggestions?

Liquidex is working well, I suggest tis for all with E2 issues. I lowered the LDex dose to see what would happen, I felt like shit very quickly.

Last question,
I’m at .50ml weekly anf have a 775T level, this is high normal. What is a cycle dose for increased mass? Is it double? Just curious.
Thanks again.

96

WOW!!! This is the best thread ever. I just started TRT and was looking for more info… wow I think I hit the jack pot. KSMam… you are the man. And to all the rest, thx for the info too.

I’m 31 and have had a crappy libido for the last couple years as well as always being lethargic. I have nodules on my thyroid so I go in for yearly checks. This year they did a full blood screen and my TT was 270 and I think my E was high 40’s… apparently that explains the loss of libido and the feeling like crap :(.

My doc started me on 200 mg Test E every 2 weeks. Doing a blood test at week 7 to check the results. No AI, no hCG. She didn’t even mention it.

Here’s my question. Should I try to persuade her or should I just go find an HRT specialist? How bout you KSMan, do you have an office in the Mesa AZ area?

Thanks again for all the help. I will try to get a copy of my test report to post the #'s.