TT = 3064, E2 <12... How Is This Possible?

Pharma TRT
41

[quote]KSman wrote:
Anyone else that can use that thermometer to see if it gets 8=98.6 for them? Sounds like it is time to get a new one.[/quote]

Not sure what you mean by that…

I checked my temp Sat morning when I woke up. It was a little higher at ~96.8, but that’s still low. I checked it with a second thermometer and got the same readings. So I took another ~60mg on Saturday and felt really good throughout the day.

Same this morning, but I took ~35mg. Still felt really good throughout the day. Just checked my temp now at 10pm and it’s 97.7 which is an improvement.

Things appear to look good.

When would be a good time to get my T levels checked with the iodine supplements I’m taking?

EDIT - thought I might want to update/edit this post with iodine supplements and AM temp:

Fr 10/26…7am…95.9…30 mg
Sa 10/27…10am…96.8…30 mg
Su 10/28…10am…97.0…15 mg
Mo 10/29…7am…97.0…15 mg
Tu 10/30…7am…97.0…30 mg
We 10/31…7am…96.5…30 mg
Th 11/01…7am…96.5…30 mg
Fr 11/02…7am…95.6…30 mg
Sa 11/03…10am…96.5…30 mg
Su 11/04…10am…96.0…30 mg
Mo 11/05…10am…96.4…60 mg

Update 11/02 - starting to see a little bit of a pattern here…

EDIT 11/5 - It looks like my numbers are wrong. The iodine product states how many mg/drop but the numbers are for the higher concentration solution… smh. Now I’m finally taking 60mg a day.

42

WOW!! I thought my endocrinologist was a moron but I HAD NO IDEA!!!

Yesterday I asked for a call-back because my body is not absorbing Axiron anymore. I come to work and have white flaky shit coming off my shirt and that’s no bueno. He tells me that Androgel is the next option available.

I told him that I periodically get physical therapy as part of treatment from a car accident last June, and transference is a concern. I asked if we could try a short-term trial of Test-c/HCG/AI per the protocol for injections thread here:
http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/trt_protocol_for_injections

Here’s what he told me…

First, ALL t-injections are deep IM, not SC. They cannot go into the thigh b/c there’s not enough muscle. The injection must go into the gluts. If you do not inject deep enough, you run the risk of an abscess.

Second, the injections are all done in the office. I can’t do them at home… partially b/c of #1. He stopped short of saying if t-injections are controlled and therefore can only be done in office.

Third, injections happen every two weeks, which would mean my hormones would go all over the place.

Fourth, there’s no real benefit to HCG other than preventing my nuts from shrinking. It would do nothing to improve FSH, which is important since I want to have kids someday.

Fifth, he said that AI’s are never used as part of t-therapy. He said this is only something that happens in circles where steroids are heavily abused.

At the end of it, we came back to Androgel so I’ll pick up that Rx today. I’m also getting lab work done at 2pm so hopefully I’ll know if my E2 levels are creeping up.

Man I really need to find another doctor… this is getting ridiculous. I’d almost be better off flying somewhere, or going to Southern California to find a decent physician!!

43

Lost for words…

44

I found out that my insurance doesn’t cover Androgel, but it does cover Testim. I will hopefully get an Rx today or tomorrow.

From my research, Testim takes longer to completely feel dry on the skin, but also absorbs T better than Androgel. There’s also reports that it creates a smell that may or may not be attractive to women shrug

I’m taking another look at the clomid option to see if that’s something I should go back to… but I don’t wanna get screwed up results.

Anyone know how long it takes for clomid to start working?

45

[quote]Master_P wrote:

From my research, Testim takes longer to completely feel dry on the skin, but also absorbs T better than Androgel. There’s also reports that it creates a smell that may or may not be attractive to women shrug

[/quote]

FWIW- I have been on Testim a couple different times. It’s an alcohol base which is where the smell comes in until it’s absorbed. Not that big a deal.

46

Thanks. I started Testim on Friday. The thickness of the gel is a little annoying.

My girlfriend works at a biotech company so she can get me a box of latex gloves. For anyone using Testim, I highly recommend using these for three reasons. First, you don’t get any of the thick gel on your hands. Washing it off took me a good while, and was annoying.

Second, since the latex doesn’t absorb gel, you get more of the product on your skin, which means less is wasted. Third, when you’re done, you can take the gloves off inside-out and use them to wrap up the empty tube, which even further diminishes transference.

The smell isn’t too bad. My gf actually liked it.

I am seeing a slight increase in my sex drive. Today is day 4 so we’ll see if this continues.

According to that site, after 30 days on 50mg Testim, men who had <300 ng/dL T levels saw their levels rise to 365. Men on 100mg saw them rise to 612, but there’s a considerable margin for error. My guess is that I’ll end up somewhere in the 350-425 range… still too low. Argh…

47

I just got some updated lab results from the urologist. The blood was drawn on 11/06/12. A couple of remarks:

First, I stopped taking iodine the day before (I think?) and didn’t take any on the day of this draw. That may not have been enough time.

Second, I wanted to know if my body was absorbing the Vit B12 I’ve been taking, so I took some approximately 30 minutes before the draw.

That being said…

Albumin serum… 4.7 g/dL… 3.5-5.5
T total serum… 228 ng/dL… 348-1197…LOW
Free T direct… 6.9 pg/mL… 8.7-25.1…LOW
LH…1.0 mIU/mL… 1.7-8.6…LOW
FSH…0.7 mIU/mL… 1.5-12.4…LOW
Prolactin…7.0 ng/mL… 4.0-15.2

SHBG…14.6 nmol/L… 16.5-55.9…LOW
Bioavail T, S… 161 ng/dL… 128-430
Bioavail T %… 71.1%
E2…11.6 pg/mL… 7.6-42.6

TSH…5.7 uIU/mL… 0.45-4.5…HIGH
Total T4…6.6 ug/dL (84.9 nmol/L)… 4.5-12.0 (58-154.5)
Total T3…122 ng/dL (1.88 nmol/L)… 71-180 (1.09-2.77)
fT4 (dialysis/MS)…1.0 ng/dL (12.8 pmol/L)… 0.8-1.7 (10.3-21.9)
fT3 (dialysis/LC/MS)…2.26 pg/mL (3.48 pmol/L)… 1.81-4.06 (2.78-6.25)
T3 uptake…30…% 24-39
FTI…2.0… 1.2-4.9

Vit B12…1588 pg/mL… 211-946…HIGH
Folate serum…18.8 ng/mL… more than 3.0
Progesterone…0.2 ng/mL… 0.2-1.4
Pregnenolone (MS)…15 ng/dL… <151…SUSPECT THIS IS LOW
hCG Serum…<1mIU/mL… 0-3

Some of the Axiron was working. This may explain why LH and FSH are low, but absorption was poor which is why Free and Total T are also low.

Vitamin B12 is high as expected. The next draw will be done at least a few hours after I take a dose.

SHBG is low… but it was the same value as what was drawn in July (last page). Not a problem.

TSH - now this puzzled me at first until I found this link:
http://www.newsmaxhealth.com/headline_health/iodine_study_misinterpret/2012/01/27/430557.html

“when you give iodine supplements to someone who is iodine-deficient, the body needs time to transport the iodine into other parts of the body, such as the breast or ovaries. TSH is needed to make the molecules â?? called sodium-iodide symporter (NIS) â?? that transports the iodine. So, the body increases the amount of TSH to make the transport molecules for iodine.”

… so this may explain why TSH is still high. fT3 and fT4 ratio seems a little off too. I think both of them need to go up to reach an optimal level. fT4 should ideally be a little higher around 1.3. I’d like to see fT3 around 3.3, so that needs to rise by a fair bit.

I suppose that means I need to keep up with the iodine for a little while longer, and would also indicate some degree of hypothyroidism.

Pregnenolone is also really low IMO. This in conjunction with progesterone probably explains a lot. From the synthesis diagram on the previous page, it looks like mitochondrial function is the big issue preventing cholesterol breakdown.

What do you guys think?

48

11 days later, what are body temp trends and observations?

49

I bought a new IR temporal thermometer which gets great reviews for accuracy. It’s showing my temp is much closer to 98 and stable throughout the day. A little lower in the morning, maybe 97.5 or so, but certainly higher and more stable.

I also have quite a bit more energy. I’m sure the B12 contributes to that as well.

On the Testim, I feel a little better. Sex drive is improving a little, but it’s still hit or miss. My confidence is up a little I’d say.

50

A couple of new developments…

I’ve been off the iodine since last Thursday/Friday. Body temp as of last night was ~98.0 to 98.2 The plan is to get lab work done on Friday to check T levels on Testim for a couple of weeks. Standard stuff… T, E2, TSH, pregnenolone, and maybe DHT too.

There’s another factor that may have emerged. For my sleep apnea management, I went to a dentist to get fitted for a mouth guard that advances the lower jaw so that the airway opens. The appliance arrived on Friday. After putting it on, I immediately felt no restriction in my airway, and could not snore no matter how much I tried.

Unfortunately that night, my girlfriend told me that I was still snoring as loud as I did without the guard, and I didn’t feel very well rested the next morning BUT I woke up in the morning with solid oak - which was the first in a loooong time! Improvement!

Saturday night I wore the mouth guard and used the CPAP. I slept very VERY well, and woke up in the middle of the night, and again in the morning with oak. Another great sign!

On Friday I’ll get the appliance adjusted to advance my jaw a little more forward so we can see if that gets rid of the snoring.

I never did the Clomid restart and am thinking this may be a good time to give it a try - especially if E2 is favorable on the upcoming Friday labs. Sex drive has been so-so but it was good Yesterday. I will need to get off Testim for a period of time before starting Clomid.

Questions:

  1. Is one week enough time to stop Testim and then restart on Clomid?

  2. Does anyone have experience with this product?
    Vitamins and Supplements Rooted in Science - Life Extension

It’s supposed to work as an AI.

51

Christ… LabCorp is really pissing me off. I took the order form from the urologist office and added the extra tests
I want done. The urologist himself said that his girls aren’t that bright and can’t figure out how to write in additional tests.
“Just tell them to check the two boxes for full T panels” he says!! … So I add in the extra tests. (Typing them in was my mistake)
and now she’s being a biiatch about drawing the labs.

Note to self - if adding labs on an order form, hand write them in!!!

Update - FINALLY got the ho to draw my blood… lets see what the results are.

Side note: Unfortunately I forgot to apply Testim this morning, so these results will show 24-hr T levels. This may also be a good time to stop using Testim and wait a few days so I can start Clomid.

52

That LEF product is very much not cost effective. If E2 is low, there is no role for it.

Suggest that you do T+comid. Would rather see T+nolvadex. Then taper off of T, then taper off of SERM. There may be a role for AI here. Do not know where your E2 is.

53

Really? I should do both T and Clomid?

I could’ve sworn reading that a SERM won’t work if you’re on exogenous T… or is that the point? Taper off the T while starting the SERM so it works slowly?

Can you suggest an effective protocol for this? Testim comes in the packets. Instead of a pack a day, make it a pack EOD, then E3D. Clomid is in 50mg doses… so start at 25mg EOD alternating with Testim?

The doctor who wrote the Rx for Clomid says to take 50mg every day. From some of the threads on here, that sounds like WAY WAY too much!

54

I alternated Testim on Friday, Sunday, and then went E3D to Wednesday.

Took 25mg Clomid on Saturday and Tuesday. Then jumped to 50mg today.

All day I’ve been thinking about sex… so I guess it must be working a little bit!

I also had my sleep doctor lower my CPAP setting from 11 to 8. Coupled with the mandibular advancement decide, let’s see if that improves my sleep patterns.

55

Clomid, do not take too much, you will overload the testes and E2 can get major bad.

TRT makes snoring worse. [So does alcohol.]

If you take 50mg T transdermal and were lucky enough to absorb 10%, that would be a 5mg delivery. Young virile males make around 10mg/day. Transdermals are often not very effective.

TRT shuts down LH/FSH, testes shrink. Prevent that with hCG 250iu SC EOD and if you cannot get that, low dose SERM will be better than nothing.

56

[quote]KSman wrote:
Clomid, do not take too much, you will overload the testes and E2 can get major bad.

TRT makes snoring worse. [So does alcohol.]

If you take 50mg T transdermal and were lucky enough to absorb 10%, that would be a 5mg delivery. Young virile males make around 10mg/day. Transdermals are often not very effective.

TRT shuts down LH/FSH, testes shrink. Prevent that with hCG 250iu SC EOD and if you cannot get that, low dose SERM will be better than nothing.

[/quote]

Good point. This raises the question of dosage. What’s an appropriate dose (both for starting and continued use)? Some say 25mg EOD, some say 50mg ED. I’m thinking 50mg ED for 3-4 days, then drop to 25mg ED.

The labs I took last Thursday supports your remarks w.r.t. transdermal absorption. Here’s how I responded to 50mg Testim.

Samples taken 12/6/2012. Testim was last applied 24 hrs earlier. No iodine supplements for 1 week. No B12 for 72 hours:

Albumin, Serum…4.5g/dL…[3.5-5.5]
Test, Serum…139 ng/dL…[348-1197] LOW
Free Test…4.6 pg/mL…[8.7-25.1] LOW
LH…0.3 mIU/mL…[1.7-8.6] LOW
FSH…<0.2 mIU/mL…[1.5-12.4] LOW
Prolactin…6.3 ng/mL…[4.0-15.2]

Test, Serum…175 ng/dL…[348-1197] LOW
Bioavail T…107 ng/dL…[128-430] LOW
Bioavail T…61.4%
SHBG…16.5 nmol/L…[16.5-55.9]

Estradiol Sensitive…<3 pg/mL…[3.0-70.0] LOW
Estradiol… 18.5 pg/mL…[7.6-42.6] NORMAL… WTF?!? Why are these two SO different?!?
Roche ECLIA method

TSH…1.9 uIU/mL…[0.45-4.5]
T4…7.2 ug/dL (92.6 nmol/L)…[4.5-12.0] (58-154.5)
T3…120ng/dL (1.84 nmol/L)…[71-180] (1.09-2.77)
T3U…30%…[24-39]
FTI…2.2…[1.2-4.9]

Free T4…1.3 ng/dL (16.6 nmol/L)…[0.8-1.7] (10.3-21.9)
Free T3…2.8 pg/mL (4.30 pmol/L)…[1.81-4.06] (2.78-6.25)

TIBC 265 ug/dL…[250-450] COULD BE BETTER
UIBC 219 ug/dL…[150-375]
Iron, serum 46 ug/dL…[40-155] BORDERLINE LOW
Iron Sat 17%…[15-35] BODERLINE LOW

Vit B12…1177 pg/mL…[211-946] HIGH
Vit B12 UBC…711 pg/mL…[725-2045] LOW
Folate Serum…>19.9 ng/mL…[>3.0]

Pregnenolone (MS)…28 ng/dL…[<151] SUSPECT THIS IS LOW
DHT…50ng/dL…[30-85]
Vit-D 25OH…40.8 ng/mL…[30-100] WANT THIS HIGHER
IGF-BP3…4.4 mg/L…[3.5-7.0]

Hemonc A1C - 5.3%

Free T4/T3 ratio is 3.86. At the 11/06 draw it was 3.67, so that’s a little improvement. I’m reading that the body naturally produces 90% T4 to 10% T3 by weight. My numbers indicate 98% T4 to 2% T3.

B12 is still holding high after going without for 72 hours. I need to read more on unbound B12 capacity.

It absolutely amazes me that serum and free T levels drop so drastically low a day after Testim. This tells me that the stuff isn’t working. It can’t be boosting my overall T numbers very high, and since it shuts off LH/FSH, once the absorbed T is gone, you’re out. No wonder I don’t feel much ebtter.

Why the hell is there such a big difference between the E2 ultra sensitive vs. standard array tests?!?

Iron is a little better. Multivitamin might be helping there.

W.r.t. HCG, there are a lot of questionable pharmacists out there. I think I recall reading that an Rx may not be necessary… I found this one:

Does the side of the bottle say “Discard after 28 days”? At 1000 IU’s a week, that would last 5 weeks.

57

Many use 10,000 vials that last 80 days with no problems. The manufactures have to have an expiry date and they do not do anything science based, they just make something up and different products have different dates?

Different E2 labs have different results? Have seen this numerous times, but no explanation. Some times see false zeros.

Transdermal FT can drop a lot, but TT does not fall like that. You are a non-absorber. Thyroid fT3, fT4 are decent and does not nail thyroid problems as a cause of non-absorption. However, low body temperatures could reverse that viewpoint and then one would want to consider adrenal stress and tT3 and iodine intake.

58

A panel came back from Quest that was drawn on 1/10 at 1:30pm in the afternoon to measure the effect of Clomid. The last dose was taken 24 hours before the sample was drawn. No iodine or B12 for a week prior to the draw.

T Total…737…250-1100 ng/dL
T Free…172.6…46-224 pg/mL
T Bioavail…369.9…110-575 ng/dL
SHBG…18…10-50 nmol/L
Albumin…17…10-50 g/dL
FSH…11.1…1.6-8.0 mIU/mL (HIGH)
LH…14.1…1.5-9.3 mIU/mL (HIGH)
Prolactin…5.9…2.0-18.0 ng/dL

E2 Sensitive…70…<29 pg/mL (HIGH)
E2 Standard…49…<39 pg/mL (HIGH)

TSH…1.39…0.4-4.5 mIU/L
T3 Total …112 (1.7 nmol/L)…76-181 ng/dL
T3 Free…3.3 (5.0 pmol/L)…2.3-4.2 pg/mL
T4 Total…7.3 (93.9 nmol/L)…4.5-12.0 mcg/dL
T4 Free…1.0 (12.9 nmol/L)…0.8-1.8 ng/dL
T3U…31…22-35%

Iron Total…83…45-170 mcg/dL
TIBC…329…250-425 mcg/dL
%Transferrin Sat…25…20-50%

Vit B12…852…200-1100 pg/mL
Serum folates…>24…>5.4 ng/mL

Steroid Panel Comprehensive:

11-Deoxycortisol…<15…<110 ng/dL
17-OH Progesterone…140…25-250 ng/dL
17-OH Pregnenolone…270…<700 ng/dL
18-HO Corticosterone…<26…<175 ng/dL
Cortisone…1.9…1.0-3.5 mcg/dL
Androstenedione…64…23-125 ng/dL
Corticosterone…132…62-1600 ng/dL
Cortisol…13.2…2.5-22.0 mcg/dL

DHEA Unconjugated…407…147-1760 ng/dL
Deoxycorticosterone…<16…<15 ng/dL
Pregnenolone…<35…<300 ng/dL
Progesterone…<0.1…<0.4 ng/mL
T Total…814…250-1100 ng/dL

MMA…117…87-318 nmol/L
Vit D3 25-OH…49…30-100 ng/mL
Vit D2 25-OH…<4…not established

T4/T3 Total ratio by volume: 98.2% T4, 1.8% T3
T4/T3 Free ratio by volume: 72% T4, 28% T3

Thyroid levels look a whole lot better!

Clomid appears to work in raising T, FSH, and LH but the sex drive is still shot with E2 numbers that high. Probably ITT aromatization at work. The reassuring point is that the boys can produce T on their own.

I am thinking that next up might be HCG injections.

Do any of you have other thoughts?

59

Got an HCG kit late last week and started this morning. The instructions call for 170 units each day. Is that preferable to 250iu as called out in the sticky? 170iu means 1190iu per week.

I also did the 4-sample saliva cortisol test yesterday. We’ll see what the results are in a few days…

60

Do not do hCG and clomid at the same time.

Albumin…17…10-50 g/dL

Is this a typo? If not, seriously wrong.

FSH…11.1…1.6-8.0 mIU/mL (HIGH)
LH…14.1…1.5-9.3 mIU/mL (HIGH)

E2 Sensitive…70…<29 pg/mL (HIGH)
E2 Standard…49…<39 pg/mL (HIGH)

Clomid dose was too high creating high LH, causing high T–>E2 inside the testes.

There is a concern that this can desensitize the LH receptors, a very wrong outcome. You were awash in E2. If you stopped clomid without a taper, your HPTA would suddenly see the high E2 and shutdown! That is why one must always taper off of a SERM.

170/day will work. You will have to watch E2, as some are hyper responders in terms of testicular T–>E2, which you might be.