Second Opinion

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    Second Opinion


    Male and 51. Typical Symptoms: lack of energy, very tired at end of day, just plain ole blahhhhh

    Professional Career, high stress.

    Typically to bed at 10:30 and up at 6:30 (when not working out) and 5:20 when working out.

    Eating habits are very good, but not optimal: Low fat, healthy, plus no smoking or drinking.

    175 lbs, 6'4" -- Yeah, probably would call me skinny. Body fat 11% and BMI 21.4

    Oh yeah, not working out but active lifestyle

    Test results
    LDL- P 1222
    LDL - C 154
    HDL - C 63
    Triglycerides 34
    Cholesterol 224 ( high but see next two)
    HDL - P 39.4
    Small LDL-P 351
    LDL Size 21.7
    LP- IR Score (insulin resistance) 13
    TSH 1.69
    T3 Free 3.1
    T4, Free (direct) 1.28
    CBC, WBC 5.9
    CBC, RBC 4.64
    Testosterone, Serum 404
    Free Testosterone (direct) 8.6
    Estradial 14.7
    PSA 0.4
    IGF-1 227
    C-reative Protein 0.21 (Yeah!)
    Progesterone .3
    Estrogens, total 56 (ideal I believe is around 20)
    Thyriod Peroxidate <6

    Result: Put on Cypoinate, .35ML per week (200mg/ML -- No cycling.) This results in 70MG per week and one Anastrozole 1 MG with each injection.

    First couple of weeks sex drive up, energy levels up and I started working out. Now, 6 weeks in, I am back to tired and less energy. I do feel better than before starting the Cyp, but I would not say it is more than 15% better.

    I have upped my protein intake considerably (ON Ultimate Whey), am taking a good multivitamin, and am being even more conscious about level of simple carbs.

    I am now waiting on updated labs for Total T, Free T, Estradial, Estrogen and TSH. I suspect I need higher than 70 per week.

    Now, finally, for the opinion part.

    I assume since I am not cycling that my body's production of Test. is limited at best. I felt much better the first few weeks because I had not only my own Test production but also the injection, and now I am "living" with the injection only?

    If my goal is to be healthy and to get from 175 pounds to 210 pounds with an 8-10% body fat, what Testosterone, Serum (now 404) levels should I be maintaining (in general terms)?

    Thanks in advance for your advice and counsel on this topic. ANY advice is appreciated.

    I hope this is posted to the correct forum.......

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    Was the test of 404 taken when on the .35 ml? Generally speaking, the benefits of trt you are looking for are found at higher doses and test levels. 70/week is kind of on the low side of trt. I'm injecting 75 mg twice a week and have put on 18 pounds since Feb, and have leaned out at the same time. My labs (cholesterol,LDL ) have all improved as well.

    However, everyones response to exogenous test is individual. It takes some trial and error to get the dose that works for you dialed in. Most here report that trt gets their test levels in the range of 700-1000.

    Good luck...
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    napalm, the 404 was before the .35 ml. I am waiting on updated tests and will post once received. Should come in this week, but had to send out to reference lab (Labcorp).

    Thanks for the feedback.
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    Test results in and resutls was Testosterone, Serum 408, no impact and I feel like I did before. Upped the dose to .50 ml per week and still on 1 mg amiridex with the injection, Testosterone , Serium 480, estrogen is high. I will increase Amiridex to 2 mg per week.

    It was suggested I come off the Cypo and go on 2500 units of HCG a week. I have read for hours and can not seem to find info on this type of a regimen in place of the cypo. Any thoughts would be appreciated. I am thinking about increasing Cypo dosage to 55-60 per week on my on and then run labs in about three weeks. What do you guys think about he HCG option?
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    Are you making up your own treatment or doing what a doctor says?

    And low fat its not great for natural test production....
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    I am under physician's care, however, the physician is amenable to my suggestions.

    Here is what I am thinking about discussing with him. Go to two injections per week, 90mg per injection, three 1 mg amdex and 250 units of HGC once per week (5-7 day life cycle)

    Man, at 100 mg per week (present) I am just not feeling the energy level and am not motivated to even workout.

    This regiment would be for energy and building muscle, no cycling, just stay on cypo.

    I did ready the HGC threads and there appears to be a LOT of opinions regarding when and for what purpose. It does make sense to keep testes producing if possible......

    I would appreciate feedback and thanks for not beating the ^&&% out of me for being a rookie with rookie questions.
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    Honestly to me it sounds like you may have jumped on trt to fast. If i had a total test as good as yours i would have looked a little deeper before starting.
    Adding adding hcg may also spike estrogen. I spent six months on 100 mg a week before my levels stabilized and i felt right. But i also tried other stuff for about a year before even talking to an endocrinologist.
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    Not sure about that, 400 is not the place to be based on everything I have read here and according to my physician.
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    So what did you actually do to determine why you are low? Are you primary or secondary? Do you have high shbg? What about Cortisol? I am not saying 400 is not on the low end of the range...i am saying throwing lots of testosterone followed by hcg without at least making sure about the rest of the system could be masking something that could have been fixed without being on medication for life. 400 was where i was at when i was 31..
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    See first post.
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    Here is another question. If I am on Cypo long-term, can I keep natural test production going with HCG? Yes, I have read all the articles (and the 50 different opinions).

    If the answer (prevailing opinion) is yes, do I need to stop the Cypo, get on HCG, restart my own test and then get back on Cypo along with HCG?

    Supplements like NOW Foods Maca 500mg, 250 Capsules seem to be effective in management of estrogen. Do I even need to consider this if I am on amdex? I'm ready for the verbal beating.....bring it on.
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    Quote Originally Posted by pappybay View Post
    See first post.


    If it answered any if my questions i would not have asked them....
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    Quote Originally Posted by v4lu3s View Post
    So what did you actually do to determine why you are low? Are you primary or secondary? Do you have high shbg? What about Cortisol? I am not saying 400 is not on the low end of the range...i am saying throwing lots of testosterone followed by hcg without at least making sure about the rest of the system could be masking something that could have been fixed without being on medication for life. 400 was where i was at when i was 31..
    Sorry for the delay and my poor response earlier. I could not find a SHGB result on my labs. Could it be called something else? With regard to Cortisol, I did do the saliva test and received a report of Cortisol levels which were in range according to the chart: 7:45 am 7.8, noon 5.9, 2:54 1.6 and 10:10 pm .8 My physician said the results were good, no issues. I apologize as I do not know what is meant by primary or secondary. Would you please mind explaining a little as I would really like your input.

    Thanks
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    Sex Hormone Binding Globulin is what it is. If it is too high it means low free test.
    Primary means non or low functioning testicles, secondary means pituitary function is impaired.
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    Changed to two injections per week 80 mg each for a total of 160 and I can DEFINITELY feel it: more energy, strength gains are improved greatly and a general better feeling of "well-being" if that makes sense.

    Blood pressure is good, a little joint "discomfort" which fish oil seems to solve. A lot of protein added to daily diet along with vitamins.

    I am very satisfied at present.
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    Quote Originally Posted by pappybay View Post
    Changed to two injections per week 80 mg each for a total of 160 and I can DEFINITELY feel it: more energy, strength gains are improved greatly and a general better feeling of "well-being" if that makes sense.

    Blood pressure is good, a little joint "discomfort" which fish oil seems to solve. A lot of protein added to daily diet along with vitamins.

    I am very satisfied at present.
    How much anastrozole do you take now? Did you decide to add HCG as well?
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    Wontstop, I am taking 3X 1mg per week with no issues or signs of Gyno. After consulting with my physician I am not adding HGC. He believes the HGC could inhibit the cypo(????). Not sure I agree but then I don't have M.D. after my last name.

    Any advice?
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    I am still a bit confused in the need to cycle off the crypto and start massive doses (5,000) of HGC for 3-4 months if I am okay with the testes impact staying on TRT. Why not just stay on the cypo long-term (ignoring the need to inject 2X per week forever and cost)
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    Quote Originally Posted by pappybay View Post
    I am still a bit confused in the need to cycle off the crypto and start massive doses (5,000) of HGC for 3-4 months if I am okay with the testes impact staying on TRT. Why not just stay on the cypo long-term (ignoring the need to inject 2X per week forever and cost)
    hcg will not impact the cyp..all hcg does is mimick the LH signal to your testies...hcg is commonly used in trt by many to allow men that have perma shutdown to have full testies..he needs to check your shbg....your estrogen is high..estrogen increases the amount of shbg in the body...both estrogen and shbg inhibit free test levels..issue for your test levels not going up is the increased estrogen #..solution is with the adex..adex has a 27 hour half life..taking it only once or twice ew in a man your age isnt going to stop the conversion of estrogen...i would stay on the test..inject half your prescribed dose e3d and use .5mg of adex ed..as men get older the conversion to estrogen greatly increases..i would find a endo that specializes in HRT for men also..most of these doctors just type symptoms into a out dated data base and follow what it says..and normally its wrong..hope all goes well..
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    S2h:
    If I am injecting .4 on a Sunday, would I not need more adex for the initial "rush" of cypo? Right now I inject on Sunday am and Wednesday am, take a 1 MG with each injection and then a .5 adex on Tuesday (2 days after Sunday injection) and Friday (two days after Wednesday injection.

    If i have 3 MG to take each week, I guess I could take .5 per day. Is that what you are suggesting, and THANK you for the advice. It is appreciated.
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    Quote Originally Posted by pappybay View Post
    S2h:
    If I am injecting .4 on a Sunday, would I not need more adex for the initial "rush" of cypo? Right now I inject on Sunday am and Wednesday am, take a 1 MG with each injection and then a .5 adex on Tuesday (2 days after Sunday injection) and Friday (two days after Wednesday injection.

    If i have 3 MG to take each week, I guess I could take .5 per day. Is that what you are suggesting, and THANK you for the advice. It is appreciated.
    test cyp peaks right at 48 hours after injection..and with adex's half life being about half of test cyps peak..then your adex is winding down as your cyp is peaking...adex at .5mg eod is optimal for keeping e2 conversion at its most best levels.. you also may look to inject your cyp mon/thurs to keep the blood levels from your cyp injection more stable..
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    in the end bloodwork is really the only solid info that you can go by..we are all different...i know of one person that requires 1mg of adex ed with 200mg of cyp ew to maintain proper levels..that amount of adex would have me crying to a horror movie..
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    Quote Originally Posted by s2h View Post
    in the end bloodwork is really the only solid info that you can go by..we are all different...i know of one person that requires 1mg of adex ed with 200mg of cyp ew to maintain proper levels..that amount of adex would have me crying to a horror movie..
    I hear ya. LMAO BTW. I am going to the .5 routine immediately and thanks for the great advice.
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    Quote Originally Posted by pappybay View Post
    I hear ya. LMAO BTW. I am going to the .5 routine immediately and thanks for the great advice.
    Done. I will get labs in a few weeks and share results.
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    New labs. Any thoughts?

    LCD/MS/MS. 766. Total test
    FreeTest. 265.8
    SHBG. 12
    DHEA Sulfate 72
    FSH < 0.7
    LH < 0.2 (hence my interest in HGC)
    Estradiol < 15

    Still waiting on estrogen total and serum

    Red Blood Count 4.91 Mil/mm3
    HGH. 15.3 G/DL
    Hematocrit. 46.2

    Labs pulled on a Wednesday morning after 80 mg injection on Sunday morning. Injected 80 after labs pulled.

    Doc says numbers look great, as a reminder, goals are improved health and to put on 20-25 pounds of mass.

    Will probably go on 250 IU HCG 2 times per week to get the LH up and my scrotum down.
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    Your hormonal pathways are not right. There shouldn't be the need to take that much adex to maintain a relatively middle of the road test levels. That could have been the main reason why your test was low from the get go. Instead of fixing the cause you just patching the one hormone that may not even be the problem. It could be other hormones afffecting it. All hormones work in a cascade.
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    Quote Originally Posted by vassille View Post
    Your hormonal pathways are not right. There shouldn't be the need to take that much adex to maintain a relatively middle of the road test levels. That could have been the main reason why your test was low from the get go. Instead of fixing the cause you just patching the one hormone that may not even be the problem. It could be other hormones afffecting it. All hormones work in a cascade.
    Not sure where you are going here?? All lab results looked great (from the beginning) except Test......
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    Quote Originally Posted by pappybay View Post
    Not sure where you are going here?? All lab results looked great (from the beginning) except Test......
    there is a cascade of hormones inter-related that each one affecting the other. You have cholesterol as primary raw material then pregnonlone, andro, and a bunch of other hormones before you even get to the test. Test is just another piece of the cascade. I would check all the other hormones and see where you stand.
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    Quote Originally Posted by vassille View Post
    Your hormonal pathways are not right. There shouldn't be the need to take that much adex to maintain a relatively middle of the road test levels. That could have been the main reason why your test was low from the get go. Instead of fixing the cause you just patching the one hormone that may not even be the problem. It could be other hormones afffecting it. All hormones work in a cascade.
    I am going to drop back on the AI since my labs are so low on Estro and see what happens.
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    Quote Originally Posted by pappybay View Post
    I am going to drop back on the AI since my labs are so low on Estro and see what happens.
    Good idea
  

  
 

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