Trt

[Jeff]

I am starting TRT again, I had to take some time off because my Family Dr. doesn't beleive in it and my health insurance doesn't cover it, and my expenses didn't allow me to continue with the program. I am now in a position to restart the program, my blood work should be in tommorow - is there any interest in me running a log for what I am using (most likely transdermal test, femera, and hcg) and how it affects my training, weight, mood, etc?

This is the same dr. that I used before, and I am glad that he started using the hcg in the protocol, he used to use clomid in its place - to ward off testicular atrophy.

 

[B5150]

There is always an interest from some of us. Activity around here has be very limited. You can be the activity we all need or you can wait for someone else.

I have journaled some of my experiences thus far. Still in the process of adjusting dose. Likely changing over to injection because my anual prescription coverage limit has been exhausted on the INSANE price of AndroGel. I will need to pay out of pocket until the end of year and 10cc/200mg cyp is a lot cheaper and lasts a whole lot longer that AndroGel. At 10mg/d of androgel I would need two boxes a month at a cost of about $230 per box. 10cc/200mg cyp is about $80 and will last me almost 20 weeks at 100mg/w.

Feel free to share if you like

 

[Jeff]

Thanks B5150 - Since I can't seem to find a decent doc in my network that knows anything about it I am forced to do this all out of pocket (Maybe I can remedy this with a new job sooooooooon )

Anyways, I got part of my lab tests back so this is where I am at as far as a baseline goes

Total Test: 198 (241-827)
Albumin: 5.0 (3.7-5.1) - Dehydration ????
Free Test: not received yet
LH: not received yet
Estradiol: 22 (15-54)
PSA: 1.0 (<=4.0)
T3(Free): 296 (230-500)
IGF-1: 177 (102-255)

So, he is going to put me back on Test. I had 3 options all from a compounded pharmacy - cream, gel, or test cyp injection. The last time I was on TRT I started with the cream and switched to the injection after a couple of months - for some reason I felt better on the cream - don't know why, maybe from the higher conversion to DHT? The Dr stated that the gel is new for them and that the absorbtion is much better with less applied volume, so I opted to give that a go for right now. The total amount applied will be 100mg twice a day (not sure about the absorbtion rate). Next month if my estradiol goes up too much, he will prescribe femura. He probably will also perscribe either clomid or HCG every couple of months to keep testicular atrophy at bay.

He has also suggested that my thyroid is on the low side and wants me to take a t3/t4 combo (16mg/30mg) every morning. Any thoughts on that given that I am technically not below the reference range? Is the above range for all age groups and since I am 36 I need to look at a different reference. Also, I didn't get the number for the T4, just for the free T3.

My igf looked pretty good, so I don't really need to consider HGH. He said he would be happier if my level was 277 instead of 177, but given the price of the gh ($250 a month), I might just consider trying some PGHt after all my other numbers stabalize.

 

[Jeff]

Dr John, thanks for the reply, It is greatly appreciated.

As far as the E2 goes, he will more then likely write the script after the first month, he said something about since I was in range with that he has to wait until he see's how much it jumps up to give me a script. I am just happy that this time he is willing to perscribe femura from his compounding pharmacy, last time I was on the program all I could get was aromasin and that stuff was expensive.

As far as cost goes, my initial lab work was around $400 bucks and a two month supply of the gel is $250 (I am not sure about the t3/t4 and femura, or the HCG). His costs are higher then a couple of other clinics I have found, but the other ones also offer Deca and that just kind of sent up some red flags for me so I didn't go with them. It is just too bad that the king of all things HRT no longer accepts out of state off site patients

I am kind of worried about taking the t3/t4 given that I am technically in range - is there anyway that fixing the hypogonadism will also make my thyroid more efficient. The thing about being hypogonadal is, if I lose my job and have to come off of the trt then I probably won't be any worse off then I was before. If I start supplementing with thyroid hormones and have to stop abruptly, I am gonna have a non working thyroid AND hypogonadism - fat gain, mooody, cholesterol through the roof......

 

[Jeff]

Well I finally started my meds this weekend. One thing that I am questioning is the thyroid medication - so far I have been really tired and dragging during the day and have been having trouble getting decent sleep at night. Is that common?

I don't think its the test, it didn't make me feel this way before and I have only been using it for 3 days so I doubt that the affects have kicked in yet.

 

[B5150]

Not unusual. How much T3 are you using? Any night sweats?

 

[Jeff]

Not unusual. How much T3 are you using? Any night sweats?

You know I am not really sure. All the bottle has on it is thyroid 60mg. I know he said it was a mix of t4 and t3 but aren't those usually dosed in mcgs not mgs?

I am sweating pretty good at night, I mowed the grass this weekend and looked like I had jumped in the pool.

 

[Jeff]

I have no history with thyroid medications - still a virgin
I asked about the type and the dosing on the thyroid medication. It's a porcine desiccated thyroid medication (similar to Armour, my guess). My 25mg dose would be pretty glose to 1/2 grain of Armour, or 12.5mcg of Cytomel, accourding to the chart at Armour Thyroid – Frequently Asked Questions.
One thing that I was worried about with the thyroid hormone was that it would raise my blood pressure (family history) but so far so good, it was actually better (120/65 with 56 bpm).

As far as the TRT, I have been using the alcohol based gel for just over a month. I felt better about two weeks ago, no depression, anxiety, etc, massive morning wood, and huge increase in stamina in the boxing gym. About two weeks ago that tapered off, I think my estrogen might have gone up too much. I should have the blood test results from my first 6 week checkup back on Wednesday and I'll post the results.

 

[pmgamer18]

Read the post "When to do labs" in this is this.
"If the 10 gram pack is not well absorbed, one possible cause is thickened skin due to hypothyroidism - called Myxedema. This may be suble particularly if the person is not obese. One patient, for example, on a testosterone gel, dropped his total testosterone from 840 ng/dl to about 500 ng/dl once his thyroid hormone levels dropped. Low thyroid hormone may also cause insulin resistance. Low thyroid hormone and insulin resistance (high insulin levels) both reduce SHBG. This can reduce the half-life of testosterone and its subsequent blood levels."

I your levels are still down on your gel this can be why.
Phil

 

[Jeff]

Good thinking. You also have now suppressed your own production to whatever extent.

Probably time for a dosage increase.

The Doc called me yesterday and faxed my bloodwork to me but I can't make out the numbers because the fax was running out of ink.

Looks like my thyroid medicine is going to be upped - the number came back at about 330. I was mistaken in my above posts, I looked at the bottle this morning and it says 60mg not 25mg (where the hell did I get that number from), so I have been on 1 grain and he is either going to put me on 1.5 or 2 grains (90 or 120 mg).

My total test result came back at 298, so back to the drawing board with that one. The only good news is that my itchy nipples must have been from a reaction to the gel. It could be like pmgamer said, the low thyroid is causing my skin to thicken and interfering with the absorbtion, or it could be that the new alcohol formula he is using just doesn't work on me. The Doc is trying to get me to at least 650ish area. Looks like I will just go back to doing the injects, I think he said 75mg every 5 days - I'll repost everything when I get the meds and a legible copy of my labs.

Thanks for the help guys, really appreciate it.

 

[Jeff]

The Doc called me yesterday and faxed my bloodwork to me but I can't make out the numbers because the fax was running out of ink.

Looks like my thyroid medicine is going to be upped - the number came back at about 330. I was mistaken in my above posts, I looked at the bottle this morning and it says 60mg not 25mg (where the hell did I get that number from), so I have been on 1 grain and he is either going to put me on 1.5 or 2 grains (90 or 120 mg).

My total test result came back at 298, so back to the drawing board with that one. The only good news is that my itchy nipples must have been from a reaction to the gel. It could be like pmgamer said, the low thyroid is causing my skin to thicken and interfering with the absorbtion, or it could be that the new alcohol formula he is using just doesn't work on me. The Doc is trying to get me to at least 650ish area. Looks like I will just go back to doing the injects, I think he said 75mg every 5 days - I'll repost everything when I get the meds and a legible copy of my labs.

Thanks for the help guys, really appreciate it.

Man I hate needles. My doc is on vacation so I am still waiting on my bloodwork results (the clear copy). I received my new perscription, I am using a 100mg every 5 days. Last time I was using the injects, Previously I was using a 3cc syringe, this time the pharmacy gave my 1cc syringes and 1.5 inch 23 guage needles. The needle collar just press fits, instead of screwing on, it made drawing the oil out kind of tough. Injecting your backside with such a 1cc is definately a pain in the butt, no pun inteded. I think I need to use a different site, or all of the funbling with the needle is going to turn my glute into hamburger.

 

[ManBeast]

I liked using my quads for an injection site, 1cc of cyp should be a cinch.

ManBeast

 

[Jeff]

I liked using my quads for an injection site, 1cc of cyp should be a cinch.

ManBeast

Thanks, I saw an injection document on here a couple of years ago, I'll do a search and find out the exact location.

 

[Jeff]

A few points.

Total T can come back the same as baseline, even though plenty is being absorbed, if induced HPTA suppression is matching that which is being absorbed. Did you have gonadotrophins assayed? If they have dropped, then you know it is getting in. Especially if FSH is down. Another trick whihc can explain things is if DHT has elevated. So I believe your "nipple issues" are real.

Five days is too short an interval between injections. This leads to a steady accumulation over time, by the half-life of the cypionate or enanthate ester, and makes it difficult to titrate dose properly. UNLESS you are merely splitting doses throughout the week, which can be beneficial in some.

Thanks for the feedback

Hopefull, I will be able to tell what is going on better when the doc gets back and I have a good copy of the labs. However, I want to say that this bloodwork was not as in depth as the last round and I might only have recieved the Total T, Free T, Estradiol, PSA, cholesterol - just the basics. I can ask specifically about the gonadotrophins, I didn't think to ask at the time he was drawing blood because I figured if I has absorbed even a tiny bit of the hormone I would have already supressed my own production, no?

The last go around, the dose was split into 2x a week (I usually did Sunday and Wednesday)- the doc said he wanted me to split it out into every 5 days this go around - I don't know why??

 

[Jeff]

So I have been on the injections E5D for a little over a month.

My total test came back as 798, and my estrogen was 55! The doc is happy with my test at that level, and he has perscribed Femura 2.5mg, 1 pill every day that I do my injections. Now that my test level is midrange, we are trying to get my estrogens back down (I think he said at least low 20's). I kind of had a feeling that my estrogen was high, when I took my dress socks off after work there was an indentation going around my calf where the socks had been, so I must have been retaining a bunch of fluid, also my BP was higher then it had been this past week.

I am also taking 2 grains of Armor Thyroid, my latest reading for free T3 came back at 480.

Other then my TRT meds, this is the only other OTC supps that I am taking.

Fish Oil 1000mg (I didn't realize the first brand that I was taking had a combination of fish and soy oil, so I found another brand that has only fish)
Vitamin C 2000mg
and ZMA (seems to help with sleep)

 

[Jeff]

I don't either. Too long for a "split" (meaning half a half-life), and too short for a weekly injection. This will take a long time to stabilize your serm levels, as it continues to build up over time.

I just had my ~6 month checkup, still waiting for blood work to show up on my fax. This is what I have so far, he didn't tell me the rest of the numbers over the phone.

Total Test: 800
T3: 490
BP: 120/75
HR: 65 bpm

My new regime is
150mg Test Enanthate split into two shots a week(changed from 75mg Cyp every 5 days)
2.5mg Femura 2x a week (chaged from 2.5mg every 5 days)
100IU HCG every other day IM injection. (new addition)
2grains Armour every Day (same)

I didn't know that you could do HCG as an IM injection.

For the last couple of months I have had some ED issues(desire problems might be a better term), that is why he switched the femura from every 5 days to twice a week and added the HCG. He felt that my estrogens were getting too high givent the half life of the femura is a couple of days at best.

I am also unsure as to why he switched me from Cyp to Enanthate, unless it is because he finally changed his protocol from 1 injection every 5 days to twice a week injections.

Does anybody else have problems with edema even when thier estrogen is in the low to mid 20's?

 

[JanSz]

I just had my ~6 month checkup, still waiting for blood work to show up on my fax. This is what I have so far, he didn't tell me the rest of the numbers over the phone.

Total Test: 800
T3: 490
BP: 120/75
HR: 65 bpm

My new regime is
150mg Test Enanthate split into two shots a week(changed from 75mg Cyp every 5 days)
2.5mg Femura 2x a week (chaged from 2.5mg every 5 days)
100IU HCG every other day IM injection. (new addition)
2grains Armour every Day (same)

I didn't know that you could do HCG as an IM injection.

For the last couple of months I have had some ED issues(desire problems might be a better term), that is why he switched the femura from every 5 days to twice a week and added the HCG. He felt that my estrogens were getting too high givent the half life of the femura is a couple of days at best.

I am also unsure as to why he switched me from Cyp to Enanthate, unless it is because he finally changed his protocol from 1 injection every 5 days to twice a week injections.

Does anybody else have problems with edema even when thier estrogen is in the low to mid 20's?

In the previous post you posted FreeT3=480
I think you have ment to post now that your FreeT3=490
If that is the case you are over the range with FreeT3
(2.3-4.2) or (230-420)
Femara,
we here try first to control estrogen using DIM+I3C+TMG and Calcium D glutarate, reservatrol
and if that is not enough we use AI, usualy Arimidex, Femara is possibly even stronger than Arimidex.

 

[Jeff]

In the previous post you posted FreeT3=480
I think you have ment to post now that your FreeT3=490
If that is the case you are over the range with FreeT3
(2.3-4.2) or (230-420)
Femara,
we here try first to control estrogen using DIM+I3C+TMG and Calcium D glutarate, reservatrol
and if that is not enough we use AI, usualy Arimidex, Femara is possibly even stronger than Arimidex.

Hmmm, the range on my bloodwork sheet lists 500 as the top, I found one reference that listed the normal ranges at 230 to 619. is 420 the generaly excepted number - I can talk to him about lowering the dose to 1.5 if need be.

 

[JanSz]

Hmmm, the range on my bloodwork sheet lists 500 as the top, I found one reference that listed the normal ranges at 230 to 619. is 420 the generaly excepted number - I can talk to him about lowering the dose to 1.5 if need be.

Do not hury with lowering.
First how you feel?
Is your temperature ok?
Is your pulse within normal range.

Read this:
Stop The Thyroid Madness » Things We Have Learned

 

[Jeff]

Do not hury with lowering.
First how you feel?
Is your temperature ok?
Is your pulse within normal range.

Read this:
Stop The Thyroid Madness » Things We Have Learned

I feel ok, maybe a little jittery a couple of hours after I take the thyroid, real bad if I don't eat anything for breakfast. I haven't been keeping a close watch on my temps, but I haven't been cold first thing in the morning like I was before, and I am not having any night sweats. My pulse is usually between 55 and 65, sometimes 75 depending on the traffic mess between my office and the doc's office

I have been looking at the thyroid madness site for a while, i need to talk to the doc next time I am in there about adrenal fatique and getting tested for that. To be perfectly honest, i am not noticing much of a difference between 1 grain and 2 grains.

On a side note, does anybody have feed back on the nutrimeds thyroid compared to Armour, I know they say it is weaker, but it is also a lot cheaper too.

 

[Jeff]

In the previous post you posted FreeT3=480
I think you have ment to post now that your FreeT3=490
If that is the case you are over the range with FreeT3
(2.3-4.2) or (230-420)
Femara,
we here try first to control estrogen using DIM+I3C+TMG and Calcium D glutarate, reservatrol
and if that is not enough we use AI, usualy Arimidex, Femara is possibly even stronger than Arimidex.

I am gonna have to look into using the DIM, the Femura is expensive and I swear it makes my joints hurt. Is DIM better then something like ATD for keeping estrogen in check, I was under the impression that DIM controlled ratio of the kind of estrogen, but didn't actually keep the number in range?

 

[JanSz]

I am gonna have to look into using the DIM, the Femura is expensive and I swear it makes my joints hurt. Is DIM better then something like ATD for keeping estrogen in check, I was under the impression that DIM controlled ratio of the kind of estrogen, but didn't actually keep the number in range?

That is also my understanding. DIM adjust the ratio of 2/16 estrones.

How to best manage estrogens is under constant guessing on this board.

At one time Dr John promissed to make available (for a price) his position paper that he planned to present at last conference in Orlando FL (Apr 27-29).

There are other supplements used to control estrogens.
Always last one is Arimidex and first one is keeping FreeT and BAT in desirable range.

The other supplements are
DIM, I3C, TMG, Resveratol, Chrysin, (7,8 benzoflavone) probably few other (Myomin).

I am assuming that keeping other hormones in their desirable ranges helps in estrogen management.

 

[aculpep]

I thought DHT is bad? But higher DHT makes you feel better?

I, too favor a T gel over T cream. And yes, the increased DHT conversion usually does make a guy feel better than with test cyp, and this happens at a lower serum T level (I always try to use LESS drugs, not more).

 

[cpeil2]

I thought DHT is bad? But higher DHT makes you feel better?



Within limits . . . it does a lot for your libido.

 

[Jeff]

So I have some issues with melanoma for the last couple of months and I am having surgery to have some senitnel lymph nodes taken out in September.

I have been considering stopping all of my TRT medications (Test Enanthate, Femura, Armour....), or finding a new doc when all of this melanoma stuff is behind me. it has been about a two weeks since my last shot of test, and I stopped taking the Armour last weekend.

Should I be concerned about stopping these meds and having surgery in September?

I have kind of lost a little faith in my doctor after trying to get him to test my adrenal function because the armour just makes me feel jittery after I take it for a few hours but I haven't noticed much else. I also asked about going back to a transdermal test from the injections for two reasons, 1. I felt better on the transdermal, 2. I hate sticking myself with the needles. My doc said that since he switched me from cyp to enanthate that I could do weekly injections instead of twice a week (I thought that the half life of enanthate is shorter then cyp??????).

I have been having some erectile issues the last month or so of the TRT, but when I bring it up to the doc he say my test numbers look good - like it's all in my head. Now that I haven't had a shot in almost two weeks - my erections are becoming more normal again. My biggest concern is stopping the Armour (2 grains a day), am I more likely going to be more "hypothyroidal" then when I started?