Here is a comparison of some labs that I had taken while on 20mg/day of "Nolvadex for TRT" and the "100mg Test + HCG for TRT" protocols. The only reason I don't call the latter the "Dr John protocol" is because the T shots were sub-q:

Nolvadex @ 20mg day, 3grains Armour Thyroid, no Medrol (was on this combo for 7 months...these are the final labs from it)
Albumin: 4.8 (3.7-5.1)
SHBG: 16 (5-49)
Total T: 585 (241-827)
Free T: 179 (34-194)
Free and Weakly Bound T: 391 (84-402)
Estradiol aka E2: 16 (13-54)
LH: 6.8 (1.5-9.3)
DHT: 52 (25-75)
Progesterone: n/a (0.6-2.6)
Pregnenolone: 10 (10-200)
Free T3: 398 (230-420)
T3 Uptake: 40 H (22-35)
DHEA-s: 231 (110-370)
AM Cortisol: 17.7 (4-22)

Week 4 @ 100mg/week (single .5cc sub-q shot) Test + 500iu/week HCG, 3 grains Armour Thyroid, 4mg Medrol
(blood drawn on Thurs after a Monday injectionof T-cyp)
SHBG: 15 (5-49)
Total T: 633 (241-827)
Free T: 233 H (34-194)
Free & Weakly Bound T: 439 H (84-402)
Estradiol: 18 (13-54)
LH: <0.1 L (1.5-9.3)
DHT: 56 (25-75)
Progesterone: 0.9 (0.6-2.6)
Pregnenolone: 38 (10-200)
Free T3: 312 (230-420)
T3 Uptake: n/a (22-35)
DHEA-s: 73 L (110-370)
AM Cortisol: 13.8 (4-22)

Although many were envious of my numbers on Nolvadex only, I didn't feel very good. Zero libido, very weak in the gym, and very poor physical and mental stamina. This is why I got off of this protocol. I competitively race shifter karts (extremely physically demanding) and couldn't drive the thing for more than 5 minutes without being totally whipped. I had to withdraw from the last race I entered due to fatigue. ARGH. This protocol gave me numbers, but not results. Dr John has repeatedly stated similar findings (numbers, but not results) and I certainly found out for myself that he was correct. I will say that on this protocol, I did not experience brain fog or dizziness though despite being on it for a very long time.

Back on lower protocol, I noticed VASTLY improved libido (best in years), tremendous strength increases in the gym, and a huge improvement in physical stamina. However, I'm at week 12 now and in the last 2 weeks, those adrenal symptoms (dizziness, brain fog, eyes bothered by light) are starting to surface very heavily. I did not have these problems on the Nolva protocol. Why have my thyroid and adrenal numbers dropped on the new protocol? Is it due to the loss of DHEA? Despite the brain fog and dizziness coming back, my libido and performance still remain excellent, so I am reluctant to blame E2.

Sonny

Originally Posted by T800

Here is a comparison of some labs that I had taken while on 20mg/day of "Nolvadex for TRT" and the "100mg Test + HCG for TRT" protocols. The only reason I don't call the latter the "Dr John protocol" is because the T shots were sub-q:

Nolvadex @ 20mg day, 3grains Armour Thyroid, 4mg Medrol (was on this combo for 7 months...these are the final labs from it)
Albumin: 4.8 (3.7-5.1)
SHBG: 16 (5-49)
Total T: 585 (241-827)
Free T: 179 (34-194)
Free and Weakly Bound T: 391 (84-402)
Estradiol aka E2: 16 (13-54)
LH: 6.8 (1.5-9.3)
DHT: 52 (25-75)
Progesterone: n/a (0.6-2.6)
Pregnenolone: 10 (10-200)
Free T3: 398 (230-420)
T3 Uptake: 40 H (22-35)
DHEA-s: 231 (110-370)
AM Cortisol: 17.7 (4-22)

Week 4 @ 100mg/week (single .5cc sub-q shot) Test + 500iu/week HCG, 3 grains Armour Thyroid, 4mg Medrol
(blood drawn on Thurs after a Monday injectionof T-cyp)
SHBG: 15 (5-49)
Total T: 633 (241-827)
Free T: 233 H (34-194)
Free & Weakly Bound T: 439 H (84-402)
Estradiol: 18 (13-54)
LH: <0.1 L (1.5-9.3)
DHT: 56 (25-75)
Progesterone: 0.9 (0.6-2.6)
Pregnenolone: 38 (10-200)
Free T3: 312 (230-420)
T3 Uptake: n/a (22-35)
DHEA-s: 73 L (110-370)
AM Cortisol: 13.8 (4-22)

Although many were envious of my numbers on Nolvadex only, I didn't feel very good. Zero libido, very weak in the gym, and very poor physical and mental stamina. This is why I got off of this protocol. I competitively race shifter karts (extremely physically demanding) and couldn't drive the thing for more than 5 minutes without being totally whipped. I had to withdraw from the last race I entered due to fatigue. ARGH. This protocol gave me numbers, but not results. Dr John has repeatedly stated similar findings (numbers, but not results) and I certainly found out for myself that he was correct. I will say that on this protocol, I did not experience brain fog or dizziness though despite being on it for a very long time.

Back on lower protocol, I noticed VASTLY improved libido (best in years), tremendous strength increases in the gym, and a huge improvement in physical stamina. However, I'm at week 12 now and in the last 2 weeks, those adrenal symptoms (dizziness, brain fog, eyes bothered by light) are starting to surface very heavily. I did not have these problems on the Nolva protocol. Why have my thyroid and adrenal numbers dropped on the new protocol? Is it due to the loss of DHEA? Despite the brain fog and dizziness coming back, my libido and performance still remain excellent, so I am reluctant to blame E2.

Sonny

Add pregnenolone compounded cream
latter possibly
DHEA compounded creme

Little Armour Thyroid (2-3 grains??)

Hi Jan,

Thanks for the response. I'm assuming you're suggesting the preg cream to bring up DHEA?

My thought is that MAYBE the lowering of DHEA since starting Test/HCG impairs adrenal function (in me). My adrenals were totally shot when I started treating them last year.

Sanesco saliva Adrenal panel ordered by Dr Mariano on 9/2006:

Cortisol @ 7:30 AM: 3.1 L (13-24nM)
Cortisol @ 11:30AM: 2.8 L (5-8nM)
Cortisol @ 3:30PM: 2.0 L (4-7nM)
Cortisol @ 7:30PM: 0.9 L (1-3nM)
DHEA-s @ 7:30AM: 8.8 (2-10ng/ml)
DHEA-s @ 3:30PM: 14.3 H (2-10ng/ml)

I have been on Medrol since starting with Dr Mariano last year. Actually, I was able to wean myself off of it for about a month before starting the Test Cyp/HCG protocol. Once I got back on the Test Cyp/HCG protocol, I had to get back on the Medrol. I guess that is a hint that somehow, my adrenals are being affected.

Supposedly, Test is Test, but for some reason, the results of the above 2 protocols are drastically different even though the numbers are close to the same. I have no idea with the Nolvadex protocol doesn't seem to affect Free T3 or DHEA.

Thanks,
Sonny

Originally Posted by T800

Hi Jan,

Thanks for the response. I'm assuming you're suggesting the preg cream to bring up DHEA?

My thought is that MAYBE the lowering of DHEA since starting Test/HCG impairs adrenal function (in me). My adrenals were totally shot when I started treating them last year.

Sanesco saliva Adrenal panel ordered by Dr Mariano on 9/2006:

Cortisol @ 7:30 AM: 3.1 L (13-24nM)
Cortisol @ 11:30AM: 2.8 L (5-8nM)
Cortisol @ 3:30PM: 2.0 L (4-7nM)
Cortisol @ 7:30PM: 0.9 L (1-3nM)
DHEA-s @ 7:30AM: 8.8 (2-10ng/ml)
DHEA-s @ 3:30PM: 14.3 H (2-10ng/ml)

I have been on Medrol since starting with Dr Mariano last year. Actually, I was able to wean myself off of it for about a month before starting the Test Cyp/HCG protocol. Once I got back on the Test Cyp/HCG protocol, I had to get back on the Medrol. I guess that is a hint that somehow, my adrenals are being affected.

Supposedly, Test is Test, but for some reason, the results of the above 2 protocols are drastically different even though the numbers are close to the same. I have no idea with the Nolvadex protocol doesn't seem to affect Free T3 or DHEA.

Thanks,
Sonny

I rather have someone else speak about your all the time low cortisol.
With what I have heard till now, my self I would try 20mg/day (may be 30mg but no more) Cortef for 1 year then try to wean out.
There are other variations (longer lasting) on Cortef that would allow you to take pills once/day to make life easier.

DHEA and as may as possible other indicators I would like to keep on their known desired levels.
Progesterone: 0.9 (0.6-2.6) try to increase it, there is a compounded cream
Pregnenolone: 38 (10-200) try to increase it, there is a compounded cream
Free T3: 312 (230-420) make it higher (gingerly~adrenals, but dr Marianco favors T4, that would mean aim for FreeT4 at the top range, freeT3 as per natural conversion if possible) (STTM and Dr Marianco= two different approaches)
DHEA-s: 73 L (110-370) try to increase it, there is a compounded cream

I am not a doctor.

It's almost like the exogenous test is causing your adrenals to be more fatigued, as both your DHEA-s & cortisol are lower after. And Pregnenolone is higher (as if not being converted into the other hormones).

Maybe the rising/falling T & E levels over the week is making your adrenals work harder ? You could try shots every 3 days instead of once a week.

You also mention u r training harder in the gym & stamina has increased. Could you be putting more stress on your adrenals than on the earlier protocol ?

How are you dosing your medrol and armour ? Are you taking it one dose, or splitting it through the day ?

Originally Posted by coz

It's almost like the exogenous test is causing your adrenals to be more fatigued, as both your DHEA-s & cortisol are lower after. And Pregnenolone is higher (as if not being converted into the other hormones).

Maybe the rising/falling T & E levels over the week is making your adrenals work harder ? You could try shots every 3 days instead of once a week.

You also mention u r training harder in the gym & stamina has increased. Could you be putting more stress on your adrenals than on the earlier protocol ?

How are you dosing your medrol and armour ? Are you taking it one dose, or splitting it through the day ?

Possible hidden insulin resistance may be rearing its ugly head and finally putting the strain on adrenals. Look at your shbg its pretty low which could indicate insulin imbalnces.
What is your lipidprofile looking like ? Driving your e2 down will also cause excessive stress on your adrenals due to that it will speed up your thyroid. I have seen this in few clients profiles. When e2 is high t4 to t3 conversion is low when e2 is driven down t4 to t3 conversion increases and causes cortisol levels to drop dramatically. Testosterone will put stress on adrenals if too high or too low and if one is constantly fluctuating back and forth it will also cause undue stress of them. Stability and consistency is the key..

I went back and reviewed some notes and found that the lab taken while on the Nolvadex protocol did NOT include any Medrol. That was a typo on my part.

So, with 4mg of Medrol on board on the new protocol, my cortisol was still significantly lower. Hmmm.

It could come down to DHEA deficiency. I know absorption with oral DHEA is kind of hit and miss, but i've been using Schiff DHEA 25mg 2x per day (with 1mg of Reservatrol) and have to say that I feel a lot better. Dizziness and brain fog have lifted.

Sonny

Originally Posted by T800

I went back and reviewed some notes and found that the lab taken while on the Nolvadex protocol did NOT include any Medrol. That was a typo on my part.

So, with 4mg of Medrol on board on the new protocol, my cortisol was still significantly lower. Hmmm.

It could come down to DHEA deficiency. I know absorption with oral DHEA is kind of hit and miss, but i've been using Schiff DHEA 25mg 2x per day (with 1mg of Reservatrol) and have to say that I feel a lot better. Dizziness and brain fog have lifted.

Sonny

That may make sense, as the medrol will be supressing some of your adrenal output - allowing them to rest & recover more. I don't believe the medrol will show up as cortisol on blood tests, as it is not bio-identicle like HC.

So just supplementing the DHEA has helped the symptoms dissapear ?

Originally Posted by coz

So just supplementing the DHEA has helped the symptoms dissapear ?

Yes. :-)

Sonny