Anyman's personal journal: May it help me and others to follow

[JanSz]

I have .01mg "minitroche" custom mixed as a sublingual dose. It is taken with the T shot, which is presently 2x/week.

I would have preferred a "normal" dose and "normal" pill, but this is what Dr Shippen does.

One Arimidex pill =1mg

you are taking 1/100 of a pill twice weekly.

I would say 1/100 of pill is about as close to zero as one can get,
sublingual or not.
Possibly you have ment to say 1/10 (one tenth)
.............................................................................................................
"""Estradiol (E2) dropped from the 60s to 52,"""

This difference may be just random spread in testing.

You are doing now much better in TT area, but I do not have any warm feelings about your Arimidex situation, may want to discuss it with your doc.

What is your SHBG situation?

As you may have noted, JackBauer's got cut in half, be carefull.

http://**************.com/forum/showpost.php?p=11439&postcount=10

 

[anyman]

The dose is indeed low. But-- It is sublingual and NOT oral.

One Arimidex pill =1mg

you are taking 1/100 of a pill twice weekly.

I would say 1/100 of pill is about as close to zero as one can get,
sublingual or not.

.
"""Estradiol (E2) dropped from the 60s to 52,"""

This difference may be just random spread in testing.

You are doing now much better in TT area, but I do not have any warm feelings about your Arimidex situation, may want to discuss it with your doc.

What is your SHBG situation?

As you may have noted, JackBauer's got cut in half, be carefull.

http://**************.com/forum/showpost.php?p=11439&postcount=10

I wonder if sublingual allows for a lower dose. Still, Shippen is KNOWN for starting people at what to many are way too low amounts. He likes to work his way up at a pace best described as "Glacial". I can intellectually agree with this in theory, but as a guy just trying to feel normal it sure drags things out way too long.

Don't know about SHBG. It's always been low. Never above 12. I'll have to find out.

 

[JanSz]

I wonder if sublingual allows for a lower dose. Still, Shippen is KNOWN for starting people at what to many are way too low amounts. He likes to work his way up at a pace best described as "Glacial". I can intellectually agree with this in theory, but as a guy just trying to feel normal it sure drags things out way too long.

Don't know about SHBG. It's always been low. Never above 12. I'll have to find out.

Your current
TT=833

SHBG=12

FreeT=283

You are about there.

Everytime you mention your low SHBG it think about you residing in NYState, you know what I mean.

 

[anyman]

More progress. Still more to come--I hope.

The most recent blood work showed T at 833 (up from 698) and E2 at 52, down from 64. This happened by adding .1mg of Arimdex 2x/week to my usual routine of 160mg/week of T cyp divided into 2 80 mg doses and 325iu of hcg also 2x/week. Finally--a little more progress. Fatigue can still be an issue, but a bit less so.

For now, I am to double my Arimidex dose to .2mg twice weekly (quite a low dose according to him) and maintain the 160mg of T cyp (80mg 2x week) and roughly 325iu of hcg 2X/week. I am also to stay on the Iodoral, which the Dr. believes can take a good 6 months to clear things out, as he puts it. Topical Seligilene is lso to be continued as well. Cobalt, of course, will also be continued at 3 drops 2x/day.

Maybe I am making some progress--not only in feeling like my old self, but in finding the root cause. During the recent consult we discussed matters and the conversation turned to my apparent hypermetabolization issue.

While the Dr. was unsure as to why this may have happened, he did agree that my theory regarding this as the "root cause" may indeed have merit. It may be possible that once hypermetabolization took root my body burned off more T than I could make and in trying to keep up essentially "burned out". Whether this is permanent or reversible to some extent remains to be seen.

There is more to do and then some, but perhaps my story and results will help others.

 

[The Matrix]

The most recent blood work showed T at 833 (up from 698) and E2 at 52, down from 64. This happened by adding .1mg of Arimdex 2x/week to my usual routine of 160mg/week of T cyp divided into 2 80 mg doses and 325iu of hcg also 2x/week. Finally--a little more progress. Fatigue can still be an issue, but a bit less so.

For now, I am to double my Arimidex dose to .2mg twice weekly (quite a low dose according to him) and maintain the 160mg of T cyp (80mg 2x week) and roughly 325iu of hcg 2X/week. I am also to stay on the Iodoral, which the Dr. believes can take a good 6 months to clear things out, as he puts it. Topical Seligilene is lso to be continued as well. Cobalt, of course, will also be continued at 3 drops 2x/day.

Maybe I am making some progress--not only in feeling like my old self, but in finding the root cause. During the recent consult we discussed matters and the conversation turned to my apparent hypermetabolization issue.

While the Dr. was unsure as to why this may have happened, he did agree that my theory regarding this as the "root cause" may indeed have merit. It may be possible that once hypermetabolization took root my body burned off more T than I could make and in trying to keep up essentially "burned out". Whether this is permanent or reversible to some extent remains to be seen.

There is more to do and then some, but perhaps my story and results will help others.

IF I were you I would divide that that 650 by 5 and break it down to smaller hcg shots. Some people have an issue of going over 125 ius at time causes an metabolic pathway to estrones or estrodial. I can not explain why, but I have seen it occur time and time in people that I have come across. You may want to speak to kanecore because he had this same issue and once he lowered the hcg from 250 ius to 125ius or lower then his symptoms got better mainly his fatigue. It may also help to reduce the amouint of armidex needed as well. Just a thought..

 

[jinxie]

IF I were you I would divide that that 650 by 5 and break it down to smaller hcg shots. Some people have an issue of going over 125 ius at time causes an metabolic pathway to estrones or estrodial. I can not explain why, but I have seen it occur time and time in people that I have come across. You may want to speak to kanecore because he had this same issue and once he lowered the hcg from 250 ius to 125ius or lower then his symptoms got better mainly his fatigue. It may also help to reduce the amouint of armidex needed as well. Just a thought..

Anyman, I dont know how that small amount of Adex is getting it done. My E2 climbed to 82, and I got it down to 20 in a few weeks taking .25 mg EOD. I would think you could take safely .7 mgs per week, without risk of dropping it too low, and I think that this may optimize your T levels. .4 mgs per week still sounds too light to me. But WTFDIK?

Glad things are improving.

 

[The Matrix]

Anyman, I dont know how that small amount of Adex is getting it done. My E2 climbed to 82, and I got it down to 20 in a few weeks taking .25 mg EOD. I would think you could take safely .7 mgs per week, without risk of dropping it too low, and I think that this may optimize your T levels. .4 mgs per week still sounds too light to me. But WTFDIK?

Glad things are improving.

If it is done sublingual it is alot more concentrated then the average .1 mg that is anticpated. Just how much i have no clue, but I swear he must get a kick back from all this compunded stuff. Give me a drug that i know works and insurance can cover

 

[anyman]

Thanks, I just wish the fatigue and occasional depression would resolve.

Anyman, I dont know how that small amount of Adex is getting it done. My E2 climbed to 82, and I got it down to 20 in a few weeks taking .25 mg EOD. I would think you could take safely .7 mgs per week, without risk of dropping it too low, and I think that this may optimize your T levels. .4 mgs per week still sounds too light to me. But WTFDIK?

Glad things are improving.

Things are better, but even now fatigue and occasional depression can manifest for no reason that I can fathom, especially since I've never been either a tired or depressed person. Weird...... Gotta be something still amiss. I just need to find it.

 

[jinxie]

Things are better, but even now fatigue and occasional depression can manifest for no reason that I can fathom, especially since I've never been either a tired or depressed person. Weird...... Gotta be something still amiss. I just need to find it.

FWIW, I started feeling better when I stopped the T, and went to hCG monotherapy. Apparently, I am a strong responder, like Colkurtz. But I've made some other changes, to address some of my other medical issues, so it's hard to know what exactly is responsibile for different facets of improvement. Coreg (an alpha/beta blocker) made a huge difference for me. I now wake up from sleep feeling somewhat restored, for the first time in years.

One thing I would suggest (and I say it because it is at odds with a strong consensus on the boards) is to let your body speak to you, and to not be overly concerned about "optimizing" your levels. I think a lot of folks on these boards are WAY over medicating, and they are obsessed with making everything "perfect" (according to the ranges), as if that is going to unlock the mystery of health. Human beings are highly variable and we are not all intended to be in the upper third of the range. I know for damn sure that there are a lot of people on Armour Thyroid on the boards, attempting to get their T3 to the top of the range, who don't need it and are not feeling any better from it, save perhaps the first few weeks, after which they become accustomed to feeling revved up. It reminds me of the whole controversy around overmedicating children with ADD with Ritalin and whatnot. (Most people would perform better in certain respects if they were taking amphetamine.)

Your perseverance is to be commended. You'll get there. Keep hanging tough. It's coming.

 

[anyman]

Thanks. Can't disagree with what you say.

One thing I would suggest (and I say it because it is at odds with a strong consensus on the boards) is to let your body speak to you, and to not be overly concerned about "optimizing" your levels. I think a lot of folks on these boards are WAY over medicating, and they are obsessed with making everything "perfect" (according to the ranges), as if that is going to unlock the mystery of health. It reminds me of the whole controversy around overmedicating children with ADD with Ritalin and whatnot. (Most people would perform better in certain respects if they were taking amphetamine.)

Your perseverance is to be commended. You'll get there. Keep hanging tough. It's coming.

I agree that many obsess and overmedicate, which is exactly what I seek to avoid. Don't want life to become a never ending science experiment. Funny you should mention Ritalin. My Dr. recommended that in low doses for when fatigue is an issue. I have tried it very sparingly and it can help, although I don't know why.

As for perseverance, I don't have a choice. I have a wife and 2 kids who need a husband and father. I also want to feel as I once did. Interestingly, I have been diagnosed as a hypermetabolizer, meaning I burn through T very quickly. I wonder if this might be the elusive root cause I've been seeking. Perhaps my body started to burn through T faster than I could make it, which caused the HPTA to go into overdrive where it eventually burned out.

 

[The Matrix]

I agree that many obsess and overmedicate, which is exactly what I seek to avoid. Don't want life to become a never ending science experiment. Funny you should mention Ritalin. My Dr. recommended that in low doses for when fatigue is an issue. I have tried it very sparingly and it can help, although I don't know why.

As for perseverance, I don't have a choice. I have a wife and 2 kids who need a husband and father. I also want to feel as I once did. Interestingly, I have been diagnosed as a hypermetabolizer, meaning I burn through T very quickly. I wonder if this might be the elusive root cause I've been seeking. Perhaps my body started to burn through T faster than I could make it, which caused the HPTA to go into overdrive where it eventually burned out.

Yep shippen knows testosterone, but does not look into other areas of endocrine system such as adrenals and thyroid thoroughly. This was one of the issues that patience of his are concerned about and look for other practioiners to address these, but let him handle there TRT.

 

[JanSz]

Yep shippen knows testosterone, but does not look into other areas of endocrine system such as adrenals and thyroid thoroughly. This was one of the issues that patience of his are concerned about and look for other practioiners to address these, but let him handle there TRT.

HAN,
do not be shy,

add nutritional side to the list,
that is where your expertse comes in.

(TRT, adrenals & thyroid) that is probably 20%, lets not forget the 80%.

.

 

[The Matrix]

HAN,
do not be shy,

add nutritional side to the list,
that is where your expertse comes in.

(TRT, adrenals & thyroid) that is probably 20%, lets not forget the 80%.

.

In anymans case I would not want to make suggestion of supplementation because of not having any clincial evidence to base it on. If one plays guessing games you can actually cause alot more damage making it harder for the clinician to do there jobs. I have 2 areas which we are going to explore very soon and if i am right he will find his answer in problems with liver function and also androgen receptors

 

[BrianEE93]

I am just jumping in here but I have a few questions anyman.

When are you doing your blood draw in relation to your last TC injection?

It looks like your TT started going up when you started doing something about your E2. Maybe just a lot of aromatasing?

Is the cobalt prescription?

 

[anyman]

Here ya go, Brian-

Let's see if I can help you:

I am just jumping in here but I have a few questions anyman.

When are you doing your blood draw in relation to your last TC injection?

I take Test cyp every Sun and Thurs night. HCG is Tues and Fri or Sat. night. Blood is always drawn on a Wednesday morning.

It looks like your TT started going up when you started doing something about your E2. Maybe just a lot of aromatasing?

Not entirely. T went up to about 600-700 after cobalt. Unfortunately, so did E2. T shot to 800 with Arimidex, and E2 dropped to around 50 something. I have since increased my Arimidex and will test again a week from today.

Is the cobalt prescription?

Yes, my Dr (Shippen) calls it in for me. It is actually Cobalt HCL

Hope this helps!

So far so good. I have finally been feeling a bit better and more like my old self. Keeping fingers crossed!

 

[BrianEE93]

Let's see if I can help you:



Hope this helps!

So far so good. I have finally been feeling a bit better and more like my old self. Keeping fingers crossed!

600-700 seems pretty good the day before another shot unless you really drop that last day. I have to think you would feel better at those levels if your E2 was down.

Good luck to you!

 

[anyman]

Thanks- Lower E2 seems to be making the biggest difference.

600-700 seems pretty good the day before another shot unless you really drop that last day. I have to think you would feel better at those levels if your E2 was down.

Good luck to you!

I seem susceptible to nasty fatigue and down moods when E2 is higher. Not a good place to be in the least when that happens.

 

[BrianEE93]

I seem susceptible to nasty fatigue and down moods when E2 is higher. Not a good place to be in the least when that happens.

I am the same way. I had a terrible day yesterday. I find out tomorrow for sure but I am positive I have thyroid problems too. What I have noticed is about 2 days after an injection(yesterday was) I feel pretty bad which is probably when my E2 is the highest. My Dr. and I are working through things one at a time but I think once we get my E2 down I will be better on those days. I have been doubling my DIM the two days after an injection but I am not completely sure is helping.

 

[greenlantern0]

QUOTE]What I have noticed is about 2 days after an injection(yesterday was) I feel pretty bad which is probably when my E2 is the highest.[[/QUOTE]

I have noticed the same thing. I just starte dT inj about 7 weeks ago. (Dr.Crislers protocol) I inject on Friday and Monday evening and all day Tuesday I feel like $#@%. I got my labs back last week and my E2 was in the mid 80's. I had the draw on Tuesday. I assume that is why I feel so bad on those days. I have an appt with the good Dr. next week. I do not know much about AI's and don't know if he will prescribe. But I hope there is something that can be done to make this tired (exhausted) / anxious feeling go away.

 

[thenxtgrt1]

IF I were you I would divide that that 650 by 5 and break it down to smaller hcg shots. Some people have an issue of going over 125 ius at time causes an metabolic pathway to estrones or estrodial. I can not explain why, but I have seen it occur time and time in people that I have come across. You may want to speak to kanecore because he had this same issue and once he lowered the hcg from 250 ius to 125ius or lower then his symptoms got better mainly his fatigue. It may also help to reduce the amouint of armidex needed as well. Just a thought..

Interesting....as I believe I experienced some of this. For a month I took 200 ius EOD of HCG. Estradiol and estrone came back at super high levels. Although I do believe these levels were higher than normal before HCG.

 

[anyman]

Bizarre regression of sorts. The saga continues...

Brief recap: Adding cobalt drops and Arimidex to the Depo-T got my T FINALLY up to around 800, although E2 was too high at 50something.

Added more Arimidex to the equation per my Doctor and then...... something totally weird happened. T DROPPED to 528, while E2 also dropped to under 32.

Huh? I changed NOTHING except to add more Arimidex. How the heck did T DROP?? Makes no damned sense, unless the arimidex somehow interfered with T. I've been told to go up from 160mg depo-T per week to a full 200. Now that is weird.....

I know I am a hypermetabolizer, but wow. Just when I thought I might finally have it licked....... Any thoughts or suggestions?

 

[BrianEE93]

Brief recap: Adding cobalt drops and Arimidex to the Depo-T got my T FINALLY up to around 800, although E2 was too high at 50something.

Added more Arimidex to the equation per my Doctor and then...... something totally weird happened. T DROPPED to 528, while E2 also dropped to under 32.

Huh? I changed NOTHING except to add more Arimidex. How the heck did T DROP?? Makes no damned sense, unless the arimidex somehow interfered with T. I've been told to go up from 160mg depo-T per week to a full 200. Now that is weird.....

I know I am a hypermetabolizer, but wow. Just when I thought I might finally have it licked....... Any thoughts or suggestions?

That is strange. I will be curious to see an explaination for this.

Welcome to the hypermetabolizer 200mg club!:woohoo:

 

[JanSz]

Brief recap: Adding cobalt drops and Arimidex to the Depo-T got my T FINALLY up to around 800, although E2 was too high at 50something.

Added more Arimidex to the equation per my Doctor and then...... something totally weird happened. T DROPPED to 528, while E2 also dropped to under 32.

Huh? I changed NOTHING except to add more Arimidex. How the heck did T DROP?? Makes no damned sense, unless the arimidex somehow interfered with T. I've been told to go up from 160mg depo-T per week to a full 200. Now that is weird.....

I know I am a hypermetabolizer, but wow. Just when I thought I might finally have it licked....... Any thoughts or suggestions?

I am so pissed that I have to post twice.
Once here:
Invalid Link Removed
now this:

I do not know about Arimidex but somehow seeing you waiting for about two years before you are "allowed" 200mg/week does not sound right to me.

Going slow may have advantage, but boy, this is not slow, this is basically standing still.

I suggest more frequent testing, and believing in every other results, Phil does that way.

200mg or more, I suggest EOD system until you get some traction.

Get nutritional analysis, you must have other problems that need to be figured out and dealt with.
.

 

[anyman]

Were it only that easy, Jan..... Still trying, though.

Hasn't been that all that long.

I do not know about Arimidex but somehow seeing you waiting for about two years before you are "allowed" 200mg/week does not sound right to me.

I only started TRT about 8 months ago +/-. I was up to 180mg/week. Arimidex made the biggest difference-and at a lower (160mg/week) dose.

Going slow may have advantage, but boy, this is not slow, this is basically standing still.

Dr. Shippen is indeed a methodical man. Maddeningly so at times, but when 180-200mg/week is still not quite working then it is indeed time to think about what else is at issue.

I suggest more frequent testing, and believing in every other results, Phil does that way.

I test about every 4-5 weeks, as often as my insurance will allow. I try an adjustment for about 3 weeks and then test again

200mg or more, I suggest EOD system until you get some traction.

I am up to 200mg/week now and notice not much difference. I already inject depo-T 2x/week and hcg 2x/week

Get nutritional analysis, you must have other problems that need to be figured out and dealt with.

Looking into other issues/alternatives, but such is time consuming and cannot be rushed. I suspect I'll be seeing an add'l Dr perhaps in July. We'll know more then.
.

In the interim I am doing what I can. Not always fun, but what can I say?

 

[OldGator]

E and HCG Dosage

IF I were you I would divide that that 650 by 5 and break it down to smaller hcg shots. Some people have an issue of going over 125 ius at time causes an metabolic pathway to estrones or estrodial. I can not explain why, but I have seen it occur time and time in people that I have come across. You may want to speak to kanecore because he had this same issue and once he lowered the hcg from 250 ius to 125ius or lower then his symptoms got better mainly his fatigue. It may also help to reduce the amouint of armidex needed as well. Just a thought..

Matrix may be on to something here.

I've been doing TRT about as long as Anyman (8 months). I started at 160mg ED of Compounded Test Cream and 1000-1200iu's of HCG a week. A long time ago doc said to do the HCG 2x a week (5-600iu twice a week) and my E went up from low 20's to mid 30.

For the last 3-4 months I've been doing my HCG ED (175iu's ED) and my E has anchored itself at 20-22, even as I increased my T-Cream dosage to 200mg ED!

In my case, it seems how I dose my HCG has more to do with my E levels than varying doses of the T-Cream itself.

On a side note, I enjoy dosing HCG ED (sub-Q). I swear I feel better in that I feel more "even keel".

 

[The Matrix]

Matrix may be on to something here.

I've been doing TRT about as long as Anyman (8 months). I started at 160mg ED of Compounded Test Cream and 1000-1200iu's of HCG a week. A long time ago doc said to do the HCG 2x a week (5-600iu twice a week) and my E went up from low 20's to mid 30.

For the last 3-4 months I've been doing my HCG ED (175iu's ED) and my E has anchored itself at 20-22, even as I increased my T-Cream dosage to 200mg ED!

In my case, it seems how I dose my HCG has more to do with my E levels than varying doses of the T-Cream itself.

On a side note, I enjoy dosing HCG ED (sub-Q). I swear I feel better in that I feel more "even keel".

i think you are more secondary vs primary as well you respond to HCG, so one may want to work on keep your t cream levels down, but increasing the hcg to thresh poiint of your benefit/risk ratio. BTW I had a wonderful time at the banquet, but i was want to bring home that big screen TV SO BAD !! HAHA Very elegant evening and was for great cause. I have been doing some brain storming on some things about CF that may open some more doors to helping controling it. !! It has to do with malfunctioning of a specific gene that can be manipulated to a point..

 

[OldGator]

i think you are more secondary vs primary as well you respond to HCG, so one may want to work on keep your t cream levels down, but increasing the hcg to thresh poiint of your benefit/risk ratio. BTW I had a wonderful time at the banquet, but i was want to bring home that big screen TV SO BAD !! HAHA Very elegant evening and was for great cause. I have been doing some brain storming on some things about CF that may open some more doors to helping controling it. !! It has to do with malfunctioning of a specific gene that can be manipulated to a point..

Thanks for coming - we raised over $100k!
We'll meet up soon (outside anyman's thread).

BTW, agree with your point on decreasing cream and increasing HCG (secondary vs primary).

 

[anyman]

Update; The saga continues. Will it ever end?

I've been all over the place as of late. T is recently in the 675 range, but with E2 at 84 (OUCH!!) with even sublingual Arimidex. Fatigue, mentally down and iffy erections have been an issue. Sleep has been tough to get, making things worse.

I had another phone consult w/ Dr Shippen. He was quite open to my suggestions and admitted I was indeed a puzzling case. We're not giving up, though.
He agreed that my consistently high cortisol that hasn't always responded to higher T needs to be addressed. "Adrenal Fatigue" may be a factor.

He suggests some adrenal tests to get a baseline, followed by further tests after taking a drug "Dexamesasomething" for 3 days to do a suppression test & see how I respond.

More interestingly still, he like the idea of switching to IM injections in the thigh for T cyp, agrees that regular arimidex pills are called for and wants to rule out everything else.

He was quite open to the adrenal issues, adding that such very often respond to higher T except in unusual cases--of which I might be one. My head is still bouncing all these things around.

As for sleeping issues/fatigue he agrees that the Cortisol could and likely is a factor. Wants to see what the tests reveal. He is not giving up and wants to try these tests as well.

Any thoughts/comments/discussion?

 

[The Matrix]

I've been all over the place as of late. T is recently in the 675 range, but with E2 at 84 (OUCH!!) with even sublingual Arimidex. Fatigue, mentally down and iffy erections have been an issue. Sleep has been tough to get, making things worse.

I had another phone consult w/ Dr Shippen. He was quite open to my suggestions and admitted I was indeed a puzzling case. We're not giving up, though.
He agreed that my consistently high cortisol that hasn't always responded to higher T needs to be addressed. "Adrenal Fatigue" may be a factor.

He suggests some adrenal tests to get a baseline, followed by further tests after taking a drug "Dexamesasomething" for 3 days to do a suppression test & see how I respond.

More interestingly still, he like the idea of switching to IM injections in the thigh for T cyp, agrees that regular arimidex pills are called for and wants to rule out everything else.

He was quite open to the adrenal issues, adding that such very often respond to higher T except in unusual cases--of which I might be one. My head is still bouncing all these things around.

As for sleeping issues/fatigue he agrees that the Cortisol could and likely is a factor. Wants to see what the tests reveal. He is not giving up and wants to try these tests as well.

Any thoughts/comments/discussion?

I got all your info bro so we will be ready to rock on friday. You provided a huge piece of the puzzle that could be the key to what I have been pondering for quite some time with people that been prescribed other drugs in the past that could have affected there hormone axis. We are going to get down to bottom of it not leaving any stone unturned. Looking forward to talking to you soon ..

 

[anyman]

UPDATE: The sage continues!

I've made "some" progress, only to discover as always that such is often fleeting and in need of fine tuning.

Thus far I got switched to regular Arimidex and not the compounded stuff. Also got my first Ultrasensitive E2 tests. Weird results. Here we go:

This is puzzling me. For the longest time I've had high E2 (50-70) on the regular test. When I got my first Ultra test I got the following:

T: 774
E2: <2
DHEAS: 302 (45-345)
ACTH: 17 (8-50)

I wonder if this explains the lack of AM wood, crappy erections and more as of late. Then again, maybe I am taking too much. I take the following:

T cyp: 160 mg/ week (2 doses of 80 each)
Arim: 1/2 tab (.5mg) 2x/week
Hcg: 325 units 2x/week

Perhaps the 1/2 tab is just too much and drivng things down.

This has been, and continues to be on ongoing saga. What a PITA! But, al least there has been some upward movement. I just wish I could be one of those guys who is low, takes a little A-gel and is thrilled. Wouldn't THAT be nice.....

 

[JanSz]

I've made "some" progress, only to discover as always that such is often fleeting and in need of fine tuning.

Thus far I got switched to regular Arimidex and not the compounded stuff. Also got my first Ultrasensitive E2 tests. Weird results. Here we go:

This is puzzling me. For the longest time I've had high E2 (50-70) on the regular test. When I got my first Ultra test I got the following:

T: 774
E2: <2
DHEAS: 302 (45-345)
ACTH: 17 (8-50)

I wonder if this explains the lack of AM wood, crappy erections and more as of late. Then again, maybe I am taking too much. I take the following:

T cyp: 160 mg/ week (2 doses of 80 each)
Arim: 1/2 tab (.5mg) 2x/week
Hcg: 325 units 2x/week

Perhaps the 1/2 tab is just too much and drivng things down.

This has been, and continues to be on ongoing saga. What a PITA! But, al least there has been some upward movement. I just wish I could be one of those guys who is low, takes a little A-gel and is thrilled. Wouldn't THAT be nice.....

I would defilitely consider EOD schedule for T shots.
Each shot 25units
With your SHBG=12

Stop Arimidex
watch your nightly wood, specially after a week or two (up to a month),
resume on half or less of your current dose.

Compare urine vs blood T, E2, DHT other.

Have you done any other testing, post it?

 

[joe143]

Anyman, low e2 will have a bad effect on erections as well. Did you ever get your DHT checked?

 

[anyman]

Haven't had DHT checked in awhile. Mot recently, though, it was OK (m)

Anyman, low e2 will have a bad effect on erections as well. Did you ever get your DHT checked?

I too have heard that too low E2 will do this, hence my concern. I wonder.... Is this test accurate, or is .5mg 2x/week of Arimidex too high for me? I wonder.

The last I checked DHT it was mid range after being on the rather low side for quite some time.

I'll likely try a lower dose (1/4 tab) and see what happens.

 

[The Matrix]

I too have heard that too low E2 will do this, hence my concern. I wonder.... Is this test accurate, or is .5mg 2x/week of Arimidex too high for me? I wonder.

The last I checked DHT it was mid range after being on the rather low side for quite some time.

I'll likely try a lower dose (1/4 tab) and see what happens.

You get customized drugs you get improper delivry systems, use real stuff get real results. Shippens should have learned this by now that compounded stuff is not always the best.

 

[anyman]

Minor update: I wonder if cortisol is behind many of my persistent issues....

As some here may recall, I've had something of a saga stretching back some time. Despite endless tinkering, feeling normal has been somewhat elusive.
During this time, however, I've noted continuously high cortisol levels. Not so high so as to shock me, but always a point or 2 or 3 past the max range. Many, Dr Shippen included, kept saying that raising T would bring it down and relieve the fatigue, fuzzy head and mentally down periods. The problem, however, was that didn't happen. Everything from Rhein 24 hr tests to blood & then saliva tests showed the same thing: high and just past max range cortisol. I had some extra weight around the middle despite eating well & exercise and wondered about cortisol, but thought is an effect of something & not a root cause. Perhaps I was mistaken.
After discussing the issue w/ Dr Shippen he suggested a "Dexamethasone suppression test", where I get baseline blood work to measure all, including ACTH & a few weeks later take 50mg of Dex. for 3 days & retest. I was told that if I felt better to continue taking it. My first ACTH reading was 17 on an 8-50 scale. Could this be considered "low" notwithstanding the high cortisol? Hmmm...

Here's the weird part: After only 2 days on it I noticed I felt better. Calmer, more at peace and more energy. I didn't crash every afternoon and was able to awaken in something more than a depressed and lethargic state. I just had the 2nd round of blood work & won't have the results back for a bit.

Maybe this is coincidence, a placebo effect, merely temporary or something else. But----is it possible that cortisol has been a problem all along? I did a little research and found that low ACTH and higher cortisol can be indicative of an adrenal issue or even a tumor.
See here: Invalid Link Removed

While a tumor is obviously unlikely and presupposes my ACTH level of 17 is low, I wonder if cortisol has been a bigger factor than anyone, me included, thought possible. This needs to be followed more closely.... Of course, I also need to determine how safe using Dexamethasone at what appears to be a low level of 50mg/day is.

 

[rfish1966]

I am interested to see what happens with you, I have about the same situation. On trt 200mg per week, adex and hcg. My numbers look good but I am still tired and in a fog, impossible to lose weight. My cortisol has been high on urine and bloodwork but my endo basically said it needs to be 4 times what normal is for her to worry.

 

[JanSz]

I am interested to see what happens with you, I have about the same situation. On trt 200mg per week, adex and hcg. My numbers look good but I am still tired and in a fog, impossible to lose weight. My cortisol has been high on urine and bloodwork but my endo basically said it needs to be 4 times what normal is for her to worry.

There is rather long list of things to check.
200mg per week, adex and hcg
is not going to solve everything.
----------------------

tired and in a fog

after you have got your FreeT, E2 and DHT where you want them,

for starters check Adrenals and thyroid.

 

[anyman]

Been awhile since I posted an update. Figured it's overdue. Some progress??

Many here are familiar with my saga. Figured I'd post a few recent results to get opinions & show others what is/is not working.

Current regimen:

140 mg T cyp (2x70 per week Sun & Thurs)
325iu hcg (2x week Tues & Fri)
1/4 tablet Arimidex 1x week
Calcium D-glucarate (daily)
Dexamethasone (.25 mg/day) Dr S is using low dose of it to see what happens to my chronically higher cortisol.

Results: (note that the draw was on a Tues & not Wed as all others are)

T: 845 (241-827 scale)
E2: 20 (<=29 ultra sens test)
DHEAS: 209 (45-345)
Cortisol: 17.4 (4-22)
ACTH: 18 (7-50)
Ferritin: 16 (20-380) LOW
IGF-1: 207 (87-220) Back to normal
Prolactin: 8.8 (2-18)

Seems T and E2 are finally getting there. I must thank HAN (The Matrix) for suggesting the calcium d glucarate as it seems to have vastly reduced the amount of arimidex needed.

What I can't figure out is why Ferritin is so damned low, as it never was before. Now THAT is weird. Might explain the still occasional fatigue. IGF-1 is way back up. Maybe the sub basement levels last month were an anomaly.

Still a bit puzzled on the cortisol, Low dose Dexamethosone dropped it a bit, from around 22 to 17. But, it still seems a bit high. I wonder why.... Just saw my primary care Dr and got a script for a glucose insulin tolerance test even though he did not feel it was needed (Yes, he saw the low hdl/high ldl and high triglycerides--he is placating me!)

Still, a bit of improvement, even if a few oddball numbers like low ferritin. Any thoughts? Maybe my saga will inspire others to keep trying & not give up.

It's been a looong journey, but I've started to notice more strength in the gym, better stamina with my wife and a better outlook. Not perfect, but better. Will it stay, or am I destined to slide back as has happened before. Stay tuned!

 

[The Matrix]

Many here are familiar with my saga. Figured I'd post a few recent results to get opinions & show others what is/is not working.

Current regimen:

140 mg T cyp (2x70 per week Sun & Thurs)
325iu hcg (2x week Tues & Fri)
1/4 tablet Arimidex 1x week
Calcium D-glucarate (daily)
Dexamethasone (.25 mg/day) Dr S is using low dose of it to see what happens to my chronically higher cortisol.

Results: (note that the draw was on a Tues & not Wed as all others are)

T: 845 (241-827 scale)
E2: 20 (<=29 ultra sens test)
DHEAS: 209 (45-345)
Cortisol: 17.4 (4-22)
ACTH: 18 (7-50)
Ferritin: 16 (20-380) LOW
IGF-1: 207 (87-220) Back to normal
Prolactin: 8.8 (2-18)

Seems T and E2 are finally getting there. I must thank HAN (The Matrix) for suggesting the calcium d glucarate as it seems to have vastly reduced the amount of arimidex needed.

What I can't figure out is why Ferritin is so damned low, as it never was before. Now THAT is weird. Might explain the still occasional fatigue. IGF-1 is way back up. Maybe the sub basement levels last month were an anomaly.

Still a bit puzzled on the cortisol, Low dose Dexamethosone dropped it a bit, from around 22 to 17. But, it still seems a bit high. I wonder why.... Just saw my primary care Dr and got a script for a glucose insulin tolerance test even though he did not feel it was needed (Yes, he saw the low hdl/high ldl and high triglycerides--he is placating me!)

Still, a bit of improvement, even if a few oddball numbers like low ferritin. Any thoughts? Maybe my saga will inspire others to keep trying & not give up.

It's been a looong journey, but I've started to notice more strength in the gym, better stamina with my wife and a better outlook. Not perfect, but better. Will it stay, or am I destined to slide back as has happened before. Stay tuned!

I belive the solution was to clear out the liver pathways which helped to restabilze your estrogen metabolism. ARmidex once a week HMM half life only being 3 days I see that this may be an issue down the road inless it was some how tapered to 1/4 m,th. Your e2 can come down alittle bit more even due to low shbg so you got room to play a bit.. Caclium D will help to manage estrogen if it lowers e2 do not know..

 

[anyman]

Does on stay on the calcium d glucarate forever?

I belive the solution was to clear out the liver pathways which helped to restabilze your estrogen metabolism. ARmidex once a week HMM half life only being 3 days I see that this may be an issue down the road inless it was some how tapered to 1/4 m,th. Your e2 can come down alittle bit more even due to low shbg so you got room to play a bit.. Caclium D will help to manage estrogen if it lowers e2 do not know..

I wonder how long one should stay on it. I am thinking of tapering. Then again, I probably should have mentioned I was using it to my Dr. My bad, I know...... I just get desperate to actually feel normal. I'll be speaking to him shortly and will reluctantly raise it then.

 

[rfish1966]

I know how you feel man. Sounds like your on the right track though.

 

[anyman]

Time for a long overdue update:

Long story short: Even though T, E2 and most other hormones seem to be "great" per Dr. Shippen I still feel near daily fatigue & malaise. Saps the energy & fun out of life. Very unpleasant to say the least.

I am in a quandary: Some say adrenals or thyroid may be an issue. Others say "no way". All I know is that my quality of life needs to be WAY better than it is. Can be discouraging & then some.

On the plus side, I've had diabetes ruled out & will be undergoing a "sleep study" to see if that is an issue.

On the minus side: Shippen came right out & said he doesn't know why I am so tired & still having erectile issues. Said he's exhausted his knowledge. This is puzzling. We've barely looked at thyroid (he says it's OK, HAN tends to disagree) and I cannot escape the conclusion that SOMETHING is missing. But what?

The search continues........ As always, I appreciate the interest of others & ability to help them as well.

 

[uptempo]

hey although I don't know much about this...i just wanted to say good luck with everything man

 

[The Matrix]

Long story short: Even though T, E2 and most other hormones seem to be "great" per Dr. Shippen I still feel near daily fatigue & malaise. Saps the energy & fun out of life. Very unpleasant to say the least.

I am in a quandary: Some say adrenals or thyroid may be an issue. Others say "no way". All I know is that my quality of life needs to be WAY better than it is. Can be discouraging & then some.

On the plus side, I've had diabetes ruled out & will be undergoing a "sleep study" to see if that is an issue.

On the minus side: Shippen came right out & said he doesn't know why I am so tired & still having erectile issues. Said he's exhausted his knowledge. This is puzzling. We've barely looked at thyroid (he says it's OK, HAN tends to disagree) and I cannot escape the conclusion that SOMETHING is missing. But what?

The search continues........ As always, I appreciate the interest of others & ability to help them as well.

I can probably get the dr to give you a trial of armour thyroid if you like to try and see how you do..

 

[anyman]

Long overdue update & progress. Must give credit where due.

Been awhile, but I've been hesitant to say much until I got a handle on where things were going.

At "The Matrix'" urging we revisited thyroid & saw T3 & T4 were indeed quite low, while thyroid antibodies were becoming elevated.

Started 1/2 grain Armour a few weeks ago and at last see some easing of the often severe fatigue & malaise. Still on TRT/HCG, but am beginning to see some progress at long last.

Shippen missed the thyroid. Shawn didn't.

 

[Philec48]

Hello anyman, I've just now finished reading your journal. I've been trying to think of what may be causing your malaise. You mentioned once you had low ferritin. How's your RBC and Hemoblogin? On TRT, I hope you know you also need to keep a watch on your hematocrit. You don't want your blood to turn to sludge and cause a stroke or heart attack.

You may want to get checked and see if you have a chronic infection somewhere (sinus?), as that can be one cause of malaise. Maybe leaky gut is something also to investigate.

You may want to have an A1C test which will give you a three month average of your blood glucose level.

Finally, have your B-12 level checked.

Phil

 

[JanSz]

Been awhile, but I've been hesitant to say much until I got a handle on where things were going.

At "The Matrix'" urging we revisited thyroid & saw T3 & T4 were indeed quite low, while thyroid antibodies were becoming elevated.

Started 1/2 grain Armour a few weeks ago and at last see some easing of the often severe fatigue & malaise. Still on TRT/HCG, but am beginning to see some progress at long last.

Shippen missed the thyroid. Shawn didn't.

I suggest that you do my long list of blood test.
You may have some more things to discover.
------------------------------------------------------------------------
1/2grain Armour is better than nothing
how do you know that you do not need Cytomel(T3)?

Your TotalT3 (IIRC) is as low as somebody's in ICU.
RT3 may be not far behind.
------------------------------------------------------------------------
Where is your

TotalT3
RT3

You want

TotalT3(in upper 1/3)
RT3 (lower half)

FreeT3 top range or even slightly over if:
it makes you feel better
temperature is better
heart beat is not overly high
you have not reached your (TT3 & RT3) goals
-----------------------------------------------------

You may accept very very low RT3
You definitely do not want to go over top range on TotalT3.
.
================================================== ============
I am currently doing
Cytomel(T3)-25mcg + Cytomel(T3)-25mcg + 1.5GrainArmourThyroid
Like my temperatures much better than previously on 2.75Grains

I am most often at my 36.6-36.7C
My normal temps when I was 16yo (now 69yo for 13 more days)
================================================== ============

 

[anyman]

Already done much of this.

Quite the long and stilted journey, eh?

Hello anyman, I've just now finished reading your journal. I've been trying to think of what may be causing your malaise. You mentioned once you had low ferritin. How's your RBC and Hemoblogin? On TRT, I hope you know you also need to keep a watch on your hematocrit. You don't want your blood to turn to sludge and cause a stroke or heart attack.

AFAIK, both of these were good the last time(s) checked

You may want to get checked and see if you have a chronic infection somewhere (sinus?), as that can be one cause of malaise. Maybe leaky gut is something also to investigate.

This is something I've been pushing for. Sinuses have been checked more times than I can count. Leaky gut is under investigation as well, although I confess to being a bit skeptical of the whole concept.


You may want to have an A1C test which will give you a three month average of your blood glucose level.

Finally, have your B-12 level checked.

Had an A1C. Was quite good. B12 is/was a concern and is being supplemented.

Phil

Thanks so much for taking the time & interest to plod through all this!!

 

[anyman]

The 1/2 grain of armour is just a start.

Thanks, Jan- I've had many of the tests and am leaving it up to Shawn/Dr O to order what they want. What a freakin' pain in the butt this whole thing has been & still is. But, my family needs me, so here I am. I just wish Shippen would have listened more & heard my thyroid concerns. Who knows, I've just started this process. Got awhile to go. Here are some comments.

I suggest that you do my long list of blood test.
You may have some more things to discover.
------------------------------------------------------------------------
1/2grain Armour is better than nothing
how do you know that you do not need Cytomel(T3)?

Your TotalT3 (IIRC) is as low as somebody's in ICU.
RT3 may be not far behind.

Yup. It is low, thus confirming I am indeed defective. We're starting with 1/2 grain for 4-5 weeks & will retest then & move up as needed
------------------------------------------------------------------------
Where is your

TotalT3
RT3


I recall the total being low (can't find labs) and RT3 being not too bad.
You want

TotalT3(in upper 1/3)
RT3 (lower half)

FreeT3 top range or even slightly over if:
it makes you feel better
temperature is better
heart beat is not overly high
you have not reached your (TT3 & RT3) goals
-----------------------------------------------------

You may accept very very low RT3
You definitely do not want to go over top range on TotalT3.


Dr O/Shawn's plan is to start gradually & move up incrementally. THey say too rapid a jump is not optimum. Your goals, however, are theirs as well. It's a shame Shippen never fully looked into this despite my pushing him. That's why I see him less & less & have added a new Dr to the arsenal.
.
================================================== ============
I am currently doing
Cytomel(T3)-25mcg + Cytomel(T3)-25mcg + 1.5GrainArmourThyroid
Like my temperatures much better than previously on 2.75Grains

I may indeed end up here as well. Well see.
I am most often at my 36.6-36.7C
My normal temps when I was 16yo (now 69yo for 13 more days)
================================================== ============

 

[JanSz]

Thanks, Jan- I've had many of the tests and am leaving it up to Shawn/Dr O to order what they want. What a freakin' pain in the butt this whole thing has been & still is. But, my family needs me, so here I am. I just wish Shippen would have listened more & heard my thyroid concerns. Who knows, I've just started this process. Got awhile to go. Here are some comments.

Look how many years (yes years) it took for you to discover that you have very low TotalT3

How long are you planning to wait until you check your RT3?

.