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STARTING TRT & HAVE SOME CONCERNS

mcs5309

Member
I am about to embark on a TRT program through my physician. I am 53 and am in good health other than the following issues. I've discussed such with my physician, but he thinks most of these will resolve and not worsen with TRT as long as we monitor everything on a regular basis. My purpose for this email is to get your opinion. My scrip is for 200mg/week of cyp.

1) BLOOD CLOTS: I had two clots in my legs last year. Cause: unknown. Knowing that exogenous T can raise RBC/HCT/HGB, is there anything else besides monitoring these levels and getting regular therapeutic phlebotomies when necessary that I should be aware of given my prior issues?

2) SLEEP APNEA: I have mild sleep apnea. Sleeping on sides to avoid it. Trying to avoid CPAP. Knowing that exogenous T is a double-edged sword: if low T, then it improves sleep apnea, but it can also worsen it over time via central apnea.

3) HYPERTENSION: I am controlling this naturally. Will only resort to meds if absolutely necessary.
From what I researched, it is from the increase in blood volume that cause this, so same, thing phlebotomies?

4) LIPIDS: LDL-C (153) has improved, but is still elevated; HDL-C (46) has improved, but needs to increase. TRT can reverse that (increase LDL and decrease HDL).

5) THYROID - I have been treating my hypothyroidism with dessicated thyroid/T3. I've read that TRT can reduce thyroid function.

But my biggest dilemma has been the inability to lose excess body and visceral fat no matter what I try diet or training -wise (and I have tried everything - i.e. low carb, intermittent fasting, keto, counting calories, etc.).

I agree with my doc that much of the above issues will improve by reducing body and visceral fat via TRT but still am concerned.

Appreciate any input.
 
First let me say, your list was almost my list. Since we don't know each other some of these comments will be generalizations. First, blood clots. HYDRATE! Drink at least a half gallon of water (if you are not working out) and at least 1 gallon if you are. And I mean water, not coffee, tea, soda, beer, I do mean water. Also, if you sit a large part of your day, get up and walk around. You need to be sure the blood is moving through your legs.

Sleep apnea. Don't f around with this. Your apnea could be one of the reasons you T is low to begin with or at least a contribution factor. Lack of decent sleep can impact everything you have on your concerns list. Don't be vain, man up and get a CPAP. My friends that have one all say it made a world of difference for them.

Hypertension. First, if you smoke, do not care if it is cigars, cigarettes, pot or e-cigs, STOP. That is the single best thing you can do to lower your BP, bar none. The increase in BP is more form the increase in hemocrit (red cells), not total blood volume. Keep an eye on this and if needed become a friend of the Red Cross and donate blood every six weeks or so. Also, some vasodilator supplements like Hawthorn and L-Ariginine can help by relaxing the blood vessels. And as always, CARDIO!

Lipids, first take a very hard look at your diet. It has been suggested in more and more literature that high LDL levels may be genetic rather than dietary. However, if you are prone to high LDL levels, you need to modify your diet. IMHO, avoid statin drugs at all costs. This can be done hopefully through diet and exercise. You will need to play with your diet some to find out what works best for you. I was diagnosed with high cholesterol a few years back. So I change my diet because that was the thinking at the time to becoming almost a vegan. My levels actually got worse even without meats, eggs, animal fats and dairy. My diet now is mainly a keto high fat low carb and my cholesterol levels came back to normal. That really screwed my doc's head right up. Plus, if you are prone to pack weight on the abdomen, Keto is the best way to go. Just remember, no matter what eating plan you are on, if you eat too much, you will gain fat.

Sorry, I have no experience with hypothyroidism. My question is, are you truly hypothyroid or have you self diagnosed? I find it odd that a doctor would agree with TRT if your thyroid is screwed up. His first reaction should have been to get you on something to take care of your thyroid first. Because if the thyroid is off, then it cascades to the rest of your system.

Hope this helped and good luck.
 
Dogsoldier said:
First let me say, your list was almost my list. Since we don't know each other some of these comments will be generalizations. First, blood clots. HYDRATE! Drink at least a half gallon of water (if you are not working out) and at least 1 gallon if you are. And I mean water, not coffee, tea, soda, beer, I do mean water. Also, if you sit a large part of your day, get up and walk around. You need to be sure the blood is moving through your legs.

Sleep apnea. Don't f around with this. Your apnea could be one of the reasons you T is low to begin with or at least a contribution factor. Lack of decent sleep can impact everything you have on your concerns list. Don't be vain, man up and get a CPAP. My friends that have one all say it made a world of difference for them.

Hypertension. First, if you smoke, do not care if it is cigars, cigarettes, pot or e-cigs, STOP. That is the single best thing you can do to lower your BP, bar none. The increase in BP is more form the increase in hemocrit (red cells), not total blood volume. Keep an eye on this and if needed become a friend of the Red Cross and donate blood every six weeks or so. Also, some vasodilator supplements like Hawthorn and L-Ariginine can help by relaxing the blood vessels. And as always, CARDIO!

Lipids, first take a very hard look at your diet. It has been suggested in more and more literature that high LDL levels may be genetic rather than dietary. However, if you are prone to high LDL levels, you need to modify your diet. IMHO, avoid statin drugs at all costs. This can be done hopefully through diet and exercise. You will need to play with your diet some to find out what works best for you. I was diagnosed with high cholesterol a few years back. So I change my diet because that was the thinking at the time to becoming almost a vegan. My levels actually got worse even without meats, eggs, animal fats and dairy. My diet now is mainly a keto high fat low carb and my cholesterol levels came back to normal. That really screwed my doc's head right up. Plus, if you are prone to pack weight on the abdomen, Keto is the best way to go. Just remember, no matter what eating plan you are on, if you eat too much, you will gain fat.

Sorry, I have no experience with hypothyroidism. My question is, are you truly hypothyroid or have you self diagnosed? I find it odd that a doctor would agree with TRT if your thyroid is screwed up. His first reaction should have been to get you on something to take care of your thyroid first. Because if the thyroid is off, then it cascades to the rest of your system.

Hope this helped and good luck.
Click to expand...

Thanks for taking the time to respond.

I am definitely hypothyroid as evidenced by labs and symptoms. I have been taking T3 for the last 3 years and recently added dessicated thyroid to see if it makes a difference. I do not smoke, drink, or use any drugs. I take supps for everything; to help regulate and control BP, thin blood, lower LDL-P, APOB, etc.

I would say I am 20-25lbs overweight based on my body composition (which doesn't help BP). My bf runs 25-29% no matter what I do. Losing weight isn't the issue; it's losing the fat.
Stats:
AGE: 53
WT: 179
HT: 5-07

My latest BodPod showed I weighed less but had more bf and less lean mass which was really disappointing:
BODYFAT %-31.10%
BODYFAT-LBS: 53.9
LEAN-FFM: 68.90%
LEAN-FFM-LBS: 119.6
TOTAL WEIGHT: 173.5
RMR: 1500

Training routine (up until I had to eliminate press movements in the last two weeks because of my shoulder impingement got much worse):
Resistance training: every other day - 45 min. 30 sec. rest; 25 sets total
Cardio: 3 x's/week on off days - 30-45 min.; elliptical/bike; outdoor (until my lower back became inflamed). I do both steady state and HIIT, depending on my energy level.
I am also engaged in a 6-week PT protocol for the shoulder and back which is a workout in and of itself.

I have been training fasted (IF 16/8) with 20g BCAAs and 5-10g glutamine to try and shed bf, but it has done nothing. I have 2 main meals/day and one snack following workouts. I am gluten-free and soy-free, eat organic only, no processed anything, lean meats, fish, poultry, eggs, Healthy fats are from whole avocados, coconut oil, seeds, nuts and nut butters, olive oil, flax oil. Carbs are mostly from veggies and a small amount of fruit (berries). Only grains are wild rice and quinoa which is technically a seed which I eat maybe once a week.

AVG MACROS:
CALORIES: 1400-1800
PRO: 150-170g
CHO: 25g (will cycle carbs so I eat a little more post workout; but no more than 50g)
FATS: 80-100g

I have not attempted to eat less than 1400 calories/day than the above because it's already at a low threshold and any lower I would fear would put me into starvation mode, damage my metabolism and worsen my thyroid function.

I can lose weight; but all I do is get skinny fat. Both my doc and I agree it's largely because my free T is in the dumps (despite my TT being in the 400s-500s) and this is primarily why I continue to have a hard time gaining lean mass and dropping bf. I have also tried working on lowering SHBG (as you can see from my labs), but that gets into a entire other discussion.
 
How the hell do you eat 1400-1800 cals per day? :D I try and try, but fail every time lol. (although I don't think its a good idea actually, but you will lose fat that is for sure).
 
AnabolicHolic said:
How the hell do you eat 1400-1800 cals per day? :D I try and try, but fail every time lol. (although I don't think its a good idea actually, but you will lose fat that is for sure).
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I can't even lose weight or fat even with those calories. Remember - I'm 53, only 5-7, 179 - and 50lbs is friggin fat! This is what happens when your hormones aren't optimized. If they were, like when I was 25, I could eat 2500 cals and get LEAN!
 
mcs5309 said:
I can't even lose weight or fat even with those calories. Remember - I'm 53, only 5-7, 179 - and 50lbs is friggin fat! This is what happens when your hormones aren't optimized. If they were, like when I was 25, I could eat 2500 cals and get LEAN!
Click to expand...

hahaha, yeah i hear you.....when I was 25 my mom would brag on me to her friends "my son can lose 20 lbs in less than a month with no problem" LOL...I'd always be bulking then cutting. Now, 15 years later, not so much.....UNTIL trt! now it seems almost as easy to drop weight even when I overeat for extended periods of time. As you said i was eating 2500-3K cals routinely (during a cut lol) and I was dropping fat the entire time....at 41. Test is like the ultimate fat burner for me. I'm only a little bit bigger than you, but I'm pretty lean at this time so it's mostly quality weight. And despite not having a big appetite....it seems that the calories just add up when you are awake for 14-16 hours, plenty of opportunities to eat :D
 
AnabolicHolic said:
hahaha, yeah i hear you.....when I was 25 my mom would brag on me to her friends "my son can lose 20 lbs in less than a month with no problem" LOL...I'd always be bulking then cutting. Now, 15 years later, not so much.....UNTIL trt! now it seems almost as easy to drop weight even when I overeat for extended periods of time. As you said i was eating 2500-3K cals routinely (during a cut lol) and I was dropping fat the entire time....at 41. Test is like the ultimate fat burner for me. I'm only a little bit bigger than you, but I'm pretty lean at this time so it's mostly quality weight. And despite not having a big appetite....it seems that the calories just add up when you are awake for 14-16 hours, plenty of opportunities to eat :D
Click to expand...

What was your pre-TRT levels for both free and total??

How long have you been on TRT and have you noticed and changes in your lipids, E2, blood pressure? Do you get regular phlebotomies?

Any improvement in fat loss/muscle mass increase?
 
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