Blackhawk's journey with TRT

[FeelingLost]

Great report. You know my lvl of knowledge in this so keep that in mind.
1st comment- keep the FT in range and HCT behaves. That is what's been happening with me. I buy blood tests from Nelson that Defy does not know about just to keep track of things.

2nd comment- DHEA is the E2 building block I stop taking that.

3rd comment- I could never live with a 51 E2 sens.
Above 33 and I experience the symptoms you are discribing.
Soft in the bedroom, moody easy to get mad but not enough I react I always catch myself but notice the anger.

4th comment- No AI i guess? If I had your numbers I'd be taking .25/wk but your consult is right around the corner
I hope you will post what you and Dr Saya deside on.

 

[Deleted member 16042]

Great report. You know my lvl of knowledge in this so keep that in mind.
1st comment- keep the FT in range and HCT behaves. That is what's been happening with me. I buy blood tests from Nelson that Defy does not know about just to keep track of things.

2nd comment- DHEA is the E2 building block I stop taking that.

3rd comment- I could never live with a 51 E2 sens.
Above 33 and I experience the symptoms you are discribing.
Soft in the bedroom, moody easy to get mad but not enough I react I always catch myself but notice the anger.

4th comment- No AI i guess? If I had your numbers I'd be taking .25/wk but your consult is right around the corner
I hope you will post what you and Dr Saya deside on.

Thanks FL.

1st comment: I question that and wonder if bringing total T down is just as important as free T, but certainly possible.

2nd comment: taking DHEA made a remarkable positive difference for me so I hesitate to drop it. That was before changing protocol with Defy when I was doing really poorly, and I don't know if with other aspects in better balance now if eliminating or lowering DHEA might be just fine. I'll talk w/Dr Saya about it.

3rd comment: VERY helpful knowing you have had what sounds like the exact same symptoms from High E2. Potentially clarifies causation.

4th comment: Correct, still no AI. Still hesitant, I'd still prefer further reduction in T cyp dosage, and perhaps going to daily injection to facilitate lowering total weekly amount, but at this point I'd take anastrazole if Dr Saya highly recommends it. Hoping that would be a stop gap/temporary situation, but if it makes me better, so much the better.

 

[Deleted member 16042]

Consultation done, we covered a LOT of ground. Just gotta say Dr Saya is awesome. Thank you sir!

-He is pleased with where the HCT is, I'm also grateful, but would like to see it another point or two lower. With the trend and life span of red blood cells at @120 days, we may still see a bit further lowering. Such natural changes in RBC numbers take a long time. The ferritin is up, but a donation would put 20 it points lower again, so we're going to wait it out, and not do a donation.

-We're both concerned about high E2 symptoms, and he (I too) would prefer to still avoid an AI, instead we will tweak other factors first.

-So the main theme to me in deciding protocol changes was how many variables to change at once and potentially better predictability vs uncertainty from such changes down the road.

-We discussed the possibility of going to daily dosing of T cyp without changing total weekly dose. He was open to going to daily, but did not want to also reduce dose as it is changing too much at once. From a few anecdotes on the forum, to me this seems to raise the possibility of increasing T, E2 and HCT levels, so less risky/more predictable to just lowering total dosage while staying on E3D. Might revisit this consideration at a later date. Going to daily would actually be convenient for me in several ways.

-Also discussed the possibility of going to HCG daily vs E3D. Same deal in terms of changing too much at once.

-I chose the more conservative plan with theoretically more predictable outcomes of lowering HCT and E2: Lower T cyp dose, monitor for symptoms and get labs if any negative changes in symptoms. Otherwise give it 3 months. So lowering T cyp from 42mg E3D to 36 E3D for a total of 84mg/week, a reduction of 10%.

-Also decreasing DHEA by half.

-Aw crap I forgot why, but he also wants me to increase D3 supplementation from 2000 to 5000/day.

-I still have some problems with recovery from exercise, and based on my history with low T before TRT and what has happened while on TRT it seems that My TT and FT levels are probably just fine. So we talked a bit about IGF-1. However, I declined any treatment due to the prostate issue since higher IGF-1 can promote growth of cancer cells. Jury is still out on my prostate, but I don't want to do anything more to provoke it.

-With the changes in diet I have made due to the prostate issue, I have decreased total protein intake, which I think may be contributing to my decreased recovery from exercise. I have also made a minor shift from animal based to plant based proteins. I am going to revisit this thinking, and probably increase protein intake a bit but continue the trend of more plant based sources. Animal proteins and especially dairy, which I have already cut down drastically raise IGF-1 and multiple studies show a relationship with animal protein fueling cancer, and specifically prostate cancer.

-Thyroid looking good, numbers indicate I am converting T4 to T3 well, not pooling to RT3 and T3 level is very good as long as I don't have hyperthyroid symptoms mornings to midday. We did not speak about the TG antibody which has been mildly high for years.

-He's referring me for hematologist regarding lymphocyte changes. I have had slowly increasing absolute lymphs over a few years and last labs are first time over normal range, plus atypical lymphocytes observed in latest (May) and last January labs. Could just be my immune system fending off viruses etc, but changes in absolute lymphs can also point to leukemia. I may defer hematologist consult until after next CBC. If still elevated then, will definitely consult.

So to sum up the new protocol and changes:

T cyp 36mg E3D (84mg/week total)
HCG 420iu E3D
DHEA 12.5mg/day
Pregnenelone 25mg/day
Same supplements but increase D3 to5000iu/day

Increase protein intake while raising plant based percentage.

 

[Vince Carter]

So a Cyp dose reduction to work the E2, I like how that's starting to appear over AI use, and I like seeing you change just one thing at a time and not upset multiple factors at once.

 

[Deleted member 16042]

Thanks Vince, Agreed.

However it is 2 changes at once: T cyp and DHEA reduction.

I think potentially the reason DHEA helped me so much at first was that my E2 was much too low, so in part it potentially helped raise E2 prior to T levels being brought up into range. Now that E2 is too high, the DHEA may be exacerbating the problem. Also, theoretically, in addition to E2 following T, the HCG backfilling is also helping boost DHEA.

 

[FeelingLost]

Great report Blackhawk thanks for the update. I look forward to reading how this new protocol makes you feel.

I got permission on my last consult to see how low I could go (Tcyp) before I felt like something was missing.
I dropped from .25(50mg) M/W/F down to .16(32mg) M/W/F (96/wk) no AI.

For reference my SHGB is 24.2 I felt less energetic everything else was the same which I would rate very good. After 6 weeks I raised the T cyp to .18(36mg) M/W/F 108/wk and on week 2 required 1 AI @ .125 taken Friday evening with injection. Held this for 6 weeks. I had more energy no other changes. I am now at .20(40mg) M/W/F (120/wk) Kept the 1 AI on Friday nights.
On week 2 E2 got out of hand. Lost my erections and libido, energy still stronger recovery from the gym is only 24 hours that is new.
Starting this week I am back on .135 3 times a wk. I'll be doing a mini blood test in 5 week.
But I will be cutting back the AI as soon as I notice my E2 symptoms clearing up.

 

[Deleted member 16042]

Crashing: I am doing terribly.

It is one month since last protocol change, reduction in T and DHEA dosage.

I've been having terrible mood swings again. Depression, frustration, anger, hopelessness, negativity, motivation has plummeted etc and of course in combination with hypervigilance over medically why, and I sure can't figure it out.

My exercise capability has gone through the floor and I am not recovering. Whereas a few weeks ago I had shifted from climbing to training, started light and had been increasing a bit, now even after 3 days rest can't do what I did the previous workout. It's all I can do to walk my standard 2.5 miles/day on our mountainous road.

I also am experiencing energy crashes almost every day at 3-4pm. Brain can't handle more input, can't think straight, work/complete tasks. body is just too tired and I have to lie down for a while.

Right now today I feel like post migraine. I have previously had migraines directly correltaed to food sensitivity, and others for unknown reasons, but since being on better TRT protocols have had none... zero for almost the last year until now. Had a headache all night last night that did not feel like migraine, but today the migraine hangover.

I have noted increased swings in belly bloating. I had a wham bang bloat yesterday, was up maybe 5 times last night urinating and this morning internal bloat has subsided, seems I have expelled a lot of the water again, but external fat layer is still puffy and jiggly.

I am really confused.

-It seems like I may have hit the lower threshold of useful T in my system
-Seems like estrogen symptoms are stronger but due to being high or low? The mood emotional component is getting like it was last year before starting with Defy when my E2 was 12, but my latest E2 May 5 was 51(sensitive), and though DHEA was reduced from 25mg to 12.5mg/day I don't have any real suspicion that E2 crashed for any reason. With the bloating it seems more like it must be too high.

Edit: Oh also, libido has tanked.

I am going to have interim labs pulled July 3 which is 6 weeks after last protocol adjustment, including PSA/Free PSA, TT, FT, E2 and CBC.

I am really at a loss about what if anything to do now, it's getting really bad.

Thoughts/ideas welcome.


(Note: I have noticed a down or rocky period at about the same interval after other dosage increases and decreases, but this one is the worst yet)

 

[lowe2sucks]

do you feel worse than you felt with low testosterone (pre TRT)?

 

[Deleted member 16042]

I have had times where I felt this bad prior to TRT.

However, the worst I've felt related to being hypogonadal and TRT was after being put on bad TRT protocol with chrysin(AI) compounded into TD cream. My T remained too low and my estradiol was 10-12 during this time. It feels like that again, but symptomatically I have not quite crashed to that low point. Since going with Defy and dropping the AI. I felt better than this by far; once the AI was removed from my protocol, and then better again after switching to injection. I was given too high a dose of T cyp and have subsequently had to reduce dosage several times to bring down HCT and E2. The last adjustment also included cutting DHEA by half.

 

[lowe2sucks]

but you are not on AI and you are on DHEA (which is known to raise e2) and testosterone and hcg. you also used pregnenolone.. all these things are supposed to raise e2 interesting why do you feel same way as you felt when on t cream compounded with chrysin e2 10-12...
something is not adding up

 

[Deleted member 16042]

Yeah. Still on DHEA but dose reduced by half.

I am confused what's happening. My last E2 May 5 before this change was 51. And I have associated mood swings/ feels like PMS with bloating coming and going, circumstantially seems like still high E2. I wonder if T has dropped but E2 remains up so that E2 ratio is even higher compared to T. But I don't know, As such I am afraid to do a thing until I have a fresh set of labs.

 

[lowe2sucks]

i felt same way this entire year. i came off 4-5 months ago. feel way better now that i did half a year ago probably my estrogen was too high on trt because i am anti AI and I was on dhea, hcg, testosterone all these things jack up your estrogen its way worse then low testosterone i feel relief now

 

[Deleted member 16042]

Glad that works for you. I can't see going back to low T. I had dangerously low levels especially Free T at 3.1. I'll take an AI if that's what it takes.

 

[lowe2sucks]

yeah everybody picks their own poison

 

[Dr Justin Saya MD]

I wonder if T has dropped but E2 remains up so that E2 ratio is even higher compared to T. But I don't know, As such I am afraid to do a thing until I have a fresh set of labs.

Took the words out of my mouth...I would wonder this as well.

Also likely the threshold has been found on the lower end for your testosterone dosage/levels.

 

[FeelingLost]

Glad that works for you. I can't see going back to low T. I had dangerously low levels especially Free T at 3.1. I'll take an AI if that's what it takes.

So sorry to read you are not feeling well.
Blackhawk, do you have any .125mg AI's laying around from before? Take 1 just 1 and see if you feel better. I do not take my AI on a schedule. I only take it if I feel extra sensitive and I only take 1. I notice improvements within 4 hours and after 8 hours all my symptoms are gone.
By not taking an AI on a schedule I always know my E2 symptoms come from being too high.

I also tested how low could I go with my T cyp it was 96mg/wk no AI was needed but I lost all my energy. I did not have anxiety just felt blaw.

 

[Deleted member 16042]

So sorry to read you are not feeling well.
Blackhawk, do you have any .125mg AI's laying around from before? Take 1 just 1 and see if you feel better. I do not take my AI on a schedule. I only take it if I feel extra sensitive and I only take 1. I notice improvements within 4 hours and after 8 hours all my symptoms are gone.
By not taking an AI on a schedule I always know my E2 symptoms come from being too high.

I also tested how low could I go with my T cyp it was 96mg/wk no AI was needed but I lost all my energy. I did not have anxiety just felt blaw.

Before, my previous AI was chrysin compounded into the testosterone TD cream. I don't have any anastrazole. I indeed would try just one if I did.

Seems my low T dose also may be 96/wk, at least at E3D interval

 

[FeelingLost]

Have you ever had a script for anastrazole with Defy in the past?
If so I believe you can just go online and place a refill order even if it is not in your current protocol.

 

[Deleted member 16042]

Have you ever had a script for anastrazole with Defy in the past?
If so I believe you can just go online and place a refill order even if it is not in your current protocol.

Never had a script, never taken it.

 

[Deleted member 16042]

Well a week later and I have emerged from the depths.

Based on having had down periods give or take around 4 weeks after every dosage decrease, I think most of what I was experiencing was from withdrawl/decreasing T level, and possibly from E2 remaining high relative to the lower T level. This time though the symptoms were a lot worse.

DHEA was also reduced, but based on shorter half lite, I suspect that level decreased earlier.

I completely bailed on any working out til today, but kept walking daily, took naps and breaks as needed, and tried to get 10hrs sleep a night. Recovery has been coming slowly, but I am feeling a bit better daily. Emotional fits have decreased, energy is maintaining through the day better and today I did the first light workout again.

I'm still having bloating coming and going. Last week it was particularly uncomfortable, restricting diaphragm movement. Severity decreasing, but still noticeable. I've been tracking it, and it seems like it correlates to the E3D dosing. according to my 3 day dosage cycle:

-Day 1 HCG 400iu never bloat on waking, commonly bloating afternoon-night
-Day 2 T cyp 36mg bloating
-Day 3 some mornings bloated

I am wondering again how daily or EOD might smooth out the E2 peaks.

Labs next Tuesday!
CBC
CMP
PSA with Free PSA %
Free and Total T
E2 sensitive

Funny, I used to dread labs, now looking forward to the new info!