Eight Weeks on TRT - Feeling No Better

[Dr Justin Saya MD]

I also forgot to mention, now that I am doing the anastrozole twice a week, is there a certain time I'm supposed to do it? Also I am wondering why my LH/FSH was not tested just to see how the HCG is working in my body?

Yes the goal was to follow the updated anastrozole and cabergoline doses until the next consult and likely next lab check, at which time any further adjustments can be made as necessary.

HCG does not increase LH/FSH...it mimics LH, but both LH/FSH are universally suppressed for everyone on TRT (hence it's a waste of your money for us to check them). All great questions for your consult.

 

[Julian]

my prolactin was at 20, so with my initial consult Dr. Saya had me up my dose of cabergoline and now its at 40, so he told me to updose it again.

are you trying to up your prolactin levels or lower? 40 is high, not dangerously high. my prolactin levels normally stay around 8-10 NG/ML but at one point they got to 30 so my doctor requested an MRI Pituitary Without and With Contrast but it was all good, pituitary gland was normal in size

 

[Libra88]

are you trying to up your prolactin levels or lower? 40 is high, not dangerously high. my prolactin levels normally stay around 8-10 NG/ML but at one point they got to 30 so my doctor requested an MRI Pituitary Without and With Contrast but it was all good, pituitary gland was normal in size

I am trying to lower it to about optimal levels which I believe is 8-10 ng/ml. I am under he assumption that the prolactin is screwing with my libido and TRT in general.

 

[Libra88]

are you trying to up your prolactin levels or lower? 40 is high, not dangerously high. my prolactin levels normally stay around 8-10 NG/ML but at one point they got to 30 so my doctor requested an MRI Pituitary Without and With Contrast but it was all good, pituitary gland was normal in size

Julian do you notice a difference in any aspect of your life when your prolactin was at 30 as opposed to 8-10?

 

[Julian]

Julian do you notice a difference in any aspect of your life when your prolactin was at 30 as opposed to 8-10?

when my prolactin levels were around 30 I didn't feel any different. my T levels were around 1500 range

[TABLE="class: cms_table_MsoNormalTable"]
[TR]
[TD="bgcolor: transparent"]

LUTEINIZING HORMONE​

[/TD]
[TD="bgcolor: transparent"]

0.13 mIU/ml​

[/TD]
[TD="bgcolor: transparent"]

6.0 - 19.0 mIU/ml​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

FOLLICLE STIMULATING HORMONE​

[/TD]
[TD="bgcolor: transparent"]

0.17 mIU/ml​

[/TD]
[TD="bgcolor: transparent"]

4.0 - 10.0 mIU/ml​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

DHEA-S​

[/TD]
[TD="bgcolor: transparent"]

2862 ng/ml​

[/TD]
[TD="bgcolor: transparent"]

ng/ml​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

SHBG​

[/TD]
[TD="bgcolor: transparent"]

19 nmol/L​

[/TD]
[TD="bgcolor: transparent"]

10 - 55 nmol/L​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

FREE TESTOSTERONE-CALCULATED​

[/TD]
[TD="bgcolor: transparent"]

39.91 ng/dl​

[/TD]
[TD="bgcolor: transparent"]

ng/dl​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

ESTRADIOL​

[/TD]
[TD="bgcolor: transparent"]

12 ng/dl​

[/TD]
[TD="bgcolor: transparent"]

0.5 - 5 ng/dl​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

TESTOSTERONE LEVEL​

[/TD]
[TD="bgcolor: transparent"]

1537 ng/dl​

[/TD]
[TD="bgcolor: transparent"]

200 - 1000 ng/dl​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

CHOLESTEROL​

[/TD]
[TD="bgcolor: transparent"]

97 MG/DL​

[/TD]
[TD="bgcolor: transparent"]

<200 MG/DL​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

TRIGLYCERIDES​

[/TD]
[TD="bgcolor: transparent"]

60 MG/DL​

[/TD]
[TD="bgcolor: transparent"]

<150 MG/DL​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

HDL CHOLESTEROL​

[/TD]
[TD="bgcolor: transparent"]

35 MG/DL​

[/TD]
[TD="bgcolor: transparent"]

>39 MG/DL​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

LDL CHOLESTEROL CALCULATED​

[/TD]
[TD="bgcolor: transparent"]

50 MG/DL​

[/TD]
[TD="bgcolor: transparent"]

<100 MG/DL​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

LDL/HDL RATIO, SERUM​

[/TD]
[TD="bgcolor: transparent"]

1.43 RATIO​

[/TD]
[TD="bgcolor: transparent"]

<3.55 RATIO​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

SOMATOMEDIN-C​

[/TD]
[TD="bgcolor: transparent"]

158 NG/ML​

[/TD]
[TD="bgcolor: transparent"]

68 - 202 NG/ML​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

ALBUMIN​

[/TD]
[TD="bgcolor: transparent"]

4.4 G/DL​

[/TD]
[TD="bgcolor: transparent"]

3.5 - 5.2 G/DL​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

PROLACTIN​

[/TD]
[TD="bgcolor: transparent"]

28.8 NG/ML​

[/TD]
[TD="bgcolor: transparent"]

4.0 - 15.2 NG/ML​

[/TD]
[/TR]
[/TABLE]

 

[Libra88]

when my prolactin levels were around 30 I didn't feel any different. my T levels were around 1500 range

[TABLE="class: cms_table_MsoNormalTable"]
[TR]
[TD="bgcolor: transparent"]

LUTEINIZING HORMONE​

[/TD]
[TD="bgcolor: transparent"]

0.13 mIU/ml​

[/TD]
[TD="bgcolor: transparent"]

6.0 - 19.0 mIU/ml​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

FOLLICLE STIMULATING HORMONE​

[/TD]
[TD="bgcolor: transparent"]

0.17 mIU/ml​

[/TD]
[TD="bgcolor: transparent"]

4.0 - 10.0 mIU/ml​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

DHEA-S​

[/TD]
[TD="bgcolor: transparent"]

2862 ng/ml​

[/TD]
[TD="bgcolor: transparent"]

ng/ml​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

SHBG​

[/TD]
[TD="bgcolor: transparent"]

19 nmol/L​

[/TD]
[TD="bgcolor: transparent"]

10 - 55 nmol/L​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

FREE TESTOSTERONE-CALCULATED​

[/TD]
[TD="bgcolor: transparent"]

39.91 ng/dl​

[/TD]
[TD="bgcolor: transparent"]

ng/dl​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

ESTRADIOL​

[/TD]
[TD="bgcolor: transparent"]

12 ng/dl​

[/TD]
[TD="bgcolor: transparent"]

0.5 - 5 ng/dl​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

TESTOSTERONE LEVEL​

[/TD]
[TD="bgcolor: transparent"]

1537 ng/dl​

[/TD]
[TD="bgcolor: transparent"]

200 - 1000 ng/dl​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

CHOLESTEROL​

[/TD]
[TD="bgcolor: transparent"]

97 MG/DL​

[/TD]
[TD="bgcolor: transparent"]

<200 MG/DL​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

TRIGLYCERIDES​

[/TD]
[TD="bgcolor: transparent"]

60 MG/DL​

[/TD]
[TD="bgcolor: transparent"]

<150 MG/DL​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

HDL CHOLESTEROL​

[/TD]
[TD="bgcolor: transparent"]

35 MG/DL​

[/TD]
[TD="bgcolor: transparent"]

>39 MG/DL​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

LDL CHOLESTEROL CALCULATED​

[/TD]
[TD="bgcolor: transparent"]

50 MG/DL​

[/TD]
[TD="bgcolor: transparent"]

<100 MG/DL​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

LDL/HDL RATIO, SERUM​

[/TD]
[TD="bgcolor: transparent"]

1.43 RATIO​

[/TD]
[TD="bgcolor: transparent"]

<3.55 RATIO​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

SOMATOMEDIN-C​

[/TD]
[TD="bgcolor: transparent"]

158 NG/ML​

[/TD]
[TD="bgcolor: transparent"]

68 - 202 NG/ML​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

ALBUMIN​

[/TD]
[TD="bgcolor: transparent"]

4.4 G/DL​

[/TD]
[TD="bgcolor: transparent"]

3.5 - 5.2 G/DL​

[/TD]
[/TR]
[TR]
[TD="bgcolor: transparent"]

PROLACTIN​

[/TD]
[TD="bgcolor: transparent"]

28.8 NG/ML​

[/TD]
[TD="bgcolor: transparent"]

4.0 - 15.2 NG/ML​

[/TD]
[/TR]
[/TABLE]

So with these labs above, do you feel better than when you weren't on TRT? And also how long did it take you to get dialed in on a protocol that was right for you? Thanks for your responses man.

 

[Julian]

Julian do you notice a difference in any aspect of your life when your prolactin was at 30 as opposed to 8-10?

I dint feel anything was wrong, I felt great. lots of energy, good sex drive, all the great benefits of higher T

 

[Julian]

So with these labs above, do you feel better than when you weren't on TRT? And also how long did it take you to get dialed in on a protocol that was right for you? Thanks for your responses man.

With my T levels been at 1500, I feel great but I think they are high but my Dr. doesn't think so. I lower my dosage for the next 3 months and my levels got even higher. my recent lab results are from 5/1/17 and my T levels got up to almost 1700. so I'm cutting back on my dosage to .40 twice a week.

it took about 3 months for me to feel a huge difference. at almost T levels of 1700 I feel the same as when I was at 1500. I'm very calm so I'm able to control any aggression. like I said before I'm gonna cut back to .40 twice a week and see where that puts me

 

[CoastWatcher]

With my T levels been at 1500, I feel great but I think they are high but my Dr. doesn't think so. I lower my dosage for the next 3 months and my levels got even higher. my recent lab results are from 5/1/17 and my T levels got up to almost 1700. so I'm cutting back on my dosage to .40 twice a week.

it took about 3 months for me to feel a huge difference. at almost T levels of 1700 I feel the same as when I was at 1500. I'm very calm so I'm able to control any aggression. like I said before I'm gonna cut back to .40 twice a week and see where that puts me

It astonishes me to read that your doctor doesn't feel your total testosterone is that high at 1537 ng/dl. When was the last time a CBC was pulled to check hematocrit and hemoglobin?

 

[Julian]

May 1st, my hematocrit levels were at 44 but I had just donated the previous week which my levels were at 47....

 

[Libra88]

I also want to ask everybody according to my blood work, is there any other red flags that I should be aware of?

 

[CoastWatcher]

I also want to ask everybody according to my blood work, is there any other red flags that I should be aware of?

I think things have been covered - as best we can. Good luck with your consultation. Let us know what emerges.

 

[Julian]

I also want to ask everybody according to my blood work, is there any other red flags that I should be aware of?

Find out if you are primary or secondary. After reading alot on this forum and i wish i had found this place before i started TRT. High LH and FSH levels may indicate that you are primary cause your testicles aren't working and producing test therefore your brain / hypo gland gets the signal and tell the pituitary gland to produce more and thats how you end up with high LH levels. I haven't seen your lab results but also I'm not a doctor. Your prolactin levels are high you might be secondary or you could be having thyroid problems. Don't start TRT until you know what the problem is.
My doctor didn't tell me shit, he just put me on it and it's my fault for not educating my self enough to know and ask the right questions. So I'm thinking of getting off and find out what's really causing me to have low T levels. Good luck

 

[Libra88]

Update to trt protocol:

80 mg test cyp 2x a week
HCG 400IU 2x a week
.125 Anastrozole 2x a week
cabergoline 1.5 2x a week
Adrenal Tea (I believe) 2 capsules every morning.

So I spoke with Dr. Calkins and he told me according to my salivary cortisol test, my cortisol is lower than average the whole day and told me I should take an adrenal tea supplement that basically has adaptogens to assist adrenals, lower stress, treat insomnia and improve energy. So my questions are: 1 is the reason why my TRT hasn't been working is because my adrenals / low cortisol throughout the day is having an affect on it? 2 Does this mean I am dealing with adrenal fatigue? 3 Will this tea actually recover my adrenals eventually or just support the adrenals to work properly? Thanks again in advance everybody!

 

[CoastWatcher]

Update to trt protocol:

80 mg test cyp 2x a week
HCG 400IU 2x a week
.125 Anastrozole 2x a week
cabergoline 1.5 2x a week
Adrenal Tea (I believe) 2 capsules every morning.

So I spoke with Dr. Calkins and he told me according to my salivary cortisol test, my cortisol is lower than average the whole day and told me I should take an adrenal tea supplement that basically has adaptogens to assist adrenals, lower stress, treat insomnia and improve energy. So my questions are: 1 is the reason why my TRT hasn't been working is because my adrenals / low cortisol throughout the day is having an affect on it? 2 Does this mean I am dealing with adrenal fatigue? 3 Will this tea actually recover my adrenals eventually or just support the adrenals to work properly? Thanks again in advance everybody!

Did Dr. Calkins suggest you retest the cortisol levels down the road?

 

[Libra88]

Did Dr. Calking suggest you retest the cortisol levels down the road?

I can't recall, side note:name of supplement is a Drenal

 

[Julian]

Update to trt protocol:

80 mg test cyp 2x a week
HCG 400IU 2x a week
.125 Anastrozole 2x a week
cabergoline 1.5 2x a week
Adrenal Tea (I believe) 2 capsules every morning.

So I spoke with Dr. Calkins and he told me according to my salivary cortisol test, my cortisol is lower than average the whole day and told me I should take an adrenal tea supplement that basically has adaptogens to assist adrenals, lower stress, treat insomnia and improve energy. So my questions are: 1 is the reason why my TRT hasn't been working is because my adrenals / low cortisol throughout the day is having an affect on it? 2 Does this mean I am dealing with adrenal fatigue? 3 Will this tea actually recover my adrenals eventually or just support the adrenals to work properly? Thanks again in advance everybody!

https://www.t-nation.com/supplements/truth-about-adrenal-fatigue

 

[Libra88]

https://www.t-nation.com/supplements/truth-about-adrenal-fatigue

Thanks for the link Julian, I think I may jave found the reason as to why TRT hasn't been working...I have had difficulty sleeping most nights since I can remember, even before TRT. So I believe if I can start to get a good 7-8 hours of quality sleep a night then it should help tremendously. Is there any supplements or sleep aids that you all recommend? (like Gaba, valerian, magnesium) Also difficulty breathing is an issue some nights which I believe is sleep apnea? What do you all think?

 

[CoastWatcher]

Thanks for the link Julian, I think I may jave found the reason as to why TRT hasn't been working...I have had difficulty sleeping most nights since I can remember, even before TRT. So I believe if I can start to get a good 7-8 hours of quality sleep a night then it should help tremendously. Is there any supplements or sleep aids that you all recommend? (like Gaba, valerian, magnesium) Also difficulty breathing is an issue some nights which I believe is sleep apnea? What do you all think?

Sleep apnea goes undiagnosed far too often. I would arrange a sleep study as soon as you can.

 

[Libra88]

I just bought Jarrow PS-100, I read that that can help with insomnia, sleep studies seem to be pretty expensive. Dr. Saya if you are reading this, do you have any sleep aid at Defy Medical that can help me sleep?