First post. Can’t get E2 under control, starting to worry

[tropicaldaze1950]

You hit the nail on the head. Highpull had an excellent spreadsheet on his patients and what dose the took and what numbers they achieved. That man does not advertise his practice on the web and isn’t trying to grab clients. He just shares his knowledge. And isn’t making money off the drug sales like some of these clinics that also charge membership fees. What incentive’s do you think these legit drs have other then having the patients feel good @Cataceous ?

I have great respect for Highpull. He doesn't hype anything; just places the facts and data out there and readily admits there are aspects that have him puzzled, specifically, the declining testosterone numbers in young men, along with young men consulting with him who, though apparently healthy, are experiencing low libido and erectile problems.

 

[RobRoy]

Glad you mentioned this example. I would bet money that raising fT3 over the long haul reduces life expectancy. Maybe it's worth it, but don't you think informed consent is essential? I don't see enough of this latter, which applies to high testosterone too. The doctors promoting excess blithely claim no risk when they actually do not know.


How do you know life expectancy is not reduced? Without a careful accounting who is going to notice a few years reduction in average longevity of the cohort? Nobody, which leads to empty assertions that there is none. That's what studies are about. It's hardly an obsession to demand rigorous scientific support for such hypotheses. You seem to be calling studies flawed without even reading them. Why not get specific and identify the studies and flaws so we can discuss them?


There are some TRT-related hypotheses for the "something else" that are mentioned above: unnatural variation in serum testosterone or disruption of other hormones. In any case, yours is a typical misrepresentation of my position. The vehemence is directed against starting new patients at high levels and then mishandling the symptoms of excess that often result.

By the way, define "moderately higher". Is 50% above top-end natural production moderate? 100%?

"Glad you mentioned this example. I would bet money that raising fT3 over the long haul reduces life expectancy. Maybe it's worth it, but don't you think informed consent is essential? I don't see enough of this latter, which applies to high testosterone too. The doctors promoting excess blithely claim no risk when they actually do not know."
Why do you even attempt to give advice on a forum? You obviously have such an extreme bias and cannot overcome your belief perseverance. You cannot advance your knowledge and understand that when we get testosterone it's not the same as when we make it. You can't understand that with regard to hormones that having a normal level does not mean they do not suffer symptoms of a deficiency. And you definitely have an extreme bias against the word super physiologic and it is men like you that have taken that word and made it to imply harm. It does not because when levels are super physiologic with regard to free T3 and free testosterone every parameter of health that we can measure improves. When you make statements like you do it becomes obvious that you are oblivious to the decades of studies we have. We have been giving desiccated thyroid and therefore raising free T3 levels since the 1890's. There were no thyroid labs until the 1970s. So we're talking about at least eight decades of utilizing thyroid and raising free T3 levels without any labs but instead just treating symptoms. Those were the good old days of medicine. There was no shortened lifespan in those treated and this is born out in all of the medical literature. The same holds true for testosterone. First started using it in the mid 1930s and there were no labs until the 1970s. Men had supraphysiologic levels for decades and yet no decrease in lifespan.
What some of us are now talking about is what should be talked about. We are talking about the fact that when we treat symptomatic men and women and resolve their symptoms the levels are typically outside of the so-called normal range and therefore supraphysiological. When we make testosterone ourselves we are simply more sensitive to it because that is a complex physiologic process with many intermediate hormones involved that certainly play a role in testosterones actions. When we bypass our natural production and just get the end product it takes more than we could produce naturally to get the same response from a clinical standpoint. In order to understand this this takes actually opening your mind and breaking away from everything that you thought you knew and forgetting about how you learned it first. You have this fear of levels outside the normal range with regard to testosterone and thyroid that is not supported by any medical data. In other words you fear a boogie man that does not exist. I've said it so many times that work was normal prior to July 2017 is now considered supraphysiologic. So do you mean testosterone levels of 1150 for instance we're healthy prior to July 2017 but after 2017 they became dangerous and super physiologic. By your logic that's exactly what you're saying and nothing could be further from the truth. Men don't need less testosterone than ever they are just producing less testosterone than ever. We need as much and potentially more than ever based on our exposure to our toxic environment. So let me be clear when I do find super physiologic and healthy. I'm finding a testosterone level usually between one and 2000 and a free testosterone level typically between 30 and 60 ng/dL. And before anyone says well if those are good why not go higher? Well the reason is that there is a plateau to the feel good effects of testosterone. That plateau is when the androgen receptors are fully saturated. Increasing testosterone any further than that will have no effect on how a man feels. These feel good effects are when the receptors are fully saturated of course in the central nervous system (T,E2DHT). Reason bodybuilders have their levels excessively high it's not because they feel better but it's because in the skeletal muscle androgen receptors are up regulated with increasing androgens therefore they can continue to increase lean muscle mass. That doesn't happen in the brain. So your question has been answered we treat mental symptomatic improvement but there is a point in which raising levels any further will have no beneficial effect other than to increase lean muscle mass. I have to find that saturation point for my clinical perspective. If you listen to peter attia he will say that it occurs at a level around 700 of testosterone which I disagree. That may occur if you make it yourself and have a level of 700 but if you take testosterone then it's going to take a level greater than that to exert the same effect you would get if you made it yourself.
You should try stepping back and opening up your mind....

 

[Deleted member 43589]

You betting money isnt very scientific is it ? Drs aren’t telling men when they put them on statins and Finasteride to name a few that it’s going to severely diminish quality of life. We can name hundreds of drugs drs prescribe like candy that they do not warn patients of issues they can cause. I’ve been prescribed ssri like candy without ever being warned of a side effect. You are just so stuck on this “do no harm” thing with testosterone but you’re willing to give all this other bullshit modern medicine pushes a pass ? Not to call you out and get in an argument with you but look at all the shit you have experimented with in your health journey. Have you ever given higher t levels a shot. With out all the ancillary drugs you’ve tried ? Maybe that’s all you would need to feel well. Or maybe you shouldn’t be on trt at all if you’re so worried about having to take all these other things to try and keep your Hpta somewhat intact.

At some point people have to be responsible for yourself’s . And if you still believe anything the medical establishment says, with out doing your own research and being your own advocate, I don’t know what to tell you. Especially after the whole covid mess. I think most men know that taking anything has its risks. But what we do know without the shadow of a doubt having low t and tons of symptoms is very detrimental to our health. Long term.

Exactly. We are putting a lot of faith in research, when research findings constantly change and progress. Remember back in the early 70's we had a fear of fats. Saturated fat seemed to be our enemy. So we cut whole milk, cut butter and added more carbohydrates into our diet. Well 30 years later we got fatter and fatter and Type II diabetes followed the same rise as did obesity rates. Now we have a dietary fat free society who are largely morbidly obese with Type II diabetes that use to only happen to our older people.

10 to 15 years ago, we discovered that fats are not bad and saturated fats are not so evil but the man made butter replacements (margarine) were full of transfatty acids that seem to directly contribute to cardiovascular disease.

I still have one of the medical inserts that came out of a vial of testosterone enanthate directly from the pharmacy back in 1985 when steroids were not CIII drugs. We were told my medical science that anabolic steroids would not enhance athletics. OK, yet athletes used them anyway and got amazingly better. After 1989, when medical science told us we were all going to die from taking steroids they were made to be a CIII drug and you could hardly get a doctor to prescribe them for anything. Yet this study came out:

Conclusion​

It is our contention that the incidence of serious health problems associated with​

the use of androgens by athletes has been exaggerated. Longitudinal studies by the​

WHO (1990) and Millar ( I 994) have demonstrated that moderate androgen use​

( 140-200 mg/week) produce minor but reversible side effects. If androgens are so​

dangerous, one would expect an abundance of maladies befalling the over 300,000​

individuals who used androgens in 199 1 (Yesalis et al., 1993). Androgens have​

been used by athletes, especially in the strength sports, since the mid- 1950s. Professional​

bodybuilders, perhaps the population most likely to use steroid, had​

used these drugs legally until the mid- 1980s, and currently use them illegally. Although​

more than one million individuals are current or former steroid users. there​

is no evidence to suggest that they suffer from hepatic or cardiovascular disease​

more so than the non-androgen-using population. Based on the available evidence,​

we would posit that the administration of moderate doses (200-300 mg/week for 6​

to 12 weeks once per year) of an injectable androgen, such as testosterone enanthate​

or nandrolone decanoate. in healthy adult males could induce positive change in​

body composition and athletic performance with little or no side effect (1,cmcke​

et al., 1996; Millar, 1994: WHO, 1990). On the other- hand, when athlete, especially​

bodybuilders, often take much higher doses for longer period of' time. It​

could be speculated that such high doses might lead to more serious health problems,​

but at this point, there is no evidence to support such a contention.​

Maybe I will drop dead tomorrow but for 44 years now I have used testosterone, both in huge doses, moderate doses and small doses, by itself or in combination with 1 or more anabolic steroids, combined at times with HGH, insulin, IGF-1 and anything else that would help me grow and get stronger. Despite what some in the medical profession keep telling us.......we are all going to die, I am still here and pretty healthy for a 68 year old who has pushed his body to the limit. We all have to make our own personal choices but seeing how medical science has seemed to change according to how outside influence push them, I am always very skeptical of anything I read and make my own choices in life. I think @Charliebizz has adequately pointed out all the medication that are being pushed on us by doctors based on the research done by medical science to end up creating more problem for us all. Statins are a very good example.

Why would anyone go to doctors for symptoms of low T and make the effort of taking the prescribed medication only to feel just as miserable doing it. Sometimes we have to think outside the box. I am doing a protocol that no doctor in the world is using, there is also no research backing it. Yet it is working well. No one that I am aware of has ever tried micro-dosing testosterone undecanoate. Hell, it is impossible to even get here in the USA because of the black box warning of micro-embolisms. Impossible to get if you go sub-q. But only in America are we not trusted to do our own medication. Yet most other countries you go to the pharmacy and get things over the counter with no prescription. My wife recently walked out of the pharmacy in Buenos Aires with tramadol (Klosidol). No prescription. Long term results, I am long term results. No research study looks at those of use who have using for 40+ years. All we see from science is fear mongering, mostly because of the fear of an athlete every choosing to use anabolic steroids. Silly.

 

[Charliebizz]

Exactly. We are putting a lot of faith in research, when research findings constantly change and progress. Remember back in the early 70's we had a fear of fats. Saturated fat seemed to be our enemy. So we cut whole milk, cut butter and added more carbohydrates into our diet. Well 30 years later we got fatter and fatter and Type II diabetes followed the same rise as did obesity rates. Now we have a dietary fat free society who are largely morbidly obese with Type II diabetes that use to only happen to our older people.

10 to 15 years ago, we discovered that fats are not bad and saturated fats are not so evil but the man made butter replacements (margarine) were full of transfatty acids that seem to directly contribute to cardiovascular disease.

I still have one of the medical inserts that came out of a vial of testosterone enanthate directly from the pharmacy back in 1985 when steroids were not CIII drugs. We were told my medical science that anabolic steroids would not enhance athletics. OK, yet athletes used them anyway and got amazingly better. After 1989, when medical science told us we were all going to die from taking steroids they were made to be a CIII drug and you could hardly get a doctor to prescribe them for anything. Yet this study came out:

Conclusion​

It is our contention that the incidence of serious health problems associated with​

the use of androgens by athletes has been exaggerated. Longitudinal studies by the​

WHO (1990) and Millar ( I 994) have demonstrated that moderate androgen use​

( 140-200 mg/week) produce minor but reversible side effects. If androgens are so​

dangerous, one would expect an abundance of maladies befalling the over 300,000​

individuals who used androgens in 199 1 (Yesalis et al., 1993). Androgens have​

been used by athletes, especially in the strength sports, since the mid- 1950s. Professional​

bodybuilders, perhaps the population most likely to use steroid, had​

used these drugs legally until the mid- 1980s, and currently use them illegally. Although​

more than one million individuals are current or former steroid users. there​

is no evidence to suggest that they suffer from hepatic or cardiovascular disease​

more so than the non-androgen-using population. Based on the available evidence,​

we would posit that the administration of moderate doses (200-300 mg/week for 6​

to 12 weeks once per year) of an injectable androgen, such as testosterone enanthate​

or nandrolone decanoate. in healthy adult males could induce positive change in​

body composition and athletic performance with little or no side effect (1,cmcke​

et al., 1996; Millar, 1994: WHO, 1990). On the other- hand, when athlete, especially​

bodybuilders, often take much higher doses for longer period of' time. It​

could be speculated that such high doses might lead to more serious health problems,​

but at this point, there is no evidence to support such a contention.​

Maybe I will drop dead tomorrow but for 44 years now I have used testosterone, both in huge doses, moderate doses and small doses, by itself or in combination with 1 or more anabolic steroids, combined at times with HGH, insulin, IGF-1 and anything else that would help me grow and get stronger. Despite what some in the medical profession keep telling us.......we are all going to die, I am still here and pretty healthy for a 68 year old who has pushed his body to the limit. We all have to make our own personal choices but seeing how medical science has seemed to change according to how outside influence push them, I am always very skeptical of anything I read and make my own choices in life. I think @Charliebizz has adequately pointed out all the medication that are being pushed on us by doctors based on the research done by medical science to end up creating more problem for us all. Statins are a very good example.

Why would anyone go to doctors for symptoms of low T and make the effort of taking the prescribed medication only to feel just as miserable doing it. Sometimes we have to think outside the box. I am doing a protocol that no doctor in the world is using, there is also no research backing it. Yet it is working well. No one that I am aware of has ever tried micro-dosing testosterone undecanoate. Hell, it is impossible to even get here in the USA because of the black box warning of micro-embolisms. Impossible to get if you go sub-q. But only in America are we not trusted to do our own medication. Yet most other countries you go to the pharmacy and get things over the counter with no prescription. My wife recently walked out of the pharmacy in Buenos Aires with tramadol (Klosidol). No prescription. Long term results, I am long term results. No research study looks at those of use who have using for 40+ years. All we see from science is fear mongering, mostly because of the fear of an athlete every choosing to use anabolic steroids. Silly.

I’ve watched what the medical establishment has done to my father. At 51 he was in great physical shape. Always doing projects at the house. Beast at work. The only issue was he smoked a ton of cigarettes and drank a lot. That led to a minor blockage and he got two stents put in. The rapid decline in his health after the amount of drugs they put him on was staggering. It opened my eyes to how fucked the establishment is. Then the guy at 60 has a bout of bph. They do laser prostate surgery and proceeded to put him on finasteride. again the rapid declining his health was staggering then at 65 he had a swollen testicle. The doctor went in and ended up taking his testicle, and finding out there was nothing wrong with it. They have done nothing about his tea levels. they are completely Rockbottom. His DHT is Rockbottom but he just listens to the doctors and won’t listen to me. He’s 70 years old and walks around like 110-year-old, meanwhile we have big tex only two years younger putting 20 year olds to shame. Maybe my dad will live till he’s 90. But he will be a shell of himself for the next 20 years.

 

[Deleted member 43589]

"Glad you mentioned this example. I would bet money that raising fT3 over the long haul reduces life expectancy. Maybe it's worth it, but don't you think informed consent is essential? I don't see enough of this latter, which applies to high testosterone too. The doctors promoting excess blithely claim no risk when they actually do not know."
Why do you even attempt to give advice on a forum? You obviously have such an extreme bias and cannot overcome your belief perseverance. You cannot advance your knowledge and understand that when we get testosterone it's not the same as when we make it. You can't understand that with regard to hormones that having a normal level does not mean they do not suffer symptoms of a deficiency. And you definitely have an extreme bias against the word super physiologic and it is men like you that have taken that word and made it to imply harm. It does not because when levels are super physiologic with regard to free T3 and free testosterone every parameter of health that we can measure improves. When you make statements like you do it becomes obvious that you are oblivious to the decades of studies we have. We have been giving desiccated thyroid and therefore raising free T3 levels since the 1890's. There were no thyroid labs until the 1970s. So we're talking about at least eight decades of utilizing thyroid and raising free T3 levels without any labs but instead just treating symptoms. Those were the good old days of medicine. There was no shortened lifespan in those treated and this is born out in all of the medical literature. The same holds true for testosterone. First started using it in the mid 1930s and there were no labs until the 1970s. Men had supraphysiologic levels for decades and yet no decrease in lifespan.
What some of us are now talking about is what should be talked about. We are talking about the fact that when we treat symptomatic men and women and resolve their symptoms the levels are typically outside of the so-called normal range and therefore supraphysiological. When we make testosterone ourselves we are simply more sensitive to it because that is a complex physiologic process with many intermediate hormones involved that certainly play a role in testosterones actions. When we bypass our natural production and just get the end product it takes more than we could produce naturally to get the same response from a clinical standpoint. In order to understand this this takes actually opening your mind and breaking away from everything that you thought you knew and forgetting about how you learned it first. You have this fear of levels outside the normal range with regard to testosterone and thyroid that is not supported by any medical data. In other words you fear a boogie man that does not exist. I've said it so many times that work was normal prior to July 2017 is now considered supraphysiologic. So do you mean testosterone levels of 1150 for instance we're healthy prior to July 2017 but after 2017 they became dangerous and super physiologic. By your logic that's exactly what you're saying and nothing could be further from the truth. Men don't need less testosterone than ever they are just producing less testosterone than ever. We need as much and potentially more than ever based on our exposure to our toxic environment. So let me be clear when I do find super physiologic and healthy. I'm finding a testosterone level usually between one and 2000 and a free testosterone level typically between 30 and 60 ng/dL. And before anyone says well if those are good why not go higher? Well the reason is that there is a plateau to the feel good effects of testosterone. That plateau is when the androgen receptors are fully saturated. Increasing testosterone any further than that will have no effect on how a man feels. These feel good effects are when the receptors are fully saturated of course in the central nervous system (T,E2DHT). Reason bodybuilders have their levels excessively high it's not because they feel better but it's because in the skeletal muscle androgen receptors are up regulated with increasing androgens therefore they can continue to increase lean muscle mass. That doesn't happen in the brain. So your question has been answered we treat mental symptomatic improvement but there is a point in which raising levels any further will have no beneficial effect other than to increase lean muscle mass. I have to find that saturation point for my clinical perspective. If you listen to peter attia he will say that it occurs at a level around 700 of testosterone which I disagree. That may occur if you make it yourself and have a level of 700 but if you take testosterone then it's going to take a level greater than that to exert the same effect you would get if you made it yourself.
You should try stepping back and opening up your mind....

AMEN! I have taken large doses and truthfully, I feel the same now using 60mg of TU every 5 days as I did using 750mg of TU every month or even 250mg of TE every week. I feel what I call as normal. I definitely agree there is a point where more is not going to make you feel any better. But obviously from the statement I posted directly from and IFBB professional bodybuilder, more is going to make you more muscular, if your genetics can tolerate more.

Thank you doctor, exactly what I have been saying quite a few of us need to take a step back and open up our mind. Not everything we are being told by medical science is true. There is still a lot of bias in any study around the use of testosterone and our best knowledge comes from those like the good doctor who are actually in the trenches treating patients. It also comes from athletes that have been using big doses for year. But how many of us have been listening. RobRoy has been around a long time, even back with Crisler. I for one am very grateful that he has taken his time to post here and try to help us in our journey.

 

[Charliebizz]

AMEN! I have taken large doses and truthfully, I feel the same now using 60mg of TU every 5 days as I did using 750mg of TU every month or even 250mg of TE every week. I feel what I call as normal. I definitely agree there is a point where more is not going to make you feel any better. But obviously from the statement I posted directly from and IFBB professional bodybuilder, more is going to make you more muscular, if your genetics can tolerate more.

Thank you doctor, exactly what I have been saying quite a few of us need to take a step back and open up our mind. Not everything we are being told by medical science is true. There is still a lot of bias in any study around the use of testosterone and our best knowledge comes from those like the good doctor who are actually in the trenches treating patients. It also comes from athletes that have been using big doses for year. But how many of us have been listening. RobRoy has been around a long time, even back with Crisler. I for one am very grateful that he has taken his time to post here and try to help us in our journey.

what are your levels at that dose. That’s what a lot of people are missing too. I’ve seen guys take 60mg a week in a 1x a week injection and still have trough levels of 700tt. And others that won’t even peak to 700 at that dose. And regardless of how many studies we see about Esters and breakdown of t an half lives. It seems everyone is different. My blood levels swing wildly on injections. I’ve tested all times in my injection cycle and my labs are all over the place. They don’t follow the “Pk” in some study or testosterone pamphlet that comes with the medication. I believe that’s last more common then people think. That’s why these so called “rules” seem like bullshit when it comes to trt. It’s very simple treat the patient within reason till the get symptom relief. If we are throwing tons of t at a guy and he’s getting sides and no positive relief then maybe it’s not testosterone. But to keep levels in this magical “normal range” just isn’t working for most in practice

 

[Deleted member 43589]

what are your levels at that dose. That’s what a lot of people are missing too. I’ve seen guys take 60mg a week in a 1x a week injection and still have trough levels of 700tt. And others that won’t even peak to 700 at that dose. And regardless of how many studies we see about Esters and breakdown of t an half lives. It seems everyone is different. My blood levels swing wildly on injections. I’ve tested all times in my injection cycle and my labs are all over the place. They don’t follow the “Pk” in some study or testosterone pamphlet that comes with the medication. I believe that’s last more common then people think. That’s why these so called “rules” seem like bullshit when it comes to trt. It’s very simple treat the patient within reason till the get symptom relief. If we are throwing tons of t at a guy and he’s getting sides and no positive relief then maybe it’s not testosterone. But to keep levels in this magical “normal range” just isn’t working for most in practice

Right now I am going 60mg of Testosterone Undecanoate sub-q every 5 days. Here is my latest blood word done in January of this year.


All lipid values normal

WHITE BLOOD CELL COUNT 8.1 Reference Range: 3.8-10.8 Thousand/uL
RED BLOOD CELL COUNT 6.11 H Reference Range: 4.20-5.80 Million/uL
HEMOGLOBIN 16.6 Reference Range: 13.2-17.1 g/dL
HEMATOCRIT 51.9 H Reference Range: 38.5-50.0 %

TESTOSTERONE, TOTAL, MALES (ADULT), IA 883 H Reference Range: 250-827 ng/dL

ESTRADIOL 24 Reference Range: < OR = 39 pg/mL

This is December 2010. At this time I was doing 250mg of TE/wk and 150mg of trenbolone enanthate/wk. Definitely not TRT.

CBC (INCLUDES DIFF/PLT) RGA
WHITE BLOOD CELL COUNT 11.5 H 3.8-10.8 Thousand/uL
RED BLOOD CELL COUNT 5.54 4.20-5.80 Million/uL
HEMOGLOBIN 17.9 H 13.2-17.1 g/dL
HEMATOCRIT 52.9 H 38.5-50.0 %

TESTOSTERONE, TOTAL, MALES (ADULT), IA 2383 H Reference Range: 250-827 ng/dL

ESTRADIOL 68 H Reference Range: < OR = 39 pg/mL

All lipid values were normal

Looking at the difference for me in higher doses and low TRT doses I am very close to the same in blood work except E2. Right now I have been taking .25mg of Anastrozole/wk pending my next blood work just to keep my doctor from freaking out over the E2. Do I feel any different? NOPE, I feel normal, just like I did in 2010 and my E2 feels the same at 24 or 68. The other difference is my doctor at that time never suggest I dump blood and was well aware of my steroids use. Yea, I think there is a lot of over thinking this process. Athletes have been using blood work for years and self monitoring their health using larger doses. Yet we are looked at as idiots.

Is muscle mass important to me, of course. With age comes sarcopenia, I don't want to look like an old man, even though I am. I also don't want to feel like an old man, but my days of competing are long gone so being huge and strong are things of the past. I am happy with looking and feeling like an old man that is still in pretty damn good shape. I have a trophy wife that looks great for her age and looking good for her also matters. Giving up on your looks is the easiest way to screw up a marriage.

I think we all need to go back and watch this video again with Dr. Larry Lipshultz being interviewed by former IFBB Pro, Lee LaBrada. Lots of good info here.

Curriculum Vita

Larry Lipshultz CV - Vasectomy Reversal, Infertility, Hypogonadism Treatment, Urologist - Dr. Larry Lipshultz

Curriculum Vitae Name : Larry I. Lipshultz, M.D. Address : Office: Baylor College of Medicine Scott Department of Urology O’Quinn Medical Tower at St.

www.larrylipshultz.com

Awards and Honors

Honors and Awards - Vasectomy Reversal, Infertility, Hypogonadism Treatment, Urologist - Dr. Larry Lipshultz

Learn about the honors and awards given to Dr. Larry Lipshultz, M.D., male infertility specialist and microsurgeon.

www.larrylipshultz.com

Research

Research - Vasectomy Reversal, Infertility, Hypogonadism Treatment, Urologist - Dr. Larry Lipshultz

Research Dr. Lipshultz' Current Urological Projects Overview Dr. Lipshultz' research is outstanding in the field of urology. Throughout his career his team has comprised of over 100 Academic Fellows, 100's of Medical Students, 100's of Residents, and several full time Research Coordinators...

www.larrylipshultz.com

 

[Charliebizz]

Right now I am going 60mg of Testosterone Undecanoate sub-q every 5 days. Here is my latest blood word done in January of this year.


All lipid values normal

WHITE BLOOD CELL COUNT 8.1 Reference Range: 3.8-10.8 Thousand/uL
RED BLOOD CELL COUNT 6.11 H Reference Range: 4.20-5.80 Million/uL
HEMOGLOBIN 16.6 Reference Range: 13.2-17.1 g/dL
HEMATOCRIT 51.9 H Reference Range: 38.5-50.0 %

TESTOSTERONE, TOTAL, MALES (ADULT), IA 883 H Reference Range: 250-827 ng/dL

ESTRADIOL 24 Reference Range: < OR = 39 pg/mL

This is December 2010. At this time I was doing 250mg of TE/wk and 150mg of trenbolone enanthate/wk. Definitely not TRT.

CBC (INCLUDES DIFF/PLT) RGA
WHITE BLOOD CELL COUNT 11.5 H 3.8-10.8 Thousand/uL
RED BLOOD CELL COUNT 5.54 4.20-5.80 Million/uL
HEMOGLOBIN 17.9 H 13.2-17.1 g/dL
HEMATOCRIT 52.9 H 38.5-50.0 %

TESTOSTERONE, TOTAL, MALES (ADULT), IA 2383 H Reference Range: 250-827 ng/dL

ESTRADIOL 68 H Reference Range: < OR = 39 pg/mL

All lipid values were normal

Looking at the difference for me in higher doses and low TRT doses I am very close to the same in blood work except E2. Right now I have been taking .25mg of Anastrozole/wk pending my next blood work just to keep my doctor from freaking out over the E2. Do I feel any different? NOPE, I feel normal, just like I did in 2010 and my E2 feels the same at 24 or 68. The other difference is my doctor at that time never suggest I dump blood and was well aware of my steroids use. Yea, I think there is a lot of over thinking this process. Athletes have been using blood work for years and self monitoring their health using larger doses. Yet we are looked at as idiots.

Is muscle mass important to me, of course. With age comes sarcopenia, I don't want to look like an old man, even though I am. I also don't want to feel like an old man, but my days of competing are long gone so being huge and strong are things of the past. I am happy with looking and feeling like an old man that is still in pretty damn good shape. I have a trophy wife that looks great for her age and looking good for her also matters. Giving up on your looks is the easiest way to screw up a marriage.

I think we all need to go back and watch this video again with Dr. Larry Lipshultz being interviewed by former IFBB Pro, Lee LaBrada. Lots of good info here.

Curriculum Vita

Larry Lipshultz CV - Vasectomy Reversal, Infertility, Hypogonadism Treatment, Urologist - Dr. Larry Lipshultz

Curriculum Vitae Name : Larry I. Lipshultz, M.D. Address : Office: Baylor College of Medicine Scott Department of Urology O’Quinn Medical Tower at St.

www.larrylipshultz.com

Awards and Honors

Honors and Awards - Vasectomy Reversal, Infertility, Hypogonadism Treatment, Urologist - Dr. Larry Lipshultz

Learn about the honors and awards given to Dr. Larry Lipshultz, M.D., male infertility specialist and microsurgeon.

www.larrylipshultz.com

Research

Research - Vasectomy Reversal, Infertility, Hypogonadism Treatment, Urologist - Dr. Larry Lipshultz

Research Dr. Lipshultz' Current Urological Projects Overview Dr. Lipshultz' research is outstanding in the field of urology. Throughout his career his team has comprised of over 100 Academic Fellows, 100's of Medical Students, 100's of Residents, and several full time Research Coordinators...

www.larrylipshultz.com

When did you pull labs? was it your true trough?

 

[Deleted member 43589]

I usually go in early in the morning and try to be at least fasted. The currant one was done on day 5 of my every 5 day cycle before I injected again. The one in 2010 most likely I just went in and have no idea when the injection day was. However, doing TU the half life is so long (~33.9 d) that the peaks and troughs are almost non existent, going every 5 days. You can see below how tight things are over a 30 day period. The downside of TU is by itself, it take 12-14 weeks to reach peak. I front loaded that whole process with test base when I got started.

 

[Charliebizz]

I usually go in early in the morning and try to be at least fasted. The currant one was done on day 5 of my every 5 day cycle before I injected again. The one in 2010 most likely I just went in and have no idea when the injection day was. However, doing TU the half life is so long (~33.9 d) that the peaks and troughs are almost non existent, going every 5 days. You can see below how tight things are over a 30 day period. The downside of TU is by itself, it take 12-14 weeks to reach peak. I front loaded that whole process with test base when I got started.

View attachment 42052

Yeah so you respond incredibly well to testosterone. Sure you dose is low but your levels match someon that would be on 120 mg 1x a week. Thats why dose is irrelevant!

 

[tropicaldaze1950]

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Cataceous and all his infinite wisdom and complete lack of clinical experience just will never understand, or know what he doesn't know. He can't open his mind enough to understand where the normal values come from. Like with estradiol for instance, he gave us a quote of a normal range or young men, but he doesn't even understand where that number came from or what it represents or what it does not represent. He's completely oblivious, but yet he gives advice. I will tell you I can show you different lab normals in different areas of the country as well as in different decades and the normal estradiol level for some of those labs was 20-90 not the 8-35 for labcorp. The normal range for LabCorp was not for me on testosterone and actually, they have no idea where those numbers came from because they have no data. It was collected several decades ago and most likely represented male volunteers that worked at endocrine sciences at that time which was the precursor to LabCorp. So we know nothing about the man at all. We know nothing about their health status order testosterone levels or anything else. I talked to the medical Director for an hour and she did the research over a period of two weeks to try to find out where the normal range came from. Ultimately, she had to call the medical Director, who worked there a couple of decades ago and told her that there were no studies, and that they had no records of how they developed that normal level but that it most likely represented male volunteers. But yet men, like Cataceous, want to take that as gospel, and nothing could be further from the truth. The normal range of 20 to 90 that I quote was in the New England Journal of Medicine in a study that was being done on a man and that was the normal range in that lab. Of course that was a 1997 when testosterone levels were higher than they are now in men. He also cannot understand that, aiming for a physiologic number that we would produce ourselves, when we give testosterone, does not result in good clinical outcomes in most men or in clinical studies. There's plenty of clinical studies out there, giving me a testosterone and keeping the numbers in the mid physiologic range where the men didn't get any improvement at all. He also is unaware that there is no harm of having a super physiologic number within reason. What is that within reason well that within reason is, there's no harm with a level of 1 to 2000 at all. When we look at clinical outcomes in men that get testosterone dosed to resolve symptoms. We see that when those symptoms resolve their numbers are typically outside of the normal physiologic range. So-called supraphysiologic. No harm in that at all. He also doesn't understand that testosterone works directly through its active metabolites, such as estradiol. When we take testosterone, we will raise estradiol because that's how testosterone provides us with benefits. It provides benefits through its active metabolites. No study, and I mean no study in 85 years of utilizing testosterone showed men got benefit when we blocked or controlled estradiol but instead, every study that did show an improvement in men, while taking testosterone, they did not block or control estradiol, but in every one of those studies, when they raise testosterone levels, they also raise levels of its active metabolites, because that's how testosterone works. He can't wrap his head outside of the normal range. He is constrained by a fear that is not founded by the medical literature. He is constrained by his belief perseverance. He is constrained by his actual lack of medical knowledge. He also refuses to understand that the recommendations that we aim for the mid normal range when giving me a testosterone is not based on any actual medical data that shows that's what works best. There is also no medical data to support staying within the so-called normal physiologic range when giving men testosterone. These are all just recommendations and opinions, but not recommendations or opinions that are based on actual medical data. Larry lip, Schultz author this study, and they're based on patients that they treated, and they treated patients outside of the normal physiologic range to supraphysiologic levels.

I just have to post this statement by Dr. John Crisler.

Some hyper-respond to a given initial dose, others show hardly any bump in serum T levels on same. Yet when you switch to a different delivery system, on initial dosing, they may convert to supraphysiologic androgen levels. The same is true of the subjective benefits from TRT. I have patients who love testosterone gel because it successfully treated their ED (the expected outcome because of dramatically increased DHT production), others get more from IM testosterone cypionate. My experience thus far has taught me two lessons: (1) You don’t know how a patient will react to a given dose/system until you try and (2) NOTHING surprises me anymore. The question of which testosterone delivery system is to be tried first (IM or transdermal) is one which brings much confusion amongst beginning practitioners of TRT.​

​

Even though this was written a few years back, Crisler understood some people respond to medication differently than others and this one size fits all treating numbers is not the answer. I know my doctor was surprised when he started me out at 150mg/test cyp/every 10 days and I came back with a T level of 2103 and HCT at 69.

More....

There simply is no way to predict how a particular patient will respond—not Medical History (i.e. number or severity of symptoms), body weight, baseline hormone levels, even anabolic steroid history. I have had very slight gentlemen barely elevate on 100mg of test cyp per week, and massively muscled former steroid athletes who went to nearly two times the top of “normal” range on the same dosage (they had similar baselines). Likewise, one man may see only a modest increase in DHT on 5gms of Testim/Androgel, another may become quite supraphysiologic on same.​

​

How about this statement.....

No such thing as normal​

With hormone testing Crisler says it is just as important to understand what normal range is not as it is to understand what normal range is.​

​

They pool all men and book-end two standard deviations – so it includes all of the top two and a half percent and the bottom two and a half percent, for all men. Crisler insists that’s actually ridiculous because we are not the same. He says the problem when you apply traditional science epidemiology to numbers is that all men are not alike – everyone has their own sweet spots.​

​

Crisler says there is a quantum nature to endocrinology. You can have numbers which are in completely normal range, but you can have all the symptoms of hypogonadism. However he has to treat the treating living, breathing human beings in front of him, not the numbers on the paper. Equally he notes about hormone testing that hormone levels are fluctuating all the time, and you really don’t know where on that roller-coaster you happen to catch the levels.​

​

Crisler gives the example of a guy who’s naturally living at 1200, where his normal testosterone is supposed to be – and he finds himself at 600. He’s still well within normal range, but he has the symptoms of low testosterone because now he only has half the testosterone his body was meant to run on.​

​

I am starting to wonder how some here would have responded to Dr. Crisler's advice when IMHO, @RobRoy has pretty well be treated like he has never treated a patient and is giving almost the same advice? After sitting back and observing things for a while, I am flattered that a medical doctor would take their time to post here and share their knowledge. Especially in an industry where professional knowledge is needed so badly.

Exactly. We are putting a lot of faith in research, when research findings constantly change and progress. Remember back in the early 70's we had a fear of fats. Saturated fat seemed to be our enemy. So we cut whole milk, cut butter and added more carbohydrates into our diet. Well 30 years later we got fatter and fatter and Type II diabetes followed the same rise as did obesity rates. Now we have a dietary fat free society who are largely morbidly obese with Type II diabetes that use to only happen to our older people.

10 to 15 years ago, we discovered that fats are not bad and saturated fats are not so evil but the man made butter replacements (margarine) were full of transfatty acids that seem to directly contribute to cardiovascular disease.

I still have one of the medical inserts that came out of a vial of testosterone enanthate directly from the pharmacy back in 1985 when steroids were not CIII drugs. We were told my medical science that anabolic steroids would not enhance athletics. OK, yet athletes used them anyway and got amazingly better. After 1989, when medical science told us we were all going to die from taking steroids they were made to be a CIII drug and you could hardly get a doctor to prescribe them for anything. Yet this study came out:

Conclusion​

It is our contention that the incidence of serious health problems associated with​

the use of androgens by athletes has been exaggerated. Longitudinal studies by the​

WHO (1990) and Millar ( I 994) have demonstrated that moderate androgen use​

( 140-200 mg/week) produce minor but reversible side effects. If androgens are so​

dangerous, one would expect an abundance of maladies befalling the over 300,000​

individuals who used androgens in 199 1 (Yesalis et al., 1993). Androgens have​

been used by athletes, especially in the strength sports, since the mid- 1950s. Professional​

bodybuilders, perhaps the population most likely to use steroid, had​

used these drugs legally until the mid- 1980s, and currently use them illegally. Although​

more than one million individuals are current or former steroid users. there​

is no evidence to suggest that they suffer from hepatic or cardiovascular disease​

more so than the non-androgen-using population. Based on the available evidence,​

we would posit that the administration of moderate doses (200-300 mg/week for 6​

to 12 weeks once per year) of an injectable androgen, such as testosterone enanthate​

or nandrolone decanoate. in healthy adult males could induce positive change in​

body composition and athletic performance with little or no side effect (1,cmcke​

et al., 1996; Millar, 1994: WHO, 1990). On the other- hand, when athlete, especially​

bodybuilders, often take much higher doses for longer period of' time. It​

could be speculated that such high doses might lead to more serious health problems,​

but at this point, there is no evidence to support such a contention.​

Maybe I will drop dead tomorrow but for 44 years now I have used testosterone, both in huge doses, moderate doses and small doses, by itself or in combination with 1 or more anabolic steroids, combined at times with HGH, insulin, IGF-1 and anything else that would help me grow and get stronger. Despite what some in the medical profession keep telling us.......we are all going to die, I am still here and pretty healthy for a 68 year old who has pushed his body to the limit. We all have to make our own personal choices but seeing how medical science has seemed to change according to how outside influence push them, I am always very skeptical of anything I read and make my own choices in life. I think @Charliebizz has adequately pointed out all the medication that are being pushed on us by doctors based on the research done by medical science to end up creating more problem for us all. Statins are a very good example.

Why would anyone go to doctors for symptoms of low T and make the effort of taking the prescribed medication only to feel just as miserable doing it. Sometimes we have to think outside the box. I am doing a protocol that no doctor in the world is using, there is also no research backing it. Yet it is working well. No one that I am aware of has ever tried micro-dosing testosterone undecanoate. Hell, it is impossible to even get here in the USA because of the black box warning of micro-embolisms. Impossible to get if you go sub-q. But only in America are we not trusted to do our own medication. Yet most other countries you go to the pharmacy and get things over the counter with no prescription. My wife recently walked out of the pharmacy in Buenos Aires with tramadol (Klosidol). No prescription. Long term results, I am long term results. No research study looks at those of use who have using for 40+ years. All we see from science is fear mongering, mostly because of the fear of an athlete every choosing to use anabolic steroids. Silly.

BigTex, thank you for the laying out the objective facts and unvarnished truth!

 

[Seagal]

Thanks guys for sharing your experiences!

I'm dose-limited by androgel. The lever I can adjust is the amount of E2 by using anastrozol. My E2 was not high, below 40. But I feel mentally better (less depressive, reactive and more energy, active, happy) when i reduce my E2 below 20.
Here it was often stated that 'men feel better', 'full symptom revolution' etc...I always wondered what that 'feel better' means or what the symptoms were. That's why I shared my mental symptoms. I guess it would help others if those symptoms are stated clearly.
Well, now we could argue what the minimum of E2 should be. There was a study that showed that low E2 by anastrozol resulted in less fat loss. What about mental scores?
After reading all your experiences I might try to go off medical record and increase the T dosage by other delivery methods. Why? Maybe I just need more T/DHT instead of less E2.
However there is another point: there seem to be men that convert more towards E2 and others towards DHT. Maybe there exists something like a underlying 'conversion imbalance'?

 

[Deleted member 43589]

Yeah so you respond incredibly well to testosterone. Sure you dose is low but your levels match someon that would be on 120 mg 1x a week. Thats why dose is irrelevant!

Exactly! Living proof that we are all very individual. My wife who is much smaller than me needs more of any medication for it to even work.

 

[jmbb]

However there is another point: there seem to be men that convert more towards E2 and others towards DHT. Maybe there exists something like a underlying 'conversion imbalance'?

This is something I've always hypothesized about why a certain percentage of men might require estrogen control no matter what the dose is. Some guys just make more E2. Some make tons of DHT but almost no E2. On paper everything could look fine, but it could just be converting at an inappropriate ratio for the individual, especially if they're more sensitive to the range/ratio that the metabolites are present in.

I hate blanket statements, and one you hear from the anti-AI crowd a lot is "the body knows what to do with testosterone and will convert the exact amount of estradiol needed." This may be true in a completely normally functioning male, but with exogenous test in men with hormonal dysfunction, that's a pretty major assumption to be making.

I think the balance is going to be different for everybody, which is why its so important to be open minded to the range of what works in hormone therapy.

 

[Charliebizz]

Thanks guys for sharing your experiences!

I'm dose-limited by androgel. The lever I can adjust is the amount of E2 by using anastrozol. My E2 was not high, below 40. But I feel mentally better (less depressive, reactive and more energy, active, happy) when i reduce my E2 below 20.
Here it was often stated that 'men feel better', 'full symptom revolution' etc...I always wondered what that 'feel better' means or what the symptoms were. That's why I shared my mental symptoms. I guess it would help others if those symptoms are stated clearly.
Well, now we could argue what the minimum of E2 should be. There was a study that showed that low E2 by anastrozol resulted in less fat loss. What about mental scores?
After reading all your experiences I might try to go off medical record and increase the T dosage by other delivery methods. Why? Maybe I just need more T/DHT instead of less E2.
However there is another point: there seem to be men that convert more towards E2 and others towards DHT. Maybe there exists something like a underlying 'conversion imbalance'?

I personally would stop chasing this magical e2 number. And just get on a proper dose of t. You most likely will never achieve that with androgel to be honest.

 

[Seagal]

I personally would stop chasing this magical e2 number. And just get on a proper dose of t. You most likely will never achieve that with androgel to be honest.

I was not chasing a magic e2 number! You probably don't know that many outside of the US are not free to choose the t dose and the delivery method. Androgel at a certain dosage is the only thing I can get prescribed. Unfortunately. Here there are serious legal risks with trying to acquire T. On top of that there is the problem with traveling even within Europe.
Otherwise I would have tried a long time ago.

 

[tropicaldaze1950]

I personally would stop chasing this magical e2 number. And just get on a proper dose of t. You most likely will never achieve that with androgel to be honest.

There was a guy who used to be on here and the old Yahoo testosterone group, @JanSz. He started out on some high dose of Androgel and it worked but his DHT went super high, resulting in prostate issues. Even with the generic versions of the various gels, IMO, one would have to use several tubes or bottles per month, which is a lot of money. Better to get high concentration compounded cream such as you're using.

 

[Seagal]

What were the symptoms that resolved for you guys only after reaching a 'proper dose of T' or 'high' T level?

Depressive state of mind, brain fog, fatique, libido, ED, little muscle strength, endurance, fat loss, etc.

 

[Charliebizz]

There was a guy who used to be on here and the old Yahoo testosterone group, @JanSz. He started out on some high dose of Androgel and it worked but his DHT went super high, resulting in prostate issues. Even with the generic versions of the various gels, IMO, one would have to use several tubes or bottles per month, which is a lot of money. Better to get high concentration compounded cream such as you're using.

janSz was a good guy but he was a nut also. How can you prove “high dht” caused prostate issues ? Plenty of men with normal or low dht have prostate issues. I’ve had a few bouts of prostatitis. Before trt. I also am having one as we speak. Should I blame the high dht from being on cream?

 

[Charliebizz]