Hello from Germany - Switching From Nebido to Enanthate

[Hellraiser]

Hey folks,

Greetings from Germany!
I'm currently 24 years old and have been on TRT since February 2016, mainly due to anxiety disorder. Funnily, a doctor - who focused on my thyroid due to the aforementioned psychological symptons - discovered the testosterone deficiency more or less by accident after all the thyroid tests came out positive.
I already read loads of information regarding TRT and the use of testosterone in a bodybuilding context on a german bodybuilding forum and the TRT subreddit. However, I still have a lot to learn and hope that this community will help me do so. Especially in light of the fact that I'm currently rather unhappy with my treatment.
It seems I metabolise the testosterone rather quickly, so my endo reduced the injection period of Nebido to 6 weeks. Finally there seems to be progress regarding my total testosterone value, even though I don't feel any better, to be honest. Especially the last days have been rough with sudden mood swings and strong anxiety kicking in again. Apart from that, my libido isn't really there where I would like it to be.
Today I also compiled my main blood levels (I have loads more, as the doctor also checked me for adrenal fatigue prior to transfering me to the endo; if you're interested, I can also upload these and some others) into an excel spreadsheet, for the sake of clarity for you guys.



From my perspective it seems my thyroid values aren't really where they should be, even though I supplement selenium and Lugol's iodine; more on supplements later.
Also I think, although not really sure, that my SHBG is rather on the low end. Do you think I'd qualify for a low SHBG patient, thus metabolising the testosterone undecanoate so fast?
On a related note, being in Germany, I don't have access to the sensitive assay for measuring Estradiol. Also, my endo seems rather reluctant to prescribe testosterone enanthate (maybe I can talk him around in the long run, who knows). The same goes for HCG, I think, because I asked him if it would be possible to use as off-label-use prior to my first Nebido injection, and even though he said yes initially, I haven't got a response on the topic thus far.
To give you more context on my lifestyle: I work out four times a week (have been working out for about 3 years now) with a friend of mine, who is really experienced bodybuilding wise. Still, I really have a hard time putting on significant amount of muscle, but I attribute this to my lack of testosterone.
I eat about 3900 calories on rest-days and 4200 calories on training days. Beeing a pescetarian, my main source of protein is fish, apart from eggs and milk/low fat quark. I also put a big emphasis on my vegetable intake, so my daily goal is to eat at least 500 grams of veggies; this is complemented by about 200-300 grams of fruits.
My main carbohydrate source is white rice, even though I also eat potatoes from time to time. Noodles are rather the exception that the rule for me personally.
I could go on about nutrition all day, but I think you get the picture. Also, I want to mention that I cook my food every day and my sugar/processed food intake is basically none. The one sweet I eat daily is a little piece of dark chocolate (ranging from 70 to 100% cacao).
The supplements I use are as follows:
- Vitamin D/K2 drops, 5000 iu (Vitamin D) daily
- 200 mcg Selenium daily
- Magnesium citrate, although I don't consume a fixed amount daily
- 25mg Zinc bisglycinate daily
- 1 drop of 5% lugol's iodine, even though I up the intake from time to time; I'm rather reluctant to go to the full 50mgs as per Dr. Brownsteins recommendations, prior to doing a iodone saturation test.
- 2 tablespoons of psyllium husks

To sum it up, I hope to receive a lot of feedback from you guys, so I/we can work out how to improve my TRT experience in the long term!

Best regards

 

[Hellraiser]

Hey guys,

so my premonition proved to be right, after the last blood tests came back. Somehow my Testosterone level has crashed, which might have caused the anxiety and mood swings mentioned in my last post.


Im really at a loss as to why my T levels suddenly crashed without any change. Do you have any idea? Might this be due to further decreasing SHGB?
Yesterday I had sort of an 'emergency-call' with my endo: after describing how I felt and seeing my latest blood tests, he accepted my proposal of trying testosterone enanthate. We will try this out for four weeks and after that period we will draw blood again and also see if I feel any better.
So, in context of my blood values, which injection intervall should I use? Once a week, every 3.5 days...? Also, what dosage should I start with? I have thought about 100mgs but I'm not really sure whether that'S too low, given my bloodwork. Could really use your help here!

 

[CoastWatcher]

Welcome to Excelmale. Your SHBG is certainly low. As for your testosterone enanthate dose, a protocol calling for 50mg every 3.5 days (100mg every week) is a reasonable starting dose. Proceed for four to six weeks and check your levels. Was any discussion undertaken in regard to your young age and hypogonadism?

 

[Hellraiser]

Would you consider 100mgs resonable even though it seems I metabolise rather much testosterone undecanoate (1000mgs/6 weeks = 166 mgs per week)?
I had a MRI prior to the therapy to rule out a prolactinoma. Also, as mentioned before, the doctor who referred my to my current endo took blood values to rule out adrenal fatigue and checked my thyroid. In both cases he said I was absolutely fine. My endo also checked my testes before beginning the TRT, but they were fine as well. Nevertheless, I can post those blood tests if you're interested.

 

[CoastWatcher]

Would you consider 100mgs resonable even though it seems I metabolise rather much testosterone undecanoate (1000mgs/6 weeks = 166 mgs per week)?
I had a MRI prior to the therapy to rule out a prolactinoma. Also, as mentioned before, the doctor who referred my to my current endo took blood values to rule out adrenal fatigue and checked my thyroid. In both cases he said I was absolutely fine. My endo also checked my testes before beginning the TRT, but they were fine as well. Nevertheless, I can post those blood tests if you're interested.

It would be interesting to see your test results. I have low SHBG, clear testosterone quickly, and found success on a protocol that calls for me to inject 16mg of testosterone enanthate every morning; I post levels at the 1000 mark. It is always easier to begin therapy with lower doses of testosterone and ramp up if that is called for. Starting with higher doses than may be necessary can provoke side effects that complicate matters and impede your therapy.

 

[Hellraiser]

So, here are the values of the doctor who checked me for adrenal fatigue and also my thyroid; if there's need for a translation just say so.

 

[snorgejr]

Did you sort this one out? What's your current state of affairs? I'm in a very similar situation to what you were before starting TRT, trying to figure out where to begin.

 

[Systemlord]

I'm seeing a steady decrease of SHBG that is coinciding with an increase in TSH, Reverse T3 has never been tested and can oppose good Free T3 since it competes for the same receptor. This mechanism would lower SHBG since it would slow down every cell in you body including the livers output of SHBG. Men with SHBG under 20 would benefit for injections EOD.

A TSH of 2.71 is clearly hypothyroid territory.

 

[Hellraiser]

@snorgejr: since ~May 2017 I've been injecting 125 mgs of Testosterone Enanthate three times a week (Monday - Wednesday - Friday). My levels have been rather stable since then for the most part and I've been feeling better than before (especially anxiety-wise).
But my last bloodtest leaves me rather puzzled. As a bit of context, between October 2017 und January 2018 I went on a weight-loss diet, losing about 8-10 kgs of fat. In that time, my bloodwork had been steadily improving with regards to the low SHBG.
How come, since if ended my diet and being in the process of gaining weight, my TSH has suddenly dropped that much and my T4 being slightly elevated? Also SHBG has dropped again as well as testerone - total and free. I also have the impression that, despite how much effort I put into my eating (tracking macros, eating really healthy) and lifting in the gym, I really have a hard time gaining a signifcant amount of muscle. This is also the case with increasing the weights used in the gym.
Oh, another thing I have just noticed: my DHEA-S (reference range: 160-449) has been elevated all the time, with my last value being 649. How do I account for this?

Here's a link to my latest bloodwork: https://www2.pic-upload.de/img/35585837/TRT.png

 

[DragonBits]

You supplement with

1 drop of 5% lugol's iodine, even though I up the intake from time to time;

I don't have any personal experience with supplementing iodine in larger than 200 mcg doses, but other posters such as Vince have stated large iodine doses have a strong effect on thyroid hormones.

So I would first look at your lugol's iodine as being a possible cause of changes in TSH and other thyroid hormones.

Your changes in Total Testosterone, first I would make sure I was testing at the same time in regards to your injections of testosterone, as that could cause large fluctuations in values. Nebido takes 12-15 months to reach steady state, while Testosterone Enanthate has a much shorter time to reach steady state. Also, in the beginning, your own production of natural Testosterone will be falling in a somewhat unpredictable manner.

 

[madman]

@snorgejr: since ~May 2017 I've been injecting 125 mgs of Testosterone Enanthate three times a week (Monday - Wednesday - Friday). My levels have been rather stable since then for the most part and I've been feeling better than before (especially anxiety-wise).
But my last bloodtest leaves me rather puzzled. As a bit of context, between October 2017 und January 2018 I went on a weight-loss diet, losing about 8-10 kgs of fat. In that time, my bloodwork had been steadily improving with regards to the low SHBG.
How come, since if ended my diet and being in the process of gaining weight, my TSH has suddenly dropped that much and my T4 being slightly elevated? Also SHBG has dropped again as well as testerone - total and free. I also have the impression that, despite how much effort I put into my eating (tracking macros, eating really healthy) and lifting in the gym, I really have a hard time gaining a signifcant amount of muscle. This is also the case with increasing the weights used in the gym.
Oh, another thing I have just noticed: my DHEA-S (reference range: 160-449) has been elevated all the time, with my last value being 649. How do I account for this?

Here's a link to my latest bloodwork: https://www2.pic-upload.de/img/35585837/TRT.png

What is your protocol.....125mg/week t cyp split into 3 weekly injections (M/W/F)?

I would not be too concerned with your total t and concentrate on your free t numbers.....especially seeing you have low shbg you may need to go to EOD or daily injections.

As far as body composition changes do not expect to gain significant amounts of muscle using trt doses as one would need to use testosterone in much higher doses to achieve testosterone levels well into the supra-physiological range.

When on trt and one has hormones in check whether testosterone levels (total t/free t) are in the mid-normal or high-normal physiological range along with a healthy e2 and one has diet/training in check than realistic body composition changes are achievable (gain muscle/strength, loss body fat) but significant gains in muscle are not going to happen as steroid doses would be needed!

The highest your free t has been 9/11/2017 was 34.02 and your most recent labs 5/28/2018 it was 23.44 (slightly below mid range).

How did you feel overall when your TT/free t were at their highest -9/11/2017 when your TT 866 and free t 34.02 and also during 11/06/2017 when your TT 805 and free t 33.09?

 

[Hellraiser]

@DragonBits:I'm aware of the effects iodine has on the thyroid (apart from a myriad of other effects in the body). I totally to forgot to mention that I stopped using Lugol's some time ago. Even though this might account for a change in levels, I'm still puzzled as to why my TSH was elevated while supplementing iodine (according to literature, TSH should decline after a initial period) and after stopping it, TSH began to actually decline while T4 is elevated. Might there be some disfunction of conversion from T4 to T3 or the like?

Also I'm equally puzzled as to the rising and now declining SHBG and my ever-elevated DHEA-S levels. Shouldn't the latter even decline due to TRT?

@madman: Exactly, that's my injection protocoll. I always test on Mondays prior to my injection because at this point - having not injected for two days - my levels should be lowest.

And I can assure you that I'm fully aware of the distinction between possible natural muscle gains and while being enhanced. But especially in the light of this, and being surrounded by a lot of very muscular, naturally training friends, the general impression is (others also have mentioned this to me) that I really don't gain muscle in the way I should - considering how rigorous the training is and how much effort I put into my nutrition. Of course, genetics do play an important role and account for a large variance between people - but still, I just can't lose the feeling that still there's something off and hindering me.

With respect to my feeling at those points, I think it's very hard to answer. In ~september 2017 I started my diet and thus 'in the zone' mentally. Also, I went through relationshop troubles at the time leading to a break-up in december, which was very taxing on me mentally.