I need to Lower Testosterone Levels, while on Cypionate, for a Blood Test

[CoronaCA]

Hello everyone, this will be my first post, but I do not know where else to turn.

Long story short, I started TRT a little over two years ago. Prior to my current job, I had a PPO and visited the Low T Center for all my care. They listened, they tested, they treated. I am now stuck with an HMO and am not getting the same level of care.

For almost two years my regimen has been testosterone cypionate @140mg weekly.
-I started with a new endocrinologist and he adjusted my dosage to 150mg weekly, because they couldn't draw 140mg.
-3 months later, testing. Was out of range for his testosterone testing, lowered my dosing to 125mg weekly. I started feeling tired, more moody, a little off on day 6 & 7. BUT I could survive.
-1 month later, testing. Was in range for everything. However, the FDA issued a warning on clotting and testosterone and forced it on the label. Lowered dosing to 100mg weekly. This is my second week into that and I cannot survive. I'm anxious, I cannot sleep, I have no energy, no sex drive, cannot think straight, and can say that I'm depressed... The only time that I am not is on day 2-4.

What can I do to crash my testosterone levels for my next blood work test. This doctor won't see me for another month and I don't know what to do except to go out of pocket and seek a new doctor. I hate to cheat on a test, because I am have ALWAYS been 100% straightforward with every question and every test, but I have been written up at work for not meeting sales quota and me and my wife are at odds because I'm not myself...

Here are my panels:

[TH="class: name fixed"]Name Standard range[/TH]
[TH="class: scroll"]11/6/14
140MG Weekly
(Prior to this test)
[/TH]
[TH="class: scroll"]1/28/15
150MG Weekly
(Prior to this test)
[/TH]
[TH="class: scroll"]3/4/15
125MG Weekly
(Prior to this test)
[/TH]
[TH="class: buffer scroll"][/TH]

[TD="class: name fixed"]HCT, AUTO 42.0 - 52.0 %[/TD]
[TD="class: scroll"]49.4[/TD]
[TD="class: scroll"]46.5[/TD]
[TD="class: scroll"]49.0[/TD]
[TD="class: buffer scroll"][/TD]

[TD="class: name fixed"]HGB 14.0 - 18.0 g/dL[/TD]
[TD="class: scroll"]17.0[/TD]
[TD="class: scroll"]15.9[/TD]
[TD="class: scroll"]17.0[/TD]
[TD="class: buffer scroll"][/TD]

[TD="class: name fixed"]MCH 27.0 - 35.0 pg/cell[/TD]
[TD="class: scroll"]32.6[/TD]
[TD="class: scroll"]32.9[/TD]
[TD="class: scroll"]33.3[/TD]
[TD="class: buffer scroll"][/TD]

[TD="class: name fixed"]MCHC 32.0 - 37.0 g/dL[/TD]
[TD="class: scroll"]34.3[/TD]
[TD="class: scroll"]34.2[/TD]
[TD="class: scroll"]34.8[/TD]
[TD="class: buffer scroll"][/TD]

[TD="class: name fixed"]MCV 80.0 - 94.0 fL[/TD]
[TD="class: scroll"]95.2[/TD]
[TD="class: scroll"]96.0[/TD]
[TD="class: scroll"]95.7[/TD]
[TD="class: buffer scroll"][/TD]

[TD="class: name fixed"]PLATELETS, AUTOMATED COUNT 130 - 400 x1000/mcL[/TD]
[TD="class: scroll"]139[/TD]
[TD="class: scroll"]173[/TD]
[TD="class: scroll"]161[/TD]
[TD="class: buffer scroll"][/TD]

[TD="class: name fixed"]RBC, AUTO 4.70 - 6.10 Mill/mcL[/TD]
[TD="class: scroll"]5.20[/TD]
[TD="class: scroll"]4.84[/TD]
[TD="class: scroll"]5.12[/TD]
[TD="class: buffer scroll"][/TD]

[TD="class: name fixed"]RDW, BLOOD 11.5 - 14.5 %[/TD]
[TD="class: scroll"]13.2[/TD]
[TD="class: scroll"]13.4[/TD]
[TD="class: scroll"]13.0[/TD]
[TD="class: buffer scroll"][/TD]

[TD="class: name fixed"]WBC'S AUTO 4.0 - 11.0 x1000/mcL[/TD]
[TD="class: scroll"]5.6[/TD]
[TD="class: scroll"]8.4[/TD]
[TD="class: scroll"]8.1[/TD]

[TH="class: name fixed"]Name Standard range[/TH]
[TH="class: scroll"]11/6/14
140MG Weekly
(Prior to this test)
[/TH]
[TH="class: scroll"]1/28/15
150MG Weekly
(Prior to this test)
[/TH]
[TH="class: scroll"]3/4/15
125MG Weekly
(Prior to this test)
[/TH]
[TH="class: buffer scroll"][/TH]

[TD="class: name fixed"]TESTOSTERONE, TOTAL 249 - 836 ng/dL[/TD]
[TD="class: scroll"]561[/TD]
[TD="class: scroll"]870[/TD]
[TD="class: scroll"]768[/TD]
[TD="class: buffer scroll"][/TD]

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[TH="class: name fixed"]Standard range[/TH]
[TH="class: scroll"]11/6/14
140MG Weekly
(Prior to this test)
[/TH]
[TH="class: scroll"]1/28/15
150MG Weekly
(Prior to this test)
[/TH]
[TH="class: buffer scroll"][/TH]

[TD="class: name fixed"]IRON 59 - 158 mcg/dL[/TD]
[TD="class: scroll"]172[/TD]
[TD="class: scroll"]81[/TD]
[TD="class: buffer scroll"][/TD]

[TD="class: name fixed"]IRON SAT 20 - 50 %[/TD]
[TD="class: scroll"]52[/TD]
[TD="class: scroll"]27[/TD]
[TD="class: buffer scroll"][/TD]

[TD="class: name fixed"]TOTAL IRON BINDING CAPACITY 250 - 425 mcg/dL[/TD]
[TD="class: scroll"]334[/TD]
[TD="class: scroll"]305[/TD]
[TD="class: buffer scroll"][/TD]

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As a side note, I was talked to about my high iron level. I changed my diet and made some huge improvements by not eating red meats and cereals (go figure, cereals contain a TON of iron. cherrios is not heart healthy when on TRT).

Any advice would be greatly appreciated.

 

[Vettester Chris]

Corona, welcome to EM! Was just down off the 15 & 91 yesterday, what a mess!

Hey, your total serum looks OK. When are you drawing labs in relation to your injections? Let's look at free test (SHBG if you have it will do?), plus D3, DHEA; or possibly a full diurnal cortisol with DHEA correlation?

For the sake of your thyroid, I would suggest trying to keep your iron serum in the upper 70% to 85% of its reference range. 120mcg to 135mcg would be a good aiming point, but you also need to ensure ferritin levels are adequate. Thyroid hormone is dependent on many of these values to get into the cells of the body. So with that said, you will no doubt want to look at a complete thyroid panel. If you have one please post the results. Thanks

 

[Vettester Chris]

Also, IMO, I truly don't see 150mg per week going down to 100mg/wk to be a huge culprit to all the symptoms you described. Not saying that things are optimal, but I think there's other factors that need to be reviewed, i.e., E2, cortisol, DHEA, back filling with Pregnenolone, D3, B12 methyl, and a review of your metabolic profile. There's just a variety of possibilities. If you are "secondary", you would probably benefit from a little HCG throughout the week.

 

[CoronaCA]

Also, IMO, I truly don't see 150mg per week going down to 100mg/wk to be a huge culprit to all the symptoms you described. Not saying that things are optimal, but I think there's other factors that need to be reviewed, i.e., E2, cortisol, DHEA, back filling with Pregnenolone, D3, B12 methyl, and a review of your metabolic profile. There's just a variety of possibilities. If you are "secondary", you would probably benefit from a little HCG throughout the week.

[TH="class: name fixed"]Name Standard range

[/TH]
[TH="class: scroll"]11/6/14[/TH]
[TH="class: buffer scroll"][/TH]

[TD="class: name fixed"]ESTRADIOL 8 - 43 pg/mL

[/TD]
[TD="class: scroll"]25[/TD]
[TD="class: buffer scroll"][/TD]

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[TH="class: name fixed"]Name Standard range
[/TH]
[TH="class: scroll"]11/6/14[/TH]
[TH="class: buffer scroll"][/TH]

[TD="class: name fixed"]SEXHORMONE BINDING GLOBULIN 14 - 48 nmol/L
[/TD]
[TD="class: scroll"]13[/TD]
[TD="class: buffer scroll"][/TD]

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Thats all I have. The rest were other tests for PSA and Liver Panels, which are both in range. Only INITIAL testing of both those were done when starting treatment, none were followed up with. I will write this down and demand further testing for those that you listed when I visit him next.

As far as HCG, I was using HCG and Arimidex while at the Low T Center, but when I arrived at my HMO they refused to continue those treatments. They halted Arimidex because it is not approved for long term care for that use. They stopped HCG because I was told either I give up natural production and the possibility of children in the future or I rely on my bodies natural ability to create testosterone - there is not the possibility for the best of both worlds. My testicles have since atrophied and become smaller. I had maintained a majority of their size with HCG prior to this.

 

[Vettester Chris]

That E2 result "could" be quite low on a sensitive reading. Your posted lab is a standard assay, excellent for peri/post menopausal females, but not so much for males. I believe there's a Labcorp in Norco, definitely Corona .. You can get a E2 sensitive assay relatively easily through Discounted Labs. Check it out.

Just my opinion, I don't think your medical team is doing you any favors! I would think they would be all over your thyroid and other labs. I started out in the same boat ... You need a team that really knows how to treat hormones. If you can get thyroid labs, run Free T4, Free T3, Reverse T3, TSH & Antibodies TPO & TgAb