Lab work on Sustanon 250. Feel nothing after 10 months

[Jamo81]

Hi Guys,

I'm posting here after discussing my case on the ******** group. But first let me explain myself.

I was born with a mild case of the rare condition called Eagle-Barrett Syndrome. My main symptoms of this are half my abdominal muscles are missing and both testicles undecended. One is currently inside my abdomen and the other is 'tethered' in my groin in an attempt to decend them manually when I was 4 years old. I'm 34 now, well today i'm 34.

I was put on TRT when I was younger to get me through puberty and stayed on it until I was 21. The past few years have seen a decline in my health, mainly lost muscle mass and extreme fatigue along with joint and bone pain in my hips and legs. I was put back on TRT back in December 2014 with one injection of Sustanon 250 every 3 weeks after being told both my testicles are now not working properly. I was initially told by my endo that they were going to decend them properly and see how they react but now my urologist said they need to be removed due to the increased chance they could become cancerous. Well he more or less stated they WILL become cancerous if left.

I'm not sure this is the correct direction, or even if i should have been put on TRT so hastily without further testing. I was recently sent to a spematologist to check fertility. This made little sense to me since I have been on therapy so long. Surely something like that need checked beforehand.

Anyway i'm going to share my blood work I've had over the past year or so to see if anything stands out. Many whom i've already spoke too have told they have never seen blood results like mine and when I ask my endo to attempt to explain them to me i'm not getting much feedback either.

23/09/2014 (Before TRT)

LH - 23.6 U/L (1.0-9.0)
FSH - 46.2 U/L (1.0-9.0)
Prolactin - 664 mU/L (0-350)
Testosterone - 27.0 nmol/L (8.4-28.7)
Cortisol - 649 nmol/L (275-690)
TSH - 3.13 mU/L (0.4-4.0)

25/11/2014 (Before TRT)

LH - 17.9 U/L (1.0-9.0)
FSH - 42.0 U/L (1.0-9.0)
Prolactin - 150 mU/L (0-350)
Testosterone - 20.6 nmol/L (8.4-28.7)
SHBG - 120.4 nmol/L (17.3-65.8 )
Free Androgen Index - 17.11 (23.3-103)

Began Sustanon 250 on 18/12/2014

07/04/2015

TSH 1.19 mU/L (0.4-4.0)
LH 6.6 U/L (1.0-9.0)
FSH 18.5 U/L (1.0-9.0)
Oestradiol 135 pmol/L (0-150)
Prolactin 204 mU/L (0-350)
Testosterone 38.8 nmol/L (8.4-28.7)
SHBG 87.5 nmol/L (17.3-65.8 )
Free Androgen Index 44.34 (23.3-103)
Total 25-OH Vitamin D 21 nmol/L

That's where I'm at just now, don't really feel any different to last year. I don't seem to react in anyway to therapy on the surface. My libido has always been good, but I feel it's frustratingly high now. Too high. I'd quite happily trade it in for better physical health.

I have got an endo appointment on the 1/10/15, I phoned my GP to see if more blood work has been requested beforehand in preparation but nothing has.

All in all I am really disappointed by the level of care I am getting. They want to remove both my testicles now but I'm seriously concerned about that, especially if i'm not reacting properly to testosterone. Perhaps there is something else wrong that they have yet to check that has been causing havoc with my hormones. They only check the bear minimums or what I ask them to. Begrudgingly of course.

Best Regards,

Jamie.

 

[Vince]

Jamie, Happy Birthday-you have many struggles to work through, I wish I could help. peace bro

 

[Jamo81]

Jamie, Happy Birthday-you have many struggles to work through, I wish I could help. peace bro

Thankyou Vince, yeah hopefully through time i'll get better.

 

[Gene Devine]

Let;s take a look:

TSH 1.19 mU/L (0.4-4.0)
This looks fine but for more Thyroid analysis you'd like to see FT4 and FT3 as well.


LH 6.6 U/L (1.0-9.0)
FSH 18.5 U/L (1.0-9.0)
These are fine given that you are on TRT; if not, they would be very elevated like you see in your labs prior to TRT.


Oestradiol 135 pmol/L (0-150)
This is your estrogen lab and I am not clear on the reference range. Generally we like to see this in the lower end of the reference range so it appears on surface that it may be somewhat high.


Prolactin 204 mU/L (0-350)
Fine.


Testosterone 38.8 nmol/L (8.4-28.7)
A bit high but given that you are on Testosterone replacement what you'd expect. Plus timing of your blood work in relationship to to your injection has a play here as well.


SHBG 87.5 nmol/L (17.3-65.8 )
Free Androgen Index 44.34 (23.3-103)
SHBG is elevated and beyond the reference range. This will have an impact on your Free Testosterone. Right now your Free Androgen is mid range so it's not that bad to be honest.


Total 25-OH Vitamin D 21 nmol/L

Your labs are not that bad to be honest and not really pointing to something that far out of the norm.

You really need to have more discussions with your Doctor's on why you feel like you do and request more testing; but from these labs they don't look that bad.

 

[MG123]

What dosage and schedule are you on with the Sustanon?

 

[Jamo81]

What dosage and schedule are you on with the Sustanon?

250mg every 3 weeks.

 

[Jamo81]

Let;s take a look:

TSH 1.19 mU/L (0.4-4.0)
This looks fine but for more Thyroid analysis you'd like to see FT4 and FT3 as well.


LH 6.6 U/L (1.0-9.0)
FSH 18.5 U/L (1.0-9.0)
These are fine given that you are on TRT; if not, they would be very elevated like you see in your labs prior to TRT.


Oestradiol 135 pmol/L (0-150)
This is your estrogen lab and I am not clear on the reference range. Generally we like to see this in the lower end of the reference range so it appears on surface that it may be somewhat high.


Prolactin 204 mU/L (0-350)
Fine.


Testosterone 38.8 nmol/L (8.4-28.7)
A bit high but given that you are on Testosterone replacement what you'd expect. Plus timing of your blood work in relationship to to your injection has a play here as well.


SHBG 87.5 nmol/L (17.3-65.8 )
Free Androgen Index 44.34 (23.3-103)
SHBG is elevated and beyond the reference range. This will have an impact on your Free Testosterone. Right now your Free Androgen is mid range so it's not that bad to be honest.


Total 25-OH Vitamin D 21 nmol/L

Your labs are not that bad to be honest and not really pointing to something that far out of the norm.

You really need to have more discussions with your Doctor's on why you feel like you do and request more testing; but from these labs they don't look that bad.

Thankyou.

What about my labs before starting therapy? Should I have been put back on TRT given just those two limited sets of tests? And do you see a positive impact on the figures before and after?

Regarding the tests, the first one was taken 1st thing in the morning but the others were taken at random points of the day. No particular point in the 3 week cycle.

Am I also right in thinking TRT will shut down HPTA functions and stopping sperm production? If so is it common practice to check while being on therapy this long.

As you may tell I'm really questioning the competence of these specialists I'm sent to. They're simply focused on having my testicles removed as a precaution. Fair enough if there not working properly and there is genuine risk then so be it. It's just some aspects of low T, libido and ED than many seem to suffer with have not been a problem with me. It's all physical. I'm weak, I can feel my legs going. I'm not a heavy man either. I'm 5ft5 and 9.5st, but 4 years ago was 12.5st and I wasn't overweight then either. My body composition has changed though.

I know my Vitamin D is prettly low, but i'm not sure if it causing or contributing to my issues. I have been supplementing D3 since May. Can't do any harm to raise that. Also take K2 and Magnesium alongside that.

Yes I wan't to push for them to check my thyroid properly, along with some other important things that could do with looking at. B12, Iron etc. My original TSH was a bit elevated.

I'm seeing the endo in a couple of weeks. I'll push him for answers on my concerns. I know 10 months isn't particularly long but I'm still getting worse.

 

[Jamo81]

Hi, just want to post up my recent blood work. It's quite limited though and was expecting something a bit more comprehensive. These were approximately 1 week after my sustanon injection. Testosterone 29.4 nmol/L (8.4-28.7) SHBG 106.1 nmol/L (17.3-65.8 ) Free Androgen Index 27.71 (23.3-103) TSH 2.21 mU/L (0.4-4.0) SHBG has gone back up a bit along with a decreased FAI. But I guess I need to figure out where abouts in my 3 week cycle my last bloods were drawn to compare.

 

[Jamo81]

Hi there guys,

Just wondering if anyone can shed anymore light in my last blood test. Am I right in thinking that the high SHBG is binding nearly all my total T, causing my low free T. Seems as my SHBG goes up, my free T comes down. And how would one expect to be feeling if this was the case and how can it be rectified bearing in mind I'm in the UK.

I requested my GP to write a letter to my endocrinologist about testing my levels at the end of my 3 week cycle and he responded accepting my request and depending on the results, may look to reducing dose frequency to 2 weeks instead of 3. I'm not sure of this will help my situation at the moment. I had the blood drawn just prior to my T shot a few days ago so still waiting on the results.

I feel my problems to begin with were more of a hormonal imbalance rather than a testosterone deficiency but I'm certainly no expert. I will also request having my thyroid looked more closely.

Do you think, given my persistent symptoms it would it be worthwhile looking at B12, folate, ferritin? My endocrinologist didn't think so anyway but then went and done a FBC which has come back all within range.

Many thanks.

 

[Jamo81]

Hi,

Anyone give me any guidance on my case please.

As I mentioned in my previous post I was waiting on blood work just prior to my previous injection at the end of a 3 week cycle. Unfortunately it was only total testosterone tested which came back at 21nmol/L, no SHBG to work out free testosterone so a bit despondent with this as it doesn't really tell me anything.

I'm really disappointed with the level of care my endocrinologist is giving me.

Best Regards,

Jamie

 

[CoastWatcher]

Has there been any discussion about Testosterone Enanthate or Cypionate? Are you in the UK?

 

[MG123]

Most guys don't have any luck with 2 week dosing, much less 3 weeks. Most guys find that they have to inject at least once a week in order to feel the effects of TRT. I personally inject every other day. Your SHBG is high, which would have an effect on your free androgen levels.

 

[MG123]

How do you feel the first few days after your injection?

 

[Jamo81]

Has there been any discussion about Testosterone Enanthate or Cypionate? Are you in the UK?

Hi, yes i'm in the UK. I was told at the beginning, that after a year we would assess the type of treatment and how I am responding. I'll be approaching that mark shortly but i've no appointment with the endocrinologist for a few months at least I imagine. I am seeing my urologist in 2 weeks though.

 

[Jamo81]

Most guys don't have any luck with 2 week dosing, much less 3 weeks. Most guys find that they have to inject at least once a week in order to feel the effects of TRT. I personally inject every other day. Your SHBG is high, which would have an effect on your free androgen levels.

Is it not strange to be still up at 21nmol/L total T after 3 weeks, most people will have dropped off by then below 12nmol/L. Does the high SHBG interfere with total T?

 

[Jamo81]

For most of the part I don't feel anything different after the injections. I mean I am in a constant 'up and down' roller coaster but there doesn't seem to be any relation to them and the injections. Although 2 days after my most recent dose I did pick up quite considerable and felt relatively good without pain but it lasted only about 3 days but it may just be coincidental.

 

[CoastWatcher]

Hi, yes i'm in the UK. I was told at the beginning, that after a year we would assess the type of treatment and how I am responding. I'll be approaching that mark shortly but i've no appointment with the endocrinologist for a few months at least I imagine. I am seeing my urologist in 2 weeks though.

I would urge you to consider asking to be switched to either Test-Enanthate or Test-Cypionate. The vast majority of members here at Excelmale are on one of these two testosterones. There is a strong consensus that smaller doses, delivered more frequently, result in greater satisfaction. For example, I'm injecting 60mgs of Test-Enth every Tuesday morning and Friday evening. Good solid levels, estradiol in range, and feeling good. A typical starting dose is 50mg every 3.5 days - one can work up from there.

 

[Nelson Vergel]

Jamo81

Sustanon 250 is used every 10 days in most overseas clinics.

I would check your thyroid function with a basic TSH, free T3 and free T4 panel.

You may also want to read this:

Fatigue- When Testosterone Is Not Enough

I would not spend the money on adrenal testing unless you can get your national health care system to pay, which I understand is very restricted in the UK. Do you get your Sustanon from your national health care system?


Are you tired even with normal testosterone? Adrenal fatigue may be the problem.

 

[Jamo81]

I would urge you to consider asking to be switched to either Test-Enanthate or Test-Cypionate. The vast majority of members here at Excelmale are on one of these two testosterones. There is a strong consensus that smaller doses, delivered more frequently, result in greater satisfaction. For example, I'm injecting 60mgs of Test-Enth every Tuesday morning and Friday evening. Good solid levels, estradiol in range, and feeling good. A typical starting dose is 50mg every 3.5 days - one can work up from there.

I will speak to my urologist about it. I think it would be worthwhile considering trying something else for better results sooner rather than later. Thankyou.

 

[Jamo81]

Jamo81

Sustanon 250 is used every 10 days in most overseas clinics.

I would check your thyroid function with a basic TSH, free T3 and free T4 panel.

You may also want to read this:

Fatigue- When Testosterone Is Not Enough



I would not spend the money on adrenal testing unless you can get your national health care system to pay, which I understand is very restricted in the UK. Do you get your Sustanon from your national health care system?


Are you tired even with normal testosterone? Adrenal fatigue may be the problem.

Hi,

Yes I get my Sustanon from the NHS and it also needs to be administered by a nurse. We're still pretty much in the dark ages regarding TRT over here.

I have been looking into adrenal fatigue and although i've not had any testing done I have cleaned my diet up considerably, had bad teeth removed. Trying to give myself the best chance. Many doctors in the UK do not even believe in adrenal fatigue. What is your thought on Candida? I have had a visible skin infection recently, my endo said to use Daktarin on it and it has cleared up but wouldn't that be a sort of marker of a bigger issue?

I have only had my basic TSH tested 3 times over the last year or so and although they all fell within the reference range they were scattered at each end of the spectrum. Lower, higher and right in the middle. Endocrinologist didn't seem to be bothered about it but I will get it checked further although has likely not even noticed. My mother has recently been diagnosed with hyperthyroydism and suffers with fatigue and weight loss. Even though I have been a stable 9.5 stone for a few years now, prior to then I had lost around 2 stone quite quickly. Mainly muscle mass and sort of coincides with the beginning of my decline in health.

Again, many thanks for all your help, it is really appreciated.

Jamie