Please help; getting thoughts together for initial consult with Dr Saya

[Deleted member 16042]

Please help!

I wrote my entire story in a previous thread that got essentially zero response relating to the hormone issues, so I had it deleted. Trying again leaving out the other things that seemed to derail what I actually wanted to ask.

If I have to, I'll separate things into sub threads for the various forum sectors. Let me know if this would be a good approach.

I have initialconsultation with Saya next week. (Finally! I've been living the nightmare of mismanaged TRT for many months)…

Currently on 150mg Tplus 50 mg chrysin/gram compounded cream, 1g/day. Cookie cutter formula from MD who did not check SHBG, LH, DHEA prior to TRT, nor specified ANY followup. Started this last December. Initial result, notable increase in libido(which never was really bad anyway), some more energy and ability to recreate. This lasted several months then testicular pain and atrophy took over, mood and exercise tolerance decreased… downward spiral.

Bloods drawn for Defy initial test attached below, I'll forego the longer part of the story, but I was ramping the topical dose back up when bloods were drawn, probably about .8-.9g/day at that time, and blood was drawn a couple hours after morning administration.

-Postive T related symptoms on TRT; excellent morning wood, OK/better libido, growing a slight bit more body hair.

-Negative symptoms(but indicate T is/has shut down LH and HPTA so I am certainly getting T through replacement): shrunken testicles, atrophy pain has mostly subsided, except I have pain with scrotum retraction,including during sex/ejaculation.

-Other generally negative symptoms: Ongoing moodiness/mood swings like I have never had before, depression, anxiety, (I do have history and sort of baseline with PSTD, Depression and anxiety, but the last 3-4 months have been markedly worse). Also mood swings worse when taking 1g cream at once, seems a little better splitting dose around 70/30% morning/evening. Some night sweats mostly around chest, also seem reduced on split dose. Poor exercise capability and recovery, ongoing fatigue.

I didn't want to mess with things much before the consult next week, but seeing the DHEA number, I started 25mg micronized DHEA BID, but got an ongoing headache so backed off to 25mg/day with dinner. (Also the first brand had added maltodextrin, which relates to food sensitivities I have,so I changed to a brand without maltodextrin… headache is gone, I may up dosage to BID again.) The result of taking DHEA seems to be very slightly more emotional stability, but really inconclusive.

Please let me know any thoughts, what to ask/consider with my consultation.

 

[ratbag]

Looks like your Estradiol (E2) sensitive looks low. Your chrysin compounded cream is an AI (aromatase inhibitor)and perhaps you should avoid that until you see Dr. Saya. You are likely suffering from low E2. Search here for low E2 or E2 crashed and read up on the symptoms. When I get low E2 I get morning wood and I can have sex but the orgasm is hard to have and if I do have one I don't feel much pleasure out of it.

 

[Deleted member 16042]

Looks like your Estradiol (E2) sensitive looks low. Your chrysin compounded cream is an AI (aromatase inhibitor)and perhaps you should avoid that until you see Dr. Saya. You are likely suffering from low E2. Search here for low E2 or E2 crashed and read up on the symptoms. When I get low E2 I get morning wood and I can have sex but the orgasm is hard to have and if I do have one I don't feel much pleasure out of it.

Thanks.

Chrysin is combined with T in a single tube. Can't separate them. If I could self prescribe, I'd up the T concentration, and get rid of the chrysin! Seems like the logical first step.

Re: low E2 issues, I'm a little confused if all my symptoms fit... Mood swings/anxiety/depression and night sweats from LOW E2?

I guess I am little less self aware/critical of quality of orgasm. Most are good, some a bit less intense, but seems like it also has a lot to do with pace and intensity of a lovemaking session. Never had much trouble to speak of (except for the noted testicular atrophy scrotal retraction problems), but things do vary. In the greater context, really the least of my worries.

 

[hva]

Re: low E2 issues, I'm a little confused if all my symptoms fit... Mood swings/anxiety/depression and night sweats from LOW E2?

Those are low E2 symptoms. You might also have some joint pain, constant thirst, and low libido from low E2. High and low E2 symptoms are similar but for most low E2 is much worse to deal with due to the anxiety, moodiness, and overall broodiness.

Dr. Saya will get you fixed up no doubt.

 

[Deleted member 16042]

Those are low E2 symptoms. You might also have some joint pain, constant thirst, and low libido from low E2. High and low E2 symptoms are similar but for most low E2 is much worse to deal with due to the anxiety, moodiness, and overall broodiness.

Dr. Saya will get you fixed up no doubt.

You got the moody broody part spot on! Friggin awful! And yes, joint pain has been worse lately.

But I guess I don't know about low libido. I just never perceived it as a problem, only noticed having more when starting TRT. Actually kind of a pain for my wife, her's has dropped quite a lot with menopause, but she won't consider any kind of hormone therapy for herself, so I am kind of a pest for her affections these days.

I don't tend to have much thirst at all, have to push myself to stay hydrated, seems my thirst is not a good indicator of hydration level for me these days.

 

[hva]

My wife is also a Defy patient and I would highly recommend. She's on testosterone cream and between the two of us we are like teenagers again.

 

[Deleted member 16042]

I wish. No way she'd go that route.

 

[Systemlord]

I'll never understand why people will chose to suffer rather than receive treatment, who doesn't want to feel like a teenager again?!

 

[Deleted member 16042]

She's happy, she doesn't suffer.

OK, this is quite a tangent, can we focus back on the original topic?

How about things like:

-appropriate amount of DHEA supplementation?
-strategies for changing protocols... one at a time or several at once?
-TSH level?
-I know reported benefits of HCG, Seems I could benefit, and I like the theory of backfilling pathways, but what are potential drawbacks in my context?

-What else am I not thinking of to ask Dr Saya that I should?

 

[ratbag]

I would wait on the DHEA... only because your protocol appears to be incorrect by having low E2 and still taking that AI compounded in with the test. Dr. Saya will likely put you on HCG and get you off AI's and once you've been thru 6 weeks of that you'll know where you stand.

 

[Matt Leiser]

Dr Saya will customize your protocol for you. As for strategies for changes to your protocol after that I recommend changing one variable at a time. That way you know what the change does for you. It will take time to find your sweet spot. Persevere. This is a marathon not a sprint.

I wish you the best.

 

[Deleted member 16042]

I would wait on the DHEA... only because your protocol appears to be incorrect by having low E2 and still taking that AI compounded in with the test. Dr. Saya will likely put you on HCG and get you off AI's and once you've been thru 6 weeks of that you'll know where you stand.

Thanks, but too late! I was thinking the same, but have been feeling so bad and desperate, I had to try something, seemed the least radical of all choices at the time. I've been on DHEA for about 2 weeks, and as stated, decreased it to a single 25mg dose each evening. Maybe slightly less mood problems and I missed a dose one day and had a particularly bad day the next. Not going to change anything further until the consultation. Only 5 days away!!!


I am open to HCG, seems a potentially good solution for me, but one concern there is I travel a lot, I mean months at a time. Seems the mixed hcg need refrigeration? Could be really troublesome. There are many days where I change location

 

[Deleted member 16042]

Dr Saya will customize your protocol for you. As for strategies for changes to your protocol after that I recommend changing one variable at a time. That way you know what the change does for you. It will take time to find your sweet spot. Persevere. This is a marathon not a sprint.

I wish you the best.

Thanks I do realize the changes take time... so does the wait for Saya. I started the process in May and encountered numerous hurdles some of which resulted in my own indecision> Finally decided to go for it in June. The waiting and my health in the meantime have been misery.

 

[madman]

Please help!

I wrote my entire story in a previous thread that got essentially zero response relating to the hormone issues, so I had it deleted. Trying again leaving out the other things that seemed to derail what I actually wanted to ask.

If I have to, I'll separate things into sub threads for the various forum sectors. Let me know if this would be a good approach.

I have initialconsultation with Saya next week. (Finally! I've been living the nightmare of mismanaged TRT for many months)…

Currently on 150mg Tplus 50 mg chrysin/gram compounded cream, 1g/day. Cookie cutter formula from MD who did not check SHBG, LH, DHEA prior to TRT, nor specified ANY followup. Started this last December. Initial result, notable increase in libido(which never was really bad anyway), some more energy and ability to recreate. This lasted several months then testicular pain and atrophy took over, mood and exercise tolerance decreased… downward spiral.

Bloods drawn for Defy initial test attached below, I'll forego the longer part of the story, but I was ramping the topical dose back up when bloods were drawn, probably about .8-.9g/day at that time, and blood was drawn a couple hours after morning administration.

-Postive T related symptoms on TRT; excellent morning wood, OK/better libido, growing a slight bit more body hair.

-Negative symptoms(but indicate T is/has shut down LH and HPTA so I am certainly getting T through replacement): shrunken testicles, atrophy pain has mostly subsided, except I have pain with scrotum retraction,including during sex/ejaculation.

-Other generally negative symptoms: Ongoing moodiness/mood swings like I have never had before, depression, anxiety, (I do have history and sort of baseline with PSTD, Depression and anxiety, but the last 3-4 months have been markedly worse). Also mood swings worse when taking 1g cream at once, seems a little better splitting dose around 70/30% morning/evening. Some night sweats mostly around chest, also seem reduced on split dose. Poor exercise capability and recovery, ongoing fatigue.

I didn't want to mess with things much before the consult next week, but seeing the DHEA number, I started 25mg micronized DHEA BID, but got an ongoing headache so backed off to 25mg/day with dinner. (Also the first brand had added maltodextrin, which relates to food sensitivities I have,so I changed to a brand without maltodextrin… headache is gone, I may up dosage to BID again.) The result of taking DHEA seems to be very slightly more emotional stability, but really inconclusive.

Please let me know any thoughts, what to ask/consider with my consultation.

What was the exact protocol you were on when these labs were drawn and were you using an aromatase inhibitor at this time? What is your protocol now? Your total t is barely mid-range and free t is way too low also sensitive e2 is really low and definitely need to look into thyroid as your number is near the top end and ldl is high which needs to be improved upon.

 

[madman]

Looks like your Estradiol (E2) sensitive looks low. Your chrysin compounded cream is an AI (aromatase inhibitor)and perhaps you should avoid that until you see Dr. Saya. You are likely suffering from low E2. Search here for low E2 or E2 crashed and read up on the symptoms. When I get low E2 I get morning wood and I can have sex but the orgasm is hard to have and if I do have one I don't feel much pleasure out of it.

Highly doubtful chrysin would be effective as an aromatase inhibitor there are no human studies stating it is maybe in a petri dish. Naturopaths/Bio-Identical hormone specialists push that sort of thing and are known for adding it to patients protocol to supposedly reduce e2. If chrysin was so effective no one would waste time using arimidex.


http://www.sciencedirect.com/science/article/pii/S096007600100098X
https://www.ncbi.nlm.nih.gov/pubmed/10997957

 

[Deleted member 16042]

What was the exact protocol you were on when these labs were drawn and were you using an aromatase inhibitor at this time? What is your protocol now? Your total t is barely mid-range and free t is way too low also sensitive e2 is really low and definitely need to look into thyroid as your number is near the top end and ldl is high which needs to be improved upon.

"Protocol" exactly as stated above, compounded cream 150mg T plus 50mg chrysin/gram, 1g/day, and was at the time increasing dose, so actual more like .8-.9g/day at time of test. Blood drawn a couple hours after application as specified by Defy.

Yes, I understand the numbers pretty much exactly as you do. Why they are still so low could be due to inadequate prescribed dose, inadequate control on compounding, i.e. actual topical concentration is lower than prescribed, or for whatever reason I am not absorbing transdermal well.

Re: lipids, I intentionally left out the cardiac history in this thread because it derailed the last. I have been around the block in regards to cardiac and lipids. That's an entirely separate topic.

 

[Deleted member 16042]

Re: Thyroid, previous MD said nothing. Blood test results from 1 yr ago:

Thyroid
TSH 3.880 uIU/mL 0.450 - 4.500
Thyroxine (T4) 4.7 ug/dL 4.5 - 12.0

And:

T4F+T3F
Triiodothyronine, Free, Serum 2.1 pg/mL 2.0 - 4.4
T4, Free(Direct) 1.21 ng/dL 0.82 - 1.77
Reverse T3, Serum 17.8 ng/dL 9.2 - 24.1

 

[ratbag]

Highly doubtful chrysin would be effective as an aromatase inhibitor there are no human studies stating it is maybe in a petri dish. Naturopaths/Bio-Identical hormone specialists push that sort of thing and are known for adding it to patients protocol to supposedly reduce e2. If chrysin was so effective no one would waste time using arimidex.

Then why do so many MD's use chrysin as an AI? Your missing the point. How effective chrysin is, is besides the point. His E2 is low and because of that chrysin should not be compounded into his testosterone. And you think your google search can prove it has no effect on him? You don't know that, you are making an assumption at the very best.

Blackhawk, your thyroid needs attention.

 

[Deleted member 16042]

Willow bark or Aspirin?

Foxglove or digitalis or digoxen?

red rice yeast or lipitor?

So jury is out on chrysin. I personally don't seem to be benefiting from an AI effect... if there is one.


Thanks for the thyroid heads up.