Possible edema? Side-effect management?

[wintermute]

So I recently was put on this TRT routine:

• Begin T Cyp 200 mg/ml – 0.25 ml inject IM/SQ three time weekly
• Begin HCG 350 iu inject SQ three times weekly
• Begin Anastrozole 0.25mg by mouth three times weekly
• Begin DHEA 25 mg by mouth at night

My first week I was feeling great. Within one month, I had gained about 12lbs despite no change in my diet and had extremely sore feet and hands. I ended up retesting all my levels, and everything was looking great and within bounds. But I still was not feeling good, and ended up stopping the routine all together. My weight returned to normal rather quickly and so did the sore hands/feet.

Reading up on this some more, I think I was dealing with peripheral edema. Is this a treatable side-effect of TRT? Does it only happen in the beginning and then subside? Should I go back to the doctor to restart?

 

[Goel]

I had a good bit of edema especially in my feet/ankles when I first started TRT (my first month) but it disappeared after about a month. It's common/normal and should pass.

ETA: I just went back to check my log of when I started. Mine peaked at the 3rd and 4th weeks and then tapered off the next couple weeks and was gone by week 7.

 

[Vince]

So I recently was put on this TRT routine:

• Begin T Cyp 200 mg/ml – 0.25 ml inject IM/SQ three time weekly
• Begin HCG 350 iu inject SQ three times weekly
• Begin Anastrozole 0.25mg by mouth three times weekly
• Begin DHEA 25 mg by mouth at night

My first week I was feeling great. Within one month, I had gained about 12lbs despite no change in my diet and had extremely sore feet and hands. I ended up retesting all my levels, and everything was looking great and within bounds. But I still was not feeling good, and ended up stopping the routine all together. My weight returned to normal rather quickly and so did the sore hands/feet.

Reading up on this some more, I think I was dealing with peripheral edema. Is this a treatable side-effect of TRT? Does it only happen in the beginning and then subside? Should I go back to the doctor to restart?

Can you post your most recent labs? Along with the ranges.

 

[wintermute]

Can you post your most recent labs? Along with the ranges.

Sure thing, these labs were collected in the midst of me feeling at my worst (before I stopped all together)

Test Name	Value	Range
Testosterone Total	736	264-916 ng/mL
Testosterone, Free	22.8	8.7-25.1 pg/mL
Estradiol	15.2	8.0-35.0 pg/mL

 

[Vince]

Sure thing, these labs were collected in the midst of me feeling at my worst (before I stopped all together)

Test Name	Value	Range
Testosterone Total	736	264-916 ng/mL
Testosterone, Free	22.8	8.7-25.1 pg/mL
Estradiol	15.2	8.0-35.0 pg/mL

The labs that you posted, look good. The only thing I would consider is lowering your dose of Anastrozole.

 

[madman]

So I recently was put on this TRT routine:

• Begin T Cyp 200 mg/ml – 0.25 ml inject IM/SQ three time weekly
• Begin HCG 350 iu inject SQ three times weekly
• Begin Anastrozole 0.25mg by mouth three times weekly
• Begin DHEA 25 mg by mouth at night

My first week I was feeling great. Within one month, I had gained about 12lbs despite no change in my diet and had extremely sore feet and hands. I ended up retesting all my levels, and everything was looking great and within bounds. But I still was not feeling good, and ended up stopping the routine all together. My weight returned to normal rather quickly and so did the sore hands/feet.

Reading up on this some more, I think I was dealing with peripheral edema. Is this a treatable side-effect of TRT? Does it only happen in the beginning and then subside? Should I go back to the doctor to restart?

Also, keep in mind that androgens increase the retention of electrolytes and it is common for most on trt to gain 5-7 lbs of water weight within the first month of starting and some even much more.

Even then once the body adjusts or measures have been taken to minimize the bloat/puffiness you are always going to hold more water when using androgens as the muscle cells will retain more water (intra-cellular).


post #3

Edema on TRT

www.excelmale.com

 

[madman]

Sure thing, these labs were collected in the midst of me feeling at my worst (before I stopped all together)

Test Name	Value	Range
Testosterone Total	736	264-916 ng/mL
Testosterone, Free	22.8	8.7-25.1 pg/mL
Estradiol	15.2	8.0-35.0 pg/mL

Keep in mind that although a TT 726 ng/dL is far from being considered very high seeing as you are injecting 3X weekly (M/W/F) if these are your trough levels then your peak TT/FT will be higher.

More importantly, even with a TT 736 ng/dL, your FT is on the higher end let alone was tested using the piss poor direct immunoassay which is known to be inaccurate.

The only way to know where your FT truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

You left out SHBG which is critical to know as not only will it have a big impact on what FT level is achieved but can also dictate what injection frequency may suit you best.

I would also look into dropping the AI!

 

[wintermute]

> You left out SHBG which is critical to know as not only will it have a big impact on what FT level is achieved but can also dictate what injection frequency may suit you best.

Yea, I didn't have any SHGB in that particular blood draw, but prior to starting TRT my SHBG is on the low end, 16.8 nmol/L (16.5 - 55.9 lab range)

 

[madman]

> You left out SHBG which is critical to know as not only will it have a big impact on what FT level is achieved but can also dictate what injection frequency may suit you best.

Yea, I didn't have any SHGB in that particular blood draw, but prior to starting TRT my SHBG is on the low end, 16.8 nmol/L (16.5 - 55.9 lab range)

How many weeks were you on trt before stopping and when were labs drawn?

 

[wintermute]

How many weeks were you on trt before stopping and when were labs drawn?

I was on for about 6 weeks. Felt great the first week but then just quickly declined. I felt I was carrying so much water that it was a pain to put on my shoes, etc.

 

[wintermute]

And to add to that, before starting TRT, my labs looked like

Testosterone, Total	221	264 - 916
Testosterone, Free	7.3	8.7 - 25.1
Estradiol, Sensative	25.7	8.0 - 35.0
Sex Horm Binding Glob, Serum	16.8	16.5 - 55.9
LH	4.9	1.7 - 8.6

 

[Cataceous]

I'd ask your provider why your starting dose was more than double the amount of testosterone that the average healthy young man produces naturally. You were averaging 15 mg per day versus the typical 6-7 mg. Your low SHBG means that total testosterone is expected to be on the low side for the dose, though free testosterone can be robust. The Tru-T and Vermeulen calculators both suggest above-average free testosterone with your previous SHBG. Chances are SHBG went lower still with the hefty doses of testosterone, meaning free testosterone was higher yet.

It's extremely frustrating to see this scenario repeated over and over: Excessive dosing and side effects. There is no good reason to start TRT this way. The default administration of an aromatase inhibitor is like an admission that "Yeah, we're overdosing you, which is going to create excessive estradiol, so here's another drug to preemptively deal with those side effects."

Everybody is just so ingrained with the idea that anything not above average is bad. We need to ditch this mentality when it comes to hormones. Your body is telling you that having above average free testosterone is not what it needs to function properly. Because you're off the TRT anyway, maybe consider some alternatives before getting back on. Enclomiphene and Natesto are two drugs that raise testosterone without shutting down your body's natural production. You would most likely be better off if you can resolve your symptoms with one of these instead of TRT.

 

[bennettjc]

Regarding edema - i have heard anecdotally that Testosterone Enanthate causes less edema than Testosterone Cypionate (likely based on the carrier oils used for each in the US ... sesame seed oil for TE and cotton seed oil for TC. )

 

[madman]

Regarding edema - i have heard anecdotally that Testosterone Enanthate causes less edema than Testosterone Cypionate (likely based on the carrier oils used for each in the US ... sesame seed oil for TE and cotton seed oil for TC. )

Regarding big pharma, generic or compounded injectable T there is no secret recipe as they are all manufactured with:

- an esterified T (prodrug) whether (undecanoate/cypionate/enanthate/propionate/ or mixed esters)

- a carrier oil (vehiculum) such as (sesame, cottonseed, castor, peanut, grapeseed)

- an excipient such as:

BENZYL ALCOHOL • Solubility enhancer • Oil viscosity reducer • Local anesthetic
• Preservative

BENZYL BENZOATE • Solubility enhancer • Solvent

ETHANOL • Solvent

CHLOROBUTANOL • Preservative


Nothing more.....nothing less!

Has absolutely nothing to do with the carrier oil (vehiculum) used.

Top it off that the amount of oil being injected whether once weekly, twice weekly (every 3.5 days), M/W/F, EOD, or daily is minuscule.

Most on trt are injecting anywhere from 100-200 mg/week using 200 mg/mL strength.

I would be much more concerned with where my SHBG sits and what FT level is achieved on such protocol (dose T/injection frequency).




William Llewellyn- ANABOLICS

*It is also important to stress the fact that esters do not alter the activity of the parent steroid in any way. They work only to slow its release. It is quite common to hear people speak about the properties of different esters, almost as if they can magically alter a steroid's effectiveness. This is really nonsense. Enanthate is not more powerful than cypionate (perhaps a few extra milligrams of testosterone released per injection, but nothing to note), nor is Sustanon some type of incredible testosterone blend. Personally, I have always considered Sustanon a very poor buy in the face of cheaper 250 mg enanthate ampules. Your muscle cells see only testosterone; ultimately there is no difference.

Reports of varying levels of muscle gain, androgenic side effects, water retention, etc. are only issues of timing. Faster releasing testosterone esters will produce estrogen buildup faster simply because there is more testosterone free in the blood from the start of the cycle. The same is true when we state that Durabolin® is a milder nandrolone for women compared to Deca. It is simply easier to control the blood level with a faster-acting drug. Were virilization symptoms to become apparent, hormone levels will drop much faster once we stop administration. This should not be confused with the notion that the nandrolone in Durabolin® acts differently in the body than that released from a shot of Deca-Durabolin®.

 

[peacethrutest]

So I recently was put on this TRT routine:

• Begin T Cyp 200 mg/ml – 0.25 ml inject IM/SQ three time weekly
• Begin HCG 350 iu inject SQ three times weekly
• Begin Anastrozole 0.25mg by mouth three times weekly
• Begin DHEA 25 mg by mouth at night

My first week I was feeling great. Within one month, I had gained about 12lbs despite no change in my diet and had extremely sore feet and hands. I ended up retesting all my levels, and everything was looking great and within bounds. But I still was not feeling good, and ended up stopping the routine all together. My weight returned to normal rather quickly and so did the sore hands/feet.

Reading up on this some more, I think I was dealing with peripheral edema. Is this a treatable side-effect of TRT? Does it only happen in the beginning and then subside? Should I go back to the doctor to restart?

I starting reading this & right away your story caught my attention. Please listen to what I have to say. I wanna help you. This was very similar to my story and it took 2 years to straighten out what I had started.

First off my protocol was as follows:

200 mg/ml test cyp. 1x per week.
1mg. of anastrozole per week
500 iu x 2 times per week.

This did the same to me & gained weight, swollen ankles, nausea, lazy, and just feeling terrible overall. I tried to alter and modify the protocol every which way but correct.
I then quit and after haggling for 2 years had some homework to do. At this point, I did what they call a washout and I went through feeling better, then worse, then better.

After 3 months of washing out, I did a lot of homework and now knew how to go about
getting back on TRT. I watched a guy on youtube named Danny Bossa and Danny clarified everything I needed to know to use TRT in an effective way.

I started the protocol with just Testosterone cyp./propinate blend 180/20 totaling 200 mg per 1ml.

I went and got my labs done like I did the first time out to establish my baseline and after this, I started on 100mg per week doing every other day subqutaneous of 25mg. per injection. I ran this protocol for eight weeks and retested it again. My total and free were still low so I increased my dose by 10mg per week totaling 110mg per week and ran it for another 8 weeks. I was still a little low and now I ran 120mg per week and once again retested and my numbers are as follows:

FT = 174
TT = 974
e2 = 35

All numbers are at trough level meaning right before I'm supposed to dose my next shot Monday Morning even though I'm doing EOD subQ.

I noticed Once I got up to the 120mg I was starting to feel lousy again and after 4 weeks from going from 110mg to 120mg I started taking the anastrozole.

I now use .25mg of anastrozole a week and this is all I need. I take it Monday morning so when I draw blood I can see the highest point of my e2 for the week. I tried to control my e2 with zinc and other things but it seems as though with .25mg this puts the protocol on point.

One of the problems I had along with many others is no one wants to give the therapy time to change the chemistry of their bodies. WHEN YOU START A THERAPY YOU MUST, MUST, MUST, run it for 8 weeks. No one does this and they just start altering doses left and right which causes a bad snowball effect to end up where you were.

To make the therapy work you must be willing to:
Invest some money.
Take your time.
RUN PROTOCOLS FOR 8 WEEKS.
Be patient, let it work, and just start with the testosterone itself.

You should not be adding HCG or anastrozole until you have blood drawn.
Many people complain TRT is very hard to manage using HCG along with Testosterone and Anastrozole.

When you restart please, Run your 100mg per week for 8 weeks and recheck your blood work every 8 weeks to see where you are at. Don't modify what you start because you will end up at square 1 once again. I don't plan on running HCG. I have found my protocol as I told you up above and it works very well now. As I said, doing it this way takes time & money but this made all the difference in my life at 43 years old and I'm so glad I washed out, and now I have returned. Remember, more is not always better. TRT therapy is for the long haul like the rest of your life long haul.

In case you're wondering, All my other labs are spot on, and my Primary Care said to me I wish all my patients' numbers were like yours. I really hope this helps you and anyone else who reads this. TRT can really help your sense of well-being but don't expect to become a world-class athlete or some raging sex machine after finding your protocol.

I have never had a problem with sex drive but this did in fact increase sensitivity And make things better than they were. Then again, everyone is different. I went on TRT because my test levels were low and I dragging my ass everywhere I went.

Again I hope this helps you and anyone who reads this that has had trouble honing in on a protocol. TRT protocols are probably the most difficult protocols to customize out of all medicines on the market. Every person's needs are so different. SO tailoring your needs over someone elses' needs is going to be most likely all together different. The standard

200mg/ml per week
500iu x 2x per week
1mg of anastrozole
is most likely not going to work for you. Please keep this in mind. Thank you.

 

[gerardo]

I starting reading this & right away your story caught my attention. Please listen to what I have to say. I wanna help you. This was very similar to my story and it took 2 years to straighten out what I had started.

First off my protocol was as follows:

200 mg/ml test cyp. 1x per week.
1mg. of anastrozole per week
500 iu x 2 times per week.

This did the same to me & gained weight, swollen ankles, nausea, lazy, and just feeling terrible overall. I tried to alter and modify the protocol every which way but correct.
I then quit and after haggling for 2 years had some homework to do. At this point, I did what they call a washout and I went through feeling better, then worse, then better.

After 3 months of washing out, I did a lot of homework and now knew how to go about
getting back on TRT. I watched a guy on youtube named Danny Bossa and Danny clarified everything I needed to know to use TRT in an effective way.

I started the protocol with just Testosterone cyp./propinate blend 180/20 totaling 200 mg per 1ml.

I went and got my labs done like I did the first time out to establish my baseline and after this, I started on 100mg per week doing every other day subqutaneous of 25mg. per injection. I ran this protocol for eight weeks and retested it again. My total and free were still low so I increased my dose by 10mg per week totaling 110mg per week and ran it for another 8 weeks. I was still a little low and now I ran 120mg per week and once again retested and my numbers are as follows:

FT = 174
TT = 974
e2 = 35

All numbers are at trough level meaning right before I'm supposed to dose my next shot Monday Morning even though I'm doing EOD subQ.

I noticed Once I got up to the 120mg I was starting to feel lousy again and after 4 weeks from going from 110mg to 120mg I started taking the anastrozole.

I now use .25mg of anastrozole a week and this is all I need. I take it Monday morning so when I draw blood I can see the highest point of my e2 for the week. I tried to control my e2 with zinc and other things but it seems as though with .25mg this puts the protocol on point.

One of the problems I had along with many others is no one wants to give the therapy time to change the chemistry of their bodies. WHEN YOU START A THERAPY YOU MUST, MUST, MUST, run it for 8 weeks. No one does this and they just start altering doses left and right which causes a bad snowball effect to end up where you were.

To make the therapy work you must be willing to:
Invest some money.
Take your time.
RUN PROTOCOLS FOR 8 WEEKS.
Be patient, let it work, and just start with the testosterone itself.

You should not be adding HCG or anastrozole until you have blood drawn.
Many people complain TRT is very hard to manage using HCG along with Testosterone and Anastrozole.

When you restart please, Run your 100mg per week for 8 weeks and recheck your blood work every 8 weeks to see where you are at. Don't modify what you start because you will end up at square 1 once again. I don't plan on running HCG. I have found my protocol as I told you up above and it works very well now. As I said, doing it this way takes time & money but this made all the difference in my life at 43 years old and I'm so glad I washed out, and now I have returned. Remember, more is not always better. TRT therapy is for the long haul like the rest of your life long haul.

In case you're wondering, All my other labs are spot on, and my Primary Care said to me I wish all my patients' numbers were like yours. I really hope this helps you and anyone else who reads this. TRT can really help your sense of well-being but don't expect to become a world-class athlete or some raging sex machine after finding your protocol.

I have never had a problem with sex drive but this did in fact increase sensitivity And make things better than they were. Then again, everyone is different. I went on TRT because my test levels were low and I dragging my ass everywhere I went.

Again I hope this helps you and anyone who reads this that has had trouble honing in on a protocol. TRT protocols are probably the most difficult protocols to customize out of all medicines on the market. Every person's needs are so different. SO tailoring your needs over someone elses' needs is going to be most likely all together different. The standard

200mg/ml per week
500iu x 2x per week
1mg of anastrozole
is most likely not going to work for you. Please keep this in mind. Thank you.

Thank you for sharing your experience. When you decided to restart anastrosol 0.25 mg per week what were you feeling? How are your hematocrit and other hormones like LH, FSH, progesterone and DHEA? Did you have testicular atrophy and decreased sperm? I will still start my protocol again after adjusting my hematocrit. Thanks

 

[Systemlord]

It's best to start TRT in isolation and find the proper dosage and injection frequency to where you don't need other compounds to treat side effects of overdosing.

What I find interesting is you are willing to give up on TRT after only 6 weeks which tells me you are just looking for a quick fix.

TRT requires patience to dial in and to find the protocol that works best for you.