Rabbits TRT THREAD lab update 5/28

[Rabbit91476]

I thought I would start a log hear for advice. If this is not the place or im doing something wrong let me know.
a little back ground. I am 42 5 8 164. September 2016 accepted I drank to much and cut back I was weighing in at 210 218# hard to remember. 4/2018 i still weighed 198# decided to change my lifestyle . with diet and exercise and dropped to 158 with running and calisthenics and got off my blood pressure medication. hell I even had a 8 pack yes was probably over training. Then I Felt like utter shit around November. Work was suffering. low libido falling asleep watching tv at 830pm and of course work out went to shit. I was moody as hell Kids were asking why I was so angry. I was up to 1 gram of caffeine just to get threw a day. Tribulus usually make me horney so I had been taking it off and on. Eventuly that stopped helping.
I have always had brain fog. but assumed it was due to nightly drinking. I eventually asked my doctor for labs as I felt physically ill and knew something wasn't right

12/1
total test 1.57 ng/ml range 1.75-7.81
free 21 pgml 47-244
tsh 1.38 0.40-5.6
along with cbc chem panel

Doc said wait a few months re check and see me

12/18/18 felt a smidge better able to finish a work out. but not as motivated.
fsh 3.5 mitlunit/ml
lh 1.o
prolactin 4.62
Total test 3.14
free 66 ng/ml range 47-244.
said he would order third set and send me to a Endocrinologist.

2/19 felt like crap. not as bad as in December. work outs performance declined but did have sex with my wife two days prior. I have never had erection problems just motivation. if Im not constantly stimulated during a video he goes soft. almost always wake up with morning wood. I added a little weight and calories to my diet. I happy with my weight at 165.
total 1.93
shbg 37 11-80
free 43 pg/ml
3/5 see endocrinologist he Said labs are low. he would order 3rd set along with psa and probably start treatment in 2 weeks

3/6/19
CBC Chem panel done
estradiol 23 pgml
lh 1.2 i5
prolactin 4.36 ng/ml
Total test 3.19 ng/ml
fsh 3.9 mintlunit/ml
psa 1.020 range 0.100-4.0\
free 74 pgml.

diet any where from 2100-2500 calories moderate to low carb, high fat protein 150-180gm day. alcohol two bud lights or one ipa a week on pizza night.
meds,
Zyrtec, krill oil orange triad mvi, vitd+k, creatine, Caffeine (600mg- 1G depending on ability to focus and exhaustion) monster, bang , coffee , tea.

I went to go see Endo 3/19 and it was actually the best I have felt in a long time. not normal but not as crappy as the last three months. was back to having a hint of libido which usually last a few hours in am then gone by bed time. Endo looks at my labs and is half listening to me. Says " well it sound like your feeling better and the your labs are normal well recheck you in a few months." I told him no im not normal im still having fatigue and some libido problems. give me a look of ok ill humor you but don't believe you. I requested injections. he was going to order 200mg every 3 weeks and I said I would like more frequent. he agrees to 100mg every 10 days but would not order 70mg/ week. Then said to see him in 10 weeks and if I didn't feel better he would stop treatment handed me a script Test C (100ml/1ml every 10 days for 3 months)and the appt was over. Said to myself wtf and left. I had to get on urology web site to find his logic in that plan.

So im waiting for insurance approval. I can afford the meds if its not covered. I just want to see what they say. I feel well enough to wait. if insurance is not going to cover meds of future labs I have 10 weeks of meds to decide if the meds are working and I should go private. Sorry for the long winded post. couldn't sleep this is heavy on my mind. the labile labs and feelings have me contemplating if it is time for treatment or not. I am a Registered Nurse so I know what im getting in to.

 

[Cataceous]

Chances are you will feel better with higher testosterone. I don't think you mentioned your age. Particularly if you're on the younger side then you might want to try a SERM like Clomid first. Did any of the docs mention this? Although such treatments are less likely to succeed than TRT, they do keep your system working more naturally, preserve fertility, and are simpler because they are oral medications.

 

[Rabbit91476]

42. no mention of clomid. He recommended gel first. I said I have small kids. I would prefer shots or scrotal cream. he said creams don't work but I expected that response. I mentioned to him a Nurse and can do shots. But I got no explinations or education from him. As a Nurse I understand that even if a patient knows what's going on they are always a little scared, and often they don't even know what questions to ask.

 

[CoastWatcher]

For what it’s worth, we see greater success with creams here at EM, by a large margin, than we do with gels. Compounded creams have brought a good number of men success.

You aren’t the first to find yourself walking in the valley of medical ignorance and arrogance. Time and again...so frustrating.

 

[Vince]

If you're going to go on trt and have small kids. I would refuse creams or gels. Injections or considering trying clomid could be your best options. When I started trt, I refused to use cream or gels, just so I would not contaminate anyone.

 

[Rabbit91476]

If you're going to go on trt and have small kids. I would refuse creams or gels. Injections or considering trying clomid could be your best options. When I started trt, I refused to use cream or gels, just so I would not contaminate anyone.

That was my thought on injections. I haven't researched clomid much what about my circumstance would make my a candidate for a clomid

also if im going on vacation in 23 days when does the crash come and will I feel any different than I do now or just not as good as the initial boost. I don't want ruin my trip

 

[Vince]

That was my thought on injections. I haven't researched clomid much what about my circumstance would make my a candidate for a clomid

also if im going on vacation in 23 days when does the crash come and will I feel any different than I do now or just not as good as the initial boost. I don't want ruin my trip

If you're going on vacation 23 days, I would wait on starting trt. Just in case you have any issues. Some men do good on low dose clomid, so I thought it might be worth a try. It's a lot easier to take clomid, then injecting yourself twice a week. Your once every 10 day protocol, probably won't work.

 

[Rabbit91476]

aware of the 10 issue I thought about just doing 70mg every 7 days. but don't know if the doctor will be able to tell with a 7 day/70mg trough vs a 10 day/100mg trough. are there any threads about what to expect from the honeymoon period. never mind I should do a search first lol.

 

[Cataceous]

... I haven't researched clomid much what about my circumstance would make my a candidate for a clomid
...

Being on the younger side is a point in favor. That's potentially a lot of years left to have your HPTA shut down with injections. A simpler protocol makes compliance easier, even if you don't mind sticking yourself. Some negatives are the lower probability of good subjective results versus TRT. Your SHBG is a little above average, and Clomid may raise it. In some cases this means free testosterone won't go up, which negates an important goal of the therapy. There's also a chance of side effects, though it's small as long as the doses are kept low.

 

[Rabbit91476]

drs office just called me about pre auth. they said the insurance wanted to know why I wanted shots not andro gel. i thought that was funny as gel is more expensive. she said they should have authorization tomorrow.

 

[Rabbit91476]

Don't know why I never check. but after reading about variocele. I did a self check. I feel what feels like a small one in my right upper scrotum. Could this be a explination for my labile levels?

 

[Systemlord]

drs office just called me about pre auth. they said the insurance wanted to know why I wanted shots not andro gel. i thought that was funny as gel is more expensive. she said they should have authorization tomorrow.

Androgel is more profitable than injections, your insurance company didn't inquire about your choice, it's clear your doctors office is the one that wanted you to chose androgel.

My first endo refused injections until androgel and Axiron gels failed to show good results, I called my insurance company to ask why gels were being pushed so hard, they told me they could care less which direction I went.

Gels are more profitable do to the patented delivery system, injectables are the lowest, least profitable for doctors.

 

[Rabbit91476]

Doc didn’t care. Md office said. They inquired. System. You know anything about varicocele. Google searched only one study being cited in all the searches. Saying correction could result a increase of t levers 100-150. Not optimal. But if it keeps me off meds?

 

[Rabbit91476]

well I did it I started well kind of. instead 100mg the next 10 days I gave my self 50. I work next 2 days and was worried about any adverse reaction but didn't want to delay

 

[Rabbit91476]

Well got a new md last week. He’s now my pcp who also does men’s health. Felt what I assume as shut down last week. Sent him a text via his patient portal asking if I could increase to 100/week and he approved. I know it’s only been 3 weeks weeks at 50 mg/ 5 day. But at least I have a realistic bear minimum dose.

A plus is. This doctor has only known me for one visit and is willing to increase my dose over a text. I know it’s no defy. But a step better than what I had.

 

[Rabbit91476]

well got my limited labs and md appt in one week.
8 weeks of 50mg every 3.5 days. labs draw before Thursday morning injection.
total t 6.36ng/ml 1.75-7.81
Free T calc arup 171 pgml 47-244
psa 1.62 ngml 0.1-4.0
hct 47.7
I know this is minimal labs but was going to wait to follow up appt and see what he says
then get shgb,estrogen sensitive. free tsh t3t4 from lab corp. didn't know wheither to do this before or after I would start an increase

was going to ask him for a increase. libdo, energy, moderate improvemet. muscles appear bigger put on 8# in water retention. muscles firmer. minimal strength change but the two weeks before schools out is a lul in exercise but will kick back up next week. have since started blood pressure medication but now under control. My thought was to get as big of a dose as I can from my doctor i dont know mabey 140mg/week. start with 120.and slowly increase dose and pull labs every 6-8 weeks depending on what every he wanted

I don't notice really any estrogen sides with exception for water retention. I teared up yesterday during the memorial day 21 gun salute and TAPS but that's expected. I don't think my primary doctor will be opposed to an increase even thought the lab ranges are lower than others. a co workers husband just got approved for 200mg/week by insurance.
My thought was to get as big of a dose as I can from my doctor and slowly increase dose and pull labs

Any input appreciated

 

[Rabbit91476]

no thoughts?