TRT Follow-Up - Concerned

[psaufan]

I wanted to post my most recent lab work and get everyone's feedback and input.

My original protocol as prescribed by Low-T-Nation was 200 mg of test cyp once per week and 250 units of HCG twice per week. I did this for two months prior to spreading the test cyp out EOD and the HCG three times a week versus two times. This lab work was done the day between my test cyp injections. I am doing IM injections in my rear or shallow IM into my thigh. The HCG is injected subq in my abdomen.

i was 162 lb when I cam off pellets to begin injections. in five months, i have gained 13 lbs...while some is muscle in my upper chest and arms, there is also some weight gain around my waistline. I have not changed my diet or workout routine at all.

How do I feel? low energy - yawning at 9:30 am. Low libido. Morning wood no problem, but low libido. Mental fog and some aches here and there.

My Doctor at Low-T-Nation reviewed this labwork and simply recommended I start taking .25 mg of Srimidex once per week. He was not concerned about the test level.

I'm not sure what all results you all want to see, so I'll list them all: (ranges in parenthesis)

Ttl Tesosterone: 1530.1 (348-1197)
Free Test: 28.0 (7.2-24)
Dihydrotest: 77
Prostate: 1.5 (0 - 4)
TSH: 1.75 (0.45 - 4.5)
Estradiol, Sensitive: 50.9 (8.0 - 35.0)
SHBG: 36.4 (19.3 - 76.4)
Ttl Cholesterol: 192 (100 - 199)
Triglycerides: 56 (0 - 149)
HDL Chol: 55 (>39)
VLDL Chol Cal: 11 (5 - 40)
LDL Chol Calc: 126 (0 - 99)
T Chol/HDL Ratio: 3.5 (0.0 - 5.0)
Glucose, Serum: 85 (65 - 99)
BUN: 14 (6 - 24)
Creatine, Serum: 1.03 (0.76 - 1.27)
WBC: 6.0 (3.4 - 10.8)
RBC: 5.06 (4.14 - 5.8)
Hemoglobin: 15.8 ((12.6 - 17.7)
Hemocrit: 46.7 (37.5 - 51.0)
MCV: 92 (79 - 97)
MCH: 31.2 (26.6 - 33)
MCHC: 33.8 (31.5 - 35.7)
Platelets: 171 (150 - 379)
Neutrophils: 58
Lymphs: 27
Monocytes: 8
Eos: 6
Basos: 1
Neutrophils Absolute: 3.5 (1.4 - 7.0)
Lymphs Absolute: 1.6 (0.7 - 3.1)
Monocytes Absolute: 0.5 (0.1 - 0.9)
Eos Absolute: 0.4 (0.0 - 0.4)
Baso Absolute: 0.1 (0.0 - 0.2)
Immature Granulocytes: 0
Immature Grans Abs - 0.0 (0.0 - 0.1)


I work out with weights for 30 minutes per day for six days and then break for one day. I consume approximately 80 grams of whey protein daily. I do not smoke and my diet is good - very little sugar. - lots of fish, chicken, red meat, salads, etc. i am 6' tall and i weigh 172 lbs. I drink two alcohol drinks per day.

I am still injected 200 mg of test cyp a week spread out EOD...500 units of HCG spread out over three injections a week.

Thoughts? Concerns? Suggestions? And, I do have paperwork to consult with Defy for a second opinion.

Thanks in advance for any replies!

-Peter

 

[AbsoluteZ3R0]

To tell you the truth, your doctor's verdict is fairly reasonable. The only real issue on your blood work is your E2, and since your free testosterone is just somewhat above range, he probably doesn't want to cut your dose back to combat E2 issues (although this could potentially be a better solution if the AI doesn't provide the desired effect). With anastrozole's half-life, I think a once a week dose isn't ideal, but I can at least appreciate that he is starting you on a minimal dose (I hypothesize that .125mg 2x a week would be better). Some of the weight gain you have noticed may be water retention from the high E2. Much of that will go to your gut and face, leading to the impression that you have gained fat.

 

[psaufan]

To tell you the truth, your doctor's verdict is fairly reasonable. The only real issue on your blood work is your E2, and since your free testosterone is just barely above range, he probably doesn't want to cut your dose back to combat E2 issues (although this could potentially be a better solution if the AI doesn't provide the desired effect). With anastrozole's half-life, I think a once a week dose isn't ideal, but I can at least appreciate that he is starting you on a minimal dose (I hypothesize that .125mg 2x a week would be better). Some of the weight gain you have noticed may be water retention from the high E2. Much of that will go to your gut and face, leading to the impression that you have gained fat.

I tried Arimidex once when I was on pellets - I was taking .25 mg every other day. Noted side effects were loss of sensation in my penis, delayed orgasm to the point of sex was getting to be a chore and diminished pleasure at orgasm.

Has anyone else experienced these side effects? Once I got off of the Arimidex - again, .25 mg EOD - the side effects went away.

Thanks for the reply, Absolute

 

[AbsoluteZ3R0]

I tried Arimidex once when I was on pellets - I was taking .25 mg every other day. Noted side effects were loss of sensation in my penis, delayed orgasm to the point of sex was getting to be a chore and diminished pleasure at orgasm.

Has anyone else experienced these side effects? Once I got off of the Arimidex - again, .25 mg EOD - the side effects went away.

Thanks for the reply, Absolute

Usually, those side effects occur when the AI is too powerful and tanks your E2 levels. Did you get any blood work done when you were experiencing those side effects? For the most part, anastrozole in and of itself does not yield side effects exclusive from its effects on estradiol.

 

[psaufan]

Usually, those side effects occur when the AI is too powerful and tanks your E2 levels. Did you get any blood work done when you were experiencing those side effects? For the most part, anastrozole in and of itself does not yield side effects exclusive from its effects on estradiol.

So, I was still on the Arimidex when I had my bloodwork done for Low-T and he said to stop taking the Arimidex immediately, so it may have tanked it. I hate to say, but I never got a copy of my original lab work from Low-T.

 

[AbsoluteZ3R0]

So, I was still on the Arimidex when I had my bloodwork done for Low-T and he said to stop taking the Arimidex immediately, so it may have tanked it. I hate to say, but I never got a copy of my original lab work from Low-T.

You may be able to request the lab work to satisfy your curiosity. Nonetheless, you are certainly entitled to a second opinion, and Defy Medical will offer you some of the best care available in the United States. In the meanwhile though, I would say that you have two available options that may help you. Since you clearly have a lot of apprehension in regards to taking an AI, you could dial back your testosterone, possibly to 140-160 a week. The plus side to this is that there is literally no consequence in doing so. It may take some time before you notice relief from your elevated E2 due to the length of the testosterone ester. Your second choice is to take the AI as directed, and notice if you experience quick relief (it will work within a day or two). You can also take a multifaceted approach, and use the AI once or twice to determine whether or not E2 is the root cause of your problem, and then once you make that determination, you can eliminate the AI and solve the issue by scaling back your testosterone dose. Hope this helps.

 

[CoastWatcher]

I tried Arimidex once when I was on pellets - I was taking .25 mg every other day. Noted side effects were loss of sensation in my penis, delayed orgasm to the point of sex was getting to be a chore and diminished pleasure at orgasm.

Has anyone else experienced these side effects? Once I got off of the Arimidex - again, .25 mg EOD - the side effects went away.

Thanks for the reply, Absolute

A bit of hesitation regrading anastrozole is appropriate. It's a drug that, while frequently necessary, is prescribed somewhat too freely and at a dose that can result in more problems than someone should have to deal with. In looking at your total testosterone, you certainly have adequate room to reduce your total weekly dose and maintain a healthy level. That would be my initial approach to dealing with the issue. It has the advantage of simplicity; you avoid adding another element to your protocol that has to be monitored. An AI may be in your future, but it's certainly worth some time (four to six weeks) to see if that is the case.

 

[psaufan]

A bit of hesitation regrading anastrozole is appropriate. It's a drug that, while frequently necessary, is prescribed somewhat too freely and at a dose that can result in more problems than someone should have to deal with. In looking at your total testosterone, you certainly have adequate room to reduce your total weekly dose and maintain a healthy level. That would be my initial approach to dealing with the issue. It has the advantage of simplicity; you avoid adding another element to your protocol that has to be monitored. An AI may be in your future, but it's certainly worth some time (four to six weeks) to see if that is the case.

Based on an earlier reply, I will cut the dosage back to 160 mg per week, spread out every other day.

Question: using 3ML syringe, I was drawing 1ML to get 200MG of test cyp. How many ML do I draw to get 160MG of test cyp? Once I determine that, I can figure out how much to draw for my EOD injection.

Thanks!

 

[user_joe]

I'd just follow the doctor's advice. Sounds very reasonable. You should see improvements pretty quick. If not plan B. Dropping your cypionate however is going to be at least a 6 week trial to see how it works out. I'd personally try the anastrozole route first.

 

[madman]

Based on an earlier reply, I will cut the dosage back to 160 mg per week, spread out every other day.

Question: using 3ML syringe, I was drawing 1ML to get 200MG of test cyp. How many ML do I draw to get 160MG of test cyp? Once I determine that, I can figure out how much to draw for my EOD injection.

Thanks!

Dose reduction would seem the most sensible and a 1530tt if it is trough is too high. If you cut back on test dose e2 will drop and you may still obtain a higher end tt trough. Guarantee you will feel better overall. Having tt levels that high especially long term will stress out other hormones.

 

[psaufan]

Dose reduction would seem the most sensible and a 1530tt if it is trough is too high. If you cut back on test dose e2 will drop and you may still obtain a higher end tt trough. Guarantee you will feel better overall. Having tt levels that high especially long term will stress out other hormones.

What is a sensible reduction? Downward from 200mg a week to 150mg? 140mg? 160mg? Thanks...

 

[CoastWatcher]

What is a sensible reduction? Downward from 200mg a week to 150mg? 140mg? 160mg? Thanks...

I would drop down to 120mg a week and see how things respond. Starting low and going slow is always a good idea in this game. Ramping up, if necessary, is easier than winding back in.