"TRT/HRT/Nutrition/Cognition/Wellness/LT student of the game"

[tropicaldaze1950]

Little update.

So 2 days ago I have finished my old Test-E batch and switched to Sustanon250 0.16ml E4D so ruffly around 75/80mg per week(+-) Next day woke up with increased GERD symptom of chest pain which I've been battling for a long time once on TRT. So struggled yesterday but today oh man woke up with even bigger chest pain and without even eating since 7pm yesterday nor drinking water. Now even taking a deep breath is painful and swallowing as well which got better after a few Rennies. No diet modifications ease the simptoms and nothing works. So at this point I'm seriously suspecting that its the fucking TRT. Maybe some esters in Sustanon don't agree with me or the damn peanut carrier oil, who the fuck knows. So I haven't eaten since yesterday 7am and decided to fast and see what happens. I haven't fasted in a long long time so will see. My next T shot is in a couple of days so will see what happens as well. I'm lean, overthise healthy (tfu tfu tfu), training hard and been on top of my health for the last 15-20 years. In 2 days I have GP appointment so will have a talk and maybe she agrees to run some blood tests and have another H Pylori test to see if its still active as I had my 2nd round of treatment in February. Nelson recoomended another type of Antibiotics but seriously after those failing 2 treatments that I had I'm not sure if I want to dabble in them one more time and if GP will prescribe them as they still roll by stone-age protocols.

Anyway the pain that I'm getting is hard and heavy which won't allow me to live normal life, not even talking about work or sport. So this must be taken care off and ASAP. I've read some studies that increased DHT is known to give problems and increase GERD symptoms but I never tested it as I'm on a small dose anyway. But if thats that then no TRT for me at either dose. I enjoy the energy and everything but the pain wrecks everything so will get off if I'll have to.

Usually my pain diminishes when I have some food if I'm hungry but WTF is this shit, I should be able to go pain free without any food. This is crazy and I want to get to the root cause of it and not mask the issue with food, supplements, etc. Anyway lets see how long can my water-fast continue and if the pain gets better or worse. Will update what happens as It feels a bit better to write and share what I'm going through right now. It's a bitch but IIWII.

Hope you feeling better guys!

Regards,
Bel

IMO, carrier oil. For me, cottonseed oil. Test C induced malaise, loose stools, aching in the eyes, low grade headaches. Test E is more expensive but no side effects.

You know that we have to be our own doctor. And that's why some doctors get annoyed with such patients because we know more than they do, LOL.

 

[Belekas]

IMO, carrier oil. For me, cottonseed oil. Test C induced malaise, loose stools, aching in the eyes, low grade headaches. Test E is more expensive but no side effects.

You know that we have to be our own doctor. And that's why some doctors get annoyed with such patients because we know more than they do, LOL.

Yeah possible for sure. Definitely alot more pain now on Sustanon then on Test-E before. I'm battling a severe form of H Pylori so who knows till I get required steps done. Pain started around 50 days post starting my TRT using Sustanon. So def think theres a relation with T and my GERD pain. Even though they found H Pylori bacteria by biopsy in January, I had no ulcers. Also wasn't diagnosed with GERD or Acid Reflux just the damn bug and pain from it. 2nd round of antibiotics did nothing, pain never went away. It's messing with my mind at this state as I'm sick and tired of trying and failing. So now I'm fasting just to reset my digestive system and will see how I feel coming into my next T shot in 2 days. I'm ready to drop the test as the pain has been killer FWIW.

About doctors I won't even start especially where I'm at in the UK. To be fair I'm thinking they are just legal drug dealers more then real doctors, if you know what I mean

 

[sammmy]

H. Pylori is often resistant to Clarithromycin, which is in the first line eradication regimens:

Helicobacter pylori eradication protocols - Wikipedia

en.wikipedia.org

Have you tried the second line quadruple therapy with bismuth (called Pylera)?

14 day therapy also increases chances of eradication, compared to 7 or 10 day therapy.

It is important to suppress the stomach acid continuously for 24 hours, so the bacteria proliferates and the antibiotics kill it (they can't kill it if the acid is high and the bacteria gets into a spore form) - the standard twice daily PPI is often not sufficient. They have a serious problem with resistant H. Pillory in Asia and use PPI 4 times daily, which claims to have better efficacy:

Efficacy of tailored Helicobacter pylori eradication treatment based on clarithromycin susceptibility and maintenance of acid secretion - PubMed

A tailored H. pylori eradication regimen based on CAM susceptibility and maintaining acid secretion (rabeprazole 10 mg q.i.d.) is useful because it can achieve an eradication rate exceeding 95%, irrespective of eradication history, thus overcoming differences among CYP2C19 genotypes.

pubmed.ncbi.nlm.nih.gov

Adding bismuth to the therapy also helps. If all regimens fail, you can get a few months of bismuth monotherapy. The best form is the European bismuth subcitrate (De-Nol, Ulkavis), not the bismuth subsalycilate in Pepto-Bismol, which converts to aspirin - harmful to intestines. The bismuth suppresses H. Pillory but usually cannot eradicate it. At least it should help with symptoms. You take it for 2 months and then stop since it can get neurotoxic if it accumulates. You have to cycle it, a few months on, a few months off.

 

[tropicaldaze1950]

Yeah possible for sure. Definitely alot more pain now on Sustanon then on Test-E before. I'm battling a severe form of H Pylori so who knows till I get required steps done. Pain started around 50 days post starting my TRT using Sustanon. So def think theres a relation with T and my GERD pain. Even though they found H Pylori bacteria by biopsy in January, I had no ulcers. Also wasn't diagnosed with GERD or Acid Reflux just the damn bug and pain from it. 2nd round of antibiotics did nothing, pain never went away. It's messing with my mind at this state as I'm sick and tired of trying and failing. So now I'm fasting just to reset my digestive system and will see how I feel coming into my next T shot in 2 days. I'm ready to drop the test as the pain has been killer FWIW.

About doctors I won't even start especially where I'm at in the UK. To be fair I'm thinking they are just legal drug dealers more then real doctors, if you know what I mean

I understand chronic gastro problems. I've had IBS since 1994 and other upper GI issues most of my life, related to either food sensitivities or depression/anxiety.

Here you're doing the right thing by getting tested, confirming H Pylori and the standard treatment protocol isn't working. Beyond frustrating. And given the brain/gut connection, problems in the gut mess with the brain. On the proverbial hamster wheel.

Fasting can be therapeutic. Nothing to lose by experimenting. Just keep banging away at it.

 

[Belekas]

H. Pylori is often resistant to Clarithromycin, which is in the first line eradication regimens:

Helicobacter pylori eradication protocols - Wikipedia

en.wikipedia.org

Have you tried the second line quadruple therapy with bismuth (called Pylera)?

It is important to suppress the stomach acid continuously for 24 hours, so the bacteria proliferates and the antibiotics kill it - the standard twice daily PPI is often not sufficient. They have a serious problem with resistant H. Pillory in Asia and use PPI 4 times daily, which claims to have better efficacy:

Efficacy of tailored Helicobacter pylori eradication treatment based on clarithromycin susceptibility and maintenance of acid secretion - PubMed

A tailored H. pylori eradication regimen based on CAM susceptibility and maintaining acid secretion (rabeprazole 10 mg q.i.d.) is useful because it can achieve an eradication rate exceeding 95%, irrespective of eradication history, thus overcoming differences among CYP2C19 genotypes.

pubmed.ncbi.nlm.nih.gov

Adding bismuth to the therapy also helps. If all regimens fail, you can get a few months of bismuth monotherapy. The best form is the European bismuth subcitrate (De-Nol, Ulkavis), not the bismuth subsalycilate in Pepto-Bismol, which converts to aspirin - harmful to intestines. The bismuth suppresses H. Pillory but usually cannot eradicate it. At least it should help with symptoms. You take it for 2 months and then stop since it can get neurotoxic if it accumulates. You have to cycle it, a few months on, a few months off.

14 day therapy also increases chances of eradication, compared to 7 or 10 day therapy.

Thanks for your post Sammy.

I have done 2 different rounds of treatment. First was with 2 antibiotics and second one was with one and antibacterial drug I believe, because doc wanted to give my liver a bit of rest. Well that worked absolutely zero and I've done it for 14 days FWIW. But I haven't had the one you say with Bismuth. I'm going to see GP on the 28th so I have a chance to talk her into trying it once more as I believe I have done a lot of damage to my gut already from taking all these meds which done none. Interesting re PPI as well. I can look my exact protocols that we used but I don't think that will give us any insight here going forward.

After 1st round of treatment and 40mg of Omeprazole 2x day I thought I was cured. But the issue came back and even stronger then before. So did biopsy January and they still found an active form of HP. The rest is pain and no gain till now. Zero food modifications worked and I started to believe that TRT is messing up with this issue as well.

 

[Belekas]

I understand chronic gastro problems. I've had IBS since 1994 and other upper GI issues most of my life, related to either food sensitivities or depression/anxiety.

Here you're doing the right thing by getting tested, confirming H Pylori and the standard treatment protocol isn't working. Beyond frustrating. And given the brain/gut connection, problems in the gut mess with the brain. On the proverbial hamster wheel.

Fasting can be therapeutic. Nothing to lose by experimenting. Just keep banging away at it.

Feel for you as well mate. Hows your GI issues now? Yeah the pain weared me out real good now as I'm on the verge to drop TRT and do all required to get to the root cause of it. Might be not a good idea though as I'm not sure about this one. Most problems started once I restarted my TRT. 50 days into it the pain came back and right now its bigger then ever. Maybe its better to stop TRT and do a treatment then continue it and start treatment again, maybe not. The pain is hard and gives me anxiety that does my head in. Felt like dying inside today thus why I started my fast :/

 

[sammmy]

Did they test your H. Pylori for antibiotic resistance?

I was lucky because I did GI-MAP which not only detected it but also did a genetic resistance profile of the bacteria, and of course it was resistant to Clarithromycin. It is also often resistant to Metronidazole but that is usually overcome by the addition of a PPI in the protocol.

I am currently doing the Japanse protocol from the article I gave above, with additional Bismuth subcitrate (De-Nol). You should not eat meat/proteins during the eradication, since protein requires stomach acid to digest and you will have none when you take PPI 4 times daily.

 

[Belekas]

Did they test your H. Pylori for antibiotic resistance?

I was lucky because I did GI-MAP which not only detected it but also did a genetic resistance profile of the bacteria, and of course it was resistant to Clarithromycin. It is also often resistant to Metronidazole but that is usually overcome by the addition of a PPI in the protocol.

I am currently doing the Japanse protocol from the article I gave above, with additional Bismuth subcitrate (De-Nol). You should not eat meat/proteins during the eradication, since protein requires stomach acid to digest and you will have none when you take PPI 4 times daily.

No they didn't test that even thought that was a private clinic and supposedly good Doc. So they did just the endoscopy and biopsy. Fucking amateurs. Yes I used Metronidazole on my second treatment, I remember now.

Didn't know about meat/protein and was always slamming my daily required protein amounts. SMH.

How severe you have it mate and how you feeling now?

 

[sammmy]

I usually do not have epigastric stomach pain but stomach is "sensitive" when I eat acids (fruits) and I get nausea when I eat protein (meat or eggs) or tannins (teas/herbs), but I also have lack of digestive enzymes. I also have silent acid reflex - sore throat and losing voice for more than a year and even my teeth started hurting recently from the acid spills overnight.

I started the eradication regimen yesterday and my throat and voice instantly improved with the first dose of antibiotics. Teeth stopped hurting too. No nausea yesterday but I am also not eating proteins because I am taking PPI every 6 hours.

If they are not going to do resistance testing on your H. Pylori, you can immediately start the Bismuth subcitrate. It should alleviate your symptoms. I test-drived it for a month before starting the antibiotics.

 

[Belekas]

I usually do not have epigastric stomach pain but stomach is "sensitive" when I eat acids (fruits) and I get nausea when I eat protein (meat or eggs) or tannins (teas/herbs), but I also have lack of digestive enzymes. I also have silent acid reflex - sore throat and losing voice for more than a year and even my teeth started hurting recently from the acid spills overnight.

I started the eradication regimen yesterday and my throat and voice instantly improved with the first dose of antibiotics. Teeth stopped hurting too. No nausea yesterday but I am also not eating proteins because I am taking PPI every 6 hours.

If they are not going to do resistance testing on your H. Pylori, you can immediately start the Bismuth subcitrate. It should alleviate your symptoms. I test-drived it for a month before starting the antibiotics.

Understood and glad you feeling a bit better. PPI every 6 hours makes sense as I was only having them morning and evening. TBH I've never met anyone who gets such severe chest pain like me. Feels like stabbing from inside. Reacts to my body positions as well. And today it got bad to a new level pain even taking a deep breath and swallowing nothing. Whats changed is I ended my Test-E 2 days ago and started Sustanon250 and boom here I am.

About Bismuth subcitrate its prescription as I understand and should ask my GP? Also I'm very interested if you are on TRT? Not sure if I can continue Sustanon while starting treatment or should I jump off, just to be sure. Wonder what your opinion on this particular one is. Thank you in advance mate!

 

[sammmy]

I'm not on TRT. I'm not sure if the Bismuth subcitrate requires prescription where you are. I got it shipped from Ukraine - yes, no kidding!

If you symptoms are severe/accute and you think TRT is implicated, of course drop it and see if symptoms subside.

Here in US, we have over the counter Bismuth subsalicylate (Pepto-Bismol), which is not the right form and has warnings to not be used if there is stomach bleeding or ulcerations because it decomposes to Salicylic acid (aspirin essentially).

 

[Belekas]

I'm not on TRT. I'm not sure if the Bismuth subcitrate requires prescription where you are. I got it shipped from Ukraine - yes, no kidding!

If you symptoms are severe/accute and you think TRT is implicated, of course drop it and see if symptoms subside.

Here in US, we have over the counter Bismuth subsalicylate (Pepto-Bismol), which is not the right form and has warnings to not be used if there is stomach bleeding or ulcerations because it decomposes to Salicylic acid (aspirin essentially).

I find only subsalicylate online so probably need prescription or either its not here as I'm in the UK and they seem light years behind everything when I need it. Pretty much stone age. Did you order it online? If so I'd gladly order it as well and see if it helps any.

Will see how I feel into my next T shot in 2 days and will drop to see if chest pain improves. Yes its severe. I also have back and neck trauma so maybe theres a pinch nerve somewhere as that can radiate into chest as much as I understand. But once I get the pain after a meal lets say and pop 1 Rennie it usually dissapears so I'm thinking thats got to be the H Pylori influence. Some times the Rennies don't help then soda in water, sometimes even that don't help, then prayers and struggle with huge stabbing pain, pressure mid chest.

 

[sammmy]

Yes I got it online.

If your pain is after meals and the soda helps, it must be digestive not cardiac - they are often mixed up. It is strange that your upper endoscopy did not find ulcers but you must have at least gastritis.

 

[sammmy]

Until you are waiting for the subcitrate, you can try the local Bismuth subsalicylate - it may help, since you don't have ulcer.

 

[Belekas]

Until you are waiting for the subcitrate, you can try the local Bismuth subsalicylate - it may help, since you don't have ulcer.

Should I get liquid or in caps form?

 

[sammmy]

The liquid form of Pepto-Bismol in US contains benzoic acid as a preservative and since I am sensitive to acids, I took the chewable tablets forms, which seemed more benign. Read the ingredients and decide for yourself.

 

[sammmy]

Also, you if you have it in UK, you can get a prescription directly for Pylera. It is a quadruple antibiotic regimen for H. Pylori and contains the subcitrate form of Bismuth.

I didn't get on it because it is something like $300 out of pocket here in US and because it uses tetracycline, which is a nasty antibiotic - can cause ulcerations if not taken with enough water. So I am taking Amoxicillin instead.

 

[Belekas]

Also, you if you have it in UK, you can get a prescription directly for Pylera. It is a quadruple antibiotic regimen for H. Pylori and contains the subcitrate form of Bismuth.

I didn't get on it because it is something like $300 out of pocket here in US and because it uses tetracycline, which is a nasty antibiotic - can cause ulcerations if not taken with enough water. So I am taking Amoxicillin instead.

Fair enough. I'll ask my GP in a couple of days but somehow I really doubt it as like I said this place looks to be behind everything whenever I need it and had no problem getting back home in Eastern Europe.

 

[tropicaldaze1950]

Feel for you as well mate. Hows your GI issues now? Yeah the pain weared me out real good now as I'm on the verge to drop TRT and do all required to get to the root cause of it. Might be not a good idea though as I'm not sure about this one. Most problems started once I restarted my TRT. 50 days into it the pain came back and right now its bigger then ever. Maybe its better to stop TRT and do a treatment then continue it and start treatment again, maybe not. The pain is hard and gives me anxiety that does my head in. Felt like dying inside today thus why I started my fast :/

Comes and goes, depending on stress level/mood as well as time of year. I've found that eating salads and beans helps. Also been prescribed dicyclomine capsules(anticholengeric) for years. So many health problems associated with bipolar illness, so I just ride out the bad times. Not much choice, LOL.

 

[FunkOdyssey]

Have you ever heard of rebamipide? It's a very safe and benign drug that heals gastritis and other GI tract injuries by increasing production of prostaglandin E2, basically the opposite effect of NSAID drugs. You can order it from asian pharmacies if it isn't available locally. It doesn't work for everyone but some percentage have tremendous success with it.

Here is one reliable Japanese pharmacy I have used: HOME | Natural Pharmacy They actually have a wide selection of gastroprotective drugs that are not available in the US or Europe if you are feeling adventurous, including rebamipide, troxipide, irsogladine, and many more.