28. 3 weeks on TRT. Initial labs.

[daleb]

For this entire process or the fertility part? My GP would not go for this. He is kind of a huge prick and I would imagine knows nothing about TRT. I appreciate the feedback.

What many people experience is Urologists tend to be better TRT docs, Endos tend to be pretty hit and miss, and GP's are ok sometimes. The best way to find a TRT doc is to call pharmacies. Tell them you are new to town and looking for a doc to continue your Hormone Replacement Therapy. Ask which doctors prescribes the most Testosterone Cypionate. Set up appointments with 3 or 4 of them, and if you find the right doctor the first appt cancel the rest of the appointments. In the mean time download and read "Male Hypogonadism - Basic Clinical and Therapeutic Principles" Its a free download. Its in the stickies, or you can google it and find it that way. There is enough information in that book to know if your doc is good or not.

 

[Bluffcityrat]

Mega you make a great point. Should have looked in to the fertility side of things more in depth before I started. But I can't turn back time so I will go about this the best I can. Thank you for the advice Daleb. I will start looking for some popular TRT doctors but in the meantime will get my weekly shot from the current provider. Any and all feedback welcome. Thanks as always.

 

[Bluffcityrat]

Did some searching on the forum for the most reputable TRT doc in the DFW area. General consensus is one guy and everyone spoke very highly of him on here. The doctor's office he works for is also open on Saturdays which is huge so I don't have to miss work. However he is a PA not an MD. Thoughts Mega?

 

[Megatron28]

Mega you make a great point. Should have looked in to the fertility side of things more in depth before I started. But I can't turn back time so I will go about this the best I can. Thank you for the advice Daleb. I will start looking for some popular TRT doctors but in the meantime will get my weekly shot from the current provider. Any and all feedback welcome. Thanks as always.

Wait. You aren't self-injecting?

 

[Bluffcityrat]

No I am not self injecting. This is under the guidance of a NP at the original Low T center by my work. I'm fine with self injecting once I get a feel for everything if needed. They check my vitals every time I go in, which I like. Now I have been directed to a local doctor that allows his patients to self inject. I'm not hiding anything from anyone. Not how I'm going to do this.

 

[Bluffcityrat]

Holy shit. I told my parents about me going to treatment and told them about me starting TRT. Their response was mind blowing. I was just told I was born with a double hernia. My nuts were in my abs when I was born. They pulled them out at birth. But they never fully dropped. Kallman's syndrome. Causes hypogonadism. Holy moly my mind is blown. Explains so much. The screwed up thing is my doctor should have started me on TRT early in life. And didn't. My mom's about to freak out on my pediatrician/our family friend of like 30 years lolol.

 

[daleb]

Its amazing how some guys can still be high level athletes and yet be disadvantaged for lack of a better way to put it.

I hit puberty good, started growing. then at the end of my freshman year its like I hit a wall of sorts. I was still good at sports but i always felt I never lived up to expectations I set for myself. I dont have Kallmans but I do kinda relate to you.

 

[Megatron28]

Holy shit. I told my parents about me going to treatment and told them about me starting TRT. Their response was mind blowing. I was just told I was born with a double hernia. My nuts were in my abs when I was born. They pulled them out at birth. But they never fully dropped. Kallman's syndrome. Causes hypogonadism. Holy moly my mind is blown. Explains so much. The screwed up thing is my doctor should have started me on TRT early in life. And didn't. My mom's about to freak out on my pediatrician/our family friend of like 30 years lolol.

You parents never talked to you about that or sought medical care for you?

 

[Bluffcityrat]

I had surgery shortly after birth to fix the double hernia and they just assumed everything developed normally. My doctors never said anything to me. I never said anything because I had no idea that my balls weren't normal. My parents and I are putting all the pieces together right now. My doctors should have noticed my lack of development over the years. I never knew anything was wrong. Didn't know to say anything. I hit puberty way late and now it's very obvious my puberty was "weak." I went on to play D1 sports in college and was otherwise healthy so we never thought anything was wrong. And they had no idea my balls never dropped or never grew. Until about an hour ago.

 

[Bluffcityrat]

I don't know for a fact that I have Kallman's. It would make sense. I'm kind of working backwards here. Found out I had low T. Then parents told me I was born with double hernia and balls never dropped fully. It all kind of makes sense now looking back. What sucks is I had the ability and coordination to compete with anyone, but physically wasn't a specimen like the rest of them. My dad is an absolute animal by the way. Always wondered why I didn't develop like him. That's what happens when you are born 2 months premature with your balls in your abdomen I guess. I weighed 4 lbs at birth.

Also my temp hasn't gotten above 96.5 today or the last few days since I have been checking. Pretty pumped to see what the iodine supplement does.

 

[Bluffcityrat]

Hey dudes. I finally found a PA in DFW that is really really knowledgable with TRT. Was very skeptical about the blood work from the Low T Center (in OP) so he took blood today to run his own tests.

Previously I was going to Low T Center once a week for injections. Would not give me HCG.

New doc has me self injecting the following:

0.4 test cyp twice a week
250mg HCG three time a week
Said after I get my blood work back next week he will determine if Arimadex is needed and dosage.

Really relieved. This guy was very knowledgable. Picked up meds and syringes at my normal pharmacy. Very excited about being on this new regimine. Slightly nervous about self injecting but I will get over it quickly.

 

[Megatron28]

Hey dudes. I finally found a PA in DFW that is really really knowledgable with TRT. Was very skeptical about the blood work from the Low T Center (in OP) so he took blood today to run his own tests.

Previously I was going to Low T Center once a week for injections. Would not give me HCG.

New doc has me self injecting the following:

0.4 test cyp twice a week
250mg HCG three time a week
Said after I get my blood work back next week he will determine if Arimadex is needed and dosage.

Really relieved. This guy was very knowledgable. Picked up meds and syringes at my normal pharmacy. Very excited about being on this new regimine. Slightly nervous about self injecting but I will get over it quickly.

One week on a new protocol is not enough time to determine if an AI is needed. I recommend waiting about 4-6 weeks.

 

[daleb]

Im curious, did you talk to him about your birth issues? Was wondering what the PA had to say about it. Anyways, seems like you found a decent doc, hopefully everything works out for you.

 

[Bluffcityrat]

He looked at the balls. He said they are normal size just not exactly hanging to the floor. Primary is probably not the case. Said my surgery was probably normal and successful back in the day. He was pumped to get me on HCG to keep those puppies working.

 

[Bluffcityrat]

That's exactly what the doc said Mega. What are your thoughts on my new protocol.

 

[Megatron28]

That's exactly what the doc said Mega. What are your thoughts on my new protocol.

It seems like a good starting point. You can get blood work and make any needed adjustments. It can sometimes take a good 6-12 months to get your protocol dialed in.

Most guys only take hCG twice a week, but give it a go and see how it works for you.

Remember to donate blood regularly to keep your hematocrit in check.

 

[Bluffcityrat]

Picked up my test and HCG from the compounding pharmacy and the cost is amazing. I'm so surprised. My 4 week supply of test was $12. Insurance covered $80 of it. 800mg.

My HCG was $60 and the supply is good for almost 4 months. 250 mg 3 times per week. Hell the syringes cost me more than everything else. I'm just surprised how cost effective this is. I was also under the impression that most health insurance did not cover Test, but mine almost paid for the whole thing. Just an observation.

 

[Megatron28]

Picked up my test and HCG from the compounding pharmacy and the cost is amazing. I'm so surprised. My 4 week supply of test was $12. Insurance covered $80 of it. 800mg.

My HCG was $60 and the supply is good for almost 4 months. 250 mg 3 times per week. Hell the syringes cost me more than everything else. I'm just surprised how cost effective this is. I was also under the impression that most health insurance did not cover Test, but mine almost paid for the whole thing. Just an observation.

hCG will not last 4 months once reconstituted.

Ask for a 10ml vial of testosterone at 200mg/ml. It is even cheaper.

Syringes only cost about $15-20 for a box of 100. That includes needles (luer Lok)

Nearly all insurance covers testosterone for TRT.

 

[Bluffcityrat]

Just got results back from new doctor that is now letting me self inject. Quick backstory I went to a Low T clinic for 4 weeks and they had no clue what they were doing. Had me on 100 mg cyp per week. No HCG. New doc has me on 0.4 cyp twice a week and 250mg HCG 3 times per week. New doc wanted to run tests on my first visit so the new test results are after 4 weeks 100mg test cyp per week. Since the test, I have been on the new protocol. Any and all feedback welcome please.

Original results from First visit with crappy doctor (also posted in my original post):
Glucose: 86 (65-99)
BUN: 13 (16-20)
AST: 32 (0-40)
ALT: 52 high (0-44)
TSH: 4.250 low (0.450-.0450)
LH: 8.5 (1.7-8.6)
FSH: 1.9 (1.5-12.4)
Prolactin: 14.3 (4-15.2)
WBC: 7.1 (3.4-10.8)
RBC: 5.35 (4.14-5.80)

Hemoglobin: 16.10 (12.6-17.7)
Hematocrit: 46.3 (37.5-51.0)
MCV: 87 (79-97)
MCH: 30.1 (26.6-33.0)
MCHC: 34.8 (31.5-35.7)
RDW: 13.1 (12.3-15.4)
Platelets: 278 (150-379)

Sexd Horm Binding Glob, Serum: 13.0 low (16.5-55.9)
Estradiol: 23.9 (7.6-42.6)

TT: 222 low (600-800)
CFT: 6.54


NEW results after 4 weeks TRT. Going forward am on new protocol:

Total test: 485 (300-1080 ng/dl)
SHBG: 13L (16.5-55.9 NMOL/L)
Free test: 15.2 (4.8-25.7 NG/Dl)
Estradiol: 20.2 (10.0-25.7)

TSH: 1.3 (0.5-4.7 UIU/ml)
T3: 3.3 (2.3-4.2 PG/ML)
T4: 7.7 (4.4-12.4 UG/DL)

I know it's different doctors and different labs but my TSH is quite different and I figured my estrogen might be a little higher after 4 weeks on TRT. Would appreciate feedback. Thanks everyone.

 

[Megatron28]

Just got results back from new doctor that is now letting me self inject. Quick backstory I went to a Low T clinic for 4 weeks and they had no clue what they were doing. Had me on 100 mg cyp per week. No HCG. New doc has me on 0.4 cyp twice a week and 250mg HCG 3 times per week. New doc wanted to run tests on my first visit so the new test results are after 4 weeks 100mg test cyp per week. Since the test, I have been on the new protocol. Any and all feedback welcome please.

Original results from First visit with crappy doctor (also posted in my original post):
Glucose: 86 (65-99)
BUN: 13 (16-20)
AST: 32 (0-40)
ALT: 52 high (0-44)
TSH: 4.250 low (0.450-.0450)
LH: 8.5 (1.7-8.6)
FSH: 1.9 (1.5-12.4)
Prolactin: 14.3 (4-15.2)
WBC: 7.1 (3.4-10.8)
RBC: 5.35 (4.14-5.80)

Hemoglobin: 16.10 (12.6-17.7)
Hematocrit: 46.3 (37.5-51.0)
MCV: 87 (79-97)
MCH: 30.1 (26.6-33.0)
MCHC: 34.8 (31.5-35.7)
RDW: 13.1 (12.3-15.4)
Platelets: 278 (150-379)

Sexd Horm Binding Glob, Serum: 13.0 low (16.5-55.9)
Estradiol: 23.9 (7.6-42.6)

TT: 222 low (600-800)
CFT: 6.54


NEW results after 4 weeks TRT. Going forward am on new protocol:

Total test: 485 (300-1080 ng/dl)
SHBG: 13L (16.5-55.9 NMOL/L)
Free test: 15.2 (4.8-25.7 NG/Dl)
Estradiol: 20.2 (10.0-25.7)

TSH: 1.3 (0.5-4.7 UIU/ml)
T3: 3.3 (2.3-4.2 PG/ML)
T4: 7.7 (4.4-12.4 UG/DL)

I know it's different doctors and different labs but my TSH is quite different and I figured my estrogen might be a little higher after 4 weeks on TRT. Would appreciate feedback. Thanks everyone.

Your E2 is low because your TT is still low. Give it more time. Glad to see your TSH is much improved.

Remember to keep checking CMP and CBC.