Am I doing the wrong thing?

[reefstar]

Hi All,

OK, I'm nearly 7 monthes into testosterone replacement therapy (TRT) and still not happy with results. 44yrs 6' 180 lbs and 294 test (tested in January). Admittedly the first 5 months were badly botched by 2 GP's and a Urologist. My first GP said 294 was in the "normal" range, and did nothing but prescribe anti depresants (which made things way worse). My 2nd Gp Started me on 1 pump of 1% Androgel, which after some time and nail pulling I got him to move me up to 1 pump of 1.62% Androgel. In the mean time in order to get him to take me seriously I agreed to see a councelor he recommended, because he was convinced it wasn't low t and I had "underlying issues" that a councelor should address. So I've been seeing a councelor who agrees I have mild depression (which is reasonable considering all i have been through with this), but that its more of a "chemical" imbalance that should resolve itself once things balance out.

After some insisting I got my GP to refer me to a Urologist who started me on 100mg test cyp injections every 10 days on May 9th, and a recheck in 8 weeks. He refused repeatedly to check my estrogen levels (my wife even called him once to ask him to check my e levels). I changed my protocol to 50 mg every 5days, which I hoped would help. So I found a new Dr who specializes in Hormone Replacement Therapy (HRT) and male vitality.

Anyway fast forward to June 1. I finally am seeing the specialist who has me now taking 100mg every 7 days. He tested my levels and they came back at 605 (48hrs after 50 mg injection) and my E cam back at 40. (I posted my latest results below) So he put me on .5mg of anastrozol 2 times a week. He doesnt care if I T dose weekly or bi weekly.

So heres my question. I still feel like crap 70 to 80 of the time. I have a few good days here and there, but I'm 44 and if I live another 30 years, this is gonna suck this way. Anyway I live in Northern WA state, and my Vitamin D levels also came back very low. So heres what I'm wondering everything started during the winter months (about October - Novemeber). Is this T replacement all wrong. Is it possible to get Low t through seasonal depression. How can / does low D affect T?

Obviously, I have no idea what my pre med T levels were. So is it possible that the low Vitamin D and poor sleep and stress during the winter months were the actual cause of my low t issues? How do I know? What I do know is that after I take my dose, I feel better (about 70 to 80%)about 48 hrs or so after the injection for about 48 hrs, and then the next three days go down hill. No motivation, no energy, anxiety, depression, low self esteem and not happy inside. So is it possible that the injections are in fact causing my body to stop producing natural t which is just off setting the shots. Each time I increase the dose, is my body just responding by decreasing what it makes naturally? How do I know?

I know this sounds crazy, or maybe it doesn't, but roller coasters are fun at disneyland, not in my home and with my wife and kids who depend on me.

Right now all I am taking is
60 mg test cyp 2 times per week
.25 mg anastrolzole EOD

I'm also taking (for about 2 weeks now)
approx 8000 iu vitamin d per day
1000 mg Calcium per day
400 mg Mag per day
15 mg zinc per day

Here are my latest results (June 1)

test total = 605 ng/dL *** 291-739 (739 for a high seems low?)
t3 Free = 3.8 pg/mL *** 2.3 - 4.2
t4 Free = 1.2 ng/dL *** 0.7 - 1.5
Then there are some LH and FSH numbers with a bunch of Tanner stages (should I post them?)

Prolactin = 6.4 ng/mL *** 1.6 - 18.8
Thyroid Peroxidase = < 0.3 IU/mL *** 0.0 - 9.0

Estradiol Ultrasensitive = 40 pg/mL *** < or = 29

It seems that since I added the vitamins to my diet, I'm finally sleeping better. Not perfect, but noticably better.

I need some input here, is there something in my protocol I'm missing/overlooking, like Hcg or something? If I throw out the first 4 months of treatment, I've been taking test cyp for almost 6 weeks now... this is frustrating. It seems there must be some additional information available in this forum, that I'm missing. How do i know if the Test cyp is the wrong thing to be doing?

Thanks

C

 

[Megatron28]

E2 at 40 is not that high. Were you noticing any high E2 symptoms? You could go without Aromatase inhibitor (AI) at that level if you didn't have sides.

Taking .25mg of adex eod on your current 120mg of test per week very well might crash your E2. Low E2 feels worse than high E2. That is probably contributing to your feeling lousy. Best bet is to get another lab test to see where you are at now.

I think your other problem is that TT at 600 for a peak is too low. I bet your trough is getting close to the Low T range. You should get your lab tests done right before you inject to see what your trough is. That is the result you want your doctor to see. Try to get your trough into at least the 600-800 range.

 

[halfwit]

It's all part of the process my man. It sounds like you're FINALLY seeing a doctor that has half a brain, so I think you're in good hands there even though he's a bit on the slow side as it shouldn't take coaxing to get your estradiol checked. Good old Washington, the place where people don't tan - they rust! I lived there for around twenty years, so it's not surprising to hear that they were trying to treat you with anti-depressants as the weather there is surprisingly a huge cause for a disproportionate rate of depressed people. I don't think that was your issue as your T levels have shown. Have you looked into a sleep study? Do you snore? If you do, that might be another piece of the puzzle that you're missing on finally achieving the quality of life that you deserve.

Remember, even though you NOW have good hormone levels - it can take several more months to a year for your body to return to normal. I know it took me about a year to get off all the b.s. drugs that doctors had put me on for depression/anxiety/RLS as the root cause was... Low testosterone. Keep pushing forward my man, it will all be worth it in the end.

 

[reefstar]

E2 at 40 is not that high. Were you noticing any high E2 symptoms? You could go without Aromatase inhibitor (AI) at that level if you didn't have sides.

Taking .25mg of adex eod on your current 120mg of test per week very well might crash your E2. Low E2 feels worse than high E2. That is probably contributing to your feeling lousy. Best bet is to get another lab test to see where you are at now.

I think your other problem is that TT at 600 for a peak is too low. I bet your trough is getting close to the Low T range. You should get your lab tests done right before you inject to see what your trough is. That is the result you want your doctor to see. Try to get your trough into at least the 600-800 range.

Megatron,

Thanks for the reply, here are the estrgen level issues I have:

* Depression (thats what the dr is convinced I need treatment for)
* Anxiety (worsened by low self esteem which is very un normal for me)
* Panic Attacks (I never panic, until now)
* Dizziness/Vertigo
* Trouble sleeping at night - waking up multiple times per night ++ big time, but less since Ive been taking vits
* Crying while watching TV shows/movies
* easily emotional, frustration make me tear up. (can't remember the last time I teared up before this)
* Redness on the face and/or chest (this seems to have gotten better)
* Feeling hotter than everybody else
* Also night sweats, I'll soak my pillow regularly. (that's getting slightly better, but i have to turn my pillow over at least once a night)
* and what is almost the worst is the shakey hands, legs and arms. (I don't know if this is related to high or low E but it really is the toughest part)

I was wondering about too much anastrolzole from what I have been reading. But how do you know if your too high or too low. Over all my joints feel fine. Should i go to 1/4 just on the day of the shot? If my E did crash, how long before it comes back up? I have a new blood test coming up here shortly, I'll post it as soon as I can. Oh, and I'll ask for a trough reading. Would I take that reading on the day of the shot or the day before since it takes time for the shot to get into your system. Seems the test the day of the shot would be best?


Thanks again,

C

 

[reefstar]

It's all part of the process my man. It sounds like you're FINALLY seeing a doctor that has half a brain, so I think you're in good hands there even though he's a bit on the slow side as it shouldn't take coaxing to get your estradiol checked. Good old Washington, the place where people don't tan - they rust! I lived there for around twenty years, so it's not surprising to hear that they were trying to treat you with anti-depressants as the weather there is surprisingly a huge cause for a disproportionate rate of depressed people. I don't think that was your issue as your T levels have shown. Have you looked into a sleep study? Do you snore? If you do, that might be another piece of the puzzle that you're missing on finally achieving the quality of life that you deserve.

Remember, even though you NOW have good hormone levels - it can take several more months to a year for your body to return to normal. I know it took me about a year to get off all the b.s. drugs that doctors had put me on for depression/anxiety/RLS as the root cause was... Low testosterone. Keep pushing forward my man, it will all be worth it in the end.

Fortunately, it didn't take any coaxing for my new dr to do the e test. He was right on it, and said that e testing must be done during testosterone replacement therapy (TRT). He says he sees about half of his patients need some sort of E control.

I only took the anti depressants for about 3 days.. Screw that noise!!! Made things much worse. Now I occasionally take a valium at night before bed, but only on nights I know I need to sleep.

I have a sleep study scheduled for Aug (hopefully by that time I can just cancel it!), I don't snore. My wife says when she wakes up she sometimes hears me lightly snoring, but nothing severe at all, and definitely not all the time. She says when she hears me snore it surprises her some time cause it's not normal.

Thanks for the encouragement. Man it can be tough!!! I have said a bunch of times, I surprised there isn't a TA group for men and there spouses to go to to get support.

Thanks again
C

 

[Megatron28]

Megatron,

Thanks for the reply, here are the estrgen level issues I have:

* Depression (thats what the dr is convinced I need treatment for)
* Anxiety (worsened by low self esteem which is very un normal for me)
* Panic Attacks (I never panic, until now)
* Dizziness/Vertigo
* Trouble sleeping at night - waking up multiple times per night ++ big time, but less since Ive been taking vits
* Crying while watching TV shows/movies
* easily emotional, frustration make me tear up. (can't remember the last time I teared up before this)
* Redness on the face and/or chest (this seems to have gotten better)
* Feeling hotter than everybody else
* Also night sweats, I'll soak my pillow regularly. (that's getting slightly better, but i have to turn my pillow over at least once a night)
* and what is almost the worst is the shakey hands, legs and arms. (I don't know if this is related to high or low E but it really is the toughest part)

I was wondering about too much anastrolzole from what I have been reading. But how do you know if your too high or too low. Over all my joints feel fine. Should i go to 1/4 just on the day of the shot? If my E did crash, how long before it comes back up? I have a new blood test coming up here shortly, I'll post it as soon as I can. Oh, and I'll ask for a trough reading. Would I take that reading on the day of the shot or the day before since it takes time for the shot to get into your system. Seems the test the day of the shot would be best?


Thanks again,

C

How can you tell if your e2 is too high or too low? Easy! Like I said, get blood work done. Read the testosterone replacement therapy (TRT) stickies to learn how to get cheap, quick blood work on your own using Private MD - Buy Lab Tests Online.

So when your estrogen was at 40 did all those problems you listed lessen or disappear?

Get your blood drawn on the day you inject, but before you actually do inject.

Post your results once you have them along with your current protocol again. Then we can advise you on whether or not you should make any changes. Let's get some numbers first.

 

[Megatron28]

Fortunately, it didn't take any coaxing for my new dr to do the e test. He was right on it, and said that e testing must be done during testosterone replacement therapy (TRT). He says he sees about half of his patients need some sort of E control.

I only took the anti depressants for about 3 days.. Screw that noise!!! Made things much worse. Now I occasionally take a valium at night before bed, but only on nights I know I need to sleep.

I have a sleep study scheduled for Aug (hopefully by that time I can just cancel it!), I don't snore. My wife says when she wakes up she sometimes hears me lightly snoring, but nothing severe at all, and definitely not all the time. She says when she hears me snore it surprises her some time cause it's not normal.

Thanks for the encouragement. Man it can be tough!!! I have said a bunch of times, I surprised there isn't a TA group for men and there spouses to go to to get support.

Thanks again
C

Try melatonin to help you sleep instead of valium. It's natural and works. There are no ill effects the next day or long-term. If you can plan ahead it is good to take 1-2mg about three hours before you want to fall asleep. If you are unable to take it in advance take 5mg of the kind that disolves under your tongue when you go to bed. Give it a try. It is cheap and readily available at any drug store or on amazon.

 

[halfwit]

Fortunately, it didn't take any coaxing for my new dr to do the e test. He was right on it, and said that e testing must be done during testosterone replacement therapy (TRT). He says he sees about half of his patients need some sort of E control.

I only took the anti depressants for about 3 days.. Screw that noise!!! Made things much worse. Now I occasionally take a valium at night before bed, but only on nights I know I need to sleep.

I have a sleep study scheduled for Aug (hopefully by that time I can just cancel it!), I don't snore. My wife says when she wakes up she sometimes hears me lightly snoring, but nothing severe at all, and definitely not all the time. She says when she hears me snore it surprises her some time cause it's not normal.

Thanks for the encouragement. Man it can be tough!!! I have said a bunch of times, I surprised there isn't a TA group for men and there spouses to go to to get support.

Thanks again
C

Oh, I must have misread as I thought it was this doctor that took coaxing. In that case, it DEFINITELY sounds like you're on the right track. I would still stick with the sleep study as apnea isn't something our loved ones always notice, and I had to have my wife record me sleeping one night as she wasn't sure if I was snoring either. Turns out you could hear me stop breathing followed by a gasping for air. You might be fine, but it's definitely something I'd have done just to be sure.

LOL at TA group. It's funny, my wife has bonded with a coworker because of the fact that both their husbands are on testosterone replacement therapy (TRT) and they get to share stories on how their sex lives have drastically changed for the better. Hormones do some crazy stuff to us, but when in proper amounts, work wonders. Keep it going man, I was on xanax/benzodiazepines/ambien and many other drugs that not only can make you feel like a zombie, but LOWER YOUR IQ! Yeah, I was shocked to see that both Ambien and Xanax can do this. Let the testosterone do its thing, you'll be up and running in no time!

 

[reefstar]

How can you tell if your e2 is too high or too low? Easy! Like I said, get blood work done. Read the testosterone replacement therapy (TRT) stickies to learn how to get cheap, quick blood work on your own using Private MD - Buy Lab Tests Online.

So when your estrogen was at 40 did all those problems you listed lessen or disappear?

Get your blood drawn on the day you inject, but before you actually do inject.

Post your results once you have them along with your current protocol again. Then we can advise you on whether or not you should make any changes. Let's get some numbers first.

Megatron,

Thanks, I undeerstand that blood tests are the way to have my levels checked. I can ask my Dr to check them again. I think He will. I was just wondering if there was a way to "tell" in between blood tests.

I have had all of those problems with my level at 40. That is why the Dr said I should take the anastrozole. One thing I don't know is if my E level was coming down or going up (because no drs up until my last one would do the test for me) considering I was using Gel prior to the test cyp. I don't know what my E is currently since I have been taking the anastrozole. From what I've been reading it seems that at a dose of 60mg two times a week that E shouldn't normally be a problem. So I'm just following my drs instructions.

I read somewhere that your test should be 20x your E levels at minimum. Is that correct. So if my level was at 600 then my E should be 30 max. Is that bunk, or is that correct?

One more thing, if I understand anastrozole will stop the conversion of T into E, but doesn't actually lower the existing E. Is that correct? Assuming it is correct, how long will it take for the existing levels to drop... I know there probably isn't a exact answer, but is it days, weeks, months? And lets just assume I want to drop it 15 pts. to 25 ( for the sake of a number). I'm sure someone has dropped that much, how long did it take? If it drops in days, then I agree, maybe my levels are too low now.

Thanks again for your patience answering my questions,

BTW I have read the stickies. All 16 pages. Good info there.

C

 

[Lindsay IMT Staff]

Hi All,

OK, I'm nearly 7 monthes into testosterone replacement therapy (TRT) and still not happy with results. 44yrs 6' 180 lbs and 294 test (tested in January). Admittedly the first 5 months were badly botched by 2 GP's and a Urologist. My first GP said 294 was in the "normal" range, and did nothing but prescribe anti depresants (which made things way worse). My 2nd Gp Started me on 1 pump of 1% Androgel, which after some time and nail pulling I got him to move me up to 1 pump of 1.62% Androgel. In the mean time in order to get him to take me seriously I agreed to see a councelor he recommended, because he was convinced it wasn't low t and I had "underlying issues" that a councelor should address. So I've been seeing a councelor who agrees I have mild depression (which is reasonable considering all i have been through with this), but that its more of a "chemical" imbalance that should resolve itself once things balance out.

After some insisting I got my GP to refer me to a Urologist who started me on 100mg test cyp injections every 10 days on May 9th, and a recheck in 8 weeks. He refused repeatedly to check my estrogen levels (my wife even called him once to ask him to check my e levels). I changed my protocol to 50 mg every 5days, which I hoped would help. So I found a new Dr who specializes in Hormone Replacement Therapy (HRT) and male vitality.

Anyway fast forward to June 1. I finally am seeing the specialist who has me now taking 100mg every 7 days. He tested my levels and they came back at 605 (48hrs after 50 mg injection) and my E cam back at 40. (I posted my latest results below) So he put me on .5mg of anastrozol 2 times a week. He doesnt care if I T dose weekly or bi weekly.

So heres my question. I still feel like crap 70 to 80 of the time. I have a few good days here and there, but I'm 44 and if I live another 30 years, this is gonna suck this way. Anyway I live in Northern WA state, and my Vitamin D levels also came back very low. So heres what I'm wondering everything started during the winter months (about October - Novemeber). Is this T replacement all wrong. Is it possible to get Low t through seasonal depression. How can / does low D affect T?

Obviously, I have no idea what my pre med T levels were. So is it possible that the low Vitamin D and poor sleep and stress during the winter months were the actual cause of my low t issues? How do I know? What I do know is that after I take my dose, I feel better (about 70 to 80%)about 48 hrs or so after the injection for about 48 hrs, and then the next three days go down hill. No motivation, no energy, anxiety, depression, low self esteem and not happy inside. So is it possible that the injections are in fact causing my body to stop producing natural t which is just off setting the shots. Each time I increase the dose, is my body just responding by decreasing what it makes naturally? How do I know?

I know this sounds crazy, or maybe it doesn't, but roller coasters are fun at disneyland, not in my home and with my wife and kids who depend on me.

Right now all I am taking is
60 mg test cyp 2 times per week
.25 mg anastrolzole EOD

I'm also taking (for about 2 weeks now)
approx 8000 iu vitamin d per day
1000 mg Calcium per day
400 mg Mag per day
15 mg zinc per day

Here are my latest results (June 1)

test total = 605 ng/dL *** 291-739 (739 for a high seems low?)
t3 Free = 3.8 pg/mL *** 2.3 - 4.2
t4 Free = 1.2 ng/dL *** 0.7 - 1.5
Then there are some LH and FSH numbers with a bunch of Tanner stages (should I post them?)

Prolactin = 6.4 ng/mL *** 1.6 - 18.8
Thyroid Peroxidase = < 0.3 IU/mL *** 0.0 - 9.0

Estradiol Ultrasensitive = 40 pg/mL *** < or = 29

It seems that since I added the vitamins to my diet, I'm finally sleeping better. Not perfect, but noticably better.

I need some input here, is there something in my protocol I'm missing/overlooking, like Hcg or something? If I throw out the first 4 months of treatment, I've been taking test cyp for almost 6 weeks now... this is frustrating. It seems there must be some additional information available in this forum, that I'm missing. How do i know if the Test cyp is the wrong thing to be doing?

Thanks

C

hi, if you like to see what testosterone replacement therapy (TRT) program our doctor recommends, feel free to send me an email and I can get your free pre approval started lindsay@increasemyt.com

 

[Megatron28]

Megatron,

Thanks, I undeerstand that blood tests are the way to have my levels checked. I can ask my Dr to check them again. I think He will. I was just wondering if there was a way to "tell" in between blood tests.

I have had all of those problems with my level at 40. That is why the Dr said I should take the anastrozole. One thing I don't know is if my E level was coming down or going up (because no drs up until my last one would do the test for me) considering I was using Gel prior to the test cyp. I don't know what my E is currently since I have been taking the anastrozole. From what I've been reading it seems that at a dose of 60mg two times a week that E shouldn't normally be a problem. So I'm just following my drs instructions.

I read somewhere that your test should be 20x your E levels at minimum. Is that correct. So if my level was at 600 then my E should be 30 max. Is that bunk, or is that correct?

One more thing, if I understand anastrozole will stop the conversion of T into E, but doesn't actually lower the existing E. Is that correct? Assuming it is correct, how long will it take for the existing levels to drop... I know there probably isn't a exact answer, but is it days, weeks, months? And lets just assume I want to drop it 15 pts. to 25 ( for the sake of a number). I'm sure someone has dropped that much, how long did it take? If it drops in days, then I agree, maybe my levels are too low now.

Thanks again for your patience answering my questions,

BTW I have read the stickies. All 16 pages. Good info there.

C

Out of balance estrogen can be hard to read -- especially when not at the extremes of being high or low. Being a little too high feels a lot like being a little too low. But in general the signs for high E2 are: bloatedness, increased blood pressure, itchy and/or puffy nipples, irritated nipples, full on gynecomastia, tiredness, exaggerated emotional responses. Low E2 signs are: tiredness/fatigue, joint pain, a sense of feeling "off", headaches, water-weightloss.

Let's do an example. If you know your E2 was too low because you had a lab test and cut back your Aromatase inhibitor (AI). Lets say you start feeling better for a while. Then after a few weeks you nipple hurt and you are tired and retianing water, it would probably be pretty easy to say you went too far the other way. But when you don't know where you are on the spectrum it is hard to read the signs.

I have had both high and low E2 and I can tell you they are hard to read. You mind really messes with you. My left nipple hurts slightly -- is that gyno coming on? I'm tired today -- is my E2 off? Get the idea? Best thing you can do is get frequent labs until you can get your protocol dialed in. That will help you learn how to read the signs your body is giving you.

Another experience I can share is that my E was fine at 50mg of test cyp 2x per week. When I bumped it up to 60mg 2x per week I had high E2 and had to start taking an Aromatase inhibitor (AI). Everyone responds differently. Get labs.

Many guys do talk about a ratio of E2 to Total T. Higher the TT the higher you should let your E2 go -- even above the "normal" range. I can't tell you what the right ratio is for you, but be conscience of it so you can gauge what works best for you. E2 of 40 might feel just fine for you if you get your TT up from 600 to 1000.

Once you start taking arimidex or change your dose, you generally need to give it two weeks to take full effect. Unfortunately, testosterone replacement therapy (TRT) protocol changes take time to play out. We would all like it a lot better if we knew in a few hours or days instead of a few weeks or months.

 

[reefstar]

Out of balance estrogen can be hard to read -- especially when not at the extremes of being high or low. Being a little too high feels a lot like being a little too low. But in general the signs for high E2 are: bloatedness, increased blood pressure, itchy and/or puffy nipples, irritated nipples, full on gynecomastia, tiredness, exaggerated emotional responses. Low E2 signs are: tiredness/fatigue, joint pain, a sense of feeling "off", headaches, water-weightloss.

Let's do an example. If you know your E2 was too low because you had a lab test and cut back your Aromatase inhibitor (AI). Lets say you start feeling better for a while. Then after a few weeks you nipple hurt and you are tired and retianing water, it would probably be pretty easy to say you went too far the other way. But when you don't know where you are on the spectrum it is hard to read the signs.

I have had both high and low E2 and I can tell you they are hard to read. You mind really messes with you. My left nipple hurts slightly -- is that gyno coming on? I'm tired today -- is my E2 off? Get the idea? Best thing you can do is get frequent labs until you can get your protocol dialed in. That will help you learn how to read the signs your body is giving you.

Another experience I can share is that my E was fine at 50mg of test cyp 2x per week. When I bumped it up to 60mg 2x per week I had high E2 and had to start taking an Aromatase inhibitor (AI). Everyone responds differently. Get labs.

Many guys do talk about a ratio of E2 to Total T. Higher the TT the higher you should let your E2 go -- even above the "normal" range. I can't tell you what the right ratio is for you, but be conscience of it so you can gauge what works best for you. E2 of 40 might feel just fine for you if you get your TT up from 600 to 1000.

Once you start taking arimidex or change your dose, you generally need to give it two weeks to take full effect. Unfortunately, testosterone replacement therapy (TRT) protocol changes take time to play out. We would all like it a lot better if we knew in a few hours or days instead of a few weeks or months.

Mega,

Thanks so much...That info was great. I noticed yesterday my joints ached and my knees popped and a few other joints popped a few times. I think I read someplace that Low E can cause that... is that right?

Thanks again
C

 

[Megatron28]

Mega,

Thanks so much...That info was great. I noticed yesterday my joints ached and my knees popped and a few other joints popped a few times. I think I read someplace that Low E can cause that... is that right?

Thanks again
C

You're welcome.

Yes. Low E2 can cause joint pain. You read that in my previous response to you.

 

[THE-DET-OAK]

Also I don't know how tall you are but if your BF is pretty high your gonna need more T to get rid of the fat, than the guy that just needs to keep it off. I only skimmed but it seems you may need a more agressive approach. Get with Lindsay so she can get you on the right track.