Blood work update.....whats the next step?

[PrinceDianabol]

For what it's worth.....

I aromatize at a decent rate...
I had 412 ng/DL(14.3 nmol/l) TT and 37 pg/ml(134 pmol/l) reg panel estradiol....
0.25 mg eod crashed my Estradiol to less than 40 pmol/l....
Not saying I'm the same as everyone...
But looking back I would def go 0.125 mg eod adex....

Again, your feedback loop was closed during this. Of course you crashed it.

Clomid is a SERM ...
U saying it closes the feedback loop?

Yes. How do you not know this? SERM's bind to the ER in the hypothalamus and produce an antagonistic effect i.e blocking it from reading estradiol in the blood. When you are on a SERM the brain is no longer regulating estradiol as it can't read your levels. Thereby, using an AI to the point of crashing e2 won't cause the brain to increase GnRH->LH->TT->E2 to correct it. Depending on the SERM and dose it's probably already pumping out it's max anyway.

 

[Atlaz]

OP

Are u in Canada by chance?
Did u know what your hematocrit was at baseline?

I felt like shit on Clomid.

My Hematocrit at baseline was:

Hematocrit: 0.471 ( 0.434 - 0.510 L/L )

Yes im in Canada.

 

[Atlaz]

Im getting mixed advice here.

 

[Alpin]

Again, your feedback loop was closed during this. Of course you crashed it.



Yes. How do you not know this? SERM's bind to the ER in the hypothalamus and produce an antagonistic effect i.e blocking it from reading estradiol in the blood. When you are on a SERM the brain is no longer regulating estradiol as it can't read your levels. Thereby, using an AI to the point of crashing e2 won't cause the brain to increase GnRH->LH->TT->E2 to correct it. Depending on the SERM and dose it's probably already pumping out it's max anyway.

How's my feedback loop closed?
Perhaps u misunderstood because I should have mentioned my LH was 4 and FSH 2 with those levels I listed.

 

[Alpin]

I felt like shit on Clomid.

My Hematocrit at baseline was:

Hematocrit: 0.471 ( 0.434 - 0.510 L/L )

Yes im in Canada.

I thought u were Canadian...
And I know the lab you went to...
Well leave that aside..
We're you well hydrated for this blood test?
That's a hefty hematocrit for such a low T level...
You went first thing in a.m right?
Before 9 am ??

 

[Alpin]

Prince,

I have blood labs WITH and WITHOUT Adex monotherapy...

On Adex 0.25 mg eod I crashed my Estradiol (less than 40 pmol/l)and my TT was 265, Bio Avail T 7.1 nmol/l.... LH 4 and FSH 2

Off adex for 4 months....TT 412, Estradiol 134 pmol/l , LH 4, FSH 2, BIO Avail T 3.2 nmol/l.

Adex did nothing for increasing my LH, FSH output....
In fact I crashed my Estradiol with 1 quarter of the "standard 1 mg dose" ....
I had less TT, and more Bio Avail T while on it...
Not that my body produced more Test off the adex monotherapy...
But it made the Test more bio available.....

Adex mono .. All in all I still felt symptoms of low T..

 

[Atlaz]

I thought u were Canadian...
And I know the lab you went to...
Well leave that aside..
We're you well hydrated for this blood test?
That's a hefty hematocrit for such a low T level...
You went first thing in a.m right?
Before 9 am ??

Yeah around 8am.

 

[halfwit]

Prince,

I have blood labs WITH and WITHOUT Adex monotherapy...

On Adex 0.25 mg eod I crashed my Estradiol (less than 40 pmol/l)and my TT was 265, Bio Avail T 7.1 nmol/l.... LH 4 and FSH 2

Off adex for 4 months....TT 412, Estradiol 134 pmol/l , LH 4, FSH 2, BIO Avail T 3.2 nmol/l.

Adex did nothing for increasing my LH, FSH output....
In fact I crashed my Estradiol with 1 quarter of the "standard 1 mg dose" ....
I had less TT, and more Bio Avail T while on it...
Not that my body produced more Test off the adex monotherapy...
But it made the Test more bio available.....

Adex mono .. All in all I still felt symptoms of low T..

I think you have a lazy pituitary Apollon. Prince is correct in how it SHOULD work; unfortunately if your pituitary and hypothalamus don't play nice - it won't work right. It's like how I can take a GRAM of clomid, and while my LH would probably skyrocket (assuming it still works), I would get zero benefit as my leydig cells don't want to listen anymore.

AI - > hypothalamus sees estradiol decrease - > gnrh is released - > pituitary responds by releasing LH - > leydig cells react - > more testosterone is created from cholesterol - > aromatase converts to estradiol until the hypothalamus is satisfied.

That's pretty much in a nutshell how it works. I left out a few intermediary steps, but that should get the point across.

 

[PrinceDianabol]

How's my feedback loop closed?
Perhaps u misunderstood because I should have mentioned my LH was 4 and FSH 2 with those levels I listed.

Ah, that makes more sense with the LH / FSH values... Yeah, as Half mentioned it's not going to work well with Secondary hypogonadism. I'm still surprised it crashed though - how long were you on that protocol before you drew bloods? Coz it will lower estradiol temporarily before TT aromatization catches up.

 

[Alpin]

Ah, that makes more sense with the LH / FSH values... Yeah, as Half mentioned it's not going to work well with Secondary hypogonadism. I'm still surprised it crashed though - how long were you on that protocol before you drew bloods? Coz it will lower estradiol temporarily before TT aromatization catches up.

I was on the adex for 16 months at that dose...

TT always between 9-10 nmol/l
LH 3-4 and FSH 2 the entire time on it....
I did 9 labs plus on adex mono....
Crashed Estradiol, achy joints, headaches, tired, till I went to 0.25 mg E3D which stopped the headaches....
Then Estradiol stayed at 75 pmol/l on the E3D 0.25 mg dosing....

I wasn't arguing with you at all. The debate was informative.

 

[Alpin]

Ah, that makes more sense with the LH / FSH values... Yeah, as Half mentioned it's not going to work well with Secondary hypogonadism. I'm still surprised it crashed though - how long were you on that protocol before you drew bloods? Coz it will lower estradiol temporarily before TT aromatization catches up.

The worst was coming off the restart of HCG and adex...
Labs were

TT: 5.9 nmol/l (lower than OP's)
Estradiol: 141 pmol/l
(A Week after stopping adex and HCG restart)
Felt wired, irritable, angry, legs like jello, tired, etc and hungry as can be.....
Tried clomid but got nasty headaches off it...dumped it a week in.

 

[PrinceDianabol]

I was on the adex for 16 months at that dose...

TT always between 9-10 nmol/l
LH 3-4 and FSH 2 the entire time on it....
I did 9 labs plus on adex mono....
Crashed Estradiol, achy joints, headaches, tired, till I went to 0.25 mg E3D which stopped the headaches....
Then Estradiol stayed at 75 pmol/l on the E3D 0.25 mg dosing....

I wasn't arguing with you at all. The debate was informative.

Oh wow, you really went through the shitter didn't you?? 16 months man! Why did you keep it up so long lol?

I would think two weeks should be plenty to know if you're going to respond or not. Crazy.

Good point bringing that up that it won't work for everyone though - something I overlooked. In light of this Atlaz it might be a good idea to go with a more conservative dose (just in case), then ramp it up based on bloods... but I think you'd be fine anyhow given how you responded to the SERMs. Your pituitary is responsive so I doubt you'd have an issue.

Also - a good thing to keep in mind is if you switch to AI monotherapy you should give time (about 4 weeks tops) for the Nolva to leave your system... if you begin an AI too early and the Nolva is still affecting your hypothalamus, you WILL crash estradiol.

 

[Alpin]

Oh wow, you really went through the shitter didn't you?? 16 months man! Why did you keep it up so long lol?

I would think two weeks should be plenty to know if you're going to respond or not. Crazy.

Good point bringing that up that it won't work for everyone though - something I overlooked. In light of this Atlaz it might be a good idea to go with a more conservative dose (just in case), then ramp it up based on bloods... but I think you'd be fine anyhow given how you responded to the SERMs. Your pituitary is responsive so I doubt you'd have an issue.

Also - a good thing to keep in mind is if you switch to AI monotherapy you should give time (about 4 weeks tops) for the Nolva to leave your system... if you begin an AI too early and the Nolva is still affecting your hypothalamus, you WILL crash estradiol.

I just got in a cruise mode and felt sort of okayish but still not good. Doc was telling me a bit longer, a bit longer...
Was dealing with uneducated docs....
It kind of kept my mood somewhat positive...
Off adex I did not feel the same even if my TT went up to 5 nmol/l.....
Which leads me to believe that the feelings of well being we experience are that from more bio available T....

 

[Atlaz]

What about HCG therapy? A couple of articles say that it works well for secondary hypo.....Could I get optimal levels with HCG only?

 

[halfwit]

What about HCG therapy? A couple of articles say that it works well for secondary hypo.....Could I get optimal levels with HCG only?

If you're going to be injecting something that suppresses you, why not just go with testosterone?

 

[Atlaz]

If you're going to be injecting something that suppresses you, why not just go with testosterone?

The less medication the better no ? and plus it keeps the fertility.

 

[halfwit]

The less medication the better no ? and plus it keeps the fertility.

Two things here:

1. HCG will only provide as much testosterone as your testes can make naturally. While it does suppress your pituitary gland, it does indeed keep you fertile. So the upside is you can make babies (never a guarantee of course), the downside is that it's still something you have to do for the rest of your life.

2. Testosterone injections allow you to customize your levels based on how you feel. While it does kill your ability to make sperm (FSH drops to zero), babies can still happen (we have plenty of dads here while on TRT); and if fertility is a concern -- there's the ability to add HCG/HMG to your protocol. In fact, many of us (me included) do testosterone injections WITH HCG to optimize hormones.

Obviously this is something you have to decide for yourself, but you do want to keep in mind that HCG may not be a lasting solution in the years to come. There are a few longer-term studies on it, but the results are still speculative at best in my reading.

 

[Atlaz]

I am on TRT too. I feel a little better at 800-1000. I notice that my recovery time after lifting weights or playing sports is a little faster. And I feel like I can see progress in the gym come a little faster. It is an incremental difference though. Not a day/night type difference.

What benefits do you see for yourself since starting TRT?

 

[Atlaz]

Two things here:

1. HCG will only provide as much testosterone as your testes can make naturally. While it does suppress your pituitary gland, it does indeed keep you fertile. So the upside is you can make babies (never a guarantee of course), the downside is that it's still something you have to do for the rest of your life.

2. Testosterone injections allow you to customize your levels based on how you feel. While it does kill your ability to make sperm (FSH drops to zero), babies can still happen (we have plenty of dads here while on TRT); and if fertility is a concern -- there's the ability to add HCG/HMG to your protocol. In fact, many of us (me included) do testosterone injections WITH HCG to optimize hormones.

Obviously this is something you have to decide for yourself, but you do want to keep in mind that HCG may not be a lasting solution in the years to come. There are a few longer-term studies on it, but the results are still speculative at best in my reading.

I have an appointment with my doc this week and most probably will ask to start injections. I feel that with Adex monotherapy or HCG I will just wasting more time for no reason....

 

[Megatron28]

What benefits do you see for yourself since starting TRT?

TRT for me is day and night difference. The difference between feeling alive and feeling like a zombie. I literally believe it saved my life.