Clueless in Japan : Need guidance on HRT

synonymous

New member
I'm going to be brief, can add details where needed if I still have them.

2008 I had blood work done. I'd been lifting seriously since 2005. My wife was concerned about my eating (Large amounts of protein). To appease my wife, I got blood work done. I saw the form and just asked if they would also check my testosterone levels. They said OK. They were low. Numbers aren't exact, but below 200 (Normal being 200-800). I freaked out and since this doctor wasn't a specialist I began looking around. Had all sorts of tests done to rule out primary hypogonadism. hcg stim test was good, so my testes were functioning (I'm assuming this). For about 2 years I was on 3000 IU of hcg per week. Always felt really good after the hcg. Read somewhere this was too much. Switched doctors. He had me on 500IU once a week and 125mg of test twice a month.

2010, new doctor, lets me take my medicine home. After labs (Which I don't have) he said that 125mg wasn't bringing my test levels up so high and that 250mg per week was OK. Then there was the 3000IU twice a week. Bringing this home I watered down the hcg to 500 iu 2 days before and day of my 250mg of test. Was told not to be surprised if levels were over 800 but a little too high isn't that bad so long as my lipid profiles were all good.

Last month I had them checked (But no hormones checked) and my lipid profiles are all clean. RBC slightly elevated. Doctor recommended I donate blood once a month if possible.

So, I've blindly followed my doctors advice but now I'm thinking more blood work needs to be done. Partly because I'm not feeling as good as I used to. Another is my fear that things are getting out of control. But that's the other problem: I have anxiety issues (On meds for them). Was told these would have no affect on my T levels. However, when I get anxious I wonder sometimes if this is hormones messing with me or if it's just me being anxious.

What blood work should I request (Apparently they won't test for SHGB in Japan, this can be a weird country) and since I haven't had any real hormone levels checked in years, I don't know what I should ask for. My doctor is very open to changing protocols. There isn't a big HRT market in Japan. And I can get clomid but that's it. No Nolva no Adex. My nipples can hurt from time to time after a hard day (Which is every day) at the gym.

Not sure if this matters:
White Canadian dude
35 yrs old
lifting 5 days a week (MI40)
6ft
290 lbs
bf 25 percent and dropping (That's only recently)
Clean eating in order to prevent diabetes (Another fear)

I've also been getting more sick as of late. Battled a bad cold in October, took a week to get better. Again in November, took a week. Clean in December but now in January I've got tonsillitis. All doctors saying 'coincidence and need to lose more fat'.

Seems like a royally messed up situation but I wasn't aware it was as complicated as it was. So, any advice would be great. I see my doctor tomorrow so I'll be discussing things with him and maybe just get EVERYTHING that would be affected by these injections. Insurance pays for it, why not.
 
First off Welcome!

Are you taking any kind of AI to control E2, do you know what your E2 is? Your protocol doesn't look that out of the ordinary but to be honest without complete blood results it is hard to determine. The anxiety you mention could be a result of your E2 being out of balance, but again without complete results we would just be shooting in the dark.

My first piece of advice would be to get a complete blood panel done, get all hormones checked as well as a sensitive E2 test.


Best of Luck!
 
First off Welcome!

Are you taking any kind of AI to control E2, do you know what your E2 is? Your protocol doesn't look that out of the ordinary but to be honest without complete blood results it is hard to determine. The anxiety you mention could be a result of your E2 being out of balance, but again without complete results we would just be shooting in the dark.

My first piece of advice would be to get a complete blood panel done, get all hormones checked as well as a sensitive E2 test.


Best of Luck!

Last time I checked (And the only time) it was 75. High I believe. I thought the protocol was Adex but that is a drug he will not prescribe. Then again, something else might work?
 
Yes you are correct, 75 is high, even if that wasn't a E2 sensitive test 75 is still on the high side. There is a chance that your high E2 is the cause of some of your issues. If your E2 is too high or too low (crashed) you will start to experience the symptoms of low T even though your are on TRT and your T levels are fine.

You are also correct that Adex is a commonly prescribed medication for controlling E2, since your doctor will not prescribe this for you that is shame, many doctors are just not as up to date as they need to be to properly treat men with Low T. If your title is correct then am I to assume you are in Japan? If not and you are in the US you might want to reach out to IMT (they are a site sponsor) and have a very good reputation for treating Low T. If you are in Japan you might want to look at DIM, it is an over the counter supplement that helps the body to dispose of E2 which might be an avenue you can peruse but regardless of what you do you MUST get your E2 in check. There are many nasty sides that are a direct result of high E2 that you do not want to deal with.


Best of Luck!
 
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There is a good list here at the bottom of this write up.

Tests included in this panel are:

Cortisol

Folate

Comprehensive Metabolic panel (14)

CBC with Differential/Platelet

Luteinizing Hormone (LH)

Thyroid Function TSH, T3, T4

Estradiol

Progesterone

Lipid Panel with LDL/HDL Ratio

Testosterone, Free and Total

Prostate Specific Ag, Serum

IGF-1 (Insulin Growth Factor 1)

Hepatic Panel

DHEA-S

Prolactin

Ferritin

SHBG

https://www.increasemyt.com/services/adrenal-fatigue
 
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Yes you are correct, 75 is high, even if that wasn't a E2 sensitive test 75 is still on the high side. There is a chance that your high E2 is the cause of some of your issues. If your E2 is too high or too low (crashed) you will start to experience the symptoms of low T even though your are on TRT and your T levels are fine.

You are also correct that Adex is a commonly prescribed medication for controlling E2, since your doctor will not prescribe this for you that is shame, many doctors are just not as up to date as they need to be to properly treat men with Low T. If your title is correct then am I to assume you are in Japan? If not and you are in the US you might want to reach out to IMT (they are a site sponsor) and have a very good reputation for treating Low T. If you are in Japan you might want to look at DIM, it is an over the counter supplement that helps the body to dispose of E2 which might be an avenue you can peruse but regardless of what you do you MUST get your E2 in check. There are many nasty sides that are a direct result of high E2 that you do not want to deal with.


Best of Luck!

I'm in Japan. The import and use of steroids and drugs like clomid, nolva and adex are all legal in Japan. My doctor can't legally prescribe Adex which is why I am not allowed to have it using insurance BUT I can buy it online (Like I said, it can be weird in this country) and import the drug. Getting a reputable source with a price that won't break the bank is, at this point, a bit of a journey. I'll ask again today if I can buy it directly from him without using insurance.

@IMT Staff

Thanks for the list. I'll see how many of those I can actually get.
 
Last time I checked (And the only time) it was 75. High I believe. I thought the protocol was Adex but that is a drug he will not prescribe. Then again, something else might work?

What was the measurement unit for Estradiol?
If it's pmol/l then your estrogen is OK.
I Didn't seek a unit convertor but my readings are:
99 pmol/l= 27 pg/ml (within the range)
 
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What was the measurement unit for Estradiol?
If it's pmol/l then your estrogen is OK.
I Didn't seek a unit convertor but my readings are:
99 pmol/l= 27 pg/ml (within the range)

Went to the doctor today. Before I saw this post I asked what my test was in 2010 for E2. It was not 75, it was 120. I didn't ask for a copy of the old tests since I'm getting new tests next Friday. I will ask what the measurements were in. BUT it did say HIGH next to the number.

The doctor and I went through what he could order from the lab, regardless of insurance. Almost everything on the list provided above I'll be able to get. Total cost will be about 80 dollars (Because of the specific tests that aren't covered by insurance). The ones I couldn't get are: Folate, IGF-1 (Insulin Growth Factor 1), and Ferritin. Without these 3, am I still going to have a good amount of information to determine a better course as far as my treatment?

ETA: Would adding DIM and Adex be good? Or is it one or the other. DIM is something I can get in a day or 2 from Amazon (Any brand recommendations, and dose recommendations...and how long it takes to work?)
Doctor also said that I could buy Adex through him but that in Japan it is only covered by insurance if I have breast cancer. I could buy it, at cost, which would come to about 15 bucks per 1mg tablet. And I'd have to buy about 50 to 100 tablets at a time. He said it may be cheaper to buy from abroad and that it's perfectly legal for me to do so since it's not a 'fun drug' like MDMA or anything like that. I have no issue buying from abroad if the source is reputable and everything comes in packages. Don't need underground stuff. Not sure if that's going to be cheaper or the same. Any advice?

If my E2 comes back high, what is the protocol when starting Adex? 0.5mg per week, blood test X weeks later, adjust up or down (Likely up if anything). Had my shot of test today. I don't feel the good feeling anymore. Want to go to sleep early (Again). In the gym doing MI40 though.
 
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Everyone's body is different, the conversion of test to estrogen in each person is determined by different factors body fat being one. I am a heavy guy (high body fat) and 1mg tab of Adex a week is what I take and it keeps my E2 in the mid 20's, I take 0.5mg the day after my T injection and another 0.5mg 3 days later. I think you would be safe taking 1mg a week to start and then bloods taken again in 4-6 weeks to see where your E2 comes in at. On a personal note if I were in your shoes and felt that Adex was the direction I wanted to go then I would order it from a source that is a lot cheaper than your doctor. I do not have any experience with DIM so I can not comment on which is better,
 
Everyone's body is different, the conversion of test to estrogen in each person is determined by different factors body fat being one. I am a heavy guy (high body fat) and 1mg tab of Adex a week is what I take and it keeps my E2 in the mid 20's, I take 0.5mg the day after my T injection and another 0.5mg 3 days later. I think you would be safe taking 1mg a week to start and then bloods taken again in 4-6 weeks to see where your E2 comes in at. On a personal note if I were in your shoes and felt that Adex was the direction I wanted to go then I would order it from a source that is a lot cheaper than your doctor. I do not have any experience with DIM so I can not comment on which is better,

I figured it would be a person to person thing...figured I'd ask though. I appreciate the response.

Adex is the way I intend on going. Even the generic version, in Japan, is extremely expensive. How is it possible that these other sources are so much cheaper?
 
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