Medical treatment advice regarding Cypionate.

[Cyper69]

So, to start off glad i found a legit forum that seems to have knowledgeable persons.

To cut a long boring story short. I'm on lifetime cypionate 200mg/1ml weekly due to childhood illness. Recently had to do a bloodwork for anxiety attacks that lasted days on end. Was put on .05 xanax So.. Thinking my pharmacy would do my automatic refills by the time friday came. Nothing was ready for pick up until the following monday.

Anxiety went through the roof.. But i remembered i have tons of old vials.. So i went MacGyver.. I went ahead and drew very small leftover amounts of cyp from 14 vials dating back to say.. February. (Cleaned all the tops with alcohol) then changed out my drawing needle for my stick needle. Got my 1ml and that was that.. Now here i am wednesday feeling like shiza.. I noticed most of the vials say discard 28 days after first use. I've never had to go back and draw from an old vial. Did i make a big mistake or should i be okay and just shake this feeling off until i can run my normal 1ml vial this friday?.. I'm freaking out.. Xanax is helping me keep calm. Thanks for the info.

If tl;dr my refill ran out. Had to draw from 14 pre-used vials to obtain 1ml until my script was ready. Freaking out.. Am i okay, or not?

 

[gdevine]

When was the last time you had BW done?

Can you tell us what your SHBG and Cortisol labs were?

Hammering Test Cyp will drop SHBG like a rock and anxiety will kick in like a mother!

Try adding in 50 mg of DHEA and lay off the over dosing of your Test.

Only BW will tell us the true story but I would bet a bunch of beers you tanked SHBG and only made matters worse.

Are you under a Doctor's care?

 

[Cyper69]

I went in for bloodwork due to this random anxiety hitting me like a train out of nowhere. Blood work was done on the 16th of this month, i didn't ask specifics but i can request a copy. They said all of my levels were in sync. It was a thursday i do my shot on fridays. My level was 858. I've been doing 1ml 200mg for about 4 years now. Before that it was 100mg/1ml propionate. Never have had these bad of anxiety days. Which started on april 29th and still rolling but the xanax is helping tremendously.

Now in conjuction of me using cypionate is not to add to my levels. I don't produce testosterone at all. Now reason being was childhood leukemia.. They did radiation and chemo. Tomorrow i will request a cbc lab result. Yes, i'm under doctors care.

So back to my other question. Was drawing from multiple used vials a big no no? Or will i be fine until my next dose? Since age may play a factor i'm 23. All my hormones are controlled by Dr.'s lol

 

[gdevine]

I went in for bloodwork due to this random anxiety hitting me like a train out of nowhere. Blood work was done on the 16th of this month, i didn't ask specifics but i can request a copy. They said all of my levels were in sync. It was a thursday i do my shot on fridays. My level was 858. I've been doing 1ml 200mg for about 4 years now. Before that it was 100mg/1ml propionate. Never have had these bad of anxiety days. Which started on april 29th and still rolling but the xanax is helping tremendously.

Now in conjuction of me using cypionate is not to add to my levels. I don't produce testosterone at all. Now reason being was childhood leukemia.. They did radiation and chemo. Tomorrow i will request a cbc lab result. Yes, i'm under doctors care.

So back to my other question. Was drawing from multiple used vials a big no no? Or will i be fine until my next dose?

I hear you loud and clear my friend.

There are a few things that will cause anxiety under a testosterone replacement therapy (TRT) protocol and they are clearly understood by the astute Physician.

Post your BW here as soon as you can complete with ranges so the boys can jump in.

We'd like to see Cortisol as well as Estrogen (Sensitive assay please!) and SHBG.

You'll get a good response here.

BTW, 200 mg of Test a week even for a Primary Hypogondal male is a lot.

Also, let me ask; are you taking Human Chorionic Gonadotropin (HCG) and if so how much? High levels of Human Chorionic Gonadotropin (HCG) can and will increase intratesticular E2 which an Aromatase inhibitor (AI) is largely ineffective in managing.

BTW, if your Test serum level was in the mid 800's the day before your next 200 mg injection you are living, for the most part, in the supraphysiological level. Really need to see E2 and SHBG,

I think there you may find the reason.

 

[Cyper69]

I hear you loud and clear my friend.

There are a few things that will cause anxiety under a testosterone replacement therapy (TRT) protocol and they are clearly understood by the astute Physician.

Post your BW here as soon as you can complete with ranges so the boys can jump in.

We'd like to see Cortisol as well as Estrogen (Sensitive assay please!) and SHBG.

You'll get a good response here.

BTW, 200 mg of Test a week even for a Primary Hypogondal male is a lot.

Also, let me ask; are you taking Human Chorionic Gonadotropin (HCG) and if so how much? High levels of Human Chorionic Gonadotropin (HCG) can and will increase intratesticular E2 which an Aromatase inhibitor (AI) is largely ineffective in managing.

I was thinking the same thing about the 200mg.. I'm like a raging bull 24/7 and my fiancé is worn out. Lol... Before this episode of anxiety i felt great.. But every few months i had some bouts of anxiety/panic attacks but i could shake them off. This.. This is different. Estrogen sensitivity aside.. I need help. I don't care to be judged.

No, i'm not on any HCG. Cypionate is my only juice.

I may get a second opinion from another endocronologist. Just because they say my levels are fine doesn't mean i feel fine. Would it be safe to back down to .05ml and see how i feel?

 

[gdevine]

I was thinking the same thing about the 200mg.. I'm like a raging bull 24/7 and my fiancé is worn out. Lol... Before this episode of anxiety i felt great.. But every few months i had some bouts of anxiety/panic attacks but i could shake them off. This.. This is different. Estrogen sensitivity aside.. I need help. I don't care to be judged.

No, i'm not on any HCG. Cypionate is my only juice.

I may get a second opinion from another endocronologist. Just because they say my levels are fine doesn't mean i feel fine. Would it be safe to back down to .05ml and see how i feel?

I personally don't advocate over riding a Physician's care. That being said, unless you are being cared by a Physician who is fully trained in testosterone replacement therapy (TRT) in men I'd be a little suspicious.

Cyper - The fact that you are HPTA suppressed and your Doc doesn't have you on an Human Chorionic Gonadotropin (HCG) protocol is usually a red flag.

Does your Physician check your Estradiol serum levels?

And you are 100% correct, labs are one thing but in testosterone replacement therapy (TRT) it's HOW YOU FEEL!

Clearly something is amiss.

Second opinion is wise; just make sure it's a Physician who knows and understands testosterone replacement therapy (TRT) in men. Most Endo's are not trained sufficiently to make the right assessment unfortunately.

Find the right Doc, they are out there just need to dig a bit...plus, these days, Google is your friend.

 

[Cyper69]

I personally don't advocate over riding a Physician's care. That being said, unless you are being cared by a Physician who is fully trained in testosterone replacement therapy (TRT) in men I'd be a little suspicious.

Cyper - The fact that you are HPTA suppressed and your Doc doesn't have you on an Human Chorionic Gonadotropin (HCG) protocol is usually a red flag.

Does your Physician check your Estradiol serum levels?

And you are 100% correct, labs are one thing but in testosterone replacement therapy (TRT) it's HOW YOU FEEL!

Clearly something is amiss.

Second opinion is wise; just make sure it's a Physician who knows and understands testosterone replacement therapy (TRT) in men. Most Endo's are not trained sufficiently to make the right assessment unfortunately.

Find the right Doc, they are out there just need to dig a bit...plus, these days, Google is your friend.

Yes in fact he does does treatment specifically in men. I was having libido issues and found that he was a highly suggested Dr. To see. First cbc they did my levels were at 50. I was taking 200mg/1ml every 2 weeks though. So it was moved to every week. I wish i could say that he checks my estradiol serum levels but i'm unsure. As far as the Human Chorionic Gonadotropin (HCG) not being given. Someone else mentioned that too. Oh boy... Looks like i opened a bag full of surprises. Tomorrow morning i will be GETTING those results. i'm pretty upset now. Will the estradiol serum results be shown on my lab report for me to post here?

 

[1693]

I would think you gathering the left over test from many vials to make your dose is not a problem, I would have done the same. I can see that since you have anxiety that can bother you though.

It would be nice to know your E2....you might be helped by pinning twice per week to help keep it down, depends on the E2 and the SHBG.

I agree with gd that a 7 day trough TT of 858 might be a bit strong and maybe you could discuss with doc about lowering your weekly dose to 150mg or .75mL (200mg/mL) and that dose might serve you better, you might try it and see, you can always go back to 200mg. It might help your anxiety to lower your dose.

Nice to see you here gd, welcome to both you and Cyper69!

 

[Megatron28]

Unless you were storing your old vials improperly, you should be fine drawing up the last remnants from them. Just a couple of tips. Call in refills to the pharmacy with more lead time. Then you have some time before you run out in case this situation happens again. I don't have anxiety but I to start getting a little nervous as my vial gets closer to empty if I don't have a new one on hand. The other thing you can do if you run out before your pharmacy can supply a refill is ask them to give you an ampule of test cyp so you don't have to miss a dose. Let's say the same thing happened with blood pressure meds and they couldn't reach the doc to confirm the refill. They would give you a few days worth of pills to hold you over. Ask for the same courtesy here.

200mg per week may be fine. 100-200 per week is considered a standard testosterone replacement therapy (TRT) dose of test. You need lab work to know where you are at and ask yourself how you feel. Since you said you feel great why change anything unless your lab results indicate there is an issue?

I get the impression that you don't participate too much in your own treatment. I woulxd recommend that you get all your past lab results and write them down or put them in MS Exel so that you can see your trends. You need to become smart about testosterone replacement therapy (TRT) and learn how to interpret your own bloodwork. This will also allow you to see if your doc has been monitoring things like estradiol. Because one of the common issues at a dose of 200mg per week is elevated estradiol.

When you get your lab results share them on here and we will help you interpret them.

 

[Megatron28]

All also say that at age 23 your fiance's ass should be worn out. If it wasn't there would be something wrong with you.

 

[gdevine]

Yes in fact he does does treatment specifically in men. I was having libido issues and found that he was a highly suggested Dr. To see. First cbc they did my levels were at 50. I was taking 200mg/1ml every 2 weeks though. So it was moved to every week. I wish i could say that he checks my estradiol serum levels but i'm unsure. As far as the Human Chorionic Gonadotropin (HCG) not being given. Someone else mentioned that too. Oh boy... Looks like i opened a bag full of surprises. Tomorrow morning i will be GETTING those results. i'm pretty upset now. Will the estradiol serum results be shown on my lab report for me to post here?

Post your BW complete with ranges here in this thread when you get them.

 

[juced_porkchop]

I went in for bloodwork due to this random anxiety hitting me like a train out of nowhere. Blood work was done on the 16th of this month, i didn't ask specifics but i can request a copy. They said all of my levels were in sync. It was a thursday i do my shot on fridays. My level was 858. I've been doing 1ml 200mg for about 4 years now. Before that it was 100mg/1ml propionate. Never have had these bad of anxiety days. Which started on april 29th and still rolling but the xanax is helping tremendously.

Now in conjuction of me using cypionate is not to add to my levels. I don't produce testosterone at all. Now reason being was childhood leukemia.. They did radiation and chemo. Tomorrow i will request a cbc lab result. Yes, i'm under doctors care.

So back to my other question. Was drawing from multiple used vials a big no no? Or will i be fine until my next dose? Since age may play a factor i'm 23. All my hormones are controlled by Dr.'s lol

drawing up form those old vails the little drop thats lef is nto worth it due ot risk of infection.. but if its been a couple days andf you havent swelled up and injection site and dont have an infection comming, id say you are fine. the test would eb fien for years, the sterility would be my concern...

also avoid meds for anxiety, it is in your head... it is hard, not saying its easy... its hell... but that doesnt change the fact its in your mind regardless of how "real" it is to you.. I deal with it aswell.

check this out , maybe it will help a bit: Help to Stop Panic Attacks

good luck man!



ps, recap: avoid drawing from old used vial. you can wait a few extra days, no biggie...

 

[juced_porkchop]

Yes in fact he does does treatment specifically in men. I was having libido issues and found that he was a highly suggested Dr. To see. First cbc they did my levels were at 50. I was taking 200mg/1ml every 2 weeks though. So it was moved to every week. I wish i could say that he checks my estradiol serum levels but i'm unsure. As far as the Human Chorionic Gonadotropin (HCG) not being given. Someone else mentioned that too. Oh boy... Looks like i opened a bag full of surprises. Tomorrow morning i will be GETTING those results. i'm pretty upset now. Will the estradiol serum results be shown on my lab report for me to post here?

I would not worrie about Human Chorionic Gonadotropin (HCG) too much... its nto needed, and many feel it even causes anxiety... if you WANT to avoid testies shrinking then sure... if you WANT a better chance at having a baby, sure... but is it needed? No , but what is is supplementation with pregnenolone during hrt/trt... because test doesnt cover all basis... maybe even pregn and some extra DHEA.
HCG is more personal choice vs. need in my opinion..
if you dont care about shrunkin balls or kids ( and your already shut down for good as it is) then I would not even bother...
maybe talk to doc about lowering to 100-150mg ew vs 200mg ew though.

good luck

 

[Cyper69]

Thanks for all the input!

Let's see... I store all my vials properly, regardless if they've been used.
No infection, no feelings of being sick.

Now about my prescription running out. I figured it was going to be ready by friday regardless. I pick it up always around wednesday. Something got mixed up in the system and it wound up being the pharmacy's mistake.

Guilty.. I will admit i need to participate more in my treatment.

More info to come soon, calling the Dr. Right now.

As for taking anything for anxiety/depression. I'm right there with you i'm totally against using anything. General anxiety and depression are human feelings, why tak meds try mask them? But.. These attacks i've been having were so severe... i had to lock my guns and give my keys to my fiancé. Until i can find some kind of correction i will be off of this stuff.

Update: going to get lab results.

 

[Cyper69]

Okay the results are in I'll just post everything that's on the page..

Glucose: 85
Urea Nitrogen (BUN): 15
Creatinine: 1.14
GFR Estimated: 90


Bun/Creat Ratio: 13.2
Sodium: 140
Potassium: 4.2
Chloride: 101
Carbon Dioxide: 25
Anion Gap: 14
Protein total: 7.8
Albumin: 5.2 High Normal range 3.3-4.9 g/dL


Globulin: 2.6
Alb/Glob ratio: 2.0
Calcium: 9.8
Alkaline Phosphate: 55
ALT: 14
AST: 15
Bilirubin, Total 0.4
TSH, Test sensitivity 1.18
T4 Free non-Dialysis: 1.3

NO Drugs detected, Duh!

Now the good stuff.

Estradiol 53 H Normal range 8-43 pg/mL
Testosterone 858 H Normal range 280-800 ng/dL

 

[gdevine]

Okay the results are in I'll just post everything that's on the page..

Glucose: 85
Urea Nitrogen (BUN): 15
Creatinine: 1.14
GFR Estimated: 90


Bun/Creat Ratio: 13.2
Sodium: 140
Potassium: 4.2
Chloride: 101
Carbon Dioxide: 25
Anion Gap: 14
Protein total: 7.8
Albumin: 5.2 High Normal range 3.3-4.9 g/dL


Globulin: 2.6
Alb/Glob ratio: 2.0
Calcium: 9.8
Alkaline Phosphate: 55
ALT: 14
AST: 15
Bilirubin, Total 0.4
TSH, Test sensitivity 1.18
T4 Free non-Dialysis: 1.3
Your TSH is fine. What is the reference range for FT4? Did you get FT3 or RT3 by any chance?

NO Drugs detected, Duh!

Now the good stuff.

Estradiol 53 H Normal range 8-43 pg/mL
Obviously, elevated. You're converting a lot of the testosterone you are injecting into unwanted E2. You need to get this down into the 20's Elevated E2 is not healthy for you on many fronts and counter to why you are taking Testosterone in the first place.

Testosterone 858 H Normal range 280-800 ng/dL

Nice. But at this point Free and/or bio-available is also important as well at this point in your therapy.

 

[Cyper69]

So what should i do? Should i decrease dosage to say... .75ml?

As per any other lab results this was all that was on the lab results. They only took one vial this round, the usual is 4 vials. I'd hate to have to take another test. I even told the phlebotomist to take more. She declined and said no other results were needed to be checked, per Dr.'s request.

Reference range for T4 is, 0.8 - 1.7 ng/dL

Nothing stated about FT3 or RT3.

 

[gdevine]

So what should i do? Should i decrease dosage to say... .75ml?

As per any other lab results this was all that was on the lab results. They only took one vial this round, the usual is 4 vials. I'd hate to have to take another test. I even told the phlebotomist to take more. She declined and said no other results were needed to be checked, per Dr.'s request.

Reference range for T4 is, 0.8 - 1.7 ng/dL

Nothing stated about FT3 or RT3.

The first thing you should do is talk to your Doctor about your elevated E2 levels and administering the proper therapeutic drug protocol to reduce it to ideal levels (20's). This is where an aromatase inhibitor comes into a Hormone Replacement Therapy (HRT) protocol.

You need a compete hormonal panel run. I like Dr. Crisler's follow up labs:

Total Testosterone
Bioavailable Testosterone
Free Testosterone (if Bioavailable T is still unavailable)
Estradiol (specify;sensitive assay for males)
LH
FSH
CBC
Comprehensive Metabolic Panel
Lipid Profile
PSA (for those over 40 with Family Hx of prostate CA, >45 yo. all others)
IGF-1, IGFBP-3 (if GH Therapy has been initiated already)

I also like:
Cortisol
Progesterone
DHEA-S
DHT

This is what any astute testosterone replacement therapy (TRT) Physician would need to make any type of hormonal health assessment of you. If you didn't get any of these there is no way in hell a Doc in the know can determine how you are responding to your protocol and what adjustments need to be made to your protocol.

You got the wrong Doc IMO.

 

[IMT staff]

I would not worrie about Human Chorionic Gonadotropin (HCG) too much... its nto needed, and many feel it even causes anxiety... if you WANT to avoid testies shrinking then sure... if you WANT a better chance at having a baby, sure... but is it needed? No , but what is is supplementation with pregnenolone during hrt/trt... because test doesnt cover all basis... maybe even pregn and some extra DHEA.
HCG is more personal choice vs. need in my opinion..
if you dont care about shrunkin balls or kids ( and your already shut down for good as it is) then I would not even bother...
maybe talk to doc about lowering to 100-150mg ew vs 200mg ew though.

good luck

I can agree with this to an extent, but what about progesterone conversion? Also how can pregnenolone really help if exogenous testosterone is suppressing the hypothalamus slowing down the conversion of preg to TSH, Cortisol and DHEA?

Yes more raw material is good, but only if your gonna use it.

 

[Cyper69]

Confused on what my next step should be concerning my next injection and what next step to take.

I'm taking all suggestions with a grain of salt, i need to be schooled. So far, so good.

But i do agree i need a new Dr. Specifically a testosterone replacement therapy (TRT) Dr. I'm already on the hunt. Fwiw, if anyone knows or can help me find one. I'm located in the east valley of Arizona.

Thanks everyone for all your input. I sincerely appreciate it.