My testosterone replacement therapy (TRT) has suddenly lost it's effect

[unkadave]

My trt has suddenly lost it's effect

I am 62 yrs old ex jock who was having trouble getting into the workout mode I had 10 yrs ago. I was tested and had a level of 224 on a 200 -- 600 scale.
I started out at 200mg/ml Depo Cyp 2xmo. Had side effects [anxiety etc] so I divided my doses so I was doing 25mg e3d. That worked great for quite awhile.
One problem is I'm in a small town [Corvallis OR] and have a GP who is ill informed on the subject.

The main problem is after about 9 months the definate effects of energy - being able to recover from a w/o the next day to increased Libido have stopped working.

I have made sure to warm the oil and shake the vial to get rid of possible crystals. Then I have increased my dose to 25mg e2d with no improvement and have tried going 30mg e2d. That didn't work either and I don't want to go off the prescribed regieme for any longer.
My GP is reluctant to issue blood level tests and mainly knows what information I bring in to her.

As I said the 25mge3d was working great for 6 - 9 months. I journal my workouts for max HR and duration I was also waking up with wood on occasion but it's like I'm using an inert substance for the last month.

Does anyone have thoughts on what may be going on?

[I subscribed to the thread so I can respond quickly if someone has possible soutions.]

 

[Bullishness]

Maybe your gear is bunk

 

[bitterdregs]

If his doc prescribed it he should be getting pharmacy grade commercial stuff. So I'd hesitate. To think its bad test. Without. Labs its a total guess. But perhaps estrogen is getting high? Or ur pituitary has decided to stop thyroid production.
Why in the world won't the Dr run labs? And did she prescribe the test or you got your own?

 

[Megatron28]

Get labs. Do a search on this website for privatemdlabs and that will tell you how to get labs done on your own cheaply. Your estradiol could be too high -- especially as you starting increasing your amount of T taken every week.

 

[Cosmoen]

Yes, getting labs and posting here is the only guaranteed way to diagnose the problem

 

[unkadave]

Get labs. Do a search on this website for privatemdlabs and that will tell you how to get labs done on your own cheaply. Your estradiol could be too high -- especially as you starting increasing your amount of T taken every week.

I'm on the Oregon Health Plan which is akin to Medicare, so they may want to minimize the costs of what they think is unnecesary tests. I'm kind of in Hicksville in Corvallis, OR. It is not exactly a progressive Metro area.

I'm going back to e3d and increase to 30mg as e2day by injection could have it's own problem I have been told.
But yes I need to find an endrocrenologist who is comfortable with testosterone replacement therapy (TRT).
I don't know the right hormones or other to ask for when I do ask for blood work and my GP sure doesn't. Never heard of Estradiol level.

If Dr's don't know what they are doing then a lot of times they just tell you it doesn't exist. Very frustrating.

What specific levels should I ask to be tested for? I will print it out and show the DR.
thx

 

[300winmag]

Doctors should know the levels. But you can google them. Somethings you might want to check are estrogen, thyroid, vitamin B and D. And if you havent a cortisol test might be good to do as well. Also check testosterone. When I started I felt great and then it leveled then i added more test and that worked.

 

[JimiThing]

Doctors should know the levels. But you can google them. Somethings you might want to check are estrogen, thyroid, vitamin B and D. And if you havent a cortisol test might be good to do as well. Also check testosterone. When I started I felt great and then it leveled then i added more test and that worked.

shbg level may need to be looked at here as well

 

[unkadave]

shbg level may need to be looked at here as well

Finally found an endroconologist who specializes in testosterone replacement therapy (TRT) for quality of life and have an apt on Fri 8th. SHBG - endroclin? This treatmentment takes a cross between a Dr. and Yoda. ;-]
I think I will ask about HGH as I had to quit my lifting w/o's because my shoulder joints are shot from working out since age 14. My father was a high profile HS wrestling and track coach since I was in the 3rd grade. I was lifting - running 60 miles a week and competeing in W tournaments from the 6th grade.
I guess HGH was initially used to develop bone density and muscle mass for elderly. I don't know if an active 63 yr old qualifies.

 

[THE-DET-OAK]

I personally think your splitting your doses up too much. I would go crazy to do all that pinning for a mere 100mg a week.

When you take testosterone, and build LBM you increase androgenic receptors, so you will need more to surpass where you are at now.

The lineman in NFL ( so ive heard ) have to take 300mg a week just to maintain there size, let alone earn more. testosterone replacement therapy (TRT) is a lot about perception, and that changes as you progress.

This is a simple case of champagne taste on a beer budget In other words if your going to continue to progress you will need to up your dose.

Or like you said look into Growth Hormone optimization, that is one thing that will increase the potency of your testosterone. This was proved in a study on 80 and 90yr olds.

 

[halfwit]

I personally think your splitting your doses up too much. I would go crazy to do all that pinning for a mere 100mg a week.

When you take testosterone, and build LBM you increase androgenic receptors, so you will need more to surpass where you are at now.

The lineman in NFL have to take 300mg a week just to maintain there size, let alone earn more. testosterone replacement therapy (TRT) is a lot about perception, and that changes as you progress.

This is a simple case of champagne taste on a beer budget In other words if your going to continue to progress you will need to up your dose.

Or like you said look into Growth Hormone optimization, that is one thing that will increase the potency of your testosterone. This was proved in a study on 80 and 90yr olds.

I really don't want to hijack this thread, but do you have more information on GH optimization? I'm definitely one of those guys that require more test than the average Joe to achieve optimal blood serum levels. I wonder if this could help. (It would be helpful for others too I'd imagine)

 

[THE-DET-OAK]

Sure no problem, there is tons of research on GH, even 10 year studies. Thats why it drives me nuts when the so called experts say there is no long term research.

Here is the one about rhGH augmenting the effects of testosterone. Basically it says lower doses of each were needed to achieve targeted physical improvements in the combined group (gh plus test).

Testosterone threshold levels and lean tissue mass targets needed to enhance skeletal muscle strength and function: the HORMA trial.
Sattler F, Bhasin S, He J, Chou CP, Castaneda-Sceppa C, Yarasheski K, Binder E, Schroeder ET, Kawakubo M, Zhang A, Roubenoff R, Azen S.
Source
Department of Medicine, University of Southern California, 2020 Zonal Avenue, Los Angeles, CA 90033, USA. fsattler@usc.edu
Abstract
BACKGROUND:
In the HORMA (Hormonal Regulators of Muscle and Metabolism in Aging) Trial, supplemental testosterone and recombinant human growth hormone (rhGH) enhanced lean body mass, appendicular skeletal muscle mass, muscle performance, and physical function, but there was substantial interindividual variability in outcomes.
METHODS:
One hundred and twelve men aged 65-90 years received testosterone gel (5 g/d vs 10 g/d via Leydig cell clamp) and rhGH (0 vs 3 vs 5 g/kg/d) in a double-masked 2 × 3 factorial design for 16 weeks. Outcomes included lean tissue mass by dual energy x-ray absorptiometry, one-repetition maximum strength, Margaria stair power, and activity questionnaires. We used pathway analysis to determine the relationship between changes in hormone levels, muscle mass, strength, and function.
RESULTS:
Increases in total testosterone of 1046 ng/dL (95% confidence interval = 1040-1051) and 898 ng/dL (95% confidence interval = 892-904) were necessary to achieve median increases in lean body mass of 1.5 kg and appendicular skeletal muscle mass of 0.8 kg, respectively, which were required to significantly enhance one-repetition maximum strength ( 30%). Co-treatment with rhGH lowered the testosterone levels (quantified using liquid chromatography-tandem mass spectrometry) necessary to reach these lean mass thresholds. Changes in one-repetition maximum strength were associated with increases in stair climbing power (r = .26, p = .01). Pathway analysis supported the model that changes in testosterone and insulin-like growth factor 1 levels are related to changes in lean body mass needed to enhance muscle performance and physical function. Testosterone's effects on physical activity were mediated through a different pathway because testosterone directly affected Physical Activity Score of the Elderly.
CONCLUSIONS:
To enhance muscle strength and physical function, threshold improvements in lean body mass and appendicular skeletal muscle mass are necessary and these can be achieved by targeting changes in testosterone levels. rhGH augments the effects of testosterone. To maximize functional improvements, the doses of anabolic hormones should be titrated to achieve target blood levels.

http://www.ncbi.nlm.nih.gov/pubmed/21059836

Maybe start a thread on Gh optimization.

another key in this study you will see they point out that results varied greatly individually. Just going further to show each person's protocol need's to be tailored specifically to them.

also look at the T levels needed to make body composition changes, and all of these men were over 65.

 

[unkadave]

I personally think your splitting your doses up too much. I would go crazy to do all that pinning for a mere 100mg a week.

When you take testosterone, and build LBM you increase androgenic receptors, so you will need more to surpass where you are at now.

The lineman in NFL ( so ive heard ) have to take 300mg a week just to maintain there size, let alone earn more. testosterone replacement therapy (TRT) is a lot about perception, and that changes as you progress.

This is a simple case of champagne taste on a beer budget In other words if your going to continue to progress you will need to up your dose.

Or like you said look into Growth Hormone optimization, that is one thing that will increase the potency of your testosterone. This was proved in a study on 80 and 90yr olds.

I'm one of those people who get a panic attack after three cups of coffee. I also am recovering fully from having a NeuroEndrocrine carcinoid cyst removed about 2 yrs ago. That alone can cause multiple unpredictable hormone surges and deficiencies.
Doing 200 e2w put me in the E room with a Carcinoid Crisis event where my BP was around 200/165 for a week with red hot flushing of the face and super anxiety. I figured the T probably brought it on as it was the only thing I'd changed. So I decided to go w lower doses more frequently so if I did have a reaction it would be minimal and shorter lasting. But yes othe people have said I need a slightly higher dose @ e4to5days as e3d can cause problems in itself by not letting the T.Cyp cycle thru properly??

 

[unkadave]

I'm going to the Dr. today 2/8/13
The testosterone seems like it is still not working. I will print this out and talk to her about looking for - Estrogen - Estrodil - SBHG - etc..
Thx
Dave

 

[JimiThing]

I'm going to the Dr. today 2/8/13
The testosterone seems like it is still not working. I will print this out and talk to her about looking for - Estrogen - Estrodil - SBHG - etc..
Thx
Dave

Keep us updated Dave.

 

[lakers0812]

I agree I'd like to hear how this goes bro. At first glance I was thinking your issue was estradiol since you never mentioned taking an Aromatase inhibitor (AI). You however are taking a low dose of testosterone replacement therapy (TRT) which could mean you may not even need an Aromatase inhibitor (AI). If in fact you do have to increase your dosage to reap the benefits of testosterone replacement therapy (TRT), I'd be curious to see how much. Good luck brother!

 

[UJMRYDER]

Definitely in for update as well.

Good luck

 

[DanielN]

I think be tested and be sure about your problem. then get a better solution.

Best Way to Burn Fat

 

[SolomonGrundy]

Your dose is low, the anxiety goes away after the first week if you ride it out, blood testing is eventual in the first few months. 150mg a week is a good start

 

[unkadave]

900

Your dose is low, the anxiety goes away after the first week if you ride it out, blood testing is eventual in the first few months. 150mg a week is a good start

Got back Fri with some labs. Testosterone was 900 I'd gotten frustrated in the last month and showed the Doc my journal I had done 3 injts of 30mg in 4 days and injected the day before the draw. So it's not like I'm hiding anything.
She said my estrodil lab hadn't come back yet. I'm still feeling l loagy physically but my mood is still great.
I will be on 30mg e3d for 5 weeks and retest.
I wonder if using the 1 ML syringe and 1" 25g needle is deep enough as the standard 2 ML syringe [I was using] had the 1-1/2" needle. The 2 ML syringe is sloppy and inacurate as I use such small dosage or .15 on the 1 ML markings - of 1 thru 10.