Ok, I'm at 800. What To Do Now?

[sqidd]

New guy here. I'll to keep this short and to the point, but I probably won't.

I'm 42yrs old

After struggling with my T levels for three years I finally have a handle on things. Thanks in part to lurking on this forum.

Three years ago I was feeling like crap (had been for a while) and my Dr suggested checking my T. well, it was low. Real low. I can't remember exactly what it was but it was somewhere in the low 300's. My Dr put me on the patch, I felt better, all is good.....right? We did some later blood tests and I was in the 400's. She said good to go so I ran with it for a couple of years.

A year and a month ago I decided that I needed to get back in shape. I had really let myself go since I retired from motorcycle racing at 35. At 35 I was 145-150lb (6 feet tall, yeah, skinny). At 41 years old I was a shocking 215lb. And that was all fat. I started walking, then walking more, then walking with a heavy pack then I got back in the gym (hadn't been in the gym since I was 25) after about six weeks. I took it easy for a couple of months doing low weight/high rep stuff then started to ramp things up. After about a month of ramp up I was getting really beat down and not recovering.

I knew I wasn't eating as well as I could be so I got a diet guy to do a diet for me and we were off to the races again. I was feeling quite a bit better. So I started ramping my workouts again.....and started crashing. I took a month off the gym to take care of my sick dog at that point. I figured the break wouldn't kill me. I had shed about 30lb at that point. When I got back in the gym I started to crash constantly. My diet guy said that I should not be. My workouts aren't that hard and we know I was eating and sleeping right. So I went back to the Dr and had a blood test. I was in the low 400's. I said I wanted to go higher, so she prescribed me some gel to stack on the patch (I'm sure most of you are cringing at this point) and we were back off to the races.

I was feeling better, I was able to work out harder, but something wasn't quite right. That is when I started to look around, talked to some guys, got sent here, etc. I had another blood test done and I was at 570ish. Not bad, but not great. And I was using the hell out of patches and gel to get there. I asked for alternatives, she didn't offer any, so I went looking for treatment elsewhere. I found a Dr that specializes in this sort of thing and he said he could get me hooked up. But he caters to people with real $$$$ and the way he was set up was very "marketing driven". Great gig if you can get it, I'm sure he makes a ton of money. But I just couldn't afford his services and he didn't take health insurance for anything but blood tests.

So I did a lot more research, educated myself and went to see my Dr with some ammo. She is reasonable and smart, that is not the issue. TRT is not her forte though. I laid out to her that I was going to have to go to this other guy and spend big bucks or treat myself "under the table". At that point she was ready to go down this road with me and get it solved. She did not want me in that position. She said she was OK with getting me up to 800 but no higher.

At this point I was not going to the gym. There wasn't much point until I got a handle on things.

She hooked me up with a Rx for testosterone, syringes and needles. She originally was hesitant about me injecting myself every 3.5 days but relented. She instructed me to hit myself with .2ml 2x/wk. I did that for a month then had another blood draw. I was at a staggering 434. Well, let's bump it up. She said go to .3ml 2x/wk, I went with .4ml 2x/wk. For some reason she wanted to wait longer for the next blood draw (PITA Doctors). So I waited 8 weeks before my next test. It was 597. Now we're getting somewhere, and I was feeling better but I wasn't ready to get back in the gym yet. I wanted to be sure I was 100% ready to rock and eliminate that as a variable (I had some other stuff going on that could cause me trouble) so I could get back in there and if I had problems I would know it wasn't my T level. She said bump it, so I did. I bumped up to .7ml 2x/wk. Screw it, if a little is good more is better right? And I was getting sick of all this time between tests and not being able to get on with things.

When I bumped up to .7ml I knew I had to be close to 800 so I waited three weeks and then went back to the gym. And oh man, things are good. I'm still not killing it like a lot of other people are, I only work out 1-1.25hrs 4 days/wk. But I have only been back three weeks, I haven't had anything near a crash, I am recovering and I am already back up to my max weights (for reps). I'm even making a dent in the last little bit around my waist and I can actually see my abs poking through. I had a blood test on Thursday. I'm at 817.

So now what? Just getting to this point has been mentally exhausting. Along with figuring this T thing out. I've also stopped taking all the crap Dr's had me on to sleep, the pain meds I was on (I'm pretty busted up from racing), etc. I don't even take Tylenol or Advil anymore. I don't drink, I don't smoke. I should be looking pretty good. But I lived real hard for a lot of years. I never expected to live until 40. I really had no plan for this.

So here is where I'm at. I'm 6' 178lb and in pretty good shape. I would guess my body fat is in the 10-12% range. I'm pretty strong, my cardio is pretty good, I eat like a pro, I actually sleep 6-7hrs a night (which is really good for me), all pretty good. I have some stuff to deal with though. One of those things is now that I have attained 800 what do I do? I'll throw this in question form so this is less confusing:

-Now that I have reached 800 and taking .7ml 2x/wk to get there what do I do for long term maintenance? What blood tests? How often? I really had no plan past getting to 800.

-Is .7ml 2x/wk a lot? It seems like a lot. Could I be TRT resistant or something?

-My kidney function numbers are not fantastic, not horrible, but not fantastic either. It probably didn't help pounding pain meds for years. Is my kidney function in any way related to the TRT?

-My blood pressure is a tad high, 125-130ish. That is hereditary. I am on no meds for it. If I understand correctly the TRT is not helping this at all. What to do here?

I have lots of questions, I'm just not sure what they are yet. I'm hopping a discussion can be started here so I can learn a lot things. I am OCD and tenacious by nature. When I get focused on something I do the shit out of it. Now that I am on this talking care of myself kick I want to do it 100%. I'm just not really sure what I should be doing.

Thanks guys.

 

[Chiefy]

I think I speak for everyone when I ask that you post your most recent bloodwork.

It's not always about your total T value. Your free T value is arguably more important than your total T. If you've got a recent estradiol value we'd definitely like to see that.

And yes, .7ml 2x/wk is fairly high (assuming your prescription is 200mg/ml). Not unheard of, but still high. Too high for the majority of guys on TRT.

 

[sqidd]

I think I speak for everyone when I ask that you post your most recent bloodwork.

It's not always about your total T value. Your free T value is arguably more important than your total T. If you've got a recent estradiol value we'd definitely like to see that.

And yes, .7ml 2x/wk is fairly high (assuming your prescription is 200mg/ml). Not unheard of, but still high. Too high for the majority of guys on TRT.

And there is one of the things I need to learn......and then I need to tech my Dr. what I need to get tested for. The test I just had was for (I had other things going on, this was not just for TRT):

-White blood cell count 8.9

-Testosternone total 816

-PSA .81

Renal Panel

-SODIUM LEVEL 135

-POTASSIUM LEVEL 4.1

-CHLORIDE LEVEL 100

-CARBON DIOXIDE LEVEL 28

-GLUCOSE LEVEL 89

-BUN 13

-CREATININE 1.3 (this is a bit high)

-CALCIUM TOTAL 9.5

-ALBUMIN LEVEL 4.2

-GFR ESTIMATED AFRICAN AMERICAN 73

-GFR ESTIMATED NON AFRICAN AMERICAN 61

-PHOSPHORUS LEVEL 3.3

That's all I got. This is where I'm at. I basically have a Dr that doesn't have much of a clue how to deal with this, but is willing to learn/work through this with me. But I don't know where to go from here either. It sounds like when I have my next blood draw in 4 weeks I should be getting more tests? Which ones?

Thanks

 

[Chiefy]

Absolutely have your total T, free T, and sensitive estradiol measured. I'd say that those are the most important tests to have done, especially the sensitive E2. My guess is that your E2 is causing your issues.

 

[sqidd]

Absolutely have your total T, free T, and sensitive estradiol measured. I'd say that those are the most important tests to have done, especially the sensitive E2. My guess is that your E2 is causing your issues.

Issues? What does the E2 cause (or show)?

Thanks

 

[Chiefy]

Issues? What does the E2 cause (or show)?

Thanks

In short, it measures your estradiol level, which could be simplified to measuring your estrogen level. Estradiol is the estrogen that men typically care about, it's essential for a successful TRT experience.

When it's too high or low (my guess is that yours is too high), symptoms usually appear. These most commonly include fatigue, joint pain, erectile dysfunction, and mood swings/depression...but there are many others.

Elevated E2 is by far the most common reason for feeling like shit while on TRT.

 

[sqidd]

In short, it measures your estradiol level, which could be simplified to measuring your estrogen level. Estradiol is the estrogen that men typically care about, it's essential for a successful TRT experience.

When it's too high or low (my guess is that yours is too high), symptoms usually appear. These most commonly include fatigue, joint pain, erectile dysfunction, and mood swings/depression...but there are many others.

Elevated E2 is by far the most common reason for feeling like shit while on TRT.

In all of my rambling I must have not made a lot of sense. I feel fantastic, absolutely fantastic. I have none of the effects listed above. But I do want to be preo active about managing this TRT thing as well as it can be managed.

I'll have those items tested in 4 weeks when I do another draw.

Any other insights? Advice?

Thanks!

 

[Megatron28]

In all of my rambling I must have not made a lot of sense. I feel fantastic, absolutely fantastic. I have none of the effects listed above. But I do want to be preo active about managing this TRT thing as well as it can be managed.

I'll have those items tested in 4 weeks when I do another draw.

Any other insights? Advice?

Thanks!

Even if you feel good on TRT you still need to check your estradiol. Testosterone aromatizes into estradiol and it can have some negative side effects if left unmanaged. Just because you can't "feel" it doesn't mean it isn't too low or high. Can you feel when your TRT protocol has increased your hematocrit and it is time to donate blood? Similarly, can you feel when your cholesterol is high or your blood pressure is a little too high?

 

[sqidd]

Even if you feel good on TRT you still need to check your estradiol. Testosterone aromatizes into estradiol and it can have some negative side effects if left unmanaged. Just because you can't "feel" it doesn't mean it isn't too low or high. Can you feel when your TRT protocol has increased your hematocrit and it is time to donate blood? Similarly, can you feel when your cholesterol is high or your blood pressure is a little too high?

Oh, don't get me wrong. I came in here looking for advice like I just got. I will absolutely get a more comprehensive panel next time.

I just didn't want anyone mistakenly thinking that I am here because of issues/not feeling well. I am here to learn, chat with people in the know and make plans/protocols for the future.

Thanks again

 

[Hypnotix]

Make sure it's E2 Sensitive, important as a male. If your doctor doesn't know what it is, tell them to search for it. I had to, and it seems like you have a pretty decent and willing doctor to help you out, that's cool.

 

[Want2FeelGood]

Oh, don't get me wrong. I came in here looking for advice like I just got. I will absolutely get a more comprehensive panel next time.

I just didn't want anyone mistakenly thinking that I am here because of issues/not feeling well. I am here to learn, chat with people in the know and make plans/protocols for the future.

Thanks again

I think what people are trying to tell you, is that even though you feel "well", is that your plans for the future should be to closely monitor the present.