Questions about lab results and lethargy on TRT

Engelwood

New member
Hello,

This is my first post here on the forum. A little background...

- 34 y.o male
- been on TRT for just over a year
- t levels before treatment consistently measured in the high 100's
- TRT regimen was (read below for reasons I had to pause treatment) 230mg/weekly with half gram Arimidex taken the day after injection.
- I also get an MiC injection the same day as my T shot.

When I started treatment, I had all the typical symptoms associated with low T. The most prevalent were chronic fatigue/ lethargy and brain fog. I was so tired all the time that if I sat for longer than a few minutes, I'd start nodding off. Prior to injections I was sleeping 8-9 hrs a night with a 2-3 hr nap after work. Brain fog made concentrating at work difficult to say the least. Thus the decision to look into TRT after bloodwork confirmed low T.

I was started on 180mg/week and literally felt better on the ride home after leaving the doctor's office. The first month I still battled the symptoms mentioned above, but they were reduced considerably. Over the course of the last year, my blood work kept bouncing, all over the place. With t-levels coming back really low - sub 300; and as high as >1500 ( the highest # the labs would return on blood work). Ultimately, over time, my dosage was upped to the number listed above.

I have been feeling really tired of late and mentioned it to the Dr at the clinic I get treated. Also, at the time, I set up an appointment with my primary care physician asking for some blood work to be done. I get my T injections every Wednesday. They draw blood every 5 weeks before giving the injection. That Saturday, I had blood drawn by my primary as well. The medical group that my primary belongs to has a system that allows patients to access their lab results via a website as they become available. Thus, I got my results from my primary before the TRT clinics. The labs from my primary showed a total test level of >1500. Also free T was ridiculously high as well. My PSA was also elevated from just under 1.0 to 2.6.

So, come Wednesday, I'm expecting the doctors at the clinic to address my PSA and high T by lowering the dosage. I get there And they go over the results. The PSA number is the same as my primary's. They no longer want to administer injections until I go see a urologist. They do not believe that it is anything serious, but they need to "cover their asses". After that they go over some of the other numbers on the test...and my test levels were just over 400!!!

My questions are:

How does T levels go from over 1500 to under 400 in a matter 4 days? I'm guessing these swings are what has caused my lethargy and sleepiness while on TRT. It also is likely the reason why I continued to need increases in dosage. Had my PSA levels came back normal, I would hAve likely received a bump up in dosage. Any ideas why this would happen?

Also, it's been almost 2 weeks since my last injection and I don't feel bad at all. I'm not saying I feel great, but I do feel better than I did the last 2-3 months on TRT. Why is this the case?

Lastly, if all goes well, I am stilling interested in TRT. Im looking to feel great as opposed to feeling ok. I definitely don't want to feel like 10 pounds of shit in a 5 pound bag, though.

Sorry for the long-winded post. I'm trying to give as much information as possible in hopes to eliminate any ambiguity.

ThAnks for reading. Any and all suggestions are greatly appreciated.
 
Btw, all my other blood work came back within range with the exception of slightly elevated hemoglobin levels. My thyroid hormones all came back within range. Not sure what my current E2 levels are. The last time they were checked they were within range. I've been on the Arimidex for a little over 6 months.

Thanks
 
Hey bud, I'm going to take a shot.
Are you injecting once weekly?
23Once a week injections don't keep levels stable as testosterone cyp has a half life of around 5 days. Possibly the reason your levels keep bouncing around.

I don't see anywhere that you tested estrogen.
Estrogen also has an effect on PSA as far as I'm aware. Since you haven't injected in a while possibly your estrogen has fallen but you still have some test in your system making you feel okay. You need to get this tested, as having levels too low or too high will still give you symptoms of hypogonadism even with sufficient testosterone levels.

You need to drop your dosage down and split it into two injections. I know this might not be possible as it seems you're driving to a clinic to get your weekly injections. If possibly I'd go twice a week.
Showing your levels <1500 on 200mgs per week is normal, same thing happened to me. Having those kind of levels long term isn't the best idea. There's a reason the LabCorp range is 348-1197.

You really need a full blood work panel, at least
Total T
Free T
Estradiol Sensitive
SHBG
 
Last edited:
I agree. It sounds like you are on the typical roller coaster ride that these stupid doctors put guys on. You need to 1) start self injecting -- demand it or find a new doc. 2) Inject twice per week. 3) Check your estradiol immediately. That is what is making you fatigued. You are aromatizing too much from what it sounds like. 4) Donate blood to get your hemoglobin back into the normal range. Go do that this weekend. Just give a pint of whole blood. You will help save a life by doing it too.

Sounds like you need a new doc.The sponsor of this forum has a great reputation. They can get your protocol set straight. You should give them a call. Their name is IMT and you will see their add to the right of your screen. I can't tell you I use them personally, but I see the great advice they give guys every day here.
 
And as jomamma said, there are theories out there that estradiol is what affects your prostate. Not the testosterone itself. That's yet another sign that your estradiol is too high. Are you getting lots of acne too? Feel bloated?
 
And as jomamma said, there are theories out there that estradiol is what affects your prostate. Not the testosterone itself. That's yet another sign that your estradiol is too high. Are you getting lots of acne too? Feel bloated?

Megaton,

Yes, the acne is pretty bad. Chest and back are pretty beat up. Not really getting the bloated feeling, though. When they ( the place is actually a male health clinic) took blood and discovered the high estrogen, I was put on Arimidex. The subsequent test showed estrogen levels were within normal range. That was 6 months ago. They haven't ran a test for estrogen since although my dosage has been upped a few times. When they do labs, they don't always test the estrogen. Not sure why.

I'm definitely interested in finding a new place for my TRT. My main concern is with the insurance. I have a good plan and it covers pretty much everything. I have a 15 dollar co-pay and pay 5 extra for MiC injection. So, 20 bucks is all I pay each week. I don't pay out of pocket for labs either. They run those every 5 weeks.

I'm just outside Chicago. Any recommendations? Also, does the sponsor site take insurance?

Thanks in advance
 
Make sure they are testing Estradiol (a potent form of estrogen).

Sometimes you get what you pay for is all I can say... I don't know any good docs in the Chicago area other than IMT.

If I were you, I would at least start running your own lab work if they aren't going to do it for you. And get educated on everything about TRT. You picked the right place to do that. Just read as much as you can in this forum. Spend the whole weekend until you can't read anymore.

You can get private labs run at Private MD - Buy Lab Tests Online. Many guys get the Hormone Panel for Females (for me too). It costs about $50 and you get the results the next day. The Hormone Panel for Males is a good one too, but it costs more.

Good luck!
 
Just so you know, you are paying $20 * 52 = $1,040 per year. And you are beholden to them to do everything for you. Plus the great inconvenience of having to go to you doc every single week for the rest of your life. And it sounds like they don't even give you very good care to boot!

I see my doc once a year for follow-up TRT care. And that visit can go down as a Physical so I don't pay anything for it since it is preventative care under my insurance. Even if you did pay for it, lets say it is $150-$200 for a visit.

You can buy 10ml (2000mg) vials of testosterone cypionate for about $40 if you use a coupon from GoodRx. So at 200mg per week each vial will last you 10 weeks. So let's call that about $40 x 5 = $200 per year.

You can buy a year's supply of needles for less than $20 at the pharmacy. Have them order you a box of 100 -- buying in bulk is cheaper.

Arimidex is cheap if you get generic Anastrozole. Let's say $20-$30 or something for 30 1mg pills which will last you 60 weeks at your dose.

Lab work is about $50 for the panel I told you about. You will probably run it 1-2 times a year once you get dialed in.

So, why would you get crappy care and be greatly inconvenienced by not even being able to self inject and pay more on top of it? It doesn't seem like a very good proposition. My total cost adds up to about $350-$550 vs. your $1,040.
 
Last edited:
I hear ya. The place I was going to ran labs every 5 weeks. Not sure what other docs would do. If I go back there , which I am not sure I will, I will ask for a more comprehensive blood panel including the estradiol. I like the idea of splitting up the dose into 2 injections along with being able to do them at home. I'm fairly certain the clinic I go to will not Rx me test and that I will have to go in to their office for injections.

I'll contact IMT and see how they do things. My concern is they won't want to deal with insurance. I see what some of the guys at the clinic pay for their injections that don't have insurance. I can't cover that much. Only way to find out though is to talk to them and find out.
 
Just so you know, you are paying $20 * 52 = $1,040 per year. And you are beholden to them to do everything for you. Plus the great inconvenience of having to go to you doc every single week for the rest of your life. And it sounds like they don't even give you very good care to boot!

I see my doc once a year for follow-up TRT care. And that visit can go down as a Physical so I don't pay anything for it since it is preventative care under my insurance. Even if you did pay for it, lets say it is $150-$200 for a visit.

You can buy 10ml (2000mg) vials of testosterone cypionate for about $40 if you use a coupon from GoodRx. So at 200mg per week each vial will last you 10 weeks. So let's call that about $40 x 5 = $200 per year.

You can buy a year's supply of needles for less than $20 at the pharmacy. Have them order you a box of 100 -- buying in bulk is cheaper.

Arimidex is cheap if you get generic Anastrozole. Let's say $20-$30 or something for 30 1mg pills which will last you 60 weeks at your dose.

Lab work is about $50 for the panel I told you about. You will probably run it 1-2 times a year once you get dialed in.

So, why would you get crappy care and be greatly inconvenienced by not even being able to self inject and pay more on top of it? It doesn't seem like a very good proposition. My total cost adds up to about $350-$550 vs. your $1,040.


Megatron,

Ideally, I'd like to get to this type of setup. I work in the trades so my travel time and expense to get to and from the clinic adds up, too. I filled out a few contact forms this weekend regarding TRT treatment. One from the sponsor site here. Interested in hearing what they have to say.

Megatron, quick question: I know that you have your treatment dialed in, but aren't you concerned with certain markers becoming abnormal without you knowing? I mention it because things like elevated hemocrit and PSA levels have surfaced with my treatment. Had I not been tested frequently, I would have never known. Is there any precautions you take against things of this nature?

I'll keep you posted as to what I hear from the treatment clinics I've contacted. I'm continuing to read the articles and forum posts.

Thanks,

Eric
 
Just got back from the urologist a bit ago. After doing 'his thing', he determined that my prostate felt normal - no inflammation or nodules. He also took a pee sample and quickly tested for infection. That also came back normal. That said, because my PSA levels have come back higher each of the last 3 labs, he wants me to refrain from starting testosterone treatment backup for another 3 months. At that time, he wants to run labs again and see where the PSA is at. If it's elevated again, he wants to do a biopsy. That did not sound like fun.

I have now been off T for just under a month. Surprisingly I do not feel all that bad. In fact, I would say I feel pretty good. My test levels I'm sure are low. I have no sex drive at all and essentially no testicles. I started T treatment to feel great and have more energy. I never really got that with my treatment. I guessing it was because the protocol used wasn't best for me. I'm still interested in restarting treatment. Just have to wait to get the green light.

Eric
 
Back
Top