Yet Another Hormone Replacement Therapy (HRT) Dosing Dillema - Tcyp/HcG/Adex

[zeissteufel]

Yet Another HRT Dosing Dillema - Tcyp/HcG/Adex

This is my first post, so please pardon if I'm in the wrong area.

Ok ... here is the PROBLEM: No energy/extreme fatigue. That is really my only complaint and probably the main reason that i started Hormone Replacement Therapy (HRT) in the first place.

My dilemma is that I have one of those docs that will pretty much give me what i want but when it comes to admin and monitoring, I am on my own. Hormone Replacement Therapy (HRT) is pretty much all he does, so the knowledge is there ... he's just kinda flaky and hard to reach for questions and VERY hard to get an appointment with - my next one is in 3-4 months. So, when I was finally able to get in with him I took some labs from previous doctor with normal readings across the board (except e2 since I didn't know to get a lab for that). Almost all numbers fell in the middle of ranges provided. I think it's safe to assume that my e2 followed suit ...

Total Test - 545 Free test - 83.2

He prescribed the following (on a Thursday), showed me how to pin, loaded me up with 300mg tcyp and sent me on my merry way .. scripts in hand:

Tcyp - 300mg 1/wk (Sunday)
HcG - 400iu EOD (MWF, actually)
Adex - 1.0 mg with HcG (MWF)

He said I would feel awesome and that I should start to tell in a couple of weeks. After 6 weeks and 8th dose of tcyp I decided to modify and cut adex in half to .5 mg MWF. My reasoning for this was derived from a)reading the boards b)not having any other high e2 symptoms (itchy tits, mood swings etc) and c)the fact that Crisler and his colleagues rarely even use AI's for Hormone Replacement Therapy (HRT) ... PLUS, and this is a big PLUS ... one day after my HcG shot and 1mg adex dose I literally started dosing off in a face to face conference with a customer (not good). I'm really thinking that I crashed my e2. So, did .5 adex for a little over a week and I'm still not seeing improvements ... it's not worse, but not much better either .. hard to tell.

Honestly, increased libido is about the only difference I'm seeing over the last 8 weeks from 300mg tcyp and 1200 iu of HcG per week. We have a problem and I would very much appreciate any thoughts from the community.

At this point, my plan is to switch to a more Crisler-ish protocol, so I have not done any adex or HcG since last Friday. Was planning on starting the following starting on Friday:

Friday:
250iu HcG >> no adex until needed
Sat:
250iu HcG >> no adex until needed
Sun:
200-300mg tcyp >> no adex until needed

My weight is 210lbs / 5'11" / 21% BF

I like Crisler's methodical approach and might even be willing to take it all the way back to 200-300mg tcyp per week and add in HcG later (which is what he would do). I know I need more labs and i know I need e2 numbers, but Ijust have to shoot from the hip for the time being ...

This is where I could use some advice. What say you?

And thanks in advance for any help! Z

 

[SilverBackGorilla]

Is that your numbers before starting TRT?

 

[Spunkey71]

Welcome, you have come to the right place, there are many very knowledgeable guys here that can get you pointed in the right direction.

The first suggestion I would make is to get labs done through privatemdlabs.com, it is quick and the cost is minimal. I believe you will want to get the female panel (for males as well) and probable the E2 sensitive. Once you have your labs post them here and guys like Megatron, Halfwit and Austin1 can give more detailed advice.


Best of luck!

 

[zeissteufel]

@SilverBackGorilla - Yep ... pretty much middle of the road. Energy has always been an issue for me. Before I found this doc, all I could get was Wellbutrin which helped a lot ... for a while anyway. I'm shooting for 1100-1300ish.

@Spunkey71 - thanks for the tip .. I'll look into that lab site

 

[Spunkey71]

Have you had a sleep study done to see if you have sleep apnea?

 

[zeissteufel]

Have you had a sleep study done to see if you have sleep apnea?

It's funny you mention that as I am highly suspicious of some sort of sleep issue. Since I have been single for so long I didn't even realize that i snored until this new GF told me. So, I downloaded an app that measures and records your snoring ... blew my mind. It didn't sound like i stopped breathing but dayumm ... I also bought this thing you put on your head and it says I get lots of REM and light sleep but very little deep sleep. My insurance kinda sucks so I'll wait to do a sleep study as a last resort, but it's def a good idea.

In any case, I have a friend who is confirmed as having sleep apnea and low T. He got an increase in energy from just treating the low t with gel. I figured I should get some sort of boost as well. My current dose is pretty decent, IMO.

 

[bigben66]

Correct me if I'm wrong, but isn't 300mg Test Cyp a VERY high dose for testosterone replacement therapy (TRT), especially if your Test levels weren't particularly low to start with...?

I know Halfwit is on a high dose - but that guy is almost 400lbs!!!

 

[zeissteufel]

Correct me if I'm wrong, but isn't 300mg Test Cyp a VERY high dose for testosterone replacement therapy (TRT), especially if your Test levels weren't particularly low to start with...?

I know Halfwit is on a high dose - but that guy is almost 400lbs!!!

I think it's a high dose as well, but i wasn't going to complain if he wanted to write that. I was thinking he would put me on 200mg tops. Oh well, I kinda just figured I would stockpile whatever I don't need. In any case, you can see why I am perplexed. I should be seriously feeling quite good.

The one thing that might shed some light is that he didn't appear to be well versed in HcG. I mean, he knew what it was of course and said it was the best way to go but from talking to friends and some of the cops he works with I get the impression that 200mg tcyp and adex is his standard script. 400iu of HcG and 1mg adex EOD just seems a little weird and has me thinking e2 is the culprit here.

 

[Spunkey71]

It's funny you mention that as I am highly suspicious of some sort of sleep issue. Since I have been single for so long I didn't even realize that i snored until this new GF told me. So, I downloaded an app that measures and records your snoring ... blew my mind. It didn't sound like i stopped breathing but dayumm ... I also bought this thing you put on your head and it says I get lots of REM and light sleep but very little deep sleep. My insurance kinda sucks so I'll wait to do a sleep study as a last resort, but it's def a good idea.

In any case, I have a friend who is confirmed as having sleep apnea and low T. He got an increase in energy from just treating the low t with gel. I figured I should get some sort of boost as well. My current dose is pretty decent, IMO.

300mgs is high, one thing you will want to do is to split your dosage into two injections. Take them 3.5 days apart (Pinn on Monday morning and then again on Thursday evening) this will allow you to have more stable test levels without having a huge spike the day after your injection and then crashing towarsd the end of the week. It will also reduce the the amount of test that is converted to estrogen which helps keep your E2 at a more level that is easier to manage.

TRT also intensifies sleep apnea, what I mean is that you are tired and woren out from having low T so when you sleep you sleep hard, once you get on testosterone replacement therapy (TRT) you have energy again but now due to sleep apnea you are not getting the rest you need. I was always tired and worn out before testosterone replacement therapy (TRT) and slept all the time. Now that I am not always wanting to sleep and have a life again I feel the effects of having sleep apnea. Been using a CPAP for a week now and it is amazing what life is like when on testosterone replacement therapy (TRT) and getting restfull sleep.

 

[Megatron28]

If I had natural test levels of 545 -- which is pretty much in the normal range -- I would not start testosterone replacement therapy (TRT). You are not doing yourself any favors. I doubt your issues are from having normal test levels.

Did you check your thyroid? Full thyroid panel?
Definitely get that sleep study done immediately.
Get 8 hours of sleep a night.
Get your diet in check.
Check your vitamin D.

It is very likely that you have another problem causing your symptoms.

 

[zeissteufel]

If I had natural test levels of 545 -- which is pretty much in the normal range -- I would not start testosterone replacement therapy (TRT). You are not doing yourself any favors. I doubt your issues are from having normal test levels.

Did you check your thyroid? Full thyroid panel?
Definitely get that sleep study done immediately.
Get 8 hours of sleep a night.
Get your diet in check.
Check your vitamin D.

It is very likely that you have another problem causing your symptoms.

Thanks for the input! I've never really thought of a thyroid panel ... hmmm ... that is something that I will definitely look into.

As far as the sleep study goes, that is something I am trying to work out. I feel like there could definitely be something preventing me from getting enough restorative sleep (N3) which could greatly be impacting my energy levels. My GF's ex-husband had sleep apnea, and she says I don't have the same patterns as him at all - loud snoring followed by silence and then gasping for air. She says I just get loud and then sometimes wake myself up. And that has actually gotten better since taking a product called SnoreStop in chewable pill form. I'm pretty good about getting 8 hrs a night and sometimes more if I'm hitting the gym hard. Diet is on point and Vitamin D is at low end of range but still normal.

The fatigue - dozing off in Dallas traffic, lunch time naps in the car, etc - was really starting to impact quality of life. There was also other stuff like restlessness, memory issues, depression, etc. My first doc (a female family practitioner w < 5 yrs) looked at my score, wrote me a script for Vitamin D and told me to add cardio to my routine. Lol. Thanks Doc! I've been a fitness nut for years ... already tried all that She totally blew me off and offered ZERO relief for my symptoms.

The second doc was an exceptional certified internist but still belonging to the school which opposes Hormone Replacement Therapy (HRT) for general vitality and quality of life ... aka bumping a 545 to a 1200-1300 just because this 44 year old guy wants to feel like a 19 year old guy. My question is this: why not? There is absolutely no shred of empirical evidence to suggest that this is harmful ... in fact, there is more evidence to suggest the opposite. And since I am augmenting with HcG, I really don't run the risk of permanently shutting myself down in case I wanted to quit and go back to baseline. He, unlike the first doc, DID offer some relief in the form of Wellbutrin. I liked it ... energy and mood improved considerably, but I still wasn't the 'go-getter' I am shooting for ... plus the effects seem to subside after several weeks. I had this same experience with Wellbutrin in my 30's: it worked for a while then quit. That drug is in a class by itself, so it makes sense.

In any case, I opted to take myself off the Wellbutrin in an attempt to get same results with added benefits of increased fat loss and boost in the gym. The cost was roughly the same (before HcG) and the 'researched and documented' adverse affects didn't exist, so ...

My third doc. My current dilemma. My frustrations ...

Thinking I'm definitely going to look into this thyroid thing and lower the HcG / Tcyp doses to something closer to maintenance. Regardless, I'll keep the doc and script just in case I ever want to do cycles.

 

[zeissteufel]

300mgs is high, one thing you will want to do is to split your dosage into two injections. Take them 3.5 days apart (Pinn on Monday morning and then again on Thursday evening) this will allow you to have more stable test levels without having a huge spike the day after your injection and then crashing towarsd the end of the week. It will also reduce the the amount of test that is converted to estrogen which helps keep your E2 at a more level that is easier to manage.

TRT also intensifies sleep apnea, what I mean is that you are tired and woren out from having low T so when you sleep you sleep hard, once you get on testosterone replacement therapy (TRT) you have energy again but now due to sleep apnea you are not getting the rest you need. I was always tired and worn out before testosterone replacement therapy (TRT) and slept all the time. Now that I am not always wanting to sleep and have a life again I feel the effects of having sleep apnea. Been using a CPAP for a week now and it is amazing what life is like when on testosterone replacement therapy (TRT) and getting restfull sleep.

Ugh! The thought of sleeping with that THING on my face ... But dang, if it helps ....