Congrats Blackhawk! There is chance HCT might drop even more with the lower dosage.
What Dr Saya said about the high lymph? I also have that and in my last lab it was at 4.4. Usually my number is just above 3.
Blackhawk's journey with TRT
- Thread starter Blackhawk
- Start date
Congrats Blackhawk! There is chance HCT might drop even more with the lower dosage.
What Dr Saya said about the high lymph? I also have that and in my last lab it was at 4.4. Usually my number is just above 3.
Blackhawk
Member
Last reduction was May 22. I have only gone from E3D to EOD starting last week. But yes, I hope HGB/HCT drops more. It is encouraging too that RDW is back in normal range. When the body is cranking out new RBCs, RDW can go a little off.
Re: lymph anomalies, Dr Saya wrote a referral for hematology and stated the lymph concerns are not in his area of expertise. I will consult with my PCP Friday and likely proceed with seeing a hematologist if there is not a simple explanation.
I also just received a reply from Dr Saya, and have been prescribed anastrazole 0.125mg BIW. It will be some time to get the script filled, so if I am still feeling PMS by then I'll start. Fingers crossed this provides some relief. And something I hadn't stated directly yet, I've been reading a lot about possible prostate provocation by E2. Despite my lower PSA now, It's not back down to baseline, so another reason to get the E2 in check.
Re: lymph anomalies, Dr Saya wrote a referral for hematology and stated the lymph concerns are not in his area of expertise. I will consult with my PCP Friday and likely proceed with seeing a hematologist if there is not a simple explanation.
I also just received a reply from Dr Saya, and have been prescribed anastrazole 0.125mg BIW. It will be some time to get the script filled, so if I am still feeling PMS by then I'll start. Fingers crossed this provides some relief. And something I hadn't stated directly yet, I've been reading a lot about possible prostate provocation by E2. Despite my lower PSA now, It's not back down to baseline, so another reason to get the E2 in check.
Vince Carter
Banned
Curious your SHBG is a bit either normal or midrange given the difference in your TT and FT, I was more curious that with that that you might do OK with your E at 38 which is also my guess on your SHBG (thereabouts)
Blackhawk
Member
Last measured SHBG 48.1
We'll see. For now I am still not doing well regarding what seem to be E2 symptoms.
Blackhawk
Member
Well, a few minor developments:
-I switched from E3D to EOD 2.5 weeks ago. The perceived effect is that my every 3 day moods swings and bloating did indeed even out, though left me irascible and a little bloated all the time. My energy has been a bit better/more even, and my daily walk is easy. I have added some mileage on some days up to 4 miles total, and some light weight training (with rocks I pick up off the road) during the walk, but have not been able to get back to any heavy training, not even body weight calisthenics. I also strained my back a few days ago carrying a queen mattress up the stairs so physically very tentative now. Still feeling pretty demoralized physically.
-Started anastrozole 4 days ago Prescribed 0.125 2x/week, but I know every 3.5 won't work well for me, so I am splitting doses in half and taking EOD at the same time as T cyp/HCG injection which is super easy to remember. This ends up 12% less than prescribed, but easy for me to be compliant.
The day I started was a rough day during a stressful week, and I ended up with heavy anxiety. I had 3 days of dental appointments in a row: 1;exam, xrays and eval, then 2; deep cleaning, then 3; two teeth worked on, one with mercury amalagam fillings removed/prepped for crown and another large filling replaced...close to 2 hours in the chair. I felt very bad that afternoon and can't attribute it either way to the cumulative stress, 4 shots of novacaine or the anastrozole. I took the 0.125 that day and crashed hard in the afternoon.
-The next day had an appt with my PCP for full physical and health review. The main outcomes: 1; I charted my absolute lymphs for the last few years and on review, the PCP agrees with Dr Saya and is sending me to a hematologist/oncologist. So yet another F$$%^ng drama. And, 2; with the drop in PSA, I'll have another PSA w free PSA % in another 90 days and he recommended saw palmetto for symptoms. Dr Saya previously said don't take it, so I am a little confused over the controversy. It may be time to see a uro.
-So TRT wise, with the slight improvements so far, I am going to wait it out for a while and see what happens. I'd like to bump T dosage back up, but am going to wait to see T levels, HCT and E2 again, before considering asking for any increase. Still some time for the EOD schedule to balance out.
-Still having inconsistent lulls mid-late afternoon, sometimes having to lie down/nap before dinner. I'll probably request Free T3 and T4 next round, and am even thinking about having it pulled twice same day, morning and late afternoon to see the diurnal story. It seems I may benefit from some T4 added to the NDT, but will have to talk with Dr Saya about this.
-This weekend, I feel a bit of recovery, less bloated less irascible, but still pretty knocked down and directionless in terms of what to do with life. Just hoping for some peace and improvement in both physical and mental condition.
-I switched from E3D to EOD 2.5 weeks ago. The perceived effect is that my every 3 day moods swings and bloating did indeed even out, though left me irascible and a little bloated all the time. My energy has been a bit better/more even, and my daily walk is easy. I have added some mileage on some days up to 4 miles total, and some light weight training (with rocks I pick up off the road) during the walk, but have not been able to get back to any heavy training, not even body weight calisthenics. I also strained my back a few days ago carrying a queen mattress up the stairs so physically very tentative now. Still feeling pretty demoralized physically.
-Started anastrozole 4 days ago Prescribed 0.125 2x/week, but I know every 3.5 won't work well for me, so I am splitting doses in half and taking EOD at the same time as T cyp/HCG injection which is super easy to remember. This ends up 12% less than prescribed, but easy for me to be compliant.
The day I started was a rough day during a stressful week, and I ended up with heavy anxiety. I had 3 days of dental appointments in a row: 1;exam, xrays and eval, then 2; deep cleaning, then 3; two teeth worked on, one with mercury amalagam fillings removed/prepped for crown and another large filling replaced...close to 2 hours in the chair. I felt very bad that afternoon and can't attribute it either way to the cumulative stress, 4 shots of novacaine or the anastrozole. I took the 0.125 that day and crashed hard in the afternoon.
-The next day had an appt with my PCP for full physical and health review. The main outcomes: 1; I charted my absolute lymphs for the last few years and on review, the PCP agrees with Dr Saya and is sending me to a hematologist/oncologist. So yet another F$$%^ng drama. And, 2; with the drop in PSA, I'll have another PSA w free PSA % in another 90 days and he recommended saw palmetto for symptoms. Dr Saya previously said don't take it, so I am a little confused over the controversy. It may be time to see a uro.
-So TRT wise, with the slight improvements so far, I am going to wait it out for a while and see what happens. I'd like to bump T dosage back up, but am going to wait to see T levels, HCT and E2 again, before considering asking for any increase. Still some time for the EOD schedule to balance out.
-Still having inconsistent lulls mid-late afternoon, sometimes having to lie down/nap before dinner. I'll probably request Free T3 and T4 next round, and am even thinking about having it pulled twice same day, morning and late afternoon to see the diurnal story. It seems I may benefit from some T4 added to the NDT, but will have to talk with Dr Saya about this.
-This weekend, I feel a bit of recovery, less bloated less irascible, but still pretty knocked down and directionless in terms of what to do with life. Just hoping for some peace and improvement in both physical and mental condition.
CoastWatcher
Moderator
You referenced saw palmetto and your concerns about taking it. My own urologist is an outspoken critic of saw palmetto and tells me he's seen instances of "post finasteride syndrome" triggered by its use. By no means does everyone who uses saw palmetto develop such terrible symptoms, but be aware that it is a possibility. Or so I have been told.
Vince Carter
Banned
Saw Palmetto is a known androgen blocker. Kind of silly to be taking T and then using a blocker...eh?
Blackhawk
Member
Yes indeed!
madman
Super Moderator
Come to your own conclusion! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4002402/
Here is a good article regarding prostatic hyperplasia drug treatments.....the highly respected Abraham Morgentaler. https://www.harvardprostateknowledg...-benign-prostatic-hyperplasia-drug-treatments
Blackhawk
Member
LOL! Scanning the first article, my conclusion is inconclusive! I need to read it thoroughly, but it looks like while it does address Saw Palmetto's effect on receptors it does not address specific "side effects" and is not specific enough in terms of specific prostate effects vs general effects body wise. Anyway I'll read it thoroughly sometime soon.
Looks pretty ineffective. Evidence sketchy at best:
https://www.ncbi.nlm.nih.gov/pubmed/16467543
https://www.ncbi.nlm.nih.gov/pubmed/21954478
https://www.ncbi.nlm.nih.gov/pubmed/10751856
https://www.ncbi.nlm.nih.gov/pubmed/9609640
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lowe2sucks
Member
I would also avoid saw palmetto.. imo coming off trt to bring prostate in good health is better than using androgen blockers they mess up your receptors and than you can't respond to androgen anymore
Blackhawk
Member
OK, so I have read a bunch more and for now, No thanks to Saw Palmetto.
On another topic, I have been slowly losing weight since the start of T dosage reduction, I believe in part due to reduced Free T, plus somewhat reduced protein intake and total calories, but now that I have taken several doses of anastrozole, the bloating seems to have subsided and I lost 4-5 pounds in the last week. Back down to my base weight of 145. Is this potentially just losing water weight? I am hoping it is not related to the lymphocyte issue.
On another topic, I have been slowly losing weight since the start of T dosage reduction, I believe in part due to reduced Free T, plus somewhat reduced protein intake and total calories, but now that I have taken several doses of anastrozole, the bloating seems to have subsided and I lost 4-5 pounds in the last week. Back down to my base weight of 145. Is this potentially just losing water weight? I am hoping it is not related to the lymphocyte issue.
Blackhawk
Member
Update:
So it's been almost 4 weeks since changing to EOD, and 2 weeks on anastrozole, 1/16mg EOD taken with my T and HCG shot.
I have almost lost the E2 related mood swings and bloating. I am still am grumpy though with less intense emotional episodes. This is VERY welcome! I still am not able to summon motivation for much and have been very unproductive with projects/work.
I have a bit more energy, have been starting to do just a little more walking mileage and warm up level super light weight training and some light calisthenics. Still afraid to push it and crash again.
I have speculations what has happened in this time, but don't positively know the cause and effect: I think I am past the effects of dropping T levels from downward dose adjustment, and the EOD may be causing a slight increased T effect compared to E3D. However, it seems pretty obvious to me that I do better in terms of physical ability exercise recovery and mental status on a higher dose of testosterone. I feel like we've found the lower limit of what's effective.
I feel a bit stuck since hematocrit remains borderline, and last check ferritin remained sub optimal. I don't want to get into a cat and mouse game with hematocrit, ferritin and donating blood, but I'd sure like to nudge the T cyp back up 5-10%.
I'm still having frequent lulls mid-late afternoon, and often lie down and nap. I'd like to revisit T3 and T4 on next labs. Anyone know whether taking these morning then late afternoon offers a better picture to base dosing? My last levels seemed to indicate I have more than enough free T3 soon after taking my morning dose, but Free T4 remains very low. My thought is some T4 in addition to NDT might be in order.
So it's been almost 4 weeks since changing to EOD, and 2 weeks on anastrozole, 1/16mg EOD taken with my T and HCG shot.
I have almost lost the E2 related mood swings and bloating. I am still am grumpy though with less intense emotional episodes. This is VERY welcome! I still am not able to summon motivation for much and have been very unproductive with projects/work.
I have a bit more energy, have been starting to do just a little more walking mileage and warm up level super light weight training and some light calisthenics. Still afraid to push it and crash again.
I have speculations what has happened in this time, but don't positively know the cause and effect: I think I am past the effects of dropping T levels from downward dose adjustment, and the EOD may be causing a slight increased T effect compared to E3D. However, it seems pretty obvious to me that I do better in terms of physical ability exercise recovery and mental status on a higher dose of testosterone. I feel like we've found the lower limit of what's effective.
I feel a bit stuck since hematocrit remains borderline, and last check ferritin remained sub optimal. I don't want to get into a cat and mouse game with hematocrit, ferritin and donating blood, but I'd sure like to nudge the T cyp back up 5-10%.
I'm still having frequent lulls mid-late afternoon, and often lie down and nap. I'd like to revisit T3 and T4 on next labs. Anyone know whether taking these morning then late afternoon offers a better picture to base dosing? My last levels seemed to indicate I have more than enough free T3 soon after taking my morning dose, but Free T4 remains very low. My thought is some T4 in addition to NDT might be in order.
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Blackhawk
Member
Based on my dosage of NDT and the resulting labs, Dr Saya said I have been converting T4 to T3 well. I've read that T4 takes longer in the body to convert then be used as T3, so I reckon taking some NDT and T4 same time in the AM may provide longer action. Would be a lot easier than trying to change dosing time, waking in the middle of the night to do so or taking multiple doses every day.
Blackhawk
Member
New labs in...
And I ordered an afternoon T3, same day:
Protocol:
T cyp 24mg QOD (84mg/week)
HCG 240 iu QOD
Anastrozole .0625mg QOD
DHEA 12.5mg QD evenings
Pregnenelone 25mg QD evenings
NDT 1gr QD
Vit D 5000iu QD
Plus the rest of my OTC supplements
Comments: I feel like I am almost there though with one small compromise:
Symptomatically doing better overall:
-Lost the mood swings and most of the bloating. Looks like we hit the right dose of anastrozole.
-Very glad hematocrit has finally come down to baseline.
-Still feel like a little more free T would help my exercise and recovery. Maybe consider raising T cyp dosage a hair in the future, but probably for now just ride with it 90 days before reconsidering.
-Still getting afternoon/evening fatigue, and still wondering about adjusting NDT and adding a smidge of T4
Questions:
Anyone see benefit going to QD at this point?
The thyroid and fatigue issue, welcome any thoughts.
Next consultation with Dr Saya next week.
I also followed up with a hematologist/oncologist about the absolute lymphs. This is not attributed to TRT. He ordered a flow cytometry test which confirms lymphoctes with mutations that are related to CLL: Chronic Lymphocytic Leukemia. At current levels he does not consider that I have Leukemia yet, but I it's looking like it's heading there. Many people with this disease still live another 20 years. The waythings have been going I'd be surprised to make it to 80 anyway, but fingers crossed for quality of life with whatever I have left.
And I ordered an afternoon T3, same day:
Protocol:
T cyp 24mg QOD (84mg/week)
HCG 240 iu QOD
Anastrozole .0625mg QOD
DHEA 12.5mg QD evenings
Pregnenelone 25mg QD evenings
NDT 1gr QD
Vit D 5000iu QD
Plus the rest of my OTC supplements
Comments: I feel like I am almost there though with one small compromise:
Symptomatically doing better overall:
-Lost the mood swings and most of the bloating. Looks like we hit the right dose of anastrozole.
-Very glad hematocrit has finally come down to baseline.
-Still feel like a little more free T would help my exercise and recovery. Maybe consider raising T cyp dosage a hair in the future, but probably for now just ride with it 90 days before reconsidering.
-Still getting afternoon/evening fatigue, and still wondering about adjusting NDT and adding a smidge of T4
Questions:
Anyone see benefit going to QD at this point?
The thyroid and fatigue issue, welcome any thoughts.
Next consultation with Dr Saya next week.
I also followed up with a hematologist/oncologist about the absolute lymphs. This is not attributed to TRT. He ordered a flow cytometry test which confirms lymphoctes with mutations that are related to CLL: Chronic Lymphocytic Leukemia. At current levels he does not consider that I have Leukemia yet, but I it's looking like it's heading there. Many people with this disease still live another 20 years. The waythings have been going I'd be surprised to make it to 80 anyway, but fingers crossed for quality of life with whatever I have left.
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Congrats. Another good example of lower dosage controlling side effects without compromising TRT benefits.
In my opinion given where you SHBG sits ED injections are a bit overkill.
Are you feeling any difference in the gym because of the lower FT? Maybe try to increase it a bit see how you feel (just keep an eye on HCT). Sometimes just a small increase is enough to take that out of balance again.
Sorry to hear about the CLL. Your lymphs are always high or this was just an one off high count?
In my opinion given where you SHBG sits ED injections are a bit overkill.
Are you feeling any difference in the gym because of the lower FT? Maybe try to increase it a bit see how you feel (just keep an eye on HCT). Sometimes just a small increase is enough to take that out of balance again.
Sorry to hear about the CLL. Your lymphs are always high or this was just an one off high count?
Blackhawk
Member
The only thought I have for QD at same 84mg/week is it could possibly push Free T trough a couple points higher, while not raising E2 or HCT.
I am still unsure about end point in terms of exercise and my free T. The dosage reductions have been difficult and the last one was the worst, but now around 90 days after lowering to 84mg/week finally it seems I am doing (relatively) OK. I wish I could raise my baseline in terms of exercise, it has been my main challenge since statin muscle damage. I was doing better on higher dose of T, but I can't play cat and mouse with high HCT, low ferritin and blood donations.
Absolute lymphs have been steadily climbing last 1-2 years, broke normal range last 2-3 labs.
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