HRT has been a game changer in every aspect of my life

[JimGainz]

Hello brothers – like many of you, I have been lurking and absorbing information from this site for a few years, but finally just signed up.

51 y/o male
210 lbs
6'1
~14% body fat
Former weightlifter / bodybuilder from the 80's
-Pre TRT levels 425 Ng/dL. 7.5 Free t, Estradiol 16
-Post TRT: 1000 Ng/dL 21 Free t, Estradiol 20
-Current regiment: 100 mg/wk split into 2 Subq injections, 350 IU HCG 2x week, .25 mg Anostrazol 2x wk (just started thyroid meds Liothyronine 15 mcg / day)

It all began in my early 40s when I started having all of the classic Low T symptoms. I was getting tested and my testosterone was in the 500s – but my free T was actually very low - around 6.5 to 7.5 but all the doctors were basically like “welcome to middle-age.” Finally I had an old college buddy who is a Doctor on TRT himself and put me on gels and hCG. Things were good for a while – but as we all know, the gels sort of stopped working. Long story short, after researching many things on this and other sites – I got a consultation from Defy medical who completely squared away my program: put me on shots – and then I finally fine tuned the protocol over several months – switching to sub q injection‘s – and I also got help on my thyroid from Defy ( and by the way – getting the right thyroid protocol dialed in was almost as much life changing as going on TRT. Very important).

Overall, I think I feel better now than I did when I was in my 20s. Cognitively, emotionally, and physically – getting the hormones on point was such an incredible and and long journey. But it was well worth it. I am literally a new man.

I would not have been able to do it without knowledge and support of sites like this where we can share information and learn from each other’s experience. So, I’m happy to be an active member now – feel free to contact me and ask me anything. I will be providing commentary on other posts where I could add value.

All the best,
Jim

 

[Vince]

Jim, congratulations on your success with TRT.

 

[littlemanb]

Hi Jim,

Thanks for that intro..I am also new to TRT, 4 weeks now, 100 mg, sub q, 2 Xs weekly..I haven’t noticed big changes yet but do feel about 30% better overall. I won’t have my numbers back until the 3 month mark..my pre TRT numbers were almost identical to you and I am 53.

I was anemic when I started so the doctor was hoping the Testosterone would increase my red blood cells..we will see.

I found it interesting about your thyroid protocol, do you know your pre and post thyroid numbers? I only have my TSH for now but I will be getting more in depth thyroid testing on next bloodwork follow up..my total TSH below: it does seem on the low side so we will see what my free t3 and t4 will show..

Thyroid Function
TSH

1.69
0.32-5.04
mU/L

Anyways, great to read others experiences and learn about TRT..I’m hoping my journey will be as successful as everyone else. I know that I too have learned a lot from this site as well!

Regards,

Mark

 

[JimGainz]

Hi Mark – thanks for your note – and I’m glad you are beginning to find success with your TRT protocol. It takes time – and you will definitely see continued changes. Also, keep in mind that that once the journey begins – it’s up to you to seek other ways to optimize your hormones and other blood markers. You mentioned thyroid – but I would also check vitamin D and B 12 - as these tend to be diminished in the Western world these days and can also make a large difference. Also look into DHEA – again – this is down the road and check with your doctor. Regarding your thyroid, your TSH value is actually perfect - I think you are confusing the role of TSH – it actually shows the inverse of thyroid hormone – so a high TSH mean someone is lacking thyroid – or hypothyroid and needs to take meds. The optimal range for TSH is 1 to 2.5 so you are great there. Mine was over 4.0 – indicating borderline Hypothyrod, and I tested positive for anti-bodies – indicating that I have Hashimoto’s disease. I have seen cases where people have optimal TSH, and also have antibodies present – or still have subjective signs of low thyroid – this is usually driven by the reverse T3 ( so essentially the T4 need to convert to T3 – however sometimes the channel does not work effectively and it converts to an inactive form of T3 (reverse T3) so you do not get the clinical benefit.

Personally, I would wait a bit more and keep
checking your TSH and dial in your TRT protocol, workout and vitamin supplements regain before doing anymore thyroid tests.

 

[littlemanb]

Hi Jim,

Thanks for your feedback! I posted some of my numbers pre TRT below..my DHEA was high due to supplementation of 25 mg daily he stopped me taking the DHEA when I started the TRT. My vitamin D was also high so my doctor cut me down from 6000 IUs a day to 3000. My B vitamins were also good along with my iron..the doc was more concerned with my borderline anemia with no real explanation..he is hoping that TRT will improve the red blood cell issue or add some EPO to assist..he feels the anemia along with the low T could be causing a lot of my fatigue/energy and other symptoms. I do work out regularly, weights and cardio, so that isn’t an issue..I’ve done that all my life. Sounds like you do as well..

I will definitely update the end of October when I get the bloodwork and see the doc again..

I also may need to increase my dose next visit but we will see what the numbers look like..

I see you are taking HCG. The doc offered it to me but said it was mainly for shrunken testicles and if I wanted to keep fertile..both of which I was not concerned..I’ve read pros and cons on the use of HCG so I’m not sure if adding it would make much difference on how I feel..I would like that clear headed feeling again and more energy would be great..

Anyways, thank you for taking the time to reply! I hope your TRT protocol is also working for you..this is a great site to learn and share!

Talk soon,

Mark

Testosterone

14.3
8.4-28.8
nmol/L

Testosterone Free Calculated

242
115-577
pmol/L


Testosterone Bioavailable Calculated

5.7
2.7-13.5
nmol/L

Sex Hormone Binding Globulin

44.2
19.0-76.0
nmol/L



RBC

4.43
4.20-5.40
10*12/L

Hemoglobin

137
135-170
g/L

Hematocrit


0.40
0.40-0.50
L/L


Luteinizing Hormone (LH)

1.7
1.1-8.8
IU/L



DHEA Sulphate

12.2
<9.8
umol/L

25-Hydroxyvitamin D

153
75-150
nmol/L

 

[littlemanb]

Oh by the way..I found it interesting that my lutinizing hormone was quite low prior to starting TRT therapy? Any thoughts on that?

Regards,

Mark

 

[MarkM]

Low LH would be sign of secondary hypogonadism. Probably a key factor in you ending up on TRT. LH tells your testes to produce testosterone. Low LH typically means low testosterone.

 

[JimGainz]

I think HCG makes a big difference on two fronts: you will get a boost in Testosterone(assuming you are secondary hypo) and it backfills other hormonal channels (like pregnenalone) that gets diminished when on TRT. I love it and feel better on HCG. It drives up Estradiol so you need an AI for sure. (You didn’t mention Estradiol or taking an Aromatase Inhibitor in your protocol).

Typically when guys start TRT and don’t get all the subjective benefits it is usually a result of one or more of the following: other deficiencies (thyroid, vitamins), Estradiol running too high, high SHBG which binds your Free Testosterone, or simply a lack of quality sleep.

Your next set of labs will dictate any changes needed to your protocol. Be patient. It does take about 6 months to get your protocol dialed in correctly. Your RBC will definitely go up too the longer you are on.

 

[littlemanb]

Thanks Jim..Sorry estrodiol was:

Estradiol

83
<157
pmol/L

The doctor doesn’t like AIs..He said studies are showing long term use can cause bone degradation? Or something like that..He would rather regulate estradiol via T adjustment/dosing..

We will definitely see how the blood work looks in October..I will keep you and everyone updated.

Regards,

Mark

 

[littlemanb]

Low LH would be sign of secondary hypogonadism. Probably a key factor in you ending up on TRT. LH tells your testes to produce testosterone. Low LH typically means low testosterone.

Yes..you are probably right on the money..I guess I won’t notice a big difference when my LH drops to zero now that I’m on my TRT..it doesn’t have that far to go..haha..

 

[Systemlord]

Thanks Jim..Sorry estrodiol was:

Estradiol

83
<157
pmol/L

The doctor doesn’t like AIs..He said studies are showing long term use can cause bone degradation? Or something like that..He would rather regulate estradiol via T adjustment/dosing..

We will definitely see how the blood work looks in October..I will keep you and everyone updated.

Regards,

Mark

In my case regulating the T dosage didn't work out for me, even with a Total T of 376 E2 was still high for me. Those studies are men who were taking huge amounts of anastrozole, 3mg weekly and not the lower more reasonable .125 and .250 doses.

83 pmol/L is 22 pg/mL which is good, I wouldn't want it below 20 pg/mL.

 

[littlemanb]

phew..thats a relief! Thanks, that really helps! I'm going to keep an eye on that..

Regards,

Mark

 

[littlemanb]

By the way..how did you do that estradiol conversion?

 

[Blackhawk]

The doctor doesn’t like AIs..He said studies are showing long term use can cause bone degradation? Or something like that..He would rather regulate estradiol via T adjustment/dosing..

I am not 100% certain about direct causation by anastrazole. I don't think that is quite correct. Bone loss comes from having estradiol that is too low. If you take too much AI, yes you will drop E2 too low. The idea of AI is to lower E2 to a useful beneficial range, not to alevel that causes bone loss. Sounds like your doc might not know how to dose an AI to adjust E2 to the correct range.

That said, when possible, certainly preferable to control E2 with lowering T dosage... until the T dosage becomes inadequate... pretty much my own case (along with managing hematocrit). With E2 as such I started low dose anastrozole.

 

[MarkM]

By the way..how did you do that estradiol conversion?

Here's the conversion of pmol/l to pg/ml:

1 pmol/l = 3.671 pg/ml

 

[littlemanb]

I am not 100% certain about direct causation by anastrazole. I don't think that is quite correct. Bone loss comes from having estradiol that is too low. If you take too much AI, yes you will drop E2 too low. The idea of AI is to lower E2 to a useful beneficial range, not to alevel that causes bone loss. Sounds like your doc might not know how to dose an AI to adjust E2 to the correct range.

That said, when possible, certainly preferable to control E2 with lowering T dosage... until the T dosage becomes inadequate... pretty much my own case (along with managing hematocrit). With E2 as such I started low dose anastrozole.

Sounds good..I think if it is an issue and can’t be regulated via T dosage, I believe he will still use an AI..I got the impression that it was a last resort and he didn’t like his patients on it long term if possible..

I’m new and still learning but all you guys have been a great help..this site has also been helpful..when I did decide to see the doctor in July, he was surprised at how much I was informed about T therapy..the good thing about the doc is he is open to working with me on my treatment plan as long is it makes medical sense..

Thanks guys,

I will keep all informed as I progress in this journey..I will definitely have more questions!

Regards,

Mark

 

[littlemanb]

Here's the conversion of pmol/l to pg/ml:

1 pmol/l = 3.671 pg/ml

Thanks for that conversion rate..so the way mine is being calculated (pmol/l), what would be an optimal estradiol range for me to be in?

 

[MarkM]

Thanks for that conversion rate..so the way mine is being calculated (pmol/l), what would be an optimal estradiol range for me to be in?

I wouldn’t want to go below 75 pmol/l or over 110 pmol/l on the top side. Of course it’s all individual and whether you have low or high E2 symptoms but this should be a safe range.

 

[littlemanb]

Thanks MarkM..that’s helpful.i’ll watch for symptoms and watch my levels..

Regards,

Mark

 

[DragonBits]

I wouldn’t want to go below 75 pmol/l or over 110 pmol/l on the top side. Of course it’s all individual and whether you have low or high E2 symptoms but this should be a safe range.

A lot of people think E2 should be in a ratio to testosterone .

"The healthy ratio should be above 14 (ng/dl of T divided by m=pg/ml of E2) from two small studies on fertility. "

https://www.excelmale.com/forum/thr...estradiol-levels-the-facts.15905/#post-118843

Here is a thread taking in more detail about the ratio. However, it doesn't seem to be a well proven theory.

I ask because last blood test my TT was 1389, FT 28.4 and sensitive E2 56.2. According to the ratio theory I am at 24.8 and me E2 should actually be higher like at least 70.

I am not doing anything because I expect my TT to decline and with it E2, and as far as symptoms perhaps I am a little more bitchy than usual, but I have always been sarcastic so hard to tell if it's unusual and no other symptoms that I can see.

So when looking at E2 levels, do you all factor in TT and FT at all?