lowTengineer looking for help

Thread starter #1
I have been on TRT for a year now. I was diagnosed secondary hypogonadism. I started at 100mg e7d. Doc raised me to 150mg e7d. Then raised to 100mg e3.5d. Both of those times the increase was due to my complaint of the weekly roller coaster. The 2x weekly dose helped with the roller coaster feeling but what I still had in a constant feeling of below average “meh” all day everyday. Defy switched me to 60mg 3x weekly. Still pretty much feel the same.

I still don’t feel great after 9 weeks of this change. I think the ups and downs that I was experiencing have gone away. Now I just sometimes have a feeling of tiredness. Libido is pretty low. Recently my joints mostly knees/legs are sore. I hurt my back maybe 5 months ago so my deadlift/squatting has been very minimal and I do no running.

I try to spread the injections evenly so I do wednesday morning, friday evening, sun night. I hate the inconsistent schedule timing. I feel like I would like the consistency for my routine to do EOD. Maybe this would help reduce the peak e2 enough to get rid of the AI. I would also be willing to think about going back to e3.5d however I'm hesitant due to my past results.

I think my total t, free t, and e2 look great on paper. I've seen a bunch of iron and thyroid discussion on this site recently. Is it possible my low iron is still causing me grief? I've never donated blood.

I have included a list of labs below. One file is my history of labs. The other just shows the recent results if you don't want to see everything.

Do you have any ideas or suggestions I should be working on?

Current meds:
60mg test cyp SQ 3x weekly
300iu hcg SQ 3x weekly
0.125mg anastrozole 3x weekly
500mg metformin 2x daily
iron supplement and extra vit c

height: 5’ 11"
weight: 185lb
BF: ~25-28%
age: 34
I go to the gym 5 days a week. 3 days weightlifting, 2 days cardio. Pretty active on the weekend with kids.
 

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#2
looks like your dosage is way to high. FT and BioT are double the top of range. cut your dose, ditch the AI (lowering dose should allow you to do that) and I bet you'll feel better.
 
Thread starter #3
looks like your dosage is way to high. FT and BioT are double the top of range. cut your dose, ditch the AI (lowering dose should allow you to do that) and I bet you'll feel better.
Does having high free t really make someone feel bad? It seems counterintuitive to me.
Defy told me in my last appointment that he thought a target free t of 30 would probably be good. I'm not sure if the lab they typically use has a different range than mine.
 
#4
Are these Labs old before you started with defy Medical. They don't look like LabCorp labs and looks like you had the wrong estradiol test?
 
Thread starter #5
Are these Labs old before you started with defy Medical. They don't look like LabCorp labs and looks like you had the wrong estradiol test?
These are not labcorp labs. I use my local doctor to order tests and send them to defy. Everything but the cmp, CBC, and iron panel were sent to mayo laboratory.

The one I labeled estradiol sensitive is lc/ms. I have called the lab to confirm and had to have it changed in the past.
 
#6
These are not labcorp labs. I use my local doctor to order tests and send them to defy. Everything but the cmp, CBC, and iron panel were sent to mayo laboratory.

The one I labeled estradiol sensitive is lc/ms. I have called the lab to confirm and had to have it changed in the past.
The only thing I can see is your reverse T3 is a little high but not bad.
 
Thread starter #8
#9
I have read about this recently and wonder if it's something to check into. I heard a Jay Campbell podcast recently that one of the docs said he doesn't test for it, just uses it with symptoms.


Does this improve with iron and ferritin?
Do you have low iron because of donating blood?
 
Thread starter #12
I had an appointment today. The main takeaway is that possibly my free e is elevated with my free t. I was suggested to switch to EOD to solve my previous dosing schedule hatred.

My new protocol to try is:
48mg test cyp eod
240iu hcg eod
0.125mg anastrozole eod

It was suggested that I alternate hcg and test days to help not forget that it is injection day or not. Has anyone else done this?

I also have a slight concern about the anastrozole. I really dont want to take it or increase the dose. My preference is to be off it if I can. Any input on this?

Happy to see my iron and ferritin go up. Still supplementing for 3 more months and rechecking.
 
Thread starter #13
Anybody have any thoughts on my revised protocol? especially the AI usage.

Has anybody done EOD injections while alternating hcg and test days? Is this more of a hassle doing it everyday?
 
Thread starter #18
It's been about 16 weeks of my EOD protocol. I've been doing:
48mg test cyp eod
240iu hcg eod
0.125mg anastrozole eod
25mg DHEA
iron supplement

Here are my recent labs. I have some questions relating to some changes so I included the last 2 sets.

test

units

range

7/2/2018

9/19/2018

1/21/2019

   

90mg e3.5d SQ

60mg 3x SQ

48mg EOD IM

   

injection day

injection day

injection day

      

weight

lb

 

187

184

178

BP

  

144/68

 

145/62

Cholesterol

mg/dL

100-200

178

 

159

Trigl

mg/dL

0-150

57

 

71

HDL

mg/dL

40-60

46

 

43

LDLc

mg/dL

0.0-130.0

120.2

 

101.9

Total Chol/HDL

 

<5

3.9

 

3.7

Sodium

mEq/l

134-145

138

137

136

Potassium

mEq/l

3.6-5.1

3.7

3.8

4.1

Chloride

mEq/l

98-110

103

102

101

CO2

mEq/l

21-32

26

27

31

Anion

mmol/L

 

12.7

11.8

 

Glucose

mg/dL

70-105

110

107

113

Calcium

mg/dL

8.4-10.2

9.2

9.2

9.2

ALT

u/l

7-52

21

17

24

AST

u/l

12-48

20

23

27

Albumin

g/dl

3.5-5.7

4.8

4.7

4.9

ALP

u/l

29-119

55

48

46

Protein

g/dl

6.4-8.9

7.5

7.3

7.4

Bilirub

mg/dL

0.3-1.3

0.5

1

0.9

BUN

mg/dL

7-25

16

18

20

Creatine

mg/dL

0.70-1.30

1.08

1.16

1.17

Creatinine+eGFR

>=60

 

78

72

81

WBC

K/UL

4.0-11.0

5

4.6

4

RBC

K/UL

3.50-5.50

5.71

5.76

5.77

Hgb

g/dl

12.0-18.0

16.8

17

17.1

Hct

%

42.0-52.0

46.9

48

48.2

MCV

fL

75.0-100.0

82.1

83.3

83.5

MCH

pg

25.0-35.0

29.4

29.5

29.6

MCHC

g/dl

31.0-38.0

35.8

35.4

35.5

RDW

%

11.0-16.0

11.8

11.9

12

      

A1C

%

4.0-6.0

  

5.3

DHEA-S

ug/dL

89-457

152

404

489

PSA

ng/mL

0-4

0.459

  

IGF-1

ng/mL

54-310

224

  

IGF-1 z-score

st dev

-2 to +2

1.05

  
      

Testost

ng/dl

262.0-1,070.0

627.1

 

1331

Test Free - calculated

ng/dL

 

14.8

 

25.6

Test total

ng/dl

240-950

 

1020

1120

Test Free

ng/dl

4.85-19.0

 

34.7

 

Test bioavailable

ng/dL

72-235

 

541

526

SHBG

nmol/L

10-57

25

27

33

Estradiol Enhanced

pg/mL

10-40

 

42

31

Estrone

pg/mL

10-60

 

43

30

LH

miU/ml

1.24-8.62

0

  
      

thyroid tests

     

T4Free

ng/dl

0.79-1.77

1.19

  

T3Free

pg/ml

2.30-4.20

3.44

  

T3Reverse

 

9.0-27.0

16.7

  

TSH

miU/ml

0.300-4.000

1.745

 

3.051

FT3:Rt3 ratio

  

20.6

  
      

Iron

ug/dL

50.00-212.00

47

101

 

Iron-Satn

  

12.18

27.08

 

Iron+TIBC

 

250.00-450.00

386

373

 

Ferritin

ng/ml

23.9-336.2

33.8

48.4

75.9

      

Vitamin B12

pg/ml

211-911

  

768

Folate

ng/ml

>4.0

  

13.8




I still would not describe myself as feeling great. I will say my gym performance is the best it ever has been. I still feel tired occasionally. Libido is kind of low. Erection problems sometimes occur during sex.

My lipid panel looks like it took a huge hit. Where did this come from?

In July I was told that my thyroid looks pretty ok although reverse t3 is starting to get high. At that time my iron and ferritin was super low. I've been supplementing iron and it has come way up. I was also suggested to not test thyroid when my iron is low since it will be changing.

This time I decided to add TSH to see where it sits. To my surprise it went way up. Is my ferritin up high enough? Is there a time I need to wait for it to stabilize? Is it time now to repeat my previous thyroid tests?

I can't decide if I should make my appointment with Defy now and then be told I need more tests. Does anyone know, when they get those results would I need to make another appointment to discuss?
 
#19
What exactly are you seeing that took a huge hit lipids wise? Other than triglycerides taking a small jump i don't see much that really stands out.
 
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