Could use a little advice..

[klepp0906]

I posted a thread not long ago in the introductions forum regarding my being placed on TRT.

My PCP started me out at 200mg/wk and did not give me arimidex or hcg, regardless of his experience or otherwise in the area, i think the consensus was to get me rolling and hand me off to an endocrinologist.

I do have an appointment with one, but its not until the 26th which will be roughly 5 weeks since the start of my TRT.

I'm on week 2/3 (just finished 4th shot yesterday of 100mg every 3.5)

These were the relevant numbers I had that got the adventure started. No E2 was done.

Now im about to call the dr, but wanted to check here first. Ive noticed some mild improvement with libido, not much but i know its still early. Unfortunately all things considered - i feel worse than I did prior to starting.

I have some sebhorriac(sp) dermatitis on my face thats been controlled for ages. This caused it to go ham. Which is fine, i can live with that. Much more worrysome however is the amount of water im holding. I lost a crazy amount of ankle mobility, they are literally tight and burning as we speak. im about 18 pounds up from where I was 2 weeks ago. The amount of water im holding is staggering. Also finding myself very emotional and depressed. Havent been either of those things in maaaaany moons. (before TRT i was moody/short tempered, but now im depressed/emotional which feels like ass).

I was "thinking" it sounds like my estrogen has gone through the roof which is probably subverting libido, and causing the water retention/depression?

Does this sound plausable?

Would it benefit me to call the doctor and ask for a small dose script of arimidex? I dont think it would be healthy, much less feel well to put this off for another 3+ weeks till I see an endo.

I was thinking next shot im going to lower my dose to 160 split in 2.

Advise?

 

[HealthMan]

I posted a thread not long ago in the introductions forum regarding my being placed on TRT.

My PCP started me out at 200mg/wk and did not give me arimidex or hcg, regardless of his experience or otherwise in the area, i think the consensus was to get me rolling and hand me off to an endocrinologist.

I do have an appointment with one, but its not until the 26th which will be roughly 5 weeks since the start of my TRT.

I'm on week 2/3 (just finished 4th shot yesterday of 100mg every 3.5)

View attachment 5811

These were the relevant numbers I had that got the adventure started. No E2 was done.

Now im about to call the dr, but wanted to check here first. Ive noticed some mild improvement with libido, not much but i know its still early. Unfortunately all things considered - i feel worse than I did prior to starting.

I have some sebhorriac(sp) dermatitis on my face thats been controlled for ages. This caused it to go ham. Which is fine, i can live with that. Much more worrysome however is the amount of water im holding. I lost a crazy amount of ankle mobility, they are literally tight and burning as we speak. im about 18 pounds up from where I was 2 weeks ago. The amount of water im holding is staggering. Also finding myself very emotional and depressed. Havent been either of those things in maaaaany moons. (before TRT i was moody/short tempered, but now im depressed/emotional which feels like ass).

I was "thinking" it sounds like my estrogen has gone through the roof which is probably subverting libido, and causing the water retention/depression?

Does this sound plausable?

Would it benefit me to call the doctor and ask for a small dose script of arimidex? I dont think it would be healthy, much less feel well to put this off for another 3+ weeks till I see an endo.

I was thinking next shot im going to lower my dose to 160 split in 2.

Advise?

My advice is stop guessing and have your doctor order blood work including estradiol sensitive. Only after that you will know if you need to add an AI. In my opinion your testosterone is too high for the average Joe so you will probably need to reduce that (a start dosage of 100-140mg a week is more common). Given the symptoms you mentioned and you testosterone dosage it is very possible that you are having issues with high estradiol. But keep in mind that testosterone by itself can make you hold water.
So if I were you i would get TT FT and E2 tested and adjust your testosterone dosage and if even after that your estradiol is high and you are having symptoms talk to your doctor about addin an AI.

 

[Systemlord]

More than likely high estrogen on a rather insane starting T dosage, 50-60mg twice weekly would have been better and will see most men reach high normal total testosterone levels.

This 200mg weekly is borrowed from 200mg every 2 weeks. Whenever we see a 200mg starting dosage we know the doctor is out of his depth.

 

[klepp0906]

My advice is stop guessing and have your doctor order blood work including estradiol sensitive. Only after that you will know if you need to add an AI. In my opinion your testosterone is too high for the average Joe so you will probably need to reduce that (a start dosage of 100-140mg a week is more common). Given the symptoms you mentioned and you testosterone dosage it is very possible that you are having issues with high estradiol. But keep in mind that testosterone by itself can make you hold water.
So if I were you i would get TT FT and E2 tested and adjust your testosterone dosage and if even after that your estradiol is high and you are having symptoms talk to your doctor about addin an AI.

this goes without saying.... but it was my understanding you cant have bloodwork until ~6 weeks?

 

[klepp0906]

More than likely high estrogen on a rather insane starting T dosage, 50-60mg twice weekly would have been better and will see most men reach high normal total testosterone levels.

This 200mg weekly is borrowed from 200mg every 2 weeks. Whenever we see a 200mg starting dosage we know the doctor is out of his depth.

so i keep hearing.

With my rather rudementary (compared to some of yous) understanding, high SHBG tends to cause the need for a high TT in order to get FT into a reasonable range? I wonder if this factored into part of the decision to start me at that.

Regardless, does dropping the dose 40mg/wk have a chance at resolving this or is that going to be an exercise in futility and i should persue an AI immediately instead and worry about adjusting the dosage after first labs in ~3 weeks?

any danger to holding this much water? Its my understanding it borks your BP and is tough on your heart? I mean the lack of libido surge and depression is terrible, but I can live with. However if its seriously impacting my health, thats something else alltogether.

As always, I appreciate your guys time taken to post/reply.

 

[HealthMan]

this goes without saying.... but it was my understanding you cant have bloodwork until ~6 weeks?

6 weeks to steady state (which actually is a bit more) but given you are having all these symptoms you can have it before to see how things are. But like it was said here. Your dosage is way too high so most likely your testosterone and estradiol levels are elevated. Consider discussing with your doctor a dosage reduction. That would be a good approach as well. First reduce your dosage (normally people start with 100-140mg a week) and wait the six-eight weeks to get bloodwork done and then adjust protocol if needed

 

[Systemlord]

There was no thought process when your doctor have you the current protocol, a large percentage of guys starting out at 200mg weekly will have estrogen problems.

A 40mg/wk a week will put in you in the range of geriatrics.

 

[klepp0906]

There was no thought process when your doctor have you the current protocol, a large percentage of guys starting out at 200mg weekly will have estrogen problems.

A 40mg/wk a week will put in you in the range of geriatrics.

i didnt mean dropping to 40mg a week lol sorry I wasnt clear. I meant dropping it 40mg which would put me at 160mg a week split in 2 doses 3.5 days apart. So 80mg saturday evening and wednesday morning.

 

[klepp0906]

i guess ill drop my dose next injection, and contact my doc tomorrow and see if he'll write me a sub for an AI.

is arimidex the preferred AI? also what is a really conservative/safe starting dose to request? Ive been made well aware of the dangers of crashing e2.

 

[Systemlord]

i didnt mean dropping to 40mg a week lol sorry I wasnt clear. I meant dropping it 40mg which would put me at 160mg a week split in 2 doses 3.5 days apart. So 80mg saturday evening and wednesday morning.

I still think you will have estrogen problems at 80 twice weekly and you will have wasted 6 weeks going through the motions. I would do 60mg maybe 70mg twice weekly.

 

[klepp0906]

I still think you will have estrogen problems at 80 twice weekly and you will have wasted 6 weeks going through the motions. I would do 60mg maybe 70mg twice weekly.

even considering my shbg of 55?

would there be any benefit to tapering down aka 80x2 next week then 60x2 the following or should i drop straight to the 60x2?

this is so bad im considering coming off while i still can super disappointed and discouraged but its probably in-part due to the accompanying depression. For low testosterone i was super happy with my body before. Wasnt strong but I was very lean/aesthetic and just wanted to get my libido back.

now im a bloated mess, depressed as all hell, and libido is better but not by much.

ugh!

trying to stay the course!

 

[Systemlord]

Your thinking higher testosterone equals higher libido, but higher testosterone also means high estrogen and that kills libido. Higher estrogen also means more irritability and depression.

60mg twice weekly isn't going to give you low testosterone, you'll be well above midrange.

 

[klepp0906]

Quick update.

I called the doc today and talked him into an AI. Hes calling it in for me now, a month's worth to last until I see endo.

Ultimately this post is for advice/suggestions regarding how to proceed from this point until next labs/endo appointment. My SHBG is 55 in case that factors into the advice.

I can stay the course at 100mg every 3.5d and add the AI.
I can change to 50mg EoD in an attempt to keep things more stable which is also a small dosage drop and I figured would potentially save the E2 spike which I assume is whats causing my anguish.
I can change to 40mg EoD which is a relatively large dosage drop.
I can do either of the aforementioned PLUS add the AI.

I know many have mentioned using as few compounds as necessary which I can get behind. At the same time, feeling like this on TRT is not an option. The only improvement at thi spoint is my sleeping. I used to have miserable insomnia and now I actually sleep the whole night. Problem is I sleep during the day too >.<

I gotta get rid of this water first and foremost. Libido and energy a close second.

I know changing too much at once is usually frowned upon as well but since im about a month out from bloods, and new to TRT, i figured if there was ever a time to make a change now would be it, circumstance n all.

 

[MarkM]

E follows T............. I believe your testosterone dose is too high and if me, I would do either one weekly injecting of 120 mg to 140 mg to offset the high SHBG or twice weekly injections, every 3.5 days, of 60 mg to 70 mg.

More testosterone is not always the answer and in many cases creates more issues than anything else.

 

[klepp0906]

E follows T............. I believe your testosterone dose is too high and if me, I would do either one weekly injecting of 120 mg to 140 mg to offset the high SHBG or twice weekly injections, every 3.5 days, of 60 mg to 70 mg.

More testosterone is not always the answer and in many cases creates more issues than anything else.

i understand and follow this to a degree. The weird part is, when I was young and dumb ~15 years ago, I did some AA's. Roughly ~600mg/wk of sustanon. Had none of the symptoms im presenting now.

Did I hold water? sure, but not like this. Energy and libido were an anti issue. Obviously much changes so its probably all but irrelevant.

Is the general consensus that lowering my T will resolve the bloat and the sensitivity? Sensitivity/Depression is purely an elevated e2 symptom yes?

So operating under the assumption I just kept the AI to the side for now, and lowered my T dose a bit. Would changing from E3.5 to EoD make 0 difference or would it be a boon in some way?

I like the idea of lower peaks higher valleys, and it will also be convenient should I need to be put on AI or hcg for scheduling. However if it wont make a shred of difference I'm not sure its worth the extra holes over time ;p

40mg eod is ~140mg a week i think. Or I could do 70mg/every 3.5.

I can already tell the 100mg shots at once is too much. My head feels like its under pressure/low grade headaches almost perpetually.

Tomorrow is shot day, today I get the AI. I need to come to a decision on how to proceed.

tyvm for the reply btw~!

 

[MarkM]

It's hard to compare what happened 15 years ago to today. Your 15 years older and your body has probably changed and will likely react differently.

With your high SHBG you would probably be better off injecting 70 mg every 3.5 days. You need to compensate for your high SHBG. If you go a smaller dose EOD it likely won't be enough testosterone to give you any real measurable Free T. It may hep the E2 from spiking but you may not feel better because of the lack of Free T.

I would probably go with the 60 mg to 70 mg E3.5D.

 

[klepp0906]

Ok, ill start there then. Any idea how long it would take for my e2 to begin dropping from a lower dose of T? Just so i can try and feel out if its helping?

I know labs will be imperative but since theyre a ways out still, Id like to garner SOME positives from this beforehand.

 

[MarkM]

My best guess, several weeks at the earliest before you may feel a difference and it starts moving down because of the half life already in your body, but everyone is different. Some say they can tell a difference right away. They are likely hyper=sensitive to it. It will take 6 weeks for you to reach a steady state and your body will continually adjust during that time. Once you reach the 6 week mark you are pretty stable.

 

[klepp0906]

oh well, in it for the long haul either way right?

just got a nice teaser the first week or so, and now its swung wildly in the other direction

 

[MarkM]

Many us us have to tweak our protocols to get them right. Very few get them right at the get go. You'll get that smile back.