First Labs on TRT

[Thrownclear]

Hello everyone,
I'm new here. Thanks for all the advise and content.
I'm a new patient at Defy medical starting middle of May.
So Far I'm very happy and impressed with everyone.
Beginning stats - 57 years old 5'10" 182 lbs all typical symptoms of low T. Tried to get help for 2 years on insurance with little to no luck.
T.T 368 ng/dl range 264 - 916 That's pretty good for me, typical baseline is usually 300
F.T 7.5 pg/ml 7.2 - 24
E 2 16.3 pg/ml 8 - 35
SHBG 30.6 nmol/l 19.3 - 76.4
Defy prescribed 40 units of test. C sub-Q twice a week , 50 units of HCG twice a week. .125 Anastrozole twice a week. 50 mg. DHEA daily

After the first 6 weeks I feel I was slowly improving then the last couple weeks I've gone backwards a bit. Energy, libido, erections seemed to improve but have since fallen off. I gained 8 lbs following my normally clean and strict diet. I'm hoping that's just water weight. I've also noticed my face is flush a lot. especially after a shot. I realize its only been 9 weeks and am trying to be patient.
Here's the latest labs that were posted today taking at trough
T.T 1279
F.T 36.7
E 2 40.1
DHEA 560.7
I was surprised these numbers were that high, especially with the low dose of test he has me on compared to many protocols I've seen on this board.
I have a follow up next Tuesday. Looking for anyone's thoughts on these numbers.
Thanks,
Jeff

 

[fifty]

40 units of test and 50 units of hcg does not compute.

I am guessing you are on 80mg of test twice per week (160 total) and 500iu hcg twice per week (1000iu total).

 

[Thrownclear]

I'm new at this. copied and pasted from defy

Plan:
BEGIN T Cyp 200 mg/ml –inject 0.40 ml IM/SQ twice weekly
++ 27G, 5/8” needle/ 29G, 1/2" needle (1cc syringe Luer only)++
Patient prefers smaller needles
BEGIN HCG inject 500 iu(50 units) SQ twice weekly to reverse/prevent testicular atrophy
BEGIN Anastrozole 0.125 mg by mouth twice weekly as needed per E2 symptoms (reviewed with Pt.)
BEGIN DHEA 25 mg one by mouth every night

 

[fifty]

.40ml x 200mg/ml = 80mg

Are you taking 25mg or 50mg dhea?

Your blood numbers look logical for that moderately high dose. I would cut everything by 30% but that’s just me.

 

[jmzwy]

40 units is 80 mg, and 50 units is 500 iu’s if it came from defy using their supplied; and yes that would be 160 mg weekly. That was my original scrip from Defy, along with DHEA. That along with the HCG was way too high for me.

The timing of your labs is crucial here, if it was shortly after the shot, or even within a day, those numbers could test high, especially the E2 if you did an HCG shot. Mine was 70 on a lab 24 hours after an HCG shot.

Because we had the same original protocol, I will share. I loved my first protocol with Defy for about three weeks. It was a honeymoon for sure. But the sides at 3 weeks were pretty harsh, and with all the prescribed meds, it was tough to dial in. Sides were acne, horrible water retention in face and chest, and heart ‘flutters.’ I’m just about a year in now and I do 8 units of T daily (16 mg). I have been on an off HCG as this med is the most impactful for me - great energy, ‘fullness.’ and libido, but 7-8 hours after shot I’m an agro, irritable, dush bag at 500 iu’s. I can tolerate no more than 250 iu’s per day 2x per week, and I schedule myself to be working out hard alone during this time as I can still get irritable at times. I’m open to stopping HCG completely if it gets out of hand. DHEA I can’t tolerate at even 10 mg per day; I dropped it. Have had hematocrit at about 51 on three straight quarterly labs so I donate. Have next labs in September and am hoping this has declined with the lower daily dose.

As for AI’s, I have nothing against these at all and I wish I could tolerate them. Even at just .125 mg once a week I am destroyed by the medication - massive brain fog where I can’t find the words to stay, extreme fatigue, and the most horrible constipation you could imagine.

I really have no sides now at 16 mg per day, other than the occasional irritability from the HCg shot, which again at 250 is nowhere near the extremes at 500.

I let side effects be my guide. For me the acne, water retention, and heart ‘flutters’ seemed to all be dose related, and potentially frequency.

I feel much better and consistent on the lower dose with daily injections. Don’t think I will change anything because it’s working.

Anyway, hope all that helps since we are somewhat similar based on initial protocol.

James

 

[Thrownclear]

I get it now, Thanks ! 25 mg DHEA

 

[jmzwy]

One quick follow up - the only other ‘side’ I currently have is minor water retention and fat accumulation in my chest. It’s realy not that bad and others would likely say I’m neurotic, but I notice it when I look in the mirror. I have been slowly improving this through diet.

 

[jmzwy]

And finally a few last things:

after reading your post again....I don’t think 160 mg is a low dose at all. 200 mg per week is usually considered the high end for therapeutic protocols.

And when I dropped HCG completely the first time, I am not kidding you I lost 10 pounds in about 4/5 days... all water weight I presume.

 

[Thrownclear]

Wow, That will take me some time to absorb. LOL Thanks

 

[jmzwy]

what was your heamtocrit? The flush face could be the water retention but also high hematocrit.

 

[sh1973]

My advice would be to substantially lower your dose. You’ll be surprised how much better you’ll feel at a lower level such as 700-900ng for a trough total t. More is not always better.

 

[Thrownclear]

Thanks everyone . hematocrit went from 42.7 to 48.9 Monday is my next shot. I will lower the dose substantially. I might drop the HCG as well. That will be brought up in my follow up.

 

[Thrownclear]

Could the face flush be a result of the high E 2 ?

 

[jmzwy]

I really don’t know; not my place to say. But from my humble experience over the last year on therapy on reading thousands of posts on this forum, 40 does not seem that high. But subjectively for you it may be high.