Hello, Protocol Advice Needed

walk

New Member
Little back story. I was in a motor vehicle accident back in 2010. Suffered a severe tbi, fractured skull. Broke hip and neck. Had surgery on hip. With some other small fractures in other areas.
Spent some time in a coma, wheel chair and have pulled my self back to "normal" physically. Im 6'3 250 workout with heavy weights or cardio daily. Been diagnosed with ptsd, post concussive sydrom, Hypersexuality, tbi. After years of anti anxiety, depression drugs prescibed to help the Dizzy, light headed and nausea spells. Among other issues. I found an article by dr marc Gordon about tbi and hormanes, "post traumatic brain injury hormonal deficiency syndrome". Had my local dr do some blood work. Testosterone came back at 140.
Began ready stickes here and other places, began trt. Probably a little to fast after some things I've learned should have been looked at first.
Three years later starting 4th different dr and trt with hcg and anatrozole has resolved alot of issues. But still a work in process.

Current protocol 50mg trt cyp. E3.5 days. Hcg 250iu eod, anastrozole .5mg at time of trt injections. 1mg a week. Added vitamins with zinc, selenium, copper. Magnesium and some fish oils. And went to using an iodized salt. Eat a high carb high protein with plenty of good fats in diet. Labs are around 3 hours after a 50mg injection and .5 mg anastrozole.

Current labs
Total t-821 (250-1100)
Free t-233.2 (35-155)
Estrodiol-21 (<or less 39)
Shbg-14 (10-50)
Absolute neutrophils-3533 (1500-7800)
Abs. Lymphocytes-2104 (850-3900)
Mpv-11.1 (7.5-12.5)
Platelet count-217 (140-400)
Rdw-12.7 (11-15%)
Mchc-33.5 (32-36)
Mch-29.2 (27-33)
Mcv-46.5 (38.5-50)
Hematocrit-46.5% (38.5-50)
Basophils-1.1%
Eosinophils-3.9%
Monocytes-7.5%
Lyphocytes-47.8%
Absolute basophils-58 (0-200)
Abs. Monocytes-398 (200-950)
Hemoglobin-15.6 (13.2-17.1)
Rbc-5.34 (4.2-5.8)
Wbc-5.3 (3.8-10.8)


This was the previous with thyriod halfway involved.

T-3 uptake-29 (22-35%)
T-4 total-7.3 (4.5-12.0)
T-4 free-2.1 (1.4-3.8)
Prolactin-8.2 (2.0-18.0)
Ast-37 (10-40)
Alt-47 (9-46)
Test total-778 (250-827)
Tsh-2.52 (.40-4.50)
Dhea-327 (106-464)
 
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CoastWatcher

Moderator
Little back story. I was in a motor vehicle accident back in 2010. Suffered a severe tbi, fractured skull. Broke hip and neck. Had surgery on hip. With some other small fractures in other areas.
Spent some time in a coma, wheel chair and have pulled my self back to "normal" physically. Im 6'3 250 workout with heavy weights or cardio daily. Been diagnosed with ptsd, post concussive sydrom, Hypersexuality, tbi. After years of anti anxiety, depression drugs. Dizzy, light headed and nausea spells. Among other issues. I found an article by dr marc Gordon about tbi and hormanes, "post traumatic brain injury hormonal deficiency syndrome". Had my local dr do some blood work. Testosterone came back at 140.
Began ready stickes here and other places, began trt. Probably a little to fast after some things I've learned should have been looked at first.
Three years later starting 4th different dr and trt with hcg and anatrozole has resolved alot of issues. But still a work in process.

Current protocol 50mg trt cyp. E3.5 days. Hcg 250iu eod, anastrozole .5mg at time of trt injections. 1mg a week. Added vitamins with zinc, selenium, copper. Magnesium and some fish oils. And went to using an iodized salt. Eat a high carb high protein with plenty of good fats in diet. Labs are around 3 hours after a 50mg injection and .5 mg anastrozole.

Current labs
Total t-821 (250-1100)
Free t-233.2 (35-155)
Estrodiol-21 (<or less 39)
Shbg-14 (10-50)
Absolute neutrophils-3533 (1500-7800)
Abs. Lymphocytes-2104 (850-3900)
Mpv-11.1 (7.5-12.5)
Platelet count-217 (140-400)
Rdw-12.7 (11-15%)
Mchc-33.5 (32-36)
Mch-29.2 (27-33)
Mcv-46.5 (38.5-50)
Hematocrit-46.5% (38.5-50)
Basophils-1.1%
Eosinophils-3.9%
Monocytes-7.5%
Lyphocytes-47.8%
Absolute basophils-58 (0-200)
Abs. Monocytes-398 (200-950)
Hemoglobin-15.6 (13.2-17.1)
Rbc-5.34 (4.2-5.8)
Wbc-5.3 (3.8-10.8)


This was the previous with thyriod halfway involved.

T-3 uptake-29 (22-35%)
T-4 total-7.3 (4.5-12.0)
T-4 free-2.1 (1.4-3.8)
Prolactin-8.2 (2.0-18.0)
Ast-37 (10-40)
Alt-47 (9-46)
Test total-778 (250-827)
Tsh-2.52 (.40-4.50)
Dhea-327 (106-464)
Welcome to Excelmale. You have faced - and continue to face - significant health challenges, but you're pulling things together and that's admirable.

After reading your post a number of times, I was struck by a number of things. First of all: how do you feel in regard to androgen associated issues? You wrote that you and your current doctor have "resolved a lot of issues;" can you expand on that a bit? With all that has happened, what has TRT helped you resolve and what still needs to be sorted out? How is the doctor managing your testosterone replacement interacting with your other health care providers? The typical question we ask members ("How are you feeling?") doesn't lend itself to a quick or easy answer in your case, but...how are you feeling?

You presented labs drawn following an injecction. It's a standard practice to test in a true trough, just prior to a shot. It's the best way to know how well the protocol you're following sustains your levels over the course of a given period. That said, your SHBG, remarkably low, and free testosterone, correspondingly high, are of note. I, again, return to the fundamental question of how you feel - might EOD injections make a positive difference in your case? Your estradiol is being managed with anastrozole; was that added to the regimen in response to elevated e2? Thyroid: have free t3 results? The uptake test you ran is an outdated procedure of no real diagnostic value.

Some observations and questions to open the discussion. Again, we're glad you're here.
 

walk

New Member
Wow. Been in many other times just readingand never seen your response. To answer these in hopes to continue conversation.

I'm feeling alot better compared to past. Trt/hcg and anatrozole has stopped my "post concussive syndrome" symptoms and other ptsd and hyper sexuality symptoms. Still have my days but as i said in comparison im not in a dark place anymore.
This protocol has worked wonders mentally. Physically I'm in good shape. 6'3 down from 260 to 250.
Im sleeping better. Was going through spells of staying up for 2-4 days at a time. Just couldn't sleep, tired or not. Still not perfect. I use melatonin and some night medical cannabis to help sleep.
Energy levels are good. A little over the top but the protocol settled that down. Energy hasn't been an issue. even before trt.
Strength in the gym hasn't changed. Fluctuates. Im strong but some days just can't left the same. Im just as strong with a test at 891 as i am at 150.
Sexually i haven't delt with ed so to speak before or after. The strength of erections has improved but fluctuates. Pe and excessive pre has been an issue. Sometimes going to the restroom causes leakage. Dr says its in my head. Or the most used phrase by drs through all this. "Its part of brain injuries" But even with my e2 at a 21 its senstive.

Sense that blood test ive tried eod (20mg) but didn't make it to a blood test. Seemed like my e2 was outrunning my ai. Or the half life stacking up? Testicles became shrivled up extremely tight and cold. Im currently taken a week off and going to attempt 30mg e3.5. And considering trying clomid. Dr is pushing that. He doesn't seem real knowledgeable.
He proscribed me .75ml (200mg per ml) once a week. 500iu hcg mon and thurs. With 1mg anastrozole at time of ejection. (Test) wasn't real concerned with the low shbg or high free.
 
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Systemlord

Member
Men with lower SHBG tend to do much better on more frequent dosing, otherwise you will tend to not feel consistent day to day.

SHBG is really low and it comprises your ability to hold on to your testosterone, frequent dosing will keep levels more stable and you will feel better.

You should be injecting testosterone daily given your SHBG. My SHBG is just a little higher so I can get away with an EOD protocol, but twice weekly I felt mediocre.
 

Vince

Super Moderator
Lab should be done on injection day before you inject at trough levels. also you need to get the right estradiol test, the Estradiol Sensitive LC/MS/MS for men.
 

walk

New Member
A daily protocol is something i would like to aviod. But im starting to think im not going to be able to. Along with the hcg dose. I want to keep fertility. 500iu at once i believe is a little high.

So far ive tried these protocols.
40mg e3d had me at a total t of 581 (250-827)
Estradiol 27 (<or=39)
About same success as now as far as symtoms.
I did 50 e3d to reach 891 (250-1100) the range changed for some reason

estradiol test im pretty sure is the sensitive. Unless this dr changed or told me incorrectly.

The blood test i normally do the day before injection. This one i didnt intend to have to done this way. Honestly just forgot about my appt. Until it was to late.
 
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Vince

Super Moderator
The range is wrong for the sensitivity test. I don't think we have many members anymore that do daily injections, it might be a good thread "how many members do daily injections". But I'm one of them that does daily's. I thought it would be hard to inject everyday but just became one of my daily routines. I have to get up before my wife so I can inject before she gets in the bathroom. LOL
 

walk

New Member
According to the lab work that's quest diagnostics estradiol ultra sensitive lc/ms/ms. (30289)

To add a little background. I was 25 at time of this accident. 29 when i requested my testosterone get checked, It came back a 140 (250-1100). dr then notified me he checked it some time before and it came back a 220.
 
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walk

New Member
Thought. This blood work was 50mg m, w, f and 500iu hcg. For three months. First month was on ai, stopped. So 2+/- months of no ai before this lab.

Was wonderful at time of lab. About a week after woke up in an anxiety attack with severe insomnia for about 3 days, then nipple issues began. before I stopped everything for a week.

Started back 34mg test m,w,f with no hcg added back yet. Also taking ai. Feeling ok, sleeping. But constipation is getting me. Any thoughts? I have a lab ordered to go do soon, Of sensitive e2 and an urine analysis. Any suggestions of a lab I should add?

And is possibly 500iu 3 times a week to much? This was a change in protocol. From 50mg twice a week. And 250iu hcg eod. , .5mg anastrozole with test injection. Had my e2 at 13
 

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walk

New Member
And thoughts. Have lab sit up for morning tt/ft, e2and urine culture with defy
Protocol 20mg daily. 250 iu hcg eod. 25mg dhea. 1 ml L-Glutathione, Fish oil, ps100, b complex, selenium and a multi.

Feel pretty good overall vs how I've felt for a long time. But have a pain/discomfort roaming around body. Shoulders down to hips to legs, calves and back up to chest and round and round. Comes and goes.
 
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walk

New Member
The pain/ back tightness is gone. changed protocol, tried 10mg daily, felt good. labs looked great, tsh went 1.3, free t etc all in range, upper level. dhea, vit d etc. e2 was a 9, back problems got worse.
I stopped and went back to 50mg m w f where i started with 500 iu hcg m w f. but eliminated hcg. added a green t extract, vit c complex. been trying to get gallon water daily, high fiber diet. high protein, card, calorie. and a probiotic. I work/exercise daily.
Tonight's inj night and even though I feel good. focus, memory, strength, sexual performance all improved. I'm skipping.
Sleeps struggles and constipation or ibs type symtoms. this was also going on when e2 was 9. when I stopped trt changing protocol this improved and went away. and my memory went to shit, couldn't focus, and become extremely lazy. I'm. ot a lazy person. never have been.

I also left the dr i was seeing and went to defy.

any ideas, suggestions? Could dht or another hormone be causing this. or possibly test cyp?
 
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Tman

Active Member
Thought. This blood work was 50mg m, w, f and 500iu hcg. For three months. First month was on ai, stopped. So 2+/- months of no ai before this lab.

Was wonderful at time of lab. About a week after woke up in an anxiety attack with severe insomnia for about 3 days, then nipple issues began. before I stopped everything for a week.

Started back 34mg test m,w,f with no hcg added back yet. Also taking ai. Feeling ok, sleeping. But constipation is getting me. Any thoughts? I have a lab ordered to go do soon, Of sensitive e2 and an urine analysis. Any suggestions of a lab I should add?

And is possibly 500iu 3 times a week to much? This was a change in protocol. From 50mg twice a week. And 250iu hcg eod. , .5mg anastrozole with test injection. Had my e2 at 13
I have low shbg, 12ish, for me, I could not tolerate HCG. I've tried restarting it several times over the course of two years. However, the side effects always outweighed the benefits. One of those side effects, was severe anxiety after about a week. Because I am a glutton for punishment, I started HCG "one last time" about two weeks ago at .2ml a day. My nipples have become sensitive, like when I first started T many months ago, but i have not noticed any testicle changes. I can tell my anxiety has been up a few times, but not the wake me up and keep me up all night type anxiety I have experienced from the past. I dose everything daily to limit the highs an lows, which has helped, but I am still not where I need to be. I will add, T has helped me greatly with the mental sides, so much so I try to share it with all my veteran buds and support group people. I am convinced that those with PTSD diagnosis need to have their T levels evaluated, as I am sure that is a contributing culprit for some. I am glad to read you've had some relief with that, as well.
 

Tman

Active Member
The pain/ back tightness is gone. changed protocol, tried 10mg daily, felt good. labs looked great, tsh went 1.3, free t etc all in range, upper level. dhea, vit d etc. e2 was a 9, back problems got worse.
I stopped and went back to 50mg m w f where i started with 500 iu hcg m w f. but eliminated hcg. added a green t extract, vit c complex. been trying to get gallon water daily, high fiber diet. high protein, card, calorie. and a probiotic. I work/exercise daily.
Tonight's inj night and even though I feel good. focus, memory, strength, sexual performance all improved. I'm skipping.
Sleeps struggles and constipation or ibs type symtoms. this was also going on when e2 was 9. when I stopped trt changing protocol this improved and went away. and my memory went to shit, couldn't focus, and become extremely lazy. I'm. ot a lazy person. never have been.

I also left the dr i was seeing and went to defy.

any ideas, suggestions? Could dht or another hormone be causing this. or possibly test cyp?
The 10mg daily dose has to build up over time. Feeling good for a few days dropping from 30 or 50mg is a powerful clue on your dosing. Dropping to 10mg is an adjustment and the half lives need to compound for a while to reach max dosing.
 

walk

New Member
its been a road to say the least. life has returned to a new normal, but normal.

I was doing the 10mg dialy for about 6 months. I also stopped the hcg during that time. I've sense tried to reintroduce it but at the point now I just dont care to use it unless needed to avoid any other problem. 10mg seemed like my e2 wouldn't climb. I attempted 20mg daily but by the 3rd dose I woke up back locked, couldn't hardly move.
10mg daily had my total t over 600, free t towards top of range. thyiod looked great.
e2 was a 9, no ai. felt good other than the constant tightness in lower back, hips.
 

Tman

Active Member
I'm low shbg also. last check 15ish. it did come up some
its been a road to say the least. life has returned to a new normal, but normal.

I was doing the 10mg dialy for about 6 months. I also stopped the hcg during that time. I've sense tried to reintroduce it but at the point now I just dont care to use it unless needed to avoid any other problem. 10mg seemed like my e2 wouldn't climb. I attempted 20mg daily but by the 3rd dose I woke up back locked, couldn't hardly move.
10mg daily had my total t over 600, free t towards top of range. thyiod looked great.
e2 was a 9, no ai. felt good other than the constant tightness in lower back, hips.
hmmmm...you have me wondering...my back and hips have been tight for a while. Why do you think it's the treatment or dosage causing it, rather than something else?
 

Tman

Active Member
hmmmm...you have me wondering...my back and hips have been tight for a while. Why do you think it's the treatment or dosage causing it, rather than something else?
By the way, that is about where 10mgs puts me, as well, on T/FT numbers.
 

Tman

Active Member
I am in the process of switching over to enanthate. I have all kinds of strange issues that I did not have on gels. I've tried grapeseed and cottonseed oils as the carrier, so the enanthate will be sesame. I told the doc, I sometimes feel like I am injecting poison...not a good feeling. For some reason, my body has not responded well. I ran 30 mg a day with 10 mg of nandralone for about 3 weeks. The best I ever felt...no sides...I actually felt much better. 3 weeks in, I started to feel like my throat and tongue was swelling, so I back it all down. I am hoping enanathate will be the ticket and I can take enough to help with my physical ailments. If not, I am going back to the gel. worked great for me. Then, i found this site and so many people were saying to ditch the gel and go with injections...down hill ever since. That's just a snipit of my story.
 

walk

New Member
hmmmm...you have me wondering...my back and hips have been tight for a while. Why do you think it's the treatment or dosage causing it, rather than something else?
the back tighness/pain could be low e2. I suspected this but other drs argued against it so I left it. when I joined defy there first follow up we talked about it, they said my e2 has to come up.
try a larger injection or possibly the oil the rest is mixed with. just changed from cotton seed to sesame, after 2nd injection it making me question if its been apart of the issue
don't really want to stop. dont like that guy lol
 
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