Stopped TRT

[McClure1978]

So I was having really high blood pressure and bad anxiety after about my second or third month on trt. My Dr advised me to see a cardiologist and stop trt. The cardiologist says he can’t find anything wrong with me so I’m thinking about starting back up again. My Dr wrote me a new script this time with hcg. I’m thinking about doing everyday subq injections this time with the twice a week injections of hcg. I also bought some pregnenelone and dhea haven’t taken it yet but read somewhere it could help with the anxiety. Was winding if I could get suggestions based on my new labs ?

 

[Vince]

I would start very low. Something like 10 mg of testosterone daily and 100 iu of hcg twice a week.

 

[McClure1978]

I trust what you say you’re very experienced but could you explain to me your thoughts as to why and what do you think about the preg and dhea? I’m 42 6’2 183 if any of that matters.

 

[Vince]

I trust what you say you’re very experienced but could you explain to me your thoughts as to why and what do you think about the preg and dhea? I’m 42 6’2 183 if any of that matters.

I supplement with pregnenolone 10 mg, 25 mg of DHEA and no AI.

I feel no benefits from pregnenolone or dhea. I use it to keep my levels in a good range. Also my E2 runs low, dhea will convert some testosterone into E2

 

[madman]

So I was having really high blood pressure and bad anxiety after about my second or third month on trt. My Dr advised me to see a cardiologist and stop trt. The cardiologist says he can’t find anything wrong with me so I’m thinking about starting back up again. My Dr wrote me a new script this time with hcg. I’m thinking about doing everyday subq injections this time with the twice a week injections of hcg. I also bought some pregnenelone and dhea haven’t taken it yet but read somewhere it could help with the anxiety. Was winding if I could get suggestions based on my new labs ? View attachment 10783View attachment 10784View attachment 10785

What was your protocol (dose T/injection frequency) and where did your TT/FT/e2 levels sit at the trough?

Do you have previous labs (on trt) to post?

 

[McClure1978]

My previous dose was .5ml of test c once weekly. I tried splitting the dose no change in the way I felt. No ai or hcg I’ll try and find the last labs

 

[McClure1978]

So these are the only labs I had before and during treatment

 

[McClure1978]

So I took my dose on Wednesday and on the next Tuesday my level was 622

 

[madman]

So these are the only labs I had before and during treatment

As you can see pre-trt your TT was dismal and unfortunately, it would have your FT levels too low.

You were only a fairly common starting dose for trt 100 mg/week.

Although some men may feel great when injecting once weekly the main downfall is there will be a large difference in peak--->trough as blood levels will peak 8-12 hrs post-injection and be elevated for the first few days only to be followed by much lower levels come weeks end let alone not as stable throughout the week which can have a negative impact on energy/mood/libido/erectile function/recovery.

Even though your trough TT 622 ng/dL may seem descent the main issue is we have no idea where your FT levels sit as you did not have your SHBG or FT tested.

For all, we know it may have very well been too low at the trough on the 100 mg once weekly injections.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

SHBG is also critical as it can make or break a protocol depending on where it sits/injection frequency.

 

[McClure1978]

Yeah my urologist only seamed concerned with my t levels and estrogen didn’t want to test anything else when I was having problems. I only seemed to be having the problems the two to three days following my injection.

 

[McClure1978]

I’m still leaning and I’m not 100% confident in my doc he’s a good guy but I don’t know how knowledgeable he is in this and I want to get it right this time.

 

[Lookingforward]

Urologists are concerned and experienced in a lot of things but not men's overall health and ageing. You need a specialist.

 

[Jman]

So I was having really high blood pressure and bad anxiety after about my second or third month on trt. My Dr advised me to see a cardiologist and stop trt. The cardiologist says he can’t find anything wrong with me so I’m thinking about starting back up again. My Dr wrote me a new script this time with hcg. I’m thinking about doing everyday subq injections this time with the twice a week injections of hcg. I also bought some pregnenelone and dhea haven’t taken it yet but read somewhere it could help with the anxiety. Was winding if I could get suggestions based on my new labs ? View attachment 10783View attachment 10784View attachment 10785

sounds like you estrogen is off. I used to get anxiety and wake up with a pounding Heartbea. The sweet spot from what I’ve read is 20-30 too high and I feel so anxious. It’s hard to get a regiment right. I’m still working on it. Didn’t know about the dhea raising e2

 

[Jake_from_StateFarm]

Urologists are concerned and experienced in a lot of things but not men's overall health and ageing. You need a specialist.

Generally agree, in that, if someone expects to just walk into any Urologist's practice and cite multiple ADAM questionnaire symptoms and have the Dr prescribe TRT ... that is unfortunately a low percentage chance for success. The same can generally be said for endos unless labs are way below "normal numbers." However, there are fortunately many urologists prescribing TRT thanks to a new trend of treating symptoms rather than simply managing lab numbers. The one major caveat with TRT treatment by Uros and Endos is that, if you expect them to come out of the gate high with ~ 200mg/week or more dosing, you can save yourself that disappointment and just go straight to a TRT Clinic.

 

[Systemlord]

I trust what you say you’re very experienced but could you explain to me your thoughts as to why and what do you think about the preg and dhea?

I tried preg once and regretted it, my heart raced for several hours and was a horrible experience. DHEA can cause some side effects as well (high estrogen/anxiety), so unless severely deficient keep your TRT protocol simple with as little variables as possible.

So I was having really high blood pressure and bad anxiety after about my second or third month on trt.

I believe your TRT protocol was to blame for your initial experience, sounds like you may have needed smaller more frequent injections and possibly a lower dosage.

I only seemed to be having the problems the two to three days following my injection.

It may not be about your levels, injectable testosterone can cause unnatural peaks and troughs that can cause anxiety, a greater shot frequency usually resolves these issues.

Yeah my urologist only seamed concerned with my t levels and estrogen didn’t want to test anything else when I was having problems.

That's because he doesn't have any clue what he's doing. Doc's doing things by the book aren't going to affect much change in patient outcome a lot of the time and in somes cases actually make things worse, the guidelines are just too dated.

 

[Jake_from_StateFarm]

Unfortunately, the Doctor and Clinic Reviews forum is a little underutilized. I found my Urologist using that forum and am up and running on TRT. Was it a "One and Done?" ... That remains to be seen, however, I think there's room for that forum to be more robust.

TRT Clinics are great and, amidst COVID-19, there's not a lot being lost because even local Drs are conducting telemedicine appointments. Unfortunately, we have members that have more complex issues that require a Uro or Endo in their area that they can go see in-person. Members experiencing treatment frustration need to post their requests for more in depth treatment here and we need to help them more efficiently and effectively find help local to them.

 

[Lookingforward]

Generally agree, in that, if someone expects to just walk into any Urologist's practice and cite multiple ADAM questionnaire symptoms and have the Dr prescribe TRT ... that is unfortunately a low percentage chance for success. The same can generally be said for endos unless labs are way below "normal numbers." However, there are fortunately many urologists prescribing TRT thanks to a new trend of treating symptoms rather than simply managing lab numbers. The one major caveat with TRT treatment by Uros and Endos is that, if you expect them to come out of the gate high with ~ 200mg/week or more dosing, you can save yourself that disappointment and just go straight to a TRT Clinic.

I wouldn't put my health in the hands of anyone who was not a specialist. Can there be a urologist that specializes in mens health and hormones yes. However they are probably not doing what is considered standard Urological patient care. There is no substitute for experience.

 

[McClure1978]

Well that’s the thing. All this guy does is trt for their office. That’s the reason I used him in the first place.