First set of Follow Up Labs since Starting TRT. Looking for Feedback

[Seagal]

But there are lots of other dose-dependent benefits from trt beyond just the anabolic ones.

I should have written that this comment is not related to your discussion (more to Vince's post and in general there is often a bias towards physique).

I was amazed how long you both discussed in a civilized manner. Bravo

Yes, I think to know that there is dose relation to symptom relief, benefits, side effects etc.
Hormone balance etc etc

I believe the initial point of discussion was about the starting dose for TRT. Btw. I assumed you both were talking about fT, TT levels wrt physiological range.
Imo it's not necessary to wait in general 12 weeks before adjusting the initial dose.
If the physiological range is reliable and meaningful, then I would advocate to initially aim for the mean.
That's my opinion.

 

[FunkOdyssey]

I was amazed how long you both discussed in a civilized manner. Bravo

Agreed. Maybe some minor sarcasm here and there, nothing serious. Hats off to you sirs, for an entertaining discussion between gentlemen.

 

[Willyt]

If you walk in and you are lean and metabolically healthy, you're getting 100-120+ mg. We avoid causing "needless suffering" without holding back the rest of the class for the slow kids. Everyone wins!

Congrats you've just prescribed 1.7x the levels of a healthy young male! That dose would put me at around 1200 TT

In the end, its a helluva lot easier to titrate up then down.

But who are we kidding with this debate - the elephant in the room is that clinics are always going to over-prescribe as part of their business model.

 

[Phil Goodman]

Agreed. Maybe some minor sarcasm here and there, nothing serious. Hats off to you sirs, for an entertaining discussion between gentlemen.

Thanks, but I wouldn’t go so far as to call me a gentleman lol

 

[FunkOdyssey]

Congrats you've just prescribed 1.7x the levels of a healthy young male! That dose would put me at around 1200 TT

Look WIlly, this is my clinic, so you're going to take your supraphysiologic dose and like it! Now go out and enjoy life in your new suspiciously athletic body.

 

[Seagal]

Look WIlly, this is my clinic, so you're going to take your supraphysiologic dose and like it! Now go out and enjoy life in your new suspiciously athletic body.

This comment was financially supported by The FunkOdyssey Makeover Clinic

 

[joetown2001]

I had my follow up with Dr. Calkins on Wednesday afternoon. He did a really good job of listening to me and how I was feeling, not just my lab numbers. He did like how my labs looked overall. He actually said they were really good for being just over two months in. I agree with that sentiment as well. He did say after listening to my issues and reviewing my labs, that my libido anxiety and short temper issues were due to slightly high estrogen. He said based on my lowish SHBG, my estrogen probably is optimal between 20-30, most likely closer to 30.

His suggestion was to take 1/2 of a .125 AI pill with each of my shots to see if that small amount fixes the issue. He said if after two weeks I see no improvement, take a full pill with my Monday and Friday shots.

As far as sleep, he felt my DHEA level is most likely the culprit, he said it’s probably 1/2 of where it needs to be. He described my sleep pattern to a T before I went into detail on it. He said to try 10 mg a night before bed to start,and to up it to 20 in two weeks if I see no improvement. I purchased som micronized DHEA, Pure Brand.

I felt good after the appointment and was ready to go. Then on Thursday, I started to feel like garbage. Headaches, muscle soreness and cramping. I felt awful Thursday night and knew it had to be my blood pressure. Today I used my machine at the local CVS around 12:30 and my BP was 148/85, 138/78 and 128/84 with three strait tests a minute apart. I did my injection this morning about 8AM, and have not started any DHEA yet. I went and worked out and felt good during my weights and cardio. Tested again on the way home and my BP was 131/77 and 127/75. I decided to go one more time in the late afternoon, and my BP was 148/90, 139/89 and 136/88.

I got home late Tuesday night from a week in Colorado, and I was at a 5000 foot altitude the whole time, and never had a single symptom while working out the whole trip. I do have some post nasal drip and have sneezed some the last two days, so my first thought was maybe Covid since I was flying and traveling. At home test came back negative today, but I do have some sort of mild virus. Before bed, I took 450 mg of magnesium citrate, and that did help my soreness in my neck and leg muscles a good bit.

I’m not sure what is going on, but it is very discouraging and have come out of nowhere. Those BP readings are pretty scary, and I’m close to going to urgent care at my GP practice this weekend if it does not go down. I don’t feel like BP readings with these kind of physical symptoms are anything to play with for very long. Any thoughts?

 

[Guided_by_Voices]

I had my follow up with Dr. Calkins on Wednesday afternoon. He did a really good job of listening to me and how I was feeling, not just my lab numbers. He did like how my labs looked overall. He actually said they were really good for being just over two months in. I agree with that sentiment as well. He did say after listening to my issues and reviewing my labs, that my libido anxiety and short temper issues were due to slightly high estrogen. He said based on my lowish SHBG, my estrogen probably is optimal between 20-30, most likely closer to 30.

His suggestion was to take 1/2 of a .125 AI pill with each of my shots to see if that small amount fixes the issue. He said if after two weeks I see no improvement, take a full pill with my Monday and Friday shots.

As far as sleep, he felt my DHEA level is most likely the culprit, he said it’s probably 1/2 of where it needs to be. He described my sleep pattern to a T before I went into detail on it. He said to try 10 mg a night before bed to start,and to up it to 20 in two weeks if I see no improvement. I purchased som micronized DHEA, Pure Brand.

I felt good after the appointment and was ready to go. Then on Thursday, I started to feel like garbage. Headaches, muscle soreness and cramping. I felt awful Thursday night and knew it had to be my blood pressure. Today I used my machine at the local CVS around 12:30 and my BP was 148/85, 138/78 and 128/84 with three strait tests a minute apart. I did my injection this morning about 8AM, and have not started any DHEA yet. I went and worked out and felt good during my weights and cardio. Tested again on the way home and my BP was 131/77 and 127/75. I decided to go one more time in the late afternoon, and my BP was 148/90, 139/89 and 136/88.

I got home late Tuesday night from a week in Colorado, and I was at a 5000 foot altitude the whole time, and never had a single symptom while working out the whole trip. I do have some post nasal drip and have sneezed some the last two days, so my first thought was maybe Covid since I was flying and traveling. At home test came back negative today, but I do have some sort of mild virus. Before bed, I took 450 mg of magnesium citrate, and that did help my soreness in my neck and leg muscles a good bit.

I’m not sure what is going on, but it is very discouraging and have come out of nowhere. Those BP readings are pretty scary, and I’m close to going to urgent care at my GP practice this weekend if it does not go down. I don’t feel like BP readings with these kind of physical symptoms are anything to play with for very long. Any thoughts?

If you have an anti-viral protocol it sounds like now would be a good time to take it. If not, upping your Vitamin C dose to around 5grams and also ideally adding in liposomal C is a startig place to consider that has worked well for me. There are lots of other things like quercetin and beta glucans and zinc lozenges you can throw into the mix.

 

[joetown2001]

If you have an anti-viral protocol it sounds like now would be a good time to take it. If not, upping your Vitamin C dose to around 5grams and also ideally adding in liposomal C is a startig place to consider that has worked well for me. There are lots of other things like quercetin and beta glucans and zinc lozenges you can throw into the mix.

Thanks. It may not be a bad idea to try that. My blood pressure has gone down a decent amount today. It averaged 127/79 this morning at about 930, did a good cardio workout and had a sauna at the gym. After that I took a few more readings and it averaged 133/77. Body still not feeling great and I have the same headaches, they come and go. Took Some total beats along with 3 g of citrulline to try to bring down my BP naturally.

I’m not sure if it’s this cold/virus I have caught, or if it’s due to my hormonal regiment. A lot of times this is how I feel when I get a cold before the congestion really kicks in, right now I just have a nasty postnasal drip at night and a little during the day. I’ve never remembered having my blood pressure elevate when getting sick though, the only time I had headaches as severe as I did Friday and Thursday is when I had Covid four years ago. I do have a nurses call scheduled with Defy Monday at noon if my symptoms are still there after the weekend. Also got a message into the doc to let him know with my BP averages and my symptoms.

Do any of you guys think that the fact that I just spent a week at a 5000+ foot elevation, and returned home to a 600 foot elevation could be contributing to my blood pressure fluctuations. The other thing I can say is I’ve been urinating like crazy the past 48 hours, and I have a noticeable decrease in the circumference of my waist and looseness there. So my body is definitely responding to something right now, I’m just not sure what it is.

 

[joetown2001]

I took another Covid test and it came back positive. I knew it couldn’t be hormonal. Wish me luck that recovery is short. My symptoms are mild besides headaches and my blood pressure going up a little.

 

[FunkOdyssey]

I took another Covid test and it came back positive. I knew it couldn’t be hormonal. Wish me luck that recovery is short. My symptoms are mild besides headaches and my blood pressure going up a little.

It's funny how we tend to assume everything that goes wrong when we're on TRT is caused by our protocol. I did the same thing a few months ago when I was in the preliminary stage of coming down with covid and feeling awful.

 

[pfuked]

my opinion - I say stick with your current protocol and take an anti-estrogen every once in a while to control estrogen symptoms. Ideally you want lower E2 since your SHBG is on the low end. I would shoot for about 20 pg/ml E2 in your case. Also, I would use HCG sparingly, if at all, since this will stimulate your nads to produce endogenous testosterone, something you don't need anymore. so what if your balls get a little smaller. I haven't used HCG in years and still have normal sized testicles.

 

[joetown2001]

my opinion - I say stick with your current protocol and take an anti-estrogen every once in a while to control estrogen symptoms. Ideally you want lower E2 since your SHBG is on the low end. I would shoot for about 20 pg/ml E2 in your case. Also, I would use HCG sparingly, if at all, since this will stimulate your nads to produce endogenous testosterone, something you don't need anymore. so what if your balls get a little smaller. I haven't used HCG in years and still have normal sized testicles.

Thanks for the feedback. I’m willing to try what the doc laid out for me. He feels the same way about my target E2 number. I don’t use HCG. I would say my natural production has completely shut down. I have been injecting for almost 3 months.

 

[joetown2001]

It’s been a while since I updated so I figured I would post and talk about how the changes Defy suggested worked and other issues that are now coming up. The micro dosing of half a .125 pill with each shot worked very well for a few weeks, but it’s kind of lost its effectiveness for libido. Still better than before, but still inconsistent at times. Took me almost 2 weeks to fully recover from Covid, but there were no lingering effects from that.

On September 2, I got the blood work done for my yearly physical, and my hematocrit has gone back up to 47.8. Starting yesterday and today, my blood pressure has been extremely high reaching 160/92 this morning, before dropping down into the 143/88 range this afternoon. I had the same symptoms the first month back in late May, and my hematocrit Was in the high 40s close to 50. Defy suggested that I donate to see if that helped, and it made a huge difference, and is also why that my July labs had a very low hematocrit. The problem is, my ferritin now sits at 10 from my latest labs for my yearly physical. I’m trying to figure out is how to keep my hematocrit in check, without depleting my ferritin any more than it already is. A couple weeks ago. I started taking grapefruit extract in the morning, not sure how much that will actually help but it can’t hurt.

Had a nurse call with Defy this afternoon, and she relayed all the info to Dr. Caulkins. May not hear back till Tuesday, but I need to figure something out. My physical is on Wednesday, I’m also not against going on a low dose of losartan or another blood pressure med that lowers hematocrit. I also asked the nurse today if I could possibly lower my dosage, as I feel like 100 a week is at the high end for me even though it’s not for most guys. It may be a coincidence, but my last two injections have been from a brand new vial, so I’m not sure if there is any possibility that the potency of it is stronger than what I was injecting before, even though it’s compounded the same according to the label.

Love and appreciate all the information and feedback I’ve gotten from you guys, before this things were settling in very nicely for me and I’d like to fix this hiccup and get back to where I was in August in early September.

 

[Guided_by_Voices]

It’s been a while since I updated so I figured I would post and talk about how the changes Defy suggested worked and other issues that are now coming up. The micro dosing of half a .125 pill with each shot worked very well for a few weeks, but it’s kind of lost its effectiveness for libido. Still better than before, but still inconsistent at times. Took me almost 2 weeks to fully recover from Covid, but there were no lingering effects from that.

On September 2, I got the blood work done for my yearly physical, and my hematocrit has gone back up to 47.8. Starting yesterday and today, my blood pressure has been extremely high reaching 160/92 this morning, before dropping down into the 143/88 range this afternoon. I had the same symptoms the first month back in late May, and my hematocrit Was in the high 40s close to 50. Defy suggested that I donate to see if that helped, and it made a huge difference, and is also why that my July labs had a very low hematocrit. The problem is, my ferritin now sits at 10 from my latest labs for my yearly physical. I’m trying to figure out is how to keep my hematocrit in check, without depleting my ferritin any more than it already is. A couple weeks ago. I started taking grapefruit extract in the morning, not sure how much that will actually help but it can’t hurt.

Had a nurse call with Defy this afternoon, and she relayed all the info to Dr. Caulkins. May not hear back till Tuesday, but I need to figure something out. My physical is on Wednesday, I’m also not against going on a low dose of losartan or another blood pressure med that lowers hematocrit. I also asked the nurse today if I could possibly lower my dosage, as I feel like 100 a week is at the high end for me even though it’s not for most guys. It may be a coincidence, but my last two injections have been from a brand new vial, so I’m not sure if there is any possibility that the potency of it is stronger than what I was injecting before, even though it’s compounded the same according to the label.

Love and appreciate all the information and feedback I’ve gotten from you guys, before this things were settling in very nicely for me and I’d like to fix this hiccup and get back to where I was in August in early September.

Since it sounds like your BP is the fundamental issue, are you supplementing potassium and getting a decent amount of sodium? (Contrary to popular belief, very low sodium can raise BP.) High 40's is not all that high for HCT and I've had low ferritin (also at 10) before with no symptoms. I have always used a test dose no higher than 90mg per week so if you still feel good at a lower dose I see no reason to stay at 100 if a lower dose has other benefits.

 

[joetown2001]

Since it sounds like your BP is the fundamental issue, are you supplementing potassium and getting a decent amount of sodium? (Contrary to popular belief, very low sodium can raise BP.) High 40's is not all that high for HCT and I've had low ferritin (also at 10) before with no symptoms. I have always used a test dose no higher than 90mg per week so if you still feel good at a lower dose I see no reason to stay at 100 if a lower dose has other benefits.

How much potassium do you supplement daily?

 

[Guided_by_Voices]

How much potassium do you supplement daily?

I usually take around 200mg, although I go higher if my BP jumps (which it rarely does) or if I'm having muscle cramps. I thought I was getting enough potassium but adding more completely eliminated muscle cramping. I've also driven my BP too low with it which can be harmful as well.

 

[joetown2001]

I usually take around 200mg, although I go higher if my BP jumps (which it rarely does) or if I'm having muscle cramps. I thought I was getting enough potassium but adding more completely eliminated muscle cramping. I've also driven my BP too low with it which can be harmful as well.

Thanks. Took 6 readings 1-2 minutes apart this morning and averaged 132/77. I’m feeling better, but body still feels somewhat tight and fatigued, but nowhere near how it felt the previous two days. It may very well just be residual from the previous two days of stress. Gonna hydrate, took my beer root powder and will take my citruline and daily cialis this evening as well. Gonna monitor every day until my PCP appointment on Wednesday. I’m just starting to feel like that a low-dose blood pressure med like Losartin is probably just the best thing for me going forward.