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We don’t really know. Anecdotally I would say that it appears not likely at physiologic levels. As with any downregulation in the body, even if a reality, we would be concerned mostly with sustained supraphysiologic levels as an etiology.

Low DHT does make one predisposed to gynecomastia (or worsening of pre-existing gyno). Outside of the US a transdermal DHT to the nipple area is sometimes used as a gyno treatment (not approved/available in the US).

A little of both!

Very welcome. It is a common point of confusion.

Glad you mentioned DHEA - that range is age adjusted as well! (the older the patient the lower the reference range) Another important point regarding TOTAL testosterone - the reference range you now see (from LabCorp) was significantly reduced in July of last year (previously 348 - 1197 ng/dL...

Not too shabby Vince. For everyone’s reference, the free testosterone reference range is AGE ADJUSTED, whereas the total T reference range is not.

Debatable, but potentially 17-OH progesterone as an upstream marker. Serum quantitative beta hCG level can be checked to show actual serum levels, but as you stated testicular size and, if fertility is considered, semen analysis are the common measuring sticks.

My pal Dr McClain. He’s more aggressive with anastrozole than I am typically, but a GREAT doc!

Well that’s an AWESOME post. Nicely done Orrin Israel!

An example of why such a regimen should, in almost every imaginable case, not be prescribed.

Important clarification here is vitamin K2 as opposed to K1.

Amberlin - please contact Jesse as noted in his post above as from this thread I see two points that seem apparent: - some clarification is needed on dosages being taken (T cyp 0.04 (1/25th of an ml) with instructions authorizing titrating up to 1 (a 25 fold increase and nowhere close to any...

Still the only time I’ve had THAT specific question, phmatthews...I remember!

CW - spoken like the seasoned veteran you are! Reason- happy to hear your success!

There is some truth here, but more so at the extremes. So many pieces to the puzzle, but E2 can be a dealbreaker if mismanaged.

We can add another layer of complexity here with androgen receptor sensitivity (CAG repeats) and also possible down-regulation over time of androgen receptors, neurotransmitter response, etc —— thus, TRT treatment for any given individual is an ever-evolving process over time...consequently the...

I agree 36mg TIW seems reasonable for now. Make sure you’re VERY well hydrated at the time of labs as well. You’re very welcome by the way!

Roguejim - I see what you did there...contemplating going rogue...sorry I couldn’t resist ;-)

As others have stated...300mg of ANY testosterone once every 2 weeks is a very poor (to be polite) protocol. Let alone T propionate which typically requires every 2 DAY (not 2 week) injection intervals as it is short-acting.

Feelinglost - no need to donate at HCT 51.3, ESPECIALLY when attempting to have ferritin recover. Taking iron supplementation and then donating is like running on a treadmill...not going to get anywhere except back to square one. The ideal approach is to hold donations, but also hold iron...

It’s very safe to say cutting down from your anastrozole 1mg three times a week before your first appointment with me is quite reasonable and advisable. For now I’d stop it altogether and we’ll see how your symptoms go. The majority of patients who need anastrozole, need less than 1mg per week...

Hi mattriggins33 - Patients can specify their pharmacy of choice and with anastrozole being a non-controlled substance, there is no limitation on an early refill through a different pharmacy.

Here is the thread from 2016 referred to by Maxadvance above: https://www.excelmale.com/forum/showthread.php?8395-Bunk-Meds-from-Hallandale

In direct violation of the Hippocratic Oath.

We must not forget that thyroid meds are notorious for having finicky absorption - the adequacy of which can be gleaned from getting labs after taking. What it all boils down to, however, is having a clinician with enough knowledge AND experience to appropriately take the timing of...

The article is well written and thought out...the only problem is the two lab variables she focuses on - TSH and FT4 - pale in comparison to FT3 which is the most important variable from a clinical perspective. TSH is *almost* inconsequential when on thyroid treatment (though it is the sole...

Yes our patients can order labs through us at any time and the cash cost should be the lowest available anywhere.

As it does for virtually everyone, though I know you’ve had unique anecdotal experience with compounded HCG in the past.

Most likely explanation is actually lab error - have staff send you a repeat sensitive estradiol lab order. If confirmed on repeat test, then there is something more esoteric going on to require discussion. The belly fat issue may tie into your increasing TG level - can be from carbs, alcohol...

They should be here learning as well! Kudos to you for taking the initiative.

Only Quest does the z-score (not LabCorp), but a z-score is simply a statistical calculation giving standard deviations from the mean.