Blackhawk's journey with TRT

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Blackhawk

Member
While definitely concerned, I am not going to worry/fret over the PSA until further followup is done. I've been through a number of medical rodeos, and know it's best for me to adopt a wait and see attitude for now.
 
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Blackhawk

Member
Appointment summary:

Dr Saya is concerned, but not worried about the PSA number… yet. Because it rose so fast he suspects prostatitis from inflammation or infection, perhaps exacerbated by having had high DHT and/or high E2. For now, we'll just work on getting sex hormones back down and retest PSA with a more sensitive test at next 6 week lab interval. And indeed, no sex/ejaculation or significant exercise 48hrs before next blood draw. Also, will increase taking NAC to 1000mg/day which could possibly help reduce inflammation.

So, aiming to bring Total T free T and E2 down together, main thing is to target for Free T in 20-35 range. With my high-ish SHBG that may result in still pretty high total T. Also with the PSA issue, wanting to see DHT in the 60's. So Reduce T cyp to 48mg E3d, so 112mg/week

My testicles don't seem to be responding to the HCG, so increase to 500iu E3D, I'm hoping this and reducing T cyp will bring my balls back around!

Keep DHEA at same level. Current blood level is great.

Thyroid: T3 level is good, and supplemental amount of T3 in 1gr/day of NDT is not enough to produce that blood level without my body converting T4 to T3. And, RT3 is OK in relation to T3 level. So I am converting well in the context of taking NDT. Based on lack of relevant symptoms, the relatively lower T4 level seems not terribly important at this time. We'll let this ride for now until sex hormones are more in target range, then re-assess.

Next round of tests:
-PSA free/total ratio
-Urinalysis for prostate issue, I am assuming checking for UTI ( I might request this now anyway)
-Total T
-Free T
-E2

 

ratbag

Member
It's great that your sharing his direction with us Blackhawk. A few questions if I may:

What about your high E2? You had that emotional episode. Is he hoping the reduced amount of test will fix that?

Did you get to discuss your thyroid antibodies being over range? Do you have Hashi's?

This protocol is well thought out. I didn't realise that exercise plays a part in PSA testing as well... if it's not one it's the other lol.

Interesting that he's keeping your DHEA-S well above range. My MD does the same thing. I believe he tries to simulate what an 18 year old would have.
 

Blackhawk

Member
It's great that your sharing his direction with us Blackhawk. A few questions if I may:

What about your high E2? You had that emotional episode. Is he hoping the reduced amount of test will fix that?

Well, yes.

Seems moot to me. I suspect it was because hormone levels were rising from the change in protocol as E2 was climbing. That was the only episode of symptom and it was weeks ago, I am not currently symptomatic. Treat the numbers or treat the symptoms?



Did you get to discuss your thyroid antibodies being over range? Do you have Hashi's?

I have not been diagnosed as such. The approach seems more about whether the NDT produces desired results, and if so, to go with it. He mentioned need for adequate selenium and if i remember correctly, more related that to elevated TPO, which I don't have. And I eat brazil nuts regularly.

This protocol is well thought out. I didn't realise that exercise plays a part in PSA testing as well... if it's not one it's the other lol.

Interesting that he's keeping your DHEA-S well above range. My MD does the same thing. I believe he tries to simulate what an 18 year old would have.

Before my first consultation with Dr Saya, My blood test showed I was very low in DHEA. I started 25mg/day and felt noticeably better even before the consultation. I'm happy to go with the recommendation for DHEA. Seems to work for me.
 
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Blackhawk

Member
I've been noticing in the last couple weeks I feel... normal, despite the potential PSA scare.

Physically doing well. I've had some full climbing days and come home not wiped out, feel normal fatigue into the next day, but not bonking, and ready for more after a rest day. With colder weather now, I am going to start weight training again before we hit the road to the SW.

Emotionally/mentally pretty stable. I can still be a grump, but no emotional episodes even with some challenges, and not feeling depressed or angry day to day.

Still unsure about HCG, testicles are not OK, but this seems par for the course at this point. I'll experiment with different brands to see what might be more effective.

Happy to be feeling well!

Protocol:
-T cyp 48mg E3D
-HCG 500iu E3D. Injecting the day before T
-DHEA 25mg and Pregnenelone 25mg every evening
-NDT 1gr every morning 1/2 hr prior to coffee.
-My laundry list of OTC supplements

I have also pretty diligently been adding a protein ****tail of whey, pea protein and gelatin along with anabolic naturals balanced aminos with extra glycine, and lysine. Have increased 2 egg breakfasts to 3 with beans or extra cheese... essentially increased protein intake by about 20-30% compared to 6 months ago.
 

ratbag

Member
I've been noticing in the last couple weeks I feel... normal, despite the potential PSA scare.

Physically doing well. I've had some full climbing days and come home not wiped out, feel normal fatigue into the next day, but not bonking, and ready for more after a rest day. With colder weather now, I am going to start weight training again before we hit the road to the SW.

Emotionally/mentally pretty stable. I can still be a grump, but no emotional episodes even with some challenges, and not feeling depressed or angry day to day.

Still unsure about HCG, testicles are not OK, but this seems par for the course at this point. I'll experiment with different brands to see what might be more effective.

Happy to be feeling well!

Protocol:
-T cyp 48mg E3D
-HCG 500iu E3D. Injecting the day before T
-DHEA 25mg and Pregnenelone 25mg every evening
-NDT 1gr every morning 1/2 hr prior to coffee.
-My laundry list of OTC supplements

I have also pretty diligently been adding a protein ****tail of whey, pea protein and gelatin along with anabolic naturals balanced aminos with extra glycine, and lysine. Have increased 2 egg breakfasts to 3 with beans or extra cheese... essentially increased protein intake by about 20-30% compared to 6 months ago.

I would be curious to see your thyroid profile because of the low amount of NDT you use. Are you going by your FT3? Are you taking any Biotin? It's in shampoo and B vitamins and it's a supp itself. Just wondered if you saw that post by Dr. Saya because I found it in my shampoo and my B-100 vitamin and PSA labs are compromised by that.
 

Blackhawk

Member
I would be curious to see your thyroid profile

Last labs post #37, p2 of this thread

Biotin is in my multi:

[TD="class: ifNcol"]Biotin (as d-biotin)[/TD]
[TD="class: ifAcol, align: center"]100 mcg[/TD]
[TD="class: ifDVcol, align: center"]RDA 33%[/TD]



None in shampoo.

Edit: And of note, I have been taking this multivitamin for years every day. I do not expect that this one test was skewed compared to all the previous tests I have had while taking it.
 
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ratbag

Member
I don't see a TPO antibody there and your Thyroglobulin antibodies are over range. This means you have autoimmumne thyroid problems and of course your FT4 is lowish. Are you taking any thyroid meds and if so which ones? So yes you have underlying thyroid issues. Do you have hashimotos?
 

Blackhawk

Member
Ratbag, This is just another rehash of what we've already discussed. Nothing has changed since you last asked/commented.

I know we both look at and comment and don't necessarily remember the specifics or each person.

Your input is invaluable, I really appreciate it, but I don't feel the need to redo it yet again until any other symptomatic, lab or protocol changes come around. I will post when that happens.
 
So Blackhawk, It is great to read you are feeling better and getting stronger. Is your belly feeing like a pin cushion yet? Mine is. I started adding my HCG to the T syringe just to cut down on the number of jab a week I have to do.
I'm a few weeks behind you on switching from creams to shots I can't quite tell anything is really happening yet. I've had a few days I might have felt a little stronger in the gym and I have started getting some morning wood. But that might be from Gene's NO stack I am not sure. Hope you had a good Christmas?
 

Blackhawk

Member
So Blackhawk, It is great to read you are feeling better and getting stronger. Is your belly feeing like a pin cushion yet? Mine is. I started adding my HCG to the T syringe just to cut down on the number of jab a week I have to do.
I'm a few weeks behind you on switching from creams to shots I can't quite tell anything is really happening yet. I've had a few days I might have felt a little stronger in the gym and I have started getting some morning wood. But that might be from Gene's NO stack I am not sure. Hope you had a good Christmas?

Thanks FL. And good wishes back at you.

I do a 6 site rotation For T (3 locations left and right): over dorsal glutes, love handles (though I don't have any, but at that location), and either side of umbilicus. HCG over quads, separate injections. All subQ. More comfortable to me to do less volume, so I am not not mixing T with HCG at this time. I may try 1/2 the volume of bacteriostatic water when mixing HCG next time to reduce injection volume, we'll see.
 

Blackhawk

Member
Slide...


I was doing remarkably well until after the Xmas holiday, but since then things have been deteriorating. I have been feeling increasingly physically and mentally clobbered.


My last post of note was about feeling pretty darn normal, but since then it's been going downhill.


I am not sure how much the decrease in T dosing is effecting this along with expected decreases in Total free T, DHT and E2. Seems it is happening right around when steady state should be occurring after last dose adjustment.


Other factors: I always have a hard time at home during winter here. The high altiitude (over 9000') environment is difficult and this time of year accompanied by lots of darkness (I get SAD), extreme winds and relentless cold. This year, the cold is less severe so far, but I am feeling the cumulative stress of being here. The preferred method of dealing is to be away in warmer climates this time of year.


However, I have made myself a quite involved project that has been taking a lot longer than expected (these things always do), and working my self physically and mentally very hard for many weeks. This is finally coming to completion and we are going to hit the road sometime tomorrow.


So, I am wondering how much has to do with decreased TRT levels vs how much I have been pushing myself in this stressful environment.

Sleep has also been not great. Actually night time erections have become one pretty main thing waking me up. Almost painful and don't subside unless I get up and walk around.


2 more weeks til next blood work. Also wondering what's up with thyroid at this point.Thyroid is not on the list for next tests, but I am wondering what the minimum useful tests might be? Maybe just free T3 and T4? I don;t feel the need for TSH, RT3, or antibodies this round.
 
Hi BlackHawk, I have read exersize or hard work burns Free T. I wonder if your project plus the T injection reduction has dropped your free T too much.

man I wish I could chase the sun during winter. I don't get sad I get anxious to the point of small panic attacks from gray skies and cabin feever. Only getting outside with a blue sky fixes it. I don't consider drugs a fix but I do have them if I can't cope.
 
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Blackhawk

Member
Hi BlackHawk, I have read exersize or hard work burns Free T. I wonder if your project plus the T injection reduction has dropped your free T too much.

The way I'm feeling this seems very plausible. But, a few weeks ago i was going at this pace and doing well.

Anyway, Hopefully now that I am finishing this project, going on the road will let me slow down and recover. Or maybe next labs will show something significant.
 

ratbag

Member
You really need to do all thyroid labs because now that you have pointed out the elevation you are at you have an additional problem... google thyroid at high elevation. Lots of people who they suspect have thyroid problems suffer at higher altitudes. It's a known situation. And they describe the same symptoms you are having. Years ago on the thyroid boards it was suggested that people who live in high altitudes need more T3 to keep them feeling well.
 
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