1. #1

    Recent labs, not feeling well

    I've been injecting Cypionate twice weekly for 6 weeks at 60mg x2. I really don't feel well but my levels look good. I'm waiting on E2 but in the 8 years on TRT E2 has never been elevated. I am on cypionate only with 10mg DHEA daily along with other daily supplements. Feel somewhat fatigued most of the time and libido isn't great. I feel like the several years and various protocols with injectable test for me is like beating a dead horse. I can't schedule my followup with Defy until the E2 test gets back. The main symptoms are fatigue and neck acne. Im having no issues with ED but I'm taking the 3mg compounded Cialis from Empower. These are all trough levels. Any thoughts appreciated.
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  3. #2
    Moderator Vince's Avatar
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    From the labs you are showing, everything looks good. I will say your fatigued is coming from something else besides your testosterone levels.
    I am not a medical practitioner. Any suggestions I provide are not medical recommendations and are just my opinions. Please consult with your physician on any matters concerning your health.

  4. #3
    Member Sean Mosher's Avatar
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    Any recent thyroid labs/tests done?

  5. #4
    I have full panel pulled e6 months all levels are normal. TSH has risen from 2.0 to 2.3 over the last couple years. I should say I don't feel terrible just sort of blah and detached. There are days here and there that are decent. Whats so bizarre with my situation is I've tried to stop TRT a few times and usually days 10-12 after last injection, I feel really well, but short lived.

  6. #5
    Have you pulled Vit-D...are you supplementing that if needed? Wintertime SAD...seasonal affective disorder????

  7. #6
    4000iu daily 25ohd stays between 50-55

  8. #7
    Hows your SHBG? Will be interested in your E2 when that comes in...historically on this protocol where is your E2 sitting at?

  9. #8
    The last two years been 60-70 for shbg. Iíve only did E2 with once weekly injections but at 120mg per week is was at 27pg/ml and total t 1015ng trough. Itís never been out of the 20s except whenever I tried Arimidex several years back. Donít seem to convert much to E2 for whatever reason. Iím hoping they have some advice I really donít want to give up if thereís hope of making it work. I do know from numerous times and numerous dosages of hCG that that is not the answer.

  10. #9
    Id cut the DHEA and see how you do.

  11. #10
    Definitely worth a try. 10mg is the max I can tolerate. The one thing I will say is going great with this protocol is Morning wood every single morning since beginning this dose and libido has improved some so maybe once I talk to them if we can tweak a couple things it might get better I hope Iím on the right track. Iíve came too damn far to give up now.

  12. #11
    Any idea about where your E2 and Ferritin levels are?
    If E2 is low, you might want to consider adding/increasing the dose of DHEA and/or HCG, to increase E2
    If Ferritin is low, you should supplement Iron (for a short time) until it is > 100. Dr. John Crisler recommends Ferritin to be around 100-150 for optimal health. Low Ferritin is a very common cause of fatigue in TRT patients due to significant drops after blood donations.
    NOTE: I would personally donate blood before trying to increase ferritin with iron supplementation, to have a bit more margin of safety, especially if your hematocrit is on the highish side.

  13. #12
    Iíve never donated blood. Should have E2 test today.

  14. #13
    I think I'm at the point of realizing, There's no doctor out there that can figure out my situation. I am just so tired of the labs, changing doses and just the whole process. After I get the last lab back, I'm going to see what they recommend and if no results, I'm done. Been fighting this BS for 8 plus years, so patience at this point is out the window. I wish I could roll back time and have never ever started TRT.

  15. #14
    Finally got E2 results. 32.5pg/ml scale 8-35 sensitive assay. Canít get an appointment with Defy until May 9th. Probably just going to make an appointment with my urologist to discuss options. Feel to dam bad to wait until May 9th.

  16. #15
    We don't really like directly measuring free T, but calculating using TT and SHBG to determine free T. If SHBG is still high then your E2 labs could be deceiving do to most of it being not free which might also mean most of your T is also in a bound state.

  17. #16
    Quote Originally Posted by Systemlord View Post
    We don't really like directly measuring free T, but calculating using TT and SHBG to determine free T. If SHBG is still high then your E2 labs could be deceiving do to most of it being not free which might also mean most of your T is also in a bound state.
    Would that be a situation youre saying E needs to be higher than 32.5 for him?

  18. #17
    The only thing I can tell you for sure is, The higher my dose regardless of frequency, the worse I feel. Whenever I start going over 1000ng is literally feels like flu type symptoms. The only thing I know to do is, let my levels fall until I feel good again and pull labs like two days in a row. I really didn't want to have to go the topical route, but the fact is the best I ever felt in my life, not just including being on TRT was on A-gel 1.62. My insurance will now cover it, perhaps thats my best option.

  19. #18
    Quote Originally Posted by Vince Carter View Post
    Would that be a situation youre saying E needs to be higher than 32.5 for him?
    It's definitely a possibility especially is his free T is also low, we don't really know what E2 ranges are for men yet. I believe this is why the guidelines haven't been updated to include estrogen management without knowing what ranges to target.

    Quote Originally Posted by sh1973 View Post
    The only thing I can tell you for sure is, The higher my dose regardless of frequency, the worse I feel. Whenever I start going over 1000ng is literally feels like flu type symptoms. The only thing I know to do is, let my levels fall until I feel good again and pull labs like two days in a row. I really didn't want to have to go the topical route, but the fact is the best I ever felt in my life, not just including being on TRT was on A-gel 1.62. My insurance will now cover it, perhaps thats my best option.

    I was watching a podcast yesterday where Dr. Robert Kominiarek sesame seed oil caused him to vomit, have you tried different carrier oils?

  20. #19
    Ive only used Pfizer and Westward brands of cypionate from Walgreens. I have also used Enanthate in the past. I have also wondered if some people have a reaction to the carrier molecule whether it be enanthate, cypionate or propionate. Whatever it is, the injectable formulations just don't agree with me. There's something somewhere that the doctors aren't seeing, I just wish I knew wtf it is. I did 100mg cypionate for nearly 2 years straight and every time the first 3 days I felt really bad then felt great the last few days without fail. Lowered to 80mg for several months, same story. Tried 60mg for 6-7 weeks, same story. I've told all my doctors this including Defy and Dr Crisler. It seems at this point it's topical or suffer

  21. #20
    Quote Originally Posted by sh1973 View Post
    Ive only used Pfizer and Westward brands of cypionate from Walgreens. I have also used Enanthate in the past. I have also wondered if some people have a reaction to the carrier molecule whether it be enanthate, cypionate or propionate. Whatever it is, the injectable formulations just don't agree with me. There's something somewhere that the doctors aren't seeing, I just wish I knew wtf it is. I did 100mg cypionate for nearly 2 years straight and every time the first 3 days I felt really bad then felt great the last few days without fail. Lowered to 80mg for several months, same story. Tried 60mg for 6-7 weeks, same story. I've told all my doctors this including Defy and Dr Crisler. It seems at this point it's topical or suffer
    Don't dismiss the carrier oil theory, this could be the key to why you feel sick on injectables. For all you know every brand you ever tried could have had the same carrier oil.

  22. #21
    You might be onto something because they all have affected me the same.

  23. #22
    Quote Originally Posted by Systemlord View Post
    Don't dismiss the carrier oil theory, this could be the key to why you feel sick on injectables. For all you know every brand you ever tried could have had the same carrier oil.
    That's a really informative suggestion...

  24. #23
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    Would a good test be to try a grape seed oil formulation from a compounding pharmacy?
    It would seem that allergies to cottonseed oil are rare but well documented. Those that do react, react badly.

    Driven Mad

  25. #24
    I found an expired bottle of enanthate and itís sesame oil so I think that rules this out. Both affect me the same.

  26. #25
    I have an appointment on Monday with my urologist to discuss going back on topical. Itís really all I know to do at this point. The people Iíve dealt with at Defy are nice, but having no link whatsoever to your physician sucks to be honest. With my urologist or primary care doctor, I can ask a question thru the patient portal and have an answer from my doctor that day. The quickest I can even see Dr Saya is in June and for someone that is having bad issues with the prescribed protocol, this isnít good. I supposed the system they use works well for patients cruising along and feeling great, but for someone having problems itís no good. I feel Iím in a spot that Iím going to have to choose my own treatment, sort of like being in a round room looking for the corner.

  27. #26
    Moderator Vince's Avatar
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    Because you felt your best with gels, I wonder if you have low DHT? I would think that may one thing you should have tested besides your other labs.
    I am not a medical practitioner. Any suggestions I provide are not medical recommendations and are just my opinions. Please consult with your physician on any matters concerning your health.

  28. #27
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    See if you can schedule an appointment with Dr. Calkins, I would bet you can see him sooner. He is treating me for my high Reverse T3 caused by low ferritin/iron from frequent blood donations and a terrible sinus/flu infection in January. He only ran 4 test that I got a script for, took to LabCorp and my insurance covered. Here is what he ran and results done on 2/16/18.

    Thyroxine (T-4) 7.6 ug/dl (4.2-13.0)
    Free T4 .097 ng/dl (.8 - 1.7)
    Reverse T3 28.1 ng/dl (9.2 - 24.1) He said during consult needs to be below 15.
    Triiodothydronine Free (T3) 3.6 pg/ml (2.0 - 4.4)

    Ratio of RT3/T3 is 12.8 and needs to be over 20.

    Prescribed T3 medicine I got from Walgreens, Liothyronine 5mcg 90 tablets and said to take 1 in am 30 minutes before food and 1 in pm 30 min before food and go up to 2 each time if not feeling better in couple weeks. Currently on 2 in am and 2 in pm and I can tell a big difference on how I feel.

    Had a quick Thyroid blood test done thru Discount Labs on 4/10 and my RT3 is down to 20.4 so, has dropped 8 points in 7 weeks...

    You cannot depend on Medical School MD'S to know all of this which is why Defy and Primebody, sponsors of this site are doing so well in medicating a multitude of symptoms and causes that are not taught in med schools.

    Low testosterone symptoms and hypothyroidism symptoms are very much related and alike. Here is a good source:
    https://www.restartmed.com/thyroid-symptoms-men/

    Too many times its not testosterone it is the thyroid. That's why I think a full thyroid panel should be pulled with any one complaining of low testosterone prior to starting any treatment. A person could very easily have both. Can save a lot of time and suffering!

    P.S. I would advise you to have an Iron/Ferritin panel done at same time to see if it could be causing your symptoms and hypothyroidism.
    Last edited by 1Draw; 04-21-2018 at 08:55 AM.

  29. #28
    Quote Originally Posted by Vince View Post
    Because you felt your best with gels, I wonder if you have low DHT? I would think that may one thing you should have tested besides your other labs.
    Iíve tested DHT a few times and itís normally top of range when t levels are over 1000ng

  30. #29
    Dr. Calkins is well up
    Into May. Iíve never donated blood so not sure I would be low in ferritin. Iíve had several full thyroid labs done in the past and all levels were normal. TSH has risen from 2.0 to 2.3 over the last year and thatís the only thing thatís changed. I might call Defy again Monday and see if thereís any way of getting some advice prior to an appointment. Waiting 6-7 weeks at this point isnít an option feeling as bad as I do. Everyone always says how well Dr Saya is and Iíd like to have a consult with him if possible.

  31. #30
    As far as ferritin, Iíve never donated blood and hematocrit stays 47-49% and hemoglobin in the 15.0-15.5 range. Never tested ferritin

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