About 4 months on TRT, Hyper-metabolizer?

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DustinU

New Member
Hey everyone, I have been reading the forums since starting TRT about 4 months ago... thank you all for sharing ... it has helped me understand and correct bad protocols.
Info about me
40 years old, 245 lbs, 6’3” tall ... boot camp/body weight style workouts 5-6 days a weeks, a lot of cardio, spartan race style workouts.

I started TRT with natural TT of 386, this was part of a annual physical that I requested from my GP. I had the typical brain fog and low energy symptoms. We started with a 1ml (200mg Test Cyp) each month. I received the shot... then came on the boards for info. At the 2 week mark I objected waiting for another 2 weeks and got another shot of the same dosage (every 2 weeks). I had labs done at two week intervals and TT 167 and 2 weeks later it was TT 64! I convinced an estradiol workup that came back low at 7 (standard Roche).... joint pain from low estrogen, joints were crackling. My Dr wanted a one week reading and it came back at TT 653.

Dr tried to switch me to androgel but insurance would not cover it, so we went to and androderm 4mg patch. I was not happy on the patch at all but it brought my TT back to 360. I this point I had to switch doctors.

At this point I started seeing another Dr who put me on 1ml (200 mg Test Cypionate) weekly to start and would adjust down in 4-5 weeks.
My trough on this protocol was
TT 368.
Free 30 (9-46)
SHGB 21.3 (16.5 - 55.9)
Albumin 4.7 (3.5 - 5.5g/dl)
F+W Bound % 30.6% (9-46ng/dL)
F+W Bound 112 (40 -250)
Estradiol 36 (7-42)
Hemocrit 44 (37-51)
Hemoglobin 15.8 g/dL (13 - 17.7)

I went back to lab Corp 24 hours after my peak injection
TT 894 (264-916 Ng/dL)
Free
SHGB 23.5 (16.5-55.9)
Albumin 4.8 (3.5-5.5 g/dL)
F+W Bound % 23.5 (9.0-46%)
F+W Bound 382.6 (40-250 Ng/dL)
Estradiol 46 (7.6 - 42.6 pg/ml)

I went back to see the Dr after the blood draw and only my trough numbers were in. He prescribed HCG .125 twice a week, but mentioned I could up it to .25 if I felt I needed it. That brings us to today, I only just saw my peak results yesterday and have not started my hcg.

After some reading last night, I think starting on my next injection Monday I will split the Test Cyp to 2x a week to get me Estradiol down and start hcg.

Just want to bounce this off all of you veterans and get your thoughts. I am of the mindset to take as little hormones as possible... that said I feel great and have not really felt any negatives from this TRT protocol yet. Training stamina and performance has improved significantly.

Note: Not sure if it’s relevant but I supplement BCAA’s, Creatine, glutamine, magnesium, CLA, glucosamine, multi vitamin, B complex, fish oil

Thanks all and I appreciate any input you have, my numbers seem low for the amount of Test that I am taking and seem to drop quickly.
 
Defy Medical TRT clinic doctor
SHGB 21.3

Once weekly isn't going to work for you, as we always say, if you're satisfied then carry on but your SHBG, you'll undoubtedly need to be on E3.5D and probably EOD shots to compensate for the SHBG. With that SHBG you need to worry about where your Free T is...do not base your dosing and frequency on Total T. And you don't want your Free T over the lab range either. Low SHBG = High Free T, also = high Free Estrogen (very bad).

I think that you're also getting the wrong Estradiol testing. Should be (ultra) sensitive LC/MS/MS method. Anything else is wrong. Though as a low(er) SHBG guy you should also be getting "Estradiol, Free" test included. So get those two tests together.
 

DustinU

New Member
Thank you Vince. I looked into the Estradiol test last night and you are correct, I will get it changed for my next labs in a month or so.
I will start E3.5 next week. What do you think about HCG? Should I wait to start it? Start low at .125 on injection days?
 

DustinU

New Member
Wow Vince those numbers are great, thanks for sharing. I think I will begin the HCG Friday, as my Test is dropping and begin the E3.5 and .25 HCG protocol and see how that works out. I may just order my own labs from discount labs early to see what the Estradiol is doing.

Vince do you inject your test sub-Q or IM daily?

I appreciate your input guys, thank you.
 

DustinU

New Member
UPDATED LABS

I switched my protocol to 100mg Test Cyp and .25ml HCG together every 3.5 days. I am now also using #29g 1/2" syringe. My new labs are as follows taken in a trough just before my regular injection, I was on the above dosing for 6 weeks before testing .

These labs were performed at Quest:

TT - 745 (250 - 1100 mg/dL)
Free T - 206.1 (46-224 pg/mL)
Test Bio Available - 432.8 (110-575 ng/dL)
SHBG - 13 (10 -50 nmo/L)
Albumin - 4.6 (3.6 - 5.1 g/dL)
Hematocrit - 47 (38.5 - 50)
Hemoglobin - 17.1 (13.2 - 17.1 g/dL)
Estradiol - 65 (< or = 39 pg/mL)


So my Estradiol is high, not taking any Armidex as I feel no adverse effects from the E.

One thing I have noticed lately is a tremor in my hands, anyone else experience this? Aside from this I feel great.
 
M

MarkM

Guest
Hi Dustin, is the Estradiol from the Sensitive test, LC/MS/MS assay(Liquid Chromotography) or the Roche ECLIA methodology? If it is the Roche ECLIA then your estradiol is likley way overstated as that test is not accurate for men.

That SHBG is pretty low.
 

DustinU

New Member
Mark, the Estradiol is Roche ECLIA (the wrong one).
I think I am going to get my own sensitive Estradiol test done, should I test the trough or peak? If the sensitive test shows high I am thinking of changing injection to EOD as Vince Carter recommended above.
 
M

MarkM

Guest
Most people including myself test Estradiol at its trough but I've heard a few do it at peak.
 
M

MarkM

Guest
Mark, the Estradiol is Roche ECLIA (the wrong one).
I think I am going to get my own sensitive Estradiol test done, should I test the trough or peak? If the sensitive test shows high I am thinking of changing injection to EOD as Vince Carter recommended above.
Your non-sensitive estradiol is at 65. It is very likely your sensitive test will be considerably lower. My personal experience was my non-sensitive estradiol was at 91.0 and my sensitive came in at 35.3. Now, 35.3 is just over the upper end of the range of 35 but I have no symptoms and therefore I take no AI. The two test gave me considerably different results.
 

DustinU

New Member
Thank guys. Mark, my Dr asked me about symptoms etc and stated all my other numbers look good... and stated since I feel good he did not see the need for an AI. I had also mentioned I did not want to take it unless absolutely necessary.

I will schedule the ultra sensitive and update the results.

Thanks again everyone!
 
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