1st follow up set of labs.... please comment

[jmzwy]

Original and follow up labs shown. 3 months apart. I’m on 160mg/week split into two doses E3.5 days. Also HCG 2x a week; .5 ml.

So obviously testosterone shot through the roof, both total and free. But so did Estradiol. But as a %, my total/E and free T/E are improved vs. my original results. Other issue is hematocrit and hemoglobin. I’ve been instructed to do a phlebotomy, although Dr. Caulkins did mention that I could be ok since I live at 6,300 feet (Jackson, WY). And I am very active outdoors in addition to strength training and Muay Thai.

Monocytes were up but I did come down with a nasty cold just the day before.

Dhea was prescribed initially before I started therapy due to low test result, but I did not take as I did not want multiple variables just starting out. Now Dr. Caulkins wants me to take 25 mg just before bedtime - did that last night and literally got zero sleep. So I’ll be switching that to the AM.

Plan - reduce TRT dose to 140 - 150mg/week (I was actually thinking going down 120 -130 mg/week). Anistozole advised to lower estradiol, but since I’ll be lowering my trt dose he wants me to take only if symptoms show up. He thinks I might be able to get by with one .125 pill per week. Again Anastrozole is to be done in response to symptoms. Dhea - 25 mg/day... as I just stated I’ll be taking this in the morning from now on. Phlebotomy - I’m going to do it. Dr. Caulkins says it’s not entirely necessary given the altitude where I live, but if I feel better afterward then it’s probably best to continue doing so if Hemo levels stay elevated.

I’m a 44 yo, fit and in good health. And overall I’ve been feeling great since starting therapy.

Thanks for listening and please share your comments.

Old labs should be first two attachments.

 

[jhperez81]

Didn’t say anything about your cholesterol?

 

[jmzwy]

Ldl a bit high but ratio good. I probably eat too many eggs and I’ll be cutting down on those.

 

[jhperez81]

I’m on almost the same initial protocol as you and am getting close to first follow up. It’s interesting to see what your protocol did for your numbers. Hoping my results aren’t too bad either. I didn’t take anastrozole for the first month and a half but started the .125mg. So far I actually feel good when taking it.

 

[jmzwy]

Like I said overall I feel great but at times.... usually within a day of my shot, I can be irritable, which is likely the estrogen. Also keep in mind my recent labs were taken almost 3.5 days after my recent shot.... so these numbers should be the low end for t and e.

 

[jmzwy]

Well you can feel great as a cocaine addict as well and it’s not necessarily optimal for one’s health, and will,eventually catch up to you.

Feeling good now but I’ve got high hematocrit (potentially), very high estradiol, and very low dhea. And yes feeling great compared to where I was in general, but have irritability issues every now and then. A little bit of water retention, which hasn’t really bothered me.

Basic feedback I am looking for would be in regards to estradiol number of 66, which is double the range; and dhea which is below the bottom end of the range. Lots of trouble with AIs around the forums it seems, and I’m a bit hesitant to start taking even .125 one time per week. So am looking for someone with similar past experiences and what they may have done to clean things up - whether it was dhea protocol, Arimidex, lower dose of T, or combination thereof.

Thanks

 

[Vince Carter]

Cut back the Cyp like you said, target your dose to get your Free T to not being over the lab range. Make small changes, and retest, resist taking a larger swing at it and then have to overcorrect. i.e, make a 5mg change to your dose, not 20mg. Ignore the TT it's not really useful.

125mg of Anastrozole isn't going to harm you, if you feel PMS'ish 24hrs post injection, may be just enough to alleviate the symptom.

I wouldn't change anything else, small change in isolation so you know what the outcome will be. More things you change the harder it is to see what works.

 

[Gman86]

So what you should do seems pretty obvious, in my opinion. If you’re feeling pretty good, and just feel irritable after your shots, just lower your dose like you planned. Dropping it to 150 would probably be a good idea. You can most likely go as low as 140 and still have you free T hovering around the top of the range, based on your last lab results. Either way, definitely don’t touch an ai yet. That’s only for when you can’t lower your dose any longer. But clearly you have room in that department based off of your free T level at trough. You can also lower your dose slightly, and switch to EOD injections. That should help manage E2 and possibly HCT a tiny bit. Probably not too much though considering your already on a twice per week injection frequency.

The other thing is your DHEA. Why DHEA is treated as a hormone that isn’t as important to worry about as say testosterone, I will never know. All hormones are extremely important. Look up what DHEA does. You will never feel optimized with your DHEA at the bottom of the barrel. So even though I agree with others that it’s not the best idea to change multiple variables at once, you really have to get your DHEA level optimized if you ever want to feel your best. But start very low with the dose. No need to start at 25mg. It doesn’t shut down your natural production of DHEA, it just adds onto it. There’s studies showing effective doses are way smaller than what we are used to hearing. Doses as small as 5mg per day. Ray peat, a doctor that has a very popular health forum, personally takes I think like 5mg or less per day with good success. With the lower doses you avoid a lot of the side effects, like increased estrogen and insomnia. I’m not saying 25-50mg doesn’t work for some men, it clearly does. But just no need to start there. Start very low, and work your way up if needed. Here’s a really good video on DHEA, as well as a few other hormones.

Also, don’t eat less eggs. Your cholesterol looks pretty much perfect! Your LDL is a little high, but that’s not necessarily a bad thing. LDL is very important and has a bunch of positive benefits. And your level isn’t even that high, definitely nothing to be worried about, that I can promise you. Cardiovascular disease has very little to do with cholesterol anyways. More to do with inflammation, plaque build up, decreased nitric oxide production, blood being too sticky, decreased elasticity of the blood vessels, weakening of the blood vessels and mineral deficiencies causing heart irregularities. Eat those eggs! Lol

And your HCT isn’t too bad. Don’t have to worry that much until you reach around 53-55. But go get a plebotomy if you want. They’re healthy for you. Men should be getting them once or twice a year anyways, to stay healthy. Don’t worry too much about it lowering your iron. I’ve been learning a lot about the misconceptions of iron, and it’s really been blowing my mind. Very interesting stuff. I’ll link a fb video of a great doctor named Morley Robbins that knows his stuff on iron, and so much more. Hopefully the link works. Iron is beneficial, don’t get me wrong. Everything in the body has a purpose, but it seems that we don’t want as much hanging around as most people think.

https://www.facebook.com/video.php?v=10156842436392937

 

[jmzwy]

These are excellent follow ups. Thank you very much.