29 trt

[jkeith]

29 years old
high fatigue
Low sex drive and trouble keep erections
Terrible recovery from working out.

Test results
Testosterone 164 range: 348-1197
TSH 0.545 range: 0.450 - 4.500
FSH 3.6 range: 1.5 - 12.4
LH 1.4 range: 1.7 - 8.6
Prolactin 9.9 range: 4.0 - 15.2
Estradiol 14.5 range 7.6 - 42.6
PSA 0.3 0.0 to 4.0
T4 10.5 range 4.5 to 12.0

Weeks 1 through 5 the doctor put me on 100mg Testosterone Cypionate 1x week
1mg Armidex 1x week

Week 6 fatugue was much better still had it however especially after day 3. Erections still hard to maintain. Doctor bumped it to 200mg Testosterone cypionate 1x week with the option of 100mg 2x week if I wanted. Still 1mg armidex 1x week
Seemed my fatigue hit an all time high. I am exhausted. Like I need to sleep now kind of exhausted. Not sure if there is an adjustment period or something else going on. I'm supposed to be on CPAP but I'm not. I'm not sure if the increase in dosage makes the apnea worse

Doctor didn't seem to know what was causing the lown to begin with as my LH was mostly normal.

 

[Vince Carter]

I'd suggest that you break that 1mg Arimidex in to 1/4s and take it that way perhaps EOD, or 1/4 - 1/2 tablet with your injection. I'd bet that the 1mg all at once is taking your Estrogen too low. People are also going to tell to that when it comes to Estrdiol testing to get the "sensitive" test if at all possible, the one that is a more suitable for males. Maybe ask for a Progesterone test, too? That's something that I've been working with. Your story sounds familiar, weak and poor erections, although the Testosterone is present in high dosages. Its sort of a mind scrambler because you expect to feel soooooo much better with that much Testosterone. It's a complicated journey for some of us.

 

[jkeith]

Thanks for the reply. I thought about splitting it as well. I felt less tired as the week has gone on. I'm getting the shot tomorrow. So it might be the armidex making it dip.

It wasn't the sensitive test I had done. It didn't appear my e2 levels were that low to begin with.

 

[Vince Carter]

Most advice is 6 weeks to start feeling better and youre in that range now. The weekly injection I too felt faded after about day three. I'd absolutely recommend the twice a week. Its my rookie opinion that your Estradiol of 14.5 on the "standard" test is too low, I think the advice is 20-30 if not a little higher before any sort of problem appears.

 

[jkeith]

Yea. The doc set re-running tests in 5 weeks. I was thinking the armidex may be causing some of the crash.

 

[jkeith]

Also bought Nelsons book today so I can learn more about what's going on. Being 29 I have a long time ahead of me with this.

 

[Vettester Chris]

Are these labs baseline before starting a TRT protocol? Got to presume they are, as I can't imagine anyone at 164ng/dl on 100mg/wk protocol, even with fast metabolizing and taking labs prior to a weekly injection. Let me know, and I will also dive into the fatigue subject ...

 

[jkeith]

You're correct, they were my baseline prior to the TRT protocol. I'll have the post in 5 weeks after starting the 200mg/wk

Are these labs baseline before starting a TRT protocol? Got to presume they are, as I can't imagine anyone at 164ng/dl on 100mg/wk protocol, even with fast metabolizing and taking labs prior to a weekly injection. Let me know, and I will also dive into the fatigue subject ...

 

[Nelson Vergel]

I agree with Chris. I bet those blood values are before TRT. If so, what are they know?

Why are you not wearing your CPAP? Have you tried nose pillows instead of the mask? You can also try the dental appliances mentioned here

Fatigue- When Testosterone Is Not Enough

 

[jkeith]

They were baseline prior to the TRT protocol. I'll another blood workup in five weeks. I have no reason why I haven't been using the CPAP. It never bothered me at all. I moved and just never started using it again.

I agree with Chris. I bet those blood values are before TRT. If so, what are they know?

Why are you not wearing your CPAP? Have you tried nose pillows instead of the mask? You can also try the dental appliances mentioned here

Fatigue- When Testosterone Is Not Enough

 

[Nelson Vergel]

If you have a diagnosis of sleep apnea, there is very little that TRT can do unless you address it.

I am looking forward to seeing your results.

 

[jkeith]

I set back an appointment for another sleep study and to get that going again. I'm rather sure if I got that going along with the TRT, I'd feel much better. Just making sure I wasn't making a poor decision by going ahead with the TRT. My results were still on the low side about 4 years ago, even with the CPAP.

 

[Vettester Chris]

OK, glad we clarified your labs being baseline. On the fatigue, Nelson provided a link that has a lot of great information. On your next labs, please look into a few different things ...

Thyroid - Your Total T4 is towards the top of the reference range, TSH is offset with being very low. Many doctors might just look at that and say you have a wonderful functioning thyroid. Who knows, maybe you do, but there are several chapters to this book that are not being presented. What if your thyroid is poorly converting T4 to T3? And/or both T4 and T3 is at a standstill and not effectively getting into the body? Correct, we can't even begin to speculate because we're missing labs ... Look into Free T4, Free T3, Reverse T3, and Antibodies. Most antibody tests will consist of TPO and TgAb. In your case it would also be good to get a TSI Antibody Lab, knowing what we know on your T4 and TSH.

Adrenals - If possible, it would be great to see a 4x Saliva Cortisol lab with DHEA-S. With this you will get a good picture of how your adrenals are functioning throughout the day, provided with a circadian profile graph. If it doesn't have one, I have a template and can create it for you. I will gladly help you with some comments on your report, and to provide you with input on the Cortisol/DHEA correlation so that you understand what it means to you.

In addition to this, we need all the basic CBC's, metabolic, lipids, etc. Please review the labs on STTM.com http://www.stopthethyroidmadness.com/recommended-labwork/ ... They're all important, but in the event there is issues with the thyroid, like an excessive amount RT3, I will be looking to see your iron, ferritin, B12, and of course your electrolytes.

I know on one hand this sounds like a lot of stuff to be doing, and I know it adds extra cost. Trust me though when I say it's ALL relevant to having a successful TRT program! Testosterone can end up being counterproductive IF other areas like the thyroid and adrenals are not functioning correctly, and ADP is overshadowing ATP! Doing some early reconciliation of this now will no doubt help your overall wellness program from hereon out.

 

[jkeith]

Thanks for taking the time to look over my blood work and giving so much information. I will look into everything you here. As far as blood work with my insurance I've yet to pay anything blood work related. Is it possible to get insurance to cover this. I'm not really sure how to present some of this to my doctor.

OK, glad we clarified your labs being baseline. On the fatigue, Nelson provided a link that has a lot of great information. On your next labs, please look into a few different things ...

Thyroid - Your Total T4 is towards the top of the reference range, TSH is offset with being very low. Many doctors might just look at that and say you have a wonderful functioning thyroid. Who knows, maybe you do, but there are several chapters to this book that are not being presented. What if your thyroid is poorly converting T4 to T3? And/or both T4 and T3 is at a standstill and not effectively getting into the body? Correct, we can't even begin to speculate because we're missing labs ... Look into Free T4, Free T3, Reverse T3, and Antibodies. Most antibody tests will consist of TPO and TgAb. In your case it would also be good to get a TSI Antibody Lab, knowing what we know on your T4 and TSH.

Adrenals - If possible, it would be great to see a 4x Saliva Cortisol lab with DHEA-S. With this you will get a good picture of how your adrenals are functioning throughout the day, provided with a circadian profile graph. If it doesn't have one, I have a template and can create it for you. I will gladly help you with some comments on your report, and to provide you with input on the Cortisol/DHEA correlation so that you understand what it means to you.

In addition to this, we need all the basic CBC's, metabolic, lipids, etc. Please review the labs on STTM.com http://www.stopthethyroidmadness.com/recommended-labwork/ ... They're all important, but in the event there is issues with the thyroid, like an excessive amount RT3, I will be looking to see your iron, ferritin, B12, and of course your electrolytes.

I know on one hand this sounds like a lot of stuff to be doing, and I know it adds extra cost. Trust me though when I say it's ALL relevant to having a successful TRT program! Testosterone can end up being counterproductive IF other areas like the thyroid and adrenals are not functioning correctly, and ADP is overshadowing ATP! Doing some early reconciliation of this now will no doubt help your overall wellness program from hereon out.

 

[Vettester Chris]

Thanks for taking the time to look over my blood work and giving so much information. I will look into everything you here. As far as blood work with my insurance I've yet to pay anything blood work related. Is it possible to get insurance to cover this. I'm not really sure how to present some of this to my doctor.

Maybe the best approach is just to make a list, hand to him, and he might just put it all together for you. Then again, he might use your notes to give you a prostate exam! My GP side of things is through Kaiser, I use a clinic for HRT. Kaiser only has certain labs available. My GP will give me anything I want on their list, but certain labs, i.e., E2 sensitive, Reverse T3, etc., are not. Anything beyond their scope is out of pocket for me. It's just the cards that are dealt when dealing with HRT.

 

[jkeith]

Sounds good. I'll have to try that. I don't think my doctor would be opposed to this as she was curious herself on what's going on with me.

Maybe the best approach is just to make a list, hand to him, and he might just put it all together for you. Then again, he might use your notes to give you a prostate exam! My GP side of things is through Kaiser, I use a clinic for HRT. Kaiser only has certain labs available. My GP will give me anything I want on their list, but certain labs, i.e., E2 sensitive, Reverse T3, etc., are not. Anything beyond their scope is out of pocket for me. It's just the cards that are dealt when dealing with HRT.

 

[jkeith]

Just on a side note my heart rate seems to be a little faster / stronger since upping to 200mg a week.

 

[Vettester Chris]

How's your BP look? Anything seem off with your body temp? Like mentioned earlier, it's good to see the whole picture on your labs, which can provide other markers that can be contributed to various symptoms.

 

[jkeith]

Well I took my shot 48 hours ago and I haven't taken the armidex yet. I feel much better. No racing heart. I know 200mg/week is on the high side. Is it too much? Should I talk to the doctor about backing it down or just wait for the labs in 5 weeks?

 

[chaps]

They were baseline prior to the TRT protocol. I'll another blood workup in five weeks. I have no reason why I haven't been using the CPAP. It never bothered me at all. I moved and just never started using it again.

Sleep apnea can cause ED and not only your hormones but your neurotransmitters as well. This alone would cause major issues, before addressing anything i'd start with getting your sleep in line.