Hello All -- I have been lurking and studying for a while, and could use a bit of input from your experience.
Started TRT as suggested by my GP (who is pretty open minded and has a "holistic" practice). However, after studying a bit, I think he doesn't have much actual experience in this area. I am meeting with him next week, so I'm preparing to get the protocols up to the modern standard.
Here's my basic info
-age: 56
-height 5ft 9in
-weight 190 lbs. This is my max weight ever. Weight was stable between 162-166 since I was in my 30s, but crept up to 168 and stayed there from about 2010-2012. I dieted in late 2013 and dropped to around 160. July 2013 had a super-tachycardia event that almost killed me. Started taking Metoprolol (beta blocker) and gained 10 lbs within 2 months. Metoprolol had other undesirable side effects (felt like it shaved off about 20 IQ points) so doc switched me to Atenolol, which does not cross blood-brain barrier. Gained 10 IQ points back, but kept the weight. Stable in the mid-170s for about a year, then started to creep up to 178-180. Started TRT Oct 1, gained a very quick 10 lbs., and have been between 188-191 for the past few months. Aaack! Most alarming! No response from PCP on this....
Heart stuff -- In 1996, age 37, my mitral valve ruptured. Cause unknown. May have happened when doing squats, but who knows. Had open heart surgery-- Valve was repaired - no artificial or pig valve. Very little exercise/conditioning after that for several years. All subsequent EKGs have been normal.
July 2013 -- woke up in the middle of the night with elevated heart rate, and could hear bubbling when I breathed. Went to emergency room. started coughing up blood. Heart rate went up to over 180 for several hours, they brought a bigger bucket for the blood. Finally got things under control. Diagnosis is still anyone's guess, but all the symptoms were super tachycardia "consistent with hypertrophic cardiomyopathy" (HCM) although there is still no visible thickening of heart walls. Could easily be something else. Current guess is that the valve repair in 96 caused some type of deformation or bend in the heart wall/septum that is the functional equivalent of HCM. I am in process of seeking long term sustainable solution to this, but in the meantime don't want to get so far out of whack that I can't get back.
Went on beta-blocker Metoprolol, which slowed down EVERYTHING. No more tachycardia. Gained a quick 10 lbs., lost a quick 20 IQ points, very bizarre dreams. Switched to Atenolol. Weight stayed, but a much better drug for me. Completely handled the tachycardia which has not reappeared since. However, it killed libido, and erections started to become scarcer and softer. First time I could recall EVER with no morning wood. No ED that actually affected sex, but opportunities were few. Refractory period seemed to be about a day or two....
So-- Good News = You're not dead! Bad News = You will spend the rest of your life fat, stupid, and impotent. And really fatigued all the time.
Since starting TRT I have not seen visible edema, but my hands and face feel swollen.
However, I must say that looking back over the years, this is actually the best I've felt in a really long time.
Last labs (summer 2014) not changed much since 2013 (for good or bad) but my PCP noted low T levels. Started TRT about Oct.1 --200 mg. T Cypionate every 2 weeks IM
After 2 months of that, without dramatic results, I found the online forums. Got permission to self inject -- then switched myself to 100 mg TCyp weekly IM.
PCP did no testing for E2,nor mention of AI or hCG. I am meeting with him next week and will discuss, so any guidance there is appreciated. I have familiarized myself with the basic rationale for all those things in the sticky posts, but case specific stuff would be helpful.
Pre TRT: (July 13, 2014)
Test Result Ref.
HCT 45.1% 39.3-52.5
Free T4 1.19 ng/dL 0.83-1.62
TSH 2.090 uUI/mL 0.270-4.200
Free T3 3.1 pg/mL 2.5-4.3
Total T 236.7 ng/dL 193.0-740.0
SHBG 25 nmol/L 10-57
Free T 52.58 pg/mL 30-150
Latest (Oct. 29, 2014)(after 4 wks TRT, just prior to second injection. Test did not include Thyroid panel)
Test Result Ref.
Total T 359 ng/dL 193.0-740ng/dL
SHBG 21 nmol/L 10-57 nmol/L
Free T 90.07 pg/dL 30-150 pg/dL
Any experience with beta blockers would be greatly appreciated. Although I don't want to get into a cascade of drugs to treat the side effects of other drugs, I do need to do what I can to increase energy, restore libido and erections, improve cognitive function, and do something about the damned weight gain.
Typical cardiologist statement: "you've gained 20 lbs? You look like you are doing okay. Eat some vegetables." (My wife pointed out that he could stand to lose 30 lbs himself...)
Thanks again for this valuable resource!
Started TRT as suggested by my GP (who is pretty open minded and has a "holistic" practice). However, after studying a bit, I think he doesn't have much actual experience in this area. I am meeting with him next week, so I'm preparing to get the protocols up to the modern standard.
Here's my basic info
-age: 56
-height 5ft 9in
-weight 190 lbs. This is my max weight ever. Weight was stable between 162-166 since I was in my 30s, but crept up to 168 and stayed there from about 2010-2012. I dieted in late 2013 and dropped to around 160. July 2013 had a super-tachycardia event that almost killed me. Started taking Metoprolol (beta blocker) and gained 10 lbs within 2 months. Metoprolol had other undesirable side effects (felt like it shaved off about 20 IQ points) so doc switched me to Atenolol, which does not cross blood-brain barrier. Gained 10 IQ points back, but kept the weight. Stable in the mid-170s for about a year, then started to creep up to 178-180. Started TRT Oct 1, gained a very quick 10 lbs., and have been between 188-191 for the past few months. Aaack! Most alarming! No response from PCP on this....
Heart stuff -- In 1996, age 37, my mitral valve ruptured. Cause unknown. May have happened when doing squats, but who knows. Had open heart surgery-- Valve was repaired - no artificial or pig valve. Very little exercise/conditioning after that for several years. All subsequent EKGs have been normal.
July 2013 -- woke up in the middle of the night with elevated heart rate, and could hear bubbling when I breathed. Went to emergency room. started coughing up blood. Heart rate went up to over 180 for several hours, they brought a bigger bucket for the blood. Finally got things under control. Diagnosis is still anyone's guess, but all the symptoms were super tachycardia "consistent with hypertrophic cardiomyopathy" (HCM) although there is still no visible thickening of heart walls. Could easily be something else. Current guess is that the valve repair in 96 caused some type of deformation or bend in the heart wall/septum that is the functional equivalent of HCM. I am in process of seeking long term sustainable solution to this, but in the meantime don't want to get so far out of whack that I can't get back.
Went on beta-blocker Metoprolol, which slowed down EVERYTHING. No more tachycardia. Gained a quick 10 lbs., lost a quick 20 IQ points, very bizarre dreams. Switched to Atenolol. Weight stayed, but a much better drug for me. Completely handled the tachycardia which has not reappeared since. However, it killed libido, and erections started to become scarcer and softer. First time I could recall EVER with no morning wood. No ED that actually affected sex, but opportunities were few. Refractory period seemed to be about a day or two....
So-- Good News = You're not dead! Bad News = You will spend the rest of your life fat, stupid, and impotent. And really fatigued all the time.
Since starting TRT I have not seen visible edema, but my hands and face feel swollen.
However, I must say that looking back over the years, this is actually the best I've felt in a really long time.
Last labs (summer 2014) not changed much since 2013 (for good or bad) but my PCP noted low T levels. Started TRT about Oct.1 --200 mg. T Cypionate every 2 weeks IM
After 2 months of that, without dramatic results, I found the online forums. Got permission to self inject -- then switched myself to 100 mg TCyp weekly IM.
PCP did no testing for E2,nor mention of AI or hCG. I am meeting with him next week and will discuss, so any guidance there is appreciated. I have familiarized myself with the basic rationale for all those things in the sticky posts, but case specific stuff would be helpful.
Pre TRT: (July 13, 2014)
Test Result Ref.
HCT 45.1% 39.3-52.5
Free T4 1.19 ng/dL 0.83-1.62
TSH 2.090 uUI/mL 0.270-4.200
Free T3 3.1 pg/mL 2.5-4.3
Total T 236.7 ng/dL 193.0-740.0
SHBG 25 nmol/L 10-57
Free T 52.58 pg/mL 30-150
Latest (Oct. 29, 2014)(after 4 wks TRT, just prior to second injection. Test did not include Thyroid panel)
Test Result Ref.
Total T 359 ng/dL 193.0-740ng/dL
SHBG 21 nmol/L 10-57 nmol/L
Free T 90.07 pg/dL 30-150 pg/dL
Any experience with beta blockers would be greatly appreciated. Although I don't want to get into a cascade of drugs to treat the side effects of other drugs, I do need to do what I can to increase energy, restore libido and erections, improve cognitive function, and do something about the damned weight gain.
Typical cardiologist statement: "you've gained 20 lbs? You look like you are doing okay. Eat some vegetables." (My wife pointed out that he could stand to lose 30 lbs himself...)
Thanks again for this valuable resource!
I have tried low carb "paleo" in the past and did well on it. But no weight changes. My wife is currently working hard at getting us to go vegan or "Whole Food, plant based" a la Dr. Furhman -- which I also do pretty well on -but also with no weight changes. My energy levels have also been pretty much unaffected by what I eat. One thing that had a very positive effect was cutting out gluten a few years back. That's when I went Paleo. Eliminating gluten reduced the overall "inflamed" feeling I had, and really helped my snoring. 
