Am i heading in the right direction?

[carkrazy]

Hello, I'm new to the site and not very familiar with all the forum etiquette so please bare with me.

I'm 48 years old and started TRT 1 year ago after my T levels came back at 201. As you can imagine i felt like shit and decided to start treatment. A friend referred me to a local men's hormone replacement clinic. I thought man this is great.. everything included. meds, blood work the works for a reasonable monthly fee. What i didn't anticipate was the roller coaster i've been on for the past year. I was initially given 200mg of test cyp per week but the weird thing was that .5 mg of anastrozole was compounded into the testosterone and i was also given hcg 2 times per week. i felt terrible on this protocol and eventually gave up with them after 4 months due to the severe joint pain high anxiety and low libido. test was 1100 and sensitive e2 was 18. they didnt check much.

I began to do my homework and found one of the most respected TRT doctors in West Palm Beach, Florida. I won't mention his name because I'm not that kind of person. I was excited knowing that i was dealing with one of the best according to many many people on different forums. Once i started, i was given every medication known to man well, not really but i was started off with 200 mg of test cyp 1xweek, .25mg of anastrozole day3 and 6 post injection, 500mg of metformin 2x per day and some thyroid medication called cytomel. With this protocol my anxiety was so bad it was disrupting my daily life and the joint pain is horrible. Little by little i would eliminate meds with doctors approval and eventually wound up at 140mg of test cyp 1xper week and .25mg anastrozole 2x per week. things got better but I think i honestly felt better Pre TRT. On this protocol my test is 550, free test 127, sensitive e2 is 25, shbg 14. After 6 months of changing this and changing that i stopped going to the second doctor.

I'm going to give this one more try with my primary Doctor who is very open and willing to work with me and how i'm feeling. I just started 50mg of test cyp every 3.5 days. no anastrozole for now (that stuff is poison) im hoping i wont need it. I will test my e2 in 4-6 weeks to make sure e2 is in check.
I'm thinking of incorporating hcg back in my protocol with the split dose but want to change things 1 thing at a time.
Do you all think this is a good start? I havent had any gaps between doctors so ive still been on trt just changing the protocol one last time.

 

[Systemlord]

This protocol will likely fail you like the ones before it because of your low SHBG. My SHBG is only 2 points higher than yours and I was miserable at 50mg twice weekly. Low SHBG guys have a ton of free hormones, free t and unfortunately free estrogen.

You will likely only do well injecting micro doses every day, 5-8mg. You might be able to get away with 15-20mg EOD. Anything else will likely fail you, I'm doing 16mg EOD and still have estrogen problems and require a low dose AI to help control estrogen.

 

[carkrazy]

so low SHBG is why i have the anxiety symptoms im experiencing? My free t isn't to high at 127 (35-155 pg/ml) is it possible to have low SHBG and not have free T issues? never been an issue for me unless 127 is considered high.

 

[Systemlord]

Low SHBG men can tolerate almost no estrogen due to the majority of it being free, the lower the shbg more free estrogen. Excess estrogen causes hypertension, anxiety and it blocks the mechanism in the brain that controls blood pressure in the brain.

 

[Mountain Man]

My guess is that the testosterone dose was too high right from the jump. Also, why HCG, AI, and metformin? Until you know the response to the testosterone, how do you know those are even necessary? Now it's going to take a long time to figure out what is the problem. Too many of these men's clinics are baffling guys who don't know better with BS. The 50mg every 3.5 is the first part of your protocol that makes sense. Too bad that wasn't where you started. Good luck with everything.

i swear, some of these men's clinics must be getting kickbacks from the drug companies for all these crazy initial protocols.

 

[carkrazy]

Thanks Mountain Man. I started to listen to my body and started to question all the other drugs. I felt 200 mg 1x per week was a bit much but this protocol was coming from a TRT expert according to many people on the forums. he's written books that have gotten rave reviews on testosterone therapy so i was going with the program initially. i finally couldn't take it anymore and wound up here. I figured with the vast experience on here and a Doctor willing to work with me it was worth a try as i dont want to go back to pre trt state. i

My guess is that the testosterone dose was too high right from the jump. Also, why HCG, AI, and metformin? Until you know the response to the testosterone, how do you know those are even necessary? Now it’s going to take a long time to figure out what is the problem. Too many of these men’s clinics are baffling guys who don’t know better with BS. The 50mg every 3.5 is the first part of your protocol that makes sense. Too bad that wasn’t where you started. Good luck with everything.

i swear, some of these men’s clinics must be getting kickbacks from the drug companies for all these crazy initial protocols.

 

[CoastWatcher]

Thanks Mountain Man. I started to listen to my body and started to question all the other drugs. I felt 200 mg 1x per week was a bit much but this protocol was coming from a TRT expert according to many people on the forums. he's written books that have gotten rave reviews on testosterone therapy so i was going with the program initially. i finally couldn't take it anymore and wound up here. I figured with the vast experience on here and a Doctor willing to work with me it was worth a try as i dont want to go back to pre trt state. i

You have found that you have to be your own advocate - no matter who your doctor is...no matter the number of books written...no matter what the internet says. TRT hasn't been a failure, the physicians you've worked with have failed. It's a story many of us have experienced.

All the best.

 

[carkrazy]

Amen to that brother!

You have found that you have to be your own advocate - no matter who your doctor is...no matter the number of books written...no matter what the internet says. TRT hasn't been a failure, the physicians you've worked with have failed. It's a story many of us have experienced.

All the best.

 

[carkrazy]

so would checking my labs after 4-6 weeks on this protocol of 50mg every 3.5 days be ok?
also, i was wondering what some of you guys think about incorporating HCG later on as my testicular atrophy is beginning to freak me out a bit.

 

[CoastWatcher]

so would checking my labs after 4-6 weeks on this protocol of 50mg every 3.5 days be ok?
also, i was wondering what some of you guys think about incorporating HCG later on as my testicular atrophy is beginning to freak me out a bit.

Sounds like a plan.

 

[carkrazy]

can anyone shed some light on what could be causing anxiety while on TRT as this is my main complaint since starting a year ago. E2 has been consistently between 18-29

 

[Vince]

can anyone shed some light on what could be causing anxiety while on TRT as this is my main complaint since starting a year ago. E2 has been consistently between 18-29

Maybe your estrogen levels are too low, if you're not on an AI. There's ways you can increase your estrogen, I supplement with DHEA and use HCG.

 

[carkrazy]

Thanks for your input Vince. My E2 has been consistent between 18-29 with .25 mg of anastrozole 2x per week and depending when i draw my blood. i cant stand the anastrozole so im hoping that the split dose at 50mg every 3.5 days will help control estrogen. i have to give it some time as i just started the new protocol wednesday and stopped taking anastrozole.

Maybe your estrogen levels are too low, if you're not on an AI. There's ways you can increase your estrogen, I supplement with DHEA and use HCG.

 

[Vince]

Thanks for your input Vince. My E2 has been consistent between 18-29 with .25 mg of anastrozole 2x per week and depending when i draw my blood. i cant stand the anastrozole so im hoping that the split dose at 50mg every 3.5 days will help control estrogen. i have to give it some time as i just started the new protocol wednesday and stopped taking anastrozole.

There are many men and doctors that believe you do not need to treat estradiol levels until it hits 60, unless of course you're having symptoms of high estrogen. Something personally I've never felt, for that matter I've never felt low or high estrogen symptoms.

 

[CoastWatcher]

Setting the anastrozole aside is a good idea. I felt elevated estradiol when my numbers hit 55 (sensitive test). Now, with no AI but daily injections, I keep it in the mid-30s and feel just fine. I suspect that even if it climbed into the 40s I would be in good shape. We're all different, but e2 is NOT a waste product, men need it. I hope your plan lowers the anxiety.

 

[carkrazy]

Thanks CoastWatcher, the anxiety issue for me is my biggest thing. I did suffer from anxiety prior to TRT but since starting TRT my anxiety is at another level. I was very clear with my Doctors about it and wish they would have started me slow but hey, at least i found a good forum and protocol to follow now. Felt like these Doctors were killing me slowly.

Setting the anastrozole aside is a good idea. I felt elevated estradiol when my numbers hit 55 (sensitive test). Now, with no AI but daily injections, I keep it in the mid-30s and feel just fine. I suspect that even if it climbed into the 40s I would be in good shape. We're all different, but e2 is NOT a waste product, men need it. I hope your plan lowers the anxiety.

 

[CoastWatcher]

Thanks CoastWatcher, the anxiety issue for me is my biggest thing. I did suffer from anxiety prior to TRT but since starting TRT my anxiety is at another level. I was very clear with my Doctors about it and wish they would have started me slow but hey, at least i found a good forum and protocol to follow now. Felt like these Doctors were killing me slowly.

"Start low and go slow" is a phrase, attributed to Dr. Crisler, that you'll read a lot here. It makes sense. In this game things can be more easily raised that lowered (I know that's a generalization and you don't want to push it too far). Nonetheless, in the estradiol game one MUST go slow.

 

[carkrazy]

Agreed! would you say that the 50mg every 3.5 days is a good starting point then?

"Start low and go slow" is a phrase, attributed to Dr. Crisler, that you'll read a lot here. It makes sense. In this game things can be more easily raised that lowered (I know that's a generalization and you don't want to push it too far). Nonetheless, in the estradiol game one MUST go slow.

 

[CoastWatcher]

Agreed! would you say that the 50mg every 3.5 days is a good starting point then?

With low SHBG, as many have commented, you need multiple/smaller injections over the course of a week. You've chosen a very standard approach, that's a compliment, not a criticism.

 

[carkrazy]

Thanks again CoastWatcher and everyone else who added to this this thread. I at least have a much better understanding and have a plan of action.

With low SHBG, as many have commented, you need multiple/smaller injections over the course of a week. You've chosen a very standard approach, that's a compliment, not a criticism.