Can anyone decipher what happened to me and what my labs mean?

[JCUSN]

I went to meet with a TRT doc because of the experience my friend had in treating his low T. I was experiencing night sweats and poor sleep (tried melatonin and even ambien), diminished ability to grow muscle (following a strict diet and 6 days per week weight training), and high/low libido fluctuations. I did also feel a bit "cloudy" at times, but not sure this is the low T "fog" I hear people talk about. I got labs, and there are the results. Estradiol was not measured at all.

Pre-TRT lab results:
SBHG 60.7
Total T 484
Free T 1.34 (calculated via Total T/SBHG/albumin levels) - doc said this was very low

Doc prescribed me 100mg Test C, injected IM once per week, and 200 iu of HCG on M/W/F injected subq. I followed this regiment for two weeks. Almost immediately after my first injection, I started to see diminished libido, as well as mediocre erections. After completing the 2nd week's injections, I decided I just wanted to quit injections altogether, and never mess with TRT again. This was a Friday.

The following Tuesday (4 days after last injection), my libido came back RAGING and my erections were incredible. I'm talking like 16 year old kid again raging and incredible. However, I attributed this to me stopping my injections...and I did not do anymore injections at all.

I went back for labs 15 days after my last injection and had these abysmal results:
SBHG 45.7
Total T 225
Free T 3.1
Estradiol 5.58 pg/ml
LH 4.23 mIU/ml

Needless to say, I was crushed to see how low these numbers were. During my two weeks of downtime, libido went down after one week of the raging, erections became less than incredible, and I also broke out heavily in acne across my shoulders. Most of this occurred in my second week of no injections (7-8 days after last injection). What would have caused this?

I've decided to try my TRT regiment again, at the advice of my doc. 100mg Test C, divided into two 50mg shots IM per week. And HCG 200iu M/W/F subq.

Am I a total mess?

 

[CoastWatcher]

I went to meet with a TRT doc because of the experience my friend had in treating his low T. I was experiencing night sweats and poor sleep (tried melatonin and even ambien), diminished ability to grow muscle (following a strict diet and 6 days per week weight training), and high/low libido fluctuations. I did also feel a bit "cloudy" at times, but not sure this is the low T "fog" I hear people talk about. I got labs, and there are the results. Estradiol was not measured at all.

Pre-TRT lab results:
SBHG 60.7
Total T 484
Free T 1.34 (calculated via Total T/SBHG/albumin levels) - doc said this was very low

Doc prescribed me 100mg Test C, injected IM once per week, and 200 iu of HCG on M/W/F injected subq. I followed this regiment for two weeks. Almost immediately after my first injection, I started to see diminished libido, as well as mediocre erections. After completing the 2nd week's injections, I decided I just wanted to quit injections altogether, and never mess with TRT again. This was a Friday.

The following Tuesday (4 days after last injection), my libido came back RAGING and my erections were incredible. I'm talking like 16 year old kid again raging and incredible. However, I attributed this to me stopping my injections...and I did not do anymore injections at all.

I went back for labs 15 days after my last injection and had these abysmal results:
SBHG 45.7
Total T 225
Free T 3.1
Estradiol 5.58 pg/ml
LH 4.23 mIU/ml

Needless to say, I was crushed to see how low these numbers were. During my two weeks of downtime, libido went down after one week of the raging, erections became less than incredible, and I also broke out heavily in acne across my shoulders. Most of this occurred in my second week of no injections (7-8 days after last injection). What would have caused this?

I've decided to try my TRT regiment again, at the advice of my doc. 100mg Test C, divided into two 50mg shots IM per week. And HCG 200iu M/W/F subq.

Am I a total mess?

When you joined EM - last month - it was pointed out that you'd had an inadequate initial workup, had been prescribed an out-of-the-box, cookie-cutter protocol, and were not being properly monitored. You wanted to quit TRT after two weeks. It was suggested, strongly, that TRT had not failed, your doctor had failed. It was suggested, even more strongly, that you needed to find better medical care (an idea you seemed very open to). Instead, you seem to have ceased injecting for a period of time, your levels fell, as one would expect - though your axis is not yet shut fully down, and you feel miserable.

I'm not exactly sure what more we can offer in the way of suggestions. It does seem that your new protocol, 50mg every 3.5 days is an improvement, it's a sound initial starting point. But the key to success is stability, patience, adequate testing, and a capable doctor. Six weeks have to pass, with no changes, before you can begin to know what is going on. Are the proper tests being run? For instance, is your estradiol level, an astonishingly low value, a sensitive test result? And what about your doctor - is he your knowledgeable partner?

 

[JCUSN]

When you joined EM - last month - it was pointed out that you'd had an inadequate initial workup, had been prescribed an out-of-the-box, cookie-cutter protocol, and were not being properly monitored. You wanted to quit TRT after two weeks. It was suggested, strongly, that TRT had not failed, your doctor had failed. It was suggested, even more strongly, that you needed to find better medical care (an idea you seemed very open to). Instead, you seem to have ceased injecting for a period of time, your levels fell, as one would expect - though your axis is not yet shut fully down, and you feel miserable.

I'm not exactly sure what more we can offer in the way of suggestions. It does seem that your new protocol, 50mg every 3.5 days is an improvement, it's a sound initial starting point. But the key to success is stability, patience, adequate testing, and a capable doctor. Six weeks have to pass, with no changes, before you can begin to know what is going on. Are the proper tests being run? For instance, is your estradiol level, an astonishingly low value, a sensitive test result? And what about your doctor - is he your knowledgeable partner?

I went back to my current doctor and voiced my concerns to him, that's why I'm starting the new protocol. He believed I had a spike in libido and erections because of the Test-Cyp finally kicking in. He also recommended the same thing in continuing the prescribed protocol for 4-6 weeks to assess the results. I'm just asking what everyone on here thinks about that idea? What does everyone think about what the doctor said?

I was also hoping for an answer as to why I would have broke out so badly when my labs show the test numbers being very very low. My doc didn't give much explanation other than "fluctuating" hormones.

My estradiol test was NOT a sensitive...just the regular test. The facility didn't offer a "sensitive."

 

[CoastWatcher]

I went back to my current doctor and voiced my concerns to him, that's why I'm starting the new protocol. He believed I had a spike in libido and erections because of the Test-Cyp finally kicking in. He also recommended the same thing in continuing the prescribed protocol for 4-6 weeks to assess the results. I'm just asking what everyone on here thinks about that idea? What does everyone think about what the doctor said?

I was also hoping for an answer as to why I would have broke out so badly when my labs show the test numbers being very very low. My doc didn't give much explanation other than "fluctuating" hormones.

My estradiol test was NOT a sensitive...just the regular test. The facility didn't offer a "sensitive."

His speculation about fluctuating hormones is perfectly reasonable. Acne is a devil of a side effect that plagues some men on/off during the course of TRT.

Ask your doctor to have your estradiol measured at a facility that does offer the sensitive test, or test yourself at www.discountedlabs.com - it's reasonably priced. E2 is simply too important a value to measure with the wrong lab test. Your estradiol, measured with either test, is awfully low. That is undoubtedly contributing to why you feel badly. It will rise over time as your testosterone levels do. There is an end to all this that is worth the process.

 

[Gene Devine]

You Doctor is probably right that when your libido kicked up you were just starting to see the results of increase serum levels even though you stopped after two weeks...think half life of the drug.

You need to run your protocol for at least 6 weeks and then get a thorough blood assessment done.

If you don't know the labs that you need you can find that in the stickies in the forum.

Give it some time and see what you look like in 6 weeks and don't over think it...TRT takes some time before you realize the great results.

 

[Vince Carter]

I feel like I'd have to write for the next half hour...get on something, 4-6 and religously stick with it. Religously. Or just don't do it. You're already so far out of whack...you absolutely cannot do this in the manner in which you've started or the IMHO, accept the half-ass Dr that this Dr is providing.

 

[JCUSN]

I realize I've definitely done myself a disservice by going on then coming off then jumping back on. I'm trying to just get myself on a stable routine now, and 50mg twice a week along with the HCG injections seems reasonable to at least see how I respond. So I'm sticking to it.

Was just looking for anyone else to chime in with some more guidance regarding the plan, and why I experienced the sides I experienced.

Thanks everyone for your input thus far!

Btw...is it even reasonable to assume the first Test Cyp injections acted that quickly and caused my libido drop and weak erections? Can it happen within a couple days like that? I've also noticed the same since restarting my injections, but I'm powering through anyway. Even my flaccid penis seems smaller and more "retracted."

 

[maxadvance]

Yes you're a total mess. You gave up after 2 weeks because you thought you were smarter than the Doctor. You thought the sky was falling because you didn't feel like superman all the time. You thought you knew better than anyone else what you're body could do after you stopped that 2nd week injection and now you realize you were just being an idiot for feeling that way. Good job dude, no sympathy here, listen to your MD and stick with the program. Your welcome.