Changing from pellets to injections

[LTChris]

Hello everyone,

I am new to this forum and new to TRT. I had several years of fatigue and loss of passion in pretty much all areas of my life. I received no answers from conventional doctors. I tried a health clinic and found I had low T. Had a few total testosterone labs done. All were between 100-300 (Test range 348-1197). Clinic Physician wanted to start me on pellets. I got a second opinion from an Endo. Of course the labs he requested put me at 300 total T. He would not treat because I was in range. Ridiculous for a 34 year old. So I went with pellets. I received the one and only pellet treatment about 5 months ago. Unfortunately I didn't do much research myself until the pellets were all ready in. I had about 3 great weeks out of the last 5 months. 4 of the pellets to date have worked their way out. Estradiol peaked at 59, Total test peaked at 1400. Free test at 25. The last labs prior to pellets were: total - 150, Free - 1.59. I am thinking for going with Defy Medical and weekly injections as chasing levels on pellets is impossible. Previous clinic did not check proper pre labs. Talked to Defy already, labs are done, waiting on call back.

Question - what is the best way to transition from pellets to injection? Do I have to come completely off pellets ( they are about done anyway)? This site is amazing. Wish I would have found it before starting pellets, would have saved me a lot of headache.

 

[CoastWatcher]

Welcome to Excelmale. You are another in a long line of guys who initiated pellet therapy in perfectly good faith, and came to realize they had been sold a bill of goods. Your decision to move toward a protocol that makes sense, and to work with Defy Medical, is the first step toward taking advantage of renewed health through a properly designed protocol. When would you be due for your next pellet insertion? And what were your labs like, the ones you submitted to Defy? You will not be asked to wait until you drop to your pre-pellet, hypogonadal state.

 

[LTChris]

due for pellets next week. have not received labs for defy yet

 

[CoastWatcher]

due for pellets next week. have not received labs for defy yet

Well, you're done with the pellets and should be able to initiate a solid protocol with Defy as soon as you've had your consultation.

 

[johndoesmith]

Hey man sorry to hear about you starting on pellets, I imagine the response wasn't what you expected from them.

Would you post your full labs? Unless you simply only got test, free, and E2 done.

Not sure if you just want to wait for defy, but in the meantime posting your full labs here some of us can comment and give some advice.

Did you have labs drawn for defy but simply not receive the results back?

 

[LTChris]

that's all the labs i have. hoping to get result back from defy and schedule consult by weeks end. will post when know more. thanks for the support

 

[1Draw]

LtChris -

I also went the pellet route for my first treatment much to my disappointment. Like you, felt good for few weeks then started to taper off. Had my final pellets inserted 3-15 - switched to Defy with new blood test 6/15 showed Total T = 1493 - Free T = 22.6 and E2 = 21.1.

Dr Saya said at that time said we had to wait until my levels dropped enough to go on Cypionate shots. Well, it took from March until late September - 7 months - for my T to drop to 591 with Free at 6.7. It was then I started with Cypionate shots 120 mg a week.

Well, we have been tweaking the doseage since then and I am now at .4 or 80 mg a week and feeling much, much better consistently with no severe prolonged valleys that I had on the pellets.

So, to answer your question, you are probably looking at at least 6-7 months for the pellets to completely dissolve for your T to drop to levels that support TCyp injections.

I know the last 2-3 weeks prior to the September blood test, I felt like a zombie almost so, just hang in there and Dr. Saya and the Defy team will get you on track.

 

[johndoesmith]

LtChris -

I also went the pellet route for my first treatment much to my disappointment. Like you, felt good for few weeks then started to taper off. Had my final pellets inserted 3-15 - switched to Defy with new blood test 6/15 showed Total T = 1493 - Free T = 22.6 and E2 = 21.1.

Dr Saya said at that time said we had to wait until my levels dropped enough to go on Cypionate shots. Well, it took from March until late September - 7 months - for my T to drop to 591 with Free at 6.7. It was then I started with Cypionate shots 120 mg a week.

Well, we have been tweaking the doseage since then and I am now at .4 or 80 mg a week and feeling much, much better consistently with no severe prolonged valleys that I had on the pellets.

So, to answer your question, you are probably looking at at least 6-7 months for the pellets to completely dissolve for your T to drop to levels that support TCyp injections.

I know the last 2-3 weeks prior to the September blood test, I felt like a zombie almost so, just hang in there and Dr. Saya and the Defy team will get you on track.

Wow. That is impressive, 3 months later you're significantly above range. What else is surprising, is your E2. 1493 total to have an E2 of 21? plus your SHBG must be sky high to have a free of 21 at 1493 total!

I'm curious, would you mind sharing your full lab results?

 

[LTChris]

Blood test with Defy (LabCorp ranges/units):

hematocrit - 45.3%
Testosterone Total - 463
Free test - 7.6
DHEA, Sulfate - 170.9
TSH - 2.030
LH - <0.2
PSA - .5
Estradiol - 10.1
Progesterone - .1
Cholesterol, total - 257 (not concerning to me)
---------------------------------
AST - 49
ALT - 66
I don't know much about AST or ALT, other then it is for liver and my results are high.

Waiting for consult, unfortunately I could not get in until next month (going to be a long month). There are more labs, I figured these are the important ones

 

[1Draw]

After 5 months your T levels have dropped to a range that Defy can justify TCyp shots. Total T of 463 and free T of 7.6 are pretty close to my levels prior to starting weekly shots. I feel your pain on having to wait a month but, I can assure you it is worth the wait.

JohnDoe yes I do have high SHBG. Latest blood test showed 88.3 nmol/L (19.3-76.4). Reason my E2 was under control on the pellets is the clinic had the pellets compounded with low does anastrozole which kept it in range. Dr. Saya said this was crazy but - it worked for me anyway.

LtChris with your Estradiol at 10, your MD must have done the same thing except had way too much anastrozole. It is pretty low when 20-30 is the ideal range.

If someone can tell me how to copy and past a link to my blood test results from 6/30/15 and 9/28/15 will post them here. Takes too long to type all this stuff out -

 

[LTChris]

surprisingly no anastrozole.
just 200mg DIM daily

 

[johndoesmith]

Blood test with Defy (LabCorp ranges/units):

hematocrit - 45.3%
Testosterone Total - 463
Free test - 7.6
DHEA, Sulfate - 170.9
TSH - 2.030
LH - <0.2
PSA - .5
Estradiol - 10.1
Progesterone - .1
Cholesterol, total - 257 (not concerning to me)
---------------------------------
AST - 49
ALT - 66
I don't know much about AST or ALT, other then it is for liver and my results are high.

Waiting for consult, unfortunately I could not get in until next month (going to be a long month). There are more labs, I figured these are the important ones

Yeah I'm gonna guess you're new, but post FULL labs. Not just ones you think are important.

Also the best way is to post pictures or screenshots, this way I don't have to guess if you made a typo, or what kind of test it is, LC/MS/MS or ECLIA, because it will say it on the bottom.



1Draw: Yeah if you have pictures then go to imgur.com and drag and drop. Compounded anastrozole in the pellets? Jesus, there's no way to dial those in if anything changes.

 

[LTChris]

 

[JV63]

I have seen a ton of labs, and that is the highest HDL and lowest triglyceride numbers (which is good) I can recall seeing.
Do you take any supplements or follow any particular diet?

 

[LTChris]

high fat low carb is all

 

[Vince]

high fat low carb is all

That's the way I eat also.

 

[CSI007]

HFLC Diets work!

 

[johndoesmith]

I'm not sure why they highlighted low LH while on TRT. Your LH is supposed to be low!

E2 is basically crashed, which must feel terrible along with low free test.

Your SHBG must be fairly high as well. I'd guess about 40-50 maybe.

I see your high HDL, and I am not sure that it is a good thing. I am clearly not an expert on all things cholesterol, I just recall reading once that high HDL can be a sign of inflammation. If anyone else disagrees with me on this listen to them over me.

AST and ALT can be raised due to tylenol or ibuprofen day of or day before testing as well as lifting heavy(Although it'd be a bit lower than what you have) or even drinking the day before. If you've never had it before, I'd retest, if it's consistent I'd talk to a doctor about it.

 

[LTChris]

thanks for the info