Current TRT Protocol 85mg E6D, thyroid?

[charile12]

my protocol, which is currently 85mg E6D. no AI. started injections 12/18. Am 41 years old.
So i got most labs back, pending - total t, E2, pregnenolone, D3.

Attached is a chart to see #s pre-injections and new labs.

Summary of key new labs from 1/30/18:
RBC 5.33 (4.1-5.8)
hematocrit 48.6 (37.5-51)

Total Cholesterol 161 (100-199)
trigl 219 (0-149)
HDL 35 (>39)
VLDL 44 (5-40)
LDL 82 (0-99)

ALT 55 (0-44) elevated now i think due to weight gain. I have fatty liver disease
AST 36 (0-40)
Ferritin 162 (30-400)

PSA .6
DHEAS- 138.1 (102-416)
Free T 15.8 (6.8-21.5)
SHBG 24.4 (16.5-55.9)
TSH - 2.45
FT3 - 3.2 (2-4.4)
FT4 - 1.12 (.82-1.77)
I really think i should try T4 medication. Please see chart for thyroid # trends. Please comment on my thyroid #s and whatever else you want.
I also would like suggestions on protocol change. I do think I need more stability As my temps fluctuates (some days I get to 98.6 some only to 97.5), a couple days a week I have ED, minor hot flashes.
Thank you all for your feedback.

 

[CoastWatcher]

Your testosterone dose, 85mg every six days - that is what it's been since therapy was initiated? How, may I ask, did you and your doctor arrive at that? It's a very modest dose. No HCG?

 

[Vince Carter]

Free T3 is the number you should be looking at, if you were to supplement T4 theres some assumption that the body will convert T4 > T3 so using T4 alone some times does not work.

 

[charile12]

Well idiot dr prescribed 200mg ever 2 weeks. So know what I know from all the reading that would mean too many highs and lows. So then i called dr and agreed to 100 mg a week, he just agreed said will make no diff. I did do a first shot of 100mg then did 85mg E6D. So I really wanted to to 50mg 2x a week. But to stay close to what dr agreed to I did E6D. no hcg. I dont care about fertility but I am concerned about getting LH some how. What do you think about DHEA and the rest of the labs? Not sure what to try next. Am thinking of asking for a trial of T4 medication, then retake labs before I do anything else.

I also think that stopping TRT and fixing thyroid and possible upping my DHEA will help me increase my t to over 500. I think its just wishful thinking.

Thanks for replying Vince and Coast.

 

[Systemlord]

Well idiot dr prescribed 200mg ever 2 weeks. So know what I know from all the reading that would mean too many highs and lows. So then i called dr and agreed to 100 mg a week, he just agreed said will make no diff. I did do a first shot of 100mg then did 85mg E6D. So I really wanted to to 50mg 2x a week. But to stay close to what dr agreed to I did E6D. no hcg. I dont care about fertility but I am concerned about getting LH some how. What do you think about DHEA and the rest of the labs? Not sure what to try next. Am thinking of asking for a trial of T4 medication, then retake labs before I do anything else.

I also think that stopping TRT and fixing thyroid and possible upping my DHEA will help me increase my t to over 500. I think it's just wishful thinking.

Thanks for replying Vince and Coast.

As I've already stated 85mg E6D makes no sense for a guy with your SHBG level, inject 50mg T twice weekly. Show you doctor a study from 11 years ago that proves why injections every 2 weeks doesn't work. -->

https://www.excelmale.com/forum/sho...-Testosterone-Injections-Every-Two-Weeks-Fail

 

[CoastWatcher]

Systemlord perfectly addressed the question of why you're struggling and gave you a potent tool, the classic study on injection frequency, to help you explain to your doctor why you're making no progress. You commented in another post that you're thinking of abandoning TRT; that's your choice, of course. But what you'd really be abandoning at this point is a poor, pale impression of what TRT is supposed to be. You've not had the benefit of a protocol that is designed for you and your unique situation. That's something every patient deserves.

 

[charile12]

Again am on a e6d 85 mg. Which is 100 mg a week. I GOT THE REST OF THE RESULTS. UPDATED CHART. Last column is blood from 1/30/18.

Total t- 589 (264-916)
Free t 15.8 (6.8-21.5)
Estradiol s - 34.4 (8-35) I think this explains my bloating and inconsistent erections.
This lab was taken right before injection time.
Am hoping when I switch two 2x a week injections my e2 will come down. Then again it's high on day of injection.
Any thoughts? Thank you.

 

[ratbag]

We are trying to tell you that E6D is no good, that protocol does not work. Even though it's 100mg weekly, it still doesn't work! DO YOU GET THAT? Because your MD doesn't get it. He's following the directions printed on the testosterone vial (200mg every 2 weeks) from 1940 (when testosterone was first synthesised) which we learned long ago doesn't work. No good TRT MD follows that dosing anywhere. The fact your MD is doing this tells us he doesn't have a clew, and has no experience in this field of medicine. What we see is you need a different protocol with more testosterone. Your Total T and free T are too low period. With that out of the way you should be trying 60mg E3.5D. This protocol may lower your E2. Once you get your T and free T higher you should feel better then you can look at DHEA and FT3, which probably need to be addressed. If your MD cannot accommodate you then you need to find a new MD that knows what they are doing... hence the reference to Defymedical.com who can work with you over the phone and they are not expensive.

 

[charile12]

Thank you for addressing my questions. Yes I already started the 2x a week. So when I see the Dr tomorrow I will ask for more t. You stating 60 2x a week makes sense. Though I thought that doing the same amount of 100 split e3.5 days would also raise my t but I guess not enough.

Should I also ask for arimidex? But hold on to it to see what the new protocol does to my e2?
I don't see Dr often. In between visits it's phone communication. So I want to get what I can while face to face. And I will not make the case to treat my thyroid. I to like to address one think at a time as you said.
Thanks again.

 

[lexer]

Your total T of 589 and free T of 15.8 are awesome. E is a tad high but not bad. Under 30 is optimal but 34 isnt bad.
you are doing 85 mgs every 6 days with these numbers?
how old are you?
you could try 40 mgs every tuesday and friday. Thats easy to do. Every 6 days can be confusing.

 

[charile12]

Am 41. 34 is on day of injection so am sure it peaked higher. Thus my ED and bloat on some days

 

[Systemlord]

Your T and E2 will be fluctuating for the next 4-6 weeks so don't worry too much about how you feel, there have been times where I feel E2 might be high on some days as I'm still 3 weeks away from stable T and E2 levels.

 

[charile12]

So I went to a urologist who was responding to many trt questions in a Dr forum at excelmale.
So he added HCG.
This is the protocol he wants.
Friday - 250 HCG
Sat - 250 HCG
Sun - 100mg T
Mon - .5 arimidex

Thougths?

 

[Vince]

So I went to a urologist who was responding to many trt questions in a Dr forum at excelmale.
So he added HCG.
This is the protocol he wants.
Friday - 250 HCG
Sat - 250 HCG
Sun - 100mg T
Mon - .5 arimidex

Thougths?

I wouldn't add arimidex especially at that dose until you have labs and symptoms that require it.

 

[CSI007]

Your E2 is really not that high. Did your ED issues begin when you started T or was the TRT for ED treatment. There is a sweet spot for erections on TRT. I am personally still trying to find that sweet spot.

As others have said, increase frequency of injections...Don't be afraid to go EOD or ED if twice a week does not work out for you. I started on about 50mg twice a week and it helped but not nearly as much as s when I switched to EOD.

 

[charile12]

I did some research and the protocol given to me is the same as dr. crisler http://defymedical.com/resources/health-articles/242-an-update-to-the-crisler-hcg-protocol
Its worth to try it. I rather split up the 100 but then the thinking behind the protocol jusy given to me is shot. I would have to figure out when to take HCG.

I started trt because of secondary hypogonadism. I had low readings of T. My lab chart is in this thread. And part of symptoms I had was ED.
SO your right finding that sweet spot is a pain in the butt. I was hitting the sweet spot only 1-2 days in a week. So you have guys lowering their dose, doing more frequent, but all you may need is a very low dose arimidex if your e2 is confirmed high in labs. When I took my lab on day of injection my e2 sensitive was 34. From what i read should be in 20s. It might just be easier for us guys to just take daily cialis or viagra when needed instead of going nuts with this sweet spot.
Viagra works great for me, just hate that I dont know when I need or I have to take before sex. Thinking of taking daily cialis so I am ready all the time and dont have to worry about if am getting hard and maintain.

Dr. added arimidex to protocol because I made a point that e2 was 34 on trough day. He plans on using it temporarily. So my goal is if I feel good, labs are good (regardless of erection because I will take cialis unless I have evidence that I will achieve an erection anytime).
I am always open to feedback if anyone else has some.
Vince thank you for your reply.

 

[charile12]

Vince looks like the protocol given to me was recommended by Dr Crisler in 2004. Is it still good? Many are telling me to split the 100 mg to 2x a week.

 

[CSI007]

My honest opinion, though you didn't ask for it (and I am not a doctor). Our natural production of T in our bodies is released in a rather consistent and frequent pattern. We don't have huge spikes up and then down through the week. When we inject more frequently we get closer to the natural T values through the week. I can only speak for myself but when I switched from twice a week to EOD I felt better, much better.

At the moment I may have to reevaluate my protocol since I have added metformin to the mix. I think its seriously affecting my T and E2 values. I will have to retest again soon to see if I have to increase my injections from 100mg per week to something higher.

Good luck to you!

 

[at15]

Vince looks like the protocol given to me was recommended by Dr Crisler in 2004. Is it still good? Many are telling me to split the 100 mg to 2x a week.

it varies patient to patient but i believe for the most part crisler now starts his injection people with 50 mg cypionate 2x/week and 100 iu hcg daily. anastrozole only added if necessary, most dont need it.

crisler himself personally? he uses 70 mg cypionate 2x/week subq. 0.5 mg anastrozole with each shot. 150 iu hcg daily. dhea twice daily.

 

[Vince]

Vince looks like the protocol given to me was recommended by Dr Crisler in 2004. Is it still good? Many are telling me to split the 100 mg to 2x a week.

I would split the dose, keep the spike of testosterone in better control. It should help you feel better without the lows and highs of T levels.