Doctor seems to be giving me some bad info

[Thomas1212]

I have switched doctors recently do to a move and seems I will have to continue looking for a competent doctor but wanted to check with the forum to ensure I am accurate in my thinking. Just got back from the visit and don't know what to think about her advice.

First, I recently lowered my dose based on her request from 16mg daily to 14mg daily. I tried it for 3 months and felt horrible. Even after telling her that 98mg made me feel horrible she recommenced a new dose of 30mg 3 times a week while also taking Tribulus.

Her thoughts were

1 - Changing my dose from daily to 3 times a week would increase my LH back to normal levels, currently <0.2 L which is what I believe anyone on TRT will be at. Claims she has had patients using TRT once, twice or three times a week with normal LH levels. Is this possible?

2 - Even though I felt horrible ( night sweets, low energy, poor libidio) on 98mg a week, she claims lowering my dose to 90mg and start to take Tribulus that I would feel much better do to the affects of Tribulus. This seems hard to believe and not supported by any scientific studies that I have found.

3 - Prior to TRT my total Cholesterol was 169. While taking 16mg daily it was high up to 217 and dropped down to 206 while on the lower dose of 14mg daily. She believes lower doses of TRT will continue to lower my cholesterol. my LDL and Non HDL Cholesterol are also high and slightly out of range. High cholesterol is a concern for me as I am only 33 and a little alarmed by this recent change.

4 - She is concerned about high Dihydrotestosterone with my current levels of 90 (range 12-65 ng/dL)

5 - She is also concerned about Estradiol being out of range but I have read enough about that to no be concerned as I have had no symptoms.

The things she has told me aren't adding up but I wanted to get the collective knowledge of this forum to bring some peace of mind to me and my wife to ensure we make the right decisions going forward. Thank you in advance.

 

[Golfboy307]

Can you post your labs so we can see what you are referencing?

 

[Cataceous]

1. Possible to have non-negligible LH and FSH on TRT, but rare. The vast majority will find these hormones suppressed at all but the very lowest TRT doses.

3-5. Not unreasonable concerns, but you do need to consider how you feel.

There is potentially a way to placate both sides in conflicts like this, but it is hypothetical and largely untested. The hypothesis is that some of the good stuff from TRT is related to peak serum testosterone, as long as it's in normal physiological limits, while maybe the bad stuff is tied more to average testosterone levels. The implementation in a case like yours would be to switch to daily injections of an ester blend that provides the same peak serum testosterone you had with 16 mg T cypionate daily, but with less testosterone given overall. For example, a daily blend of 7 mg T cypionate and 5 mg T propionate cuts testosterone by 19% while likely giving a daily peak that is at least as high as when on T cypionate alone.

I've been experimenting with such a protocol that involves a 23% reduction in injected testosterone. Overall the new protocol is better. The subjective experience is improved, though subtly. Lipids improved, and estradiol declined some. Athleticism did take a small hit; in my sport of cycling I am riding about 5% slower than at the higher dose. But the tradeoff is worthwhile.

The argument to make to any doctor potentially overseeing such a treatment is that the results more closely mimic what happens in natural men. Risks in such a protocol should be comparable to those associated with taking higher doses of a single ester. It's mainly the time and effort that's at risk if no benefits are seen.

 

[Thomas1212]

Labs taken 4/2020 on 16mg daily

 

[Thomas1212]

Labs taken on 6/2020 8 weeks on lower dose of 14mg daily

 

[Thomas1212]

Labs taken 7/2020 8 weeks on 14mg daily.