Eight Weeks into My Protocol - Feeling No Better

[Lonestar71]

eight weeks into TRT and I have felt no change whatsoever.....

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Patient Details Specimen Details Physician Details

DOB: 12/18/1971 Date collected: 05/10/2017 0858 Local Ordering: R MCCLAIN

Age(y/m/d): 045/04/22 Date received: 05/10/2017 Referring:

Gender: M SSN: Date entered: 05/10/2017

Patient ID: DL 4771 Date reported: 05/17/2017 1807 ET NPI: 1487804308







Ordered Items

CBC With Differential/Platelet; Comp. Metabolic Panel (14); Lipid Panel w/ Chol/HDL Ratio; Testosterone, Free+Total LC/MS;

Dihydrotestosterone; Estradiol, Sensitive; Sex Horm Binding Glob, Serum; Venipuncture



TESTS RESULT FLAG UNITS REFERENCE INTERVAL LAB

CBC With Differential/Platelet

WBC 9.0 x10E3/uL 3.4 - 10.8 01

RBC 5.15 x10E6/uL 4.14 - 5.80 01

Hemoglobin 17.3 g/dL 12.6 - 17.7 01

Hematocrit 51.2 High % 37.5 - 51.0 01

MCV 99 High fL 79 - 97 01

MCH 33.6 High pg 26.6 - 33.0 01

MCHC 33.8 g/dL 31.5 - 35.7 01

RDW 13.6 % 12.3 - 15.4 01

Platelets 256 x10E3/uL 150 - 379 01

Neutrophils 67 % 01

Lymphs 19 % 01

Monocytes 9 % 01

Eos 5 % 01

Basos 0 % 01

Neutrophils (Absolute) 6.0 x10E3/uL 1.4 - 7.0 01

Lymphs (Absolute) 1.7 x10E3/uL 0.7 - 3.1 01

Monocytes(Absolute) 0.8 x10E3/uL 0.1 - 0.9 01

Eos (Absolute) 0.4 x10E3/uL 0.0 - 0.4 01

Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 01

Immature Granulocytes 0 % 01

Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1 01



Comp. Metabolic Panel (14)

Glucose, Serum 83 mg/dL 65 - 99 01

BUN 10 mg/dL 6 - 24 01

Creatinine, Serum 0.92 mg/dL 0.76 - 1.27 01

eGFR If NonAfricn Am 100 mL/min/1.73 >59



Date Issued: 05/18/17 1017 ET FINAL REPORT Page 1 of 3




Patient Report



Specimen ID: 130-363-1055-0

Control ID: B0059171001 Date collected: 05/10/2017 0858 Local



TESTS RESULT FLAG UNITS REFERENCE INTERVAL LAB

eGFR If Africn Am 116 mL/min/1.73 >59

BUN/Creatinine Ratio 11 9 - 20

Sodium, Serum 139 mmol/L 134 - 144 01

Potassium, Serum 4.6 mmol/L 3.5 - 5.2 01

Chloride, Serum 102 mmol/L 96 - 106 01

Carbon Dioxide, Total 23 mmol/L 18 - 29 01

Calcium, Serum 8.9 mg/dL 8.7 - 10.2 01

Protein, Total, Serum 6.3 g/dL 6.0 - 8.5 01

Albumin, Serum 4.1 g/dL 3.5 - 5.5 01

Globulin, Total 2.2 g/dL 1.5 - 4.5

A/G Ratio 1.9 1.2 - 2.2

Bilirubin, Total 0.5 mg/dL 0.0 - 1.2 01

Alkaline Phosphatase, S 60 IU/L 39 - 117 01

AST (SGOT) 18 IU/L 0 - 40 01

ALT (SGPT) 25 IU/L 0 - 44 01



Lipid Panel w/ Chol/HDL Ratio

Cholesterol, Total 183 mg/dL 100 - 199 01

Triglycerides 100 mg/dL 0 - 149 01

HDL Cholesterol 37 Low mg/dL >39 01

VLDL Cholesterol Cal 20 mg/dL 5 - 40

LDL Cholesterol Calc 126 High mg/dL 0 - 99

T. Chol/HDL Ratio 4.9 ratio units 0.0 - 5.0



Please Note: 01

T. Chol/HDL Ratio

Men Women

1/2 Avg.Risk 3.4 3.3

Avg.Risk 5.0 4.4

2X Avg.Risk 9.6 7.1

3X Avg.Risk 23.4 11.0



Testosterone, Free+Total LC/MS

Testosterone, Total, LC/MS 962.0 ng/dL 348.0 - 1197.0 02

Adult male reference interval is based on a population of lean males

up to 40 years old.

Disclaimer: 02

This test was developed and its performance characteristics

determined by LabCorp. It has not been cleared or approved

by the Food and Drug Administration.

Free Testosterone(Direct) 27.5 High pg/mL 6.8 - 21.5 02



Dihydrotestosterone 69 ng/dL 03

Reference Range:

Adult Male: 30 - 85



Estradiol, Sensitive 40.5 High pg/mL 8.0 - 35.0 02



Date Issued: 05/18/17 1017 ET FINAL REPORT Page 2 of 3





Sex Horm Binding Glob, Serum 18.5 nmol/L 16.5 - 55.9 01



01 HD LabCorp Houston Dir: Kyle Eskue, MD

7207 North Gessner, Houston, TX 77040-3143

02 BN LabCorp Burlington Dir: William F Han****, MD

1447 York Court, Burlington, NC 27215-3361

03 ES Esoterix Endocrinology Dir: Samuel Pepkowitz, MD

4301 Lost Hills Road, Calabasas Hills, CA 91301-5358

For inquiries, the physician may contact Branch: 800-877-5227 Lab: 713-856-8288



Date Issued: 05/18/17 1017 ET FINAL REPORT Page 3 of 3

 

[Lonestar71]

My current protocol:


Testosterone 200mg/mL
- Injecting 1mL weekly
HCG: Injectable
- 0.5mL twice weekly

 

[sportsfan8724]

Is Dr McClain ur doctor ? I thought he uses ai with everyone.

 

[madman]

My current protocol:


Testosterone 200mg/mL
- Injecting 1mL weekly
HCG: Injectable
- 0.5mL twice weekly

200mg/week is a high dose to start trt. Your shbg is low you may need to look into injecting more frequently with lower doses as oppose to the once weekly. Your e2 is high from the hefty 200mg once weekly injection. Your hemoglobin/hematocrit are in the top end of range, need to keep an eye on and your lipids need to be improved low hdl/high ldl. I would think about lowering weekly test dosage slightly.

 

[Lonestar71]

Thanks for the input Madman.....Any comments how TRT has done nothing for me? I feel the same as the day I started and my libido is still MIA? :/

 

[Lonestar71]

No AI yet.....

 

[sportsfan8724]

Splitting the 200 into 100 mg twice a week might be enough to lower e2 some since it's not that high. I'd do that and see how you feel in a few more weeks. So McClain is ur doctor?

 

[Vince]

Low SHBG guys seem to do better on more frequent injections, some even inject daily.

 

[Lonestar71]

So Dr. Mcllhenny changed up my protocol to the following:
Testosterone: 200mg/mL- 1 mL weekly ( 0.5mg x2 )
Anastrozole: 0.25mg- 1 capsule weekly.
HCG: 500IU x3 weekly

Would someone please offer some insight/personal findings on the Anastrozole? As I said, I'm not feeling any different than the day I started TRT. As always, thank you.

 

[ERO]

Thanks for the input Madman.....Any comments how TRT has done nothing for me? I feel the same as the day I started and my libido is still MIA? :/

Having low SHBG makes it difficult to "feel" any benefit from TRT. Not impossible, but difficult...in my case I am finally feeling a weak libido after 5+ years on TRT - but that is compared to ZERO for the first 5 years.

What has (sort of) worked for me: Small daily T injections combined with one click of T Gel applied to the scrotum daily to raise DHT.

 

[Lonestar71]

I've been reading up on Anastrazole. Just NOW got my shipment in (a week late) from Prime Body. I'm losing hope in them.......
I'm supposed to be taking .25MG every seven days. Has anyone on AI lost their libido/erections? Appears this is a common side effect. I don't want to take anything that will drop it further down the toilet. I don't have one as it is now?

Thanks guys!

 

[CoastWatcher]

I've been reading up on Anastrazole. Just NOW got my shipment in (a week late) from Prime Body. I'm losing hope in them.......
I'm supposed to be taking .25MG every seven days. Has anyone on AI lost their libido/erections? Appears this is a common side effect. I don't want to take anything that will drop it further down the toilet. I don't have one as it is now?

Thanks guys!

It is very easy for an AI to lower estradiol levels dramatically. That can result in erectile issues and loss of libido. However, your prescribed dose is a modest one, not a blockbuster by any means. My doctor, typically, prefers to wait and see if splitting the dose manages to deal with estradiol levels without turning to an AI. In fact, with a split dose, it's not unusual for a patient to need less total testosterone in order to maintain solid levels. For example, lower the amount injected to 80mg every 3.5 days and see where things stand in four to six weeks. Her philosophy is simple: the fewer elements in a protocol the better.

Nonetheless, your prescribed AI is a reasonable dose. You should see an adjustment in your e2.

 

[Lonestar71]

Thanks CW- That's what i was planning.....wait 4 more weeks with the split T dose and increased HCG to 3x a week and have another panel draw. Then decide on the AI? Or should I just follow the Prime Body directive?

Thanks again.

 

[madman]

Thanks CW- That's what i was planning.....wait 4 more weeks with the split T dose and increased HCG to 3x a week and have another panel draw. Then decide on the AI? Or should I just follow the Prime Body directive?

Thanks again.

I am with CW on this lower your dose to 80mg every 3.5 days by splitting twice weekly you should still be able to hit a fairly high tt with a lower dose which may improve e2,hematocrit/hemoglobin, lipids.