Eight Weeks on TRT - Feeling No Better

[Libra88]

Hello Excelmale family,

I have my 8 week bloodwork results in this link

https://www.dropbox.com/s/1fmavjkr2pdi1aw/MIRZADA, JAMAL SYED LAB RESULTS 4.11.17.pdf?dl=0

I am trying to find out why there has been absolutely no change as far as getting better and was trying to see if you all had any input. I know 2 months on TRT is not that long, but I am just curious as to why I don't feel any better since starting back in Feb. Thanks in advance!

Jamal

 

[Vince]

You may want to read up on prolactin.
https://www.excelmale.com/forum/sho...hould-Men-with-Erectile-Dysfunction-Be-Tested

 

[lowe2sucks]

your e2 is pretty low.. for me if e2 is low enough I lose the mental benefits of testosterone, you might want to raise it atleast to 20 pg/ml

 

[johndoesmith]

E2 is way too low. Everything else looks great.

I assume these were taken at trough?

 

[Sean Mosher]

May or may not feel better with a higher Total T (that's something to look at).
Prolactin to high and estradiol WAY too low.....

What's your current protocol look like?

 

[CoastWatcher]

Your prolactin is high, slightly over 40. Where did it sit prior to the start of TRT?

 

[Libra88]

Protocol:

70mg Test cyp 2x aweek
HCG 400IU 2x a week
anastrozole .125 3x a week

I also take cabergoline .5mg 2x a week

I spoke with Dr. Saya in this forum and he told me to lower the AI to 2x a week, but also told me because my SHBG is in the lower range of normal that more of the free estradoil can be used in the body, so my estradoil technically isn't REALLY low. He also uptitrated my cabergoline dose to help lower the prolactin. I updated my protocol a week ago, but still have no energy, motivaton, ED, low libido, etc,...literally all symptoms of low T.

 

[Libra88]

my prolactin was at 20, so with my initial consult Dr. Saya had me up my dose of cabergoline and now its at 40, so he told me to updose it again.

 

[Vince]

Sounds like you're​ having some issues getting dialed in, hitting that sweet stop. Stick with Dr Says protocols and hopefully it will get better.

 

[CoastWatcher]

You've every reason to believe you'll end up finding success.

 

[Dr Justin Saya MD]

The prolactin and E2 (though taking into consideration the free E2 as we discussed prior) are both likely contributors. Would be interesting and informative to add the free estradiol test to your next labs, unfortunately is a very expensive test (~$100), which is why I don't utilize it as much as I would like.

 

[Libra88]

The prolactin and E2 (though taking into consideration the free E2 as we discussed prior) are both likely contributors. Would be interesting and informative to add the free estradiol test to your next labs, unfortunately is a very expensive test (~$100), which is why I don't utilize it as much as I would like.

Dr. Saya, whatever test I need done to make me feel better I am willing to take. I am just tired of living life the way that I am. I've been dealing with low T for over 10 years and now I am 28. Your next avaliable appointment is May 30th, I have an apoinment on May 10th with one of your doctors. I was wondering if I can talk to you for my appointnent on May 10th because I have a unique case if possible. I would really appreciate it.

 

[Will Brink]

Protocol:

70mg Test cyp 2x aweek
HCG 400IU 2x a week
anastrozole .125 3x a week

I also take cabergoline .5mg 2x a week

I spoke with Dr. Saya in this forum and he told me to lower the AI to 2x a week, but also told me because my SHBG is in the lower range of normal that more of the free estradoil can be used in the body, so my estradoil technically isn't REALLY low. He also uptitrated my cabergoline dose to help lower the prolactin. I updated my protocol a week ago, but still have no energy, motivaton, ED, low libido, etc,...literally all symptoms of low T.

That's what I was going to suggest, so looks like a change that may help.

 

[Dr Justin Saya MD]

Dr. Saya, whatever test I need done to make me feel better I am willing to take. I am just tired of living life the way that I am. I've been dealing with low T for over 10 years and now I am 28. Your next avaliable appointment is May 30th, I have an apoinment on May 10th with one of your doctors. I was wondering if I can talk to you for my appointnent on May 10th because I have a unique case if possible. I would really appreciate it.

Unfortunately that would require moving another patient out of their appt slot.

The changes that we recently discussed over the forum (with cabergoline for prolactin and downward adjustment in anastrozole) need time to impact (thus waiting actually would be ideal for this reason). The providers under me are trained well and often review complex case questions with me.

 

[ERO]

I am curious about the free estradiol test. Specifically, what part of the protocol would be changed based upon the results. Please keep us in the loop going forward!

 

[CoastWatcher]

I am curious about the free estradiol test. Specifically, what part of the protocol would be changed based upon the results. Please keep us in the loop going forward!

https://www.excelmale.com/forum/sho...on-of-Free-Estradiol&highlight=Free+estradiol

ERO - Read down the thread for some comments on free estradiol that you might find interesting.

 

[ERO]

https://www.excelmale.com/forum/sho...on-of-Free-Estradiol&highlight=Free+estradiol

ERO - Read down the thread for some comments on free estradiol that you might find interesting.

Coastwatcher - thank you for the link!

 

[Dr Justin Saya MD]

I am curious about the free estradiol test. Specifically, what part of the protocol would be changed based upon the results. Please keep us in the loop going forward!

What is believed to be low (total) estradiol may occasionally turn out to not be low at all or even high (free estradiol).

 

[Libra88]

Ok that is fine, I also hope that I can raise my Testosterone/HCG dose so that I can achieve the highest optimal Testosterone levels. I plan on becoming a personal trainer or something to do with fitness and know how important Testoterone is. Will the doctor allow me to have a higher Test level as long as I keep track of my hemocrit levels, PSA, etc.? Thanks again for the replies!

 

[Libra88]

I also forgot to mention, now that I am doing the anastrozole twice a week, is there a certain time I'm supposed to do it? Also I am wondering why my LH/FSH was not tested just to see how the HCG is working in my body?