First test results after starting trt

[Everydaystruggle]

First test results after starting trt, not feeling to great.

I’ve been on trt for a little over 2 months and just got my blood work back. These are the things that showed high or things I’m not sure about level wise. I’m currently with Dr. Saya and Defy Medical. I’m on 132mg of testosterone split into 3 separate dosages on m/w/f, along with 200iu of hcg on the same days. 30mg of dhea nightly, 100mg of 5htp nightly, 5000iu of vit d3 nightly. I do feel better but not great by any means. A couple days I have felt really good but the majority of the days I don’t feel to swell, still very low energy, I feel like my blood sugar crashes a lot through the day which I felt before trt. I’m currenrly waiting to get my 4 point cortisol test back which I think might be the reason I’m feeling that way. At first I was able to get erections easier but now it’s hard for me to get them again. My sex drive has not increased at all. I’m still unable to keep an erection for very long at all. I have been very hot and sweaty which I think might be due to my high hematocrit. I’m donating blood today. My constant adrenaline feeling haven’t changed. I’m still not sleeping well at all. I’ve never had issues sleeping in the past, in fact I could go to sleep any time of the day and pretty much sleep all day and all night.and then one day my body just decided not to want to sleep. My body just can’t calm down. The only way I can describe it is to much adrenaline. Melatonin does not work. I have no trouble at all falling asleep, it’s staying asleep. I think my trt dose might to be lowered a bit maybe? I’m thinking maybe checking my thyroid might be a good idea along with my prolactin. I have myconsult with Dr. Saya on November 14th. My diet is good, I have been able to get back in the gym which is a plus but I’m a lot of times during my work out I feel like my sugar tanks (possibly coristol again?) despite having protein carbs and fats. And then some days it doesn’t happen. Or like yesterday at the gym I felt amazing and by the time I got home I’m drained, very flush, hot and sweaty and physically drained. Even before trt my resting heart rate has been 90bpm. This is even checking as soon as I wake up, which I have noticed that adrenaline feeling is usually at its worst. My blood pressure has been good. I know it’s a trial and error process but if there’s anything else anyone can think of to ask Dr. Saya about i would greatly appreciate it. Also do you guys thing pregnalone could benefit me at all?

 

[CoastWatcher]

First of all, eight weeks of therapy in this game is just a good, first step. Please remember it's a marathon you're running and not a sprint. As you're possibly discovering, hypogonadism isn't always neatly and easily fixed by elevating one's total testosterone...which is very frustrating, I know.

Your dose of testosterone might well be lowered a bit, though in this game nothing is by any means linear. You could see a lower total testosterone value and you *might* see your estradiol slip down a bit. That, possibly (how possible I couldn't say), might impact some of the negative symptoms you report - the night sweats.

If you've not looked at thyroid and prolactin, and Defy is as good as any clinic at ordering the right labs, by all means do so. Thyroid is critical to bring onside; it can undermine all your other efforts. The cortisol results could shed a lot of light on the issue as well.

You reference blood sugar fluctuations. Do you have glucose and A1c results?

Finally, libido and erections can typically be the last elements to sort themselves out. I'd say the majority of members here rely on Cialis or one of its cousins to support erectile function.

 

[Everydaystruggle]

I had an a1c test about a year ago and it was negative. Although I feel like I remeber reading something where that testosterone can skew the results. And for the sweating, it’s throughout the whole day. I was thinking about trying some Cialis actually. About a month in I was having morning errections but have sense gone away. No spontaneous errections or urge to have sex either. But like you said I have come to realize that’s it’s a marathon and not a sprint. I was just hoping I would get lucky and feel a little better then what I do with my testosterone being significantly higher along with my free t being higher. My igf1 before trt were low and those have raised, my dhea was low before trt and hat has raised as well. So that’s a plus. Thank you for your reply. I’m hoping Dr. Saya can shed some light on things on my next consult.

 

[FeelingLost]

Wow those numbers aren't bad for their first attempt. Mine wasn't so good. TT300 after 6 weeks under their care.

Donate blood and drop your T dose is what I will guess they recommend. That should bring your E2 down.

I would not supplement pregnalone unless you tested low on your blood test. Same for DHEA these are not Vitamins.

Remember getting your harmones optimized is just the start of your journey. Good exersize, stress reduction, sleep, lipids, blood pressure and nutrition all play a role.

 

[CoastWatcher]

I've no doubt that Dr. Saya will respond to all your questions, but I always try and rember that too many protocol changes at one time, drop this a bit/raise that slightly/discontinue this at once/start this now, can lead to uncertainty as to which change is the impactful one. As FeelingLost said, none of what you're considering is akin to a vitamin supplement.

 

[Saul]

I know very little, but my only comment is to lower your T dose. I am at 85 mg per week and last BW put me at 671. My E2 is also 40. I feel good all around. I am of the opinion that more is not always better. IMO most people don't walk around, even when young, with T levels over 1100. It works for some and I have not been that high so perhaps I don't know what I am missing out on. Maybe my expectations are not too high. Also, the last thing to improve for me was libido and sex stuff and it is still not perfect but better than before, so that takes time, even after about 6 months it is still getting better slowly. T is not always the solution for ED or libido issues. Good luck. Finally, I agree with FeelingLost, for me, T helped me exercise and eat better and these elements are vital to feeling better.

 

[Weasel]

I had an a1c test about a year ago and it was negative. Although I feel like I remeber reading something where that testosterone can skew the results. And for the sweating, it's throughout the whole day. I was thinking about trying some Cialis actually. About a month in I was having morning errections but have sense gone away. No spontaneous errections or urge to have sex either. But like you said I have come to realize that's it's a marathon and not a sprint. I was just hoping I would get lucky and feel a little better then what I do with my testosterone being significantly higher along with my free t being higher. My igf1 before trt were low and those have raised, my dhea was low before trt and hat has raised as well. So that's a plus. Thank you for your reply. I'm hoping Dr. Saya can shed some light on things on my next consult.

A1C is not a positive or negative, its an actual number.

 

[Virginian]

Having a total T of 1178 using only 132 mg/week shows that you respond strongly to T. Many TRT users think they feel better at about 800 than at higher T levels. On the other hand, I keep my T at about 1000 - 1200 (low point just before next injection) and I like the benefits that I get and do not have any adverse effects that I am aware of. You will have to find out what works best for you.

Your hematocrit is too high. Some people produce too many red blood cells with high T levels, but others don't. You do. You will have to reduce your T dose or donate blood or both.

Your estradiol at 40 is high. That may be reducing your ability to have a good erection.

Your blood sugar and occasional lack of energy could have some other cause. To my knowledge, that is not a common effect of high T levels.

Some people report sleep problems with high T, but most don't. Could be too much T or could have a completely different cause.

A resting heart rate of 90 bpm is too high and not healthy. That's worth looking into.

You did not post any cholesterol levels. Those are very important as well.

You have a lot of work to do to get yourself healthy. Listen to the doctor and listen carefully. And, by the way, how old are you?

 

[Everydaystruggle]

Thank you all for the advice. It’s greatly appreciated. I’m 29 years old. 165lbs. Eat fairly clean, lift weights on days that I feel good enough to go to the gym also. As far as sleeping, I’ve been having issues before trt. I used to have zero problems sleeping and in fact slept to much. Now with this adrenaline feeling, that is what has been keeping me from sleeping. I’m glad I respond well t testosterone. Honestly I think it’s becssuue it’s split into 3 separate dosages. I just went and tried to donate blood and they said my hematocrit was to high. It was 56. The cut off is 55. So I ordered a therapeutic phlebotomy. Which I will still be to high even after donating. The reason I brought up pregnalone was because it was the master hormone and after reading about it, it sounded like many men do well with if. But I’m leaving everything up to Dr. Saya. Just trying to cover my bases for my next consult and see if there’s anything I should mention other then what I brought up. I don’t see my hdl or ldl on my results. Shouldn’t the CBC have that?

 

[user_joe]

You've got a dr that knows what he's doing obviously so I wouldn't change anything without him on board.

Theres nothing alarming in those results. I'd keep a tight eye on e2 and a diary of symptoms days to day. Test as often as the doc will provide orders. That number is probably not settled where it will stay yet and is most likely to effect the symptoms you mention.

Give blood, but understand that may not be needed in the future. It tends to settle down.

I think changing the T dose is crazy. More variables. That number is reasonable so see if you can get dialed in. Change the dose and set yourself back another 6-8 weeks.

Id do this and try to be patient.

 

[Everydaystruggle]

Oh no I'm not changing one thing without having him telling me to. I am donating blood though as of right now due to specifically stating on Defy website that they suggest donating blood if you levels are about 52. Mine today were at 56. I'm letting him making all the judgment calls. I'm just more or less looking for things to bring up to him that could help me or that I haven't thought of.

 

[Murderface]

I use Testopel. On my first implant, my doc put 22 75mg pellets in me... SAY WHAT??

1 month in, my free T was 1492, E2 30, everything else low normal.
Had my two month BT done, free T was 800, E2 13, everything else normal.
Coming up on 3 months, so going in next week for more pellets. Have him bring it down to 15. I feel best
when my free T around 1000, E2 around 25.

 

[lexer]

Personally, i think your T levels are a bit too high. I would try getting into the 700 -800 range. That may get estradiol to the low 30's and reduce your hematocrit.
Your dht isnt too affected by high T which is good. That may have something to do with using pellets opposed to injections or gels. Usually having T levels over 1000 will put DHT well over 100.
Although, as you age, more T is converted to DHT.

 

[Everydaystruggle]

I’ve very anxious to get my cortisol test results back. This feel of a CONSTANT adrenaline feeling is really getting to me and it’s such an uneasy feeling and is keeping me from sleeping. This was way before trt also. I have had anxiety all my life but this more like an adrenaline rush that never ends. I can feel each and every heart beat as well. And my anxiety always had triggers. Plus anxiety is normal part of life. This constant feeling I’m getting I know is not normal. I’m very anxious to see what Dr. Saya has to say about it and if the cortisol comes back fine if maybe it could be a thyroid problem? Not really sure at this point.

 

[Deleted member 16042]

Yes, Thyroid could be a player... pretty classic signs of hyperthyroid.

Whole body: excess sweating, excessive hunger, fatigue, heat intolerance, or restlessness
Mood: mood swings, nervousness, or panic attack
Heart: abnormal heart rhythm, fast heart rate, or palpitations
Sleep: difficulty falling asleep or insomnia
Menstrual: irregular menstruation or short and light menstruation
Behavioral: hyperactivity or irritability
Eyes: abnormal protrusion of eyes or puffy eyes
Also common: weight loss, diarrhea, hair loss, muscle weakness, tremor, or warm skin

 

[Murderface]

Personally, i think your T levels are a bit too high. I would try getting into the 700 -800 range. That may get estradiol to the low 30's and reduce your hematocrit.
Your dht isnt too affected by high T which is good. That may have something to do with using pellets opposed to injections or gels. Usually having T levels over 1000 will put DHT well over 100.
Although, as you age, more T is converted to DHT.

hemocrit was never an issue, normal for me at T at 1400.
my PSA actually dropped a bit at 1400 (1.6)
No signs that my DHT levels are high. Honestly, I think I feel best at 1000 - 1100, my E2 was around 30 at this level.
Doc isn’t too concerned, it drops fast with the Testopel. It’s also biologically identical Test.

 

[Murderface]

I've very anxious to get my cortisol test results back. This feel of a CONSTANT adrenaline feeling is really getting to me and it's such an uneasy feeling and is keeping me from sleeping. This was way before trt also. I have had anxiety all my life but this more like an adrenaline rush that never ends. I can feel each and every heart beat as well. And my anxiety always had triggers. Plus anxiety is normal part of life. This constant feeling I'm getting I know is not normal. I'm very anxious to see what Dr. Saya has to say about it and if the cortisol comes back fine if maybe it could be a thyroid problem? Not really sure at this point.

Dude I had same issue for years! Even without TRT.
listen to me. Tell him to prescribe you low dose of Trintellix. It's an SSNRI, but 4 weeks in, it has completely eradicated my anxiety. Gone. You can also try a beta blocker, I tried Propranolol, but it made shit like crazy.
im telling you try the Trintellix, low sexual effects, start at 5mg, titrate up 10mg at 3 weeks I feel great! Been on it 2 months, with TRT I've never felt and looked better in my whole damn life!

 

[lexer]

Murderface
how old are you?
Any hair loss issues?
enlarged prostate? More Frequent urination, weaker urine stream?

 

[Murderface]

Murderface
how old are you?
Any hair loss issues?
enlarged prostate? More Frequent urination, weaker urine stream?

Im 52, full head of hair, actually seems to be getting THICKER. Hair is genetically programmed to fall out or not fall out, irrelavant of DHT levels. High DHT will accelerate hair loss for genetically predisposed follicles. Guess I got lucky, my old man was bald at 40. My Johnson also seems to be getting longer. No ball shrinkage.
No urination issues. Same as before I got on TRT, I don't get up to pee at night, never have. PSA low normal.
only thing I've noticed is I wake up at night a few times, sometimes sweaty.
get my blood tested every month, cholesterol slightly elevated, but all other liver function normal, hemo low normal.

 

[Everydaystruggle]

Dude I had same issue for years! Even without TRT.
listen to me. Tell him to prescribe you low dose of Trintellix. It’s an SSNRI, but 4 weeks in, it has completely eradicated my anxiety. Gone. You can also try a beta blocker, I tried Propranolol, but it made shit like crazy.
im telling you try the Trintellix, low sexual effects, start at 5mg, titrate up 10mg at 3 weeks I feel great! Been on it 2 months, with TRT I’ve never felt and looked better in my whole damn life!

I don’t need see trintellix on Defy’s store.