Gyno Symptoms - Am I Just Being Paranoid?

[johnt]

I started TRT for first time 3 days ago (Wednesday). Doc gave me .25 of an AI to take 1x per week starting three days after first injection which was today (Saturday). It has been on my mind that I need to take my AI ever since I got the injection.

I awoke today with a sort of pulling feeling (hard to describe) in nipple area on left chest, its not a constant feeling and not sensitive to touch. I did do a chest workout at the gym yesterday. Its not a sore feeling like after working out. I wonder if I am just being paranoid about gyno and being more aware of things and making them amplified.

Is it even possible to have gyno symptoms within three days?

Keep in mind prior to starting TRT my estradiol was <5.0 on regular test and 11 on the Sensitive Test.

 

[johndoesmith]

I started TRT for first time 3 days ago (Wednesday). Doc gave me .25 of an AI to take 1x per week starting three days after first injection which was today (Saturday). It has been on my mind that I need to take my AI ever since I got the injection.

I awoke today with a sort of pulling feeling (hard to describe) in nipple area on left chest, its not a constant feeling and not sensitive to touch. I did do a chest workout at the gym yesterday. Its not a sore feeling like after working out. I wonder if I am just being paranoid about gyno and being more aware of things and making them amplified.

Is it even possible to have gyno symptoms within three days?

Keep in mind prior to starting TRT my estradiol was <5.0 on regular test and 11 on the Sensitive Test.

Please do not take automatic AI. There is much misery to be had down that path.

That being said, you did not develop gyno in 3 days. That's not how it works.

Post the rest of your labs, but most likely, you do not need AI, and AI is only when you actually have high E2 documented with labs and symptoms.

You do not.

 

[Vettester Chris]

Your E2 is on the low end, it is normal to see receptor sensitivity when E2 starts climbing back up as a direct result of downstream conversion from testosterone.

Once upon a time, my entire E2 was tanked, and the estrogen rebound was everything you're dealing with (and some). I was able to mitigate a lot of that with a small, small amount of Tamox, but in your case it should pass and stabilize fairly quick.

Agree with JDS, I wouldn't mess with any AI at this time. You probably want to get yourself into the low/mid 20's, then refine it from there. Do yourself a favor, spread your injections out 2x per week and your overall program will be much more stable and consistent. BTW, how much total mg per week are you prescribed for?

Your physician should be running follow up labs in 6 weeks (?). Please post your baseline labs when you can, and post your follow ups on this same thread. And please, post everything, not just the ones you think need discussed

 

[CoastWatcher]

Patience is the key to success on a TRT protocol. The advice you received from johndoesmith and Chris was right on the mark. As Chris noted, you should be getting labs in some weeks - was he right?

 

[lowe2sucks]

funny things even with my e2 low i had some days when it looked like i have gyno.. but when it went higher (e2) problem dissapeared.. my chest started to look good again

 

[johnt]

Thanks for all the responses. You put my paranoid mind at ease. Here are my Pre-TRT labs. Doc prescribed 200mg T-Cyp one time per week. I asked about doing multiple injections and he said preferred I start off with one for several weeks to get used to it then can always go to multiple if I choose. I think my follow-up labs are in 12 weeks but can do sooner if I prefer (not sure, I'll call office next week to confirm). Since I am not interested in having more kids no HCG. He did say if I want to start HCG no problem we can always add later. This is what I actually preferred to do. I rather first see how I feel on test then add HCG later.

I also asked if we should start with a lower dose of T. He said there are two approaches, start low and adjust upwards or start higher and adjust down, if needed. He said based on his past experience prefers to start higher at beginning then adjust lower if needed after blood work.

 

[johnt]

The Estradiol Snesitive was run 1 week later since regular test came back so low.

 

[CoastWatcher]

Keep in mind that you're injecting a significant amount of testosterone in one single, weekly injection. It's at the upper end of most initial TRT protocols. The possibility for unwanted side effects, including elevated estradiol, increases with such a schedule. Your body will not develop a tolerance to testosterone, so your comment about your doctor mentioning your "getting used to" it is a bit puzzling.

All of of which is to say, note your symptoms - as your're doing - and remain your own advocate as you navigate this process.

 

[johndoesmith]

Thanks for all the responses. You put my paranoid mind at ease. Here are my Pre-TRT labs. Doc prescribed 200mg T-Cyp one time per week. I asked about doing multiple injections and he said preferred I start off with one for several weeks to get used to it then can always go to multiple if I choose. I think my follow-up labs are in 12 weeks but can do sooner if I prefer (not sure, I'll call office next week to confirm). Since I am not interested in having more kids no HCG. He did say if I want to start HCG no problem we can always add later. This is what I actually preferred to do. I rather first see how I feel on test then add HCG later.

I also asked if we should start with a lower dose of T. He said there are two approaches, start low and adjust upwards or start higher and adjust down, if needed. He said based on his past experience prefers to start higher at beginning then adjust lower if needed after blood work.

View attachment 3382View attachment 3383

Seems like a decent doctor honestly, hCG, AI if needed, open minded to different protocols and injection frequencies, and orders a decent amount of labs.

There are few minor problems, but overall seems like he is open minded, so those can be dealt with. Such as the standard E2 test(which he seems to have changed), starting with a high dose, but these are minor things that are EASILY worked with.

You've already gotten the sensitive test, hCG offered, and he's open to your preferences. I think this is a sound doctor who is honestly trying their hardest to be a decent TRT provider.

Personally, it doesn't make much sense to start high, you can ALWAYS add more, but you can't take more out of your system.

 

[CSI007]

My T values were lower then yours when starting out. I take 100mg t-Cyp EOD and I am feeling pretty darn good right now. As everyone else has said, take it slow and perhaps lower your dose. Much easier to go up then to come down. The nipple sensitivity - Had the same thing. As a matter of fact they hurt pretty bad for a few weeks when my shirt would get caught on them. They are much better a few months in and sensitive in a "good" way.

 

[HealthMan]

My E2 before TRT was also <5 pg/ml. And i end up having gyno after starting TRT (i started TRT without using anastrozole and no HCG). For me at the beginning nipples were erect quite often. Then they became very itchy. And then i got lumps on both nipples. If you start to get the first two symptoms i would be careful and monitor E2 closely (not necessarily you need to have above range E2 to get gyno.. it depends on how sensitive you are). But good news is. If you treat gyno soon it will most likely go away. So no need to worry too much. If i were you i would just monitor symptoms and E2 levels. If necessary increase anastrozole dosage slightly. Just make sure if you do get gyno to treat it early. In my case i waited a couple of months and it was a battle to get rid of it. I had to use tamoxifen which worked like a charm to resolve the problem.

A lot of guys get nipple sensitivity and that goes away without any further issues. But for some guys like me... the story was different and it took a long time to get rid of the gyno (and i felt miserable using tamoxifen). Everyone is different. And this is just my experience. And yes gyno takes time to develop. You will not get it in just a fews days.

 

[madman]

My T values were lower then yours when starting out. I take 100mg t-Cyp EOD and I am feeling pretty darn good right now. As everyone else has said, take it slow and perhaps lower your dose. Much easier to go up then to come down. The nipple sensitivity - Had the same thing. As a matter of fact they hurt pretty bad for a few weeks when my shirt would get caught on them. They are much better a few months in and sensitive in a "good" way.

Did you mean to say 100mg/weekly split up eod because 100mg eod makes no sense!

 

[Vettester Chris]

Just an observation on the thyroid side of it ...

Your Free T4 is at 56% of reference range
Your Free T3 is at 25% of reference range

A good "zone" for 'most' men to aim for would be having FT4 and FT3 somewhere in the 50%-to-80% area of reference range; relatively close together, e.g., FT4 at 65% and FT3 at 63%, or vice-versa. For the most part, consider FT4 to be the reserves which converts down to T3; being 4 to 5 times more potent at the cellular level. No doubt most doctors looking at your TSH result will be satisfied and consider everything to be "fine". TSH is a good secondary marker to work from, but unreliable as a primary marker.

Again, just an observation ... If you're seeing any of the signs of hypothyroidism (lethargy/fatigue, variance in body temp, weight/metabolism, dry skin, etc.), then take a deeper look into it. It would be good to also draw a Reverse T3 lab for ratio comparison to Free T3. Your FT3 isn't elevated, so I don't suspect pooling or an RT3 imbalance, but it's good to cover the bases just so that nothing is overlooked.

More than likely you might just need a little more T4-toT3 conversion, which can 'sometimes' be easily attained by just supplementing selenium and iodine (kelp works good too). It's not uncommon for some people to have a tad excess over production of hydrogen peroxide in the thyroid gland during the whole T4 production phase, which essentially exposes a deficiency of selenium.

Again, may or may not be relevant to you, but if you're experiencing any of the symptoms it's worth researching and talking it over with a knowledgeable physician. BTW, both TPO & TgAb antibodies look good, I'm glad your doctor ordered both!! Most tend to run with one or the other, but both need to be address for autoimmune at the enzyme and protein level of the thyroid. Keep us posted ...

 

[CSI007]

Did you mean to say 100mg/weekly split up eod because 100mg eod makes no sense!

DOH! Yes.

 

[johnt]

Just an observation on the thyroid side of it ...

Your Free T4 is at 56% of reference range
Your Free T3 is at 25% of reference range

A good "zone" for 'most' men to aim for would be having FT4 and FT3 somewhere in the 50%-to-80% area of reference range; relatively close together, e.g., FT4 at 65% and FT3 at 63%, or vice-versa. For the most part, consider FT4 to be the reserves which converts down to T3; being 4 to 5 times more potent at the cellular level. No doubt most doctors looking at your TSH result will be satisfied and consider everything to be "fine". TSH is a good secondary marker to work from, but unreliable as a primary marker.

Again, just an observation ... If you're seeing any of the signs of hypothyroidism (lethargy/fatigue, variance in body temp, weight/metabolism, dry skin, etc.), then take a deeper look into it. It would be good to also draw a Reverse T3 lab for ratio comparison to Free T3. Your FT3 isn't elevated, so I don't suspect pooling or an RT3 imbalance, but it's good to cover the bases just so that nothing is overlooked.

More than likely you might just need a little more T4-toT3 conversion, which can 'sometimes' be easily attained by just supplementing selenium and iodine (kelp works good too). It's not uncommon for some people to have a tad excess over production of hydrogen peroxide in the thyroid gland during the whole T4 production phase, which essentially exposes a deficiency of selenium.

Again, may or may not be relevant to you, but if you're experiencing any of the symptoms it's worth researching and talking it over with a knowledgeable physician. BTW, both TPO & TgAb antibodies look good, I'm glad your doctor ordered both!! Most tend to run with one or the other, but both need to be address for autoimmune at the enzyme and protein level of the thyroid. Keep us posted ...

Doc did prescribe me Armour Thyroid, I think 60 mg once per day. He said he would like to see me in upper range. I have not yet taken it as I have not done any research on thyroid optimization. Took me two years of researching TRT before I got the guts to proceed with it so the whole thyroid recommendation caught me by surprise. Also, I did not want to introduce anything else new into my body until at least a few weeks into TRT. What are your thoughts on Thyroid meds?

Also, labs do include Reverse T3, see post #7 above.

 

[johnt]

@Vettester Chris Any thoughts on Thyroid question?