HELP! Feeling like shit and heading to a new doctor

[JetSpyder]

I’ve been on TRT for 5 years now and it has been pretty successful for the most part. However I recently moved to a new state and changing doctors. The past 3 weeks or so I have been feeling like absolute shit! My body temp is up and I have trouble sleeping at night. In the mornings I have a hard time getting up and I feel nautious nearly every day. Also I have been extremely irritable and my wife really notices. I saw an endocrinologist in January and he tried to tell me that I shouldn’t be on TRT, I’m too young and its no way to live the rest of my life. While I agree that is for another discussion. He was adamant that I do not take any AI and how bad they are for me. I am looking for help from this forum in having a positive conversion this week with him about my future on TRT.
I started 5 years ago taking 200mg/wk with .5 mg anastrozole 3x weekly. Over the years I have tweaked it slightly and recently I have been on 140mg/wk and occasionally anastrozole if my estrogen got elevated. I haven’t changed this for a while and when I got my lab work done in January my levels are all of a sudden really high. My fault because the injection was done 1.5 days before the lab work.

Testosterone
Tot. 1497. (300-1080)
Free 47.2. (4.8-25.7)
SHBG 21.8. (16.5-55.9)
Estrogen. 37.2 (19.0-69.0)

At the time of these labs I wasn’t feeling badly but I could tell that my Estrogen was beggining to elevate. So about 4 weeks ago I started feeling really shitty so I called my doc and asked him if I could get just an estrogen test. When I received the results it was at 76.0!!! (Again this was 1 day after a shot so probably inflated slightly)

I had a full panel test ran this past week and I see him in 2 days. I know he is going to react to my estrogen levels being so high because he disapproves of AI. Any suggestions from here? I just don’t understand how all of a sudden my estrogen levels have shot through the roof!?!

One other question if anyone has had this issue. I have had folliculitis for about 12 years (painful whitehead bumps on the scalp) and have always been able to keep them under control. However in the past 2 years they are so bad I am losing my mind. 4 different dermatologists and none can figure it out. In my mind its because of the higher estrogen levels caused by my TRT or the oil that is used with my cypionate. Has anyone ever had an issue with this or just acne getting really bad and what did you do? I feel like my skin is more oily since i’ve been on TRT.

Thanks

 

[Vince Carter]

I think it's all kind of moot until you get the proper tests in your trough, would be pointless to discuss your numbers and dose at this point.

Advice on the scalp that works for me is using Selsun Blue and adding a glob of Benzoyl Peroxide cream cleanser and working it in with a body brush. My scalp can get nuts breaking out and this works really well for me.

 

[Systemlord]

We often see a lot of guys having problems with testosterone levels above ranges, increased acne and oily skin from elevated DHT, which is a byproduct of testosterone. I to get very oily skin and acne nearing 900-1000 ng/dL, simply lowering the dosage is enough to clear up the oily skin and acne. Your problem is you dosage of testosterone is too high, most men do well in the 600-800 ranges. The level of care you have been receiving for TRT has been subpar, the excess testosterone is the cause of the oily skin and acne, or rather excess DHT.

Do not allow these doctors to charm you into quitting TRT to clear their conscience, if you were truly hypogonadal then you absolutely deserve to be on TRT. Some doctors refuse to believe that a young man could even have a testosterone deficiency and that only a mid aged man can experience andropause, but we are seeing young men everyday who are showing signs of a testosterone deficiency with feminine features.

 

[madman]

I've been on TRT for 5 years now and it has been pretty successful for the most part. However I recently moved to a new state and changing doctors. The past 3 weeks or so I have been feeling like absolute shit! My body temp is up and I have trouble sleeping at night. In the mornings I have a hard time getting up and I feel nautious nearly every day. Also I have been extremely irritable and my wife really notices. I saw an endocrinologist in January and he tried to tell me that I shouldn't be on TRT, I'm too young and its no way to live the rest of my life. While I agree that is for another discussion. He was adamant that I do not take any AI and how bad they are for me. I am looking for help from this forum in having a positive conversion this week with him about my future on TRT.
I started 5 years ago taking 200mg/wk with .5 mg anastrozole 3x weekly. Over the years I have tweaked it slightly and recently I have been on 140mg/wk and occasionally anastrozole if my estrogen got elevated. I haven't changed this for a while and when I got my lab work done in January my levels are all of a sudden really high. My fault because the injection was done 1.5 days before the lab work.

Testosterone
Tot. 1497. (300-1080)
Free 47.2. (4.8-25.7)
SHBG 21.8. (16.5-55.9)
Estrogen. 37.2 (19.0-69.0)

At the time of these labs I wasn't feeling badly but I could tell that my Estrogen was beggining to elevate. So about 4 weeks ago I started feeling really shitty so I called my doc and asked him if I could get just an estrogen test. When I received the results it was at 76.0!!! (Again this was 1 day after a shot so probably inflated slightly)

I had a full panel test ran this past week and I see him in 2 days. I know he is going to react to my estrogen levels being so high because he disapproves of AI. Any suggestions from here? I just don't understand how all of a sudden my estrogen levels have shot through the roof!?!

One other question if anyone has had this issue. I have had folliculitis for about 12 years (painful whitehead bumps on the scalp) and have always been able to keep them under control. However in the past 2 years they are so bad I am losing my mind. 4 different dermatologists and none can figure it out. In my mind its because of the higher estrogen levels caused by my TRT or the oil that is used with my cypionate. Has anyone ever had an issue with this or just acne getting really bad and what did you do? I feel like my skin is more oily since i've been on TRT.

Thanks

Even if your injection was done 1.5 days before lab work instead of at trough your total t/free t levels are way too high.

I could not even begin to imagine what levels they were at when you were using 200 mg/week.

Your shbg is on the lower end and seeing as your free t is almost double I would say your e2 is elevated. Was the estradiol (sensitive assay) used?

Regarding the folliculitis.............testosterones metabolite dht (dihydrotestosterone) is responsible for increasing the size of the sebaceous glands which result in overproduction of sebum (oil/waxy substance) secreted by the oil glands which can cause oily skin/acne in genetically prone individuals.

Ones genetics is the biggest factor as some even with mid-normal physiological testosterone levels can experience excess oily skin/acne due to the sensitivity of ones AR (androgen receptor).

Although running higher testosterone levels whether high-normal physiological levels or supra-physiological levels can increase ones chance of acne among other side effects.

Post full labs when you get them and I would say lowering your dose and bringing down your free t levels will give you a better chance of improving the folliculitis and of course lowering your e2!

 

[JetSpyder]

Thanks Vince I agree with it being pointless but I thought it was a little odd that it was that high, even during the peak. Ive had it tested before but it was no where near that.

I have selson blue and benzoyl peroxide but have never tried them together so I'll give it a shot. I am also on 150 mg doxycycline a day and it does nothing. This shit is intense with my levels this high. I'll post my labs when I get them later this week.

 

[JetSpyder]

Systemlord you are correct in that I have been getting subpar care. Problem is that with my career I have lived in 3 states over the past 5 years. I have been to at least 10 different doctors/clinics over the years trying to find the right fit. I've been to some really shady places that knew nothing about TRT but were prescribing it anyway. I recently moved to Las Vegas and can't find anyone who knows jack out here. I'm giving my endocrinologist another shot but he instantly threw shade at me when I told him that I am on TRT. I am currently 37 and when I started at 33 my total T was 210 ng /dL and I felt absolutely awful. The first few years were great and I feel so much better when I get my levels in check.

 

[madman]

If you are only injecting once weekly than peak will be 24-48 hrs post injection...............your total t was 1497 ng/dl..............1.5 days before labs which is way too high!

As an example if you are injecting every Monday morning than your trough would be taken the following Monday morning just before your next injection.

 

[JetSpyder]

Madman thanks for the reply but surprisingly my levels weren't crazy when I was on 200mg. The first few years my trough was around 900 ng/dL and I felt great. I got really screwed up about a year and a half ago when I did a lot of experimenting to have a baby. I dropped my test injections down really low and HCG way up. It did work and I was able to father my baby girl but I haven't been right since. I haven't gone above 160 mg since that time but whatever it did my estrogen levels have been really sensitive since. I can feel it when they begin to elevate and I get nervous to take my shot next week.
As for the sensitive assay they had no idea what I was talking about and 2 of my previous doctors said there is no proof that this test is any more accurate hence none of them would send for it. I know everyone on here uses this test but none of my doctors were willing to order it.
My thoughts if my test is still high is that I am going to drop to 100mg/wk for a few months and see where that gets me. What free levels should I be looking for with my SHBG being relatively low? I am so tired of feeling like shit that I am willing to do whatever it takes.

 

[JetSpyder]

Maybe I posted that wrong. My labs were done 1.5 days after injection and that's why they were so high. However I just thought that seemed really high even for the peak.

 

[1Draw]

Your symptoms may not be all testosterone/estrogen related. Have you had a full Thyroid panel done? Many of your symptoms are signs of hypothyroidism. Here is an excellent website to check off all the symptoms of low thyroid:
https://www.restartmed.com/hypothyroidism-symptoms-checklist/

Dr. Childs also list all thyroid test to have run along with optimal ranges. Good luck and keep us posted!

 

[madman]

Maybe I posted that wrong. My labs were done 1.5 days after injection and that's why they were so high. However I just thought that seemed really high even for the peak.

I see now you cleared that up.....if you are injecting 140 mg once weekly than a higher supra-physiological peak would be expected.

Since your labs were taken at your peak than wait until new labs are done to see where your total t/free t levels and e2 sit at (trough) and than decide as they very well may be in a descent range and it is elevated e2 that is causing you issues.

Relief/improvement of your low t symptoms is what matters and whether that requires you to have your testosterone levels in the mid-normal or high/normal physiological range only you will know gauging by how you feel and your overall lab work.

Some will do better having free t (trough) in the mid-normal physiological range as oppose to high normal or over the top end of the range.

 

[JetSpyder]

I had my appointment yesterday with my Endo and now realize he is just as clueless as the rest. My understanding from most users on the forum is to get your bloodwork done during your trough. He was adamant that I had mine done in the middle of the week. I inject once weekly on Monday (140mg) so these lab results were taken on Friday (approx 4 days). He says they don't know what they are talking about if they are doing lab work during your trough.

Next I questioned him about getting back on HCG (been on for years) and he claimed that I did not need it. I explained that I was thinking about trying to have another child so I needed to get back on it. He said to email him when I was sure that we wanted to try and he would consider it. And he absolutely will not give me a script for AI (I don't need right now).

Total Test. 665 NG/DL (300-1080 NG/DL)
Free Test. 167.6 PG/ML (47-244 NG/DL)
Estrogen. 25.3 PG/ML (0-60.7 PG/ML)
SHBG. 25.7 NMOL/L (16.5 - 55.9 NMOL/L)

So not sure where to go now because I was feeling like shit for about a month and these are pretty good numbers. Does anyone have experience with stopping HCG and it causing them to feel bad? I have been on HCG for most of the past 4 years and I stopped in January when this guy wouldn't prescribe me anymore. Also I think I am going to switch to 80mg 2x weekly instead of 1 injection a week.

 

[1Draw]

https://www.restartmed.com/thyroid-symptoms-men/

 

[FeelingLost]

I had my appointment yesterday with my Endo and now realize he is just as clueless as the rest.snip...

Are you trying to use med insurance? Are you in a financial position to seek TRT treatment outside of med ins? If so give Defy a call. They do telemed over the phone.
The prices are very reasonable and you can pretty much move around the country and not have to fine a new doctor. Plus they are about the best dam TRT clinic in the country. Just my opinion. Check them out. https://www.defymedical.com/ also if you need blood work done at a very good price and no doctor to convince give the owner of this forums site a try. Want to just see your TT and FT no problem buy only the blood test you want. https://www.discountedlabs.com/

Oh welcome to the forum.