Help Please... shortness of breath, no results, etc.

[Scotty323]

Need some opinions/advice. When I started my total test was 190. Was seeing an endo, he got me up to 400 total and said that was the highest he would go. Ended up signing up with a much better doc ( Dr.Saya with Defy ) and my protocol is now the following:

Cyp - inject .35 twice a week
Hcg- inject .40 twice a week
AI- .35 twice a week

Results are below from the morning of my day for injections ( tested before injections ).

Results are way higher than I expected.

Also, I have yet to notice a difference with energy or a "pick me up". The only difference I have noticed through this whole process is some weight gain, neck fat, and I get much more irritated lately. Also have noticed shortness of breath and a lot of sweating. I still can't get myself to the gym.

I am awaiting cortisol tests to come back. I'm not sure what to do at this point. I do take prozac for anxiety and amlodipine for HBP so maybe this is interferring?

Not sure where to go from here...
Any thoughts or anything I can change until I get in with the doc?


Labs below...

https://imgur.com/a/TXMam

 

[Vince Carter]

You have the wrong test for Estradiol, that's one for women and it incorrectly reads levels in men, it's basically useless though as a ballpark the correct UltraSensitive test typically reads LOWER than that so you could presume your E is below 22 which by most accounts we would say that that's too low, maybe 30 is a better target to aim for.
I would also try some Vitamin D @ 5000iu daily.

Back off the Anastrozole to twice per week and see how that feels. Change just one thing at a time!

 

[Scotty323]

The lab slip said e2 sensitive. I didn't even realize they did the wrong one. Also, I currently take the AI twice a week. Should I go to once a week until my appointment ?

 

[CoastWatcher]

While I understand what Vince Carter advises regarding the Anastrozole, and agree it would be prudent, any change your make will not be reflected in your blood work unless you test again prior to your conference with Dr. Saya. If you make a protocol change contact Defy and have labs run prior to your consultation. When are you speaking with him?

 

[Scotty323]

The labs I posted are from last week but they are still waiting for the cortisol results so I cant schedule with the Dr. until the cortisol results come back.

 

[Vince Carter]

I agree...dont change anything until you have your consult as any change would skew the tests you have which will be the topic of conversation. Thanks for noticing that Coastwatcher.

 

[Nelson Vergel]

Also, I have yet to notice a difference with energy or a "pick me up". The only difference I have noticed through this whole process is some weight gain, neck fat, and I get much more irritated lately. Also have noticed shortness of breath and a lot of sweating. I still can't get myself to the gym.

I am awaiting cortisol tests to come back. I'm not sure what to do at this point. I do take prozac for anxiety and amlodipine for HBP so maybe this is interferring?

Not sure where to go from here...
Any thoughts or anything I can change until I get in with the doc?


Labs below...

https://imgur.com/a/TXMam

You may still have unresolved high blood pressure and/or water retention.

What is your diet and exercise program? What is your blood pressure at rest and after 10 min of exercise?

What is your height, weight and waist circumference?

 

[Scotty323]

You may still have unresolved high blood pressure and/or water retention.

What is your diet and exercise program? What is your blood pressure at rest and after 10 min of exercise?

What is your height, weight and waist circumference?

Exercise hasn't really happened since I have zero energy to get to the gym. I've been on HBP meds since my mid 20's, my father started on them in high school.

I'm 5'11, 204 lbs and I very from a size 34 to 36 inch waste. My sleep apnea numbers have also gotten worse since starting TRT. They are in the process of trying to get my settings adjusted for that.

 

[Scotty323]

Exercise hasn't really happened since I have zero energy to get to the gym. I've been on HBP meds since my mid 20's, my father started on them in high school.

I'm 5'11, 204 lbs and I very from a size 34 to 36 inch waste. My sleep apnea numbers have also gotten worse since starting TRT. They are in the process of trying to get my settings adjusted for that.

Ive always been a more stockier build. I got down to 178 about 5 years ago and I looked anorexic. When I started injections I got up to 212 so I've gotten 8 lbs off.

Also, and I'm not sure if this matters but tomorrow I have an appt with an urologist to get my bladder and prostate checked because for the last 2 years I've been peeing about 10 times a day and that's with not being able to drink water or else I would go 20 times a day. I'm on the road a lot for my job so my water intake is probably horrible right now.

 

[Scotty323]

Was in the store so I just got this done. This is wit the HBP meds

BP https://imgur.com/gallery/eE020

 

[johndoesmith]

Ive always been a more stockier build. I got down to 178 about 5 years ago and I looked anorexic. When I started injections I got up to 212 so I've gotten 8 lbs off.

Also, and I'm not sure if this matters but tomorrow I have an appt with an urologist to get my bladder and prostate checked because for the last 2 years I've been peeing about 10 times a day and that's with not being able to drink water or else I would go 20 times a day. I'm on the road a lot for my job so my water intake is probably horrible right now.

How long have you been with defy on this protocol? Not every guy gets the frequent urination effect of low E2, which I think you have due to 22 on a standard test.

If the frequent urination has been there for 2 years, and you've been on this protocol less, then it's probably something else.

Are you sure it's not a recent symptom? I would urinate about every 1 or 1.5 hours. It was terrible. My e2 was about 8 on a 7-43 standard test.

 

[Scotty323]

How long have you been with defy on this protocol? Not every guy gets the frequent urination effect of low E2, which I think you have due to 22 on a standard test.

If the frequent urination has been there for 2 years, and you've been on this protocol less, then it's probably something else.

Are you sure it's not a recent symptom? I would urinate about every 1 or 1.5 hours. It was terrible. My e2 was about 8 on a 7-43 standard test.

Ive been on Defy's protocol for a little over 2 months. The frequent urination has definitely been much longer than that.

 

[Dr Justin Saya MD]

Sleep apnea treatment/optimization is critical as it will drain/negate just about every subjective benefit one might receive from TRT. The salivary cortisol results will give clues as to whether the adrenals are struggling (from sleep apnea or otherwise).

Frequent urination can be from many factors, but also sometimes an adrenal indicator secondarily through aldosterone levels and sodium/fluid balance.

Since we have your levels now, doing a trial of taking the anastrozole once weekly until our consult would be okay, just remind me during consult that you did. Preferably, due to half life of anastrozole, would take a smaller dose twice weekly, but we'll make due with what you have currently and use this as a trial until consult.

 

[Scotty323]

Sleep apnea treatment/optimization is critical as it will drain/negate just about every subjective benefit one might receive from TRT. The salivary cortisol results will give clues as to whether the adrenals are struggling (from sleep apnea or otherwise).

Frequent urination can be from many factors, but also sometimes an adrenal indicator secondarily through aldosterone levels and sodium/fluid balance.

Since we have your levels now, doing a trial of taking the anastrozole once weekly until our consult would be okay, just remind me during consult that you did. Preferably, due to half life of anastrozole, would take a smaller dose twice weekly, but we'll make due with what you have currently and use this as a trial until consult.

Thank you for your help. You and Defy have been fantastic ever since I switched to you guys. Much appreciated.

 

[johndoesmith]

Sleep apnea treatment/optimization is critical as it will drain/negate just about every subjective benefit one might receive from TRT. The salivary cortisol results will give clues as to whether the adrenals are struggling (from sleep apnea or otherwise).

Frequent urination can be from many factors, but also sometimes an adrenal indicator secondarily through aldosterone levels and sodium/fluid balance.

Since we have your levels now, doing a trial of taking the anastrozole once weekly until our consult would be okay, just remind me during consult that you did. Preferably, due to half life of anastrozole, would take a smaller dose twice weekly, but we'll make due with what you have currently and use this as a trial until consult.

I imagine that's from the poor quality of sleep from untreated sleep apnea, right?
I ask this because I have narcolepsy, which ruins sleep quality and sleep architecture. In what ways exactly, would sleep apnea drain most of TRT's benefits?

PS: Hope all is well down in florida with the hurricane!

 

[Dr Justin Saya MD]

I imagine that's from the poor quality of sleep from untreated sleep apnea, right?
I ask this because I have narcolepsy, which ruins sleep quality and sleep architecture. In what ways exactly, would sleep apnea drain most of TRT's benefits?

PS: Hope all is well down in florida with the hurricane!

Yes, poor sleep quality is a major contributor, but also sleep apnea puts tremendous stress on the cardiovascular system, the adrenals, and puts the sympathetic nervous system into overdrive.

 

[johndoesmith]

Yes, poor sleep quality is a major contributor, but also sleep apnea puts tremendous stress on the cardiovascular system, the adrenals, and puts the sympathetic nervous system into overdrive.

Interesting. I imagine from the lack of oxygen while sleeping, the body is desperately trying to stay alive hence the sympathetic nervous system involvement.

I don't think narcolepsy has that effect right?

 

[Dr Justin Saya MD]

Interesting. I imagine from the lack of oxygen while sleeping, the body is desperately trying to stay alive hence the sympathetic nervous system involvement.

I don't think narcolepsy has that effect right?

No, as far as I know that is not an issue with narcolepsy (obviously unless one ALSO has sleep apnea with narcolepsy).

 

[johndoesmith]

No, as far as I know that is not an issue with narcolepsy (obviously unless one ALSO has sleep apnea with narcolepsy).

Okay cool. IIRC, my O2 sats dropped to about 92 or so during the night, could be remembering wrong. Also my sleep doctor never said anything about sleep apnea.

 

[Scotty323]

Cortisol results came back. Normal or no?



https://imgur.com/gallery/IJy41