Living in Italy , stone age hrt. Help please

[Harley]

Hi ,
My name is Luca I live in Umbria /Italy, 55 years old.
In Italy especialy the area I live in its impossible to find a doc. That can help with hrt .
I would be grateful for your advice.
These are my lab results after 6 weeks
200 mg test-c (two shots of 100mg a week)
Hcg 350iu twice a week.
Arimidex 0.5 mg twice a week.

Sesso: Maschile Data di Nascita: 07/12/1962
Esame Esito U.M. Valori di Riferimento
Testosterone ng/ml [ 2,80 - 10,60 ]
Metodo: Chemiluminescenza
10,2
Uomini:
10-20 anni: 24,5 - 64,8
20-30 anni: 27,3 - 69,3
30-50 anni: 20,8 - 64,0
> 50 anni: 15,3 - 51,8
Donne: < 9

Testosterone libero ematico pg/ml
Metodo: Chemiluminescenza
68,1
Donne:
Fase follicolare 19,5 - 144,2
Metà ciclo 63,9 - 356,7
Fase luteinica 55,8 - 214,2
Post-menop. < 32,2
Uomini < 39,8

17 beta Estradiolo pg/ml
Metodo: Chemiluminescenza
21,7

Antigene Prostatico Specifico (PSA) ng/ml [ 0 - 4,0 ]
ELFA - Enzyme Linked Fluorescent Assay
3,04

This are my labs before starting test:
Esame Esito U.M. Valori di Riferimento
Testosterone ng/ml [ 2,80 - 10,60 ]
Metodo: Chemiluminescenza
1,7*
Uomini:
10-20 anni: 24,5 - 64,8
20-30 anni: 27,3 - 69,3
30-50 anni: 20,8 - 64,0
> 50 anni: 15,3 - 51,8
Donne: < 9

Testosterone libero ematico pg/ml
Metodo: Chemiluminescenza
9,0*

LH mUI/ml [ 1,1 - 8,6 ]
Metodo: Chemiluminescenza
3,9

SHBG nmol/l [ 13 - 71 ]
13.1

I would be grateful for any advice on how to continue.
Grazie mille .

 

[Deleted member 16042]

I think the grouping of your lab results and ranges are difficult to interpret as displayed. And the references to women are not relevant to you.

Does this look correct?

Testosterone 10,2 ng/ml,
Range 2,80 - 10,60
Metodo: Chemiluminescenza

Testosterone libero ematico 68,1 pg/ml
Range Uomini:
10-20 anni: 24,5 - 64,8
20-30 anni: 27,3 - 69,3
30-50 anni: 20,8 - 64,0
> 50 anni: 15,3 - 51,8
Metodo: Chemiluminescenza

17 beta Estradiolo 21,7 pg/ml
Range Uomini < 39,8
Metodo: Chemiluminescenza

Antigene Prostatico Specifico (PSA) 3,04 ng/ml
Range: 0 - 4,0
ELFA - Enzyme Linked Fluorescent Assay


This are my labs before starting test:
Esame Esito U.M. Valori di Riferimento

Testosterone 1,7* ng/ml
Range 2,80 - 10,60
Metodo: Chemiluminescenza

Testosterone libero ematico 9,0* pg/ml
Range Uomini:
10-20 anni: 24,5 - 64,8
20-30 anni: 27,3 - 69,3
30-50 anni: 20,8 - 64,0
> 50 anni: 15,3 - 51,8
Metodo: Chemiluminescenza


LH 3,9 mUI/ml
Range: 1,1 - 8,6
Metodo: Chemiluminescenza


SHBG 13.1 nmol/l
Range: 13 - 71



Your total testosterone and free testosterone levels look to be in good but high range which is to be expected with your low SHBG on that kind of dose.

When was your blood drawn relative to your injection schedule? With your low SHBG,
Your lab results could look very different if labs were taken a couple days off in relation to your injection schedule.

This matters because with low SHBG you use free testosterone quickly and excrete the rest quickly in your urine, and you do not bind as much to retain in the blood stream as men with higher SHBG. This means that men with low SHBG typically do better with lower testosterone dosage and more frequent injection every day or every other day to keep levels more stable. Many men with low SHBG do not do well with higher levels of testosterone, and it can also push total and free estradiol too high.

I assume your estradiol test is not LC/MS/MS sensitive. The test you had is for women who have a much higher level of estrogen. Men need the sensitive test, but unfortuantely it is not available in many countries. So, your E2 number 21.7 may be misreprensentative, and in most cases the non sensitive test indicates an actually lower level of E2 in your blood. So, monitor for low E2 symptoms, and consider lowering the anastrazole dosage if you have joint or tendon problems, hot flashes, depression and anxiety. (Unfortunately other symptoms also mimic low testosterone symptoms: fatigue, erectile/sexual dysfunction etc, but if your T levels are high, such symptoms are not from low T).

0.5 anastrazole 2x/week may or may not be appropriate for you. Some men are very sensitive to this drug and have to adjust testosterone dosage lower first to help lower E2 then consider lower dose anastrazole if high E2 is still a problem. It is a matter of balance for each individual.

HCG looks like a nice dosage, and hopefully will help to keep your testicles full size and comfortable.

The general thoughts for low SHBG men on this forum are lower dose and more frequent injections. Many do every other day or daily injections and a weekly total around 100mg, sometimes lower.

Also, especially on dosage that high, monitor your hemoglobin and hematocrit. It is a common problem for men on high dosage.

How you feel over time will tell if your protocol is working for you.

 

[Harley]

Thanks for the reply , its very difficult to be your own doc.
I really appreciate you taking the time to write to me .
I had the labs done in the morning before the shot.
I think I will take your advice and lower the test-c weekly amount to a 100 mg per week .
I will stay on two shots per week as I don't wish to make too many changes at once and frankly I hate shots.
Hcg I will continue as before.
I am thinking of dropping the Arimidex at least for a while as I think my Estradiol is low , even though the test result was ok , I do suffer from ed , hot all the time , fatigue so I could contribute that to low E2.
Have a beautiful evening .

 

[Deleted member 16042]

Re: disliking shots, Many guys who come to the forum are using overly large needles. The general recommendation here is for 1/2" 29-27g insulin syringes, 29g for grapeseed or sesame oil carrier, and 27g for cottonseed oil. For some of us even smaller 5/16" 30g work fine for subQ.

And re: the "advice", for the record, I am not offering "Advice", I am offering information based on reading this forum, related books, studies, and somewhat based on my own personal experience. I highly advise you to follow up and confirm all information that seems meaningful to you, and consult with a knowledgeable doctor. EVERYONE on this forum has personal bias, and different things work for different people. Please go further and educate yourself by reading a LOT more of this forum, the books offered by Nelson and other contributors, read studies etc.

Hopefully others will add to this thread as well!

 

[Harley]

Its not that I feel any pain , my gf took a course in administering shots and when she gives me the shot I reel nothing . But the idea of the shot......

 

[Systemlord]

My SHBG is only a few points higher than yours, I didn't respond well to TRT injecting twice weekly and I to didn't like the idea of injecting frequently.

Time and time again I see people doing what they want to do instead of what they should be doing. This often gets in the way and sabotages a successful outcome.

It will most certainly prevent a full recovery.

Insulin syringes are painless, sounds like you're large needles and is completely unnecessary. I inject using an 29 gauge insulin syringe into my shoulders and outer quads.

I don't feel a thing.

 

[Harley]

If the twice a week method doesnt get me the results I need then I will try eod and then ed . I am just taking it slow.

 

[Deleted member 16042]

Its not that I feel any pain , my gf took a course in administering shots and when she gives me the shot I reel nothing . But the idea of the shot......

I understand and have been there myself. It was cured by virtue of IV training as an EMT, and through self practice. I taught emergency care and trained others how to administer shallow IM and SubQ injections, and took every training opportunity to also practice on myself since I had a bee sting allergy and wanted to be confident and ready to draw and self administer epinepherine if needed. I was lucky to have that practice prior to having to start TRT injections.

I'll still believe in using the smallest needles appropriate for the task whether for myself or in former days for my patients in the ambulance.

 

[Harley]

I will let you know how it goes , I had low test for many years without really having any problems but now I suffer from ed and its killing me .lol

 

[Harley]

Hi,
Attached are my new blood test results.
Test where done the morning before the test-c shot.
My protocol right now after your advice :
Test-c 75 mg every 3 days.
Arimidex 0.35 at day of shot.
I would be grateful for your advice specially on the following :
Psa took a jump from 3.04 to 3.64 its within range but still a jump.
Ferritin is low.
Magnesium is low.
Dhea is low.
As for Estradiol it is very low but this is not the sensitive test and I am unsure I can trust the results. I feel fine with morning wood etc'
Thanks in advance .
Luca.

 

[Pongo]

Stop the arimidex fast you are about to crash your Estradiol!

 

[Harley]

Hi ,
Thanks for the reply .
I stopped it yesterday , usually I take it after my shot of test but yesterday I didn't . I think I should down the dosage to about 0.2 after each shot.