Living in Norway, Advice on Lab Tests, Please

[Kristian]

Hi,
I am in Norway and have been on Nebido for about 1 year now. I take a weekly injection of about 125 mg a week and Arimidex 0,25mg twice a week.

I have not been feeling as good as I had hoped. I asked my doctor, Dr. Purvis, if I could try another type of testosterone instead (Enanthate or sustanon). He now suggest I stop treatment and try to re-start my own testosterone production. He says he will retire soon, and he is one of the very few TRT doctors in Norway.

I do not want to stop treatment, I just want a good protocol. One that works well for me. I might have to go to Sweden or another country to get it. However, there is one other clinic in Oslo, that might be able to help.

It is a very frustrating process.

Anyway, please see attached my latest bloodwork taken june 7th. I hope this is understandable to you.
Can you please comment on the results?

 

[madman]

Your tt/free t numbers look good, maybe your e2 is too low from your use of AI as I would think in Norway it is the standard e2 test as oppose to the sensitive which would give you an accurate picture of where your e2 really sits as the standard usually over estimates ones e2.

 

[ScottM]

Are you feeling any improvement at all? Did you when you started?

 

[Kristian]

Hey,
Thanks a lot for feedback!
@Madman - you might be right. I am not sure, but this is probably the standard test. I have not discussed this issue with my doctor. I think I will in the future, because it seems I might need to change clinic. I used Arimidex because I had symptoms of high E and gyno symptoms too actually. Are you suggeting I use a smaller dose - or drop Arimidex altogether?

@ScottM - well, I guess I feel a bit better in some ways on some days, but I do not feel quite right either. And it is a rather uneven experience. Its a bit hard to explain. But I feel tired a lot, I had hoped to have more energy and libido, and I have a kind of "brain-fog" that many people describe... A kind of feeling that your cognitive functioning is not as sharp as one might normally expect. So, I think my protocol needs fine tuning - for sure.

Again, I appreciate your feedback.

 

[ScottM]

Did you go from symptoms with no armidex to 0,5 mg each week? Or did you try 0,25mg a week first?

 

[Kristian]

Scott,
Since I had lumps under my left nipple, I first tried to resolve that with Nolvadex for a while. After many weeks, and no improvement, I then started 0,5 mg arimidex a week. I was a bit worried about the whole gyno issue, and getting a bit desperate, but at the same time I wanted to avoid "crashing" my E levels altogether. Perhaps 0,5 mg of arimidex a week is too aggressive for me... You might be right - perhaps 0,25 mg a week is enough. It is certainly something to consider. I have an appointment with a new clinic now. But I am not too optimistic - this doctor is an urologist - and not really a TRT specialist. I will ask for the sensitive estradiol test from him in either case.

 

[ScottM]

You could also ask your doc to consider trying a bit of Tamoxifen again w/ a lower dose of AI.

 

[Kristian]

Yes, well - I think I might start with lowering the AI dose. Just to keep other variables constant, to see how that goes. Good info for sure. I had heard about the standart test vs the sensitive test, but had sort of forgotten about it.

 

[madman]

Hey,
Thanks a lot for feedback!
@Madman - you might be right. I am not sure, but this is probably the standard test. I have not discussed this issue with my doctor. I think I will in the future, because it seems I might need to change clinic. I used Arimidex because I had symptoms of high E and gyno symptoms too actually. Are you suggeting I use a smaller dose - or drop Arimidex altogether?

@ScottM - well, I guess I feel a bit better in some ways on some days, but I do not feel quite right either. And it is a rather uneven experience. Its a bit hard to explain. But I feel tired a lot, I had hoped to have more energy and libido, and I have a kind of "brain-fog" that many people describe... A kind of feeling that your cognitive functioning is not as sharp as one might normally expect. So, I think my protocol needs fine tuning - for sure.

Again, I appreciate your feedback.

I would not drop AI just try lowering dose first.

 

[Kristian]

Hi,
Just a quick update here. I am currently reducing my AI a bit. I do 0,25 mg a week. I still do not feel right. I will have to do new bloodwork after the summer to find what the right way forward is.

Other than this I recently visited a new doctor, since my current Endo is getting retired. The guy I met is an urologist. He said he did not have much experience with TRT. He suggested I contact another doctor. The said he had experience with giving testosterone to patients with low-t, but the use of Arimidex seemed quite new to him. He thought of this as a cancer medication for women, and seemed sceptical to its use in men. Very strange indeed. I explained to him that the use of Arimidex with TRT is very common in many countries, the UK and the US etc, and I felt it necessary since I had experienced gyno symptoms etc. He said that if his patiens developed gyno they solved that problem with surgery - no big deal. I found this quite amazing. He was no big beliver in controlling estrodial, but surgery was no big deal. I think Norwegian doctors have a long way to go regarding TRT.

Anyway, I hope to meet another specialist over the summer. I hope he is more updated with regards to best practise in the TRT field.

 

[Tommy Wall]

Kristian, I also had very bad experience with a normal Urologist. He didn´t even wanted to order E2 blood test. I was lucky to find one doctor that was treating her own father " Jack Pot" and she was willing to learn everything and was open minded. I even give her this forum´s website. Anyway you can find some really good protocols here on this forum. Maybe you should consider injecting twice per week instead. Myself I just copied Nelson´s protocol and so far it works really well.

 

[Kristian]

Hey Tommy,
I am open to injecting twice a week for sure. Can you list Nelson's protocol? Or add a link?
The new guy I am seeing is an endo. I will need to get a letter from my regular doctor to see him. The whole TRT business here in Norway is kinda crazy. Most doctors here have hormone-phobia.
I was going to ask also if I could use cypionate or enanthate instead of Nebido.
Do you think twice a week injections are better also when using Nebido?

 

[Tommy Wall]

https://www.youtube.com/watch?v=0uXoBb6mkys&list=PL9soaSMOrIC-sZLjZ1UBvJ-tg2aP2q0Jd
You can find it under "Sticky" notes. I would change to cypionate or enanthate I use enanthate. I´m not sure what you can get in Norway I´ll guess maybe Testoviron 250mg 1ml ampulle that you have to draw from into a vial that you can buy from Ebay UK or othwerwise preload syrings.
I´m sure more experient guys than me could give you some more tips.

By the way I´m swedish but reside in Portugal for 20 years so I have no clue what could be offered in Sweden.

 

[goga]

Do you mean, you injected 0.5 ml of Nebido per week? Did you keep it in the syringe?

 

[Kristian]

@ Tommy - I will look into that video later. I am still at work now. Yes, well I had hoped to use cypionate or enanthate, but I am not sure that is possible. That is what I mean by hormone-phobia. Doctors here seem to equate cypionate and enanthate with abuse of anabolic steroids (black and white thinking) and Nebido is acceptable for TRT since their reasoning is that it is almost impossible to reach supra-physiological levels of test with Nebido. Anyway, this is one topic I hope to discuss with my new doctor - after the summer.

@ Goga - Yes, I do inject 0,5 ml of Nebido pr. week. I only draw out this amount. The rest I keep in the original vial. I do not store anything in a syringe.

 

[goga]

Tack! I think you mean an ampule, not a vial. Interesting. It means, there is no need to care about keeping the remains. Nothing will influence the ampule. I was prescribed Nebido in Sweden. I think, full ampule was too much for me

 

[Kristian]

Hi Goga,
Yes, you are right! Sorry about that - this medical jargon is confusing!

@ Tommy. Yes I like that video and I really do hope to get a protocol like that. But there seems to be a different philosophy regarding TRT in Europe vs. the US. I think testosterone (enanthate or cypionate) and HCG together (and maybe arimidex if needed) are ideal, but here you only get Nebido testosterone and no HCG. And you also have to argue for the use of arimidex too. Its very challenging this process.

@ Goga. It is interesting that you get TRT in Sweden. How is that? Are there many good TRT doctors in Sweden? There are very few in Norway. I am considering going to Sweden to work with a doctor there. If you have ideas or names for me, that would be great.

 

[Tommy Wall]

Kristian, I'm living in Portugal since 20 years. Sorry I don't have any contacts or info that could be helpful to you. I have a friend in Sweden who takes Nebido and he is not very satisfied with that.