Low Testosterone + High Estrogen + Obesity = Is TRT really the solution for me???

[amatos70]

Hello Nelson and Excel Male Community…

My hope is that Nelson may shed some light with me and anyone else in this community that may be going thru the same or similar challenge as I am with Low Testosterone, High Estrogen levels and Obesity. (See attached most recent Dexa Scan)

Now to my challenge...

I’ve been struggling with being overweight for most of my life, but more so over the last 10 years.

I’ve followed diets, exercised, taken supplements, you name it.

Last year during my annual physical, I requested my doctor also test my testosterone (in addition to other areas) and found it was borderline low. (See Bloodwork result images dated 7/29/2017)

A few months after doing some research and learning more about Testosterone, I started TRT because I felt that it could help me burn fat, not as a wonder solution but as an addition or part of other positive health-enhancing practices and habits.

Before starting TRT my Total Testosterone was 443, somewhat borderline but not as low as I’ve seen most guys on TRT. I didn’t have problems with libido or anything sexual. I was still able to take care of business. She just had to look at me and it was on! ?

Last week on Wednesday 3/28/18, I had my 3 months blood work labs done and this week I met with my (General Practitioner) doctor to go over the results. (See attached images dated 3/28/2018)

The first words out of his mouth were...

“These are some alarming numbers Alex!”

And after checking them out for myself, they are!!! (See attached)

When I asked what now? And though he’s not the doctor that’s managing or overlooking my TRT treatment, but he is aware of and supports what I’m doing, I was interested to know his viewpoint on the matter as a 2nd opinion.

His suggestions were to:

1. Lower my Testosterone Cyp 200mg intake from .35ml to .25ml
2. Increase my dosage of Anastrozole from .125mg to .25mg
3. Continue taking the .50ml HCG
4. Continue taking the above-mentioned meds 2x a week
5. Start a strict Ketogenic diet and do lots of cardio to lose body fat

When I mentioned and asked...

“Doc, most men that are on Testosterone Replacement Therapy (TRT) started it because their Testosterone levels were between 140-160ng. My testosterone levels were at 443ng before starting TRT.
What’s the possibility that if I dropped 40-50lbs of weight (and body fat from 38% down to 15-20%) that my testosterone would increase?”

His answer to this really concerned me...

He said NO that the reason that it wouldn’t and why it would be difficult for me to lose the weight is because my high “Estrogen Levels”.

This REALLY baffled me!!!

I then called the TRT clinic and informed them of the Bloodwork lab results and their suggestions were to immediately:

1. Lower my Testosterone intake from .35ml to .30ml
2. Increase my dosage of Anastrozole from .125mg to .50mg
3. Stop taking the .50ml HCG
4. Continue taking the above-mentioned meds 2x a week

I have a follow-up appointment with the TRT doctor on Tuesday 4/17/18.

Disclaimer:
I know you’re not a doctor and anything you mention is from your personal and professional knowledge and won’t be held responsible.

Brother...

You’re association with medicine and wellbeing + years in health and fitness + your good heart = 100% Trust in My Book

I’m really confused by the conflicting information I’m getting...

It’s really frustrating… Not to see any positive results.

Time-consuming… To test blood, take medication, test blood again, tweak medication, test blood again, tweak medication, etc.

Plus, the resources being invested… (which is no bother since it's my life we’re talking about here)

I need clarity, unbiased answers, and a little direction.

I’m hoping I can get it here.

Based on the information I've provided, Is it possible that TRT is not for me?

In addition to anything you’re willing to share...

Are there any questions you’d suggest I ask my TRT doctor during my consultation in 2 weeks?

Thank you!

 

[Vince]

These labs that you just posted, are they from before you started TRT?

 

[Nelson Vergel]

Welcome to ExcelMale!

I would not have started TRT with your baseline numbers. I would have started a diet/exercise program and possibly Metformin. But now that you are on TRT, I am sure you just want to make the best of it.

Your doctor's suggestions:



1. Lower my Testosterone Cyp 200mg intake from .35ml to .25ml

I agree. .25 mg twice per week subcutaneously or shallow IM on shoulders with 27 gauge 1/2 inch syringe.

2. Increase my dosage of Anastrozole from .125mg to .25mg

I would take .25mg per week. Retest sensitive estradiol after 8 weeks and then readjust or stop anastrozole. This low dose will ensure you don't crash your estradiol, which could slow down your fat loss and decrease your libido.

3. Continue taking the .50ml HCG

I have no idea what IU dosage that is since I do not know the dilution factor. I am assuming it is 350-500 IU twice per week (i would keep it)

4. Continue taking the above-mentioned meds 2x a week

Yes

5. Start a strict Ketogenic diet and do lots of cardio to lose body fat

Strict anything does not work in the long run. Follow my suggestions:

Tips to Lose Fat

I would also start 500 mg twice per day of Metformin with food.

Metformin Update

Is Metformin a Miracle Drug ? : Nelson Vergel Explains


These suggestions should help you lose fat, lower your lipids, improve your estradiol and hopefully keep your hematocrit below 54.

After 8 weeks of following this comprehensive program, ask your doctor to run a panel like this one (bare minimum):

TRT Follow Up Blood Test Panel

 

[amatos70]

Nelson,

I am EXTREMELY grateful for your response but most of all, for your honesty and transparency.

I've decided to give both myself and my body the opportunity to produce its own testosterone while looking for ways maintain estrogen levels at a level I feel good and healthy.

I am researching the benefits of starting and following a Keto diet, a weightlifting program and may even look into consulting with a CNS Nutritionist. (Please let me know if you know of any you'd feel comfortable recommending)

Next week (on Tuesday) I have my follow up with my TRT doctor. I still think it's a good idea (even though I plan on stopping TRT) to communicate it to him and be sure I do so safely and know what to expect.

Next time I'm in Houston, we'll get together and go to a Venezuelan restaurant and have some Patacones, Arepa Reina Pepiada, and Cachapa with Queso Guayanes.

Thanks again,
AM

 

[Nelson Vergel]

Hey Amatos

I would not stop TRT cold turkey. Talk to your doctor about 25 mg per day clomiphene for 4 weeks followed by 12.5 mg per day for other 4 weeks. This is a super simple protocol that may work in guys with "good" pre-TRT blood levels.

I personally like my buddy Dr Spencer Nadolsky as a great doc who knows about nutrition, etc

http://drspencer.com/

He may not let you go with me to eat Venezuelan food, though!