My current hunt for TRT, Help!

[shan1784]

Shan (op), Like me you've already invested a huge chunk of your adult life relying on the medical establishment for TRT. Recently you came to the conclusion that you could no longer allow your health to suffer and considered paying $850 for a consult and script. The doctor you were referred to in the sunshine state is awesome. He's worth every penny of his fee. As time and your finances permit you should absolutely seek admission to that practice.

If I still lived in Brooklyn I would be accessing alternate channels. The reality of retirement is that many are finding that utilizing alternative channels is increasingly becoming the only option. If you notice many smiling people of southern European descent about you are shopping in the right neighborhood.

Thank you for the confidence boost. Beyond excited to get moving with Defy.. Physical today and lab results hopefully soon and I can get on with the initial consult. Very pumped!

 

[shan1784]

So faxed in my physical form this morning and just got a call from the local clinic saying that my lab results are in and they see an issue with my cholesterol. Not sure what it is as I didn't get the specific test they were speaking of only my value was over 2000 and the high end is 1800 or something. Said it puts me in the 88th percentile... Wanted to make sure that I follow up on this with my primary care doc...

Anyone have a clue on this? I know it's vague as to what I'm talking about since I don't have specifics to what test it is...

I'm going to pick the results up after work so I'll post all the labs on here as well as email them into Defy...

 

[CoastWatcher]

So faxed in my physical form this morning and just got a call from the local clinic saying that my lab results are in and they see an issue with my cholesterol. Not sure what it is as I didn't get the specific test they were speaking of only my value was over 2000 and the high end is 1800 or something. Said it puts me in the 88th percentile... Wanted to make sure that I follow up on this with my primary care doc...

Anyone have a clue on this? I know it's vague as to what I'm talking about since I don't have specifics to what test it is...

I'm going to pick the results up after work so I'll post all the labs on here as well as email them into Defy...

Absent actual results, it's all speculation on anyone's part.

 

[shan1784]

Absent actual results, it's all speculation on anyone's part.

Yeah, I figured as much, just got a little concerned.. I'll post the results when I get home...

 

[shan1784]

Here are my results to my latest labs from last week... I was shocked by the testosterone results. I've never had them that high and to be honest does not represent the way I feel on a daily basis... I get my injections on Sunday nights and this blood test was Thursday morning at around 10:30 AM or so... I would have thought it would be lower...

See what you experts think here...

 

[John O'Connor]

OK, here is summary of noteworthy numbers:
PSA 0.7 (0.1 3.9) - good
Glucose 85 - good
Vitamin D 41 (30-100) ok, but 50+ is better and 65-80 optimal.
Uric Acid 7.7 (2.0 - 6.9) any symptoms of gout? I'm guessing not at this slightly elevated level.

Creatinine 1.3 (0.7-1.2) Do you take creatine? This could explain water retention too.
BUN aka Blood Urea Nitrogen, 31 (6-20) How much protein are you consuming?
BUN-to-creatinine ratio: 23 (>20 = prerenal, BUN reabsorption is increased. BUN is disproportionately elevated relative to creatinine in serum. Dehydration or hypoperfusion is suspected. From Wikipedia.) Where you dehydrated during blood draw?

FSH <0.1 (shut down due to TRT)
LH <0.1 (shut down due to TRT)
Total Testosterone 926 (on day 3.5 = peak) last shot Sunday night, blood draw Thursday morning.
Free Testosterone 23.42 (4.7-24.4)
Estradiol 46.3 (25.8 - 60.7)
Prolactin 9.71 (4.04 -15.20)
DHEA-S 361 (range???) Are you taking DHEA supplement?

Thyroid: Currently takes 137mcg synthroid - correct? Are you taking this in morning on empty stomach for 1 hour? No orange juice or oatmeal that would impact absorption?
TSH 2.58 (0.27 -4.20)
T4 6.7 (4.5 - 11.7)
Free T4 1.22 (0.93 - 1.70)
T3 95 (80 - 100)
Free T3 3.3 (2.0 - 4.4)
Reverse T3 13 (8 -24)

Lipids:
LDL 165 (<100 = optimal, 100-129 = intermediate risk, >130 = high risk)
HDL 60 (>40) = very good.
Triglycerides 67 (<150) = good.

I'm not sure what to make of high LDL, when other 2 look great.

 

[CoastWatcher]

Your estradiol was measured with the wrong lab test. You want the sensitive, LC, MS/MS, protocol. Your reading isn't accurate. Defy will sort that out in the coming days, I'm sure.

 

[shan1784]

Thank you so much for the reply and time put into this, very appreciated!

Wasn't dehydrated, was drinking water all morning.

Synthroid (that is correct dose) was always taken with breakfast, never empty stomach. Never knew this but bet it's printed on bottle.

There is creatine in my preworkout supp.

No dhea supp

I take in about 230-260 grams of protein daily (mainly focus on macros mon-fri) so weekends vary.

No gout symptoms I don't think, just water retention in hands and feet.

Turned these into defy and got response that I could schedule at anytime so hope the estradiol test won't be an issue..

 

[John O'Connor]

How long have you been taking synthroid? I'm guessing you started on lower dose than current 137mg. What was your TSH when first diagnosed? I have a feeling 137 will be too high of a dose when you take it properly on an empty stomach.

Be careful with that much protein. I've heard a urologist give a lecture explaining that bodybuilders on high protein often cause kidney failure. I think you might want to consider backing off to get the BUN to creatinine ratio under 20. I'd be less concerned with the creatinine level as it is only slightly elevated, and it makes sense due to your creatine intake and the fact that you work out regularly.

I'm no expert on this BUN and BUN/Creatinine ratio - so hopefully someone else can provide further insight.

 

[shan1784]

How long have you been taking synthroid? I'm guessing you started on lower dose than current 137mg. What was your TSH when first diagnosed? I have a feeling 137 will be too high of a dose when you take it properly on an empty stomach.

Be careful with that much protein. I've heard a urologist give a lecture explaining that bodybuilders on high protein often cause kidney failure. I think you might want to consider backing off to get the BUN to creatinine ratio under 20. I'd be less concerned with the creatinine level as it is only slightly elevated, and it makes sense due to your creatine intake and the fact that you work out regularly.

I'm no expert on this BUN and BUN/Creatinine ratio - so hopefully someone else can provide further insight.

Been on synthroid for years. It was increased about 2 years ago I believe. Don't remember what my level was previous but was low enough to justify going on along with family history. Going to start taking my synthroid when I get up first thing in the morning to give it time to absorb properly..

I'll look at my protein intake and see how I can work my macros but I'm a gym rat so need to build up the muscle, even at 40 years of age...

 

[John O'Connor]

What is normal range on your DHEA-S test. It was too small to read. Based on range I googled, it seemed high.

Can anyone explain why it would be, since you are not supplementing any DHEA?
Would high protein intake cause that?

DHEA-S = 361

 

[shan1784]

What is normal range on your DHEA-S test. It was too small to read. Based on range I googled, it seemed high.

Can anyone explain why it would be, since you are not supplementing any DHEA?
Would high protein intake cause that?

DHEA-S = 361

Range for my age is 89-427

 

[John O'Connor]

Range for my age is 89-427

OK, no worries then. Medscape has different range (40-49 age male = 48 - 244 mcg/dL)

 

[shan1784]

Ok it's in the books... Appt with Dr. Crisler on April 21st... Saya was booked out further and wanted to just get going sooner.. I've heard good things so pretty excited to talk with him...

 

[shan1784]

So had my meeting with Dr. Crisler yesterday afternoon... Feel so much better knowing I'm set with proper TRT moving forward... He's a very decent guy and enjoyable to talk to... As we talked I mentioned my wife having issues with my libido and that it's been an issue lately... He never let go of that and was sure to make mention several times about making us both happy which is my total goal... Really appreciated that...

Didn't have the correct estrogen lab so not doing anything about that at this time but he feels that my estrogen is elevated. Will address after next set of labs in 6 weeks. Also wants me to give blood, which I will be doing soonish, to address thickening blood.

So meds are on the way, this is what I'm going to start with -

Existing protocol
100mg test cyp weekly IM injection
137mcg synthroid daily


New protocol
60mg test cyp 2x week SubQ injection
100iu HCG daily SubQ injection
Desiccated Thyroid 1 grain x2 daily (no more synthroid)


How does this look for my starting point with Defy?

 

[CoastWatcher]

So had my meeting with Dr. Crisler yesterday afternoon... Feel so much better knowing I'm set with proper TRT moving forward... He's a very decent guy and enjoyable to talk to... As we talked I mentioned my wife having issues with my libido and that it's been an issue lately... He never let go of that and was sure to make mention several times about making us both happy which is my total goal... Really appreciated that...

Didn't have the correct estrogen lab so not doing anything about that at this time but he feels that my estrogen is elevated. Will address after next set of labs in 6 weeks. Also wants me to give blood, which I will be doing soonish, to address thickening blood.

So meds are on the way, this is what I'm going to start with -

Existing protocol
100mg test cyp weekly IM injection
137mcg synthroid daily


New protocol
60mg test cyp 2x week SubQ injection
100iu HCG daily SubQ injection
Desiccated Thyroid 1 grain x2 daily (no more synthroid)


How does this look for my starting point with Defy?

It's a solid protocol. Give it the appropriate six weeks and test. All the best.

 

[shan1784]

It's a solid protocol. Give it the appropriate six weeks and test. All the best.

Thank you much... Blessed to have found this site which led to Defy...

 

[Re-Ride]

That's a good protocol. In the event you tire of daily hCG injections discuss with your doctor the option of less frequent hCG injections. The purpose of hCG in dual therapy is to maintain healthy testicular tissue rather than provide endogenous T. It's possible Dr. Crisler is seeking to avoid excess estrogen production by giving smaller daily injections rather than the two or three per week taken by many others. Ultimately it is his advice you need to follow.

 

[shan1784]

Well I did my first subq pin last night... Nothing to it and didn't feel the needle pierce the skin.. Harder to push the test through a 25g needle but it's half the amount so not so bad...

Still waiting on meds from Defy but had my test cyp from current script, Crisler said to just use that so I got a couple 25g syringes from the local pharmacy and started on the twice weekly subq injections.

Question, on the days I have to do HCG and Test Cyp can I combine them into one injection rather then doing 2? If so will combining the test with the hcg make the test easier to push so I could use the 29g?

 

[shan1784]

Bump on my question above... Curious about combining Test Cyp and HCG for 1 injection and if it would make the Test easier to push through a higher gauge needle..


Got all my meds yesterday from Defy and did my first HCG shot... Nothing to it, pretty easy, no pain... Although I think I may be looking to try SQ into the glute for both test and HCG. I've did my stomach 3 times now and it leaves a lil itchy/sore spot... Nothing terrible but notice it alot at the gym when moving around or leaning on a bench for example.. A little distracting and uncomfortable.

Also another thing I goofed on... Started on SQ for test cyp as of last Sunday night.. I have my test from current script from my endo so I decided to start new protocol with this before meds got here... Well Dr. Crisler increased my dose and split it to twice a week... So instead of 100mg once a week I'm doing 60mg 2 a week. Like an idiot when I drew the test up I drew it up to one line past the .5 thinking that would be 60mg. So long story short I gave myself 2 injections with 110mg each... Not happy, bad start...

So how long should i wait before my next pin.. Was thinking to skip this Sunday but then continue next Thursday... That make sense?