Need advice on first lab results, my initial Defy consultation is 5 weeks away

[jack64]

Just received my first labs after 3 months of TRT. I started with 100mg cypionate E3.5D (IM) for the first 3 weeks, changed to 50mg e3.5D (IM) after experiencing symptoms of high estradiol. I tried .25 arimidex in Sept and the next day both knees hurt and suffered a L quad tendon strain. Haven't taken arimidex since and am kind of afraid of additional injuries with it.

For the last 6 weeks I've injected SubQ 50mg E3.5D. What would you guys do with these labs? I talk with Dr. Saya at the end of December, but am kind of concerned about the out of range tests and how I feel.

 

[Vettester Chris]

Thanks for posting. One form or another, you will need to control the E2. There's just really know way around it, at least until you can find some absolute balance with your TRT program; having a controlled amount of E2 conversion that doesn't require any AI administration. Talk to Dr. Saya about this, and maybe there's another inhibitor like Aromasin, which has also worked good for others.

 

[johndoesmith]

1. When were these taken relative to injection?

2. How DO you feel? You never explained, just said you were concerned with how you feel.

3. What tests are you concerned with?

The ONLY one that's out of range significantly there, is E2. That is HIGH! You will probably grow breasts pretty soon. Progesterone is only "out of range" due to labcorp changing it drastically for no reason. HDL is kinda low, but certainly not as urgent as addressing that E2 level. LH is supposed to be low when on TRT. DHEA is somewhat concerning for how low range it is. I don't know much about DHEA though.

 

[jack64]

Thanks guys, the blood was taken about 7 hours before injection on my injection day.

I've been feeling pretty stressed and not as much energy as I'd expect for a guy with 799 testosterone. I was 290s in August before starting TRT. Letting E2 run high for another 5 weeks before talking with Dr. Saya worries me. I guess I have the classic high E2 symptoms, water retention, bloating, hard, sensitive nipples, infrequent night-time erections, increased bp. Also, my gains in the gym have been basically the same as I would have made with my old 290s T. Hair is thinning too so I guess DHT is probably high.

I don't mind frequent injections, do you guys think I might get lowered E2 if I switch the SubQ injections to .15ml (30mg) every other day?

Nuts are also shrinking, but hopefully I'll have HCG from Defy after speaking with Dr. Saya next month.

 

[johndoesmith]

Thanks guys, the blood was taken about 7 hours before injection on my injection day.

I've been feeling pretty stressed and not as much energy as I'd expect for a guy with 799 testosterone. I was 290s in August before starting TRT. Letting E2 run high for another 5 weeks before talking with Dr. Saya worries me. I guess I have the classic high E2 symptoms, water retention, bloating, hard, sensitive nipples, infrequent night-time erections, increased bp. Also, my gains in the gym have been basically the same as I would have made with my old 290s T. Hair is thinning too so I guess DHT is probably high.

I don't mind frequent injections, do you guys think I might get lowered E2 if I switch the SubQ injections to .15ml (30mg) every other day?

Nuts are also shrinking, but hopefully I'll have HCG from Defy after speaking with Dr. Saya next month.

I'd call defys office on friday and ask them what to do, I highly doubt they will want you to wait 5 weeks with an E2 level that high, you're at a decent risk for gyno.

I imagine they will work something out.

 

[Vince]

If you do have high levels of DHT, there are many benefits. You can use the search and find many. I think we all know low levels of E2 are worse than high levels. I always believed the best way to control estradiol is by losing belly fat, easier said then done.

 

[jack64]

Thanks guys, I'll call Defy on Friday. Today is my injection day for 50mg E3.5D and I'm going to skip it, I think with 799 T and with the elevated E2 I can do the next injection at the 7 day mark.

I've trimmed down a little since starting TRT, 6'1" 171 now, but I'm still carrying belly and chest fat. I did kind of an exam around the nipples and the gyno might already be there, not sure, hopefully it's stubborn fat that doesn't want to burn off because of the high E2.

I'm visiting relatives today and don't have the arimidex with me, but the Rx has refills on it. I'm debating going out today and getting it refilled and taking apprx .10-.15mg and then being very careful with light exercise. Maybe just an hour a day on a stationary bike for a few days and no weights.

 

[CoastWatcher]

Thanks guys, I'll call Defy on Friday. Today is my injection day for 50mg E3.5D and I'm going to skip it, I think with 799 T and with the elevated E2 I can do the next injection at the 7 day mark.

I've trimmed down a little since starting TRT, 6'1" 171 now, but I'm still carrying belly and chest fat. I did kind of an exam around the nipples and the gyno might already be there, not sure, hopefully it's stubborn fat that doesn't want to burn off because of the high E2.

I'm visiting relatives today and don't have the arimidex with me, but the Rx has refills on it. I'm debating going out today and getting it refilled and taking apprx .10-.15mg and then being very careful with light exercise. Maybe just an hour a day on a stationary bike for a few days and no weights.

I would not skip an injection. If you don't reach Defy tomorrow, and they may be closed for the holiday weekend, you can revisit your options.

 

[Vince]

Thanks guys, I'll call Defy on Friday. Today is my injection day for 50mg E3.5D and I'm going to skip it, I think with 799 T and with the elevated E2 I can do the next injection at the 7 day mark.

I've trimmed down a little since starting TRT, 6'1" 171 now, but I'm still carrying belly and chest fat. I did kind of an exam around the nipples and the gyno might already be there, not sure, hopefully it's stubborn fat that doesn't want to burn off because of the high E2.

I'm visiting relatives today and don't have the arimidex with me, but the Rx has refills on it. I'm debating going out today and getting it refilled and taking apprx .10-.15mg and then being very careful with light exercise. Maybe just an hour a day on a stationary bike for a few days and no weights.

I definitely agree with CW, don't skip a dose of testosterone. Your levels will probably go to low, they're not very high now.

 

[jack64]

Maybe I'll start .15ml (30mg) every other day with today's injection, do you guys think it might help keep things more even throughout the week and possibly lower E2? I don't think E2 could get much worse than the 67.2 currently.

Also, have been taking 50mg of Zinc daily, read that Zinc might work as an AI. Maybe 100 mg of Zinc daily will help drop E2.

 

[Vince]

Don't over do the zinc, I use jarrow zinc balance. That may be a good plan, daily injections of T. CW injects daily to keep his E2 under control.

 

[johndoesmith]

Maybe I'll start .15ml (30mg) every other day with today's injection, do you guys think it might help keep things more even throughout the week and possibly lower E2? I don't think E2 could get much worse than the 67.2 currently.

Also, have been taking 50mg of Zinc daily, read that Zinc might work as an AI. Maybe 100 mg of Zinc daily will help drop E2.

I don't think it'd be a good idea to make all these changes to your protocol, you seem a little excited, first skipping a dose, then adding in AI, then switching to EOD, then zinc.

If you must make a change, only change ONE thing, do not add in multiple variables.

Best bet would be to try to reach defy on friday, maybe saturday, another day or so with high E2 shouldn't make a huge difference.

I don't think EOD in your case will lower E2 as much as you need.

 

[Dr Justin Saya MD]

Jack64 - if I'm reading your thread correctly, you are not a current patient of mine but have a consult scheduled next month correct? If so, we wouldn't be able to prescribe you any prescription medications (including micro-dose anastrozole, if needed) until the consult establishes a legitimate physician-patient relationship.

Until then, however, I can offer advice and supplement recs:

Calcium D-glucarate 500mg twice daily (OTC)
DIM 200mg daily (OTC)
If you feel up to it, get some small insulin syringes 29G, 1/2" and do a trial of a DAILY T cyp injection schedule 14mg daily (0.07ml daily).

If you follow through with this, it would be interesting to get another check on T, E, SHBG about a week prior to our consult. I look forward to talking then.

HAPPY THANKSGIVING EVERYONE!

 

[chrismez]

I doubt .25mg of Anastrozole one time would cause your knees to hurt and quad strain. I think they are unrelated especially with high e2 numbers....

 

[jack64]

Jack64 - if I'm reading your thread correctly, you are not a current patient of mine but have a consult scheduled next month correct? If so, we wouldn't be able to prescribe you any prescription medications (including micro-dose anastrozole, if needed) until the consult establishes a legitimate physician-patient relationship.

Until then, however, I can offer advice and supplement recs:

Calcium D-glucarate 500mg twice daily (OTC)
DIM 200mg daily (OTC)
If you feel up to it, get some small insulin syringes 29G, 1/2" and do a trial of a DAILY T cyp injection schedule 14mg daily (0.07ml daily).

If you follow through with this, it would be interesting to get another check on T, E, SHBG about a week prior to our consult. I look forward to talking then.

HAPPY THANKSGIVING EVERYONE!

Thank you very much Dr. Saya. Yes, our initial consult is on the 27th.

I will definitely add Calcium D-glucarate and start daily 14mg SubQ today. With the 27th consult I'll plan T, E, SHBG labs on the 20th or 21st.

I have a question about DIM please I was hoping you or a forum member could answer. I have the Nature's Way brand DIM-plus pictured below. According to the label, 2 capsules contain 25% diindolylmethane (25 mg). Would I take 4 capsules twice daily? I noticed after purchasing it says it also contains soy (I later read soy can lead to gyno). Is there a better brand of DIM if the soy could be a concern? I don't mind the additional expense if it could help prevent gyno.

Thanks again for your help, Happy Thanksgiving to all!

 

[johndoesmith]

Thank you very much Dr. Saya. Yes, our initial consult is on the 27th.

I will definitely add Calcium D-glucarate and start daily 14mg SubQ today. With the 27th consult I'll plan T, E, SHBG labs on the 20th or 21st.

I have a question about DIM please I was hoping you or a forum member could answer. I have the Nature's Way brand DIM-plus pictured below. According to the label, 2 capsules contain 25% diindolylmethane (25 mg). Would I take 4 capsules twice daily? I noticed after purchasing it says it also contains soy (I later read soy can lead to gyno). Is there a better brand of DIM if the soy could be a concern? I don't mind the additional expense if it could help prevent gyno.

Thanks again for your help, Happy Thanksgiving to all!

View attachment 2772

I'd do the labs maybe the 20th, with christmas eve being the 24th, it may delay it a bit.

Your supplement seems to have a bunch of other crap in it, although I'm no expert on DIM, I just looked at others online and they're pure DIM. https://www.amazon.com/DIM-Diindoly...ominance-Mico-Encapsulated/dp/B006KL4TYG?th=1

I highly doubt the amount of soy in it is enough to do anything to you. They're probably using it in the capsule, and have to say for allergy reasons.

 

[Vince]

I do not use a DIM but others have recommended these.
DIM 200mg (Smoky Mountain Naturals)
https://www.amazon.com/gp/product/B006KL4TYG?th=1
I3C 200mg (Absorb Health)
https://www.amazon.com/gp/product/B00JROML5W?

 

[CoastWatcher]

Jack64,

Eighteen months ago I went to a daily injection protocol, in my case 16mg of testosterone every day. I brought my estradiol down to a very comfortable level and maintained steady-state testosterone levels at the 1000 mark within six weeks. It doesn't work for everyone, my friend Vince Carter here at EM seems to have intractable e2 issues, but my doctor has seen great success with daily injections in the vast majority of her patients. You have every reason to be hopeful.

All the best.

 

[jack64]

Thanks again guys, ordered these from amazon, should have them Monday. Will post labs in about 1 month to see how I do. And thanks Coast for your protocol info & words of encouragement, much appreciated!

 

[jack64]

Guys, since 11/24 I've been on the 14mg daily injection schedule, on 11/30 received and started the Calcium D-glucarate 500mg twice daily and DIM 200mg daily. Also been taking 50mg Zinc daily and some days 100mg.

The last 3-4 days have been strange, bad insomnia, night sweats, hot flushing in my face and feeling a lot of stress to the point of my eyes starting to tear up for no good reason a few times. Would you think it's ok to bump up the Calcium D-glucarate and DIM. Appointment with Dr. Saya is two weeks from Tuesday. This high E2 is really awful, I'm going to ask him about raloxifene for the gyno I'm pretty certain I have. Have been doing a lot of cardio (bike) and sweating and a healthy diet and my belly/chest fat has increased this week.