New Guy Trying to Figure it Out

[Raindog]

Hi All-

I got a secondary hypogonadism diagnosis in January. But, based on what I've learned and have felt, pretty sure I have run low for a very long time. 15 years? Prolly in range but either low or maybe sensitive to E, both? Mostly emotional symptoms, so it is really hard to say. Not sure yet and actually I don't think matters anyway. In January, complained about delayed orgasm so doc tested. Test results:

% Free T MALE: 1.2 Range 1.6-2.9%
Free T MALE: 35 Range: 47-244 pg/mL
T: 292 Range: 241-827 ng/dL
SHBG: 66.3 Range: 15.0-87.0 nmol/L
PSA: 1.29 Range: 0.00-4.00 ng/mL
LH: 2.5 Range: 1.5-9.3 IU/L
Prolactin: 8.1 Range: 2.1-17.7 ng/mL
Estradiol 17-B: 25 Range 0-40 pg/mL (Believe it is the Siemens Centaur method)
TSH: .844 Range: 0.400-4.00 mU/I

He started me on a single gel pack a day. Progressed to two packs a day then to injections. Early using the packs I felt REALLY good during moments, it was fleeting and I was flushing real bad still had delayed O. Test were coming back still low. So moved to injections a couple months ago. 200mg/1ml vials, started injecting 100mg every two weeks, then to 50mg a week. Had flushing, retained water, hormones felt up and down, brain fog, etc. So I went to 25 mg twice a week up to Sunday. Water started to shed, I still flushed a little. But I still felt on a roller coaster up down and completely lost the feelings of confidence, zest, focus. Was here for about 3, maybe 4 weeks. Blood test Monday this week, taken in my deepest valley:

Estradiol 17-B: 30 Range 0-40 pg/mL (Believe it is the Siemens Centaur method)
% Free T MALE: 1.5 Range 1.6-2.9%
Free T MALE: 86 Range: 47-244 pg/mL
T: 575 Range: 241-827 ng/dL
SHBG: 56.4 Range: 15.0-87.0 nmol/L

So, I see this before my doc appt and think okay I am low on Free T, cause of the % Free T test. Figured doc was gonna just boost me. I went in today. He wasn't going to. He was going to let it ride as is. Said he was shooting for 600, but thought that might be close enough. But, I explained to him how I felt and he agreed to bump me up 20% on my dosage and to give me something to control my E. I have read a little and knew more about Arimidex, but he prescribed Tamoxifen. I haven't run into that on my google research yet. I just read a little. Sounds like Arimidex is more standard and a preferred way to go. But I think I also read that Tamoxifen is good for guys who have higher SHBG, which I think I do.

Any guidance would be really great!

Dave

 

[Raindog]

I didn't properly introduce myself. David. I live in the Portland Or. area. 53 y/o. Mostly active guy. MTB, some road riding. But, half ass. Not that fit, lol. Regular, middle aged, suburban guy.

 

[Sean Mosher]

Thankfully he allowed you to up your dose based on how you were feeling and not just targeting a number like 600.
That's kind of absurd.
Looks like you have a good opportunity here to work with this doc and tailor a protocol that fits you and your numbers (as long as he stays flexible to your input).
You can always arm yourself with info/printouts from this site when you talk with him as well.

Also, you need to run the sensitive estrogen test, e2 (LC/MS) before any talk/dosing of an inhibitor.

 

[Nashtide]

You have highish SHBG. You may need more T to get your FT high enough to feel better. Other guys on here with high SHBG will chime in with their experience. Best of luck.

 

[Raindog]

Thanks for the info. I had to chime in here. Maybe not good, but on Monday when I saw my labs and knew how I felt, I bumped up my injection w/o consent to .5ml/50mg on Monday and Thurs. I managed to acquire an Armidex sample and took 1/4 of a tablet. I have to say, today is the best I have felt in prolly 15-20 years. Amazing. Like a vail has been lifted. I am sharp, focused, happy, no anxiety, confident, energized. Just amazing. Life changing.

Curious about controlling my E using Tamoxifen in-lieu of Arimidex. Doc prescribed Tamoxifen, I expected him to prescribe Arimdex. Also, a point he mentioned on A.I.'s was there was little scientific data on log term effects of A.I's on men. So, thinking maybe he went with Tamoxifen because it is more benign then the other? I think I read that Tamoxifen is better for guys with higher SHBG, which I am a little high on. Also any benefits from Tamoxifen towards FREE T? I took a 1.4 of Armidex Tues. eve. If I want to get back on my doc's therapy and get on the Tamoxifen, how long should I wait to get the Armidex out of the way?

 

[CoastWatcher]

Why do you and your doctor assume you'll need an AI? It's an easy element to ADD to a protocol if necessary, a much more difficult and painful process to eliminate and wait for estradiol levels to return to a healthy level once they have crashed.

 

[Raindog]

When I first started injecting, at 100 and 50 mg I swelled up to the point my shoes didn’t fit, had really bad flushing, itchy nips, brain fog, lack of focus, anxiety, delayed orgasm, weepy, gained 5 pounds when I should have lost 5 pounds, penis wanted to crawl back inside. Labs have all been done in valleys. It has not show up in labs. My doctor actually seems reluctant. So, based solely on that. I am not sure if something else could be responsible for these things, let me know, but so far from what I have read it sounded like high E.

My plan is to do what my doc says. Even though this feels good, instead of 50mg inject 2x a week, I’m going to 30mg, no AI. I know I get bad mojo at 50mg and I know I fall short at 25 mg., but I don’t know what 30 feels like and could be a sweet spot without AI.

 

[Systemlord]

The first couple months I had flushing and retained water, but after a couple of months it all subsided. You're supposed to feel like you're on a rollercoaster for the first 6 weeks after changing your protocol.

Your protocols are all over the place and you're so far off the mark protocol wise, 30mg twice weekly is just wrong given your SHBG level. What you need is an experienced doctor plain and simple or it will be years before you finely through in the towel.

 

[Raindog]

Ive got a huge learning curve. It is very confusing to me. I have a very mechanical mind and I should be able to figure this out. I like my doc a lot. I do trust him. I know he has experience with this therapy, I don't know to what degree. I like his curious mind and willingness to listen and act. I respect his intellect. But, I have some apprehension about where it is heading too. Probably a big reason I registered and posted. Ive begun to do a little research for a new doc in the Portland area in case I become too discouraged with my guy, but tossing in the towel ain't happening. One or two more adjustments and I am out. So, you hit the nail on the head, it's why I am here. To learn more so I can make a more informed decision about all of it, including making a doctor change.

 

[FeelingLost]

I didn't properly introduce myself. David. I live in the Portland Or. area. 53 y/o. Mostly active guy. MTB, some road riding. But, half ass. Not that fit, lol. Regular, middle aged, suburban guy.

Hi David nice to see another mtn bikers. Now there are three of us. Welcome. Take all these posts as data points along the way to getting smarter.
Some of the members here have very bad bedside manners hell they scare half the new guys away with their attitudes and the mods don't seam to do anything about it. You are on the right track keep at it in time you will figure out who to trust and who to ignore.

 

[Raindog]

Thanks for the welcome! I lurked for a month or so so I understand what you speak of. Its cool. Lots of forums can get blunt, sometimes its how you read the tone. I go in assuming its meant as help. 30 years in B2B distribution sales, Ive got thick skin w/controlled response. Plus, I really need the knowledge. For the record, I haven't taken anything on this thread as negative, I got something out of each post to look into. As long as you some what respect where I come from too, I'm good.