New member 42 years old

[Matthew Leiser]

Hey all,

New member and first time posting. I have been on TRT (test cyp 100 mg weekly) for about 2 years.

About 6 months from my 40th birthday my marriage fell apart and I felt horrible mentally and physically. I am 6 feet tall and at the time weighed in at 345 lbs. this is the most i have ever weighed. I tried hitting the gym but had no energy and my strength was gone. I was struggling with 20 lb dumbbells when in my prime I was working out with 90 lb dumbbells. I knew something was not right. I went to my doctor and he ordered some tests and diagnosed me as hypogonadal. No brain tumors or history of testicular damage. I started on Androgel which after 3 months proved ineffective so moved to injection.

Initial total serum test 259 ng/dl range 348 to 1197

follow up tests
total serum test 232 ng/dl 348 to 1197
free test 38 pg/ml range 46 to 224

Vit D was almost non-existent.

It has been about 2 years and I have seen many benefits. My strength has returned and I am stronger now than I have ever been. I am down 20 lbs overall based on the scale but have filled out when it comes to musculature. I have always had broad shoulders but have gone from a 54 to a 58 and have had to throw out my suits and sports jackets. I have lost fat everywhere except my mid section. I really seem to hold on to that and am struggling there. My diet has not always been the greatest and I know I can do better there.

Area where I have not seen improvement is erections. I can't remember the last time I had "morning wood" and erections are weak and do NOT last. Being the marriage fell apart 2 years ago sex is not plentiful so was put on the back burner to work on my mental and physical health. I would like to correct this part of my life

I did not know about estrogen management when I started so have no baseline info so just had those levels measured last week.

Estradiol was 50 pg/ml range < or equal to 39
total serum estrogen 209.1 pg/ml range 60 to 190

Total serum test 388 ng/dl 250 to 827
free test 97.6 pg/ml range 46 to 224

i also hold water Especially in my legs and feet and feel bloated 3 to 4 days a week.

I am open to any advice from everyone's experience and looking forward to,learning all I can.

thanks for listening

 

[Vince Carter]

You're being given the wrong Estrogen tests, you need the test for males, (Ultra)Sensitive, Estradiol, LC/MS/MS...this is the only test you need and this is for males. The test you received is for females and (typically) overestimates Estrogen in males.

Bloat and water retentin those few days with your injection and tapers off at the end of the week prior to your next shot?

 

[Gene Devine]

Hi and welcome to Excel Male...you've come to the right place.

First and foremost, you need to learn everything you can about TRT for men and it's all here for you to do that and why we created the site and forum.

As far as what you posted re your blood work; your serum testosterone levels are terrible and at the bottom end of the reference range.

Also, estrogen needs to be tested using the "Sensitive" lab and not the standard lab designed for women so it's really useless.

Need to know what your TRT protocol is; dosages, frequency, use of HCG...

Something is not adding up; to be on TRT and have the levels that you posted says something is wrong with what you are doing.

Is your Doctor well trained in TRT for men...and I have a strong suspicion that's not the case or else you'd have better serum levels.

Your erection issues can be caused by a lot of things one of which is elevated and/or suppressed estrogen levels and holding water is another red flag on elevated estrogen.

Can you post your most recent labs here please?

 

[Vince Carter]

I'd bet he's low SHBG with those troughs

 

[Gene Devine]

I'd bet he's low SHBG with those troughs

Or every two week injections!!!

 

[Matthew Leiser]

I inject weekly 100mgs test cyp. No hcg and no AI's. my serum levels usually are ~650. I did miss a dose in the last 3 weeks.

SHBG was 40 when last measured. Range 27.9 to 146.0 nmol/L. This was just prior to starting on my current protocol.

I have been working with an endocrinologist but he is not a men's health specialist.

 

[Gene Devine]

If you're injecting 100 mg weekly and your serum levels are test 388 ng/dl (250 to 827) free test 97.6 pg/ml range 46 to 224 then you need to increase your dosage.

Still something seem suspect here....

 

[Matthew Leiser]

Hey Gene,

thanks for for your comments. I really appreciate your time. I am not sure by what you mean by suspect?

I did miss a dose within the last few weeks per my last post and my trough levels are usually around 650. I am guessing I am going to need a few weeks to normalize from the missed dose. Agreed 388 is not a good number.

i have ordered the sensitive estradiol test from discounted labs and will post results once I have them and will instruct my Dr to order that test.

Question though - how did you know my original test was not the sensitive estradiol test?

thanks again for listening.

 

[Vince Carter]

Because of the lab ranges...the proper test has a lab value shown as <29, the test you took is < or equal to 39, we learned to know what's what by the ranges.

By suspect I think we mean something isn't being expressed right as we know how the math typically plays out something is different with your numbers. Are you having your blood drawn in the morning, right before your due for an injection? That is the ONLY time you should be testing. Also, please do what you can, don't miss a dose, if you miss a day get back on the next day, it's very important to stay steady and consistent through your therapy.

 

[Matthew Leiser]

Yes. I always have blood drawn in the morning and inject after I get home.

 

[CoastWatcher]

You noted that you've been on TRT for two years; do these most recent results mirror what you've posted in the past?

 

[Vettester Chris]

Mathew, thanks for signing up with EM! Great comments above! The only thing I might add is if you can post a complete set of labs (scan image is fine), with CBC's, lipids, metabolic, thyroid, etc., the forum will have more to discuss, plus there could be other factors for talking points that might be relevant to your current situation?

 

[Matt Leiser]

Here are my latest labs as requested.

I also have have my results for the sensitive estradiol from discounted labs. 63.6 pg/ml range 8 to 35.

 

[Vettester Chris]

Hi Matt, thanks for getting back and posting the labs. Real quick, you setup two (2) memberships, one under Matt, one under Mathew. If there's a problem with your first account that your originally posted, please let myself or one of our other staff members know, thanks!

Triglycerides are quite high as you know. Is there anything immediate in your diet that you can attribute this to? Sugars, high carbs??

RBC's and HCT is just starting to get to the outside of reference range. Would be good to look into donating blood.

Total test is LOW for 100mg/wk. Were you on your TRT protocol when drawing these labs? Do you remember when your last draw was in relation to these labs (1 hour, 1 day, 7 days?)

PSA is excellent!!

Both estradiol assays are high. To really gauge the accuracy of measurement we need to see this on a Sensitive or Ultra-Sensitive platform. I honestly believe that will register "High" as well, but trying to set a program and goal to manage your serum levels will be significantly easier, and more successful with an assay designed for adult males.

Vitamin D at 42ng/ml ... IMO, optimal Vitamin D serum levels will be achieved somewhere in the 60 to 80 range. 5,000iu/day usually put me at 75 on the last labs. You could also talk to your physician about Drisdol, which I initially did 1x/week for about 6 weeks, then my doctor just had me on OTC D3.

Not seeing anything on thyroid ... Need Free T3, Free T4, Reverse T3, TSH and antibodes, TPO & TgAb. Iron serum, TIBC, ferritin, B12. Also, DHEA at 141 is quite low, but I would do ANYTHING in this area until you get your E2 under control. This could also be a marker for other imbalances in the adrenals; possibly in a maladaptation phase ... All just speculation, but a 24 hour saliva kit with Cortisol and DHEA correlation will tell the story on your circadian profile.

Just saw TSH, one would expect the other primary thyroid labs would be in the optimal zone, if only the TSH by itself had any reliability. I've seen females with estrogen dominance that have severe hypothyroidism, meaning in the tank, below reference range on FT4 and FT3, and their TSH is < 1.0. I suspect that actual active thyroid hormone levels are going to be low, and/or pooling can be problematic when iron is off, adrenals are off, and even some of the electrolytes and D3 can play into this.

 

[Matt Leiser]

Hi Chris,

Thanks for you comments.

I have have a second account I am using because my original account "Matthew Leiser" sign in was via ******** and it is now not working.

For the triglycerides, I have to relate that to my diet. It had too many sugars, not enough fiber. I have corrected both of those items. Nelson had posted links to Dr Robert Lustig's videos and it clicked with me. It was tough for the first 3 to 4 days but now I don't even miss the sugar. I crave the protein and vegetables.

I am am due to give blood. I did not know about the higher crit on trt until joining this forum. It is always something I like to do at least once a year.

My serum T was low this draw as I missed a dose a few weeks back at the beginning of march. I went almost 2 weeks without dosing and was starting to feel like I used to and then suspected I had missed a dose. I did not alter dosage just dosed and then moved my injection days to Friday mornings. My last labs were prob about 6+ months ago. I would need to go back and look it up.

I have had the sensitive e2 test and the results are attached. I am almost twice the highest range.

I take Vit D3 5000iu per day plus another 600 in my multivitamin. I was on 50000 d2 for a few weeks in 2015 until things normalized. I was thinking of possibly upping but it is Baseball season and I am coaching so may wait and measure it again in about a month after opening day.

Will LL look more at thyroid hx at a different time. Lunch break is over.

Thanks again,

Matt

 

[CoastWatcher]

Are you dealing with symptoms associated with elevated estradiol? That is an elevated value, no question.

 

[Matt Leiser]

Yes. Libido is really low, no morning wood ever and erections are soft and don't last. I also retain water especially in my legs and feet.

 

[Matt Leiser]

In addition my endocrinologist has reported the onset of gyno. 3 cm on left, 2 cm in the right.

 

[CoastWatcher]

In addition my endocrinologist has reported the onset of gyno. 3 cm on left, 2 cm in the right.

Has an AI been prescribed? When gynecomastia is confirmed, a prompt response leads to the best outcome.

 

[Matt Leiser]

No AI as of yet. I have an appointment tomorrow to discuss.