New to TRT and need advice on possible change in dosage (NOT WORKING)

[bigman]

So after several years on my primary care Dr trying to persuade me to do TRT I relented. I was consistently low 200's. I worked hard to get it up on my own naturally (sleep, ZMA, weights, stress management, etc) and had some success (see final baseline tests). My goal with TRT was better workouts, better sense of well-being, less brain fog, and lastly, and most importantly, I wanted to chase my wife around the house.

My Dr chose to start me out of the gate with 100mg ONCE weekly. I am doing sub-q injections. After being underwhelmed by my initial tests and feeling no real changes, my protocol was bumped to 70mg TWICE weekly. Here is a recap of my blood tests.

45 years old
6'6"
250lbs
15ish% BF
workout hard with weights 3.5x week
high pressure job
medium nutrition

Final baseline test 19 Oct 2016
Estradiol - 14.1 (reference interval 25.8-60.7)
Human Sex Hormone-Binding Globulin - 56 (10-80)
Test - 439 (347-1197)
Free Test - 6.36 (4.7-24.4)
DHEA - 208 (44-331)
LH - 4.1 (1.7-8.6)
DHT - 52 (30-85)

3rd AM after 3rd dose of 100mg ONCE weekly

30 Dec 2016
Estradiol - 28.2 (reference interval 25.8-60.7)
Human Sex Hormone-Binding Globulin - 40 (10-80)
Test - 559 (347-1197)
Free Test - 10.64 (4.7-24.4)

3rd AM after 3rd week of 70mg TWICE weekly (and 5 weeks of 100mg)

2 Feb 2016
Estradiol - 39.9 (reference interval 25.8-60.7)
Human Sex Hormone-Binding Globulin - 48 (10-80)
Test - 689 (347-1197)
Free Test - 12.03 (4.7-24.4)


Fast forward, I have completed 5 weeks of 100mg per week and 5 weeks of 140mg per week (70mg TWICE weekly) and I am feeling very modest changes. None of my original goals have been accomplished. No real strength gains in the gym, modest muscle mass increase, no discernible increase in libido, no improved sense of well-being, no reduction in brain fog. In any case, I feel under dosed. I am not getting any morning wood. Zero.

My Dr wants me to stay the course and is only recommending that I add .25 mg of Anastrozole TWICE weekly post injection. The thinking is that this will reduce the Estrogen and increase the Testosterone thereby creating the effect that I am seeking.

I am anxious to hear if everyone else is similarly optimistic. Any thoughts, suggestions, or ideas?

 

[johndoesmith]

So after several years on my primary care Dr trying to persuade me to do TRT I relented. I was consistently low 200's. I worked hard to get it up on my own naturally (sleep, ZMA, weights, stress management, etc) and had some success (see final baseline tests). My goal with TRT was better workouts, better sense of well-being, less brain fog, and lastly, and most importantly, I wanted to chase my wife around the house.

My Dr chose to start me out of the gate with 100mg ONCE weekly. I am doing sub-q injections. After being underwhelmed by my initial tests and feeling no real changes, my protocol was bumped to 70mg TWICE weekly. Here is a recap of my blood tests.

45 years old
6'6"
250lbs
15ish% BF
workout hard with weights 3.5x week
high pressure job
medium nutrition

Final baseline test 19 Oct 2016
Estradiol - 14.1 (reference interval 25.8-60.7)
Human Sex Hormone-Binding Globulin - 56 (10-80)
Test - 439 (347-1197)
Free Test - 6.36 (4.7-24.4)
DHEA - 208 (44-331)
LH - 4.1 (1.7-8.6)
DHT - 52 (30-85)

3rd AM after 3rd dose of 100mg ONCE weekly

30 Dec 2016
Estradiol - 28.2 (reference interval 25.8-60.7)
Human Sex Hormone-Binding Globulin - 40 (10-80)
Test - 559 (347-1197)
Free Test - 10.64 (4.7-24.4)

3rd AM after 3rd week of 70mg TWICE weekly (and 5 weeks of 100mg)

2 Feb 2016
Estradiol - 39.9 (reference interval 25.8-60.7)
Human Sex Hormone-Binding Globulin - 48 (10-80)
Test - 689 (347-1197)
Free Test - 12.03 (4.7-24.4)


Fast forward, I have completed 5 weeks of 100mg per week and 5 weeks of 140mg per week (70mg TWICE weekly) and I am feeling very modest changes. None of my original goals have been accomplished. No real strength gains in the gym, modest muscle mass increase, no discernible increase in libido, no improved sense of well-being, no reduction in brain fog. In any case, I feel under dosed. I am not getting any morning wood. Zero.

My Dr wants me to stay the course and is only recommending that I add .25 mg of Anastrozole TWICE weekly post injection. The thinking is that this will reduce the Estrogen and increase the Testosterone thereby creating the effect that I am seeking.

I am anxious to hear if everyone else is similarly optimistic. Any thoughts, suggestions, or ideas?

I'm sorry, I'm having trouble understanding when your tests were taken relative to injection.

Your doctor seems to mean well and knows a decent protocol, but doesn't know the appropriate labs to run.

Unless you're only giving us what's "relevant". I didn't even know that labcorp had an E2 test with a starting range of 25. Definitely not a sensitive test, and that range makes it tough to interpret.

 

[zojo360]

It looks like your switching your protocol quickly and not allowing the minimum 6 weeks on a religious dosing schedule then do blood work. You did do a decent job of raising your T levels naturally btw but TRT may be your best bet. If you choose TRT, stick to an injection protocol, then get blood work to see how that schedule is working. Do you have full blood panels to share (pre TRT and latest)? I'm not to versed on subq injections but it seems 70mgs at one pin subq is a big amount. Most guys doing subq inject less more often (ED, EOD) and have great success. Maybe subq isn't what's best for you and IM might be better. The Arimidex dose seems to be a good start if that is your problem with high E2. Your on the path, just stick with it for 6 weeks RELIGIOUSLY then get full blood tests.

Good luck...

 

[bigman]

Thanks for the replies. Let me try and clarify the lab test sequence. I have had 3 labs so far relating to TRT (I had many labs over the years, most all showed total T in the 200's).

Lab Test #1 - Baseline Pre-TRT
Full spectrum comprehensive lab test. 5 pages of everything. Full lipid, adrenal, mineral, you name it. Here are the highlights:
Estradiol - 14.1 (reference interval 25.8-60.7)
Human Sex Hormone-Binding Globulin - 56 (10-80)
Test - 439 (348-1197)
Free Test - 6.36 (4.7-24.4)
DHEA - 208 (44-331)
LH - 4.1 (1.7-8.6)
DHT - 52 (30-85)

Lab Test #2 - 3 weeks into TRT (3 doses of 100mg per weekly performed sub-q)
This lab test was a very limited hormone profile and was taken 3rd AM after the 3rd weekly dose of 100mg. Here is all of the data captured for this test:
Estradiol - 28.2 (reference interval 25.8-60.7)
Human Sex Hormone-Binding Globulin - 40 (10-80)
Test - 559 (348-1197)
Free Test - 10.64 (4.7-24.4)

Lab Test #3 - 3 weeks into new TRT protocol of 70mg TWICE weekly performed sub-q (6 weeks total into TRT)
Once again, this lab was taken 3rd AM after completing my 3rd week of this new protocol. Here is all the data captured:
Estradiol - 39.9 (reference interval 25.8-60.7)
Human Sex Hormone-Binding Globulin - 48 (10-80)
Test - 689 (348-1197)
Free Test - 12.03 (4.7-24.4)



The lab company I am going to is Any Lab Test Now and the data sheet comes back from a company called True Health Diagnostics. I do not know if this test is for "sensitive Estrogen". The report only says Estradiol on it with no mention of "sensitive" anywhere.

 

[CoastWatcher]

Thanks for the replies. Let me try and clarify the lab test sequence. I have had 3 labs so far relating to TRT (I had many labs over the years, most all showed total T in the 200's).

Lab Test #1 - Baseline Pre-TRT
Full spectrum comprehensive lab test. 5 pages of everything. Full lipid, adrenal, mineral, you name it. Here are the highlights:
Estradiol - 14.1 (reference interval 25.8-60.7)
Human Sex Hormone-Binding Globulin - 56 (10-80)
Test - 439 (348-1197)
Free Test - 6.36 (4.7-24.4)
DHEA - 208 (44-331)
LH - 4.1 (1.7-8.6)
DHT - 52 (30-85)

Lab Test #2 - 3 weeks into TRT (3 doses of 100mg per weekly performed sub-q)
This lab test was a very limited hormone profile and was taken 3rd AM after the 3rd weekly dose of 100mg. Here is all of the data captured for this test:
Estradiol - 28.2 (reference interval 25.8-60.7)
Human Sex Hormone-Binding Globulin - 40 (10-80)
Test - 559 (348-1197)
Free Test - 10.64 (4.7-24.4)

Lab Test #3 - 3 weeks into new TRT protocol of 70mg TWICE weekly performed sub-q (6 weeks total into TRT)
Once again, this lab was taken 3rd AM after completing my 3rd week of this new protocol. Here is all the data captured:
Estradiol - 39.9 (reference interval 25.8-60.7)
Human Sex Hormone-Binding Globulin - 48 (10-80)
Test - 689 (348-1197)
Free Test - 12.03 (4.7-24.4)



The lab company I am going to is Any Lab Test Now and the data sheet comes back from a company called True Health Diagnostics. I do not know if this test is for "sensitive Estrogen". The report only says Estradiol on it with no mention of "sensitive" anywhere.

It isn't the sensitive test and it isn't to be trusted when treating men.

 

[CSI007]

It isn't the sensitive test and is it to be trusted when treating men.

Not only that it probably is registering HIGH since it's not the sensitive test.

If you add Anastrozole into your body you are going to regret it with where you are right now with your E2. This is just a guess on my part but you do not want to deal with crashed estradiol.

 

[CoastWatcher]

You do not want to tank your estradiol by adding an AI at this point. You want to give your protocol time to work, changes after less than six weeks are premature and will only confuse the issue. You want to test your estradiol with the sensitive lab test - you can pull it yourself at www.discountedlabs.com.

 

[bigman]

I certainly appreciate the feedback on the AI and the "sensitive" test. I am not suffering any symptoms of high Estrogen and from what I read on this forum, low Estrogen is considered a far worse fate than high Estrogen.

 

[madman]

Thanks for the replies. Let me try and clarify the lab test sequence. I have had 3 labs so far relating to TRT (I had many labs over the years, most all showed total T in the 200's).

Lab Test #1 - Baseline Pre-TRT
Full spectrum comprehensive lab test. 5 pages of everything. Full lipid, adrenal, mineral, you name it. Here are the highlights:
Estradiol - 14.1 (reference interval 25.8-60.7)
Human Sex Hormone-Binding Globulin - 56 (10-80)
Test - 439 (348-1197)
Free Test - 6.36 (4.7-24.4)
DHEA - 208 (44-331)
LH - 4.1 (1.7-8.6)
DHT - 52 (30-85)

Lab Test #2 - 3 weeks into TRT (3 doses of 100mg per weekly performed sub-q)
This lab test was a very limited hormone profile and was taken 3rd AM after the 3rd weekly dose of 100mg. Here is all of the data captured for this test:
Estradiol - 28.2 (reference interval 25.8-60.7)
Human Sex Hormone-Binding Globulin - 40 (10-80)
Test - 559 (348-1197)
Free Test - 10.64 (4.7-24.4)

Lab Test #3 - 3 weeks into new TRT protocol of 70mg TWICE weekly performed sub-q (6 weeks total into TRT)
Once again, this lab was taken 3rd AM after completing my 3rd week of this new protocol. Here is all the data captured:
Estradiol - 39.9 (reference interval 25.8-60.7)
Human Sex Hormone-Binding Globulin - 48 (10-80)
Test - 689 (348-1197)
Free Test - 12.03 (4.7-24.4)



The lab company I am going to is Any Lab Test Now and the data sheet comes back from a company called True Health Diagnostics. I do not know if this test is for "sensitive Estrogen". The report only says Estradiol on it with no mention of "sensitive" anywhere.

So you only gave yourself 3 weeks of 100mg/week and than had blood work so first and foremost you did not stay on your original protocol for a full 6 weeks until your blood levels stabilize so you have no idea where your true tt numbers would be.

Than after 3 weeks you increased dose quite a bit to 70mg twice/week and only stayed on that protocol for another 3 weeks and again had blood work done to early as you did not give yourself a 6 full weeks at your new dosage so how can you expect to know what tt range you would reach at that level?

As far as beneficial effects for some it takes time as a lot of changes do not come quick.

 

[Vince]

The only thing I would add, remember to do labs on injection day before you inject.