Numbers and protocol - 34 year old male 6 months into Test cyp shots

[Scorelando]

Please let me know your thoughts...



1) 40 mg Test cyp eod Sub q
2) Just started Anastrozole .5 every 3.5 days (will adjust dosage to avoid over responding if necessary as the pills are in powder form from a compounding pharmacy) Was using chrysin but after reading studies on it in vitro I figured it wasn't worth it
3) Just went from 1/2 grain dessicated thyroid daily to 1/2 grain EOD
4) HCG 250 iu EOD

Looking to lock in on a good test level and estradiol level.....I am about to order the sensitive essay from labcorp in the hopes my functional medicine docter will write a script for it. However, even with that test I believe something serious needs to be done about the E2 (Moody, feel like crying lol, can not lose weight off of the belly with a very good diet, no deep sleep, etc.)

 

[Gene Devine]

I think you have a handle on your labs.

As for Estrogen; as you know by now, the standard default E2 lab is designed for women and over estimates men's values.

So, you really don't know your true E2 serum level till you get the Sensitive assay.

As for the AI; I am a real believer that this is one drug where starting low and going slow should be the mantra. I'd start with .25 twice weekly and then get tested to see if you need to move up.

Also, you may want to start supplementing 50 mg each morning of DHEA and Pregnenolone as well. Both are very good for "back filling" the pathways when on TRT and your Pregnenolone labs shows you somewhat low.

Outside of that, you look pretty solid.

 

[TestAdvocate]

Man, I love this site. Such good info. Scorelando........just curious what were your levels were before starting TRT. Six months in, your killing it on your Free Test! Awesome. The reason I'm asking, I'm 53 years old, I've just started therapy, my fifth week is this week. I'm on 80mg/week of TestCyp.......my before therapy Test levels were 470 Total, and 11 Free. Five weeks in, I feel awesome, great sleep, gym sessions are great. Two weeks away from my first labs on therapy.......but so far, the best health decision of my life has been going outside the box from GP's advice, getting educated (like this site), then taking matters into my own hands......loaded with the info I've learned from doing my own research. Looking forward to seeing how things are for me when I'm 6 months down the road like you.

 

[Vettester Chris]

How are you able to "tweak" your thyroid protocol, based on FT4 and TSH only? FT4 is obviously over the top, outside the reference range, but how does that compare to Free T3 and Reverse T3? 1/2 grain of NDT is a basic starting point for a protocol. Something isn't right. Post the other labs when you have time.

 

[Scorelando]

@gene
Thanks bud. How are you? I'm on dhea 50 mg and pregnenalone 10 mg as well (I don't want to go too high being only 35?)I will take your advice with the anastrozole and go .25 2x a week for 4-5 weeks and use the morning wood/see how I feel/blood results to determine next steps.

@testadvocate what's up man. I was at 50...35-155ng/dl Free
330...348-1197 total before trt
Early 30's unfortunately. I'm glad you are feeling good and getting quality sleep. I just started my cpap machine and hoping that helps me find deep sleep as I'm sure that is a big piece of all this. Found out I have severe obstructive apnea during two overnight sleep studies at a local hospital.

@vettester hope you are well. My functional medicine doctor advised me to consider going to 1/4 grain so we can be more around 1.0. However I only have 1/2 grain powder capsules at the moment so I'm doing eod for now until I see her/talk to her again. Let me know exactly what other results I ought to post as I'm not sure if I have the ones you are referring to. I think something is wrong there as well but that is currently over my head as I'm still new on this journey. To be quite honest I'm not sure I ever needed the NDT but my old trt doc said 1/2 grain would help me with depression and energy...which it did a bit. Learning weekly though.

 

[Vettester Chris]

Score, ideally you would want both FT4 & FT3 fairly close together in the 50% to 80% area of the reference ranges. If your physician is aiming for 1.0 area for FT4, that's only in the 20% range, that's not the place to be. Regardless, Free T4 (for the most part) should be considered as the reserves, which converts to T3. Free T3 is significantly more active in the body, so it's essential that it is measured in conjunction with Free T4, and against Reverse T3, as a gauge to ensure conversion activity is adequate.

In addition to your labs, look at Free T3, Reverse T3, and your antibodies (TPO & TgAb). With only 1 grain of NDT, I'm curious if there's a problem with converting to T3, or lack thereof (?). If so, we might need to talk about other variables like iodine, selenium & cortisol .. But, first thing first, see about getting the other labs. I'm trying to understand your physician's approach for treating this (?). If it was just based on T4 & TSH, then to me that's like driving in the night without headlights .. That's just my .02 on the matter.

 

[Scorelando]

Chris thanks for the wealth of information and feedback. To be fair, I just started with this doc (only one visit so far) and came for the trt doc who put me on the NDT. So I think she is also going to try and figure out if I actually need the NDT. I am not sure if I can do this without side effects but I trying 1/2 grain eod of NDT until I get this figured out?

I wrote down the labs I should add and will ask her to test them. I'm supplementing with 50 mg of iodoral and 200-300 mg of selenium as a suggestion by ksman from tnation. I read those stickies and do have waking temperatures from 96.0-96.4 amongst other issues. I have been able to get to 98.6 mid day most recently. My new functional medicine doc is waiting for the cortisol test, stool profile, food allergies/sensitivities, and vitamin and mineral testing results. I'm coming at my health from all angles. I was very unwell for a long time. 6 weeks off ssris as well. I truly appreciate you guys taking the time to help.

I am a bit nervous about the anastrozole as I don't want to crash my e2 if I'm an over responder. Am I playing it as safe as I can by doing .25 2x a week and could there be too much fluctuation by not dosing eod?

 

[Scorelando]

Hey guys,

Its been a while. I am now working with Defy medical as of a month ago. I tried a clomid restart and wanted to know everyone's thoughts.

I stopped TRT back in December 2015 (On and off for 3 years).I am 35 now. I wanted to see what my true natural levels were and then try a restart.

Here were numbers of no treatment from December 2015 to February 2016:






Here are my levels with no treatment from February 2016 - March 2016




Here are my levels with Clomid treatment 12.5 daily (3 weeks) May 2016:







So now I am working with Dr. Crisler at Defy Medical.

I am starting the following:

1 grain of naturethroid
50 mg test cyp 2x a week
HCG 100 iu every day
1/4 or 1/8 mg of arimidex 2x a week

I was wondering why the clomid doubled my LH in 3 weeks and my total T did not move and my free t dropped from 18 to 7.6?

Also, I am nervous about being an AI over responder so wondered if 1/4 mg could tank my E2?

When I was on test cyp before i had estrogen side effects at levels in between 40 and 55. I did not like the anxiety and mood issues. So now I am biting the bullet and doing the whole Test+arimidex+HCG.

I did take a zrt cortisol test and it was high morning, noon evening but normal at night. So I am due for another test to see if the adrenals have improved. Any feedback would be great. I hope everyone is doing well.

 

[Scorelando]

My labs wouldnt post ughhhh

 

[CoastWatcher]

You are certainly in good hands with Dr. Crisler and Defy. Absent your labs we can't really offer many comments.

 

[TestAdvocate]

Hey guys,

Its been a while. I am now working with Defy medical as of a month ago. I tried a clomid restart and wanted to know everyone's thoughts.

I stopped TRT back in December 2015 (On and off for 3 years).I am 35 now. I wanted to see what my true natural levels were and then try a restart.

Here were numbers of no treatment from December 2015 to February 2016:






Here are my levels with no treatment from February 2016 - March 2016




Here are my levels with Clomid treatment 12.5 daily (3 weeks) May 2016:







So now I am working with Dr. Crisler at Defy Medical.

I am starting the following:

1 grain of naturethroid
50 mg test cyp 2x a week
HCG 100 iu every day
1/4 or 1/8 mg of arimidex 2x a week

I was wondering why the clomid doubled my LH in 3 weeks and my total T did not move and my free t dropped from 18 to 7.6?

Also, I am nervous about being an AI over responder so wondered if 1/4 mg could tank my E2?

When I was on test cyp before i had estrogen side effects at levels in between 40 and 55. I did not like the anxiety and mood issues. So now I am biting the bullet and doing the whole Test+arimidex+HCG.

I did take a zrt cortisol test and it was high morning, noon evening but normal at night. So I am due for another test to see if the adrenals have improved. Any feedback would be great. I hope everyone is doing well.

There's nothing wrong with using the AI if you have to. I too aromatize more than most, so managing E2 was really tricky with me. I had to eventually use the AI when my E2 levels reach 60 at about 6 months into my therapy. I was hoping my body would eventually level out and adjust on it's own but not for me. Ankles were swollen, I had the puffy face, acne was becoming uncontrollable. Defy presribed me .5mg arimidex/DIM capsules, twice a week. It definitely worked, almost immediately, the swelling and puffiness went away. My E2 has leveled out at between 29 and 31 now, which is perfect for me.