Simple question from new TRT patient

[mxman420]

I'm a relatively new patient of Defy Medical since January.
I just had my first refill of my Testosterone Cypionate 200mg/mL, 10mL , which I inject .35ml twice a week.
I started off with low T, about 170, and I just had new labs drawn after being on TRT for almost 4 months now. Haven’t got the results back yet. But to be honest, I haven't felt much different. I started with a keto diet (as per Defy's recommendation) and exercising when I started my therapy. Over the past 4 months I have lost some weight, but am still very tired, and have absolutely zero sex drive, no ambition and still a bit of brain fog. Going keto helped with the brain fog a little but still….
I was really hoping this was going to help me feel like my old self again. But I don't.
Is this normal?

 

[Country23030]

Have to wait for the blood work.

 

[Systemlord]

Posting some pre-TRT labs might explain why you aren't feeling great, for instance if low SHBG that could definitely explain the lack of progress. TRT will only work if thyroid is performing optimally and all your other systems must be functioning well before you start feeling like your old self again. I have low SHBG and started feeling slightly better by about 6 weeks in even with levels barely above midranges at halfway point between injections.

Thyroid requires good cortisol levels, you can't really expect miracles this early in treatment. Most take a year or more to find the right dosage and injection frequency that's right for you. I suspect that you could be having problems with estrogen for the fact no mention of an AI to block excess estrogen conversion, if high is one of those hormones that can make TRT seem like it's not working. It can block testosterone at the receptors and prevent testosterone from working fully.

Taking medications like SSRIs can sabotage your results. If you're a hypermetabolizer that would mean your body is using up the majority of your testosterone faster, this would mean you should move injections closer together. The good news is you're working with the best doctors you could hope to find and they will sort you out. Your labs will tell us everything.

TRT is much more than just injecting testosterone.

 

[mxman420]

Testosterone, Serum
196 Low ng/dL
Free Testosterone(Direct)
14.4pg/mL
DHEA-Sulfate 263.0ug/dL
TSH 2.100uIU/mL
Luteinizing Hormone(LH), S
LH 0.1 Low mIU/mL




I'm also taking HCG 50ml once a week and anastrozole .125 2-3 times a week.

 

[mxman420]

Estradiol, Sensitive 15.6
Sex Horm Binding Glob, Serum 26.8

 

[Systemlord]

Brain fog is usually to first thing to clear, my money is on high estrogen because when it gets high can cause brain fog. If this is the case the solution is rather simple, depending on where testosterone levels are, the course of action is usually lower the cypionate dosage andor increase the AI dosage. Increasing the AI dosage will yield quickest results in a matter of days. I'd wait for the labs though, you don't want to experience crashed estrogen levels, trust me.

SHBG is great, not too low and not too high. Perfect.

 

[lowe2sucks]

brain fog is much more common with low estrogen^
and his e2 is 15 its low

 

[Systemlord]

brain fog is much more common with low estrogen^
and his e2 is 15 its low

Those are pre-TRT labs, he had brain fog then and now. I had more brain fog with high estrogen then low, low estrogen I could think and my mind would tend to race.

 

[Vettester Chris]

As noted, labs need to be posted before any real conversation can take place, otherwise it's just all speculation. Beyond the various assays related to the endocrine system, we need to see CBC's, metabolic & electrolyte labs, iron/TIBC/ferritin. Current stats, lifestyle, injuries and/or illnesses would also be helpful. Testosterone is only one variable of many, don't put all of your chips on it as being the sole answer for optimal wellness.

 

[mxman420]

Ok, labs are back.
Testosterone, Serum 209
Free Test 5.7
DHEA 198.5
TSH 1.840
IGF-1 168
Estradiol, Sensitive 13.0
SHBG 47.0

 

[blitzen]

Those numbers don't make much sense (if they are from the same lab).
TT stayed close to the same (daily swings) and FT dropped to 1/3 of prior (the raise in SHBG explains that partially)
How did the TT stay the same with 140mg a week? And the E is lower too ....
I'm missing something here as this should not happen.
Let me know what Defy says

 

[JMP]

I would think it is completely impossible to have no increase in TT after 4 months of 140mg/wk. And how did SHBG go from 26.8 to 47? Basically unheard of. E2 sensitive went down a couple points??? Any AI? Something is not adding up here obviously.

 

[mxman420]

Those numbers don't make much sense (if they are from the same lab).
TT stayed close to the same (daily swings) and FT dropped to 1/3 of prior (the raise in SHBG explains that partially)
How did the TT stay the same with 140mg a week? And the E is lower too ....
I'm missing something here as this should not happen.
Let me know what Defy says

It's actually only 70mg a week. 2 shots of 35 ea. But yeah, I don't get it either. I did run out for literally one week before my refill came, but even so it's shouldn't be that low still? I'll post after I have my consult.

 

[mxman420]

I would think it is completely impossible to have no increase in TT after 4 months of 140mg/wk. And how did SHBG go from 26.8 to 47? Basically unheard of. E2 sensitive went down a couple points??? Any AI? Something is not adding up here obviously.

anastrozole .125 2-3 times a week. And it's 70 a week.

 

[mxman420]

anastrozole .125 2-3 times a week. And it's 70 a week.

Oh I'm wrong. It is 140 a week. Sorry, still new to this.

 

[JMP]

.35ml 2x/wk of 200mg/ml test is a total of 140mg/wk. I have never heard of Defy putting someone on 70mg/wk, but heard lots of 140mg/wk. Of course wait to hear from Defy before proceeding, but the first thing that I would do is drop the AI. Are you sure that the syringe is totally penetrating the skin? We had a guy on here a while back who's levels didn't budge and was not really getting the test into his body.

 

[mxman420]

.35ml 2x/wk of 200mg/ml test is a total of 140mg/wk. I have never heard of Defy putting someone on 70mg/wk, but heard lots of 140mg/wk. Of course wait to hear from Defy before proceeding, but the first thing that I would do is drop the AI. Are you sure that the syringe is totally penetrating the skin? We had a guy on here a while back who's levels didn't budge and was not really getting the test into his body.

I'm fairly certain. I have 25g 1/2 in needles. Usually inject into my shoulder, and sink it.
Like I said also, I missed 3 doses until my refill arrived. Could it drop back to my pre treatment numbers that fast?

 

[blitzen]

.
Like I said also, I missed 3 doses until my refill arrived. Could it drop back to my pre treatment numbers that fast?

When did you do your labs? After the 3 missed shots?

 

[JMP]

Well a week and a half with no injection (missed 3 doses) would definitely drop your levels significantly but I am not going to say all the way to baseline. My advice if you find yourself running out before your refill is either use a 27g 1/2 insulin syringe to lessen waste or inject a hair less than .35 (.33-.34) so that you know that you wont run out.

 

[Systemlord]

.35ml out of a 200mg 10ml vial is 70mg twice weekly, you have to multiply 35ml x2 = 70. The only way it would be 70 total weekly is if the vial was 100mg 10ml, then it would equal 35ml twice weekly equaling 70 total weekly. You missed a couple of injections and this might mean you might have not injected the right amount the first couple of times. Missing 3 doses would explain your situation and your low levels.

The only way it would be 70mg total weekly is if you were a really low SHBG guy like myself and in that case you'd be injecting every day or EOD. 70-80mg EOD would be more than enough for me.

No judgements here, we all started out as beginners.