Suggestion for edema with TRT

[1lion]

Hello,

I am a middle age man going back on injectable T after 1.62% gel not working predictably.
Quit T gel two years ago. Gained 40 lbs. The extra weight makes running painful. Lift free weights--still fat.

Issue:
With injections I can get bad edema days after a shot.
Going to be the same protocol except with 1mg anastrozole per week.
I now take a BP med and might need a diuretic after restarting injectable T.

One doc suggested 50 mg Spiro, but I heard about its anti-androgen effects. True?
I read about Eplenerone with less sides---anyone have experience with either?

I want to get my quality of life back. Total T is so low that body hair and vascularity have vanished.
Urologist called it "obesity of hypogonadism." DEXA scan said osteopenia. It's a NIGHTMARE.
Really hoping the ExcelMale members can help.

 

[Cataceous]

Anastozole is going to be counterproductive if you already have osteopenia. Also, estradiol isn't necessarily the primary culprit in fluid retention. Before considering a host of other drugs to combat this side effect, why not see if you can avoid it from the start with physiological dosing? The average healthy young man makes 6-7 mg of testosterone daily. There's no reason to start TRT with a higher dose than this. The equivalent in testosterone cypionate is 60-70 mg per week. This should be split into at least two doses per week, and ideally would be split into every-other-day dosing, so that excessive peaks in serum testosterone are avoided.

If you have problems with modest doses of cypionate then there's still the option to experiment with propionate blends, which have anecdotal support for decreasing fluid retention.

 

[1lion]

Thank you!
The Uro planned 1ml vial 200mg/ml T cyp every 2 wks.
Instead I can try to use 1/3 ml or 1/4ml per week depending on the syringe graduations.
Would be great if there will be no problems this way.
My past estrogen numbers were high--maybe why the Uro wrote for the E2 blocker.
Estrogen Total, Serum 340.8 H 60-190 pg/mL

 

[Systemlord]

The Uro planned 1ml vial 200mg/ml T cyp every 2 wks.

This is stupid, this will shoot your testosterone and estrogen into the supraphysiological range risking worsening side effects. You can’t like front load medicine like this without consequences.

I talked to guy in the gym today and told me he was on a every two week protocol the guy was bufff as s*** and complained of feeling edgy 4 days after his shots.

I set him straight and told him what I’m telling you. Any doctor that prescribes these types of protocols doesn’t know what the hell they’re doing. Most doctors follow the guidelines, and the guidelines are outdated and wrong.

 

[Systemlord]

DEXA scan said osteopenia.

Uro wrote for the E2 blocker.

Your doctors, a freaking moron! The current prescribe protocol is the worst protocol you could ever be on given your condition.

 

[1lion]

Glad you told me the logical options--he might see it this way when I discuss it.
Nice person, but he doesn't keep up to date.

I asked him today if he could figure out what was going on with my discolored thumbnails--been this way for some years--he said ask Dr. Google.

 

[1lion]

I thank everyone for the help + concern.
I have another lab coming in this week before beginning T--will try to post it.

 

[Cataceous]

You really need to get an accurate measurement of estradiol. If you're in the U.S. you should try to persuade your doctor to order a test based on LC/MS, e.g. Quest, Labcorp. Or order one yourself. Have you looked at other possible causes of osteopenia? Dietary calcium? Vitamin D status? Too much alcohol, smoking or caffeine? Lack of exercise?

If you can stand to I would start TRT with 0.1 mL (20 mg TC) injected subcutaneously every other day. Use insulin syringes for minimal waste and discomfort. For example, 0.3 cc, 30 gauge, 5/16". Or 1 cc, 29 gauge, 1/2".

 

[1lion]

Thank you again for the excellent suggestion--I will try to do this.

My new labs below show my ALK Phos slightly up--been this way since off TRT.
Protein has been on and off elevated.
Don't eat red meat--sometimes just fish. No protein shakes either or supps.
Went to a hematologist --he could not determine why. I was worried so Dr. did an electrophoresis, which was OK.

If I start the T with the subQ protocol, is anastrozole still needed?
Would 1/4 tab per week be safe?

NEW LABS 11-4-22--NOT ON T:
Estradiol 17 (≤44 pg/mL)
Estrogen Total, Serum 214.1 H (60-190 pg/mL)
Protein, Total 7.8 H (6.0 - 7.7 g/dL)
Alkaline Phosphatase 146 H (40 - 140 IU/L)

 

[Cataceous]

With your estradiol that low on a standard test you definitely should avoid anastrozole for now. If you keep your testosterone doses low to moderate then estradiol may well stay in range. It's going to be hard to justify any AI use unless your estradiol is also high relative to testosterone and you're having clearcut symptoms of high estradiol.

What is your total testosterone currently? Do you know your SHBG? Ideally you should also measure other baseline parameters before going back on TRT. In particular it would be good to see where hematocrit, hemoglobin and the free thyroid hormones are. If money is not an issue then this is a good comprehensive panel you can get on your own.

 

[bixt]

there's still the option to experiment with propionate blends, which have anecdotal support for decreasing fluid retention

I concur, personal experience. I tend to hold a lot of water on daily or any frequency cypionate > 100mg / week. Not much peeing, infrequent.

On the other hand, on ANY dose of daily prop (even high), I seem to pee more regularly (normal, not excessively) and hold less water.

Most bodybuilders across various forums will agree too.

Its strange, there is not much by way of explanation for why this is in term of science, but it seems to be the reality.

 

[1lion]

I thank everybody for the advice.
Is there any safe diuretic if needed with TRT?

 

[JmarkH]

Two weeks ago, I started dr.bo Water Away from Amazon. It seems to help with water gain from MK677. The scale indicates 1.5 to 2 lbs less. Before starting MK677, I could fluctuate by 3 lbs during the week anyway but I quickly gained and kept 3 lbs afterward.

 

[Systemlord]

Is there any safe diuretic if needed with TRT?

Dandelion root, is a natural diuretic that doesn’t effect potassium. Prescription diuretics tend to affect potassium levels.

 

[Nelson Vergel]

Very popular topic with lots of suggestions. Tip: Lower your T dose and ask for a potassium-sparing diuretic if water retention does not go away.

water retention

www.excelmale.com

 

[sexualathlete]

Eplenerone is amazing. Telmisartan helps too. I'm on both. 80mg telmisartan and 150mg Eplenerone. No AIs. Dry as bone.

 

[Nelson Vergel]

Eplenerone is a mild potassium sparing diuretic that should be first line treatment for men on TRT who have edema