Switched Dr's and now feeling AMAZING.....yet confused

[You Gonna Learn Today]

I was seeing a Urologist in the Houston area, but after a year on treatment of 200mg of Testosterone Cypionate every two weeks and nothing else I was not seeing any improvements and my TT only increased by 14 points (from 296 to 310). I was still feeling like crap and sometimes even feeling worse than before I started treatment. I decided to switch doctors and heard of Dr. Larry Lipshultz so I've started seeing him. He has me on 200mg of Testosterone Cypionate every week, along with HcG 75 units per week. Everything is going well, I'm feeling fantastic, and my numbers have finally increased! I finally have energy again to work out and now have high motivation to eat very clean each day since I'm now seeing results in my body composition and weight training! Feeling like I was in my 20's again!!!

Full Labs are as follows (taken 4 days after injection of 200mg Test Cyp only):
Testosterone Level = 1,309 ng/dl
SHBG = 19
Calc Free Testosterone = 42 ng/dl
Somatomedin-C = 182 ng/ml
Hemoglobin = 16.1 g/dl
Hematocrit = 48%
Prolactin = 9.2 ng/ml
DHT = 513 pg/ml
DHEA-S = 1,498 (not sure what the measurement unit is, doesn't say)
Estradiol = 11 ng/dl
FSH = 0.26 mlU/ml
LH = 0.40 mlU/ml

With Estradiol at 11 ng/dl, isn't that pretty high? Doesn't that come out to 110 pg/ml? The first two weeks were amazing! Had about 5 night wood episodes per night and was feeling awesome. Over the past week and a half, I'm now at about 1 night wood per night (sometimes none) and starting to feel a little puffy around the nips. I talked to the nurse at Dr. Lipshultz office and they said my Estradiol levels are ok for someone with my TT levels, but they would prescribe an AI since I was seeing some side effects. I just started Arimidex at .5mg twice a week.

My Hematocrit levels were at 52.9 when I was with my previous doctor taking 200 mg every two weeks, so I've started donating blood every 8 weeks. Now my levels are at 48 now after my first blood donation. I haven't had them tested yet on my new protocol with Dr. Lipshultz, but I would assume I would need to keep doing blood donations on twice the dosage now.

I'm new to all of this and I'm finally starting to read into details of the way TRT should be handled correctly. This forum is amazing, btw. My question is, based on my lab work, does anything look alarming or is there anything I should be paying close attention to? And how can I tell if that's my trough or peak? I've seen graphs showing day 1 after injection and for some reason day 5 are the highest, so I was confused to see day 4 being so high. Are my TT and FT levels too high to be safe for long-term use? I know this is a stupid question to some, but should I think about reducing my dosage of Test Cyp? I'm feeling fantastic, so I would prefer not to but just looking at it from a long-term health stand-point.

Sorry for all the questions, but I've noticed a LOT of people here are very knowledgeable on this topic and hoping some of you can shed some light on my specific situation.By the way, I just want to add, Dr. Lipshultz is freakin amazing! Very knowledgeable in his field and open to treatment that helps stabilize any issues encountered. For those in the Houston area, I highly recommend Dr. Lipshultz to anyone seeking low T treatment.

 

[DLK]

your test levels taken only 4 days after a 200mg shot will be high but should taper off toward the end off that week, your at the high end of natural range but not that high to worry about, I'd like to be in that range myself. We really need range values to make a call on the estro but puffy or itchy nipples is a sure sign of high estrogen. Most guys splitting shots into twice a week or more for best result with least amount of estrogen conversion.

 

[ERO]

With once a week shots, you typically do your blood work on the day of your shot, but BEFORE the shot to get your trough reading. Your levels look fine overall, but if you switch to injecting half your dose every 3.5 days (Say Monday AM, Thursday PM) you will have more stable levels and less E2 conversion.

Be careful on the AI dosing as well - 0.5mg twice a week doesn't sound like much, but it is actually a pretty hefty dose and it is easy to tank your E2 to single digits.

 

[Vince Carter]

Isn't Lipshultz(?) supposed to be one of the Kings or TRT or am I thinking of a similar name, because this guys post indicates a pretty poorly managed HRT regimen.

 

[You Gonna Learn Today]

Thanks for the feedback. Others are also saying the recommend twice a week shots, as well. I appreciate your response.

 

[You Gonna Learn Today]

Yeah, I just switched to Lipshultz because I also heard he is the King. Like I mentioned, I was with a previous doctor which obviously wasn't treating me correctly.

Also, to Lipshultz defense, I just started seeing him on the 11th of March. The labs I mentioned were from the day I first went to see him and were based on my previous protocol (at day 4 of my previous injection). I am due to see him back to review everything for his protocol after 3 months, he said. I'm sure he will adjust accordingly after that review, but again these results were based on previous treatment, not his.

He put me on 200mg a week and 75 units of HCG based on my lab work from my previous doctor from February 15th, this year. Based on my testosterone coming back at 310, that's why he immediately placed me on his treatment plan. However, he had not yet seen the lab results from that day (which I posted).

I'm sure his normal procedure is to do lab work, then place me on a certain protocol. However, since I already blood work done a few weeks prior, he just went off of that. Not 100% on that, but I'm pretty sure that's the normal procedure for him.

Again, I'm sure he will adjust as needed on my next visit, but the only reason I called about the AI was based on this lab work and the side effects I noticed.

 

[You Gonna Learn Today]

I'll keep that in mind for my next labs. That's a good point on the trough.

 

[CoastWatcher]

Isn't Lipshultz(?) supposed to be one of the Kings or TRT or am I thinking of a similar name, because this guys post indicates a pretty poorly managed HRT regimen.

Very steange, Vince. I would agree with you.

 

[Vince]

I'll keep that in mind for my next labs. That's a good point on the trough.

I like your picture. I agree too, inject very 3 1/2 days. It would be nice to see your ranges.

 

[Vince Carter]

I wouldn't have guess the Lipshultz(?) I'm familiar with would drop someone on 200mg a week and 75iu's of HCG...

 

[You Gonna Learn Today]

I wouldn't have guess the Lipshultz(?) I'm familiar with would drop someone on 200mg a week and 75iu's of HCG...

No, I think there's some confusion. My previous doctor had me on 200mg every TWO weeks with no HCG. My lab was constantly coming back in the high 200's or very low 300's on that protocol.

Once I saw Dr. Lipshultz and I showed him my previous lab work being that low, he immediately increased me to 200mg every week, along with 75 iu's of HCG. Only then did I start feeling well. If it wasn't for that increase, I would still be feeling the same way. Obviously, 200mg every two weeks was not doing anything for me. Not only that, but my previous doctor didn't have me on HCG and never even brought this into our discussions, like Lipshultz did in our initial discussions.

After I got my lab work from that day (4th day after 200mg shot) and I started reading about testosterone levels being high and the extra production of estrogen and what some of the side effects are of it that I was feeling, did I contact them about an AI. I would much rather not be on an AI, but I haven't spoken to Lipshultz about it yet since I meet with him on June 17th. I'm sure at that time he will decide what we should do, in my case.

 

[You Gonna Learn Today]

I like your picture. I agree too, inject very 3 1/2 days. It would be nice to see your ranges.

Thanks, Vince. Saw that online somewhere and had to "borrow" it.

What exactly do you mean by "see your ranges"? Sorry, new to this, so not really sure what you mean by that. Can you please explain? I noticed DLK mentioned something similar.

 

[Vince Carter]

I'm questioning why one of the (supposed) Kings of HRT is putting you on an archaic therapy protocol, irregardless of your past, and then tells you to wait til June when you're experiencing high E symptoms?

 

[You Gonna Learn Today]

I'm questioning why one of the (supposed) Kings of HRT is putting you on an archaic therapy protocol, irregardless of your past, and then tells you to wait til June when you're experiencing high E symptoms?

I appreciate your response, Vince. Please don't take that the wrong way. It's obvious I'm new to this, but what exactly do you mean by "archaic therapy protocol"? Is what you're saying that 200mg/week and 75 units/week of HCG not what's done these days?

Again, my apologies.

 

[Vince Carter]

yes...200mg per week, that's just old school thinking, and only 75iu of HCG...none of that makes sense, from someone that is renowned in HRT. If you're basic Dr had you on that I wouldn't be chewing on it so much. Most anyone is using no more than 140mg and split atleast twice with HCG of 205iu 3x a week. Generally speaking.

 

[You Gonna Learn Today]

yes...200mg per week, that's just old school thinking, and only 75iu of HCG...none of that makes sense, from someone that is renowned in HRT. If you're basic Dr had you on that I wouldn't be chewing on it so much. Most anyone is using no more than 140mg and split atleast twice with HCG of 205iu 3x a week. Generally speaking.

Ahhhhhh, ok....NOW I understand what you've been saying all along. That's interesting indeed. In the meantime, do you suggest I split my 200mg into 100mg twice per week? Or do you suggest I stay on this protocol until I meet with Lipshultz? I'm feeling good now, but just worried about my E2 levels and losing my wood with puffy nips. I would hope not be on an AI if possible, personally. Or have to worry about E2 levels overall.

 

[Jackie Treehorn]

I appreciate your response, Vince. Please don't take that the wrong way. It's obvious I'm new to this, but what exactly do you mean by "archaic therapy protocol"? Is what you're saying that 200mg/week and 75 units/week of HCG not what's done these days?

Again, my apologies.

Are you sure you don't mean 750 IUs of HCG per week? The HCG injections should be taken (at a minimum) twice a week. That would mean a 375 IU injection twice a week. Personally, I take them EOD.

Also, what Vince means by archaic protocol is the one big injection of Test (200mg) per week. Modern TRT protocols now call for twice a week injections (every 3.5 days) to help promote more stable Test levels, and less aromatization. There are a bunch of guys here that are on EOD protocols to promote even more stable levels, and even less aromatization.

 

[Jackie Treehorn]

Ahhhhhh, ok....NOW I understand what you've been saying all along. That's interesting indeed. In the meantime, do you suggest I split my 200mg into 100mg twice per week? Or do you suggest I stay on this protocol until I meet with Lipshultz? I'm feeling good now, but just worried about my E2 levels and losing my wood with puffy nips. I would hope not be on an AI if possible, personally. Or have to worry about E2 levels overall.

I would definitely split that dose in half, and pin it every 3.5 days (ex. Mon am, Thurs pm). Keep a close eye on your sensitive E2, especially if you're taking that much AI per week. Crashing your E2 will make you feel like shit.

Splitting that dose up into a twice a week injection schedule might eliminate the need for you to take an AI all together. If that doesn't do it, I would consider an EOD schedule.

 

[You Gonna Learn Today]

I would definitely split that dose in half, and pin it every 3.5 days (ex. Mon am, Thurs pm). Keep a close eye on your sensitive E2, especially if you're taking that much AI per week. Crashing your E2 will make you feel like shit.

Splitting that dose up into a twice a week injection schedule might eliminate the need for you to take an AI all together. If that doesn't do it, I would consider an EOD schedule.

Ok, I just made myself look stupid on this one. Sorry about this, but I was confused. I'm taking 75 units of 1,500 IU's per week. According to my pharmacy, Empower Pharmacy, the 75 units is equivalent to 1,500 IU's of HCG per dosage.

Thanks for pointing that out, Jackie. Again, newbie here so bear with me.

Do you recommend I also split that dosage into 750 IU's E3.5D the same as the TCyp? Another question, can I inject the .5ml of TCyp sub-q with insulin needles into my stomach fat and still have good results?

 

[Jackie Treehorn]

Ok, I just made myself look stupid on this one. Sorry about this, but I was confused. I'm taking 75 units of 1,500 IU's per week. According to my pharmacy, Empower Pharmacy, the 75 units is equivalent to 1,500 IU's of HCG per dosage.

Now I'm confused. HCG is dosed in IUs (International Units). Are you now saying that your weekly dosage of HCG is 1500 IUs? 75 units of 1500 IUs doesn't make sense to me.

Do you recommend I also split that dosage into 750 IU's E3.5D the same as the TCyp?

If your weekly dosage of HCG is in fact 1500 IUs, then at a minimum, you should split that into 2 injections of 750 IUs. Personally, I pin HCG EOD (Every Other Day). If you want to pin EOD, then your dose would be approximately 430 IUs EOD. I think this is the better option, but you'll have to decide for yourself.

For myself, .5mL or 500 IUs is the limit for my abdomen in any single injection. Any more than that, and it leaves a very noticeable lump. Again, keep in mind that everyone is different.

Another question, can I inject the .5ml of TCyp sub-q with insulin needles into my stomach fat and still have good results?

You could, yes. Keep in mind that if you ask this question to 10 guys, you'll get 10 different answers. It's really a personal preference thing.

Test is oil based, and very thick. A lot of guys (like me) don't and won't pin Test into their abdomen. I don't want any lumps, bumps, or red irritation at the injection site. I personally pin Test in my quads, and my quads only. I use a 1/2"/29ga insulin pin, and never have any lumps/bumps or irritation. Your mileage may vary.

You're going to have to experiment with injection sites/locations, and find the one (or ones) that work best for you.