Too Many Supplements While On TRT

[andrewBwinter]

Good Morning.

56 y.o. male taking 120mg Test-E / wk. 2x60 Saturday 8 a.m. and Tuesday 8 p.m.
Prescribed for a combination of ED and concussions that happened once in the 80's and sever whiplash in '91.
I don't feel that much better after the regimen below that is recommended by my specialist. Numbers included. Planning a detox from all supps. except *** and Vit D3 for 3 days, until next injection to shake things out. Lastly, I've been referred for a sleep study to determine OSA.

All of this seems excessive and I welcome comments/thoughts. I am currently taking daily:
Magnesium Threonate - 2000 mg
Zinc / copper balance - 45mg
Vitamin D drops - 15,000 iu
Selenium - 4 brazil nuts (contra-indicated for benign skin "spots")
He also recommends on a daily basis that I just can't jam down my throat:
Omega 3, Vitamin B complex, Melatonin, Iron, Curcumin, co-Q-10, Taurine, L-Glutamine

I choose to take:
*** - for my osteoarthritis (hip)
Boron - 9 mg
Stinging nettle - 870 mg (last PSA score was 1.6!)
Horny Goat weed - 1500 mg

So, while some of these supplements are designed to assist with the long-term effects of concussion swelling on the brain pan, I feel like crap.

Most recent numbers for 120 mg, sub-Q e3.5d:
TT - 33.1 nmol/L
Estradiol - 103 pmol/L
Hemoglobin - 171
Hematocrit - .485
Ferritin - 27
B12 - 228 pmol/L
Vit D - 162 nmol/L

Thanks for the input.

 

[locutus]

I am taking 40+ supplements on a daily basis. for years now. all blood work good.
your supplements look ok (although I am too lazy to convert to US units).
I would skip the B complex, Iron, Curcumin personally

 

[andrewBwinter]

Appreciated.
TT - in US would be 955.
B-complex gives me stomach aches so i am not taking, I can raise iron with beef and C (which I have done successfully - blood donor) and curcumin I am taking but it might be redundant with the *** oil.

 

[madman]

Appreciated.
TT - in US would be 955.
B-complex gives me stomach aches so i am not taking, I can raise iron with beef and C (which I have done successfully - blood donor) and curcumin I am taking but it might be redundant with the *** oil.

You are missing some critical blood markers such as free testosterone and SHBG.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

When was blood work done?

When injecting twice-weekly (every 3.5 days) as an example Monday morning at 8 am and Thursday evening at 8 pm then blood work would be done the following Monday morning just before your next 8 am injection which would be roughly 84 hrs after your last injection (true trough).

Although a TT 955 ng/dL is far from absurdly high you need to keep in mind that if this is at true trough (lowest point) then your peak TT, FT estradiol will be much higher seeing as you are injecting twice-weekly (every 3.5 days).

Have no clue where your SHBG sits but it is a given that with a trough TT close to 1000 ng/dL your FT will be very high even if you have highish/high SHBG.

Your ferritin is really low and I would look into iron supplementation.

Have you been donating frequently?

 

[madman]

Appreciated.
TT - in US would be 955.
B-complex gives me stomach aches so i am not taking, I can raise iron with beef and C (which I have done successfully - blood donor) and curcumin I am taking but it might be redundant with the *** oil.

FT 5-10 ng/dL would be considered low.

FT 16-31 ng/dL (high-end) is healthy.

Most men will do well with a FT 20-30 ng/dL.

Some may choose to run higher levels.

Comes down to the individual.

Always need to keep in mind where your trough FT level truly sits whether injecting once weekly, twice weekly (every 3.5 days), M/W/F, EOD let alone daily.

Too many are gung ho about jacking up their FT level without taking into consideration peak--->trough on such protocols.

Going to be a big difference in someone running a trough FT 30+ ng/dL injecting once or twice-weekly compared to EOD or daily.

Excess FT levels can result in acne/oily skin (genetically prone), accelerated balding (genetically prone), drive down HDL, increased RBCs/hemoglobin/hematocrit (common), overstimulation of the CNS (common), bloating/water retention due to androgens effects on the retention of electrolytes (common).

Let alone many end up trying to manage estradiol with the use of an aromatase inhibitor.

Some of the side effects are due to testosterone metabolites estradiol/DHT.

 

[andrewBwinter]

You are missing some critical blood markers such as free testosterone and SHBG.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

When was blood work done?

When injecting twice-weekly (every 3.5 days) as an example Monday morning at 8 am and Thursday evening at 8 pm then blood work would be done the following Monday morning just before your next 8 am injection which would be roughly 84 hrs after your last injection (true trough).

Although a TT 955 ng/dL is far from absurdly high you need to keep in mind that if this is at true trough (lowest point) then your peak TT, FT estradiol will be much higher seeing as you are injecting twice-weekly (every 3.5 days).

Have no clue where your SHBG sits but it is a given that with a trough TT close to 1000 ng/dL your FT will be very high even if you have highish/high SHBG.

View attachment 19761
View attachment 19762

Your ferritin is really low and I would look into iron supplementation.

Have you been donating frequently?

Thank you very much for the information. The blood work per my DR. is done 72 hours (to the hour) after injection, so in this case the Tuesday morning at 8:00 (Life Labs appt.) before my injection on Tuesday night. The blood work was done on February 1. So I guess those would be my trough numbers?

As for SHBG, I get a standard OHIP panel from Dr. K. and see what happens. I suppose I should be at least asking why SHBG and FT aren't requested.

Yes, I am a registered donor CBS and I calculated that I loose about 33 ug/L per donation. I was able to raise my ferritin (before I started TRT) from 26 to 126 in 8 months without donating through diet.

 

[madman]

Thank you very much for the information. The blood work per my DR. is done 72 hours (to the hour) after injection, so in this case the Tuesday morning at 8:00 (Life Labs appt.) before my injection on Tuesday night. The blood work was done on February 1. So I guess those would be my trough numbers?

As for SHBG, I get a standard OHIP panel from Dr. K. and see what happens. I suppose I should be at least asking why SHBG and FT aren't requested.

Yes, I am a registered donor CBS and I calculated that I loose about 33 ug/L per donation. I was able to raise my ferritin (before I started TRT) from 26 to 126 in 8 months without donating through diet.

Definitely need to get your ferritin up.

You would be better off getting blood work done Saturday morning just before your next injection if you want to test at the true trough.

Even then you are still hitting a TT close to 1000 ng/dL (72 hrs post-injection) so your peak TT, FT, and estradiol will be much higher.

*I don't feel that much better after the regimen below that is recommended by my specialist. Numbers included. Planning a detox from all supps. except *** and Vit D3 for 3 days, until next injection to shake things out. Lastly, I've been referred for a sleep study to determine OSA.


As you would most likely know sleep apnea can drive up hematocrit let alone have a negative impact on sleep quality/quantity which can easily make one feel like a sack of s**t!

 

[andrewBwinter]

Definitely need to get your ferritin up.

You would be better off getting blood work done Saturday morning just before your next injection if you want to test at the true trough.

Even then you are still hitting a TT close to 1000 ng/dL (72 hrs post-injection) so your peak TT, FT, and estradiol will be much higher.

*I don't feel that much better after the regimen below that is recommended by my specialist. Numbers included. Planning a detox from all supps. except *** and Vit D3 for 3 days, until next injection to shake things out. Lastly, I've been referred for a sleep study to determine OSA.


As you would most likely know sleep apnea can drive up hematocrit let alone have a negative impact on sleep quality/quantity which can easily make one feel like a sack of s**t!

Yep. That's why i am at wit's end and just want to feel better.

 

[madman]

Yep. That's why i am at wit's end and just want to feel better.

Does your doctor know you are splitting your weekly dose and injecting twice weekly?

He is well known for prescribing once-weekly injections and unfortunately has his patients get blood work 72 hrs post-injection instead of testing at the true trough.

 

[andrewBwinter]

Oh, so you are aware of Dr. K.? Yes, I shared that after my first blood panel review and the N.P. didn't argue it. She simply said not to inject any more frequently than 2 /wk.

My first blood panel on 130mg/wk (single dose) 3 weeks after starting (4 injections) at 72 hours post injection:
TT - 1,295 ng/dL
E - 167 pmol/L

They lowered it at that point and I have been at 120 for the past 3 months. Tomorrow is 4 months treatment to the day.

Great info. Thank you very much.

 

[sammmy]

I would not take buckloads of vitamins/supplements just because internet claims they are "healthy". Healthy diet and exercise is what you need most of the time, and synthetic vitamins are reserved only when your blood tests show deficiency.

Viagra is the drug of choice for ED. The effect of Horny Goat Weed is almost zero in comparison and would drastically depend on manufacturer/seller and type of concentrate.

TRT is not a treatment for concussion. If your free T is normal, there is no point getting on TRT and whole new sets of problems stemming from it.

 

[Systemlord]

Vitamin D drops - 15,000 iu

10,000 iu is concerned a mega dose, you're on 15,000. I mean for someone deficient in vitamin D the protocol is 6000 daily and once levels are healthy a maintenance dosage of 2000 is the norm.

A normal daily mag dose is 310-420. Guys that go overboard being proactive usually cause more problems down the road.

 

[Systemlord]

Ferritin - 27

I feel like crap.

I bet you do, been there myself with ferritin at 24 and life was hell. I didn't start feeling well 24/7 until I got my ferritin over 80 and have been taking 140mg iron daily (chelate) for the last 12 months and feel bad any time I try to lower it.

My advice is stay away from ferrous sulfate as it has more side effects and isn't absorbed nearly as well as iron chelate.

I use the Vitamin Shoppe brand.

 

[andrewBwinter]

10,000 iu is concerned a mega dose, you're on 15,000. I mean for someone deficient in vitamin D the protocol is 6000 daily and once levels are healthy a maintenance dosage of 2000 is the norm.

A normal daily mag dose is 310-420. Guys that go overboard being proactive usually cause more problems down the road.

This is good. So Vit-D came in at 162 nmol/L with a range (for my lab) of 75-250 so maintenance should be warranted.

As far as mag threonate, my specialist prescribes 2000 daily total (3 caps) and of that 48 is elemental mag per cap so that gets me 184 elemental per day. When you quote 310-420 is that total mag or elemental mag?

 

[andrewBwinter]

I bet you do, been there myself with ferritin at 24 and life was hell. I didn't start feeling well 24/7 until I got my ferritin over 80 and have been taking 140mg iron daily (chelate) for the last 12 months and feel bad any time I try to lower it.

My advice is stay away from ferrous sulfate as it has more side effects and isn't absorbed nearly as well as iron chelate.

I use the Vitamin Shoppe brand.

At one point my ferritin was eight (8). I am a blood donor here in Canada and just reached 60 donations. However, pre TRT I was able to get my ferritin from 62 to 162 in about 8 months through diet and no donations.

Debating the ferritin raising protocol here on the boards or simple supplementation. I have 25 mg bis-G chelate, all elemental iron. One a day and a good diet and hydration to manage HGB and HCT might help?

good advice. Thank you.

 

[andrewBwinter]

I would not take buckloads of vitamins/supplements just because internet claims they are "healthy". Healthy diet and exercise is what you need most of the time, and synthetic vitamins are reserved only when your blood tests show deficiency.

Viagra is the drug of choice for ED. The effect of Horny Goat Weed is almost zero in comparison and would drastically depend on manufacturer/seller and type of concentrate.

TRT is not a treatment for concussion. If your free T is normal, there is no point getting on TRT and whole new sets of problems stemming from it.

Thanks. The recommendations for the vits come from the doc and I don't agree with them, hence the post.

I did find an old panel from July 2019 (pre TRT) that showed:
TT - 432 ng/dL
FT - 291 pmol/L (.29 nmol/L - 22.6 ng/dL)

Correct, TRT is not a treatment for concussion. TRT is a treatment for low T as a result of concussion, especially in the teen years. Supposedly you aren't making as much as if you were non-concussed. I agree with that assertion from my doc, just not all of these vitamins and minerals. I prefer to do as much as possible with food.

In January 2018 my total T (they didn't request FT) was 506. In March of 2021 it went down to 383 and at that point I sought treatment after 3 years of diet and zinc, and, and, and

 

[sammmy]

I would drop all the supplements and add only vitamins in which blood tests show deficiency. Adding anything else, opens vast possibilities for interactions and confusion.

You have to measure Total T and SHBG. If you have no access to a reliable test for free T (by dialysis or ultrafiltration), calculate it with the TruT calculator from total T and SHBG. If your free T is fine, there is no need for zinc, boron, nettle.

For ED, drug of choice is Viagra - no need for unreliable Horny Goat Weed to mud the waters.

For osteoarthritus, contemporary western medicine does not have a good option. Some people use anti-inflammatory Boswellia extract by Now Supplements. There are thousands of reviews on Amazon.

 

[locutus]

I would definitely NOT drop all the supplements and rely on blood tests. this is non-sense. blood tests only focus on a small subsection of what is happening in your body. there is good evidence (just do a web search) that boron can have positive impact on some form of arthritis. check out The Borax Conspiracy. How the Arthritis Cure has been Stopped |. you can try L-Citrulline for ED for example. experiment and see what works for you. I've been taking vit D 10k for years, and my levels (living in one of the most sunniest states and doing a LOT of full body exposure) and my level are 80ng/dl.
you need to experiment and see what addresses your symptoms best.
for your osteoarthritis you should research DMSO (maybe MSM), definitely keep boron (look into borax article above), and I'm sure there is a solution out there somewhere for you. good luck

 

[andrewBwinter]

Everyone has been really helpful.

I lift so I have been taking L-citrulline as a preworkout for about 7 years. I use it like Viagara about 45 minutes before "entertaining" for ED and it works great as long as you keep hydrated during the day. I'm 56.

Prior to TRT I didn't take anything to speak of other than some Vit D and *** oil for the osteo however, my doc has some solid research on the brain benefits of some of this stuff so I am willing to give it a go. BUT, I have a check-up in March and I will advise that the vitamins and minerals are just too much to handle. I will experiment before then.

When I first started TRT I had about 3+ weeks of just TRT and I felt really good. Call it a honeymoon phase but I wasn't taking anything extra. All of this general malaise came after my first consult 4 (1 x week) injections after starting and the recommended vits and mins.

As I have said before, "I just want to feel 'better'" whatever that means to each of us and I think I can get there starting with ferritin.

"for your osteoarthritis you should research DMSO (maybe MSM), definitely keep boron (look into borax article above)," - This looks interesting.

 

[TorontoTRT]

Easy to see what the issue is. Your estrogen is too low for your total T.