TRT, HCG and AI

[Loki]

As I feel like some of my symptoms of low T are creeping back I was researching the forum and found another poster with a very similar protocol to my own-


Monday night 250 units HCG
Tuesday night 250 units HCG
Wednesday night 200 MG CYP


My doctor is very lacking in his knowledge but will try anything I bring to him. The bloodwork is limited so I don't have much to offer on Test other than my total T. The HCG was a recent addition (last couple months) as I wasn't comfortable with the testicular shrinkage I was experiencing... Prior to adding HCG my total T was in the 800-950 range and I had wood from the moment I feel asleep to waking up...

After my first test of adding in the HCG here is my bloodwork -


Total T - 1323 range 250-1100ng/dl
Estradiol - 59 range 20-75 pg/ml


My thoughts seem to be that I respond well to HCG and my Estradiol is too high? Body is lean, strength is great... Sex drive is gone, erections weak...

Thoughts and input appreciated and welcome...

 

[CoastWatcher]

Your total testosterone is exceeding your lab's reference range, and your estradiol is elevated. That said, you ran what appears to be a standard, rather than a sensitive, estradiol test and so it is of limited (if any value) in managing your E2. Why are you injecting once weekly? And why such a large single dose? Most members here at Excelmale do very well on multiple, smaller injections over the course of a week. A typical starting dose is 50mg every 3.5 days, it's fairly straightforward to make upward adjustments if necessary. I would urge you to consider adjusting your testosterone down and run a sensitive estradiol test - you may find it very easy to dial things in.

 

[ERO]

instead of "bringing your doc along," why not switch docs? Working with a doc that is a TRT expert makes all the difference. For example, your current doc doesn't even use the correct E2 test...Defy Medical's tele-medicine model works great, they know what they are doing, have great prices, etc...(I am not affiliated with them)

Also, splitting your T dose in half and doing half every 3.5 days will likely lower total E2 and help you keep a more stable T level as well. Most of us here inject T twice weekly.

 

[Vettester Chris]

Correctly noted above .. At least split your dosages up to stabilize your serum peaks, which will also help balance some of the downstream E2 conversion and AI administration.

Your E2 assay appears to be a standard lab. The E2 sensitive assay is the gold standard for measuring E2 serum in males. Look for that on your next round of labs.

 

[Vettester Chris]

Also, need your Free & Bio test to really know what's getting used in the body.

 

[CoastWatcher]

To echo the point E RO made, working with a doctor who understands TRT make a world of difference. If not Defy, I am not a Defy patient though I respect them highly, someone else.

 

[Loki]

Thanks everybody for your feedback... I am open to injecting twice per week. The doctor that started me on TRT closed his practice... My second DR put me on clomid and if I didn't have a wife and 4 kids I very well may have ended my life (my depression was that bad). The doctor I currently see is the only one willing in my area (Arkansas) to help and let me use my limited knowledge to get be back on TRT... I have read up and I 100% want to start with Defy... I have been in contact with them but the current DR will not sign the written document... I wonder if Defy can recommend anyway to get past that...

As far as exceeding my ranges this was the first time and I assume it has to be the HCG... The current DR goal is to keep me at the highest level within the ranges... The labs he runs via Quest are very simple and not thorough... My ultimate goal is to start with Defy as soon as I can... In the interim should I discontinue the HCG? And I can start injecting Wednesday and Sunday starting tonight by doing a half dose....

Thanks again for the feedback!

 

[ERO]

You don't need anything from your current doc to start with Defy. All they need is a recent physical and you can get one at most Walgreen's these days. Also, get your baseline blood work at discountedlabs.com

When I started with Defy, I emailed them my lab work & my physical and let them know that I wanted to switch providers (to them) and I was up and running in no time.

 

[Loki]

Ok guys I contacted Defy and I had my blood work, physical and paperwork completed this morning... Any advice on which Doctor I should go with? Or just any other advice prior to my first call with them?

 

[Vince]

Mica, this is just my opinion. I would ask for Dr. Saya.

 

[brutusman]

Mica,

Just started with Defy yesterday after years of TRT procrastination and several electronic ass-kickings from a buddy. Had my consult with Dr. Crisler. Great session, very thorough, good back and forth discussion. No BS. Has me on 160mg test cyp inject SubQ 2x week (80 mg ea time), HCG 100 iu daily and Anastrozole(sic) with DIM on injection days (Fri and Tues). I live in SW Colorado and my meds came via FedEx this afternoon. The day after my consult. Couldn't believe it. Can you say Merry Christmas !!!

Did my first round of injections today. Crisler also ordered up some additional thyroid tests to evaluate high TSH. Tried to get my GP to order the same tests and he refused, said they were not necessary. Defy wrote me a script for my labs and I took them to the local hospital lab to have the work done. My insurance will cover a portion of the tests. The nearest Lab Corp facility is a 5 hour 1-way drive to Albuquerque NM or Grand Junction CO. Wasn't sure the hospital would do the work, bu they said it was no problem. Once the thyroid labs come back, will meet with Dr. C again to dial my thyroid in.

Follow up labs in after 7 weeks of TRT and Thyroid for additional review/fine tuning.

Had some resistance from my GP when I told him I was seeking a consult with Defy. Don't get the sense he was too crazy about the idea, but said he would work with me. Completed the physical form a few days after I gave it to him. I have the hospital send him copies of my labs so he is in the loop.

Overall, I am very pleased with Defy. Staff is very responsive. Have a good rapport with Dr. Crisler. Doubt you can go wrong with Defy.

 

[Loki]

Ok so I am awaiting for the scheduling team to get with me in regards to my consult with Dr. Saya... But I did get my labs today... Curious to see what anybody's feedback is...

Free T- 49.0 Range 6.8-21.5
Estradiol, Sensitive 66.8 Range 8-35.0
TSH 2.52 Range .45-4.5
DHEA Sulfate 246 Range 102.6-416.00

 

[Nelson Vergel]

How do you feel?

 

[Loki]

How do you feel?

Nipples burning and sensitive... Libido has fallen off and morning erections gone... I have felt worse but I have also felt much better...

 

[Nelson Vergel]

Ehat's your total T and hematocrit?

You may want to discuss anastrozole with the doctor and probably digging a little more into your thyroid with free T3 and free T4.

Are you sleeping well? Is that guy in your profile pic you?

 

[Loki]

Total T was 1323 Range 250-1100
Hematocrit was 47.8 Range 40.8-52.0

I have never been a good sleeper... I take 2 MG of generic Xanax as soon as I lay down and 10MG of melatonin... That is me in the pic...

 

[Loki]

The most recent and newest addition to my protocol was the HCG... I must be responding well to it... To be blunt prior to that it seemed like when I closed my eyes at night I had an erection until I woke up.... I would have to stand on my head to pee at night or first thing in the morning!!!! I was seeing testicular atrophy and the aesthetics was bothering me so I have my doctor add HCG... When I started feeling the nipple issues and libido fall I suspected Estradiol and when he ran the other lab it was 59 on a 20-75 range (not sensitive)... So it is even higher on the sensitive test... I would think it has to be the issue.... Is that Free T number ok? My work outs are incredible...

 

[CoastWatcher]

Are you splitting your testosterone dosage, as was suggested above, at the present, or still on a single weekly injection?

 

[Vince Carter]

Youre Free T being "off the chart" is, 1) great, 2) a likely indicator that your SHBG is low, which IMO is good. Low SHBG usually dictates the guy use an EOD T injections as the swing up and down is rather rapid, EOD gives a smoother ride.

 

[Loki]

Are you splitting your testosterone dosage, as was suggested above, at the present, or still on a single weekly injection?

I have split my injections to twice a week... Sunday and Monday... I had been doing that for 2 weeks when the Estradiol, Sensitive test was run...