TRT hcg and E2 management

[Bud Black]

Hello gents, just a few generalities. 4 months on 200 TC@ 3.5ml E3.5 days. 500 Hcg E3.5 days, tried AI @ .25 a week.
Found out I am very E2 sensitive. So i crashed last month. LOL
Question. last labs (local Dr. not as astute as some of yours for sure) so I have to ask for labs every month.
Didn't know to ask for full panel. (next week).
my Free T before Hcg was Free Testosterone(Direct)27.0 Range 7.2-24.0 (pg/mL)
Estradiol 5.6 Range 7.6-42.6 (pg/mL)
so we dropped the TC from 3.5ml to 3 and upped the Hcg to 3x a week.
Here's the question: Can I lower the TC to manage the E2 since I am very E2 sensitive?
Thoughts gents?

 

[Vince]

Why are you on an AI?

 

[johndoesmith]

Hello gents, just a few generalities. 4 months on 200 TC@ 3.5ml E3.5 days. 500 Hcg E3.5 days, tried AI @ .25 a week.
Found out I am very E2 sensitive. So i crashed last month. LOL
Question. last labs (local Dr. not as astute as some of yours for sure) so I have to ask for labs every month.
Didn't know to ask for full panel. (next week).
my Free T before Hcg was Free Testosterone(Direct)27.0 Range 7.2-24.0 (pg/mL)
Estradiol 5.6 Range 7.6-42.6 (pg/mL)
so we dropped the TC from 3.5ml to 3 and upped the Hcg to 3x a week.
Here's the question: Can I lower the TC to manage the E2 since I am very E2 sensitive?
Thoughts gents?

Wait what? This is very hard to follow.

I assume you mean ".35mL" of 200mg test cyp E3.5D? 3.5mL would be 1400mg per week.

You only had free test and E2 tested?

When you had those tests done, that was before HCG? When was it taken relative to injection? How did you feel at that time?

Your E2 is nearing undetectable levels, and is already low on a test that overestimates E2 in men, so you're beyond low!

What makes you think you need to manage E2 when it's already managed into the ground?

You shouldn't chase numbers, especially when using the wrong test! You need a sensitive E2 test not the standard. You want to manage symptoms, not numbers, what exactly are your symptoms that need managing?

 

[CoastWatcher]

Wait what? This is very hard to follow.

I assume you mean ".35mL" of 200mg test cyp E3.5D? 3.5mL would be 1400mg per week.

You only had free test and E2 tested?

When you had those tests done, that was before HCG? When was it taken relative to injection? How did you feel at that time?

Your E2 is nearing undetectable levels, and is already low on a test that overestimates E2 in men, so you're beyond low!

What makes you think you need to manage E2 when it's already managed into the ground?

You shouldn't chase numbers, especially when using the wrong test! You need a sensitive E2 test not the standard. You want to manage symptoms, not numbers, what exactly are your symptoms that need managing?

All excellent points/questions. Remember, estradiol is not a waste product, something that men need to purge from their system. It plays an important role in your health. In addition to these questions, can you tell us how long you have been on a TRT protocol?

 

[Bud Black]

Been on TRT now 4 months. My E2 had spiked to 75 and i developed migraines and had temporary blindness in my left eye. it was a nightmare so Dr. put me on .5 Dex 2x/wk. that lasted 2 wks and i tested low. So i am trying to see if I can manage this with an AI.

 

[Bud Black]

after being on TRT for a month my e2 went to 75 with migraines and temporary blindness in left eye. so my Dr. put me on dex .5 2x/wk. that lasted 2 wks and I tested the numbers posted. Just trying to manage the TRT with an AI.

 

[Vince Carter]

If you're displaying that kind of sensitivity to Anastrozole, .5mg 2XW is a rather healthy dose and has taken you too low, cut it back to .25mg 2XW. And get the sensitive test, the LC/MS/MS as opposed to the Roche ECLIA which is for women. Even as the wrong test it can be informative but no conclusion should be drawn from it. Also, curious before never seen migraines and blindness attributed to high E...how'd your "Dr" arrive at that conclusion?

 

[Bud Black]

All points taken so thank you kindly. Will do so next week. The Dr. also put me on DHEA/pregnolone(100mg/400mg) and he believed the DHEA drove my e2 high too quick. I have since cut that in half and all things seems to be working. DHEA-Sulfate 304.1 71.6-375.4 (ug/dL)

My Dr also did not pull any blood to begin. he consulted me asked questions and started me on TRT. Thing is I am taking the Hcg to try and get my boys back. Before my beginning I never had hypogonadism. After consult he started me on TRT and drew initial blood. I believe now I have secondary hypogonadism.
Free Testosterone(Direct) 7.7 7.2-24.0 (pg/mL)
DHEA-Sulfate 69.2 L 71.6-375.4 (ug/dL)
TSH 2.070 0.450-4.500 (uIU/mL)
Triiodothyronine,Free,Serum 3.0 2.0-4.4 (pg/mL)

I was 3 months post op Gallbladder surgery. (it almost went sepsis) very hard time. (healthy as hell now) But i think I may have been dealing with adrenal stress prior to TRT and now need to deal with this. I actually thought of stopping TRT. and do a reset. Just thinking out loud.
52 yrs old
240 lbs (down 45 from the gall bladder surgery)
6'2" height

 

[johndoesmith]

All points taken so thank you kindly. Will do so next week. The Dr. also put me on DHEA/pregnolone(100mg/400mg) and he believed the DHEA drove my e2 high too quick. I have since cut that in half and all things seems to be working. DHEA-Sulfate 304.1 71.6-375.4 (ug/dL)

My Dr also did not pull any blood to begin. he consulted me asked questions and started me on TRT. Thing is I am taking the Hcg to try and get my boys back. Before my beginning I never had hypogonadism. After consult he started me on TRT and drew initial blood. I believe now I have secondary hypogonadism.
Free Testosterone(Direct) 7.7 7.2-24.0 (pg/mL)
DHEA-Sulfate 69.2 L 71.6-375.4 (ug/dL)
TSH 2.070 0.450-4.500 (uIU/mL)
Triiodothyronine,Free,Serum 3.0 2.0-4.4 (pg/mL)

I was 3 months post op Gallbladder surgery. (it almost went sepsis) very hard time. (healthy as hell now) But i think I may have been dealing with adrenal stress prior to TRT and now need to deal with this. I actually thought of stopping TRT. and do a reset. Just thinking out loud.
52 yrs old
240 lbs (down 45 from the gall bladder surgery)
6'2" height

Bud, I am significantly younger than you are, but I think your doctor is somewhat incompetent when it comes to TRT. I am not sure if he only ran those 4 tests, or if you're only listing those 4 tests. If the former, you need a new doctor, if that latter, you need to post them.

It would be to your advantage to go back to my post, and answer all the questions I listed. It will only help you.

Right now, all we can say is your E2 is crashed, stop taking so much AI, and you may need a new doctor.

Regarding the restart, we can't say, we need pre trt labs and symptoms. I would at 52 consider a restart less, unless you want that, or have profound secondary hypogonadism, again I am much younger than you, and some of the members are closer to your age than I so maybe they have more perspective on TRT vs clomid at AARP member status

 

[Bud Black]

Agreed
those 4 were the only labs taken. Makes me totally agree with you on finding a new Dr.
Also i only take the AI now when I feel the puffiness and loose the wood.
staying on TRT isn't a problem for me I just want to manage it without an AI if possible

As far I am feeling pretty good. I have shoulder blade popping and a little ache here and there. I assume from the low e2.

I only started Hcg a month a go after my nads shrunk.
Looking into a new Dr. today.

 

[johndoesmith]

Agreed
those 4 were the only labs taken. Makes me totally agree with you on finding a new Dr.
Also i only take the AI now when I feel the puffiness and loose the wood.
staying on TRT isn't a problem for me I just want to manage it without an AI if possible

As far I am feeling pretty good. I have shoulder blade popping and a little ache here and there. I assume from the low e2.

I only started Hcg a month a go after my nads shrunk.
Looking into a new Dr. today.

Right and members here will give you advice but without answering the questions I've asked you're limiting the advice we can give.

You probably shouldn't take ai based on feel, especially since you've crashed your e2.

 

[Vince Carter]

All points taken so thank you kindly. Will do so next week. The Dr. also put me on DHEA/pregnolone(100mg/400mg) and he believed the DHEA drove my e2 high too quick. I have since cut that in half and all things seems to be working. DHEA-Sulfate 304.1 71.6-375.4 (ug/dL)

My Dr also did not pull any blood to begin. he consulted me asked questions and started me on TRT. Thing is I am taking the Hcg to try and get my boys back. Before my beginning I never had hypogonadism. After consult he started me on TRT and drew initial blood. I believe now I have secondary hypogonadism.
Free Testosterone(Direct) 7.7 7.2-24.0 (pg/mL)
DHEA-Sulfate 69.2 L 71.6-375.4 (ug/dL)
TSH 2.070 0.450-4.500 (uIU/mL)
Triiodothyronine,Free,Serum 3.0 2.0-4.4 (pg/mL)

I was 3 months post op Gallbladder surgery. (it almost went sepsis) very hard time. (healthy as hell now) But i think I may have been dealing with adrenal stress prior to TRT and now need to deal with this. I actually thought of stopping TRT. and do a reset. Just thinking out loud.
52 yrs old
240 lbs (down 45 from the gall bladder surgery)
6'2" height

That dosing is OUTRAGEOUS...please verify, your DHEA-S test doesn't reflect you taking 100mg DHEA.

 

[CoastWatcher]

All points taken so thank you kindly. Will do so next week. The Dr. also put me on DHEA/pregnolone(100mg/400mg) and he believed the DHEA drove my e2 high too quick. I have since cut that in half and all things seems to be working. DHEA-Sulfate 304.1 71.6-375.4 (ug/dL)

My Dr also did not pull any blood to begin. he consulted me asked questions and started me on TRT. Thing is I am taking the Hcg to try and get my boys back. Before my beginning I never had hypogonadism. After consult he started me on TRT and drew initial blood. I believe now I have secondary hypogonadism.
Free Testosterone(Direct) 7.7 7.2-24.0 (pg/mL)
DHEA-Sulfate 69.2 L 71.6-375.4 (ug/dL)
TSH 2.070 0.450-4.500 (uIU/mL)
Triiodothyronine,Free,Serum 3.0 2.0-4.4 (pg/mL)

I was 3 months post op Gallbladder surgery. (it almost went sepsis) very hard time. (healthy as hell now) But i think I may have been dealing with adrenal stress prior to TRT and now need to deal with this. I actually thought of stopping TRT. and do a reset. Just thinking out loud.
52 yrs old
240 lbs (down 45 from the gall bladder surgery)
6'2" height

As Vince Carter asked, please clarify the dose of DHEA you are taking.

 

[Vince Carter]

I see he references if I read just a little bit farther that he halved that dose, so 50mg leaves me curious about the 400mg of Preg, where he's at with that. 200mg is still a massive dose.

 

[CoastWatcher]

I see he references if I read just a little bit farther that he halved that dose, so 50mg leaves me curious about the 400mg of Preg, where he's at with that. 200mg is still a massive dose.

Hopefully, we'll find out. You're right, a whopping dose.

 

[Bud Black]

Gents I just got back in internet range and saw your responses. The DHEA is a blend with the Preg. I can definitely take another brand of DHEA only at 25. I am ignorant to the preg usage.
Here's what the supplement states: dietary supplement formulated to help maximize internal health and support the endocrine system.* It contains pregnenolone and DHEA, two substances produced naturally by the body that decline with age. Pregnenolone is the key precursor for the body's production of estrogen, DHEA, and progesterone, and it also has an impact on mental acuity and memory.* DHEA is involved in maintaining the health of the cardiovascular and immune systems.

BTW My Dr. drew labs at the 4 month mark a month ago.
These are the results
DHEA-Sulfate 304.1 71.6-375.4 (ug/dL)
Estradiol 5.6 L 7.6-42.6 (pg/mL)
Free Testosterone(Direct) 27.0 H 7.2-24.0 (pg/mL)

This is with the
50 DHEA/200 preg
Testosterone Cypionate 200 MG/ML 0.35ml Intramuscular twice a week
HCG 1000IU/ml 0.5ml sq twice a week

we have since lowered my T-cyp to .3ml twice a week. I took new labs yesterday. I should have results back tomorrow. Sorry for the confusion gents.

 

[johndoesmith]

Gents I just got back in internet range and saw your responses. The DHEA is a blend with the Preg. I can definitely take another brand of DHEA only at 25. I am ignorant to the preg usage.
Here's what the supplement states: dietary supplement formulated to help maximize internal health and support the endocrine system.* It contains pregnenolone and DHEA, two substances produced naturally by the body that decline with age. Pregnenolone is the key precursor for the body's production of estrogen, DHEA, and progesterone, and it also has an impact on mental acuity and memory.* DHEA is involved in maintaining the health of the cardiovascular and immune systems.

BTW My Dr. drew labs at the 4 month mark a month ago.
These are the results
DHEA-Sulfate 304.1 71.6-375.4 (ug/dL)
Estradiol 5.6 L 7.6-42.6 (pg/mL)
Free Testosterone(Direct) 27.0 H 7.2-24.0 (pg/mL)

This is with the
50 DHEA/200 preg
Testosterone Cypionate 200 MG/ML 0.35ml Intramuscular twice a week
HCG 1000IU/ml 0.5ml sq twice a week

we have since lowered my T-cyp to .3ml twice a week. I took new labs yesterday. I should have results back tomorrow. Sorry for the confusion gents.

Those are all the results you have?

You weren't on AI when these were taken?

When were they taken relative to injection?

How did you feel when these were taken?

Your E2 is crashed to death. I think these may be the same results you posted earlier though.

 

[CoastWatcher]

Based on the reference range, it's clear your doctor ordered the wrong estradiol test. Men need to have the sensitive test, LC, MS/MS, procedure run when measuring estradiol. I, too p, am very confused as tom what labs were run, when they were run, and why others weren't run.

 

[Bud Black]

The labs in the beginning were first taken the very day I started TRT
Dr took 4 labs, they are in the pic.
4 months later he took what i posted yesterday.
I am doing all I know to do to get this protocol balanced and get feeling better (low E2 junk)
Like I said I am currently in search of new Dr. that can direct me.
Just trying to understand it all and get the body feel in check.

 

[Bud Black]

unfortunately yes this is it right now. I took AI only 2 weeks of the time. I just knew I crashed my E2 and sure enough.
All my tests are taken 2 days after injection. Feel like my shoulders and neck muscles ache and dry eye. Weird.
Hopefully my E2 is climbing.

New tests taken yesterday
Total Testosterone
Free Testosterone
Estradiol (E2)
Estradiol (E2) sensitive
Hemocrit
Comprehensive Metabolic Panel
Vitamin D3
Vitamin B12