Trying TRT for the third time :/

[Johnnyv412]

Hello everyone. Short story from my experience from my trt and my protocols. I'm 6'7" and always around 290 lbs. I've always lifted, and stayed pretty athletic and I'm 33 years of age. So in 2014 I went into the doctors office with general symptoms of lethargy and general feelings of just being "unwell." After a slew of blood tests (total T as well) my Total T levels came back at 88 at 12pm LH was .7 and fsh was 1.3. All well below values. Rechecked levels twice more before 8am and both were around 220 but free test was always in range at 55. At this point I was in poor shape due to no energy level and a poor diet. So I began the the first journey of trt. I had slight anxiety over starting something like this but reluctantly I continued.
First TRT trial: January 2014
200mg of testosterone cypionate every 2 weeks

Felt better for a couple months. Summer was here, I was working out a lot and generally happier. About 5 months in I became very irritable, I began having panic attacks out of nowhere. Doc didn't know what was wrong so he took me off it and sent me to an endocrinologist.

Second TRT trial with a "specialist" 2015
150mg testosterone self injected weekly

Same. Felt good, lost a bunch of weight, until about 5 months in I began having panic attacks and retaining water. (Mind you, I've never been an anxious person). Throughout my whole experience up to this point I began educating myself. I felt I had the standard symptoms of high estradiol. Doc tested my total estrogen and its was 242. (Normal lab range <120). I asked for arimidex and she told me she doesn't prescribe that because it's a drug for breast cancer. Again, after getting a panic attack 2 days after my shot every week I said enough is enough and stopped it again. She rechecked my labs about 2 months after I stopped and everything returned to normal except my tsh which went up to 5.3. She immediately said I had hypothyroid and put me on levothyroxine. I repeatedly called her over the next few months of horrible side effects I was getting from that drug and she stopped getting back to me. I gained a ton of weight (up to 340lbs) and felt horrible. My GP took me off the drug and 6 weeks later my tsh was 1.6 and I felt great lol. I came to the conclusion I never should of been on it and maybe abruptly stopping the TRT temporarily effected my TSH? Who knows..

I just restarted TRT with another doctor that I have been talking with that seemed to know more about it. This will be my last attempt.

August 2017 6'7" 320lbs (decent shape, lift quite a bit, some cardio but about 30lbs overweight)

Labs before TRT
Total Testosterone: 223
Free testosterone: 51.2
shbg: 10
E2: 34
Lh: 2.6
Fsh: 3.0
Tsh: 1.8

What does this seem like? My lh and fsh are on the low end of normal? So is that secondary hypogonadism? My e2 is on the high end of normal.

He started me on 100mg of test cypionate a week and I spit the dose to 50 mg every 3.5 days due to my past with high estrogen.

6 week labs:
Total T: 511
Free T: 134
Estradiol: 43
Felt great for about a month, then started to gain a lot of water weight, lost my libido and energy level went down.
He just started me on arimidex .5 twice a week last week and lost 10lbs in 72 hrs. He raised my dose to 75mg every 3.5 days and so far I feel better, my face doesn't feel puffy, I lost a whole belt size, and feel generally better. I know I should start some hcg and I will talk with him on my next appointment.

So basically my questions are will abruptly stopping trt effect my tsh? Or does being on trt effect your tsh? And is .5mg twice a week anastrozole sufficient for 75mg 2x weekly? Will I be able to come off anastrozole after I drop body fat?

 

[Johnnyv412]

Btw, I'm sorry for the lengthy post and I'm glad to be part of the community

 

[Systemlord]

Welcome to Excelmale,

Seem the first two protocols were a disaster put together by doctors who should know better and no AI. Sounds like your female doctor was only willing to meet you halfway in regards to TRT, give you testosterone and if you end up converting too much of it into estrogen too bad, horrible! Your SHBG is super low and you should be injecting smaller doses either M/W/F, EOD and even ED. Large doses of testosterone push down SHBG, this is why it's important to use smaller more frequent doses.

Your current doctor should know this, it's really tough to find a hormone doctors who is skilled! You'll also maintain better control over you E2 with more frequent, smaller doses. These small doses means you'll end up converting less of your testosterone into estrogen. It's possible once you lose fat and switch to more frequent dosing you just might be able to kick the AI altogether. I don't know about the TSH, I've heard it can go either way, up or down. I just don't understand the mechanism at play, but I do know TRT will change you life for the better.

https://naturalbiohealth.com/2015/05/06/shbg-critical-to-your-health/

 

[Johnnyv412]

I've read a bit about shbg. Does having low shbg mean I am a hyper t metabolizer? I wish I would of gotten a shbg test after the 6 weeks. My doctor has never mentioned the pathetically low number. I always thought it was my body's way of keeping the free T in check with such normal total. I could try and inject more often. I just hate sticking myself with needles so much. I've heard about people doing the sub-q. Just have never tried it, not sure I'd know how lol. I also read that excessive androgen activity can lower shbg. Does that mean now that I have an ai my shbg may go up?

 

[Systemlord]

Basically with low SHBG you're effectively dumping your FT quickly (pissing it out), a hypermetabolizer actually uses the T quickly. You're excreting testosterone into your urine, if you were to check you blood level for testosterone, you'd find more of it in your urine than what's in your blood. Smaller doses tend to not push SHBG down as much allowing you to use more of your FT. If your SHBG gets too high all your FT is bound up unavailable to your body. SHBG is made in the liver, diabetes (insulin resistance), hypothyroidism and excess androgen activity (large doses of T) will decrease SHBG.

When I first started injecting at home the thought of more injections than once a week were out of the question, once you get used to injecting it's not a problem. My SHBG was @18 4 weeks into my current protocol (50mg twice weekly), when I was injecting once weekly I would always feel a little low towards the end of the week, now I don't feel the peaks and valleys anymore. I feel the same all the time, the body likes regularity and consistency.

You might also consider SubQ injection found to help some of those with low SHBG.


https://youtu.be/Wz3CPkX6zrQ Time index 4:20

 

[madman]

Welcome to Excelmale,

Seem the first two protocols were a disaster put together by doctors who should know better and no AI. Sounds like your female doctor was only willing to meet you halfway in regards to TRT, give you testosterone and if you end up converting too much of it into estrogen too bad, horrible! Your SHBG is super low and you should be injecting smaller doses either M/W/F, EOD and even ED. Large doses of testosterone push down SHBG, this is why it's important to use smaller more frequent doses.

Your current doctor should know this, it's really tough to find a hormone doctors who is skilled! You'll also maintain better control over you E2 with more frequent, smaller doses. These small doses means you'll end up converting less of your testosterone into estrogen. It's possible once you lose fat and switch to more frequent dosing you just might be able to kick the AI altogether. I don't know about the TSH, I've heard it can go either way, up or down. I just don't understand the mechanism at play, but I do know TRT will change you life for the better.

https://naturalbiohealth.com/2015/05/06/shbg-critical-to-your-health/

Injecting more frequently with smaller doses may aid in controlling e2 but it is not a given.

 

[Vince]

It would be nice if you posted your full labs with ranges, also did you have the right sensitive test for men. Low estradiol can be worse then high estradiol.

 

[Johnnyv412]

It would be nice if you posted your full labs with ranges, also did you have the right sensitive test for men. Low estradiol can be worse then high estradiol.

Before TRT

POTASSIUM 4.3 MMOL/L 3.5 - 5.3 MMOL/L
CHLORIDE 107 MMOL/L 98 - 110 MMOL/L
CARBON DIOXIDE 22 MMOL/L 20 - 31 MMOL/L
CALCIUM 9.2 MG/DL 8.6 - 10.3 MG/DL
ALK PHOS 44 U/L 40 - 115 U/L
SGOT/AST 19 U/L 10 - 40 U/L
SGPT/ALT 43 U/L 9 - 46 U/L
BILIRUBIN-TOTAL 2.3 MG/DL 0.2 - 1.2 MG/DL
GLUCOSE 99 MG/DL 65 - 99 MG/DL
BUN 15 MG/DL 7 - 25 MG/DL
CREATININE SERUM 1.10 MG/DL 0.60 - 1.35 MG/DL
BUN/CREATININE RATIO 13.5 6 - 22
PROTEIN TOTAL 6.6 G/DL 6.1 - 8.1 G/DL
ALBUMIN 4.2 G/DL 3.6 - 5.1 G/DL
GLOBULIN CALCULATED 2.4 G/DL 1.9 - 3.7 G/DL
A/G RATIO 1.7 1.0 - 2.5
EGFR NON-AFR. AMERICAN 88 ML/MIN/1.73M2 > OR = 60 ML/MIN/1.73M2
EGFR AFRICAN AMERICAN 102 ML/MIN/1.73M2 > OR = 60 ML/MIN/1.73M2

E2 34pg/ml. <39pg/ml
Lh 2.6miu/ml 1.5-9.3miu/ml
Fsh 3.0miu/ml. 1.5-8.0miu/ml
Free testosterone 51.22 35-155pg/ml
Total testosterone 230.11 250-1100ng/dl
SHBG 10mnol/l 10-50mnol/l
PROLACTIN 5.9 NG/ML 2.0 - 18.0 NG/ML

6weeks in 45mg testosterone cypionate twice a week

sodium 138 MMOL/L 135 - 146 MMOL/L
POTASSIUM 4.3 MMOL/L 3.5 - 5.3 MMOL/L
CHLORIDE 107 MMOL/L 98 - 110 MMOL/L
CARBON DIOXIDE 22 MMOL/L 20 - 31 MMOL/L
CALCIUM 9.2 MG/DL 8.6 - 10.3 MG/DL
ALK PHOS 44 U/L 40 - 115 U/L
SGOT/AST 25 U/L 10 - 40 U/L
SGPT/ALT 45 U/L 9 - 46 U/L
BILIRUBIN-TOTAL 2.3 MG/DL 0.2 - 1.2 MG/DL
GLUCOSE 99 MG/DL 65 - 99 MG/DL
BUN 15 MG/DL 7 - 25 MG/DL
CREATININE SERUM 1.10 MG/DL 0.60 - 1.35 MG/DL
BUN/CREATININE RATIO 13.5 6 - 22
PROTEIN TOTAL 6.6 G/DL 6.1 - 8.1 G/DL
ALBUMIN 4.2 G/DL 3.6 - 5.1 G/DL
GLOBULIN CALCULATED 2.4 G/DL 1.9 - 3.7 G/DL
A/G RATIO 1.7 1.0 - 2.5
EGFR NON-AFR. AMERICAN 88 ML/MIN/1.73M2 > OR = 60 ML/MIN/1.73M2
EGFR AFRICAN AMERICAN 102 ML/MIN/1.73M2

Estroidial 43pg/ml <36pg/ml
Total testosterone: 511ng/dl 250-1100ng/dl
Free testosterone: 142.1pg/ml 35-155pg/ml

 

[Johnnyv412]

Since day one I've been prescribed 150mg a week of testosterone. I've been taking much less and splitting dosages biweekly because from past practice I know my E2 rises and when it does I bloat and get panic attacks. So since my six week visit I've raised to 60mg biweekly (120mg per week) and I took .5mg of arimidex 2 days after my shot (when I picked up the prescription) and .25mg 24 hours after my last shot. I was gonna continue to try .25mg 24 hours after my shots. When I took the .50 after my first shot I lost like 10 lbs of water weight in the first 40 hours and morning wood returned (been gone for a couple weeks). Ive been lifting like crazy and doing a good amount of cardio while eating very clean trying to drop body fat in hopes that I can raise my shbg and lower my aromatase activity. I have felt better overall on trt than before but I do have days where I don't feel as good as others.