What is next?

[Worried]

I started TRT on 12/29/16

Reasons: Extremely low energy /bouts of depression/ chronic muscle fatigue

History: used self prescribed steroids from 1997 to 2000. Went well at first but then I Got extremely sick (flu) and never did it again. Since that time I have dealt with chronic digestion issues.

Prescribed Dosage:

300ml testosterone cypionate per week divided 200 then four days latter 100 and so on.

HCG 350 IU EOD

Anastrozole 1ml tab EOD

All three scheduled to start on the same day.

Dosages taken.

December 29 100 mg testerone,250 units hCG, half a tablet of anastrozole.

All three were taken first thing in the morning, I felt euphoric, high-energy for about four hours. Rest ofthe day I felt normal. Worked out that night.

Friday was a normal eventful day for me.

Because I had no negative side effects from that dosage I went back to the prescribed dosage on Saturday. One full Tab of anastrozole, 350 IU HCG, also included the other 100 mg of testosterone.

That day I was flying high in a great mood, but I knew I had taken too much. Dry mouth, sore joints in the thumbs. Started to have anxiety around 11:00 PM. That night I feel asleep at 2am woke up at 4:30, back to sleep 7am, woke up 9. I felt okay and carried on with my day.

Did not sleep well that evening (Sunday). Felt like sleep apnea was occurring. I would start to doze off and quit breathing and get scared. Finally fell asleep and got about six hours that night.

I woke up Monday morning called the prescribing doctor. I told them I did not want to do that high of a dose. They cut my testosterone down to 200 mg weekly, half a tab of anastrozole, 350 IU hcg.

Monday morning I administered 250 MG hCG, 1/2 tablet anastrozole. This time extreme anxiety immediately following the injection. Same with the tablet. Worked out that night. Sleep again that night was not good.

Woke up Tuesday morning injected 100 mg of testosterone. Had a good day. Worked out that night. But again that night I was unable to sleep. Maybe got six hours.

Wednesday 250 of hCG. Half a tablet of anastrozole. I laid around and rested all day.

Wokeup Thursday called the prescribing doctor with an update. I told them I felt I was crashing my estradiol. They scheduled me for a testosterone estrogen and progesterone blood test to be taken the next day a.m. No injections on Thursday or anastrozole . I felt great all day. Amazingly strong. Worked all day. Went to the gym and lifted that night.

Woke up Friday morning went and got my blood test. Went home took 250 IU of hCG no anastrozole. That day was not great but it wasn't terrible. I felt a huge relief from not taking anastrozole tablet.

(I would like to note that starting Wednesday I started to feel some mild body chills and coughing up small amounts of mucus.)

Saturday morning I woke up and took 50 mg of testosterone. I worked out that morning felt strong I did back, abs, cavs. I did some cardio for 20 minutes started feeling tired and quit. I went to do some shopping and I noticed that my sense of smell was through the roof. I had a reasonable amount of energy throughout the day.

That night I got extremely sick. Body chills, fever, sweats. I fell sleep about 2 o'clock in the morning, woke up around nine. Same thing sick as a dog all day long. I elected to take no hCG today.

I have taken screenshots of my labs, excluding any personal information. Please let me know how I can attach those.

My thoughts are that I should've never started out with all three of these at the same time. I feel reasonably comfortable continuing the testosterone cypionate twice a week at 50 mg per. I believe that the combination of all three was too hard on my system and broke down my immune system. Leading to flu symptoms.

I would like to add that my libido has been nonexistent since the beginning of TRT, and it was a non-issue prior to that. My chest and nipples have continue to swell. Although today not taking the hCG it feels as though I am not as bloated.

I will have results from the second blood test on Tuesday.

 

[johndoesmith]

You're going to have to shorten this.

Plus, what are you doing? Honestly, you're changing doses as fast as most people change their underwear. You will never achieve success on a TRT protocol by changing doses regularly, and basically based on how you feel.

200mg then 100mg? That's...I honestly don't know what to call that but it's not a protocol.

Getting labs 1 week after starting TRT is not going to result in actionable data.

Look, I may be coming off blunt, but I think you need it.

 

[CoastWatcher]

I started TRT on 12/29/16

Reasons: Extremely low energy /bouts of depression/ chronic muscle fatigue

History: used self prescribed steroids from 1997 to 2000. Went well at first but then I Got extremely sick (flu) and never did it again. Since that time I have dealt with chronic digestion issues.

Prescribed Dosage:

300ml testosterone cypionate per week divided 200 then four days latter 100 and so on.

HCG 350 IU EOD

Anastrozole 1ml tab EOD

All three scheduled to start on the same day.

Dosages taken.

December 29 100 mg testerone,250 units hCG, half a tablet of anastrozole.

All three were taken first thing in the morning, I felt euphoric, high-energy for about four hours. Rest ofthe day I felt normal. Worked out that night.

Friday was a normal eventful day for me.

Because I had no negative side effects from that dosage I went back to the prescribed dosage on Saturday. One full Tab of anastrozole, 350 IU HCG, also included the other 100 mg of testosterone.

That day I was flying high in a great mood, but I knew I had taken too much. Dry mouth, sore joints in the thumbs. Started to have anxiety around 11:00 PM. That night I feel asleep at 2am woke up at 4:30, back to sleep 7am, woke up 9. I felt okay and carried on with my day.

Did not sleep well that evening (Sunday). Felt like sleep apnea was occurring. I would start to doze off and quit breathing and get scared. Finally fell asleep and got about six hours that night.

I woke up Monday morning called the prescribing doctor. I told them I did not want to do that high of a dose. They cut my testosterone down to 200 mg weekly, half a tab of anastrozole, 350 IU hcg.

Monday morning I administered 250 MG hCG, 1/2 tablet anastrozole. This time extreme anxiety immediately following the injection. Same with the tablet. Worked out that night. Sleep again that night was not good.

Woke up Tuesday morning injected 100 mg of testosterone. Had a good day. Worked out that night. But again that night I was unable to sleep. Maybe got six hours.

Wednesday 250 of hCG. Half a tablet of anastrozole. I laid around and rested all day.

Wokeup Thursday called the prescribing doctor with an update. I told them I felt I was crashing my estradiol. They scheduled me for a testosterone estrogen and progesterone blood test to be taken the next day a.m. No injections on Thursday or anastrozole . I felt great all day. Amazingly strong. Worked all day. Went to the gym and lifted that night.

Woke up Friday morning went and got my blood test. Went home took 250 IU of hCG no anastrozole. That day was not great but it wasn't terrible. I felt a huge relief from not taking anastrozole tablet.

(I would like to note that starting Wednesday I started to feel some mild body chills and coughing up small amounts of mucus.)

Saturday morning I woke up and took 50 mg of testosterone. I worked out that morning felt strong I did back, abs, cavs. I did some cardio for 20 minutes started feeling tired and quit. I went to do some shopping and I noticed that my sense of smell was through the roof. I had a reasonable amount of energy throughout the day.

That night I got extremely sick. Body chills, fever, sweats. I fell sleep about 2 o'clock in the morning, woke up around nine. Same thing sick as a dog all day long. I elected to take no hCG today.

I have taken screenshots of my labs, excluding any personal information. Please let me know how I can attach those.

My thoughts are that I should've never started out with all three of these at the same time. I feel reasonably comfortable continuing the testosterone cypionate twice a week at 50 mg per. I believe that the combination of all three was too hard on my system and broke down my immune system. Leading to flu symptoms.

I would like to add that my libido has been nonexistent since the beginning of TRT, and it was a non-issue prior to that. My chest and nipples have continue to swell. Although today not taking the hCG it feels as though I am not as bloated.

I will have results from the second blood test on Tuesday.

I don't know where to begin. Well, I'll begin by welcoming you to Excelmale, we're glad you're here. That said, you are totally out of control. Initiating TRT with an insanely high dose of testosterone, a very high dose of HCG, and a dose of Anastrozole that would be appropriate if you were a woman dealing with breast cancer. On top of that, you have made significant protocol changes on the basis of how you feel after less than a month of therapy. It is no wonder you feel miserable.

There are certain hallmarks of a successful protocol. One injects smaller doses of testosterone on a more frequent basis over the course of a week. One only takes an AI if labs and symptoms call for it, and one doesn't use excessive amounts of HCG. Once in place, you wait four to six weeks with no changes before testing.

A good starting protocol is 50 - 60 mp of testosterone every 3.5 days accompanied by HCG twice a week. If your estradiol on the sensitive test is not elevated there is no reason in the world to take Anastrozole. It's unlikely that you have done anything to your immune system, as you suggest, you have, however, ridden into hormone hell.

What you need is a more modest, realistic protocol and a bit of patience. Even more patience is needed now for your system to recover with a good protocol in place.

Yes, post labs. Screenshots or type them in; please include reference ranges.

Finally, consider a new doctor who understands the basics of androgen replacement. You'll be OK...but it may take a bit of time.

 

[Worried]

Labs

Here are my labs. Thank You for your imput.

 

[Worried]

I just posted my labs. Thank You

 

[CoastWatcher]

Thank you for posting these. There are important labs that were not run. Your LH, FSH, and SHBG were not measured. The first two are likely now of little value as they are, or shortly will be, suppressed by exogenous testosterone. Even with a history of prior steroid use some effort should have been made to determine if you were dealing with primary or secondary hypogonadism. SHBG is important to have in order to properly understand how testosterone clears your system so as a protocol can be designed. These are three key tests that weren't run.

Your TSH is elevated. You have thyroid problems - how are they being addressed? It's not referred to as the "master gland" for no reason.

What is your diet like? Your lipids are all out of range (and TRT can further impact some of them).

So, your doctor failed to perform an in-depth workup, your thyroid is in need of immediate attention, your lipid profile is skewed, and you were prescribed a protocol that made no sense at all - which you changed every time a symptom did.

You need better medical care and patience. What else is significant in your medical history? What other drugs/supplements are you taking? Age and weight? Where do you live?

 

[Worried]

Thank You.

What else is significant in your medical history?
A- I have never been diagnosed with any type of serious element. I've had digestion issues for the last 16 years that have been undiagnosed. I have had many different types of test ran on my gallbladder and investigating the digestive track through an endoscopically and another scope going the other direction. I have never seen an Andro canal a just or urologist to examine lab work or hormones of any type.

What other drugs/supplements are you taking? A- I am not taking any other drugs whatsoever other than an occasional adville or Aleve. But that is very rare.

Age and weight?
A- I am 6 foot one 265 pounds.

Where do you live?
A- In a suburb just outside of Sacramento California.

 

[Worried]

Today I will eat three meals consisting of one can of tuna, with a teaspoon of flaxseed oil and 2 teaspoons of sesame seed oil, a quarter cup of apple cider vinegar with the mother in it, along with mixed greens, bell pepper onion perhaps a mushroom, along with a quarter cup of gluten-free oatmeal. One scoop of whey protein. In the evening I will have a fourth meal with lean steak steamed cauliflower broccoli and mushrooms. I will normally eat that for five days and then on the weekends cheat a bit. At other times my diet will start in the morning with two boiled eggs a lean steak, baked potato, salsa, whole fruit jelly, two pieces of whole grain bread. I will eat snacks in between consisting of almond butter and green apple slices.

 

[Worried]

I would not pay much attention to the cholesterol portion of my blood test because I was not truly fasting. I've had that ran in the past and there was never a problem.

 

[CoastWatcher]

Thank You.

What else is significant in your medical history?
A- I have never been diagnosed with any type of serious element. I've had digestion issues for the last 16 years that have been undiagnosed. I have had many different types of test ran on my gallbladder and investigating the digestive track through an endoscopically and another scope going the other direction. I have never seen an Andro canal a just or urologist to examine lab work or hormones of any type.

What other drugs/supplements are you taking? A- I am not taking any other drugs whatsoever other than an occasional adville or Aleve. But that is very rare.

Age and weight?
A- I am 6 foot one 265 pounds.

Where do you live?
A- In a suburb just outside of Sacramento California.

What about your thyroid? What did your doctor say? Are you on HCG?

 

[Worried]

I would like to add that today this morning I am feeling 1000 times better. I have not taken any Anastrozole since Wednesday, I have not taken any hCG since Friday. The swelling in my chest and abdomen is gone. The panic anxiety is gone. I have been able to sleep through the entire night no problem. I feel very strong this morning.

 

[Worried]

The doctor said that it was a little elevated but with the protocol he was giving me that it should come under control. I am with you I do not fully trust this clinic, even though they seem to be well-established and I was referred there from one of their patients, my chiropractor.

 

[Worried]

I do have medical insurance. I was thinking about going to my primary to see if I can get a referral to an enchronologist or urologist, so that I can get a second opinion on many of the issues that you just raised. But if there is a better doctor close to where I live that can deal with all these things at once and has proven to be successful I would rather go that route and pay the money.

 

[CoastWatcher]

I do have medical insurance. I was thinking about going to my primary to see if I can get a referral to an enchronologist or urologist, so that I can get a second opinion on many of the issues that you just raised. But if there is a better doctor close to where I live that can deal with all these things at once and has proven to be successful I would rather go that route and pay the money.

Defy Medical - telemedicine works. Dr Justin Saya, their medical director, is one of the leading practitioners in the field of androgen therapy/replacement, he is a moderator here at EM, and a fine fellow. Plug his name into the search box here and read some of his contributions. Better yet, go to www.defymedical.com and then call them and ask any question you have. They will answer your questions. I am not a patient, but info respect them very much.

Get a a grip on your health.

 

[Worried]

I got my labs back and my estrogen is way low. Pre TRT 18, a week later it is a 6

 

[Chivato]

Relax. Now that you have ceased taking Anastrozole your E2 will gradually adjust to normal. Many worry about keeping it low but a bit on the high side is fine, in my opinion, as long as you are not having symptoms. In fact your libido and general health may be better with it on the high side. I would be much more concerned with your thyroid panel than you or your doctor seem to be, however.

 

[CoastWatcher]

I got my labs back and my estrogen is way low. Pre TRT 18, a week later it is a 6

Given the foolish protocol your were prescribed, I'm not at all surprised. It will bounce back eventually. This just illustrates how bone-headed your doctor is. Lousy protocol, dismissing your thyroid labs...bad medicine.

 

[Worried]

I spoke with a new doctor within the same clinic today. He said that because my T3 and T4 levels are within range that he is not concerned about the TSH being high. He said that it is elevated because it is working hard to keep the T3 and T4 with in range. But, He said it cannot continue that way indefinitely and we will keep an eye on it. If the T3 and T4 were low then it would be a serious concern. Because then you have hypothyroidism. We will be checking it again in a few months.


They have agreed to withdraw the blocker to allow my estrogen level to normalize. They would however like to introduce it at a much lower dose A week from now. And then test my levels again three weeks from now.

They would like for me to continue with the hCG every other day at 350 IU. I wish they had not required that. I really feel as if I don't need it this point and that it is the cause of some side effects I am experiencing. I asked him if I could not do it, he said that it is a concern for them because they don't want to get sued for shutting down a person's natural reproductive organ. He then added that it is an important part of a healthy protocol.

In the end I'm going to try it out again the way that they have suggested. Perhaps the low estrogen has been the cause of all these issues.

Based on the fact that I met with a different Doctor Who I like a lot better, and that they are going to continue testing bloodwork every three weeks until this gets resolved I feel much more comfortable.

 

[CoastWatcher]

I spoke with a new doctor within the same clinic today. He said that because my T3 and T4 levels are within range that he is not concerned about the TSH being high. He said that it is elevated because it is working hard to keep the T3 and T4 with in range. But, He said it cannot continue that way indefinitely and we will keep an eye on it. If the T3 and T4 were low then it would be a serious concern. Because then you have hypothyroidism. We will be checking it again in a few months.


They have agreed to withdraw the blocker to allow my estrogen level to normalize. They would however like to introduce it at a much lower dose A week from now. And then test my levels again three weeks from now.

They would like for me to continue with the hCG every other day at 350 IU. I wish they had not required that. I really feel as if I don't need it this point and that it is the cause of some side effects I am experiencing. I asked him if I could not do it, he said that it is a concern for them because they don't want to get sued for shutting down a person's natural reproductive organ. He then added that it is an important part of a healthy protocol.

In the end I'm going to try it out again the way that they have suggested. Perhaps the low estrogen has been the cause of all these issues.

Based on the fact that I met with a different Doctor Who I like a lot better, and that they are going to continue testing bloodwork every three weeks until this gets resolved I feel much more comfortable.

Why take an AI if labs and symptoms don't require it? That is utterly foolish and likely to push you back into the pit you just climbed out of. As my own doctor has said, it's easy to lower estradiol, and a painful ride for the patient of it needs to be raised. But it's certainly your health and your choice. Time will tell. I wonder, but wish you the best.

 

[johndoesmith]

I spoke with a new doctor within the same clinic today. He said that because my T3 and T4 levels are within range that he is not concerned about the TSH being high. He said that it is elevated because it is working hard to keep the T3 and T4 with in range. But, He said it cannot continue that way indefinitely and we will keep an eye on it. If the T3 and T4 were low then it would be a serious concern. Because then you have hypothyroidism. We will be checking it again in a few months.


They have agreed to withdraw the blocker to allow my estrogen level to normalize. They would however like to introduce it at a much lower dose A week from now. And then test my levels again three weeks from now.

They would like for me to continue with the hCG every other day at 350 IU. I wish they had not required that. I really feel as if I don't need it this point and that it is the cause of some side effects I am experiencing. I asked him if I could not do it, he said that it is a concern for them because they don't want to get sued for shutting down a person's natural reproductive organ. He then added that it is an important part of a healthy protocol.

In the end I'm going to try it out again the way that they have suggested. Perhaps the low estrogen has been the cause of all these issues.

Based on the fact that I met with a different Doctor Who I like a lot better, and that they are going to continue testing bloodwork every three weeks until this gets resolved I feel much more comfortable.

This is strange, while they're doing the right thing with hCG, and are correct about hCG being a part of a healthy protocol(for most), the removing AI and then adding it back in, without a lab test or symptoms to justify it is ridiculous.

Not everyone NEEDS an AI.

Low estrogen is TERRIBLE. Seriously.

hCG dose is rather high btw, that's almost an hCG monotherapy dose, for TRT it'd be more 500-1000IU a week split into 2 doses.