First D Visit Post TRT

[Signmaker]

Im so glad I came across this site and because of it I have learned a lot of valuable information. In two days (Wed) I have my first Doctors appointment since starting TRT ..............
I have been taking 40mg Testosterone Gel daily (24 days) and 2000iu of Vitamin D3. I definitely feel a ton better with energy, motivation, strength, and my sex drive is like that of a 16 yr old.
I know for sure that TRT has been the missing link for me over the past 5 years,....I just feel more alive,...and I eat like a horse.
I'm thinking of switching to injections for a couple of reasons, one being- my new insurance kicks in pretty soon and they really frown upon this type of treatment and the injections are less
expensive. And two, I don't really like the time it takes to lather the gel on and let it dry. I also have my doubts as of how much of it my body really absorbs and how much my clothes absorb.

What would be the injectable dose equivalent to 40mgs. of Test gel??
Ive seen many of you here on the forum start out with 100mg/week and seem to do pretty well with it. Would 100mg/wk be a good a good place to start injections at?
Do you think that this would be a good appointment to bring up HCG as I think that could only help things at this point?
I'm not as concerned with starting AI just yet because I don't think I've really been on TRT long enough or at a high enough dose to need it so....I think I will hold off on AI until my BW says I need it.
Is there anything I am missing or could benifit from by mentioning to my doctor?

For those of you who don't know,.....my stats:

32
220lbs
5'10"
20% BF

and my blood tests PRE TRT:

These are my results from 10/4/11:

Ranges are beside each result...

Vitamin D: 15.5 (L) (30-100)
Testosterone serum: 59 (L) (249-836)
Free Test Direct: 3.2 (L) (8.7-25.1)
IGF -1: 186 (115-307)
Adrenocorticotropic Hormone : 16.7 (7.2-63.3)
Calcium: 9.7 (8.6-10.4)
Magnesium: 2.2 (1.6-2.5)
Estradiol: 3.0 (L) (7.6-42.6)
Folate: 24 (>5.38)
FSH: 4.45 (1.5-12.40)
LH: .89 (L) (1.70-8.60)
Prolactin: 15.73 (L) (4.04-15.20)
T3 Free: 3.25 (2.30-4.20)
T4 Free: 0.99 (.93-1.70)
B12: 377 (211-911)
Cortisol: 3.02 (2.3-19.40)
DHEA-S: 178.2 (160-449)

I think thats everything....Thanks!

Also, any feedback on these results and my TRT treatment would be greatly appreciated .
Right now all I am taking is 40mg of Testosterone Gel per Day.
Last edited by Signmaker; 11-10-2011 at 04:45 PM. Reason: add ranges

[bigboy67]

59 Serum Test? Holy shit dude, no wonder you feel amazing now, you must have been a zombie before.

Don't guess on the E2 levels or assume E2 is ok, always confirm assumptions with blood test to make sure it doesnt get away from you. I blinked my eyes and my E2 hit 112!

Basic TRT protocol
100mg ew Test Cyp
250iu 2x a week hcg
1mg Arimidex per week split into four doses

[sirupate]

I've tried to determine equivilants between the gel and the injectible testosterone, and while you can get into the same "ballpark", there are too many variables to determine exactly. One of variables you discuss is just how much of the gel your skin is absorbing...it varies depending on the individual and maybe some other factors like dry time and clothing.

Also keep in mind that your body can't use 100% of what you are injecting....the number is closer to 70%, as some of the injection isn't in a bioavailable state. Is the gel you are using the 1% gel, or the newer 1.62 or 2% gels?

[steroid.com 1]

Im so glad I came across this site and because of it I have learned a lot of valuable information. In two days (Wed) I have my first Doctors appointment since starting TRT ..............
I have been taking 40mg Testosterone Gel daily (24 days) and 2000iu of Vitamin D3. I definitely feel a ton better with energy, motivation, strength, and my sex drive is like that of a 16 yr old.
I know for sure that TRT has been the missing link for me over the past 5 years,....I just feel more alive,...and I eat like a horse.
I'm thinking of switching to injections for a couple of reasons, one being- my new insurance kicks in pretty soon and they really frown upon this type of treatment and the injections are less
expensive. And two, I don't really like the time it takes to lather the gel on and let it dry. I also have my doubts as of how much of it my body really absorbs and how much my clothes absorb.

What would be the injectable dose equivalent to 40mgs. of Test gel??
Ive seen many of you here on the forum start out with 100mg/week and seem to do pretty well with it. Would 100mg/wk be a good a good place to start injections at?
Do you think that this would be a good appointment to bring up HCG as I think that could only help things at this point?
I'm not as concerned with starting AI just yet because I don't think I've really been on TRT long enough or at a high enough dose to need it so....I think I will hold off on AI until my BW says I need it.
Is there anything I am missing or could benifit from by mentioning to my doctor?

For those of you who don't know,.....my stats:

32
220lbs
5'10"
20% BF

and my blood tests PRE TRT:

These are my results from 10/4/11:

Ranges are beside each result...

Vitamin D: 15.5 (L) (30-100)
Testosterone serum: 59 (L) (249-836)
Free Test Direct: 3.2 (L) (8.7-25.1)
IGF -1: 186 (115-307)
Adrenocorticotropic Hormone : 16.7 (7.2-63.3)
Calcium: 9.7 (8.6-10.4)
Magnesium: 2.2 (1.6-2.5)
Estradiol: 3.0 (L) (7.6-42.6)
Folate: 24 (>5.38)
FSH: 4.45 (1.5-12.40)
LH: .89 (L) (1.70-8.60)
Prolactin: 15.73 (L) (4.04-15.20)
T3 Free: 3.25 (2.30-4.20)
T4 Free: 0.99 (.93-1.70)
B12: 377 (211-911)
Cortisol: 3.02 (2.3-19.40)
DHEA-S: 178.2 (160-449)

I think thats everything....Thanks!

Also, any feedback on these results and my TRT treatment would be greatly appreciated .
Right now all I am taking is 40mg of Testosterone Gel per Day.
Last edited by Signmaker; 11-10-2011 at 04:45 PM. Reason: add ranges

There's a lot of reasons you felt bad here.

* Test serum in the basement!
* E2 levels which also is in the basement!
* LH in the basement (Secondary diagnosis?)
* Cortisol is also very low on the reference range; ideal is mid range so you can see how far off you are.
* Prolactin high and over the reference range.

For a man your age and that you felt bad for some time I would investigate more with focus on your Pituitary gland.

Know, increased Prolactin:
Significant cause of hypogonadism (Your low test & LH serum levels)
May signal tumor presence >300= tumor
Health benefits - Must be maintained within normal range

Know Cortisol:
Cause of secondary hypogonadism (Your low test & LH serum levels)
Must be maintained within normal range
If depressed --> Hydrocortisone PO

There are things going on here that are not right; you need a more thorough diagnosis IMO.

[Signmaker]

First off, I am taking Fortesta which is 2% gel...I shave the area of my inner thighs where I apply it. It takes at least 20-30 minutes to dry fully, but I don't ever have that long so Its still a little tacky after 15 mins when I get dressed.
The only other thing I notice is when I apply the gel and up to a few hours afterward, the area is pretty red and sensitive to the touch...??

As for the secondary diagnosis, I have heard several people on here tell me I should have a MRI to rule in/out a pituitary tumor. If its something my insurance will cover, I will try and have one done, otherwise things are a bit tight for that test
so It will have to wait.

I'm really liking this Protocol....Not a bad place to start!! Do you think I should come right out and tell my Doctor that I've been doing a lot of research and
this is what has been reccomended for me?

Basic TRT protocol
100mg ew Test Cyp
250iu 2x a week hcg
1mg Arimidex per week split into four doses

[steroid.com 1]

I think you need to be properly diagnosed is what I think.

Your hormone panels suggest (actually scream)that something is medically wrong with you and you're focusing on TRT protocols.

Cart before the horse.

Find out what's wrong first and go from there.

Insurance should cover any test.

[bigboy67]

I agree with GD, get a solid diagnosis first. firnd out if you are primary or secondary hypo, then you can start to work on the protocol. I just showed that "basic protocol" to give you an idea of what is generally accepted as a solid protocol.

It is possible that you could jumpstart your own system and avoid TRT all together in the long run and still feel very good, depending on the diagnosis

[Signmaker]

So my appointment is tomorrow and I am going to ask for an MRI to hopefully shed some light on the cause of my low levels. Thinking back, I had been on Klonopin for close to 10 years for panic attacks starting when I was 14.
And at 23, I was in a pretty bad car accident and have been prescribed everything under the moon for some back issues Ive had ever since. I have not taken any pain medicine in over a year because I just felt bogged down and tired
when I would take it....I'm wondering if there could might have been any irreversible damage that could have contributed to my current condition?

A few things that have caught my attention since starting TRT:

-I am constantly hungry and especially crave sweets.

-I have had a couple episodes where I will get very shaky, my hands feel week to grip, I break out in a sweat and feel light headed. This usually only happens in the morning after coffee
and a light breakfast but I end up craving sweets even more at this time. It almost feels like a blood sugar issue??

-I also feel bloated...all the time!

Im not sure if this is just my body adjusting to the Test or something else. I would think that if it were something else they would have caught it in the BW.

[steroid.com 1]

So my appointment is tomorrow and I am going to ask for an MRI to hopefully shed some light on the cause of my low levels. Thinking back, I had been on Klonopin for close to 10 years for panic attacks starting when I was 14.
And at 23, I was in a pretty bad car accident and have been prescribed everything under the moon for some back issues Ive had ever since. I have not taken any pain medicine in over a year because I just felt bogged down and tired
when I would take it....I'm wondering if there could might have been any irreversible damage that could have contributed to my current condition?

A few things that have caught my attention since starting TRT:

-I am constantly hungry and especially crave sweets.

-I have had a couple episodes where I will get very shaky, my hands feel week to grip, I break out in a sweat and feel light headed. This usually only happens in the morning after coffee
and a light breakfast but I end up craving sweets even more at this time. It almost feels like a blood sugar issue??

-I also feel bloated...all the time!

I'm not sure if this is just my body adjusting to the Test or something else. I would think that if it were something else they would have caught it in the BW.

I wouldn't be surprised if the Test combined with your condition is causing these ned sides. Your panels are all over the place and on top of it all your dumping Testosterone into the mix.

You need proper treatment and soon my friend.

[fit2bOld]

Be sure to have your glucose/hemoglobin checked to rule out diabetes or borderline diabetes.Everyone should also get PSA test to get a baseline established and monitor at least once or twice a year for prostate health.

[kelkel]

GD nailed it (as expected). Get the MRI done asap. Your insurance will cover it. You need to rule the pituitary tumor in/out to progress properly (take it from someone who is the proud owner of one). Also, if you don't switch to injections then try switching over to Androgel 1.62%. It's effective, non-sticky, dries in a minute. Piece of cake.

Good luck and keep us posted!

[Signmaker]

Thanks guys!

Don't get me wrong, I'm not trying to just jump in to this TRT thing full swing without really knowing the root cause. When I had my initial blood work done I had no intention of getting on TRT, I didn't even know about TRT. I just wanted to feel better than what I had been feeling like for several years.....S#!T!!! Once I got my prescription for Fortesta I got on the internet to learn more and this is where I ended up. It just so happened that I have cycled before and have been wanting to get back to the gym. I think that the Test has been the missing link in my life because of all the positive effects I am experiencing. I am sure that there will be some side effects at first while my body is adjusting to it and it is going to take a while to get things dialed in. But the reason I came here is to learn as much as possible so that I will have a successful treatment.
So when you say..."and on top of it all your dumping Testosterone into the mix" I am a bit taken back by it. I am trying to take advice from my PCP and this forum and do my best to come up with a plan for treatment.

My PCP prescribed me the Fortesta...40mg/day and I trust him.....However, due to the advice from this forum I am asking for an MRI at my appointment today to rule in/out anything else that might be contributing to my levels.
If something does come back, like a tumor, What is the usual treatment for it?

I have also started taking Vitamin D 2000iu/day, and Omega 3 due to the advice of this forum.

My intentions are not to take any and everything I read or hear about, but rather take a little bit from each experience to better my Treatment. I have read several articles on TRT and HCG by John Crisler, and have a list of questions and print outs for my PCP to look at. Hopefully my PCP knows his S#lT and will be open to reading these articles.

I will update after my Appointment and Testing

[steroid.com 1]

Good luck signmaker; keep us posted on your appointment and subsequen next steps.

gd

[Signmaker]

OK, so my appointment yesterday was BS and my PCP is full of SH!T1!! First off, I explained to him all of the positive effects I've had like 1000% better libido, energy, mood, stronger, and general well being. Then I asked him if he thought an MRI would help rule in/out a pituitary tumor or another cause for my abnormal levels. He said that it was NOT needed and that prolonged use of narcotics will shut down a mans ability to produce Test...?
I haven't taken any narcotics in a long time and have never heard that they would shut you completely down. Next, I told him that I had been doing a lot of research on TRT because I wanted to know more about it and how it will effect me down the road. I asked him if he had heard of Dr. John Crisler and showed him the articles on TRT and HCG which he chuckled at, briefly looked them over and said you can't believe what you read on the internet. He said "those guys take all that other crap like HCG and AI because they are on super sized doses trying to body build and get big" I then told him that I was concerned that I had been feeling bloated since starting TRT and my wedding ring doesn't fit anymore and I was concerned my estrogen levels would go up because Im a little over weight as well. He said "when you were 18 and your Testosterone levels were fine then, Were you bloated?" and "That usually only effects people who are very over weight" I really wanted to bitch slap him at that point!! When I asked him about HCG he said because I was shut down it wouldn't make any difference..That visit officially sucked A$$!!!

I already know what you guys are going to say, but I don't have a whole lot of options...I just moved, and my wife has not found work so thing$ are very tight. Also my insurance has crappy coverage here because it was from another state, so this PCP is the only one (In Network) within 100 miles. I will have new insurance but not for 2 more months and Im not sure they are any better..?

Id like to know if there is any legitimacy behind his claims that previous narcotic use can shut down a mans ability to produce Testosterone?

Im obviously not going to be getting any HCG or AI from him, so what are my options? I have heard so many positives about supplementing TRT with these that I don't really want to continue TRT unless I can get these.
From what I have read about problems of too much Estrogen and Shrinkage along with not being able to have more children make these a must in my mind.

Again, I can't just jump around from Dr to Dr because of insurance and its starting to really add up. Its looks like I am going to have to self medicate if I want to have any success at all!!!

Any Thoughts?

[bigboy67]

man, your doc sounds like the epitomy of all of the ignorant crap that docs say about TRT. i am real sorry man. sounds like in your situation, your best bet is going to be to continue getting your Test from the doc, but then also go to a clinic, explain your situation, and get bloods done and get on an AI/hcg. prescriptions will either be covered or not by your insurance anyways, doesnt matter who writes the script. you may have to pay out of pocket at the clinic, but at least you will be taken care of

[Signmaker]

OK, so my appointment yesterday was BS and my PCP is full of SH!T1!! First off, I explained to him all of the positive effects I've had like 1000% better libido, energy, mood, stronger, and general well being. Then I asked him if he thought an MRI would help rule in/out a pituitary tumor or another cause for my abnormal levels. He said that it was NOT needed and that prolonged use of narcotics will shut down a mans ability to produce Test...?
I haven't taken any narcotics in a long time and have never heard that they would shut you completely down. Next, I told him that I had been doing a lot of research on TRT because I wanted to know more about it and how it will effect me down the road. I asked him if he had heard of Dr. John Crisler and showed him the articles on TRT and HCG which he chuckled at, briefly looked them over and said you can't believe what you read on the internet. He said "those guys take all that other crap like HCG and AI because they are on super sized doses trying to body build and get big" I then told him that I was concerned that I had been feeling bloated since starting TRT and my wedding ring doesn't fit anymore and I was concerned my estrogen levels would go up because Im a little over weight as well. He said "when you were 18 and your Testosterone levels were fine then, Were you bloated?" and "That usually only effects people who are very over weight" I really wanted to bitch slap him at that point!! When I asked him about HCG he said because I was shut down it wouldn't make any difference..That visit officially sucked A$$!!!

I already know what you guys are going to say, but I don't have a whole lot of options...I just moved, and my wife has not found work so thing$ are very tight. Also my insurance has crappy coverage here because it was from another state, so this PCP is the only one (In Network) within 100 miles. I will have new insurance but not for 2 more months and Im not sure they are any better..?

Id like to know if there is any legitimacy behind his claims that previous narcotic use can shut down a mans ability to produce Testosterone?

Im obviously not going to be getting any HCG or AI from him, so what are my options? I have heard so many positives about supplementing TRT with these that I don't really want to continue TRT unless I can get these.
From what I have read about problems of too much Estrogen and Shrinkage along with not being able to have more children make these a must in my mind.

Again, I can't just jump around from Dr to Dr because of insurance and its starting to really add up. Its looks like I am going to have to self medicate if I want to have any success at all!!!

Any Thoughts?

[kelkel]

Now you've realized your doc is a moron and puts down what he doesn't understand. Common unfortunately. You need to either doc shop or go the clinic route. A clinic may accept your BW if it's current btw. There have been previous threads on this but to repeat, call your local compounding pharmacy, or stop by, and ask them what doc's treat patients with all three (t-hcg-ai). They will know. Or, call some doc's/endo's and question the staff if their doc will treat you following Crislers protocols. If they don't know ask them to ask the doc and call you back as you don't want to waste everyones time with a one and done appointment. You will find someone this way. Worked for me. Keep us posted.