need help with trt

[coach669]

I am 38 years old and a little over a year ago my primary doctor confirmed I had low testosterone level (238). He put me on Androgel one 5g packet daily. After a few weeks I felt better than I had in years. My energy and sex drive was way up. Well my doctor thought my levels had gotten too high after about 5 weeks and cut my dose to one 5g packet on Mon, Wed, Fri and Sun. I then noticed a decrease in energy and later upped on my own back to every day 5g. I then began to experience hot flushed feeling in my face and my sex drive further decreased and my testicles shrank. When I was tested my level was around 1000 total which I was surprised.

I then decided to try injectables from a hormone replacement clinic. I was put on test enanthate 400 week and deca 300 week. I gained muscle but felt terrible. My levels tested at 1700. I was feeling anxious and depressed and my sex drive was nil. I did PCT of HCG and Clomid then went back on the Androgel with almost no break.

I have been back on Androgel for about 4 months. I started with 5g every day but began feeling that hot flushed feeling again along with being very irritable. I dropped back to the doctor recommended dose of Sun, Mon, Wed and Fri and no longer felt the hot flush. I had my levels tested and it was at 235. This was lower than when I started Androgel the first time when it was 238. I am now weening myself off of the Androgel. Next week I will only take one packet on Friday and will then give myself some time off.

My question is how long should I wait to resume? I only want to feel good and for my sex drive to improve like when I started Androgel the first time. I was thinking of asking my doctor to switch me over to Androgel pump and just use 2 pumps daily instead of one 5g packet every other day. I was thinking this may give a more steady release of the test into my system . Or would I be better off just using a low dose of an injectable like cyp 250 weekly. I have also even been considering hgh to improve my depression and libido but need more information. Any advice would be appreciated. Let me know if more info is needed

Thanks

[zaggahamma]

sorry to hear about your treatment turning out bad and becoming so variable....i had a doctor try a similar thing with me when i upped my dose of androgel to 10mg ED....i was feeling great but he said that my androgen index level was too high (superphysiological) he called it and wanted me back to 5mg....
where i differ is i took his reccommendation as ADVICE and never once considered lowering my dose and in fact have went up in test dosage with injects and have not experienced any negative sides thus far (10 months)...

once again, a lot of us will differ in our reaction to hormones, etc. (any meds at that)

i wish i knew the answer you were looking for, i know we all want to see you experiencing what you did the first few weeks of starting trt

[scott2393]

May I humbly suggest that estrogen levels are relevant here. If your test goes up and your est goes up with it, the est can cancel out the boost you got from the hrt. And look what you said, "at first" things were great, but then your body had time to aromatize that extra test, and then things went downhill. Well that's what it seems like to me. This is why drs think that test injections "don't work" for sex drive, because they work for a week then the benefits start wearing off. Well, duh, it's called aromatization. Yeah I'm the anti estrogen freak of the year, and ppl are going to be quickly sick of me talking about estrogen and test:estradiol ratios. Oh well. So don't drink too much, get enough zinc, lower your bf%, and get your dr to test estradiol or do it yourself. Then if you find it is still to high like abouve 30 then read up on arimidex or similar.

And can I also just add that if you "feel great" then your dr should take that into account and not just treat towards the blood numbers. If your dr is a slave to the lab reports and doesn't take into account how you feel then I'd ditch him.

[fbcoach]

Coach,
What Scott said about the testosterone /estrogen ratio is right. It's the most important thing to take into account when balancing hormones. Your symptoms do describe highE2 levels. The high E2 levels can cancel out all of the desired effects of the higher test levels. If I were you, I would do what your Doc recommended (2.5). If I didn't feel any better, I would have levels re-tested, then go from there. Make sure your Doc tests for E2 levels using the (male sensitive) estrogen test.

[zaggahamma]

agree with scott and fbcoach....i failed to make that observation...i get discombobulated when i hear/see doctors backing off doses when patients are experiencing positive symptoms
has your doctor ever mentioned estrogen?
i know that i had several doctors comment that testing for estrogen
WASN'T NECESSARY!

[fbcoach]

Coach,
I also want to add that from what you mentioned, it looks like you were on a bit of a hormonal rollercoaster ride. I do know that it's not just about what levels your hormones test at, but to feel your best they have to stabilize and give your body time to adjust.

[WallyWorld637]

Ok here is my 2 cents. I have been in major depression for most of my life. It's call Dysthymia. My primary which by the way was only a regular doc put me on andro gel 10g a day. The first few days were great then bam, back to I don't give a crap about anything again. I gave up. Then about 4 months ago A friend turned me to his doc which is an endocrine specialist. He did my blood work (testosterone was so low that it wasn't showin up on the test) and put me on 200mg test injection 1 time a week, 1 B12 injection every 2 weeks and capped it off with Anastrozole .5mg 3 times a week (Estrogen blocker). I almost forget he upped my thyroid to a real thyroid not synthetic called Armour Thyroid 90mg a day. I'm rockin. Now I did not get in to TRT to get big muscles, just a better way of life and to be an active person again. But I figured if I was going to be on this stuff I was going to see what it did. For the first time in 16 years I benched 275 for reps at the gym on Monday. I thought I would never feel this good in my life. I believe it's all in a good doc that runs the right tests and truly cares about how you feel. I still have bouts with my depression but nothin like I did. I'm a successful photographer now and a real husband and what really matters is that I'm a real father now to my kids that didn't understand why daddy blows up and has nervous break downs. I thank God for my Doc.

[zaggahamma]

Ok here is my 2 cents. I have been in major depression for most of my life. It's call Dysthymia. My primary which by the way was only a regular doc put me on andro gel 10g a day. The first few days were great then bam, back to I don't give a crap about anything again. I gave up. Then about 4 months ago A friend turned me to his doc which is an endocrine specialist. He did my blood work (testosterone was so low that it wasn't showin up on the test) and put me on 200mg test injection 1 time a week, 1 B12 injection every 2 weeks and capped it off with Anastrozole .5mg 3 times a week (Estrogen blocker). I almost forget he upped my thyroid to a real thyroid not synthetic called Armour Thyroid 90mg a day. I'm rockin. Now I did not get in to TRT to get big muscles, just a better way of life and to be an active person again. But I figured if I was going to be on this stuff I was going to see what it did. For the first time in 16 years I benched 275 for reps at the gym on Monday. I thought I would never feel this good in my life. I believe it's all in a good doc that runs the right tests and truly cares about how you feel. I still have bouts with my depression but nothin like I did. I'm a successful photographer now and a real husband and what really matters is that I'm a real father now to my kids that didn't understand why daddy blows up and has nervous break downs. I thank God for my Doc.

glad for your bro...we do need more docs like that....curious about the thyroid meds and your bloodwork prior to starting this hrt combo and have you been retested since....with this severe depression, is it safe to assume there is a lot of fatigue and how if so has that changed...oh and i guess i would like to know if your B12 levels were low prior as well

[fbcoach]

WallyWorld,
That is very inspirational....THANK YOU!! Did your Doc also address your adrenals as well? Sounds like you found a really good Doc. Congratulations, and I wish you continued GOOD LUCK!!

[WallyWorld637]

I haven't heard him say anything about adrenals. Exactly what is that? I figure it has something to do with your adrenalin but what I'm I looking for. I go back in 2 weeks for my blood work to be done after about 4 months. So tell me what I should ask, I'm curious. Thanks

[coach669]

Thanx for the advice guys. My doctor is a good guy but I don't think he is knowledgable about estrogen and the use of blockers. He is my primary care doctor so my insurance covers him and my androgel . If anyone could recommend a doctor in the Fort Lauderdale area I guess I would pay out of my pocket to get it done right.

[WallyWorld637]

Well, I'm just a little north of you in Jacksonville FL. I wish I could help you. Maybe I can ask my doc when I go in next time and see if he knows anyone in your area.

[fbcoach]

WallyWorld,
Your thyroid can function optimally without the support of your adrenals. Ask your Doc for the saliva test for your cortisol levels. If you're not producing enough cortisol, your body cannot properly handle stress. Just remember, too much cortisol, for obvious reasons (muscle loss, etc.), is not good either. PM me and I can direct you to a site that is devoted to mainly thyroid and your adrenals.

Sorry Coach..didn't mean to hyjack your thread. Just remember if you get your E2s tested, asked for the (male sensitive) test. Good luck!

[fbcoach]

WallyWorld,
I meant your thyroid CANNOT function optimally without the support of your adrenals.

[coach669]

Wallyworld,
Thanks. I would drive up there once but it would probably not be feasable to continue making trips up there. Let me know if he has any recommendations.

[WallyWorld637]

I wouldn't drive up here either. I personally know the billing manager at my docs office and I will see if she can find a good doc in your area. PM me and give me your zip and county and I will see what I can do.