25 years old TRT 6 months in. Need advice

[johnt2333]

Hello,

I have been strugling with some helth issues over the last few years, most notible is low T. About 6 months ago my bloodwork revealed I had low T (about 100mg/dl) and I have been taking 400mg of depo test every 2 weeks for the last 6 months.

To throw a wrench in the mix 3 months ago an MRI showed that I have a small cyst in my pituitary gland. According to my bloodwork last month my levels are at about 800mg/dl.

This whole situation has wrecked my body, I went from being fit and muscular to weak and fat in under a year (and im only 25). Gains in the gym are very slim and I have not noticed any boost in energy.

I need to get out of this slump ASAP, but do not know how. Should I be looking into adding HGH, HCG , IGF? What am I missing here? Any advice would be greatly appreciated

[edmundo22]

I'm a total newbie but would having a cyst on ur pituitary gland be interfering with whatever signals are been sent to produce testosterone ?

[zaggahamma]

agree with ed
i'd be looking into what your doctor is advising for the affected gland
can you share what your specialist said so far
doesnt make sense that you didnt share that already imo

[johnt2333]

I'm a total newbie but would having a cyst on ur pituitary gland be interfering with whatever signals are been sent to produce testosterone?

Yes. Its not always the case, but doctors suspect that the cyst shutdown my testosterone production.

jpkman
agree with ed
i'd be looking into what your doctor is advising for the affected gland
can you share what your specialist said so far
doesnt make sense that you didnt share that already imo

Sorry for leaving out detail. So far all the Doctors recommend is injecting test. All my other levels seem to be healthy at this time.

The cyst is benign and will not need to be removed at this size. I must have seen about 12 doctors in the last few years, 6 of whom lead me down the wrong road.

[zaggahamma]

Yes. Its not always the case, but doctors suspect that the cyst shutdown my testosterone production.



Sorry for leaving out detail. So far all the Doctors recommend is injecting test. All my other levels seem to be healthy at this time.

The cyst is benign and will not need to be removed at this size. I must have seen about 12 doctors in the last few years, 6 of whom lead me down the wrong road.

all good and makes sense
if it is not dangerous to go on a hormone therapy in your condition i can attest that it did wonders for many with levels similar to yours including me
sorry u developed the condition but optomistic that you will soon get help
good to know u arent satisfied with only a doctors opinion and are the sole decision maker in your health
i'll bump for more read members...there are even doctors in this forum as you may know and will only offer sound opinions/advice
best of luck
jp

[Bio-Active]

If you are not satisfied with your docs opinion. Why not get a second opinion?

Yes. Its not always the case, but doctors suspect that the cyst shutdown my testosterone production.



Sorry for leaving out detail. So far all the Doctors recommend is injecting test. All my other levels seem to be healthy at this time.

The cyst is benign and will not need to be removed at this size. I must have seen about 12 doctors in the last few years, 6 of whom lead me down the wrong road.

[steroid.com 1]

Can you post your most recent blood work complete with ranges?

Amy E2 management?

Every two weeks is putting stress on you...better to inject weekly or twice a week to balance serum levels and control aromatization.

[johnt2333]

jim230027
If you are not satisfied with your docs opinion. Why not get a second opinion?

Im currently on my 4th opinion regarding my putitary. Working with Mayo clinic this time. I am not expecting any good answers, so that is why I am thinking of taking matters into my own hands.

[johnt2333]

Can you post your most recent blood work complete with ranges?

Amy E2 management?

Every two weeks is putting stress on you...better to inject weekly or twice a week to balance serum levels and control aromatization.

Yes, I will post my most recent blood work tonight.

I am a n00b what is Amy E2 management?

This Tuesday I will get some more blood work done (2 weeks after my last injection of 400mg). After that I will start injecting 100mg twice a week and see how i feel. Thanks for the tip!

[zaggahamma]

Yes, I will post my most recent blood work tonight.

I am a n00b what is Amy E2 management?

This Tuesday I will get some more blood work done (2 weeks after my last injection of 400mg). After that I will start injecting 100mg twice a week and see how i feel. Thanks for the tip!

E2 MANAGEMENT- estradiol(e2) management

estradiol(e2) - a type of estrogen ...found in women AND men...main hormone for women but men have some...when you go on a testosterone therapy it is VERY COMMON for estrogen to increase due to aromotization...your body is trying to go back to the ratio of test to estrogen it was before your testosterone therapy....

next question

[Brohim]

200mg per week would be better but you might have to take an AI for estrogen control. Have you looked into that? With a level of 800 I woudl like to know what your Estrogen number is.

[kelkel]

Pituitary tumors can do different things, such as shut down your hormone production, increase growth hormone levels, prolactin, etc. It's a complicated gland. I'm assuming you had an MRI to confirm this diagnosis? And relax, it's not the end of the world. I have one myself. You'll be fine. You just need to find the correct doctor to get straightened out. The majority of times surgery is not needed unless they are very large (over 10mm), which is relatively unusual. The Mayo Clinic btw is highly rated for this.

As the guys stated above, we need to see FULL bloodwork with ranges so we can review it and try to guide you. Starting with a better injection protocol. Post up as soon as possible. It takes time to get dialed in so before you add in any new products let us take a look at current BW and start there.

**I did not say complicated twice. Why does it do that?)

[zaggahamma]

Pituitary tumors can do different things, such as shut down your hormone production, increase growth hormone levels, prolactin, etc. It's a complicated gland. I'm assuming you had an MRI to confirm this diagnosis? And relax, it's not the end of the world. I have one myself. You'll be fine. You just need to find the correct doctor to get straightened out. The majority of times surgery is not needed unless they are very large (over 10mm), which is relatively unusual. The Mayo Clinic btw is highly rated for this.

As the guys stated above, we need to see FULL bloodwork with ranges so we can review it and try to guide you. Starting with a better injection protocol. Post up as soon as possible. It takes time to get dialed in so before you add in any new products let us take a look at current BW and start there.

**I did not say complicated twice. Why does it do that?)

did u mean a second MRI ? Thus confirming the MRI he mentioned in the op?

[johnt2333]

Brohim
200mg per week would be better but you might have to take an AI for estrogen control. Have you looked into that? With a level of 800 I woudl like to know what your Estrogen number is.

I have not looked into any AI.

kelkel
Pituitary tumors can do different things, such as shut down your hormone production, increase growth hormone levels, prolactin, etc. It's a complicated gland. I'm assuming you had an MRI to confirm this diagnosis? And relax, it's not the end of the world. I have one myself. You'll be fine. You just need to find the correct doctor to get straightened out. The majority of times surgery is not needed unless they are very large (over 10mm), which is relatively unusual. The Mayo Clinic btw is highly rated for this.

As the guys stated above, we need to see FULL bloodwork with ranges so we can review it and try to guide you. Starting with a better injection protocol. Post up as soon as possible. It takes time to get dialed in so before you add in any new products let us take a look at current BW and start there.

**I did not say complicated twice. Why does it do that?)

Yes I had an MRI that confirms the diagnosis.



Here are all the numbers from my last blood work on 1/19/2012. Estrogen was not checked, I will make sure I get estrogen checked next time (3 days).


T3U, T4, TSH, T3 Uptake- 28.4% -- 23.4-42.7

T4 (THYROXINE) - 6.9 ug/dL -- 4.5-12.5

TSH, High Sensitivity TSH - 1.22 mU/L -- 0.45-4.50

T7 Index - 2.0 -- 1.2-4.3

Cortisol AM - 22.8 (high) ug/dL -- 4.0-22.0

Total Testosterone - 863 ng/dL -- 250-1100

Free Testosterone - 308.7 (high) pg/mL -- 35.0-155.0

[bass]

John, edit your post and add ranges...

[johnt2333]

Sorry ranges updated...

[zaggahamma]

I have not looked into any AI.



Yes I had an MRI that confirms the diagnosis.



Here are all the numbers from my last blood work on 1/19/2012. Estrogen was not checked, I will make sure I get estrogen checked next time (3 days).


T3U, T4, TSH, T3 Uptake- 28.4% -- 23.4-42.7

T4 (THYROXINE) - 6.9 ug/dL -- 4.5-12.5

TSH, High Sensitivity TSH - 1.22 mU/L -- 0.45-4.50

T7 Index - 2.0 -- 1.2-4.3

Cortisol AM - 22.8 (high) ug/dL -- 4.0-22.0

Total Testosterone - 863 ng/dL -- 250-1100

Free Testosterone - 308.7 (high) pg/mL -- 35.0-155.0

quite high on the free T

when did you draw THIS bloodwork in relationhip to days after you injected the 400mg?

i should have asked earlier but how have you felt/what have you noticed since starting injecting test? any improvement in any category? stength, fat loss, mood, energy, libido/wood, water weight/bloat.....?

[kelkel]

did u mean a second MRI ? Thus confirming the MRI he mentioned in the op?

totally missed that jpk. Maybe I need the mri?

[zaggahamma]

totally missed that jpk. Maybe I need the mri?

well i wasnt sure if u missed it or meant a second one was needed to confirm like maybe the first mri might have saw a shadow, etc.

[johnt2333]

quite high on the free T

when did you draw THIS bloodwork in relationhip to days after you injected the 400mg?

i should have asked earlier but how have you felt/what have you noticed since starting injecting test? any improvement in any category? stength, fat loss, mood, energy, libido/wood, water weight/bloat.....?

Blood work was done 2 weeks after 400mg injection.

Very small boost in energy and strength. Still fat with no water weight and bloat. Lots and Lots of libido and wood (for about 7 days after injection). Other than that no notable improvements.

[zaggahamma]

Blood work was done 2 weeks after 400mg injection.

Very small boost in energy and strength. Still fat with no water weight and bloat. Lots and Lots of libido and wood (for about 7 days after injection). Other than that no notable improvements.

your not exercising and lifting ?

[johnt2333]

your not exercising and lifting ?

I exercise. Here is a rough outline.

-60min of walking/running in the morning 4-5 days a week
-60-90 mins lifting in the evening 3-4 times a week

I try and keep a balanced diet and eat about 2000-2500 calories a day.


BTW... Just got blood work done today, the doctor ordered a much more detailed lab. I will post results ASAP.

[HRTstudent]

your testosterone numbers don't seem to be your problem based on those recent lab results. in fact, that says your free test is double the high. I would actually lower the dose if I were you. keep in mind, most people feel worse if they get too high testosterone . your goal here is quality of life, not developing the most anabolic body for muscle/strength/etc.

you really need to get your estradiol sensitive checked. that is because our bodies will readily convert testosterone into estrogens. estradiol (e2) is specifically a very important estrogen for men on TRT. be sure to ask for the SENSITIVE or ultrasensitive test.

also, like you mentioned, changing to a weekly dose is likely to provide you with a benefit, although it might be small. right now you're on 200mg per week (average) and you wanted to do 100mg twiice a week, but that's pretty high. if I were in your shoes and I did not feel good, I would try doing 150mg once per week and see how that makes me feel. I would make that change and get my e2 tested. e2 would be expected to come down slightly as well with the smaller testosterone dose.

[johnt2333]

your testosterone numbers don't seem to be your problem based on those recent lab results. in fact, that says your free test is double the high. I would actually lower the dose if I were you. keep in mind, most people feel worse if they get too high testosterone . your goal here is quality of life, not developing the most anabolic body for muscle/strength/etc.

you really need to get your estradiol sensitive checked. that is because our bodies will readily convert testosterone into estrogens. estradiol (e2) is specifically a very important estrogen for men on TRT. be sure to ask for the SENSITIVE or ultrasensitive test.

also, like you mentioned, changing to a weekly dose is likely to provide you with a benefit, although it might be small. right now you're on 200mg per week (average) and you wanted to do 100mg twiice a week, but that's pretty high. if I were in your shoes and I did not feel good, I would try doing 150mg once per week and see how that makes me feel. I would make that change and get my e2 tested. e2 would be expected to come down slightly as well with the smaller testosterone dose.

Thank you for your advice.

The e2 results will be in next week. The doctor did not specify whether or not he ordered a sensitive test.

My doctor does not agree about injecting a lower dose more frequently. The doctors explanation was that the testosterone is more likely to aromatize with weekly injections (as stated before) and aromatization is what causes estrogen to rise. Any thoughts?

[kelkel]

The larger the dose, the larger the relative spike in E can/will be. He doesn't seem to understand the process of aromatization.

[HRTstudent]

My doctor does not agree about injecting a lower dose more frequently. The doctors explanation was that the testosterone is more likely to aromatize with weekly injections (as stated before) and aromatization is what causes estrogen to rise. Any thoughts?

I have NEVER read that. it goes against my intuition but I am not a medical doctor. I would firstly believe that the smaller, more frequent dose would lead to a lower peak thus less aromatization AT THAT TIME. however, this is a key here, that MIGHT not be as significant of a drop off in aromatization compared to the fact with a 2 week injection your testosterone levels are low around day 10-14. this might be good because you certainly will aromatize less, but this is potentially a lot worse because, of course, you have low testosterone 1/3 of the time. that's a problem because.... you are taking these shots solely to raise your testosterone.

so, the bigger point here is really not the aromatization but the normalization of your testosterone levels. with a 2 week injection protocol your levels get too low in the days before your shot. it makes no sense, and nowhere else in medicine are doctors so ignorant of half lives as they are with testosterone injections.

I will tell you flat out, with 100% certainty that most doctors know very very little about HRT and especially male HRT. it is simply not a big part of the medical training they get. the people who know a lot about it are the people who specifically go after this information and that patient population.

[kelkel]

^^^Extremely well stated HRT!

[johnt2333]

Small delay but here is the last lab work three weeks after my last 400mg test injection. I'm not sure what to make of the results, the doctor didn't have much to say other than we will be doing 200-300mg every 2-3 weeks. Thoughts? ...


T3U, T4, TSH, T3 Uptake- 30.0% -- 23.4-42.7

T4 (THYROXINE) - 8.9 ug/dL -- 4.5-12.5

TSH, High Sensitivity TSH - 0.33 mU/L (low) -- 0.45-4.50

T7 Index - 2.7 -- 1.2-4.3

Estradiol - 59 pg/ml (high) -- 8-43

HGH - 0.1 ng/mL -- <3.0

LH - <0.1 mIU/mL (low) -- 1.7-8.6 (range for male adult 18 years and older)

Total Testosterone - 938 ng/dL -- 250-1100

Free Testosterone - 231.4 (high) pg/mL -- 35.0-155.0

Estrone, LC/MS/MS - 55 pg/mL -- < OR = 68

T3 free non-dialysis - 4.0 pg/mL -- 2.0-4.8

Aeginine Vasopressin - 2.7 pg/mL -- 1.0-13.3

[Brohim]

bro split your dose and take it every 7 day's. It will stabilize your level's. I never heard of 400mg injection of cyp. It will help you avoid crashing and also it won't spike your e2 level's - which should be down to at least 30. You need an AI it looks like to lower your estrogen. Did your doctor give you something like Liquidex to take?

[kelkel]

If that is 3 weeks after your shot and your T levels are still that high, imagine how high they were several days after your shot! They'd be through the roof. Definitly change your dosing schedule like stated above. You doc doesn't understand half-lives. Work on your E2, carefully that is.

Your TSH is really NOT out of range. A more realistic (modern) scale used is 0.3 - 3.0 for it. If your TSH was to low your T4 & T3 would be higher IMO. But I'm no thyroid expert.

[Honkey_Kong]

Pituitary tumors can do different things, such as shut down your hormone production, increase growth hormone levels, prolactin, etc. It's a complicated gland. I'm assuming you had an MRI to confirm this diagnosis? And relax, it's not the end of the world. I have one myself. You'll be fine. You just need to find the correct doctor to get straightened out. The majority of times surgery is not needed unless they are very large (over 10mm), which is relatively unusual. The Mayo Clinic btw is highly rated for this.

As the guys stated above, we need to see FULL bloodwork with ranges so we can review it and try to guide you. Starting with a better injection protocol. Post up as soon as possible. It takes time to get dialed in so before you add in any new products let us take a look at current BW and start there.

**I did not say complicated twice. Why does it do that?)

Dr. Swerdloff at UCLA Medical Center Harbor is probably one of the best in handling this sort of thing.

[HRTstudent]

honestly, my thoughts are that you are on a poor TRT protocol. injecting a drug with a half life of 10-14 days every 3 weeks is nuts, to put it nicely.

I would find a new doc, and in the mean time, I would push for weekly injects (smaller dose of course) and if he refuses I would simply do weekly injects anyway and EITHER WAY I would be searching for a new doctor. chances are you have 8-12 weeks or more of testosterone available so u should hopefully be able to find a specialist in male trt by then.

[bass]

i agree with all of the above. your e2 is slightly above normal, i bet if you split your dose as suggested above you will bring your e2 down and you won't need AI.

[johnt2333]

Thanks for all your replies.

My results are in from Mayo clinic and there "expert" radiologist says that there is no cyst in my pituitary after looking at the MRI. Not sure what to make of that news, let me know your thoughts.

Also should I be looking into supplementing HGH given my levels?

bro split your dose and take it every 7 day's. It will stabilize your level's. I never heard of 400mg injection of cyp. It will help you avoid crashing and also it won't spike your e2 level's - which should be down to at least 30. You need an AI it looks like to lower your estrogen. Did your doctor give you something like Liquidex to take?

I have never taken any AI.

HRTstudent
honestly, my thoughts are that you are on a poor TRT protocol. injecting a drug with a half life of 10-14 days every 3 weeks is nuts, to put it nicely.

I would find a new doc, and in the mean time, I would push for weekly injects (smaller dose of course) and if he refuses I would simply do weekly injects anyway and EITHER WAY I would be searching for a new doctor. chances are you have 8-12 weeks or more of testosterone available so u should hopefully be able to find a specialist in male trt by then.

I just had a 1.5 cc injection last week. I will wait two weeks then start injecting 1 cc weekly. Do any of you on TRT just inject the stuff your self and take the doc out of the loop?

[johnt2333]

I forgot to mention...

I am down to 165 lbs from 185 lbs three months ago. Slowly I am starting to notice more energy, and working out has never felt better. I cant get enough of the weights.

[lovbyts]

No dont wait 2 weeks, just start the 1cc ever week now. Most of us do self injections. I have been doing it for 3+ years but the doctor is not out of the loop. He writes the prescriptions and does blood work ever 6 months or 1 year.

[zaggahamma]

yes...having to go in every week to the doctors office would be a pain in the butt

[lovbyts]

yes...having to go in every week to the doctors office would be a pain in the butt

Not if they are injecting in your quads.

[zaggahamma]

yeh that would give u a leg up good point

[ecdysone]

honestly, my thoughts are that you are on a poor TRT protocol. injecting a drug with a half life of 10-14 days every 3 weeks is nuts, to put it nicely.

I would find a new doc, and in the mean time, I would push for weekly injects (smaller dose of course) and if he refuses I would simply do weekly injects anyway and EITHER WAY I would be searching for a new doctor. chances are you have 8-12 weeks or more of testosterone available so u should hopefully be able to find a specialist in male trt by then.

Your "doctor" is over dosing you which will force you to use an AI. Probably your high E2 is negating the expected favorable effects from your super physiologic test levels.

Just curious, what kind of doc do you have? Is he a specialist?