My doc thinks TRT, good idea?

[steroid.com 1]

IMO E2 is too low.

I know guys who will present with neg sides at this level...and a big one is ED or ability to get a strong erection!

You'd be best in the mid to upper 20's pg/ml Zen.

[ZenFitness]

Thx GD - do you have any suggestions as to how to raise it?

Funny - low E2 is the last thing I was thinking of before my BW!

[Brazensol]

Alcohol and increased body fat come to mind...but probably not the way to go! Raising your test levels usually raises E if I remember correctly.

[Brazensol]

The human body is a strange thing. Two guys with exactly the same baseline and getting the exact same treatment can end up worlds apart at their next labs.

[ZenFitness]

I wonder if adding hCG would potentially up estradiol?

I'm also wondering if the rhodiola rosea contributed to it.

[kelkel]

Also, someone mentioned that vit D can help with free test... Is there a particular type/amount that works best?

Vit D will definitely help with free T. It lowers shbg which means less binding so more free for use. D is extremely important and most are low. I tested initially at less than 25 (low.) Asked my doc for a script for Drisdol which is a once a week D pill at 50K IU's. My next BW about 3 months later I was at 80. Also my shbg was reduced and free was up. Win-win. Most any D3 is fine. Maybe start at 5k per day and adjust via bloodwork.


http://www.ncbi.nlm.nih.gov/pubmed/20050857

[steroid.com 1]

You could be prescribed estrogen but I would highly not recommend that route.

kel is right, I've read that men taking 10,000 units daily of D3 had 25% higher Testosterone levels then a hold out group...that's an eye opener.

Every man is different, that's why we have two men here presenting with the same pathology but different outcomes...think how a Doc has to manage this day in and day out...not easy for sure.

hCG is far up stream and impacting E2 is a possibility if it makes it all the way down to natural Test production...so this could be a nice option.

Raise testosterone levels and you should see an increase in E2 as noted.

[ZenFitness]

Thanks GD - yep, I don't really want to take estrogen I put a call in to my doc last night to see what he thinks, and I am going to mention hCG as it may also help with the "let down" from pellets that should be coming along in a couple of months. I think I am going to switch to injections after my levels get low enough (assuming they do).

As per usual, all you guys are great... this is a great forum.

HealthyinNH - look forward to seeing what route you take and your progress. Keep us posted!

[ZenFitness]

Okay, finally spoke with my doc, they want to schedule my next blood test in October. I know pellets last a while, but I was thinking I would probably be on at least a monthly or every other month blood draw to see how it goes during this first round. Does this seem unusual?

Still haven't heard back from them on the low E2... left another message. I had to call the receptionist to figure out when my next blood draw would be.

[kelkel]

Jeez, early October I hope? I'd be kinda looking for almost monthly tests to see what type of curve it gives you along the way. But that's probably asking too much of doc's! Yes, seems unusual to me but your only the second guy here I know on pellets. Hopefully they are on top of things and know when you'll hit trough level and take care of you by then.

Make sure you get proper bloodwork Zen. It's in the stickies.

[ZenFitness]

I will be following up with a doc visit in a week and a half... I plan to ask him about starting hCG , etc. He did prescribe me daily Cialis at 2.5mg (a month's supply) as I have a free voucher for it that I printed off their website. Honestly I'm not sure if I really need it at this point... things have picked up a bit since I dropped melotonin, rhodiola, and l-theanine. However, it's always feeling a little touch-and-go, so taking it every day won't hurt. 2.5mg is not the 5mg I asked for, but hey, at least it is something.

[kelkel]

Keep taking it. Find more. Great for you!

[ZenFitness]

Good results with the daily Cialis. I'm not sure if my E2 levels have naturally risen after quitting herbal supplements, if I'm just feeling better overall, or if it is the Cialis (my expectation is that it is a combo of events). I amped the daily use quite a bit at first (10 mg the first couple of days, then 7.5, then 5, now back to 2.5 a day to see if it continues to work).

I know the higher dosages (7.5 - 10 mg a day) allowed me to get an erection virtually at will - really nice. The only problem I faced last week was being at a beach... had to be a bit careful as to when to stand up at times

I'm hitting the doc tomorrow to discuss when I can start injects, if he will prescribe hCG , etc. etc. After a month on pellets, I was disappointed to find my T in the 600 range. I'd like to hit 800-900 if possible.

I'm also noticing that my lifts in the gym and overall muscular look has backed off from what it was a few weeks into the pellets... can that happen as T declines?

Also, I have no idea how my doctor will want to administer injects. If he says 200mg every other week, then I'm not going to like it. I'd rather dose it more frequently to mimic the natural test production and to hopefully avoid spiking E2. Is there a particular pattern I should use for hCG and T, say if I want to do T once a week or twice a week? I'd like to have something to recommend to the doc before I get there.

[kelkel]

Zen visit Crislers site at www.allthingsmale.com and read up. If your doc suggests 200 EOW that's a big sign he's clueless to TRT and the half-life of test. Your in charge of your health. Tell him based on your self-educating in this field you want to go with weekly injections. As you know some of us go every 3.5 days for even more stable levels. When it comes to hcg I keep it simple with 250 IU's M-W-F. Crisler is known to recommend HCG 2 and then 1 day prior to injection.

Lifts and muscular looks backing off? Take a look at GD's sticky on "What to Expect from TRT" for some insight. Sure it can happen. Could it be water retention or a plethora of other variables too, for sure.

[ZenFitness]

Back to the doc today to discuss my results and questions. He did say that I might do well in a couple of months (when the pellets wear off) to start weekly injections since I felt so great initially on the pellets. When I asked him about hCG he looked confused and said its use in conjunction with TRT is "not described in the medical literature". Additionally, he said its use would be a negative feedback loop... produce LH/FSH, testosterone suppresses it, and so forth. He said he would look into it, but I think he was pacifying me as he took no notes.

At any rate, he wants follow up bloodwork in two months (end of Sept.). Not sure if I should push on the hCG or just shrug it off for now and see what happens.

In terms of weekly injections, I believe he said 0.75 once a week, although I don't know what 0.75 is a measurement of (I think CCs maybe?). Not sure.

[kelkel]

Just a second ago I posted two links to package inserts for HCG on another thread that state for "hypogonadic hypogonadism." It's right there, on the inserts. Jeez these guys don't keep up with the times. He doesn't understand what it does and this does not bode well for the future, unless you can educate him. .75 would be 150mg per week based on test at 200mg per ml/cc. A relatively high start.

Google "Chorionic Gonadotropin package insert"

[ZenFitness]

Agreed. He also was insistent that my E2 is within range at 11... although after discontinuing regular melatonin, rhodiola, and l-theanine, I'm feeling WAY better and think I may have been inadvertently suppressing my own E2. I'm interested to see what it is now and might ask to move my blood test to the end of August.

[ZenFitness]

Just a second ago I posted two links to package inserts for HCG on another thread that state for "hypogonadic hypogonadism." It's right there, on the inserts. Jeez these guys don't keep up with the times. He doesn't understand what it does and this does not bode well for the future, unless you can educate him. .75 would be 150mg per week based on test at 200mg per ml/cc. A relatively high start.

Google "Chorionic Gonadotropin package insert"

Going for bloodwork this Friday.

Kel, do you think 150mg per week would be too high to start with? Should I ask to dial it back to 100 in your opinion?

Thanks!

[kelkel]

Well, I think it's always best to start lower and titrate up, instead of the reverse. It just makes sense. Best bet would be for him to write you @ 150 per week and do only 100, or 200 and do only 150, etc. This way you have wiggle room. It's what I do basically. My doc writes me for 200 per week knowing full well I do 60 X 2 per week. I do not want to be micromanaged by my pharmacy and have to deal with supply issues or anything else that may arise. Your doc should write you a tad more for everything he prescribes you on these protocols if possible, IMO.

It all depends on your relationship with your doctor and the trust developed. Mine lets me control everything myself as long as my logic is sound. I tell him everything and we learn from each other. He wasn't used to being challenged, so to speak, but he now enjoys it and prepares much more thoroughly for our appts. It makes it fun.

[ZenFitness]

Turns out my doc won't do hCG . My last results came back in the mid 400s in terms of total test, and he was willing to move forward on 1 CC/2 weeks for injections (which I guess is 200mg every two weeks, although I'd spread that to 100mg every week). However, I'm asking my general practitioner if he'd take over my TRT and, if so, if he would do hCG.

I definitely notice testicular atrophy now. It's not ridiculous, but I can tell a difference. If nothing else, it'd be nice to reverse that with some hCG. Do many people incur bad side effects with hCG?

[TraceMYD]

My TRT doc in Louisiana told me that in some states, LA being one of them, docs can go to jail for writing scripts for hcg .

I'm not sure what the details are but he prescribes me to take hcg because of my age being 35 and that i may want more kids in the future making it a valid reason to give me hcg.

I'm wondering if that's why some people are having a harder time getting hcg. Docs could be afraid of going to jail.

[jasondd1]

I don't know anything about Docs not wanting too, my doc was like no problem. Regardless, HCG can be found on the net very very easily and affordable. Research is key.

BTW i am one week into HCG and my boys feel very plump.

[ZenFitness]

Thanks guys. Jasondd1, can you PM me where you found it online and what you mean specifically by research?

[ZenFitness]

My general practitioner got back to me and said he doesn't prescribe hCG and doesn't know anybody who does. Starting to feel like I'm not going to find this an option.

[juice2012]

I'd hate to illegally mail order something you have a right to be prescribed legally. Keep calling around, try to find some one that knows what's up when it comes to TRT, or print out Crislers guide on HCG and try to convince your GP. Worst case break the law and order online.

[HRTstudent]

HCG has been under some heat recently by the FDA due to the weightloss gimmicks... Its definitely a drug that experienced HRT docs only will know about, or urologists.

[ZenFitness]

First self inject just now, half a cc test cyp, will do it weekly. Just did it... I kind of puzzled the nurse by wanting half a cc every week instead of one every two weeks. Self administration was a snap. BW in a month

[zaggahamma]

they are easily puzzled

[ZenFitness]

Question - I'm three weeks into injections once a week of 0.5cc (100 mg). However, the test cyp bottle I have is still half full, and I should just have one dose left as one bottle is 200 mg. I assume I throw it away with a decent amount of liquid left in it?

[zaggahamma]

question - i'm three weeks into injections once a week of 0.5cc (100 mg). However, the test cyp bottle i have is still half full, and i should just have one dose left as one bottle is 200 mg. I assume i throw it away with a decent amount of liquid left in it?

no!!!!!!!!!!!!!!!!!!!!!!!!!!!

[ZenFitness]

Thanks - so a 200 mg bottle actually holds more than advertised?

[zaggahamma]

YOUR BOTTLE IS PROBABLY 200MG/ML NOT 200MG TOTAL!

and probably 10ml which is 2,000 mg..you probably have a shit load left...it must be if there is a lot of liquid left

[zaggahamma]

Thanks - so a 200 mg bottle actually holds more than advertised?

no read my other post....?????

[ZenFitness]

Ah - my pharmacist said they could only fill a month's supply at a time, which made me think four doses. I do have a 10 ml bottle. So I'm looking at about twenty doses in a bottle, not four.

Thanks for clearing this up!

[zaggahamma]

a 10 ml vial is way more than a months worth...they either lied or are stupid or both...

no problem

[jasondd1]

Hey Zen did you ever find a source for HCG ?

[ZenFitness]

Hi guys, just got my BW back after 1 month of injections:

Total T: 882, normal range 348 - 1197
Free T: 32.46, normal range 5.0 - 21.0
Estradiol: 25.3, normal range 7.6 - 42.6

Obviously the free T is high - what are the ramifications/side effects of this, and should I be concerned at this level? According to the nurse, the urologist thought it was "a little high" and he wants to do repeat BW in a month.

In terms of how I feel - I have not felt this great in years, my lifts are going up like crazy at the gym (which I could never do before no matter how hard I controlled diet and how hard I lifted), and my libido is through the roof. The only thing going on that I've noticed is that I have a hard time falling asleep at night, but I have also been burning some late hours either working or partying with wife and friends. I am curbing this pattern in an effort to get sleep under control, and I'm not sure it is free T related.

Feedback appreciated... all you guys are great!!

[ZenFitness]

Hi jasondd1, sorry for the late reply... if you still need input please send me a PM, yes I found a hCG source thanks to the group here, but I have not pursued it as a. my wife is 100% against me going on my own here and b. I really would like some medical oversight.

[ZenFitness]

I think this is obvious, but, just to be sure, my new post is the "High Testosterone - bad?" two posts above this one... don't want my response to jasondd1 to run interference on my latest question

[ZenFitness]

Hi guys, just got my BW back after 1 month of injections:

Total T: 882, normal range 348 - 1197
Free T: 32.46, normal range 5.0 - 21.0
Estradiol: 25.3, normal range 7.6 - 42.6

Obviously the free T is high - what are the ramifications/side effects of this, and should I be concerned at this level? According to the nurse, the urologist thought it was "a little high" and he wants to do repeat BW in a month.

In terms of how I feel - I have not felt this great in years, my lifts are going up like crazy at the gym (which I could never do before no matter how hard I controlled diet and how hard I lifted), and my libido is through the roof. The only thing going on that I've noticed is that I have a hard time falling asleep at night, but I have also been burning some late hours either working or partying with wife and friends. I am curbing this pattern in an effort to get sleep under control, and I'm not sure it is free T related.

Feedback appreciated... all you guys are great!!

*bump* (I won't bump it again)