Hello good people, here are my lab results.

**izverg** · 07-03-2012, 10:45 PM

Hi all

First i want to thank you for all the great info you share on this site and insightful discussions.

Now about me.

I will be jumping around timeline a bit.

I am a 35 yea old dude. I am 5'10 and 220 with a wife and a 2 year old daughter. I never did steroids but i also don't live a real healthy life. I have high blood pressure, high cholesterol, and sleep apnea. I sit in the office and i write software for banks.

But i am trying to turn my life around, how? About 5 months ago i joined a Jiu Jitsu academy and ever since i lost 20lbs (i was about 240), gained muscle and overall feel MUCH better.

About a year ago, out of nowhere, i was diagnosed with gynecomastia . I went to an endo, she did all kinds of tests, gave me a memo (yep, twice and it was PAAAAINFUL). She mentioned that my T is on the low normal level and she wasnt going to do anything about yet. Also, i have weak bones!

About 2 months ago, i am still feeling like crap, sporadic anxiety episodes, depression, tired, forgetful, can't concentrate at work. So i went back to my endo and she did another blood test. She said the result came in and my T level is still low, so she wants me to go on HRT. I am like ok, if its going to help me live better then why not, lets do it.

So she prescribed AndroDerm 4mg. What a disaster that turned out to be, not only it would give me crazy rashes , but it would fall off during Jiu Jitsu classes (because i am wet with sweat) and it made me feel embarrassed. So i called her and said i need her to either prescribe me injectibles or give me something else. She said she is not specialized with injectibles and instead told me to try AndroGel 1.62%. Today is my second day on it and i am cool with it as i didnt have to worry about having a patch during my practice.

Anyway. What my endo didn't tell me is that that i also may need to take HCG with Androgel, etc.....

So i made an appointment with a test specialist and i am going in a week.

Here are my current lab results, if you have a second please let me know what i should be taking, and overall your feeling about my lab results.

thanks!

Testosterone , Serum (Total) - Low 320 ng/dL
% Free Testosterone - 1.7%
Free Testosterone, S - 54 pg/mL
SHBG (IRMA) - 19 nmol/
Estradiol 29.3 pg/mL 7.6-42.6

also, here is something else on another page.

hCG,Beta Subunit,Qnt,Serum mIU/mL 0-3

**Simon1972** · 07-04-2012, 12:35 AM

yep definitely low test , low free test and low shbg which is very good

your results are hard to read can you re-do them?

see how you go with test dr- its not wise to advise someone until you find out what the dr has in store for you.

**edmundo22** · 07-04-2012, 04:52 AM

If you were diagnosed with gynecomastia then your estrogen/estradiol (E2) levels should have been checked your Endo must be retarded, you said you have weak bones, Osteoporosis is a symptom of elevated estrogen levels, you may not have needed to have started TRT, if your estrogen is indeed elevated that can be controlled with the use of an aromathose inhibitor (AI) which would increase your testosterone levels without TRT.

Any symptoms of ED or libido issues?

Your Endo isn't even familiar with injectables find a better one.

Here's the list you need.

• Total Testosterone
• Bioavailable Testosterone (AKA “Free and Loosely Bound”)
• Free Testosterone (if Bioavailable T is unavailable)
• SHBG
• DHT (perhaps) *Gel user especially pay attention to this.
• Estradiol (specify “sensitive” assay for males)
• Prolactin
• Cortisol
• Thyroid Panel
• CBC
• Comprehensive Metabolic Panel
• Lipid Profile
• PSA (age dependent)
• IGF -1, IGFBP-3 (if HGH therapy is being considered)

**izverg** · 07-04-2012, 10:22 AM

Thanks guys, i fixed my chart so it’s more readable.

Also, i forgot to paste in this other important piece of info

my Estradiol 29.3 pg/mL 7.6-42.6

Some more info on me:
As of few months ago my gyno in my right breast only. I also had a petuetory MRI which was fine. I had every kind of test and the only not so great result beside low T was Fatty liver.

I had an ultra sound on my testies, all is fine in that area.

What does my Estrodiol say to you?

**kelkel** · 07-04-2012, 10:22 AM

Make sure it's a complete thyroid panel. You need to determine exactly what is wrong and not just jump into TRT unless absolutely necessary. There are other routes to take that can help to jump start your system into better production such as clomid therapy or HCG /Nolva that may be worth a try with a doc who's knowledgeable. Also add vit D to your list of tests please as no doubt your low and supplementing will improve your free T.

Is the above lab work pre-trt I assume? If so post the rest and include LH & FSH please.

We posted at the same time. Glad you ruled out pituitary adenomas as well as testicular issues. So we still need to find out what the cause is right? Your E appears to have been a sensitive assay and if so it looks good. Between 20 - 30 is great, based on how you feel.

When it comes to gyno read this: http://jcem.endojournals.org/content/96/1/15.full as well as visit the AAS Forum and search up their sticky on all you need to know about gyno and read up. If it's not fibrous (older) Nolvadex will help.

**izverg** · 07-05-2012, 06:45 AM

THanks for the reply.

Yep above lab work is pre TRT. I am still using AndroGel , but i am not seeing anything different. You know what makes me feel good, going to Jiu Jitsu, right after i am on this HIGH/RUSH i can't explain it. I had vit D tested last year, indeed it was low, so i started taking vit D , had myself retested few months after and i was fine (per my endo).

What does sensitive assay mean?

**HRTstudent** · 07-05-2012, 12:20 PM

Originally Posted by izverg

THanks for the reply.

Yep above lab work is pre TRT. I am still using AndroGel , but i am not seeing anything different. You know what makes me feel good, going to Jiu Jitsu, right after i am on this HIGH/RUSH i can't explain it. I had vit D tested last year, indeed it was low, so i started taking vit D , had myself retested few months after and i was fine (per my endo).

What does sensitive assay mean?

the sensitive assay basically measures the small concentrations of e2 and this is important for men specifically because we have less estrogen in general.

basically, we ONLY ask for sensitive tests because thats what gives us a true idea of your e2 situation. gyno is complicated though and a complex interplay of many hormones. its possible that you could have gotten gyno and whatever caused it is resolved now. at this point, its just a good idea to keep an eye on e2 to make sure the gyno doesnt get worse.

the endo you are seeing is not good though for your TRT.

also, why do you say you NEED hcg ?

are you interested in conceiving in the next year? ever?

androgel works for a lot of men, but whether or not you want injects or androgel is a personal decision first and foremost. the fact that your doctor knows nothing about injectable is just comical because guess what... that androgel 1.62 has been around for like 2 years maybe but the injectable has been unchanged for over 50 years. What does that tell you about her expertise in this field?...

and as for the vitamin D being "fine" never take a doctors word for face value unless you know they are a TRUE EXPERT. and even then i would personally double check. my doctor never blinked an eye on my vitamin D test because it was in range.... oh, and on the scale of 30-100 i was 30 or 31 I believe.

have faith in your doctor, but not blind faith. i recommend you find a true expert in male TRT before you waste more time with this endo.

**kelkel** · 07-05-2012, 03:33 PM

^^^Could not have been said better HRT.

**izverg** · 07-06-2012, 09:47 AM

HRTStudent,

Obviously i realize its all $$$ to her, she has to push AndroDerm/AndroGel on me. I think more than anything as far as gyno goes, i think my nipples just puff up randomly, i don't understand why. Does it still mean i have gyno?

So E2 is Estradiol, correct?

Why do i need HCG , well, as i understand it will make sure that my pituitary gland will send message to my testies to tell them that they need to work and produce testosterone , so that my system doesn't shut down. Correct?

I am not planning on having another kid yet, but if i change my mind i want to have that option, why not.

Here is my latest Vit D test.

Vitamin D, 25-Hydroxy 31.4

I have all my blood work online in the Medical Portal so if you need me to tell you anything i have it on-hand.

again, thanks so much for the info

**HRTstudent** · 07-06-2012, 12:07 PM

Originally Posted by izverg

HRTStudent,

Obviously i realize its all $$$ to her, she has to push AndroDerm/AndroGel on me. I think more than anything as far as gyno goes, i think my nipples just puff up randomly, i don't understand why. Does it still mean i have gyno?

Sounds like it could be gyno or water retention. My nipples get puffy when my e2 gets too high but there is NO mistaking that its not water retention. I also get itchiness. if you have itchiness or pain its a good sign that that is gyno starting.

So E2 is Estradiol, correct?

yes, its just a shorthand.... there is e1 estrone, e2 estradiol ad e3 estriol. but estradiol is the most potent of the 3 and, as far as i know, in males on trt the only one of concern.

Why do i need HCG, well, as i understand it will make sure that my pituitary gland will send message to my testies to tell them that they need to work and produce testosterone, so that my system doesn't shut down. Correct?

thats basically the theory... but is this necessary? not based on our clinical knowledge and experience over years. remember that testosterone has been used for decades now, without hcg . Does that mean HCG is worthless? Not at all, but it is not "necessary".

I am not planning on having another kid yet, but if i change my mind i want to have that option, why not.

Well this is most important when kids are in the near future, like 1-2 years. HCG might make this transition from TRT to "maximum" fertility easier and/or quicker.

Here is my latest Vit D test.

Vitamin D, 25-Hydroxy 31.4

What is the range on this test? We generally like to be in the upper quartile for vitamin D. Thats really just a rough guideline. There is probably nothing wrong with going lightly above range even.

**izverg** · 07-06-2012, 12:28 PM

vit D range is 30.0-100.0 ..... so its on a low normal end, right?

So if i don't take HCG for a year or so, and lets say i want to have a kid in next few years, all i need to do is take HCG for X amount long, and i can have kids? Or it's not say black and white?

My nipples get puffy, but not itching or hurting. However, a year or so ago when they puffed up and there was some hardness bellow there once in a while they would itch, it was so annoying.

I am tired right now, i wish i had more energy. Yesterday i felt so sluggish in my Jiu Jitsu class, i didn't stay for the advanced class, i wouldn’t be able to handle it. I have a feeling the patch was working better. I am on 2 pumps a day, maybe i should call my endo and ask if she can up it?

I'd like to see what my new endo will tell me. If he suggests to stay with AndroGel i'll have to ask him for something stronger, maybe an injectable. I really don't like this AndroGel, one major reason is after i put it have to wait 2 hours so I can touch my wife or hold my daughter. I hate it! :/

**izverg** · 07-12-2012, 10:09 AM

Went to the specialist. He said he doesn't do HCG but he mentioned another name, i can't recall what it is.

He explained to me that i may have issues having more kids, and that there are dangers to taking test. Made me sign some waiver and gave me a 200mg shot of Test Cyp. Gave me a prescription and told me to comeback in 2 weeks and he will watch me administer it to myself. If i can do my own shots i won’t have to come in to see him every two weeks.

Is 200ml shots every 2 weeks ok? I guess it's tough to say, I’ll know soon enough.

**Brohim** · 07-12-2012, 10:22 AM

the dose is correct but timing is not. You need 100mg every week because of testosterone cyp half life.

**izverg** · 07-12-2012, 10:53 AM

he said that he wants to see how i feel, he did say that we may have to split it to 100ml a week

so i guess, do you guys that take a 100ml shot a week feel good? or so so?

**izverg** · 07-12-2012, 03:29 PM

Here is another update:

What a bummer!

My pharmacy called and said i Test Cyp is not covered by my insurance and that i'll have to pay for $100+ . That's such BS , they cover AndroGel and AndroDerm but not Test Cyp.

Is there anything else that is just as good if not better that a doctor can prescribe which something like Test Cyp?

thanks

**kelkel** · 07-12-2012, 08:32 PM

Have your doctor write a "Letter of Medical Necessity" and get it to your plan administrator. It should be approved.
Weekly shots for life, yes, if you want good T levels. Yes, we feel good unless there is something else wrong/missing from our protocols. You will subsequently have to test and make adjustments along the way. Some of us even inject twice a week (every 3.5 days) for even more stable levels.

This is a journey your on here. It takes time to get dialed in. Most of us have been through several doctors along the way until we found the right one. You'll get there! Keep educating yourself as you are your best advocate.

**izverg** · 07-13-2012, 07:46 AM

I opologize for a stupid question.

This is the RX.

TESTOST CYP 200ml over injection - 1ml every 2 weeks - 10ml

How many months will this supply last if i take 100ml a week?

It's $120 at Shop Rite Pharm.

**kelkel** · 07-13-2012, 01:08 PM

What you have is Test cyp @ 200mg per ml or cc. 10 ml vial. 2000mg total.
It will last 20 weeks at 100mg (.5cc) per week.

Check Costco's pharmacy is there's one near you. I'm told very cheap and you don't have to be a member to use their pharmacy. Walmart is cheaper too, or so I'm told.

**izverg** · 07-13-2012, 02:14 PM

thank you so much

So, called Costco, they are selling it for $71 , not bad at all. Also called Walmart and they are selling it for 130 (just like my local pharmacy). So this is obviously a no brainer.

By the way, i called my ins co and they said that they need a note from a doc to be able to auth Test Cyp, but they can't promise 100%.

Do you think if i go back to my pharmacy and as for RX back they will give it back to me?

**izverg** · 07-17-2012, 08:29 PM

Just an update on how I feel.

I felt a bit tired all day. I went to my Jiu Jitsu sparring session and did really bad. Which is ok , and when I do bad I still feel great because I learn something new even when I get submitted. But today , I gassed out after half hour , did really bad. The worst part is I am very angry right now, I should be happy, but I am so angry I don't know what to do with myself. My wife irritates me for no reason, my daughter annoys me, I hate my daughters nanny. I am angry at my developers at work for not doing what I instructed them. I just feel like shit.

I want to be honest and say that I have been using my gel since I got the 200ml injection, I felt all week realy well, but right now I am in a very bad mood.

Am I just being human, or something else could be wrong . Maybe a glass of wine can help.

Thanks for listening if anyone is....

**izverg** · 07-31-2012, 09:45 AM

So after a month of doing the patch and androgel , then a week on test cyp here are my new test results. Looks lime my Test went up, SHBG went up by about 50 points. LH is horrible right?

Testosterone , Serum (Total) 395 ng/dL Final 07/29/2012 104
% Free Testosterone 1.8 % Final 07/29/2012
Free Testosterone, S 71 pg/mL Final 07/29/2012
SHBG (IRMA) 25 nmol/L Final 07/29/2012
Vitamin D, 25-Hydroxy 31.0 ng/mL Final 07/29/2012
LH Low 0.1 mIU/mL Final 07/29/2012
FSH Low Final 07/29/2012

**kelkel** · 07-31-2012, 11:11 AM

Well, you need to pick a therapy and stick with it giving it time to settle in. You can't really know what is getting you where using basically three sources of exogenous T. We also need ranges for the levels above to really tell you anything. Vit D is low banking on the range being app 30 - 100. Start supplementing as it will increase your free T. LH/FSH are not worth testing as you're in HPTA shutdown.

**izverg** · 07-31-2012, 12:17 PM

Originally Posted by kelkel

Well, you need to pick a therapy and stick with it giving it time to settle in. You can't really know what is getting you where using basically three sources of exogenous T. We also need ranges for the levels above to really tell you anything. Vit D is low banking on the range being app 30 - 100. Start supplementing as it will increase your free T. LH/FSH are not worth testing as you're in HPTA shutdown.

My insurance approved Test Cyp by the way, so i am happy.

I really don't want my testes to shrink, it's kind of bothering me, and my doc doesn't do HCG . But he told me to get him some artciles and he will take a look. From what i have been reading if i take HCG 3 times a week my testes will not shrink and if i want i can still have kids.

**HRTstudent** · 07-31-2012, 03:41 PM

Originally Posted by izverg

So after a month of doing the patch and androgel , then a week on test cyp here are my new test results. Looks lime my Test went up, SHBG went up by about 50 points. LH is horrible right?

Testosterone , Serum (Total) 395 ng/dL Final 07/29/2012 104
% Free Testosterone 1.8 % Final 07/29/2012
Free Testosterone, S 71 pg/mL Final 07/29/2012
SHBG (IRMA) 25 nmol/L Final 07/29/2012
Vitamin D, 25-Hydroxy 31.0 ng/mL Final 07/29/2012
LH Low 0.1 mIU/mL Final 07/29/2012
FSH Low Final 07/29/2012

What therapy are you currently on? Mixing gel and test cyp is unnecessary IMO.

LH is expected to be nil, don't bother testing it while on TRT.

Vitamin D range?

SHBG of 25 seems to be only a slight increase, not 50 points? A few points is reasonable. E2 rising will increase SHBG.

Whats your E2 sensitive lab say? This is important.

Finally, your testes are liable to shrink but the degree is variable. Some men its not noticeable. For most men its only slight shrinkage and certainly tolerable.

Are you interested in having children in the next year? Starting TRT and trying to start a family at the same time is a bad idea. TRT will hurt your chances at conceiving. As always, of course, there are no guarantees one way or the other.

**kelkel** · 07-31-2012, 04:19 PM

Izverg tell you doc it's right on the package inserts. See below:

http://www.ferringfertility.com/medi.../novarelpi.pdf

here also and this is what I use:

http://www.apppharma.com/our-product...roduct-26.html and open pdf link to package insert.

**izverg** · 08-01-2012, 07:46 AM

(hmm, for some reason i can't reply with quite, the little icon keeps spinning)

HRTStudent , thanks for the reply.

I am on 250 shot once every two weeks. I know you guys will say that not right and i should split it in two, one shot a week. I will be doing this now that i picked up my own Test Cyp.

I did apply AndroGel last few days when before my second shot, and i felt kind of normal. Overall i don't feel anything different since i started HRT.

D range is 30.0-100.0 , so i need to start taking more D, i will do 10,000iu until my next lab.

I don't know why they didn't order e2 this time, i will make sure that in a month I’ll get tested for it.

So does this mean if my e2 is up for sure if SHBG is up? Does this mean i need to ask my doc for Arimidex (another one he doesn't prescribe), i do still have a mild gyno and i want it GONE ?

I already have a 2 year old daughter and we don't really want any more kids, at least not for now.

Kelkel, thanks for the links, i will print it out and bring it to my doc.

**izverg** · 08-01-2012, 03:39 PM

another question

I got these B-D 3ml 22g1 syringes, i guess this means its a 1 inch needle. Is this the most "gentle" syringe out there to inject Test Cyp?

By the way, the pharmacy didn't have test cyp so they gave me the brand name Depo-Test for $10 , not bad.

**chuckt12345** · 08-02-2012, 12:30 PM

one shot E2W is fine with CYP,, and there is no point to take your gels during your shots. I like androgel but i just switched because it is 525 for 3 months compared to 75 for Axiron. ive done patches, shots, gels and now this axiron. Shots even at every 2 wks still seem to be the best.

**chuckt12345** · 08-02-2012, 12:32 PM

BTW DepoTest is cyp

**izverg** · 08-02-2012, 02:02 PM

thanks chuck

by the way my doc says that he has patients that still use Gel with Test Cyp shots, and that it's ok. I don't really want to use Gel (don't want to get in on my kid/wife) but i use it thinking that my t levels will go up faster. Maybe i should just stop.

**izverg** · 08-03-2012, 09:07 AM

So today i had my appointment with my Endo, the one that prescribed AndroDerm and then AndroGel . I came in to the office with this new found knowledge on testosterone . I told her that i went to specialist who started me on a 200 shot of test cype, bluh bluh, and that he wouldn't prescribe me HCG and arimidex .

I really like this endo, she listens and I feel like she really cares. She told me she is just not comfortable about giving me cyp and hcg shots because it’s not her specialty. But then she tells me she will think about giving me HCG and arimidex( if needed), BUT she said if i do stay with her she wants me ONLY to take HCG and not test cyp.

She said she would also want to stop after 6 months and see how i will do without HCG.

What do you guys think about this approach?

**HRTstudent** · 08-03-2012, 12:53 PM

Originally Posted by izverg

So today i had my appointment with my Endo, the one that prescribed AndroDerm and then AndroGel . I came in to the office with this new found knowledge on testosterone . I told her that i went to specialist who started me on a 200 shot of test cype, bluh bluh, and that he wouldn't prescribe me HCG and arimidex .

I really like this endo, she listens and I feel like she really cares. She told me she is just not comfortable about giving me cyp and hcg shots because it’s not her specialty. But then she tells me she will think about giving me HCG and arimidex( if needed), BUT she said if i do stay with her she wants me ONLY to take HCG and not test cyp.

She said she would also want to stop after 6 months and see how i will do without HCG.

What do you guys think about this approach?

It sounds like she might be wanting to try you on a HCG restart protocol. basically, get your nuts producing again and then take you off to see if you can naturally sustain the higher levels. Its not necessarily a BAD idea.

It really boils down to what you want with therapy. There is no 1 single best way to treat you. That's why there are so many protocols and just about everyone here is on something slightly different, and some radically different.

Are you interested in staying on TRT for the rest of your life, or would you rather see if you can bring up your natural production and live "drug free"?

**izverg** · 08-03-2012, 01:02 PM

I want to live dr0g free for sure. I want to lose weight and stop taking Crestor and Metoprolol. However, i also want to have a high normal test as long as i possibly can, but i doubt that is possible without dr0gs as i grow older.

**izverg** · 08-08-2012, 02:19 PM

Went back to the specialist today. He showed me how to inject myself. I gave him few papers by Dr Crisler and my doc was actually interested. He was reading some of it in the office. He said that maybe he should just put me on HCG over Test, but he would get back to make about it after he reads Dr Crisler's stuff.

We talked about how i was feeling and i basically thought i felt best on 1ml , but the thing is after 5-6 days i would start feeling crappy. So i asked him if it’s ok to inject 1ml a week and he said "Oooooookay lets try it...". I guess he wasn't overly enthusiastic about it but he still let me do it and told me to come see him right before i finish with the bottle, almost 2 months.

1ml a week is too much , right?

**izverg** · 11-14-2012, 02:55 PM

Sup people

I have been here lurking , reading, learning, but have not posted much.

After about 6 months on TRT doing 200mg of Test Cyp a week i had my blood checked last month and results were not that great. However, i do feel much better than when my T was 320.

My e2, free test and prolacten are too high. My doctor told me to back off to 100mg and scripted .5mg Adex ever other day. I have to say i felt a little better when i was on Adex, i think i lost few pounds and some of the gyno washed away. My gyno is very minimal, almost not noticeable.

Yesterday was my last adex day and today i took another blood test.

Overall my libido is much better on 200mg than on 100mg, but that’s the only difference i noticed.

Few questions.

Should if my e2 went down to lets say below 30 , i should not ask my doc to script me more for adex, correct?
How can i stay on 200mg of test cyp but lower my free test?
How do i lower my prolactin? (last year i had MRI done and all is good there).

My nuts are still same size so i am not worrying about HCG at the moment, plus he wont give me a script for it becuase "he doesn't know much about it".

ALso, he offered to put me on Clomid, i told him i'll think about it.

Thanks as always!