Overweight, looking to turn my health around....

[LiquidMark]

(This is a duplicate of my "new members post", per suggestion of one responder to that post...)

Hi, I'm a 57 year-old male, 6'1", 252 lbs, mostly around mid-section. Probably press 50 lbs. You would definitely kick sand in my face if you saw me on the beach.

I "discovered" T when I read an article about HRT leading to unexpected weight loss over the long term for male subjects. Further reading suggested that T also helps with clarity of thought, energy levels, self-confidence. Sought out help from my Dr. and got an Rx for Axiron, 2 pumps.

I felt great for about 3 days, including actually wanting to exercise. (I exercise regularly, but it is a real struggle, and I don't manage as much vigor as would be beneficial -- as evidenced by my pathetic gut and wimpy arms/shoulders.) Curiously, it got much easier to do my work (computer programming)!. Everything just made sense, and my memory worked better. I think my brain functions much better with more T! Now, I'm as subject to placebo effect as anyone, but I also know my body and my mind. I had 3 days of unmistakable, dramatic, improvement.

Of course, my body quickly turned down native T production, and likely started converting the exogenous T to estrogen.

Talked to Dr; switched to Androgel 1.62%, 3 pumps. Each pump has 20.25 mg of bio-identical T, so that's ((3 x 20.25) * 7) = 425.25 mg of T per week. But, I read that only about 10% of that actually gets absorbed through the skin. So, ~40 mg/week. Still, I only felt marginally better. Remembering the first 3 days on TRT, I know that my body / brain can respond much more strongly. I suspect that my endogenous production was just turned down by the amount I was rubbing in.

Switched doctor in 3rd month, seeking a more effective dose. Here is my blood work, taken while on the 3 pumps Androgel, as submitted to new doctor. I was also taking an over-the-counter anti-estrogen:

- Testosterone , total: 860 ng/dL, reference: 240-950
- Testosterone, free: 34 ng/dL, reference: 9-30
- Estradiol: 34 pg/mL, reference range: < 20-47

(There were lots of other things tested, I figure these are the 3 critical values for this discussion group?)

New Dr. has prescribed:

1 -10 cc vial of Testosterone Cypionate200 mg/ml- $145
1 -10 cc vial of Nandrolone Decanoate 200 mg/ml- $240
90 tabs of Anastrozole .5mg (Anti Estrogen)-$270
Syringes (for the testosterone)- $8
$65 Dr. Fee/Shipping
Total:: $728

I injected 1 CC each of the test cyp and nand dec 6 days ago. I take the Anastrozole every day. Again, I felt pretty good for a couple days. Critically, I felt like exercising, and did. But, it has gone back to being a struggle for the last few days.

I am about to inject my second week's dosage, 1 day early, in the hope that the tail-end of the first week's dose will complement the 2nd.

My goals are just to be able to live and work well:

- be able to do both strength and endurance training, vigorously. Feel like doing it!
- reduce fat, gain lean muscle.
- feel confident and clear-headed.

I'm trying to figure out whether I should ask for a higher dose of T, higher dose of anti-estrogen, or whether I'm already at optimal doses, and I should just be happy with my "sometimes I feel better than I used to" status...

Please comment on dosages, alternative steroids that might help, even on the amount I'm paying for what I'm getting.

Thanks in advance,

[bass]

welcome here Mark. i take it you're going through a clinic?! be advised clinics will over prescribe meds and you can end up worse than before. that's what happened to me and others as well here. my advice is to seek a good TRT doctor that will treat you properly, otherwise you can still go with the clinic but follow our advise if you choose to.

first of all drop the deca , its way too early in the game to use that.

second, lower your test dose to 50 mgs twice a week

third, cut your AI dose to 0.25 mg once one day after each test injection.

so basically your total protocol should only be test and AI, you will also need hCG but we can cover that later, but what's important is test and AI for now. do this for about a year then introduce other compounds like deca, var and such. you also need to donate blood as often as you can especially at your age, you want to keep your blood thin to avoid any cardiovascular problems. consider supplementing with vitamin D and DHEA.

you're taking AI every day! how much? i doubt that your e2 shot up within three days on gel, it takes a while to convert to e2, but with injections you maybe up some by now. post your entire BW with ranges, believe me we will see things that most doctors overlook or ignore, and just because things are in range it doesn't mean they are optimal.

[LiquidMark]

Bass, thanks for your interesting post. Your recommendation is that I go from .5 mg Anastrozole per day to .25 mg per week? That's quite a difference! Do you have any good articles about use of Anastrozole in men during TRT? My estradiol, prior to starting the Anastrozole, was 34 pg/mL.

Here are all the labs I have:

Before starting TRT, my free T was 11 ng/DL, total T was 410 ng/dL. I especially took note of free at 11, where bottom of 'normal' range is 9

After 2 months of TRT (first month 2 pumps Axiron, 2nd month 3 pumps Androgel 1.62%). Blood was drawn October 25, 2012 -- prior to my starting my currently-prescribed regimen.

Free Testosterone : 34 ng/dL
Total Testosterone: 860 ng/dL

CBC with AUTO differential:
WBC 7.6
RBC 5.36
Hemoglobin 15.2
Hematocrit 46
MCV 86
MCH 28
MCHC 33
RDW-CV 14.6
Platelet count 237
Neutrophil % 51
Lymphocyteds % 26
Moncytes % 14
Eosinophil % 8
Basophil % 2
Neutrophil # 3.9
Lympocyte # 2.0
Moncytes # 1.1
Eosinophil # 0.6
Basophil # 0.1

Comprehensive Metabolic Profile:
Sodium 138
Potassium 4.0
Choloride 105
TC02 27
Anion Gap 6
Bun 12
Creatinine 1.4
GFR (estimated) 56
Glucose 74
Calcium 8.6
Total Protein 5.9
Albumin 3.4
Bilirubin, total 0.5
AST/SGOT 32
ALT/SGPT 74
Alkaline Phos 101

Lipid Profile
Cholesterol 203
Triglycerides 136
HDL Cholesterol 34
LDL Cholesterol 142

TSH 0.66
PSA, Total below 0.05. (No prostate for several years now. Yes, I was cleared for TRT by my urologist.)

Estradiol 34

[bass]

Wow 0.5 mg ed! This will do far more harm than having high e2! I said 0.25 AI once after every test shot, which means twice a week. Most of us do 100 to 120 mgs per week, your dose is very high for starting. Read the stickies regarding e2, great information there.

[bass]

BTW, do you have any idea why your liver enzymes are elevated, do you drink, taking pain killers? Also your cholesterol is pretty bad, need to work on that.

[jasc]

I concur with Bass. His suggested protocol is much more suited to obtaining healthy levels than what your dr. recommends.

To put your Anastrazole dose in perspective, your protocol of .5mg ed is more than most people take who are running 1000mg of Test per week. His suggested dosage is a great place to start and future bloodwork will determine if it needs adjustment. As with anything else, everyone is different so there is no standard dose that works for everyone.

As far as when you will feel the optimal effects of injecting Test C, this will not take days, but weeks. Cypionate is a long ester and may take up to 4-5 weeks to achieve stable blood serum levels. If you felt if after only a couple days it was most likely placebo.

As far as your test levels, I think there may be something else causing your lowered sense of well being. On the gel your test levels were equal to or greater than most 18 yr olds. Theoretically, if low test was the only issue, you should have felt great at the time of your bloodwork.

I'll let some of the pro's in this section expound even further, but these were a couple main points that jumped out at me.

[LiquidMark]

> BTW, do you have any idea why your liver enzymes are elevated, do you drink, taking pain killers? Also your cholesterol is pretty bad, need to work on that.

Don't drink to speak of -- ~ 1 drink/week.

I take Ibuprofen daily.

Which are the liver enzymes? I just typed info from report in -- don't know what's what, really.

[LiquidMark]

Could you please translate "ed" and "e2" for me? I thought "ed" was erectile dysfunction. Where are the "e2 stickies"? Ah, guess "e2" is "estradiol". Where are the "stickies"? Thanks for your patience & help...

[juice2012]

ED is just an abbreviation for "every day". E2 is estradiol which is the type of estrogen we worry about on TRT. And the "stickies" are the threads at the top of this forum that always stay "stuck" at the top. It means they are important.

[bigboy67]

ED = Every day, unless someone is specifically talking about problems with wood
EOD = every other day
EW = every week
e3D = every 3 days
E2 = the common measure used to check estrogen levels

[bigboy67]

ED is just an abbreviation for "every day". E2 is estradiol which is the type of estrogen we worry about on TRT. And the "stickies" are the threads at the top of this forum that always stay "stuck" at the top. It means they are important.

what he said...

[bass]

> BTW, do you have any idea why your liver enzymes are elevated, do you drink, taking pain killers? Also your cholesterol is pretty bad, need to work on that.

Don't drink to speak of -- ~ 1 drink/week.

I take Ibuprofen daily.

Which are the liver enzymes? I just typed info from report in -- don't know what's what, really.

Yup, ibuprofen will do it, just take a break for a week or so to help your liver recover, also get milk thistle and take it as recommend to help aid your liver. Liver enzymes are AST and ALT.

[kelkel]

Great advice from Bass and the guys above. Op, I'm confused why you even jumped off the agel when your TT, FT and E2 levels were very good, IMO. It takes time for your body to find homeostasis on TRT. It does not happen overnight or in a few weeks, exactly what Jasc said. One of the stickies deals with exactly what to expect when initiating TRT. Read it.

The advice given is really on point. That amount of AI recommended by the clinic is MORE than most use on cycles. And an average test cycle will be at least 500mg per week during which a common AI dosage is .25 EOD. Eventually on .5mg per day you would no doubt crash your E and be in for even more problems. Correct again on the Deca . There is no need to run that at this time, whatsoever.

You need to give this time and work on diet, exercise and other lifestyle changes to maximize your health. We say this all the time but it really is a journey with TRT, not a sprint.

Welcome to the forum Mark!

kel

[LiquidMark]

Thanks for the abbreviation key! "Obvious" in retrospect.

[LiquidMark]

Thank you, and Bass, and others for your help. I will indeed cut way back on AI. Doc probably gave me that because I have man-boobs, but I think they're mostly fat, not breast tissue. (Anyone know how to tell?)

Sounds like the consensus is:

- Eliminate the Nandrolone Decanoate entirely.
- Reduce Testosterone Cypionate from 1 CC once a week (total 200 mg) to .25 CC twice a week (total 100 mg).
- .25 mg Anastrozole twice a week, the day after the 50mg T.

I will study the sticky posts too.

Thanks again!

[bp2000]

Your numbers were great on the Gel. Why jump to injections so quick? Some insurance cover gel it might be cheaper than going through a clinic.

[bass]

Thank you, and Bass, and others for your help. I will indeed cut way back on AI. Doc probably gave me that because I have man-boobs, but I think they're mostly fat, not breast tissue. (Anyone know how to tell?)

Sounds like the consensus is:

- Eliminate the Nandrolone Decanoate entirely.
- Reduce Testosterone Cypionate from 1 CC once a week (total 200 mg) to .25 CC twice a week (total 100 mg).
- .25 mg Anastrozole twice a week, the day after the 50mg T.

I will study the sticky posts too.

Thanks again!

you got Mark.

as for the moobs, if you feel hard tissue or small marble size hard balls then its more than fat. only surgery can get rid of it, but don't worry about that now, fist get your TRT, diet and exercise under control then tackle the rest one at a time. you are on good hands here, you heard from Kelkel already, but we have quitevfew more member in Kel's caliber that can guide you to a new healthy you.

[LiquidMark]

> Your numbers were great on the Gel. Why jump to injections so quick? Some insurance cover gel it might be cheaper than going through a clinic.

My GP didn't want to do HRT because I had prostate cancer, so made me go back to my urologist. (Radical prostatectomy 2.5 years ago. Clear lymph nodes and surgical margins. Undetectable PSA since.) Urologist agreed to do HRT, but made it very clear that he didn't want to -- both because HRT after prostate cancer is controversial, and because it just isn't his area of practice. So, he was unresponsive regarding dosage and estrogen issues. Gave me 2 pumps, even though follow-up blood work showed my total T actually dropped from starting level. Didn't respond to questions about that. An hour's drive to get to his office to ask any questions in person. Generally, it didn't seem like this was going to get me where I wanted to go. I increased my dose without permission to 3 pumps. Also, I was self-medicating with "LG Sciences, Formadrol Extreme, Anti-Estrogen". I did this because a) my total T dropped from 410 ng/dL before starting treatment to 360 ng/dL after a month on 2 pumps; b) I was feeling some nipple sensitivity; I know my body will turn down natural T production in response to exogenous source, and will also convert it to estrogen.

The complete blood panel as posted was required by an out-of-state doc before he would prescribe anything. (I didn't find any HRT specialists within a reasonable drive, so went wider.) In it, I agree that total and free T looked good. At 47 out of 20-57, my Estrodiol was in the 52nd percentile, a bit above the "lower third" of the range I see recommended.

It now looks like I have a year's supply of AI, so I won't need to get that again for a while, and 16 weeks remaining supply of Testosterone Cypionate .

Questions:

1) If I went back to the gel after my Testosterone Cypionate runs out, would 3 pumps be about equivalent to the .25mg test cyp twice a week being recommended by this group?
2) My last injection of 1 cc of 200mg test cyp, 1 cc of Nandrolone Decanoate 200 mg/ml was Tues, 11/20. In switching to this group's recommendation of .25 cc of 200 mg/cc twice a week, when should my first injection of that be? I guess I'd like to catch my decreasing blood level of T at the "right" point to match the level my bi-weekly, lower-dose injections will produce.

Thank you all!

[LiquidMark]

No hard tissue in my moobs, whew! Thanks for the explanation!

[kelkel]

Really sorry to hear about the prostate issues! I can't estimate if 3 pumps would be equivalent. People absorb differently. You seem to do well with it. Lab work is the only way to know. A little trick to increase gel absorption is to apply moisturizer about an hour or so after after application to the same area. Over it if you will. This will increase absorption by 14-17%. This info comes directly from the androgel insert (I used to use it as well.)

I'd start the new injection protocol on whatever day you plan on being consistent with. Monday a.m. and Thursday p.m? Tests half life is app 5-7 days metabolism dependent. Once you start your twice a week protocol you'll be operating more at peak levels consistently. You'll be fine.