TRT with Family Doctor

Hi gurus! After years and years of typical low T symptoms, I started TRT with my family doctor. My goals: cure fatigue and libido problems. Build a little muscle through body weight training.

Age: 39
Sex: Male

Numbers:
4/29/13 Total: 697 Free: 86.4

Note: I know my numbers aren't low, but I have pretty much ruled out everything else as to why I feel so damn tired all the time, and why my sex drive is not where it should be despite just getting married to a chick I find very attractive. I don't give a shit what my numbers say - I just want to feel good.

Doc suggested Androgel but I asked for IM injections, so she prescribed me 1ml test cypionate every two weeks. I just gave myself my first injection and it went well enough. The doc gave me the first injection 2 weeks ago.

Note: I have a 10ml Vial of Depo-Testosterone from Pfizer. My script says "inject intermuscular 1ML every 2 weeks". Has quantity of 10 and 2 refills before 11/2/2013 (6 months). This vial appears to be a 5 month supply.

Questions for you experts:

1) How is this dosage? Is it enough to do anything? I see some of you do 200mg/week.
2) How long should I continue this to see if it has the affect I'm looking for? (fatigue, libido)
3) With a dose such as this, should I also take HCG or an estrogen inhibitor? Note: had 2 vasectomies last year so fertility is not an issue
4) Since I self-administer, should I cut the dose in half and inject every week?

I see some more complicated protocols that you all are using, and I just wonder if doing it through the family doc is a good idea or if I should go to a specialist. The next blood work and appointment we have scheduled is for 3 months. I guess her idea is for me to self-administer for 3 months, get blood work done, and come in for a follow up appointment. I'll have to be on the look out for side effects, such as ball shrinkage and sore nipples.

Any other advice would be greatly appreciated.


Thanks!

I'm curious, did you only do one blood test? Someone once mentioned to me that I should get 3 tests each 2-3weeks apart and take the average number of the three to get my T score...

Quote:

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Originally Posted by chuck_norris

Hi gurus! After years and years of typical low T symptoms, I started TRT with my family doctor. My goals: cure fatigue and libido problems. Build a little muscle through body weight training.

Age: 39
Sex: Male

Numbers:
4/29/13 Total: 697 Free: 86.4

Note: I know my numbers aren't low, but I have pretty much ruled out everything else as to why I feel so damn tired all the time, and why my sex drive is not where it should be despite just getting married to a chick I find very attractive. I don't give a shit what my numbers say - I just want to feel good.

Doc suggested Androgel but I asked for IM injections, so she prescribed me 1ml test cypionate every two weeks. I just gave myself my first injection and it went well enough.

Questions for you experts:

1) How is this dosage? Is it enough to do anything?
2) How long should I continue this to see if it has the affect I'm looking for? (fatigue, libido)
3) With a dose such as this, should I also take HCG or an estrogen inhibitor?
4) Since I self-administer, should I cut the dose in half and inject every week?

I see some more complicated protocols that you all are using, and I just wonder if doing it through the family doc is a good idea or if I should go to a specialist. The next blood work and appointment we have scheduled is for 3 months. I guess her idea is for me to self-administer for 3 months, get blood work done, and come in for a follow up appointment. I'll have to be on the look out for side effects.

Any other advice would be greatly appreciated.


Thanks!

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Quote:

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Originally Posted by Keep_It_Moving

I'm curious, did you only do one blood test? Someone once mentioned to me that I should get 3 tests each 2-3weeks apart and take the average number of the three to get my T score...

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No. I usually get it once a year with my physical. I have a few years of data.

I dont think you want to inject once every 2 weeks. 2xs a week is pretty standard to keep yourself leveled out.So .25ml 2xs a week. I sure some of the experts will be in shortly to get you straight tho.

Sorry, but your decision to start medicating is absurd! Your serum level is in a optimal zone. Your free test appears that it could use improvement, 2% to 3% is optimal. Your SHBG is more than likely high, and I suspect your E2 is elevated as well. However, it's speculation without seeing labs.

I would also be leaning to believe that your thyroid could be part of the problem as well. You need a comprehensive thyroid panel with antibodies, and iron, ferritin, B12.

Bottom line, there could be a myriad of variables that are causing your issues, but testosterone serum isn't one of them. Testosterone is like GW Bush, it seems everyone blames it for all their problems. Stop, review and educate, and fix the areas that need fixed.

Sorry chuck but I think you are making a terrible mistake with your decision to start injecting T. Im sure you are here for open, honest feedback/advice, but yor T levels are already at a level that many strive to get into?? I know these Docs are clueless when it comes to hormones but how did you ever find one that would give you an Rx @700???
Hope you understand what it means to be "shut down"????

Quote:

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Originally Posted by Vettester

Sorry, but your decision to start medicating is absurd! Your serum level is in a optimal zone. Your free test appears that it could use improvement, 2% to 3% is optimal. Your SHBG is more than likely high, and I suspect your E2 is elevated as well. However, it's speculation without seeing labs.

I would also be leaning to believe that your thyroid could be part of the problem as well. You need a comprehensive thyroid panel with antibodies, and iron, ferritin, B12.

Bottom line, there could be a myriad of variables that are causing your issues, but testosterone serum isn't one of them. Testosterone is like GW Bush, it seems everyone blames it for all their problems. Stop, review and educate, and fix the areas that need fixed.

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Thanks for your input. I don't see SHBG on my lab work anywhere, unless it is called something else. I also do not see E2 or other items you listed. My B12 is: 650.

Like many others, I'm tired of feeling tired, having brain fog, and a lack of sex drive. I feel as though I have optimized my health and diet in every way I can, but I still feel like shit.

What is your advice? Stop TRT and do what? Talk to my doc and get the right lab work?

I really do appreciate your advice. It's not like I WANT to start TRT for life, I just want to feel better.

bullshark99

I don't understand what that means, and I do want honest feedback. Doctors don't seem to know much about hormones. I simply explained to her that I have all the symptoms and she suggested the gel. Since I have all the symptoms of low test, I figured I should do it. I will stop with the injections until I learn more. I've had two doses so far.

Chuck, there's two primary components with testosterone. You have your total serum (which yours is good), and then there's the free and an unbound portion, which is the actual amount of testosterone that is available in the body for use. The optimal range is usually in the 2% to 3% range. Yours is 1.24%. Again, the factor behind this is primarily SHBG, and albumin (weakly bound), which testosterone is bound to. In many cases we see men will have elevated E2 levels, and I would bet that you're deficient in Vitamin D3. Optimizing your vitamin D level, possibly adding a small amount of nettle root, and getting your E2 balanced will make a world of difference in this department. Again, study as much as you can first and you will see how this all works.

As far as labs ... Kelkel has a great sticky (finding a HRT physician), which lists all the specific labs to be considered. In the meantime, could you give us your stats (besides 39yo), and list any medications, medical conditions, family history, etc., which could be contributing to your issues?

Quote:

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Originally Posted by chuck_norris

bullshark99

I don't understand what that means, and I do want honest feedback. Doctors don't seem to know much about hormones. I simply explained to her that I have all the symptoms and she suggested the gel. Since I have all the symptoms of low test, I figured I should do it. I will stop with the injections until I learn more. I've had two doses so far.

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Hypothyroidism can just as easily display these symptoms, as could a myriad of other issues within the endocrine system (E2, prolactin/progesterone, DHEA, adrenals ...). Again, I do think your free testosterone could improve, but medicating with exogenous testosterone to increase the total serum isn't the route to take to accomplish this, especially if your E2 and other variables are out of balance.

Listen to Vett please. Do a complete thyroid panel including

T3 uptake (THBR)
Thyroid-stimulating hormone (TSH)
Thyroxine (T4)
Tri-iodothyronine (T3)
Tri-iodothyronine (T3), Free, (FT3) Serum
Thyroxine (T4) Free, Direct (FT4)
Ferritin, Serum
Iron, Serum

As well as all hormones listed in sticky. You could be fixed way easier than a lifetime of HRT. I personally tried everything before reluctantly starting HRT

Chuck, your response is appreciated and I wasnt trying to be confrontational or anything, posted real quick, thats all. Nothing I could add of value that Vette didnt already mention, he knows his Biz, I would listen.
My point of "being shut down" just didnt know if you realize once you start adding Exg Tes you stop producing your own. Many people/Drs are under the impression that you are supplementing ON TOP of your own and that is just false. Once you start messing with this naturel process there is no guarentees you can reverse it if you choose to stop in the future even if it is short lived.
Many like myself didnt know what we were getting into when we started this journey, now Im stuck, yes, could be worse things, but wish I had my facts straight to begin with. Just dont know if your in the best possible care with this family doc.....

if I were you i'd stop TRT immediately and let your body recover for about 2-3 months from the two shots you took then do a complete blood work. see Kelkel's post regarding Finding a Physician to see what BW you need done. then post everything here so we can help guide you to make the right decision. there are many negative sides to TRT and all have to be managed, TRT is not just administering test, a complete TRT consists of,

1. testosterone, minimum once a week or twice a week is best
2. AI as needed
3. hCG to keep your testis healthy
4. proper diet
5. proper exercise (weight lifting)
6. donating blood as needed to maintain RBC, Hemoglobin, and Hematocrit at healthy levels. many of us do it every two months.
7. supplements like DHEA, fish oil, vitamin D
8. blood work every 3 months until you get dialed in, then twice a year.

oh I meant to say BTW, I believe you won't see any improvements with TRT since your problem is not low T, in fact TRT may make it even worse!

Thanks a lot to all you guys! Wish I had posted before I started, but I guess I was just looking for a solution.

Quote:

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Originally Posted by chuck_norris

Hi gurus! After years and years of typical low T symptoms, I started TRT with my family doctor. My goals: cure fatigue and libido problems. Build a little muscle through body weight training.

Age: 39
Sex: Male

Numbers:
4/29/13 Total: 697 Free: 86.4

Note: I know my numbers aren't low, but I have pretty much ruled out everything else as to why I feel so damn tired all the time, and why my sex drive is not where it should be despite just getting married to a chick I find very attractive. I don't give a shit what my numbers say - I just want to feel good.

Hopefully most of us don't marry ones we find disgustingl!

Doc suggested Androgel but I asked for IM injections, so she prescribed me 1ml test cypionate every two weeks. I just gave myself my first injection and it went well enough. The doc gave me the first injection 2 weeks ago.

Note: I have a 10ml Vial of Depo-Testosterone from Pfizer. My script says "inject intermuscular 1ML every 2 weeks". Has quantity of 10 and 2 refills before 11/2/2013 (6 months). This vial appears to be a 5 month supply.

Questions for you experts:

1) How is this dosage? Is it enough to do anything? I see some of you do 200mg/week.
2) How long should I continue this to see if it has the affect I'm looking for? (fatigue, libido)
3) With a dose such as this, should I also take HCG or an estrogen inhibitor? Note: had 2 vasectomies last year so fertility is not an issue

Dying to know. Why two? First not effective?

4) Since I self-administer, should I cut the dose in half and inject every week?

I see some more complicated protocols that you all are using, and I just wonder if doing it through the family doc is a good idea or if I should go to a specialist. The next blood work and appointment we have scheduled is for 3 months. I guess her idea is for me to self-administer for 3 months, get blood work done, and come in for a follow up appointment. I'll have to be on the look out for side effects, such as ball shrinkage and sore nipples.

Any other advice would be greatly appreciated.


Thanks!

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Great advice above chuck. Full BW is your key here, not TRT. Find a more astute doc. I'm shocked your doc agreed to this at your levels. Be sure to look into iron panels as well.

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Originally Posted by kelkel

Great advice above chuck. Full BW is your key here, not TRT. Find a more astute doc. I'm shocked your doc agreed to this at your levels. Be sure to look into iron panels as well.

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Will do. Need to find a better doc, for sure. I hope I'll be able to recover from the effects of the 2 shots I've taken....we'll see.

Two vasectomies. First time the doc used pro-vas clips, which essentially clamp down the vas deferens and prevent sperm from moving into the semen. $300 more expensive, easier procedure and this recovery time. Did not work. Thankfully I found out with my sperm tests and not by getting my then fiance pregnant. Thankful that we used protection, even though I was SURE I'd be safe after a vasectomy. Second procedure was much worse, and now I have the clips hanging around as a reminder of the failed first vasectomy. Urologist was a total ass clown. I should have gotten references...

Appreciate the advice! Many thanks!