37 year old TRT and gyne

[jay adams]

Hello everyone. Love the site. I can't stop reading.

Im a member on the site XXXXX and was told to check this site out when I told another member I'd be starting TRT.

I hade gyno surgery 7 weeks ago and man I'm looking good.lol. I've had it since puberty and I've always dieted and worked out most of my life.

I got screwed up and became an alcoholic. December of last year I quit. I also quit lorazapam cold turkey after 2 years on that walking coma of a time.

So last week I went to my doc to have my test checked and it was 317. My doc said she wanted to try TRT. She asked me what delivery system I'd prefer and I went for injections.

Thanks to this wonderful site I made an appointment to be checked for prostate abnormalities on Tue before starting my therapy. I don't think my doc knows a lot about this. She seems to be laxed too.

Im worried about getting gyne again. Im just getting my levels around the 800/ 1000 level from what my doc says. Should I use a AI? Im sure if I ask she'll give it to me. Also, is there a way to keep my balls active?

Eventually later in the year I'd like to do 12 weeks at 500 a week. But for now I just want to lift like nuts, eat healthy and get normal.

Do you guys think I should worry about gyne if my levels get near the 1000 mark?. Im 37. Will be on test cyp. Waiting to see an Endo later in the year but I got you guys, which may be better.lol

Thank you for your time and sorry if this is lame cause I have very limited knowledge.

Best regards, Jay.

[ZenFitness]

Welcome!

In regards to gyno and E2 levels, you need blood work (preferably the sensitive estradiol test). That is the first place to start.

To keep the balls active, check out the hCG sticky in this forum.

Disclaimer: I'm only repeating what I've learned here... someone else with more knowledge will chime in.

[phaedo]

Hello and welcome, jay adams.

Good choice on opting for injections over gels, creams, and patches. Injections, though intimidating at first, are the superior delivery system for testosterone (in my opinion).

With all things being equal, no, gynecomastia will not reoccur on a balanced TRT regiment. In short, gynecomastia is one of many consequence of excess estrogen in the male body, and for obvious reasons, the superabundance of estrogen is to be avoided.

Your estrogen should be kept in check; that is, and as ZenFitness has alluded too, a sensitive estradiol test is used to determine if E2 creeps beyond the acceptable normal. If so, than an aromatase inhibitor may be warranted and/or a reduction in the dosage of testosterone. The general consensual range for estrogen falls somewhere between 20 to 30, individual dependent.

I do think that the best TRT protocol utilizes the least number of medications -- as veteran member Roman always chimes: "less is more."

So, with that said, I would begin TRT without an AI. After the first round of blood work, your doctor and you can determine whether an AI prescription would be beneficial. Give your history with gynecomastia, I would make your concerns with estrogen clear from the outset with your doctor.

In regards to maintaining spermatogenesis ("keeping the balls active," in the vernacular), TRT is often accompanied with a low-dose of HCG . Though I have perused the medical literature and it seems the combination of both HCG and HMG - LH and FSH analogues, respectively - offer a more robust sustainment of testicular activity than HCG alone. If you suspect to father children in the future, than I would inquire for both HCG/HMG, albeit the latter being expensive. Given your age, I would wager that a pregnancy is not your aim, whereas accompanying TRT with solely HCG would suffice.

As with anything in life, start small and work up. It's easier to add (medications/dosages/etc.) than the reverse.

Keep us posted, and again, welcome.

[kelkel]

Good advice above op. It would have been nice to know your E2 level prior to starting this protocol. Actually, an example of blood work to pull is in the Finding a Doc Sticky. Take a look please.

When it comes to gyno please be careful. If you're prone it can come back depending on the way your surgeon did his work. Please be sure to check bloods again in six weeks and make the proper adjustments. Even sooner for an E2 panel if the need arises. The obvious goal though is to not have to use an AI. With that in mind try not to get stuck on a number with your T level. You're not a number. Base things on how you feel.

What exactly will your protocol be?


Good advice above from phaedo.

[jay adams]

Thanks guys. I'll have my estrogen checked asap.
I'll look the other tests up too that kelkel spoke of.

I'll ask her at the next appointment about HCG also.

Thanks a million guys. When I get the more in depth results I'll post em.
Very interested in what can be learnt.

[jay adams]

testosterone free 4.87
test total 317
vitamin D 20.7
vitamin B-12 400

Comp Metabolic Panel
glucose 82
blood urea nitrogen 16
creatinine 0.9
sodium 142
potassium 5.1
chloride 109/high
carbon dioxide 21/low
calcium 9.7
protein total 7.4
albumin 4.7
-globulin 2.8
-albumin/globulin ratio 1.6
alkaline phosphatase 85
bilirubin 0.8
ast (sgot) 26
alt (sgpt) 25
bun/creatine ratio 18
anion gap 17
gfr non african american >60
gfr african american >60

bilirubin direct 0.1
bilirubin indirect
total 0.8
direct 0.1
indirect 0.7

lipid panel
triglycerides 75
cholesteral 204 h
cholesteral hdl 45
non hdl cholesteral 159
t. chol/hdl ratio 4.5
cholesteral-vldl 15

hemoglobin-a1c (hplc) 5.3
amylase serum 19
rpr non reactive
psa ultra sensitive 0.115
tsh 3rd gen 1.324
t-4 total 6.8
sed rate westergren 12

Complete Blood Work
wbc 8.2
rbc 5.02
hemoglobin 15.6
hematocrit 45.3
mcv 90.2
mch 31.1

mchc 34.4
red cell dist.width 13.1
platelet count 304
mean platelet volume 11.4 h
neutrophils 39.9
lymphocytes 8.6
monocytes 8.6
eosinophils 4.5
basophils 1.6
neutrophils absolute 3.3
lymphs absolute 3.7
monos absolute 0.7
eosinophils absolute 0.4
basophils absolute 0.1

microalbumin/creat. ratio
creatine urin random 249.5
microalbumin urin random 0.58
-alb/creat ratio random 2

[jay adams]

I'm trying to find out what I'm missing. I know I'm missing the E tests.
I'm going to see the doc in two days so I'm going to ask for whatever they didn't do already.

kelkel = testosteronecyp 200 mg/ml
inject 0.5ml every two weeks
I've never done this so I'm a little nervous about not measuring correct.
I was giving a 25Gx5/8". I'm just sitting on my cyp right now.
I'll prob have the Doc show me how to load the correct amount when I
go in.

[jay adams]

From what I can find I'm missing the E tests and the thyroid.
Is that correct?

Should I do those tests before beginning treatment? I need to get this started

[jay adams]

Hello forum. I assume I'm not getting a reply cause I'm missing something I should see already.

I'm thinking these are the tests I need to request tomorrow.

PSA
DHEA
DHT
Luteinizing Hormone (LH)
Sex Hormone Binding
Estrogen.

I'm trying here.haha. I'm just hoping I'm not missing anything important I'll need to adjust my levels over the next six months.

Like I said my doc doesn't know any of this. It's kinda like the blind leading the blind.

Any advice would be greatly appreciated. It seems like we have to be our own substitute doc when it comes to TRT.

Thanks again. Jay

[kelkel]

I'm trying to find out what I'm missing. I know I'm missing the E tests.
I'm going to see the doc in two days so I'm going to ask for whatever they didn't do already.

Good. You should never start TRT unless it's a last resort actually. Meaning your doc should attempt to find a causative factor and correct it, thus restoring natural levels if at all possible.

kelkel = testosteronecyp 200 mg/ml
inject 0.5ml every two weeks
I've never done this so I'm a little nervous about not measuring correct.
I was giving a 25Gx5/8". I'm just sitting on my cyp right now.
I'll prob have the Doc show me how to load the correct amount when I
go in.

Injections should be once per week, minimum. If your doc is suggesting every two weeks he doesn't understand the half life of testosterone . If he does not know that you should probably just find another doc as HCG and and AI may be beyond him, quite honestly. Take a look at lowtestosterone.com.

From what I can find I'm missing the E tests and the thyroid.
Is that correct?

Should I do those tests before beginning treatment? I need to get this started

Above answers that. You did not put ranges with your Blood Work. Hypothyroid can cause hypogonadism (low T) so all should be ruled out first.

Hello forum. I assume I'm not getting a reply cause I'm missing something I should see already.

I'm thinking these are the tests I need to request tomorrow.

PSA
DHEA
DHT
Luteinizing Hormone (LH)
Sex Hormone Binding
Estrogen.

I'm trying here.haha. I'm just hoping I'm not missing anything important I'll need to adjust my levels over the next six months.

Like I said my doc doesn't know any of this. It's kinda like the blind leading the blind.

Any advice would be greatly appreciated. It seems like we have to be our own substitute doc when it comes to TRT.

Thanks again. Jay

Just get what is in the Sticky that you did not get. Avoid ejaculation for a couple days prior to the PSA as it can temporarily spike results. Get DHEA-S, LH & FSH and an estrogen sensitive assay. If you use labcorp let me know and I can give you the proper codes.

[phaedo]

Hello forum. I assume I'm not getting a reply cause I'm missing something I should see already.

I'm thinking these are the tests I need to request tomorrow.

PSA
DHEA
DHT
Luteinizing Hormone (LH)
Sex Hormone Binding
Estrogen.

I'm trying here.haha. I'm just hoping I'm not missing anything important I'll need to adjust my levels over the next six months.

Like I said my doc doesn't know any of this. It's kinda like the blind leading the blind.

Any advice would be greatly appreciated. It seems like we have to be our own substitute doc when it comes to TRT.

Thanks again. Jay

I'm caught up with work -- I'll take a closer look at your thread when I get a bit. I scrolled through kelkel's post quick and agree with his advice.

[jay adams]

I called Low T. I feel like I should go that route so I can learn the proper way to do this.
Im really worried about this doc not knowing enough.
I'd hate to have my E go unchecked and get gyne again.

Also, I'd be paying about half the price of LowT for my treatment anyway.
Might as well do it right the first time. I'll be back with news on how it comes along.

Thanks so much for the preventative advice. Jay.

[phaedo]

Hey jay adams,

Yeah, I agree. Low T would prolly be your best bet, give your concern about your doctor's limited knowledge and under-experience with TRT. I have fought that battle of ignorance many, many times. It's really not worth it.

When you say "I'd be paying about half the price of LowT for my treatment anyway," do you mean to say Low T is half the cost or twice as expensive as your current plan?

[jay adams]

LowT will be twice the price.
The peice of mind knowing I'm in good hands "priceless".

I just paid $7000 for gyne surgery and I sure in the hell
Don't want a revision AND have to wear the compression
Vest again.lol

I've been studying gynecomastia for years preparing for
surgery. Now if I have to take this voyage (TRT) I want
to learn about about it the right way.

This is a damn good site!

[phaedo]

LowT will be twice the price.
The peice of mind knowing I'm in good hands "priceless".

I just paid $7000 for gyne surgery and I sure in the hell
Don't want a revision AND have to wear the compression
Vest again.lol

I've been studying gynecomastia for years preparing for
surgery. Now if I have to take this voyage (TRT) I want
to learn about about it the right way.

This is a damn good site!

It's good to see you're doing mindful research and finding the best option for you. Though I cannot personally vouch for Low-T, I can assert that their approach to male hypogonadism is more cogent that most typical TRT administrations.

In regards to your gynecomastia surgery, do you know if the complete glandular tissue and surrounding adipose was removed (mastectomy), or was there any sculpting involved with the residual for aesthetics? I ask, since leaving behind some of the gynecomastia is viable to regrow with excess estrogen.

[jay adams]

The doc removed 95% of the tissue. To remove it all (mastectomy) would leave a cratering effect.

I have one year for a free revision if needed. That's why Im trying to get this hormone business handled as fast as possible.

I prob should have done that first but I couldn't live another day with it. Going to the gym at four in the morning wearing a jacket SUCKED!haha