6 weeks into TRT

[thic-tac]

I am a 29 year old male, 6 weeks into my TRT. I was started on 100mg/ml test cyp and 40 units of hcg 2 x per week and 0.15 anti-est / day (would prefer to be on higher test dose). I go in for my first blood test tomorrow since starting to determine where my new levels are at. 6 weeks ago I was at total test 321; free test 61; and estrogen 180 (Bloodwork through QD). I was advised that it was best to space out the test and hcg. Day 1 test, day 5 and 7 hcg. The reasoning was that it will keep my test levels higher throughout the week. I am a novice, so I am interested in thoughts.

[OingoBoingo]

Days 5 and 6 would be better for the hCG .

If you mean 40IU twice a week for hCG, that's way low. 350IU on days 5 and 6 would be much better.

[OingoBoingo]

Also, I wouldn't take the AI unless I needed it.

[thic-tac]

Thank you, day 5 and 6 was my original though too. The 40 units = 400 IU twice a week of HCG . As for the AI pre treatment my levels of estrogen were 180 and according to my Dr. normal levels are less than 135.

[OingoBoingo]

It sounds like you've got a doctor who is better than most of us have.

[Beethoven]

It sounds like you've got a doctor who is better than most of us have.

Sounds like it. BTW if you don't mind me asking , what is his title? (GP, endo , urologist )

[kelkel]

What put you on TRT at such a young age? What was the diagnosis? Don't just say low T please. What actually caused it?

[OingoBoingo]

Thank you, day 5 and 6 was my original though too. The 40 units = 400 IU twice a week of HCG. As for the AI pre treatment my levels of estrogen were 180 and according to my Dr. normal levels are less than 135.

Oops. My bad. I meant days 6 and 7.

The thing is, it does sound like you have a good doctor, so I wouldn't make an issue over it. Either way, it won't change things *that*much.

[Chauffeur]

Thank you, day 5 and 6 was my original though too. The 40 units = 400 IU twice a week of HCG. As for the AI pre treatment my levels of estrogen were 180 and according to my Dr. normal levels are less than 135.

Total estrogen is a relatively insignificant value when determining treatment.

Estradiol is the value that we care about as men.

[OingoBoingo]

Total estrogen is a relatively insignificant value when determining treatment.

Estradiol is the value that we care about as men.

Good catch!

[thic-tac]

What put you on TRT at such a young age? What was the diagnosis? Don't just say low T please. What actually caused it?

I am not sure what caused it, and what diagnosis you are looking for other than low T. I never really thought about TRT. My sex drive was fine, no ED, and I'm only 29. Around early 28, my weight started to yo-yo a bit bouncing between 185-200, then I quit smoking cigarettes and ballooned up to 230 lbs. My diet hadn't change after I quit smoking (not that it was the healthiest to begin with, but I was always able to maintain) so I didn't contribute the weight gain to smoking. I figured it was time to become more active so I started running everyday, twice a day and logging everything I ate. I stuck with this routine for 8 months and had only lost 15 lbs. May not seem that bad, but for me something was off. I started to reasearch everything metabolism related and the more I reasearched the more I was pulled in the direction of low T. I decided to take a blood test and here we are. So far I am 210 + or - 3 on a given day but see a major difference in body composition. The most significant improvement is my increased mental clarity. Hopes this helps.

[thic-tac]

Total estrogen is a relatively insignificant value when determining treatment.

Estradiol is the value that we care about as men.

How so? My blood work shows Estradiol is in range at 19 pg/ml.

[thic-tac]

Sounds like it. BTW if you don't mind me asking , what is his title? (GP, endo , urologist )

Doctor of Osteopathy

[kelkel]

I am not sure what caused it, and what diagnosis you are looking for other than low T. I never really thought about TRT. My sex drive was fine, no ED, and I'm only 29. Around early 28, my weight started to yo-yo a bit bouncing between 185-200, then I quit smoking cigarettes and ballooned up to 230 lbs. My diet hadn't change after I quit smoking (not that it was the healthiest to begin with, but I was always able to maintain) so I didn't contribute the weight gain to smoking. I figured it was time to become more active so I started running everyday, twice a day and logging everything I ate. I stuck with this routine for 8 months and had only lost 15 lbs. May not seem that bad, but for me something was off. I started to reasearch everything metabolism related and the more I reasearched the more I was pulled in the direction of low T. I decided to take a blood test and here we are. So far I am 210 + or - 3 on a given day but see a major difference in body composition. The most significant improvement is my increased mental clarity. Hopes this helps.

What I meant was exactly what was the causative factor. Were you diagnosed as primary, meaning testicular failure. Or as secondary, meaning pituitary issues. With primary Blood Work would show high Lh & FSH levels with low test levels. With secondary your BW would show low LH & FSH levels as well as low testosterone . Another major cause of low T is hypothyroidism. Which is something many doc's don't really understand to well, similar to hormones. Other causes could be cortisol, prolactin or even head or testicular trauma.

I mainly ask as it fascinates me that so many guys are put on TRT by their doctors without a proper explanation as to why. Many doc's also only look at the patients test levels and don't investigate why they are actually low. It would suck to be put on TRT 20 years early when a problem was fixable. Hopefully, that's not the case.

[thic-tac]

Got my new bloodwook back after 6 weeks.
Total test up from 321 to 592
LH down from 2.4 to 0.1
FSH down from 2.5 to 0.2
Are these LH and FSH drops concerning?
Also the Dr increased my Test Cyp to 150mg / week
kept my HCG at 400 IU twice a week,
And kept my AI at .15mg everyday.
Estrogen went down from 180 to 73.
What is weird is that my Free Test dropped from 61.6 pg/ml (Quest Diagnostic; range 35-155 ) to 18.1 pg/ml (Lab Corp; range 9.3 -26.5) but is still in range. I don't quite understand the discrepancies.

[kelkel]

LH & FSH dropping is absolutely normal. Your body senses it no longer needs to produce them so they shut down.
It appears your FT went up, not down. Just different ranges. Stick to one lab if possible.
To me it seems you have a doc that's on top of things at this point. Evaluate labs in another few months and adjust.

How do you feel?

[OingoBoingo]

I'm more conservative so would rather titrate at 20mg instead of 50mg. It looks like you're headed in the right direction.

Like kelkel asked, how do you feel?

[Chauffeur]

How so? My blood work shows Estradiol is in range at 19 pg/ml.

A total estrogen test measures the amount of E1, E2, and E3.

E1 and E3 are relatively weak estrogens and aren't known to cause symptoms unless they are extremely high.

E2 (estradiol) is a very strong estrogen and is responsible for causing the symptoms that men associate with elevated estrogen levels.

So if your E1 and E3 are high, no worries. If your E2 is elevated, you'll probably have some issues.

Was your estradiol value of 19 from the sensitive estradiol assay? If so, that's not a bad place to be. If it was 19 on the standard assay, that's far too low. The standard assay significantly overstates actual E2 values when measuring low levels found in men.

It's not uncommon to have a 20-30 point discrepancy between the 2 values.

[kelkel]

A total estrogen test measures the amount of E1, E2, and E3.

E1 and E3 are relatively weak estrogens and aren't known to cause symptoms unless they are extremely high.

E2 (estradiol) is a very strong estrogen and is responsible for causing the symptoms that men associate with elevated estrogen levels.

So if your E1 and E3 are high, no worries. If your E2 is elevated, you'll probably have some issues.

Was your estradiol value of 19 from the sensitive estradiol assay? If so, that's not a bad place to be. If it was 19 on the standard assay, that's far too low. The standard assay significantly overstates actual E2 values when measuring low levels found in men.

It's not uncommon to have a 20-30 point discrepancy between the 2 values.

Very well put.

[thic-tac]

LH & FSH dropping is absolutely normal. Your body senses it no longer needs to produce them so they shut down.
It appears your FT went up, not down. Just different ranges. Stick to one lab if possible.
To me it seems you have a doc that's on top of things at this point. Evaluate labs in another few months and adjust.

How do you feel?

I feel good in all area except for one. I started getting HSA II about 4 weeks after first starting TRT. I had this type of migraine in the past but it would typically go away after a few days and things would go back to normal. Now, its been going on for about a month and I forgot to mention it to the Dr last week to see if it could be exasperated by the TRT.