Second guessing TRT decision. low end of average T, low Estradiol, Hypothyroid..

[beleaguered]

Hi Guys,

I'm hoping you can help me clarify my situation somewhat. A week ago I was put on a TRT protocol and prescribed Thyroid medication for Hypothyroidism. At the time, I thought, 'Fantastic, a solution to my problems, action instead of paralysing fear!" Now, I'm second guessing the decision and wondering if I'm making a mistake. There's just so much information out there, and so much of it is conflicting, it's kind of sending me into a tail dive of uncertainty.


FYI; 38 yr old male.
6'1
107kg

I have felt kind of shitty for a long time: bad sleep (insomnia), lethargic, brain fog, impossible to put muscle on, no matter how much I tried. Gaining weight even though I stick to a very low carb paleo type diet for 80% of the time and try and keep my calories under 1800 a day. I put almost 10kg on the last year while trying to actively lower my weight - quite frustrating.

I always thought my natural inclination was just to be lazy and fat with a low sex drive. I wondered if I had depression, but didn't want to go down that route as i've had friends on SSRI's and i really didn't like the effect it had on them.

I originally got tested as I have small varicoceles I wanted checking out, as well as I've noticed my orgasms have been quite weak and getting worse over the last year. The urologist tested my blood (First round of tests) and said that my Testosterone was a bit low but nothing concerning, and that I should just take vitamins, get better sleep (ha!) and it will sort itself out.

I did that, then got a second round of tests, where I asked the lab to do some more tests than the initial round. The Urologist was happy with my results and just told me to diet and exercise. He didn't think surgery was warranted on the varicoceles unless I have problems conceiving in the future. I didn't feel totally happy with this result, so I found a hormone specialist clinic, and got a full workup from them. That you can see as the 3rd column of results.

In addition to the bloodwork, I also got a Thyroflex test as part of the workup, and it showed all the reflex scores as firmly in the red 'Hypothyroid' scores. I also somehow have become 36% body fat which the doc said was the primary goal to fix.

Based on these results, the doc put me on :

- 100mg (0.5 ml in the syringe) Testosterone Enanthate injected weekly IM. He wants my levels to get to around 700-900 ideally.
- 2 grain Biothroid (Contains T4 and T3) 1 hour before food in am
- Iodine 12g at breakfast
- Glucophage 500mg am and PM (i switched to XR a yesterday, and that seems to have stopped the incredible squits it was giving me)
- D3 10,000IU at night
- Bergamot supplements with dinner, supposedly will help with the cholesterol.

My reading lines up mostly with his prescriptions, but after going through my results one by one, it seems my Estradiol is super low, and that wasn't mentioned. I think bringing up my testosterone will have the side effect of raising the Estradiol as well, but i wonder if something separate needs to be done about that.

It's been about 7 days since I started this protocol, and the only noticeable difference I've seen has been a bit more endurance/strength in the gym, though that might be placebo, and more frequent, better erections and much better orgasms, and that's definitely not placebo.

I tried to link to a spreadsheet, but the spam filter won't let me use URL's

pertinent info:


Test (Total) 3.83 ng/mL
Test (Free) 100 pg/mL
T3 1.18 ng/mL
T4 9.74 ug/dL
TSH 2.45 uIU/mL
Vit D 18.5 ng/mL
FSH 3.6 mIU/mL
LH 4.3 mIU/mL
Prolactin 7.3 ng/mL
Haemocrit 42%
Estradiol II 29.68 pmol/L
DHE 354.6 ug/dl
IGF-1 252 ng/mL
PSA 0.911 ng/mL
Cholesterol Total 276 mg/dL
HDL 62/mg/dL
LDL 184 mg/dL
Triglycerides 77mg/dL
Cholesterol HDL ratio 4.45



My questions are:

1. My Testosterone is on the low side at 430 last test, but not in the commonly held "Under 300" area. Yet the Doctor seemed very convinced/convincing that based on the results combined with my symptoms and physical appearance (very little body hair/patchy beard, fat accumulated around midriff), that I would benefit greatly from TRT. I'm wondering if this is common - are there any others around here that started TRT with numbers similar to mine? I feel I may have jumped the gun, but I want to give this a shot as it were..

2. The Estradiol. Is quite below the reference range and I've read that low E can give you similar symptoms as low T. I'm going to go back to the doctor and ask for further clarification on that, but should I expect that the TRT will adjust the Estradiol up to better levels as a side effect?

3. I've gotten a lot of scaremongering comments about how TRT will kill my balls forever and that there's no going back. I'm single, but i would like to have kids in the future. I realise, that it will be a few years before thats realistically likely. I told my doctor, and he said that he's used things like clomid to get his patients fertility on track when it's needed. I know a lot of bodybuilders go on testosterone cycles and then restart, so it seems like not as big a deal as people make it out to be... is it?

4. On another forum, someone mentioned that if my levels were 430 before going on TRT, then the levels after injections peak would dip below that midweek, and I would feel worse than before - I'm trying to wrap my head round this - if this is a concern, how should I express it to my Doc? Is the solution to split the dose into more frequent injections, or higher weekly doses? I'f I'm going to go through all this, I want to be at optimum levels not just hovering around average...

Sorry if I'm being too much of a noob, it's just a lot to process..

[The_Crawfish]

1. Free test is the important number, total can be high with free being low, and you'll feel like shit with the symptoms u listed. Ranges are important when u list your lab work
2. Doesn't look low to me, but again reference ranges are needed.
3. Bullshit....HCG
4. Nobody can tell u what your numbers would be at at any given time, that's what blood work is for. What they're talking about is, once you inject test, your body stops making it. Therefore the only test in your body, is what you put in it. All of your natty test goes bye bye.
Most people here pin at least twice a week to avoid the ups and downs.

[beleaguered]

1. Free test is the important number, total can be high with free being low, and you'll feel like shit with the symptoms u listed. Ranges are important when u list your lab work
2. Doesn't look low to me, but again reference ranges are needed.
3. Bullshit....HCG
4. Nobody can tell u what your numbers would be at at any given time, that's what blood work is for. What they're talking about is, once you inject test, your body stops making it. Therefore the only test in your body, is what you put in it. All of your natty test goes bye bye.
Most people here pin at least twice a week to avoid the ups and downs.

1. the range from the Lab of the Free test is 35 - 155 pg/mL. This seems to be in the middle
Also, I just noticed, my first blood gave me 3.83 ng/ml (reference 2.8 to 8) then after taking a load of vitamins and working out hard for 6 weeks, i got it to 431 ng/dl (reference 285 to 801), but the doc wasn't happy with it and said it should be much higher.

2. The reference for the Estradiol is 49.6 - 218pmol/l so my numbers of 29.68 are pretty low.

3. Are you saying HCG is something I should be on now, or something to look at when i need it?

4. Im only halfway through the 2nd week, so I can't tell if I'm getting ups and downs or not - will it be obvious if I need to change to twice a week?

Thanks again for looking at this !

[The_Crawfish]

The lab work you posted was taken BEFORE you started trt?? If so, I'm far from an expert and your doc may have other info that we don't know about, but I can't see why he put you on trt to begin with??
I don't know why your e2 would be low, given your middle to upper ranges of test.
Yes, if you're on trt, HCG should be part of your protocol. Read this for HCG info... http://forums.steroid.com/hormone-re...ould-know.html
The ups and downs I was talking about is more along the lines of your test numbers not necessarily how you feel (although it's definitely possible you would feel it). The half life of t-cyp is 8 days, so if you inject every 7 days, there's somewhat of a roller-coaster effect.