39yo male started trt 1/15/16

Hello,

As the title says I started trt a few weeks ago. Been lurking the forums in order to gain a basic understanding how to do this correctly as my GP doesn't seem to have a ton of experience or (dare I say?) knowledge about it. Thought I'd post formally and try to garner some guidance.

Symptoms (to name a few): low libido, depressive episodes, anxiety, terrible concentration, cognitive decline, energy decline.

Lifestyle: cycling(approx 3500mi/yr), running, rowing, body weight training and trx. I try to do something everyday. I travel a lot. Father and husband.


I understand that the community may need to see more data on my BW but I'll include the basics. Please tell me what else you'd like to see and I'll provide it. Although I have a feeling that I have not been tested for everything that would be recommended.

BW (initial) 12/15/15:
T-Serum 330 (348-1197 ng/ml)
Free t 5.0 (8.7-25.1 pg/ml)

BW (to check LH levels I guess?) 1/14/16
LH 8.8 (1.7-8.6 mIU/ml)
FSH 6.3 (1.5-12.4 mIU/ml)

NO ESTRADIOL TEST YET (I'm concerned about this)

Diagnosed Hypogonadiasm primary
Prescribed 200mg test cyp EOW

1st pin 1/15/16 200mg test cyp

1st follow up BW 1/20/16
T, serum 890(348-1197 ng/ml)
Free t 21.9(8.7-25.1 pg/ml)

After reading threads I learned that EOW is not recommended and I understand why. I appealed to my doc and he approved 100mg every week.

So that's where I'm at. 100mg t cyp every week. I pin myself. Next BW scheduled in 4 weeks. No idea where my E2 levels are.

My intentions are to optimize my treatment. I feel like the only way I can do that is to educate myself so that I can, in effect, counsel my doc on the correct way to go about this. Don't know if he'll get on board but if he doesn't I'll find another. I've experienced some of the benefits of treatment (libido, energy, confidence) and want to continue (correctly) so that I can get back to my old self.

Any input/advice would be appreciated.

I'm new to TRT so I'll tread lightly with advice. With that being said, I'd try to split your shot into 50mg every 3.5 days (Sunday night and Thursday morning is what I do) and think about adding HCG even if doc won't prescribe it. That's what I'm going to do.

Also, as I've said in a couple other threads...if your primary care doc doesn't know what they're doing, then set up an appointment with a Urologist. They are way more familiar with prescribing test and running the right blood work. Way better than an Endo (they are more familiar with diabetes than hypogonadism).

Good luck!

Also, if you need to pull your own blood work, check out priva te md la bs. c o m or dis counte d labs . com

i agree with charlie
3.5 days is best - if only because you will get less conversion of your T to E- more bang for buck.
I assume you are injecting sub Q- if you find the increase in injections into muscle troublesome- this is a great alternative.

I wouldnt get HCG without your drs knowledge- do all you can above board- you need your dr more than he needs you- cherish the relationship, but do investigate a uro if you find one that has more experience than your current dr.

Solid advice from the guys above. EOW injections is ridiculous and based on terminal life. Weekly is far better but twice weekly keeps serum levels much more stable.

I've been inserting these pics lately to give guys a visual on how quickly test metabolizes after injection. To me, it makes it clear how twice weekly injections are superior.

http://circ.ahajournals.org/content/...7/F3.large.jpg


And welcome to the forum. Great first post.

Thank you for the replies.

I'm self injecting every 3.5 days now based on the empirical experience of everyone. 50mg per pin. IM. Kel, thank u for the graph. Simple visual of treatment doses and effect logic.

Thanks for the suggestion of sub-q option. I've been comfortable enough so far with IM but good to know. Also, I appreciate the perspective on doc/patient relationship. I'll talk to a trusted compound pharmacist I know to see if he knows a decent uro just in case.

I'm interested in hcg but will be patient, stay above board, and work with my physician at my next appt in 3 weeks.

I will post BW and treatment plan in a few weeks.

2 questions:
1.) what type of E2 test should I request? Sensitive? Ultra sensitive? Regular (for lack of a better term)?
2.) should I wait for the e2 test results before lobbying for an ai?

Thank you all.

Re E2:

https://www.labcorp.com/wps/portal/!...l%2C+Sensitive

Yes, wait. Goal is to not use one unless absolutely necessary.