TRT issue need some direction/guidance on next steps

[Toiaphi]

I originally posted this in the induction area and figured it was better suited here in the TRT forum.

Hey all,

I've been reading posts in here off and on for years. I figured it was time to join since I've just started TRT and need some help with some issues.
Quick background on myself:

My name is Phil, I'm 27 and been having issues with Low T most of my adult life. Endo believes it's related to delayed onset of puberty and delayed GH output during that time. I also had issues with hypothyroidism during puberty which righted itself after.

Numerous testing of my levels show I've never gone last 500-550 ng/dL, with the latest being 230 and hovering around there. All testing was A.m. Within an hour of waking. I tried many different means naturally as I felt I was too young to start and didn't even think to ask. I tried natural test boosters and has a very strict clean diet. It was a struggle to gain weight in the last 7-8 years. More recently I've been having issues with gyno and nipple sensitivity (my estradiol levels never went above normal) and low sex drive and unwanted fat gain. I finally sought treatment. My endo Put me on androgel . In that time my test levels only climbed to 380 and my gyno and sensitivity remained... All while having little to no sex drive still.

I decided to reach out to a TRT clinic and was placed on 200mg test cyp weekly as well as hcg . I have been feeling great, my drive to get up in the morning is back, my sex drive is back, and I'm feeling over all great. My gyno and sensitivity virtually disappeared.

Now I'm six weeks in and I'm having sensitivity issues again like as bad as they were at my lowest T levels.
My levels now, two days after injection, 1300 ng/dL and my estradiol is 82.0 on a scale of 0.0-40.0.

After that long drawn out post my questions are the following:
will my body adjust itself to the new T levels over time and my estrogen reduce slightly/level out here or will they continue to rise?
Should I take tamoxifen that was prescribed by my endo or try to get on Adex from the TRT clinic?
Would I benefit from DIM and other natural options while being on TRT or would the returns Fein the supplements diminish over time?

Thanks In advance.

[2Sox]

Welcome to the forum. Best place to be for the concerns you have and you will find the answers to your questions.

My suggestions are as follows:

Reduce your T dose to 100mg/week - doing 50mg twice a week.

The dose you are one is rather high and is apparently the cause of your returning nipple sensitivity. 200mg at one time will drive up your estrogen response. If that estradiol level is from the "sensitive" test, you are really, really high! Look into Exemestane/Aromasin. IMO, and from my experience, it is gentler and much easier to get a handle on the proper dosing.

I've done Adex and I personally found it to be impossible to get the dosing right and it has a horrible rebound effect. Tamoxifen I've never taken. The thing you want is to find the lowest dose and weakest medication to address your symptoms. I'd say to start with Exemestane and see how you feel. I'm still experimenting with the timing of my dose but it's so gentle that it's easy to do.

My T dose in 84-98mg/week - I divide this by seven because I inject SQ every day along with my hCG - at 100iu/day. Yes, daily to keep the estrogen response at a minimum. (You must know that T converts to E). And I'm stretching my Aromasin dose out to 12.5mg every 10 days or so. At this point, I may not need to take it anymore but I have to do a little more research with my blood work before I make that decision. But the main thing is that I'm feeling very good where I am.

[Toiaphi]

I did not state above but it's 200mg a week at two 100mg injections. So I should still drop down to 100mg at 50mg an injection?

Also thank you for the prompt reply! I appreciate it. And regarding DIM and other agreements, would I see an benefit there?

[IncreaseMyT]

You need to do 0.5mg of anastrozole the day of your shot or the day after. That should correct your E2. Please ask your doctor first.

Just FYI if you are idiopathic hypgonadotropic hypogonadism as the doctor is suggesting, you may be able to come off T in 3 months and return to normal.

It happened to 10% in a clinical trial and none used HCG.

Hope this helps.

[Toiaphi]

I forgot to mention before that I, in my younger years, had used Prohormones once(major mistake) and that may have made everything worse than it already was. My endo felt that could've been what has worsened my issues. I'll chat with the Dr from the TRT clinic about anastrazole and see what they feel is necessary. I'll talk to them too about dropping the dose down to correct the sides. Would keeping the same level of test but more frequent doses help combat estro increases as well?

[IncreaseMyT]

Maybe but based on your E2 your going to need an AI at least temporarily to get it down and stabilized.

[Toiaphi]

I'm going to be getting anastrazole Monday from them and hopefully have it righted in a couple weeks. I'm getting such great results overall I just don't want to have to stop or reduce because I'm side effect prone. :/

Thank you guys for responding so promptly

[Toiaphi]

I forgot to ask, would using tamoxifen for this week combat any of the sides until I can get aromasin or Arimidex? I'm dying with the sensitivity and what's borderline pain in my nipples.

[kelkel]

No sense starting tamox if you're getting adex on Monday. Adex will work very quickly.

[Toiaphi]

No sense starting tamox if you're getting adex on Monday. Adex will work very quickly.

I meant I would be ordering it Monday. Probably wouldn't come until Friday.

[kelkel]

I meant I would be ordering it Monday. Probably wouldn't come until Friday.

I'd still wait. Remember, sensitivity does not equal gyno. Hormonal changes routinely cause such sensitivity.

[Toiaphi]

I'd still wait. Remember, sensitivity does not equal gyno. Hormonal changes routinely cause such sensitivity.

Ok. I figured it could be my body trying to level OF causing some imbalance for a bit.

So I inject every M and Th 100mg at a time. With cyp being such a long half life could this contribute to my extreme high that my test was when tested on Wednesday? IE was that not a completely accurate number?

[kelkel]

Sure. Test will peak in 24 to 48 hrs metabolism dependent so yes, you basically tested at or near your peak. The thing with twice weekly injections is that you can usually get by with less T and less ancillaries, which has its benefits. Also prudent is the 5 day protocol that IMT recommends. I'm not a fan of once weekly protocols due to the large swing in T levels (as shown) but to each his own.

[Toiaphi]

Just an update: still waiting on my Anastrazole. I have been taking 10mg tamoxifen ED and it's been helping the sensitivity issues. I can tell my estrogen is still high(obviously), as my anxiety is heightened. My anxiety and stress was reduced little to none until my estrogen levels climbed up to where they are. Definitely making me drag and not want to do anything except worry.

[Toiaphi]

7/31 update. My BP has been high and I noticed a correlation with my high e2 and elevated bp. I'm hoping with anastrazole it'll lower and I'll be alright there.

What can I do to lower my bp aside from what I'm currently doing:

3g Fish Oil daily
100 mg CoQ10 daily
5000iu Vitamin D daily

And would my injections amount/ dosing regimen, be causing an elevated BP at six weeks in? Would I benefit from injecting every five days vs 3-4?