Been On TRT for 10 Months Consistently Cannot Dial In.. Bloodwork Here. 29yr/M

[Stormyyy]

Hey guys,

I have been on TRT for 10 months consistently now through Defy.

I am 29 years old, active 6'4" 245 lbs (workout 3-4 times a week), overall a good diet (high protein, average carb, lower fat diet).

Current protocol: 40mg of T Cyp EOD, 200iu HCG EOD, occasionally 5mg of Cialis troche.

Vitamins: 1 B12 dissolving tablet, 5000iu D3, 4000mg Fish Oil, 200mg of DIM on T days and 100mg of DIM on HCG days (Estrogen control), Cholestoff Plus 1 serving, Red Yeast Rice 1 serving. I have just purchased Berberine to do 500mg 3x a day for Cholesterol and blood sugar.

I have a history of Anxiety (used to take anxiety meds from doctor) but TRT has helped it a bit. I have occasional panic attacks and would still like to get those under control without prescription medicine.

I have low energy, especially on the weekends when I don't have to go to work.. I can't get anything done and it is hard to get out of bed. I have a very low sex drive (gf gets mad a lot because I don't want sex).

Please review my bloodwork and let me know what you think as well as my symptoms. I have also started injecting into my upper thigh for T subcutaneous and my hcg has always been done in my belly fat.

**Note on bloodwork*** These are my recent labs, but I will say that I did not fast beforehand, I took HCG a couple of hours prior so I think it made my Total T way higher than what it actually is. *Post number 3 and 4 have more bloodwork, sleep apnea sleep study, and cortisol 24hr saliva test as well*

[kelkel]

Dr. Saya is one of the best around....

What is he telling you that you doubt?
Where do your lipids normally run on fasted blood work? I'm aware some of the newer theories don't require fasting, etc.
Why an EOD test protocol? Did you start on something different and adjust?
Any further thyroid testing as your TSH level is high? I know, not on that range but it's old. More modern range is .3 - 3.0 and anything over 2 should really be investigated. Problems here can cause a myriad of issues. Should probably see FT3, FT4, RT3 and Antibodies.

[Stormyyy]

Dr. Saya is one of the best around....

What is he telling you that you doubt?
Where do your lipids normally run on fasted blood work? I'm aware some of the newer theories don't require fasting, etc.
Why an EOD test protocol? Did you start on something different and adjust?
Any further thyroid testing as your TSH level is high? I know, not on that range but it's old. More modern range is .3 - 3.0 and anything over 2 should really be investigated. Problems here can cause a myriad of issues. Should probably see FT3, FT4, RT3 and Antibodies.

Hey thanks so much for the input! I agree, Dr Saya is great, but since his knowledge costs money after each blood test, I cannot afford that in my current position and I know you guys are knowledgable as well on here so I figured I would get some other feedback as well.

Dr. Saya is the one that put me on the protocol I am currently on. He stated that this is because my SHBG is on the lower side so I need the injections more frequently, which I agree since I do feel better compared to when I used to go to the clinic and they would just inject me once a week with a higher dose.

Here is the bloodwork I did with Defy prior to getting put on Test Therapy again. Keep in mind, during these blood tests I was on 25mg of Clomid ED dose. I had just came off of T a few months prior to that from the local clinic and was trying to reboot my production naturally, but I did not respond well and after coming off of Clomid my T level tanked (Total T was back in the 200's). So I am stuck on this needle for life unfortunately...

This bloodwork will show you what my lipids were when fasting. I believe the Triglyercides being over 400 was because I did HCG and ate in the morning prior to my blood draw.. I'm going to get another draw done in a couple of weeks since I just gave blood today to help get my hematocrit back down. This bloodwork has the full Thyroid things on there as well.. Defy said my Thyroid is normal as well and according to these ranges, yes, but I'm not sure if it is really is or not.. Please let me know. Thanks a lot!

[Stormyyy]

Dr. Saya is one of the best around....

What is he telling you that you doubt?
Where do your lipids normally run on fasted blood work? I'm aware some of the newer theories don't require fasting, etc.
Why an EOD test protocol? Did you start on something different and adjust?
Any further thyroid testing as your TSH level is high? I know, not on that range but it's old. More modern range is .3 - 3.0 and anything over 2 should really be investigated. Problems here can cause a myriad of issues. Should probably see FT3, FT4, RT3 and Antibodies.

Pictures would not fit with full bloods so here are the other 2 and here is a full cortisol 24 hr salvia test I had done as well since I suffer from anxiety.. *Edit* I'm also attaching the sleep study I had done as well that shows Mild Sleep apnea. I had this done 5 months after I started TRT with Defy, which I heard you could have more sleep apnea with taking TRT. Is this True? Thanks

[Stormyyy]

Dr. Saya is one of the best around....

What is he telling you that you doubt?
Where do your lipids normally run on fasted blood work? I'm aware some of the newer theories don't require fasting, etc.
Why an EOD test protocol? Did you start on something different and adjust?
Any further thyroid testing as your TSH level is high? I know, not on that range but it's old. More modern range is .3 - 3.0 and anything over 2 should really be investigated. Problems here can cause a myriad of issues. Should probably see FT3, FT4, RT3 and Antibodies.

Have you had any time to look at my blood work I posted?

My biggest concern is my Low Ferritin level, my high hematocrit, my thyroid, and the sense of well being I don't currently have.. Like today I had a horrific panic attack that was almost impossible to recover from.. I thought TRT was supposed to help with anxiety spikes?

Can anyone please help? I'm a hypochondriac and my anxiety has been through the roof with all of this.. I have started injecting my test into my stomach too.. will that cause a spike in anxiety? I got a smaller needle since I do a small 40mg dose EOD so into the stomach has been helping ease the soreness.

Thanks much!

[assguy22]

Dr. Saya is one of the best around....

What is he telling you that you doubt?
Where do your lipids normally run on fasted blood work? I'm aware some of the newer theories don't require fasting, etc.
Why an EOD test protocol? Did you start on something different and adjust?
Any further thyroid testing as your TSH level is high? I know, not on that range but it's old. More modern range is .3 - 3.0 and anything over 2 should really be investigated. Problems here can cause a myriad of issues. Should probably see FT3, FT4, RT3 and Antibodies.

@kelkel what target level for TSH during thyroxine therapy do you think is better? I'm @3.7 with 75mcgs of levotiroxine and I feel like shit, My doc says it's ok but I feel really bad, very tired all the time and not even able to concentrate or just read a book, the same symptoms as when I wasn't in treatment. Should I go to other Dr.? Maybe my thyroid is ok and now it's only low T problem (still in the 300's).

[kelkel]

We'd have to see all your numbers to assess that. I would lean toward your T being the issue right now as well. If your Total T is low then your Free T (what actually works for you) would normally be low as well, assuming a normal shbg level. Straighten your T out then see how you feel.

Think about this, so many guys go to doc's for basic depression and docs throw meds at them when in reality their T is low. Correct the T issue and the depression issue more often than not is corrected as well. Just an analogy...

[Stormyyy]

We'd have to see all your numbers to assess that. I would lean toward your T being the issue right now as well. If your Total T is low then your Free T (what actually works for you) would normally be low as well, assuming a normal shbg level. Straighten your T out then see how you feel.

Think about this, so many guys go to doc's for basic depression and docs throw meds at them when in reality their T is low. Correct the T issue and the depression issue more often than not is corrected as well. Just an analogy...

No one can help me? I posted the bloodwork that you asked for..

[kelkel]

I'll review the whole thread again when I can. It's not something I'd want to do quickly or callously. Probably tomorrow during the day Stormyyy. The more complicated the post the less replies you normal get as guys don't want to steer someone in the wrong direction.

[OdinsOtherSon]

I'll review the whole thread again when I can. It's not something I'd want to do quickly or callously. Probably tomorrow during the day Stormyyy. The more complicated the post the less replies you normal get as guys don't want to steer someone in the wrong direction.

Bingo!

[kelkel]

Have you had any time to look at my blood work I posted?

My biggest concern is my Low Ferritin level, my high hematocrit, my thyroid, and the sense of well being I don't currently have.. Like today I had a horrific panic attack that was almost impossible to recover from.. I thought TRT was supposed to help with anxiety spikes?

Can anyone please help? I'm a hypochondriac and my anxiety has been through the roof with all of this.. I have started injecting my test into my stomach too.. will that cause a spike in anxiety? I got a smaller needle since I do a small 40mg dose EOD so into the stomach has been helping ease the soreness.

Thanks much!

I must be missing it as I do not see Ferritin on your blood work? But if it is low, couple that with elevated hematocrit and sure you can be feeling lethargic. Either issue can make you feel this way. You need to give blood which will instantly help. If you are in fact low in Ferritin consider supplementing with Elemental Iron at maybe 65mgs per day. Take it with Vit C for best absorption.

TRT can help with anxiety and depression but it's no panacea and won't fix everyone. But there's no doubt your body will function better with optimized hormones that it would without. I've also not heard of test enhancing issues with sleep apnea. There's writing on it but no functional studies confirming this. Seems to be all conjecture at this point.

Very sorry to hear of your panic attack. Staying calm and not obsessing on numbers will really help you if you can. SQ injections into belly fat is just fine for small amounts of Test. It's a bit slower in absorption but the results are the same. You'll be fine with this.

Step one is to give some blood. I can feel a difference almost immediately after doing so if my hema is elevated. I bet you will too. Consider the elemental iron as well if Ferritin is low.

[jwh7699]

I have had Low T for about 5 years and dialed in for about 3 years. I know from my own experience it takes time to find out what dosing works best for you. You don't want to adjust multiple things at once. It's better to adjust one thing at a time that way you know what worked.

As far as Estradiol goes, when it is too high or too low it can make me Moody. Usually if it's too high I'm more lethargic and mopy and when it's too low I'm more irritable. I recently stopped taking an AI for a month. I am back on it and at a slightly higher dose of Test. As it adjusts right now, I'm kind of fluctuating between Mopy and Irritable. Fortunately I have been on TRT for a few years and am more self aware of my "Hormone Moods".

Unfortunately like Kel mentioned it won't remove Anxiety 100%, but once you get adjusted you should feel more awake and hopefully calmer. Nothing wrong with taking a Xanax or a Lorazapam to help. When you become impatient on waiting for a response, read up some more on TRT. There are a lot of good Educational Sticky Posts. If that doesn't do it. Go for a walk and get some from fresh air.

I've had Sleep Apnea for about 4 years. Unfortunately TRT will not cure you of sleep apnea. As you probably already know, sleep apnea is more about the neck. It relaxes and closes the air way and we automatically cough or gasp to re-open it and it happens over and over all night long. You may lose some weight with the help of TRT and this will make breathing easier.

Read and Educate yourself and try not to stress so much.

[Stormyyy]

I must be missing it as I do not see Ferritin on your blood work? But if it is low, couple that with elevated hematocrit and sure you can be feeling lethargic. Either issue can make you feel this way. You need to give blood which will instantly help. If you are in fact low in Ferritin consider supplementing with Elemental Iron at maybe 65mgs per day. Take it with Vit C for best absorption.

TRT can help with anxiety and depression but it's no panacea and won't fix everyone. But there's no doubt your body will function better with optimized hormones that it would without. I've also not heard of test enhancing issues with sleep apnea. There's writing on it but no functional studies confirming this. Seems to be all conjecture at this point.

Very sorry to hear of your panic attack. Staying calm and not obsessing on numbers will really help you if you can. SQ injections into belly fat is just fine for small amounts of Test. It's a bit slower in absorption but the results are the same. You'll be fine with this.

Step one is to give some blood. I can feel a difference almost immediately after doing so if my hema is elevated. I bet you will too. Consider the elemental iron as well if Ferritin is low.

Hey thank you so much for replying back! I've been waiting on it because I know how knowledgable you are from reading your other posts. I will post my labs with Ferritin and iron below. Won't taking iron increase my hematocrit even more? Also, please check my iron levels on the bloodwork that I'm posting below as well. It shows that my iron levels are within "normal" levels so it is weird that my ferritin is low.

I actually just gave blood on Sunday and that usually makes me feel worse actually. I'm not sure why but it always make me feel much worse. I still don't feel like I have fully recovered from it yet. I have been trying to drink plenty of orange juice and apple cider to get my sugar levels back up, but it doesn't seem to be helping that much. I went out to a really busy bar tonight with my parents and had to leave because of my anxiety spiking so high.

I went to the doctor and he put me back on Lexapro 5mg to start and 10mg to get up to in a couple of weeks. I also got clonopin as needed as well since these are the two things that helped with anxiety attacks in the past. Do you think these are safe to use with TRT or in general? I really didn't want to go back on it, but hopefully it helps and it will allow me to do my desk job again soon.. I took a couple of days off of work from that panic attack so I really want to get to feeling better again soon.

Did you get a chance to look at the thyroid labs I posted? Did anything else stand out to you like DHEA or Progesterone or anything? I'm glad to hear that the sub q into the belly fat is okay to do for the Testosterone . It is way easier for me to do and painless for doing EOD injections. I have just been doing the HCG and test into my bell fat.

Please let me know, especially about the thyroid and the ferritin/"normal iron levels.

EDIT: Here are the labs with Ferritin, Iron, etc. I took these labs 4 months after starting with Defy. This is where my total T/free T are typically at with TRT as well to give you a better idea since I didn't do an injection before going into the doctor. This was on the EOD of Test at 40mg, HCG at 200iu EOD through Defy.








Thanks a lot!!! I really appreciate it!

[Stormyyy]

I have had Low T for about 5 years and dialed in for about 3 years. I know from my own experience it takes time to find out what dosing works best for you. You don't want to adjust multiple things at once. It's better to adjust one thing at a time that way you know what worked.

As far as Estradiol goes, when it is too high or too low it can make me Moody. Usually if it's too high I'm more lethargic and mopy and when it's too low I'm more irritable. I recently stopped taking an AI for a month. I am back on it and at a slightly higher dose of Test. As it adjusts right now, I'm kind of fluctuating between Mopy and Irritable. Fortunately I have been on TRT for a few years and am more self aware of my "Hormone Moods".

Unfortunately like Kel mentioned it won't remove Anxiety 100%, but once you get adjusted you should feel more awake and hopefully calmer. Nothing wrong with taking a Xanax or a Lorazapam to help. When you become impatient on waiting for a response, read up some more on TRT. There are a lot of good Educational Sticky Posts. If that doesn't do it. Go for a walk and get some from fresh air.

I've had Sleep Apnea for about 4 years. Unfortunately TRT will not cure you of sleep apnea. As you probably already know, sleep apnea is more about the neck. It relaxes and closes the air way and we automatically cough or gasp to re-open it and it happens over and over all night long. You may lose some weight with the help of TRT and this will make breathing easier.

Read and Educate yourself and try not to stress so much.

Hey thanks for your post, I really appreciate it! I really figured my mild sleep apnea was due to my slight deviated septum. My one nostril doesn't really flow that well and is almost always clogged. I try to do Flonase but it doesn't seem to help much.

I went to the doctor the other day and he put me back on Lexapro 5mg (will switch to 10mg soon), .5mg of klonopin as needed. So far it doesn't seem to help much either since I went out to eat to a bar and it was really noisy and crowded and I had another panic attack and had to leave early. I really wish I could figure this stuff out.

Since you have been on TRT for so long do you think my protocol of EOD 40mg of Test and 200iu of HCG is good? I will definitely try to cut some weight but being 6'4" and around 250lbs, I'm mostly muscle. I carry a bit in my waist and hips but that's most it. I could probably get down to a clean 215lbs and that would be perfect. I just don't want to lose too much muscle. With my sleep apnea being mild, you don't think I need the PAP machine do you? I tried it but since I can't really breathe out of that one nostril that well, it is very difficult to use a mask that you have to breathe out of your nostrils, lol.

Thanks for your help though!

[kelkel]

Not that weird that your Ferritin is low. Ferritin has to do with iron storage. Yours is barely below range and remember it's just a snapshot in time. I would not treat it at this point but would monitor it. Yes, iron can increase hema but the amount you would take I'd imagine would be barely (if at all) noticeable.

Re giving blood I have to think it's more psychosomatic that it makes you feel off. Honestly you could probably use another donation very soon. Regarding the meds interacting with testosterone , I see no issue whatsoever. Test is bio-identical and your levels are not supraphysiological. I think your thyroid levels are fine. When it comes to your progesterone level being high odds are that's simply due to your HCG injections which can spike it briefly. Normally estrogen would rise before prog but that's not the case here so odds are it's the HCG. No worries.

[jwh7699]

I personally use a full face mask, one that covers the mouth and nose. I don't think the nose only one's are very practical. For one your nose can't be blocked at all and two while you're using a nose mask you're supposed to sleep all night with your mouth closed which I think is not very doable. They do sell a strap to Velcro over your head to to keep your mouth closed, but that seems more annoying then wearing a mask.

It depends on what your Doctor said regarding your level of sleep apnea, how often it might be waking you up and how rested you feel in the morning. You could try recording yourself for a couple of hours while sleeping to see how loud you snore. If you decide to use the cpap I would recommend a full face mask. I'm a side sleeper. I tie a knot in each velcro strap that way it can't detach while I'm moving around and side sleeping. If you decide to not use it for now, you could try wearing a breath right nose strip to bed to see if that helps. I would defiently try recording yourself.

Lexapro is a good medication. If you haven't taken it before or have stopped taking it for awhile it usually takes a couple of weeks, 2 or more, before you feel a difference. When going somewhere that may cause Anxiety I recommend taking the Klonopin 30 minutes before, this will give it time to kick in. It can make you sleepy, so avoid Alcohol while taking it.

The EOD protocol is the only protocol I haven't tried. I inject 65mg of Test C 2 x a week and 250mg of HCG 2 x a week.

I have tried the everyday protocol before and didn't like it. Too many injections, all my Testosterone numbers went down and for some reason I just felt weaker on that type of dosing.

EOD is very close to the 2 x a week Injections. Best thing to do is to keep tabs on your Blood work and how you feel. Based on the blood work above your Testosterone levels look good.

[TRA]

No one can help me? I posted the bloodwork that you asked for..

I personally don't think your thyroid based on results is going to give you the symptoms as profoundly as you prescribe them. Are you on CPAP for sleep apnea, because I think there you have your answer.

If you are on any SSRI's or other similar meds they can wash you out as well, but that is not advice to not take them.

Being depressed for whatever reason doesn't show up on labs, and depression and anxiety go hand in hand. No doubt your TRT is helping, but you expend a lot of energy with anxiety and being admittedly "hypochondriac" wreaks havoc on your brain chemistry and energy levels as well. Try not to embrace that. It can only get worse. There are a lot off non pharmaceutical means of addressing it in addition to medications.
There is nothing very alarming in your bloodwork in terms of the symptoms you describe. For general health purposes I would definitely focus on the TG, HDL and get rid of some blood at some point. But as far as anything else, you sound somewhat neurotic (and I mean this to be honest, not critical or cutting) and that will eventually wear you out.

Good luck. Stick tight with the TRT and try to find constructive ways of changing the way you perceive things with your health.

[TRA]

Not that weird that your Ferritin is low. Ferritin has to do with iron storage. Yours is barely below range and remember it's just a snapshot in time. I would not treat it at this point but would monitor it. Yes, iron can increase hema but the amount you would take I'd imagine would be barely (if at all) noticeable.

Re giving blood I have to think it's more psychosomatic that it makes you feel off. Honestly you could probably use another donation very soon. Regarding the meds interacting with testosterone, I see no issue whatsoever. Test is bio-identical and your levels are not supraphysiological. I think your thyroid levels are fine. When it comes to your progesterone level being high odds are that's simply due to your HCG injections which can spike it briefly. Normally estrogen would rise before prog but that's not the case here so odds are it's the HCG. No worries.

I agree with this ^^^

[Sh0tsf1red]

I'll review the whole thread again when I can. It's not something I'd want to do quickly or callously. Probably tomorrow during the day Stormyyy. The more complicated the post the less replies you normal get as guys don't want to steer someone in the wrong direction.

You're going to have to start doing private consults!