12 week BW TRT - Need Help

[fossilk1]

I just went for a 12 week BW and was retested for the normal stuff with added tests for curiosity. At this point my testosterone seems to be in optimal ranges for a 50mg Cypionate twice a week and 350iu HCG three times a week. No AI.


Seeing my E2 is now about >50, I do not think I am experiencing E2 side effects but should an AI be administered at this point?

I still have frequency with urination, and some days I am light headed, also appetite isn’t really there, sometimes I have some brain farts. No energy boost and motivation yet.

Any suggestions would be greatly appreciated, but as of right now I am not getting much out of my TRT protocol.

[Youthful55guy]

Your labs look good. A couple of comments:

1) ALT is a bit high. Are you taking OTC analgesics or some other drug that might affect liver enzymes (e.g., Naproxen or Ibuprofen)?

2) Cholesterol is borderline line high. Consider bringing it down with a low dose of statin.

3) Total T looks great, but free T is a bit high which is mainly driven by a somewhat lower range SHBG (though still well within range). About your only options here are to lower the T dose, or break it up into smaller and more frequent doses. Many guys with lower SHBG do daily or E2D subcutaneous injections with good results.

4) If you do not change your T dose schedule as I discussed above, you may want to consider very low dose anastrozole to bring the E down. See my thread on the Vodka/Eye Dropper method: https://forums.steroid.com/hormone-r...astrozole.html. I'd start with no more than 3 drops per day (about 0.3 mg per week) and then retest and adjust in about 6 weeks. Alternatively, the dosing schedule change I discussed in #4 may also help to bring E down.

[fossilk1]

Your labs look good. A couple of comments:

1) ALT is a bit high. Are you taking OTC analgesics or some other drug that might affect liver enzymes (e.g., Naproxen or Ibuprofen)?

2) Cholesterol is borderline line high. Consider bringing it down with a low dose of statin.

3) Total T looks great, but free T is a bit high which is mainly driven by a somewhat lower range SHBG (though still well within range). About your only options here are to lower the T dose, or break it up into smaller and more frequent doses. Many guys with lower SHBG do daily or E2D subcutaneous injections with good results.

4) If you do not change your T dose schedule as I discussed above, you may want to consider very low dose anastrozole to bring the E down. See my thread on the Vodka/Eye Dropper method: https://forums.steroid.com/hormone-r...astrozole.html. I'd start with no more than 3 drops per day (about 0.3 mg per week) and then retest and adjust in about 6 weeks. Alternatively, the dosing schedule change I discussed in #4 may also help to bring E down.

Thanks for the input. My ALT has been high for the last year and I do not take anything at all which may elevate it. Also I may consider taking a very small dose of an AI seeing my E2 is higher and prolactin.


My biggest concern is my DHEA which may be the reason why I have been having so much difficulties with everything lately. My sulfate is fine but my serum is through the rough... should I be concern?

Also RT3 was at 30 now it’s at 28... still high but slowly going down.

[Youthful55guy]

Thanks for the input. My ALT has been high for the last year and I do not take anything at all which may elevate it. Also I may consider taking a very small dose of an AI seeing my E2 is higher and prolactin.


My biggest concern is my DHEA which may be the reason why I have been having so much difficulties with everything lately. My sulfate is fine but my serum is through the rough... should I be concern?

Also RT3 was at 30 now it’s at 28... still high but slowly going down.

ALT and other liver enzymes can be affected by many things. The most common are OTC analgesics, some antidepressants, alcohol, and even exercise. Give that it's the only liver enzyme out of range and it's not that far out of range, I would not be overly concerned.

I saw the serum DHEA. Not sure what to make of it, as it's not commonly measured. Usually it's DHEA-s that's measured. Are you taking supplemental DHEA? The obvious advice if you are is to lower the dose. Not sure what else to tell you except dos some research on the internet. I'd be interested in knowing what you come up with.

I didn't see the RT3 lab. It's not one that I'd be overly concerned with. It often goes up when you cut calories drastically and/or up your exercise. It's a natural response by the body to conserve fat by lowering your metabolism. The fact that it is going down is good. I'd say, just keep monitoring it.

Per my previous post a small dose of anastrozole may be warranted to bring E down. Lowering the T dose too will also help to bring it down and to bring the Free T into range. Personally, I'd increase the frequency and lower the dose of T to work on both hormones at the same time. You mentioned prolactin. I don't recall your prolactin numbers, but I don't think anastrozole will have any impact on it.

[fossilk1]

ALT and other liver enzymes can be affected by many things. The most common are OTC analgesics, some antidepressants, alcohol, and even exercise. Give that it's the only liver enzyme out of range and it's not that far out of range, I would not be overly concerned.

I saw the serum DHEA. Not sure what to make of it, as it's not commonly measured. Usually it's DHEA-s that's measured. Are you taking supplemental DHEA? The obvious advice if you are is to lower the dose. Not sure what else to tell you except dos some research on the internet. I'd be interested in knowing what you come up with.

I didn't see the RT3 lab. It's not one that I'd be overly concerned with. It often goes up when you cut calories drastically and/or up your exercise. It's a natural response by the body to conserve fat by lowering your metabolism. The fact that it is going down is good. I'd say, just keep monitoring it.

Per my previous post a small dose of anastrozole may be warranted to bring T down. Lowering the T dose too will also help to bring it down and to bring the Free T into range. Personally, I'd increase the frequency and lower the dose of T to work on both hormones at the same time. You mentioned prolactin. I don't recall your prolactin numbers, but I don't think anastrozole will have any impact on it.

See that is the the strange part I do not take any supplements which would increase DHEA. Just K2 100mg and one a day multivitamin. And you are right RT3 shouldn’t be touched with a 10 foot pole. I’ll just keep adjusting my biofeedback and eat normally. As for prolactin my numbers were normal prior to TRT, but now they are borderline. Libido is fine and i’m not lactating. Also MRI didn’t show anything.

My DHEA Serum prior to TRT was 770 I believe, but now starting Cypionate and HCG my numbers are almost double.

I am putting my money on this DHEA issue, I may have had this issue since I was a kid and taking peptides and that pgf2a might have put it into overdrive. If DHEA is truly my issue, it must be down the the cellular level for my adrenal glands. Because anatomically, they are functioning fine, cortisol and ACTH are fine as well as ALD. and i’m sure a 24 hour saliva test will come up clean as well. As for that i’m gonna get my moneys worth with my endocrinologist and really put her education to the test. I’m very confident my issues are related to adrenal function at this point. It all makes sense, very high DHEA has been shown to suppress testosterone , I also have crazy amount of sebum on my scalp. Also anxiety as well as increases scalp acne. Also hair loss as well as sleep issues. It all makes sense now if my DHEA is truly my issue.

Ehhhhhh fml I am screwed lol. Doctors are puzzled and i’m doing my best to find out what the hell is going on lol.

[Youthful55guy]

My DHEA Serum prior to TRT was 770 I believe, but now starting Cypionate and HCG my numbers are almost double.

Consider dropping the HCG dose to see the effect on serum DHEA. I doubt that the T-cyp is driving it up. However, we do know that HCG will stimulate steroidogenesis in both the testicles and adrenals. DHEA is an upstream hormone in the steroid pathways, so HCG may be the root stimulus. Why it's getting stuck at DHEA and not converting to Androstenedione, I don't know.

Attachment 173185

[fossilk1]

Consider dropping the HCG dose to see the effect on serum DHEA. I doubt that the T-cyp is driving it up. However, we do know that HCG will stimulate steroidogenesis in both the testicles and adrenals. DHEA is an upstream hormone in the steroid pathways, so HCG may be the root stimulus. Why it's getting stuck at DHEA and not converting to Androstenedione, I don't know.

Attachment 173185

Hmmm interesting.... why does DHEA convert to Androstenedione?

[Youthful55guy]

Hmmm interesting.... why does DHEA convert to Androstenedione?

It's part of the normal steroid hormone synthesis cascade. The prior attachment explained that, but evidently it didn't upload properly. I'll try again:

[kelkel]

Consider dropping the HCG dose to see the effect on serum DHEA. I doubt that the T-cyp is driving it up. However, we do know that HCG will stimulate steroidogenesis in both the testicles and adrenals. DHEA is an upstream hormone in the steroid pathways, so HCG may be the root stimulus. Why it's getting stuck at DHEA and not converting to Androstenedione, I don't know.

Attachment 173185

Our body will shunt this hormone cascade in a direction it feels it needs at the time. Doesn't always seem to make sense though.....

[fossilk1]

Doctor just prescribed me .5 anastrozole to take once a week. (Half tab)

But I think i’m going to split these into quarters and take .25 after my injections. So .25 Saturday and .25 Wednesday post injections.

Does this sound right? AI’s get me worried since I believe this is what had me all screwed up to begin with. The last thing I want to do is crash my estrogen again.

[Country23030]

Hang in there bro! it takes awhile!

[kelkel]

Doctor just prescribed me .5 anastrozole to take once a week. (Half tab)

But I think i’m going to split these into quarters and take .25 after my injections. So .25 Saturday and .25 Wednesday post injections.

Does this sound right? AI’s get me worried since I believe this is what had me all screwed up to begin with. The last thing I want to do is crash my estrogen again.

Yes it does.

[fossilk1]

Yes it does.

Alright thank you, I will stick with my protocol and break up my AI into quarters at .25 and take it twice a week on the same day as injection.

Saturday: 50mg Cypionate + 350iu HCG + .25 AI

Monday: 350iu HCG

Wednesday: 50mg Cypionate + 350iu HCG + .25 AI


Hopefully by adding the AI it will lower my prolactin into optimal ranges, since I believe estradiol raises prolactin a bit (or both have a correlation). The last thing I want to do is crash my estrogen again. Believe that is what ruined me for over a year. Now I am starting to show some progression.