Body fat increase on TRT?

[sarge40]

Hey everyone. I'm a new member here (after lurking for a while), and to TRT as well. As a brief background, I have never done AAS cycles in the past, but I did do a cycle of andro when it was legal (man, did it work), and have played around with DHEA here and there. Also was on finasteride for a few years until I just gave up trying to save my lion's mane. Over the last few years, I got fat and sluggish, and wasn't the ladies man I used to be for sure. So, I went to the TRT clinic.

For just under two weeks now, I have been on a TRT dose of 200mg/week (1 IM injection per week), along with 1mg adex 2x/week (total of 2mg), and 500iu hcg 2x/week (total of 1000iu). My total testosterone before starting was somewhere in the 300-400 range, up from 280 or so before I went on a strict diet and exercise regimen, and my free testosterone and LH were both at the rock-bottom end of the spectrum. E2 (non-sensitive) came in at just over the upper end of the clinical spectrum (around 54). SHBG was also at the absolute upper end of the clinical range. DHEA-S at the bottom end of normal. Thyroid was all normal, as was prolactin. Here's my current problem...

I was on a weight loss regimen of eating right, cardio, and moderate weight lifting before starting TRT. I went from 205 down to 175 pounds and got my body fat down 6-7% according to my bathroom scale (not the most accurate, but consistent), in my attempt to get T up and E down. In the almost two weeks that I have been doing the TRT regimen, I have gained approximately 10 pounds, and went up about 2% body fat. It's not what I was exactly expecting to see, but given my high E2, I suspect that it has something to do with my E2 levels. If that is the case, I don't know if it is because the anastrazole (2mg/week total) is killing my E2 too much, or if my SHBG is sequestering too much of my free testosterone, or if the E2 levels which were ultra high before TRT, have just been getting higher because the arimidex isn't working on me, and as we know E follows T to begin with. I have read conflicting things about E2, from E2 is an important fat regulator, to E2 is going to cause bloat and fat in the belly and chest. I also started taking creatine monohydrate around the time I started TRT and know that can contribute to bloat.

I can feel an overall positive change coming on. I feel that my muscles are responding to resistance training, more in feel and tone than an increase in size. It almost feels like a constant pump in my muscles rather than a soreness after working out, even in muscle groups not directly hit by the workouts. Something is going on, and it feels like it is a positive change. With the 10 pound and 2% bf increases though, I don't know what to make of my situation. I defer to more experienced minds on this. I'd confer with the doc, but I know that is going to be more bloods that are paid completely out of pocket, something that I just don't want to pull right now, but will if I have to. I wanted to see if anyone here had ideas of what is going on in my body, so I can accurately address my concerns with the doc next time we talk.

I'm not really going to mess around with the prescribed regimen until I get with the doc, but I can and will alter my supplements. I'm currently doing stinging nettle, magnesium glycinate, PES Erase, zinc, boron, creatine, and DAA (which I'm cutting out as I heard it raises E2 too much).

Thanks for any suggestions!

[OingoBoingo]

200mg is a lot of T. And your Anastrozole dose is also quite high. There could be a rough road for you ahead.

Do you know how the doctor came up with those doses?

[Beethoven]

200mg is a lot of T. And your Anastrozole dose is also quite high. There could be a rough road for you ahead.

Do you know how the doctor came up with those doses?

Agreed. You should post your complete BW along with the ranges BEFORE trt began. Ten pounds that fast is probably bloating. It's strange that a Dr started you at what is generally considered the top end of trt.

[kelkel]

Doesn't sound like a squared away clinic, imho. Like said above, normally that's way to high a test dose to start and the adex is cycle dosage levels. Think about it, what other medicine does a doctor start you out at the highest level? It's few and far between. You start lower and titrate up based on BW, side effects and how the patient feels.

What you've gained may simply be water, who knows at this point. But regarding your bathroom scale and 6-7% BF, don't trust it. That's pretty much a BB-er competition level percentage.

You need to check BW in another 3-4 weeks and be prepared to make adjustments.

[sarge40]

200mg is a lot of T. And your Anastrozole dose is also quite high. There could be a rough road for you ahead.

Do you know how the doctor came up with those doses?

I believe it had to do with my high E2 and high SHBG. Apparently, high t doses are effective in bringing SHBG down. My E2 was pretty high pre-TRT, and that was with the zinc, stinging nettle, etc. already incorporated into my regimen. I was told that after my first post-TRT bloodwork comes in, they will be able to better dial me into my sweet spot, numerically.

[sarge40]

Agreed. You should post your complete BW along with the ranges BEFORE trt began. Ten pounds that fast is probably bloating. It's strange that a Dr started you at what is generally considered the top end of trt.

I agree that the dosing is high. I've read that some people are taking doses that high, but more often than not it seems that they are taking 100-150mg weekly, even less if injecting more frequently. I'm particularly concerned about the anastrazole. If a dose that high can't control the E2, assuming my weight gain and bf increase are due to increased E2, then I don't know what my options are. Also, if my E2 is going up, I assume my SHBG probably is too.

Here are my pre-TRT labs, compiled from a couple of draws just before getting the green light:

Testosterone (total) 377 (250-1100 ng/dL)
Testosterone (free) 48.6 (35.0-155.0 pg/mL)
Estradiol 43.5 (7.6-42.6 pg/mL)
DHEA-S 145.0 (80-560 ug/dL)
SHBG 53.8 (16.5-55.9 nmol/L)
Albumin 4.4 (3.6-5.1 g/dL)
Globulin 2.3 (1.9-3.7 g/dL)
A/G Ratio 1.9 (1.0-2.5)
Bilirubin 0.9 (0.2-1.2 mg/dL)
Bilirubin, indirect 0.7 (0.2-1.2 mg/dL)
Alkaline Phosphatase 49 (40-115 U/L)
ALT 24 (10-40 U/L)
AST 24 (9-46 U/L)
Glucose 95 (73-101 mg/dL)
Sodium 143 (131-145 MEQ/L)
Potassium 4.1 (3.4-5.2 MEQ/L)
Chlorine 106 (103-112 MEQ/L)
BUN 24 (8-21 mg/dL)
Creatinine 1.1 (0.6-1.2 mg/dL)
Calcium 9.7 (8.6-10.3 mg/dL)
Protein 6.8 (6.2-8.2 g/dL)
Anion Gap 8 (7-16 MEQ/L)
Hemoglobin 15.5 (12.7-18.0 g/dL)
Hematocrit 47.2 (38-52%)
HDL 55 (29-83 mg/dL)
LDL 92 (75-130 mg/dL)
Cholesterol, total 157 (130-200 mg/dL)
Triglycerides 51 (46-187 mg/dL)

[sarge40]

Doesn't sound like a squared away clinic, imho. Like said above, normally that's way to high a test dose to start and the adex is cycle dosage levels. Think about it, what other medicine does a doctor start you out at the highest level? It's few and far between. You start lower and titrate up based on BW, side effects and how the patient feels.

What you've gained may simply be water, who knows at this point. But regarding your bathroom scale and 6-7% BF, don't trust it. That's pretty much a BB-er competition level percentage.

You need to check BW in another 3-4 weeks and be prepared to make adjustments.

I will need to make adjustments, no doubt. BTW, I went down 6-7% (i.e., from 27 down to 20ish) from before I started a clean diet and exercise regimen, not down TO 6-7%. I don't think I will ever be able to accomplish that, nor do I think that I want to. Too much work, and I love me some sweets every once in a blue moon.

[kelkel]

Sarge post up your BW on this thread when you get it. I'd like to see where you land on this protocol. Make sure you get a Sensitive E2 Assay. Standard estradiol is geared for women, no matter what the clinic says. Clinics choose estradiol as it's dirt cheap to test compared to E2.

It would have been great to see LH, FSH, Cortisol and Prolactin and a full thyroid panel. They would have helped to possibly diagnose the issue and give you the chance to correct it without TRT, but that would not be to their monetary benefit.

Welcome to the forum Sarge.

[sarge40]

Sarge post up your BW on this thread when you get it. I'd like to see where you land on this protocol. Make sure you get a Sensitive E2 Assay. Standard estradiol is geared for women, no matter what the clinic says. Clinics choose estradiol as it's dirt cheap to test compared to E2.

It would have been great to see LH, FSH, Cortisol and Prolactin and a full thyroid panel. They would have helped to possibly diagnose the issue and give you the chance to correct it without TRT, but that would not be to their monetary benefit.

Welcome to the forum Sarge.

Thanks for the welcome! I do have some labs from earlier in the year when I started to try to get to the bottom of this. My GP sent me to an old endo guy who didn't want to pursue anything with me. At the time my total testosterone was a whopping 325, and he didn't even bother to order a free testosterone assay. Anyway, some of my other numbers at the time were as follows:

Prolactin 7.4 (2.0-18.0 ng/dL)
LH 1.8 (1.5-9.3 mIU/mL)
FSH 1.9 (1.6-8.0 mIU/mL)
Thyroid peroxidase AB <10 (<35 IU/mL)
Thyroglobulin AB <20 (<20 IU/mL)
PSA, total 1.0 (<4.0 ng/mL)
T3 uptake 34 (22-35%)
T4, free, calculated 2.4 (1.4-3.8 U)
T3, total 94 (76-181 ng/dL)
Ferritin 115 (20-380 ng/mL)

Based on my LH/FSH numbers, I am under the impression that I am secondary, and I should respond to hcg. I'm not sure about my HPTA, and the docs never suggested an MRI to look for any structural issues. The thyroid stuff is a bit foreign to me, but the numbers are within parameters, which incidentally sounds an awful much like the endo when he told me that 325 is within normal parameters, so he isn't concerned because "you don't need too much testosterone to function." His words verbatim. I knew then I had to look elsewhere.