LowT Triumphs and Tribulations

[ktmsmith]

I began TRT about 2 months ago and recently stumbled across this forum while doing internet research about this therapy. I am amazed by the quality of the information available here and some of the members blow me away with their knowledge of the subject and their willingness to offer insight and help fellow members…what a fantastic resource. As a new member to the community I thought I would introduce myself and share my story of TRT as it develops. It’s a bit long winded but please bear with me.

My story plays out like many of those I have read about on here. I am 45 years old and for most of my life I gave little thought about my hormonal well-being as I found maintaining my fitness and overall health non-issue. I am not a body builder but I have always been in good physical condition. Through my mid 20’s to 30’s I regularly participated in competitive off-road motorcycle racing. The events I competed in typically consisted of 2 to 6 hour races and are very endurance oriented. The body type which is most adaptive favors strength over size with the ability to periodically perform at nearly 100% of threshold capacity with quick recovery stabilizing to 60% to 80% as the base performance. Cardio capacity and muscular endurance during the event is key to doing well as the races become as much about endurance as riding skill. At my best race performance I was weighing about 180-185lbs with body fat of 12% to 15%. I am 5’10” when gravity isn’t too high for the day. I typically did well in my prime, racing the A class in events, which is one step down from the pro-class. In other words I spent a lot of money making no money.

When I turned 39 I made a big life change and started my own business. I was fed up with the partnership I was in and my wife was so tired of listening to me bitch about it she agreed to quit her job too and join me in creating our company. We have been lucky and all of our hard work has paid off with all the success I could have hoped for with our new business. But it has no doubt come at a cost. We both work very long hours and have new stresses that come with turning on your own lights so to speak. None the less I definitely would not change the move we made but over the course of those 6 years my outlook and vitality really changed as did my wife’s.

I guess about 3 years ago I noticed some changes going on in my health and overall well-being. I started to put on weight and my zest and energy levels really plummeted. At first I explained it away by the work load and stress I was under. Eventually I figured it was the inevitable course of getting older and starting to realize a man’s finite life and vitality. I started to talk like those mid-life guys, “I remember when, back in the day, I used to” or some other variant of BS. I still competed from time to time but it was way different. I had lost my killer instinct and really just didn’t have much motivation to do anything. Eventually I quit racing and just rode for fun but at a much reduced frequency. About a year ago it had reached the point that I barely rode at all. I also quit doing other activities and my life pretty much consisted of working, sleeping and eating and drinking. Even on weekends I would just go to work or sit on the couch reading or watching TV which is something I never did before. Without the activity level being there I started to put on weight and right now I am at 215lbs. I am a good 30lbs over weight for sure; something I have never been. Last year I was disgusted enough with myself that I started the P90X program which was a real eye opener for me showing me how far I had deteriorated. I went 45 days on the program and lost 17 pounds and then hung it up. Mistake….1 year later I am right back where I started. However the biggest shock for me when I did the program was how weak my body was that I did not respond to the strength training at all. I could do no more push-ups or pull ups etc. at 45 days than day 1. I really could not make any sense out of that at all. I ended up deciding most of the weight loss was a result of my diet rather than working out so I figured the heck with P90X.

Six months ago I really started to notice my decline. I started having a lot of joint pain and muscle stiffness after doing almost nothing at all. I starting thinking I must be turning into an old man as I hobbled out of bed in the morning figuring all of those old motorcycle injuries and years of abuse was coming back to haunt me. I also began wondering if I was depressed or if something else was wrong. I did not feel depressed in the traditional sense but I had absolutely no desire to do anything. Even sex was barely worth the effort, and maintaining a strong erection periodically became an issue…something I never had happen before. Even with all these new symptoms I just kept chalking it up to work and stress and reserved myself to the idea that getting older was going to suck.

Then one day I saw a TV ad for LowT. I joked with the wife that I probably had LowT as a result of the vasectomy I had when I was 36 and I wasn’t a man anymore and she would have to trade me in. But the commercial did have me contemplating researching LowT a bit more as the symptoms seemed to fit me text book. Still I didn’t get off my lazy azz and take it any further. Fast forward a couple more months and the same add is on again and I crack the same joke with the wife again. This time however she says to me... “I want to go to a Dr. I have heard about in the area that specializes in HRT and see if I need hormonal therapy.” Turns out that many of the symptoms I was experiencing such as low energy and motivation, sex drive poor sleeping etc. she was feeling too. So I encouraged her to go and she did. She discovered she was deficient in T and had a super high estrogen level which apparently is not good for a lady. The Dr. put her on a program right away and she started noticing an improvement in 30 days…..yay! OK so now I am thinking…go see this guy and get your answer. Truthfully I was afraid the Dr. was going to say… “You are fine, try to act like a man” or some variation of that. Anyway…I went.

First visit was a general health exam. Lots of questions, a little poking and prodding and I was sent on my way with BW request. A week later the results were in. Here they are and I am not really clear on what they mean as there are numbers all over the place. As an example the Free T3 column reads: FreeT3 4.2pg/ml then below that is the Dr.’s handwriting in parentheses {2.5-3.9} then what I assume is my reading of 2.7. Anyway here they are as shown on the sheet given to me by the Doc.

Date 12-2-11

Free T3 Male 4.2pg/ml……………….…{2.5-3.9}………My Score: 2.7
DHEA Male 500-600 ng/ml………. {44 -331}……..My Score: 144
Total Test Male 500-1000ng/ml……....{349-1197}…..My Score: 188
Free Test Male 40-41 pg/ml…………….{6.8 -21.5}……My Score: 6.8
Estradiol Male <55 pg/ml………………………………......…My Score: 18.7
Progesterone No test given
TSH No range given…………………………………...... My Score: 1.97
Free T4 No test given

I do not know if any other blood work was done. These are the only scores I was given. Unfortunately I went into this completely uniformed and didn’t even know enough to ask questions until I stumbled upon this site. I am interpreting the first column as the ideal range or score for each category with middle column representing the typical range for a male at my age, but what do I know? The Dr. did say I was LowT but didn’t really express it in terms of how low.

Here is what he prescribed:

Armour Thyro 15mg once daily tablet
DHEA Micro 15mg once daily capsule
Testosterone 100mg/ml Gel…. 2 ml per application twice a day. Pharmacy compounded.

He prescribed a 90 day supply and set up BW one week before my next visit 90 days out. I am 2 months into the program. I really can’t say I have noticed a major improvement in any one category except joint and muscle pain has been greatly reduced. The libido is about the same and erections could be better..ie last longer like when I was 25. Energy levels seem about the same or slightly better. Based on what I have read here it looks like the Doc has me on a high dose of T at 2800 mg per week assuming a 10% absorption rate that’s 280 mg a week. I realize it takes time for benefits to show but I am wondering if I am a low-responder to Tgel. I guess that will be more clear from the next BW results which are 30 days out.

So that my story for now. I would appreciate any feedback you guys might have about my experiences, the Dr.’s prescribed therapy and especially my BW results. What do you think I have to look forward to in terms of HRT? I realize I am probably on this course for the rest of my life and I am alright with that. I just want to get the maximum best advice, care and effect possible. Come to think of it…maybe my competitive type A personality is awaking. Anyway, I am anxious to see some of the great results I read about on here and am looking forward to feeling better; losing some weight and gaining back the competitive fire I used to have in the past.

[kelkel]

Welcome KTM. Fantastic opening diatribe! It would be helpful to get a complete copy of your BW from your doctor and to start getting them emailed or faxed to you from the lab directly in the future. Fill out the forms at the lab you use and they will do it. Start a folder to keep track of your health/progress. With BW in hand you have time to do your research and prepare for your next visit. Do you have LH/FSH as it would help us determine if your primary or secondary. SHBG and Albumin possibly?

You are definitly in need of TRT although I'm confused a bit about what your taking and what the dosage actually is. Does the med insert actually say it's 10% absorption rate on this compound? Also curious why the doc put you on Armour Thryoid which is for Hypothryoid. If you were hypo-T then your TSH level would be higher. Reason is your hypothalamus would recognize this and in turn stimulate the pituitary to release more TSH resulting in a higher TSH level, which you don't have. Normal range is .3 to 3.0 for TSH. That in mind, being hypothryoid can effect T levels and give similar symptoms. Maybe that's his thought process but I'm just guessing here. The micronized dhea is a great idea.

Glad your here. Hope you stay. We all learn here everyday!

[ecdysone]

I think everything kelkel said is what I would do... only thing I would recommend is that you get your test measured now - for transdermal applications there no reason to wait more than a few weeks prior to making a dosage adjustment.

The Armour Thryoid is a puzzler - your lab tests would not support the need to take it, so maybe your doc has some other ideas.

[ktmsmith]

Thanks for the feedback guys. I am going to be more proactive on the bloodwork results cause I am anal like that and want to keep a complete log over time. I am getting the BW done at my local hospital so hopefully they can email results directly to me. I have no idea if I got my complete results from the Doc as I would have thought a PSA test had been done. Kelkel, the other tests you asked about I have no idea if they were and what they would indicate if they had been. Can you shed some light on why I would want to know these levels and what it could mean ie primary vs. secondary.

As far as the Test compound, I cannot find anything on the label or presrciption which indicates what the absortion rate is, I just assumed the 10% absorption rate was standard so I am assuming the weekly absorption of 280mg which would be a very high amount correct?

Finally, the explanation for the Armour Thyroid therapy is for the bad joint pain I was experiencing. The Doc. maintains that he will slowly increase my prescript which he claims will increase joint fluid an alleviate my difficulties. He actually put my wife on the same prescript because she has had some severe hip pain and was unable to sleep through night on her side. I can say that we are both responding extremely well to the therapy. I am amazed with how much better I feel with my joint pain greatly reduced so the Doc. Defintely has my attention.

[kelkel]

Call your docs office and have one of the nurses fax you your lab results. They are yours. If they won't for some odd reason call the lab and find out their procedures for obtaining them and get a copy.

PSA: Need baseline to monitor for changes possibly brought on by T therapy. Remember no sex for about 48 hrs prior to a psa test. It can/will spike your levels.

LH/FSH: These levels can determine if your primary or sedondary. Produced by your pituitary LH with FSH stimulates the leydig cells in your testes to produce T. So, if your levels of LH/FSH (proteins btw) are higher than normal and your T is low it could indicate a problem with your testicals=Primary Hypogonadal. If your LH/FSH levels are very low to non-existent and your T is then low=Secondary Hypogonadal. If secondary then an MRI is needed to check for pituitary tumors inhibiting natural production. I happen to be the proud owner of one of these tumors! We've developed a relationship and are going out for a drink later tonight!

280mg would be a very high amount which is why I questioned it. Still wondering why a specific compound and not androgel 1.62 or something similar. Is he mixing something else in the compound?

Armour Thyroid. If that works then awesome. Some Deca, a 19 Nor steroid would also probably help with your joints also.

SHBG and Albumin: Blood proteins that T binds to. Moreso shbg than albumin. What is not bound is called Free T and is available for use.
Knowing these levels along with your T levels can give a clear picture of the percentage of T available for use. High shbg levels mean your T is being bound to much.

[bullshark99]

^^^^ was thinking the same thing regarding joint pain, deca. Depending on how interested you are in getting into the gym this would clearly give you an advantage. As kel indicated, DO NOT overlook the PSA test @ age 45 you need to have a baseline. TRT has the potential to increase PSA (minor BPH or inflamation) mine did go up but then did go back down regardless this is one marker you are gonna always want to track.
Most people here use injections, dont know how your Doc feels about that??? Deca, injectable, may want to discuss going this route with the Tes with your Doc. You have not convinced me that other than the joint pain relief that you are reaping the full benefits of TRT. libido, erections, well being ect....
Glad you are here, keep us all in the loop!

[ktmsmith]

Well the Dr.'s office just faxed up my bloodwork and apparently what I posted is all that was tested. This concerns me after reading the stickies and learning what should have been requested. I am going to give the Dr. the benifit of the doubt at this point because he may have not run the larger battery due to costs. Being self employed I am on the ticket for all of this cost because of my high deductable, $7500. I do remember him asking about my insurance coverage and commenting that he would factor that. He also stated that the reason he uses a pharmacy to compound the Test is because of cost. I get a 30 day supply for $99.00, so I will be out $1200 for the year excluding bloodwork just for my T. How would that cost compare to Androgel or the like or say IM...which I think I might push for if my T levels aren't where I want them? What kind of cost would be associated with the full battery of BW tests?

I think I might right the Dr. an email prior to my next visit expressing my concern over the lack of some of the BW tests, particularly not getting the PSA which really has me scratching my head. I am expecting him to respond that some of these other tests are not necessary if the T level rises and I feel better. I don't have a read on this Dr. yet so I am not sure to what degree he will work with me. I did not get impression from him of the typical Dr. big ego and he is in my home town so the convience of that is a big seller to me. He advertises himself as an Internist and I believe he pretty much only does hormonal therapy. All and all I would really like to develop a symbiotic relationship here but will move on if necesaary. I just see this therapy as a life long commitment and I want the most control and best advise I can get.

Are there any publications out there written by say Dr. Crisler or Shipman etc. that I can read and gain some greater insight on this whole TRT.

[bullshark99]

I pay 155 for a 10 week supply(10ml) of Tes Cyp (IM of course) so I feel what you are doing is expensive. regarding the BW, it is expensive, for example, I had a full panel done at Qwest a few months ago and total cost BEFORE ins adjustments was over 2k. You have a high deduct but as long as the lab is in network you will get the negotiated rates. In my case it was 250 dollars even (neg rate) , which I had to pay 10% 25 bucks. Running a PSA test for someone on TRT is the most basic of basic, it really is. Any Dr that wouldnt do this would REALLY have me scrathing my head???? TRT is for life, most people here do inject, even the ones that started out with gel or patch, eventually most seem to go IM. Might really want to research this more, if your in, jump all the way in.

[ktmsmith]

Update:

I just received my new blood work results taken on 3/06/12. I haven’t gone into to see the Dr. yet and I want to be prepared for him when I do. As I mentioned last time I thought the absence of a PSA test was a mistake from my first blood work so I asked the Dr. to make sure he included it in this round. Here are the results compared with my first blood work on 12-2-11.

Date:................................. 12-2-11................................................ Date: 3-6-12

PSA ...................................None........... ..........................................1.6..... ........Range: 0.00 to 4.00 ng/ml

Free T3................................2.7 .................................................. ....3.1.............Range: 2.50 to 3.9 ng/ml

DHEA-S................................144.............. .......................................297.1...... ....Range: 44.30 to 331.00 ug/dl

Total Test ............................188................... ...................................610............ Range: 348 to 1197 ng/dl

Free Test .............................6.80................. ....................................12.70......... Range: 6.80 to 21.50 pg/ml
.
Estradiol...............................18.70..... ..............................................69.1 0.........Range: 7.60 to 42.60 pg/ml

TSH.....................................1.97...... ...............................................1.2 8...........Range: 0.34 to 5.60 uIU/ml


Looks like my total T and Free T are up but not to a satisfactory level. As I mentioned earlier I feel a little better overall but not significantly. It looks like my estrogen is high moving up from a previous normal level and this is a concern to me. I am wondering if I am beginning to convert T to E and that is why my T hasn’t moved into the 20 year old age group despite being on a large 280 mg per week dosage via pharmacy compound. My concern is if the Dr. increases T levels via more application will my E go up too high or maybe I am already there.

What say you experts? Looking for any and all feedback based on my situation. I think I have a lot more potential here and am looking for max positive results. Thanks in advance for all the help.

[kelkel]

Ok. You've now got a baseline PSA. Did you refrain from sex for a couple days prior to the test to avoid a spike in levels as suggested?
Beginning to convert T to E? Your past that point. You need an AI pronto to lower this to app 25-30 range based on how you feel. I'd test every month or so if possible until your where you need to be. Easy test, no fasting. Introducing an AI to your protocol can substantially free up more test for your body to use. I don't see SHBG or Albumin? Were they not done? Get them next time if possible as right now I'd bet your shbg is relatively high based on your E2 level.

Overall, great progress. It's only been a few months for you and it does take time. Be patient and make changes one at a time so you know what is working for you! Get your E2 under control and your on your way. Congrats!

[Vettester]

Definitely listen to what Kelkel is saying on the E2. This will turn into a disaster if you don't get a handle on it now. Hopefully your doctor will be tuned into this. This is why it is imperative that a patient runs labs 6 weeks after starting their protocol. No sweat off the doctor's back since you're the guy that has to carry the burden of this. And yes, the PSA was crucial in the beginning as well, glad you informed your doc.

Presuming nothing is whacked on your albumin, your SHBG calculation is looking mid to high 30's. Your free test is just a little over 2%, which 2% to 3% is usually the place to be. It would be good to get an albumin and/or SHBG to know for sure.

[PPC]

Interesting, another case where blood work reveals a good looking TSH, yet low freeT3. If your Doc had only tested for TSH and T4 as many are apt to do, your low active thyroid hormone would have been missed - along with the primary reason for your joint pain. It's still could come up further but I'm sure your Doc will help you get there. It seems odd that your Doc neglected PSA the first time around yet was proactive on the thyroid.

It's generally accepted that if your TSH is between 1-2, your thyroid hormones are in good working order. Your blood work proves that wrong as does my friend's blood work. She had a TSH of 1.6 yet free T3 at the very bottom of the range. Armour has made all the difference in the world to her. There is an issue with the conversion of T4 to T3 somehow in the body in these more rare cases I would have to assume.

Congrats on getting started on your path to restoring your hormones. It's excellent that both you and your wife are in this together. Would you mind sharing how high her estrogen levels were? Sometimes that happens during the years of peri menopause, right before the official change starts. Women may have anovulatory cycles where estrogen rises but an egg is unable to be released from the ovaries. High estrogen sits out there all alone without the balancing effect of progesterone, since progesterone is only released if there is an egg for it to nurture. The years of peri can be a strange time and even hard to track via blood work because the sex hormones rise and fall more dramatically in a last hurrah before they finally putter out.

[ecdysone]

This is why it is imperative that a patient runs labs 6 weeks after starting their protocol. No sweat off the doctor's back since you're the guy that has to carry the burden of this. And yes, the PSA was crucial in the beginning as well, glad you informed your doc.

I think this may well be the best 'take-home' lesson from your lab tests - and you will need to be more proactive in trying to manage your E2.

With your relatively high transdermal dosing, you might also want to consider adding DHT to the next labs to see if it's rising beyond the acceptable range.

As regards your post-TRT TSH, it is not uncommon for TSH to drop with supplemental testosterone administration and many guys (not all) have to increase their thyroid meds a bit, so another thing to watch out for.

[ktmsmith'swife]

Hello, this is ktmsmith's wife and I am responding to PPC's post in regards to my levels as well as wondering about my own progress and what I might change and/or improve over what the doctor has done to date. I do think I would like my T levels to be a bit higher as the libido is not where I want it and I would really like to have more strength so that workouts are more effective and maybe someday I can have a toned body and not be so soft all over. I am 48 years old, 5'7" and weigh 137 lbs. My weight has alsways been pretty stable but I believe I have less muscle and more fat than in my younger years. I want that to change, I don't want to be tired or achy from old age and I am willing to do what it takes to feel good including the exercise and a well balanced diet. In 2010 I had an overy removed and I wonder about the effects of one less ovary. I had been experiencing occaisonal night sweats along with considerable moodiness-crying for no reason which is not me at all. These have been eliviated since begining BHRT. My first blood work results were in Nov. as follows:
DHEA-S 173.4
Estradiol 153.9
Progesterone 0.3
Free Test 1.0
Total Test 14
TSH 1.73
Free T3 3.0

I have been prescribed Armour Thyro 15mg once daily tablet, Testosterone 1/4 ml daily (cream), Progesterone 250 mg/daily tablet.

Bloodwork 2/18/12

DHEA-S 224.9 (up 51.5)
Estradiol 50.1 (down 123.3)
Progesterone 9.3 (up 9.0)
Free Test 1.7 (up 0.7)
Total Test - did not test this time?
TSH 0.74 (down 0.99)
Free T3 2.9 (down 0.10)

He did not change my scripts-said lets see what another 3 months does for your T. I was hoping for a stronger script for the T. The doc was more interested in asking my hubby if I was less bitchy now....I was never bitchy to begin with so no real good answer on that one but the doc is 76 years old and I think he believes most women get bitchy when hormones are out of whack....not the case with me..I did cry but I even hid that from the hubby till I was seriously concerned and wanted to see a doctor about it. He, of course was completely supportive as he always is and now we are both on track to being healthier and younger feeling. Any comments on what I should be looking for, tests I should have done and what I might expect will be much appreciated....thanks!

[PPC]

Hello, this is ktmsmith's wife and I am responding to PPC's post in regards to my levels as well as wondering about my own progress and what I might change and/or improve over what the doctor has done to date. I do think I would like my T levels to be a bit higher as the libido is not where I want it and I would really like to have more strength so that workouts are more effective and maybe someday I can have a toned body and not be so soft all over. I am 48 years old, 5'7" and weigh 137 lbs. My weight has alsways been pretty stable but I believe I have less muscle and more fat than in my younger years. I want that to change, I don't want to be tired or achy from old age and I am willing to do what it takes to feel good including the exercise and a well balanced diet. In 2010 I had an overy removed and I wonder about the effects of one less ovary. I had been experiencing occaisonal night sweats along with considerable moodiness-crying for no reason which is not me at all. These have been eliviated since begining BHRT. My first blood work results were in Nov. as follows:
DHEA-S 173.4
Estradiol 153.9
Progesterone 0.3
Free Test 1.0
Total Test 14
TSH 1.73
Free T3 3.0

I have been prescribed Armour Thyro 15mg once daily tablet, Testosterone 1/4 ml daily (cream), Progesterone 250 mg/daily tablet.

Bloodwork 2/18/12

DHEA-S 224.9 (up 51.5)
Estradiol 50.1 (down 123.3)
Progesterone 9.3 (up 9.0)
Free Test 1.7 (up 0.7)
Total Test - did not test this time?
TSH 0.74 (down 0.99)
Free T3 2.9 (down 0.10)

He did not change my scripts-said lets see what another 3 months does for your T. I was hoping for a stronger script for the T. The doc was more interested in asking my hubby if I was less bitchy now....I was never bitchy to begin with so no real good answer on that one but the doc is 76 years old and I think he believes most women get bitchy when hormones are out of whack....not the case with me..I did cry but I even hid that from the hubby till I was seriously concerned and wanted to see a doctor about it. He, of course was completely supportive as he always is and now we are both on track to being healthier and younger feeling. Any comments on what I should be looking for, tests I should have done and what I might expect will be much appreciated....thanks!

Hello and welcome. Nice to have you here.

You are correct to think the loss of your ovary may be related to some of your hormone loss. The weepiness and night sweats after your surgery are very common. Your ovaries make the majority of your testosterone and the first blood test result at 14 was extremely low, as was your Free Test. The loss of an ovary can have a negative hormonal impact on a woman at any age but having it removed in your mid to late forties exasperates things. You were wise to seek out bio identical hormone repla***ent.

I would love to know about what day of your cycle you had your first and second blood tests taken. That will tell us quite a bit about the state of each hormone tested. As you know, our hormones make big dips and climbs each month so test days give us more clues as to what is really happening. Currently, you are very low in estrogen. Even if this current test was taken during your period or before ovulation, 50 is a low result. It indicates a movement toward menopausal estrogen levels.

Why did your Doc think your estrogen number was too high in the first test? If it was taken in the second part of your cycle ie your luteal phase, then it looked nice. Yes, your progesterone was terribly low and again it gives very strong clues that you may have had a cycle without the release of an egg, so...basically no progesterone. That's very common for women with only one ovary.

Your Testosterone levels have come up but female hormones are fickle and while it is good your testosterone is no longer so low, your new low estrogen could be detracting from a healthy libido. Women, first need a nice baseline of estrogen. That helps us feel feminine and keeps the vagina well lubricated and youthful. Testosterone is the next layer which fuels more carnal desire and heightens genital sensitivity. The two must go hand in hand. Testosterone without enough estrogen will usually just result in increased aggression. So there's a delicate dance here. You'll find it. It usually takes a while to get hormones back to levels that look good on paper but also make each unique women feel "right."

It also looks like you are not having an easy time getting your thyroid hormone levels optimized. He may need to up your dose slowly. If that causes heart palpitations you may need to take some supps to help you adrenal glands support your thyroid hormones better. Selenium, iodine and Vitamin C are the first few that come to mind.

I would make sure to get an FSH test next time. That tests your follicole stimulating hormone. If it is high then you know your body is pressing the accelerator very hard for your ovaries to work. That happens when menopause is near and the body wants the ovaries to do their thing but they just don't know how anymore.

I would talk to your doctor about getting a compounded script for estrogen, in the form of biest. You'll be needing it.

He is having you take quite a lot of progesterone. Most women cannot handle that much orally. Personally, it makes me feel drowsy and bloated at the doses you are taking. But each women is unique. Some women find a nightly dose of 200mg of progesterone calms anxiety and allows them to sleep. At present, your progesterone is dominant over your estrogen levels and trust me, that is not good for libido. YOu need progesterone but you just need it in levels enough to balance out your progesterone.

So you have made a start. You can stay the course and press for more tests and more scripts with this Doc. He has been open minded enough to atleast give you Testosterone. Or you could find another Doc...maybe a female who understands more about the delicate balance that is required for female HRT. Don't give up. You'll get there.

[ktmsmith]

My thread has been hijacked by my wife…good thing I like her. In response to some of the questions put forth to my blood work I plan on getting my Doc to do a complete workup next time out and I am going to run the Bw every 6 weeks until I am dialed in. I don’t like going in blind with my health so tests like SHBG, Albumin, LH/FSH, DHT etc. are going to get done.

I had 36 hours between relations with the wife and my PSA test. I kinda took the test on a whim as I had some time to kill waiting for the wife while she was having her annual done. I should have waited another day perhaps and the PSA may have been lower.

As a general question…just how high is my E2 relatively speaking? If it is lowered by AI what kind of jump in T levels could I expect if I DID NOT change my T prescription? At my wife’s last visit the Doc. mentioned that some men do not absorb the T compound he initially described to me because of cream agent used. He asked if I had a lot of dry white residue after application and I do…looks like I white washed my leg. He said that he can have the pharmacy compound the T in a gel solution which would enhance absorption. Based on my T levels, do you think the T is being absorbed adequately? I am wondering if it’s the E2 conversion or the poor absorption, or insufficient time on HRT or a combination of the three that is keeping the T level down. Heck I don’t even know what I should be shooting for with T levels but I figured ideally I should have Total T north of 900pg/ml and Free T north of 20pg/ml.

Does the body ever adjust to the introduction of T and self-adjust to lower the E2 without the introduction of AI? Could my E2 be lowered with supplements or diet change etc. I have read that drinking will complicate the issue so I will be cutting back on that. Currently I probably average 2 drinks a night.

I will say this…I am having a major issue with erections now. It’s funny….well actually it is not….I have a more active libido since getting on the T but I cannot maintain an erection to save my life/wife. Is this a result of higher E2? I have got to get this fixed ASAP and I don’t want to have to do it with another medication.

Finally, are there any blood tests that I have waited too long to do that consequently won’t be of any use since I have been on the therapy for 3 months? What are the tests I haven’t had done that should be. I plan on going to the Doc with the list of BW I want and leaving with the prescript. Thanks again everybody for your help and insights.

[SEOINAGE]

I'm kind of curious what your pains were like more in detail. And how much they have improved. I'm wondering if my pains are thyroid related as I have high tsh, low t4 waiting on t3 results as old doc didn't take. I tried synthroid and hated it. but might go on armour thyroid if t3 is low, just wondering what I can expect as for as pain improvements. I have pain whenever I squat in glute and hips, pain in a foot a knee and a shoulder and like bicep tendinitis feeling. And for 6 moths last year in the left side of my neck but that went away. I know how it feels to feel 80 years old. So if your pains are similar and armor is working I'm more apt to trust it.

As for your E2 should be something you monitor. Is your doctor increasing your test dosage? Should check e2 after that and see where you are at. I was fine on 100 mg of cyp with a 21 e2. but now that I am on more need to check e2 again. But given the erection issues this is something you definitely need to check. My old doctor only wanted me to get into the 600 range, and like you i wanted to be more like 900, so this might be something you should talk to him about, but in a way like saying your libido isn't improved enough or still have some other symptoms, if you do of course.

[kelkel]

Your PSA could have been elevated within that time frame. Next test hop off the wife for a long enough period and you'll know for sure where it will land. Yes, your E is high. 3.5 times your original baseline. It needs to come down which will raise your T level. How much depends on your metabolism and you will have to just wait and see. Residue is not uncommon. I used to get it from Androgel myself. Try spreading it over a larger area and see if that helps. Also apply just after a morning shower if possible to enhance absorption. I don't remember exactly what your using but if your going to continue creams/gels and don't like what your on, try Androgel 1.62%. Non sticky and absorbs in seconds. Eventually it seems that most guys end up on T shots.

Assuming the BW was pulled 24 hrs after application I think your doing well with your T levels. Remember your not pulling BW at your peak, but at your trough. Do a pull maybe 6 hrs after application one time and see the difference. With me there was a several hundred point swing at peak time.

I've not heard of the body self adjusting down unless you lower dosage which would lower conversion. High E2 comes with many sides, one of them is your erection problem. You need an AI asap as mentioned above. Always start low with these as your new to them and don't know how you will respond. Yes it's another medication but living with the other issues is far worse than maybe taking a .25mg pill twice a week?

BW is always of use. Except for maybe LH,FSH as once in HPTA shutdown these will basically be non-existant. It's in the stickies. DHT was mentioned above which would be good to get a baseline as transdermals effect it more. Add vit D also to see where your at. That's all I can think of now. Your on the right track just give it time. Get your AI from your doc. If he won't write it, go to our site sponsor and you'll have it in 2-3 days. Always get your BW ahead of time so you can prepare for your visit.

Keep us posted.

[ktmsmith]

[QUOTE=kelkel;5939771]Your PSA could have been elevated within that time frame. Next test hop off the wife for a long enough period and you'll know for sure where it will land.

HAHA...easier said than done since she started on T too.



Assuming the BW was pulled 24 hrs after application I think your doing well with your T levels. Remember your not pulling BW at your peak, but at your trough. Do a pull maybe 6 hrs after application one time and see the difference. With me there was a several hundred point swing at peak time.


Actually the blood work was probably pulled about an hour after I had applied since I put it on twice daily..AM blood work, I never considered doing the pull mid point between applications. I guess I should factor that in next time and that means my T levels might be a good bit lower?

[kelkel]

If I'm reading your last paragraph correctly, no. If you pulled mid day your levels will be higher. The gel you apply is not absorbed all at once. Your skin acts as a resevoir for the gel and it absorbs slowly. One hour later, IMO, is not long enough to garner your peak level.

[ktmsmith]

I'm kind of curious what your pains were like more in detail. And how much they have improved. I'm wondering if my pains are thyroid related as I have high tsh, low t4 waiting on t3 results as old doc didn't take. I tried synthroid and hated it. but might go on armour thyroid if t3 is low, just wondering what I can expect as for as pain improvements. I have pain whenever I squat in glute and hips, pain in a foot a knee and a shoulder and like bicep tendinitis feeling. And for 6 moths last year in the left side of my neck but that went away. I know how it feels to feel 80 years

My joint pain was significant and I think reflective of the injuries and abuse I accumulated over the course of racing and riding over the last 25 years. Although I felt pain and stiffness throughout many parts of my body it was most profound in those parts of my body where I had experienced injuries. As an example, when I was 35, I shatered my tib/fib from the knee down to my ankle. It took 18 months and 3 surgeries to heal including electric bone stimulation. I essentially twisted my foot an ankle 180 degrees backwords until the leg bones disintegrated into multiple pieces. Through the course of riding I have dislocated knees, broken multiple bones, bruised my aorta and generally beat the tar out of my body. For the most part I recovered from each of these incidents and reaaly didnt experience any residual effects until about the last 18 months. Prior to this trt program I am on I was really suffering with joint pain, especially when I rose from bed in the morning. Since treatment which has been less than 90days I can say I feel muvh better...probably a 75% reduction in pain. it hasnt eliminated it...as I lie in bed right now my leg and ankle are backtalking to me.....but it is much better.

[ktmsmith]

If I'm reading your last paragraph correctly, no. If you pulled mid day your levels will be higher. The gel you apply is not absorbed all at once. Your skin acts as a resevoir for the gel and it absorbs slowly. One hour later, IMO, is not long enough to garner your peak level.

Good to know...I keep learning every time I get on here!

[ktmsmith]

Well Dr. visit today was interesting. Doc resisted my request to try AI and rather pushed for Resveratrol 200mg/day. He claims this will suppress T converrsion to E naturally and may eliminate the need to go on an AI. I argued that I wanted AI and we agreed to compromise with me trying the Reservatrol until next visit...which I plan to schedule 30 days from now. Basically I figure I can give a go and see where I am at and if necesarry govto an AI if it doesnt work. His suggestion for Reserveratrol was a complete unknown to me. I have done al ittle research this evening and it appears that it he might be on to something. Has any one else taken or heard of this approach? Sucess or not?

[kelkel]

I have no personal knowledge or know of no one who has used that approach. Read the following link:

http://lpi.oregonstate.edu/infocente...s/resveratrol/