MY E2 Management Thread :)

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Free Test: 47pg/mL (8.7-25.1)

Total Test: 1479ng/dL (348-1197)

E2(sensitive): 46pg/mL (3-70)

Free T4: 1.37ng/dL (0.82-1.77)

Free T3: 3.2pg/mL (2.0-4.4)

TSH: 1.95uIU/mL (0.45-4.50)

mainly feel tired a lot during the day as well as when i wake up in the morning. this is more pronounced here in the last several months. thought it might be thyroid as my doc has asked my if i felt tired before and told me my thyroid was "slugggish" and "not optimal" but also not hypothyroid either..

Austin??

also my E2 is slowly climbing.. it was 40 back in march and now its 46.. im not on any AI and would rather not get on one.

[phaedo]

Free Test: 47pg/mL (8.7-25.1)

Total Test: 1479ng/dL (348-1197)

E2(sensitive): 46pg/mL (3-70)

Free T4: 1.37ng/dL (0.82-1.77)

Free T3: 3.2pg/mL (2.0-4.4)

TSH: 1.95uIU/mL (0.45-4.50)

mainly feel tired a lot during the day as well as when i wake up in the morning. this is more pronounced here in the last several months. thought it might be thyroid as my doc has asked my if i felt tired before and told me my thyroid was "slugggish" and "not optimal" but also not hypothyroid either..

Austin??

also my E2 is slowly climbing.. it was 40 back in march and now its 46.. im not on any AI and would rather not get on one.

I read through your thread - interesting to say the least! It appears you've had quite the time nailing down your TRT protocol.

I've noticed you've consistently kept your testosterone at supraphysiological levels. You've been running a permanent, low-dose cycle, I think. Is there any reason you're pushing beyond normal levels?... I'm assuming for the merits of performance and bodybuilding?

Your thyroid looks normal (which is good). Your fatigue, however, raises a few questions. Regarding your fatigue pattern, do you have trouble waking up, but once you "get going" your best or most alert part of the day is between morning and noon? But by early afternoon, you begin to feel somewhat lethargic, and by evening you're pretty worn out and ready for bed?

Also, how sensitive are you to caffeine? Do you chronically drink coffee, use pre-workouts, etc.?

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[QUOTE=phaedo;6570818]

I read through your thread - interesting to say the least! It appears you've had quite the time nailing down your TRT protocol.

you are correct sir! most of this time that was so tuff was when i was injecting IM. since i have switched to subq i actually got it dialed in. im currently running 160mg test per week because i had it raised due to a cut i was on and have not brought it back down. my TRT doc prefers to see my free test around 30-40.. my dialed in dosage is 120mg per week. it keeps total around 1000 and free around 25 and E2 around 19 which is pretty much perfect.

I've noticed you've consistently kept your testosterone at supraphysiological levels. You've been running a permanent, low-dose cycle, I think. Is there any reason you're pushing beyond normal levels?... I'm assuming for the merits of performance and bodybuilding?

yes u are correct aside from what i mentioned about my doc liking to see it high..

Your thyroid looks normal (which is good). Your fatigue, however, raises a few questions. Regarding your fatigue pattern, do you have trouble waking up, but once you "get going" your best or most alert part of the day is between morning and noon? But by early afternoon, you begin to feel somewhat lethargic, and by evening you're pretty worn out and ready for bed?

my doc insists my thyroid is "sub-optimal" but normal. as far as ur description of my daily fatigue pattern: have u been following me around or what?? LOL.. that is the nail on the head!

Also, how sensitive are you to caffeine? Do you chronically drink coffee, use pre-workouts, etc.?

not sensitive to caffeine. i drink 12 cups coffee everyday in the am.. (yes 12).. i make an entire pot and i have 2 bubba kegs that hold 34 oz each and i fill em both up and drink them within 2 hrs of waking up. after that i may have a diet dew or 2 or 3 throughout the day and another 2-3 more at night when i get home. i dont use any pre workout drinks.

[phaedo]

Another few questions: Do you crave salt? Do you drink large quantities of water compared to your work co-workers or friends, etc.? Do you urinate pretty frequently? (sorry, but trying to embarrass you lol). How often do you workout? (frequency, intensity, time...)

Perusing the historical trend of this thread (symptoms, labs, caffeine use, and most notably the persistent supraphysiological levels of testosterone) I think you're borderline adrenal insufficient, if not already there. People on the interwebs (with an M.D. from Google Med School) claim this phenomena as "adrenal fatigue," but the medical industry doesn't recognize "adrenal fatigue" and refer to it as the aforementioned insufficiency. In other words, you're probably producing inadequate amounts of cortisol. Chronic levels of high testosterone has exhausted your adrenals.

Inducing high levels of testosterone or thyroid hormones provokes intense adrenal stimulation. You're literally instigating greater stress on the body, where in turn, the adrenals compensate by secreting higher levels of cortisol.

In the bodybuilding community, cortisol is deemed as this great "catabolic" hormone responsible for the "metabolism of hard earned muscle" and causes lots of "fat gain." It makes for good article in Muscle Fitness, but cortisol is very necessary for life. It's not all the detestable; quite the contrary. Most dramatized magazine inserts or under-qualified hearsay on message boards draws erroneous conclusions from Cushings Syndrome, where cortisol in excess and will cause problems and symptoms we want to avoid. Their argument is a straw man. Anything in excess (or in deficiency), however, is a malfeasance.

In the 1940s, those with adrenal insufficiency, called Addisons, lived an average of 8 years. With the advent of hydrocortisone, predisone, and dexamethasone, simple cortisol-replacement-therapy now allows patients to live long, healthy, normal lives. If, for example, you suffer from adrenal insufficiency and you are involved in a car wreck, you'll most likely die without an injection of hydrocortisone soon following the trauma. My point is that cortisol, when moderated, is good and should always be considered during any form of treatment for hypopituitarism.

Cortisol usually begins to rise four hours before you wake up, and is at its' highest level in the morning and slowly tapers off over the day. Your diurnal curve is probably similar, just relatively much lower on the scale. During periods of high stress, you probably feel tired and overwhelmed. Hence, you supplement with extraordinary amounts of caffeine to get you through the day.

I'd suggest you speak to your medical professional and request a diurnal cortisol saliva test and cosyntropin stimulation test. Together, both of these should give you commensurate numbers regarding your symptoms, lifestyle, and offer substantial prognosis.

If you do have adrenal insufficiency, my recommendation would be to lower testosterone into "normal" levels (800-ish) and reduce the amount of training. The adrenal glands are pretty resilient, and given time and adequate rest, can recover and maintain proper cortisol and norepinephrine levels. Resorting to exogenous cortisol therapy would be my last option, in my opinion.

~ phaedo