45+ TRT, anything I should add beyond HCG?
I'm 45 now. Eight months ago, my doctor prescribed TRT 120ml Test Cyp every week. It has changed my life.
My doc is conservative about treatment. He normally prescribes only Test, exercise, and diet. When I noticed shrinkage, I had to press a couple times for HCG. He eventually prescribed HCG and was OK with continuing to prescribe based on the results. HCG helped with shrinkage, I suspect it helped with lipid profile too.
Should I be asking him about Nolva or Clomid while on TRT? Does either help with HDL/LDL ratio?
I have learned a lot about what affects my HDL/LDL ratio over the decades. Low carb, high fat reduces LDL. Alcohol in moderation increases HDL. For example. My doc has a machine to test artery health, and it says I have the arteries of an 18 year old. I don't believe HDL/LDL ratio is the be-all, end-all of artery health. And I don't trust statins. But I want to be careful about heart health.
Blood pressure, blood thickness, lipid profile. What else beyond HCG should I check out?
- Bookmark
- 1
- 1
Have you had blood work done? Can't make any suggestions with out it
Yes, every 4 months, but just total test, LDL, HDL. Test stays around 800-900. LDL is high, but HDL is high enough to make ratio below average risk.
I haven't had anything out of line that would prompt the doc for full hormone profile. Not trying to fix any problem at the moment. Just wondering if I should be testing anything else or taking extra precautions to avoid potential heart issues in the future.
I can push for FSH, LSH, estradiol, etc. or get it myself, but the docs philosophy is this is TRT, not a cycle, so he feels monitoring test and cholesterol is sufficient unless there are specific concerns.
Knowing your total estrogen is REALLY important, and it certainly doesn't hurt to have other data (like liver data). The more data you have, the better you can proceed, especially as time progresses if you see those numbers change. Don't be afraid to get your own blood test(s) through privatemedlabs or one of the other online labs that the boys here on eroids use. PM me if you'd like more info. (If you go through privatemedlabs, choose "Female Hormone Panel" and then select "MALE" as you're "checking out." It'll give you all you need to know for 65 bucks, or if you use one of their discount codes that they'll e-mail you, it's 52 bucks. TOTALLY WORTH IT to have that extra data for future piece of mind.)
It doesn't include free T Zeus. Is that not a problem? Just curious.
I checked out PrivateMdLabs. They have labs near my house. I will do my own test every 3 weeks. Thanks for the tip!
Always, +1 for blood work!
Hey, got the first Private MD Labs result back. Estradiol is 77, 2 days after the injection!! I take BP reading two times every AM and PM, and it swings between high and normal on a one week cycle. Damn, I'm glad you suggested I get this tested! I will bring up with the doc at my next appointment. First thing I am going to try is switch to injections every 4 days instead of once per week. The doc already suggested this as an option if I feel the Test Cyp crashing out by end of week.
He was also encouraging me to take synthroid, becouse my thyroid is in normal range, but not "optimal".I said no, because I was worried about atrophy of my thyroid. But I guess synthroid will clear the Estradiol faster too. Is synthroid safe long term? And tamoxifen could keep it lower too. My cholesterol numbers are good, all in reference range and ratio of 2.0, so the LDL-lowering effect of tamoxifen would be icing on the cake.
LH/FSH near zero. This is normal, right? All liver tests good. All blood tests normal. How do I measure blood thickness? Is that covered by Hematocrit, RBC, Platlets? Or do I need a different test?
I noticed the Female Hormone Panel doesn't show Free Test or E3/E2 breakdown. Do I need a different test for those? Are those important?
Stats
Age: 42
Height: 6'1"
Weight: 220
Since: Oct 16th, 2016
Last: Oct 26th, 2016
Things that can affect your FICO score is the length of your credit history. and on time payments.
Likewise, here on eroids the things that can affect your trustworthiness is the amount of time you've been here. and being able to remember your stats. Ageing 3 years in 10 days is like missing a mortgage payment. Now everything you've said here is suspect in my eyes.
First off you always take a blood test early morning the last day before your next injection. It'll give you your best "low" reading.
The tenor of your posts does not sit right by me now that I'm reading it a bit more critically. I can not see this same scenario playing out with my doc. I would have brought up all of your questions with him and he would have been more than happy to run every blood test known to man without me doing one behind his back.
I highly doubt your doc would suggest thyroid meds if your numbers were within normal range. That's like saying you need the oil level in your car to be 100% and if you run it a half quart low you'll see a performance drop.
The endocrine system is a complicated and fascinating system. There is no way you, or your "doc" can do a better job at regulating it than what your body does naturally. It's difficult enough to handle just ONE piece of the puzzle much less several all at once. 8 months and it sounds like you haven't gotten your test levels worked out yet. And you're suggesting your doc wants to start "tweaking" your thyroid?
Eight months into "treatment", you're asking about RBC levels? I guarantee you that would be one of the most important and first thing your doctor would have looked at.
You say (or your "doc" says) you have the arteries of an 18 year old.
That much I believe.
I'm between 42 and 46. I'm not going to post anything specific enough that it could be used to positively identify me. I hope you wouldn't pressure anyone here to do otherwise. You're a mod with tons of exp, I would trust you to look at redacted photos of my labs and doctor recommendations to prove to you I'm telling the truth. Let me know how to send you the evidence privately for your review.
As a matter of fact, my doc recommended Synthroid BEFORE treatment, based on labs in normal range. I said no, because I don't know enough about thyroid endocrinology to feel comfortable with the risk. I never want to make uninformed decisions, regardless of doctor recommendation, which is one reason I am lurking and posting here.
Also, as a matter of fact, my doc never asked for CBC. I didn't ask about CBC tests either, until someone here recommended I do Female Hormone Panel at PMD Labs. I don't find that to be weird.
Also, there is no "behind the back" blood tests. I have shared previous blood tests with my doc, and he has always allowed me to choose to have additional tests added and blood drawn by his office, by my primary care physician, or any other way I choose. He has always encouraged me to do as much research on my own as possible. Why would it be otherwise? This isn't like some drug test where the scowling doc has to watch you pee in the cup to know it's yours.
I'm not sure what is so hard to believe about this. My doc is highly credentialed with decades of experience with hundreds of clients. He is very conservative. His clients are mostly older men and some athletes. I don't think he has much or any experience with the kind of people who post here. I had to nag him for HCG. I am on a standard TRT program with test levels consistently maintained. You could be correct that CBC is SOP for TRT docs, but I somehow doubt it. Measuring CBC makes sense for people blasting and cycling with shit they bought from the Internet. It may be less important for people on low dose replacement therapy with pharmacy pure product and a standard protocol used by hundreds of patients.
Either way, the people who post here (aka, people who blast and cycle with shit they bought on the Internet) probably have more knowledge and experience than a bunch of old dudes all following the same basic low-dose replacement routine. That's why I'm coming here for knowledge. I expect a lot of noise, and I take everything with a grain of salt, but I'm here to learn.
First off you always take a blood test early morning the last day before your next injection. It'll give you your best "low" reading. Your doc would have had you do the same every 4 to 6 weeks while he monitors and tweaks your dosage. I would have expected that you would have followed suit and got the blood test the morning before you took your injection. Not Day 2. Your results are not that helpful for your doctor because he wants to make sure your levels are still in that optimal area of say 600-800 at your low point and not 300.
I would have expected you would have requested your doc to do the tests you had MD labs perform.
The questions you are asking here e.g. RBC count is something you would have faced with your doctor after your first blood draw with him. Not something that appears you stumbled across on google just last week.
Again, It's the tenor of your posts that does not sit right by me. I am on scripted TRT. It was a battle to get the doctor to accept my 200 as low. and it took little more than a year of careful monitoring to to find that sweet spot. I too was researching everything I could find and discussing options with my Doc... but by eight months into treatment many of the questions you're just now asking would have been brought up already.
I agree, create stats as close to real life and stick with it. No need for a sliding scale.
https://www.eroids.com/forum/general/general-talk/shut-the-hell-up
Your endo sounds way more professional than my 1st one. Mine didn't care what time or what day I took my bloods and only for total test @ free test lvls. He also would only perscribed max 100 tcyp a wk regardless how off my levels were.
Needless to say after doing copious research I found a decent endo.
People definitely need to shop around for a quality endo who will work with their patients specifically, not just cookie cutter one size fits all.
I'm sure different docs have different styles. My GP is quite different from my TRT doc and I wouldn't expect my TRT doc to behave exactly like yours. Your TRT doc sounds more conservative than mine.
Of course the blood draw is in the morning, because fasting. My doc said he doesn't care what day I draw. I assumed people who wait until last day are trying to get their doc to prescribe a bigger dose, or are troubleshooting crash effects. I can see your point, but I would rather just pin E4D rather than worry about where the peaks and troughs are.
His office is heavily booked and difficult to schedule draws, so patients take whatever day they can get. I agree that's suboptimal for charting. That's another plus in favor of using PMD Labs, where I can walk in without an appointment any time.
Again, I'm not sure why you are getting hung up on RBC. RBC never came up with my doc before now, and I'm not even sure it's relevant now. I'm not troubleshooting any problem, I'm just trying to educate myself.
Is your point that no real doc would do blood draws without checking RBC? He's a real doc and he's never checked my RBC. My GP gets RBC in the bloodwork at my annual checkup, and it's never been out of reference range. My TRT doc didn't ask for my annual bloods from GP though. Maybe he doesn't expect low dose exo test targeting test levels within reference to have any impact on RBC? Maybe he didn't feel it worth troubleshooting, since my cholesterol and artery health looked good? Who knows? It's not obvious to me why a doc would check RBC for every patient. Every patient is different.
Or is your point that I'm stupid for not Googling RBC and bringing it up with him sooner? I'm not sure why I would have looked up RBC sooner though, because I don't even know how relevant it is. But the entire point of this thread was me asking for advice from more experienced people about any other things I should be paying attention to.
I agree Frank, Hormone clinic docs are way more comfortable with administering hormones than a GP.
My wifes Doc has not asked for a RBC on any bloods yet, and when we did it on our own and she showed elevated RBC and hemo #s just above the normal range he was not concerned at all.
I asked if she should donate blood and he said only if she wants to. He explained that the increase in RBC is just a normal side, and is not polycyclemia. The platelets are not elevated, and a slightly elevated RBC is just not a big deal.
My wife gets test pellets, as well as a host of other hormones. Normal test range for women is <45, but she stays above 45 for the entire 3 months between pellets. when she drops down to 45 it's time for new pellets.
Not every Dr treats HRT and TRT the same. Your Dr sounds like a typical hormone clinic Dr.
+1
How can anybody expect to get advice of this nature if they aren't being honest.
Every little detail counts, including age
sometimes guys post a fake age along with a fake name.
As long as he's not 20 something I dont see a problem with it
Lots of mods, ADV, gurus etc that dont post real stats.
My stats are real. And, if I could prove beyond a reasonable doubt his age was less than 25 he would not be here.
Yeah I see what you're saying and I suppose that makes sense
It sounded like his doc was a real assclown but I think the real clown here is the OP. I was thinking "what kind of doc in their right mind would be suggesting all that crazy stuff," lol
How is it not optimal if it is in the normal range. This doc sounds like a real assclown. I'd be steering clear of him.
How am I posting on a "45+ TRT" forum, and people don't understand the difference between "normal/reference" and "optimal"? Isn't there a sticky that explains this basic shit?
If you measure test levels in 10,000 men, and plot it on a graph, it will make a Gaussian curve. Men will be considered to be "normal", or "within reference", if their test level falls within 2 standard deviations of the mean. For my age, Test levels of 300 would be considered "normal". There are enough 45 year-olds with test level 300 that it's not an outlier, thus it is "within reference range".
Do you think that is optimal? Do you want to try living with a test a level of 300 for any extended period of time?
My doc targets 850 as "optimal" for my age. Test level of 850 feels pretty optimal to me. That is also "within reference". Test level 850 is just as "normal" as 300. That's how Gaussian curves work.
He is obviously using the same language regarding Synthroid. However, my trepidation to target "optimal" Thyroid is based on my doubts about long-term damage or ability to restart natural production. I feel that TRT is safe, because bodybuilders have much practical experience with PCT. I have no such confidence about Thyroid.
my wife goes to a hormone Dr and was given t3 t4 supplement even with her level being within range.
Dr's have a level they want their patient at, and they will supplement even though its in the labworks range.
Here is a copy paste from her Dr consultation notes.
. Thyroid
a. Thyroid Peroxidase Antibodies - <1 . You do not have any
Hashimoto’s Thyroiditis.
b. Free T3 - 3.3 à 2.9 . Baseline f ree T3 falls on the low range of
normal. It should be closer to 4.4 . Free T3 signifies that not enough
T4 is being converted into T3. Your levels have actually dropped.
c. Iodine - Adequate iodine levels are essential for proper thyroid
function. Supplementation of iodine is needed.
d. Recommended treatment:
i. Increase : Armour thyroid 1.0 grain; take one (1) tablet
each morning, ½ hour before food and other hormones
ii. Continue: Ioderal (Iodine) complex, 12.5 mg ; t ake one (1)
capsule ev ery other day
iii. Retest free T3 levels in 3 - 4 weeks once thyroid
replacement therapy has started.
Damn,..........I'm at 5 grains and have been for 2 years and I'm should be looking at an increase, 8 PM rolls around,......... and I just crash, it's like walking into a wall. I'm fine one minute, then 10 minutes later I'm crashed.
Damn. This is me, too, @KMC. I have always attributed this to the fact that I work like a pack horse, but before my own self prescribed testosterone cruise, I felt like I'd hit the wall every day just after lunch. I tried small meals all day, just to see if it was insulin, but there was no change until I elevated my test levels. After that, I still get tired, but I'm not "dead to the world."
My doc told me my thyroid numbers "looked fine" on my last visit (last fall, over a year ago) and with my own privatemedlabs tests, I've only done the female hormone panel "for men," so I'm thinking it's time to gather more thyroid data. Hmmm. Thanks for the share, KMC. +1
I just recently read about Nolva helping lipids as well as HCG.
Hey brother, if you can share that link, I'd love to learn more about that avenue as well, just for the info! No worries if not. It simple piques my curiosity.