+ 2 Dr driving me Nuts
Been on TRT for almost 17yrs. Got a new Dr and he has been driving me nuts. Started me back on Androgel which never worked for me in the past and still doesn't now. Switched me to shots but of course only wanted to give me 200mg every 2 weeks. I proved to him already by blood work that wasn't going to work and only gave me low T at the end of the 2 weeks. I told him I needed 150mg a week to feel normal and that's what I was on for many years. He still wouldn't up the dose. After 1.5yrs of his BS I decided to just order and take my own Blood panels and prove to him what works. Sust works the best to feel normal everyday so that's what I ordered. To combat the negatives like higher hematocrit (thickening of the red blood cells) which was starting to happen so I give him credit for that but I believe it's because of the higher spike in Test causing it.
Taking 200mg eow I would never feel horny. Not even the spike would improve my libido. So I decided to take much smaller daily doses to mimic how the body produces Test. 30mg/day Subq, 29g 1/2" insulin syringe, and now within a week my libido is coming back. BP is normal 126/85. I will adjust my dose as I get blood work done every 2 weeks. Without the big spikes I expect my hematocrit level to start going back down. Last blood work showed hematocrit at 51.
Taking daily Subq shots is so easy and painless. This should help keep levels more normal and avoid negative sides like high estrogen / hematocrit / BP etc no matter if you use Test E, C or Sust.
I will update this as I go along and show blood work panels.
Where is the best place to order Blood work from?
Thanks
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Sounds like you should find a new Doc. it might be easier than arguing with this one. Plus once you get your doses adjusted all things will fall into place! Many online blood labs just Google it!
30mg eod is working fine and approved by my Dr. SubQ shots are easy. Thanks
Update: After lots of experiments, I'm now just using 200mg every 2 weeks and I'm good with it. I take approx 30mg SubQ every other day. Mon, Wed, Fri, Sun, Tues, Thur, Sat Repeat.
I told my Dr and showed him the process I went through. Showed how it was the spike causing issues like hematocrit levels rising. My estrogen level dropped but it's still a bit high. With this hernia getting worse over time I haven't been able to exercise and I've put on some weight. He wants to give it another month before he puts me on an Ai. He seamed alright with what I had done and was very interested seeing the test results I had to show him.
I didn't want to get hernia surgery until I finished roofing my house. I just finished a few days ago so now I need to plan this surgery. This hernia looks like 2 Aliens trying to get out of my stomach just like the movie. lol
Some MDs are very experienced and good, but MANY have no experience in hormone replacement. One MD told me guys usually quit coming to see him after a year. Because the doses and frequencies are inadequate and the MDs do what is only peer based, for the most part.
Quick update: I switched to every other day shots of 40mg Test Subq and I noticed an improvement in libido. So that's about 140mg a week. It's easy. Mon Wed Fri Sun Tue Thu Sat / repeat. I need to get blood work done to see how this works for me. If all goes well I'll do it sometime next week.
I'm not advocating, nor condemning, the idea of doing one shot a week of 140-150mg test cyp for your context, but I have to ask: Have you tried going to one shot per week to see how it would feel, let alone how your blood work comes back? (If you've already addressed this in previous comments on this thread, my sincere apologies. I only read back on this page of comments only. Just shooting from the hip.)
TIP: In relation to the day you pin, always try to do a blood test at a constant interval afterwards. For example, if you pin on Tuesday mornings, always try to do a blood test on Friday mornings, or Friday after lunch, or Monday mornings, etc, to whatever schedule fits your context (work schedule, etc).
Just make sure that you don't do one blood test two days after you pin, then the next test is six days after you pin, etc. You want consistent data, so the more consistent you can be with you pin time, and then later your blood work time, the better idea you'll get as to how your blood data is responding. (This isn't fool proof, I admit, but it simply adds one more layer of consistency to your data gathering.)
Update: I've been very busy working toward launching a business and I'm still moving my stuff out of my fire burnt Apt back into my house. My protocol is still the same. 20mg Test/daily Subq. I haven't had time to test again but I know I really need to just so I know what is going on. I feel OK by not perfect. I want to exercise but 3yrs ago I had an appendicitis and from that surgery I have developed 2 hernias that have progressively gotten worse this past year. Sometime before the end of the year I'll have surgery for it.
That's rough.
I popped a hernia doing leg press with a belt on. horrible feeling, really weird, not like a specific pain, but a very odd weakness. terrible stuff and cannot imaging 2.
Good luck with the business!
I also want to put a roof on my house before I get surgery, so hopefully next weekend will be dry so I can get a new roof on. It's an old flat tin roof that we will strip off and just put a rubber roof on. Getting the old roof off will be the hardest part since it's been coated with tar etc over the years.
I have constant pressure in my stomach from the hernias. Whenever I eat I feel bloated. Now it looks like I have aliens trying to get out.
Dave_61I get where you're coming from, and how frustrating it can be when dealing with doctors about this issue. I'm on trt myself, and I've been through similiar situations. I know you may feel great with your test at 1271, but on most lab ranges, 1271 is actually high and not normal. So, he may of course not want to keep you there. But, instead of doing this by yourself, you should really try and just work with a trt doctor, even if you have to maybe find another one.
Most importantly, you really need to get your estradiol levels under control! If your estradiol levels stay that high for a long enough time, then you could end up developing serious cardiovascular problems! This should really be your main concern at this time. Along with maintaining your complete lipid profile and whatnot.
I have the name of a really good medical company that can offer you basically, anything you need. They offer bloodwork, test and hgh from legitimate doctors, and even have offices where you can go and talk to their doctors. I'm pretty sure their doctors will be easier to work with. So, I sent you a fr request so I can give you their name and info.
Thanks for the reply... There are several well known clinics close to me. My Dr. even recommended one of them. Your friend request doesn't show . Thanks
I feel your pain on a to conservative Dr.
This has been a very educational topic...
Update: Aug 1st my place caught fire in the bedroom and basically destroyed most things. Not sure how it started as I wasn't home. May have been the lamp that was on blew the bulb and caught fire. Fire dept couldn't figure it out. Wife was there and got the 5 dogs got out. We had insurance that covered most everything but we can't get back the close personal items and the wife is taking it hard. For me mentally I'm fine as it's just stuff. I got lucky because I never took my main computer with all my business stuff to that place.
Going to dig through the mess this weekend and search for a really nice engagement ring that is missing and it was right where the fire started. It's all a bummer but lucky, life goes on.
Giardap, I'm still taking 20mg Test Cyp daily SubQ. my last lab showed my test level is good but estradiol is high and so is hematocrit and RBC. I discussed the hematocrit level with my Dr. and he suggested blood donation... so when I decided to actually do it I asked him to prescribe it and he called in for another CBC... he's driving me nuts. I didn't think they would accept the donation if my hematocrit was high...so I thought my Dr. would make it simple... and order a therapeutic donation... not with him... make me jump through another hoop even though he already knows and has seen it was high. If I have time I may just go donate somewhere tomorrow and get it over and if they accept it then great.
Update: I haven't had time to go donate
I haven't been on an AI since Aug 1st and I feel like I never even started TRT. I'm sure it's Estradiol causing this. I just want to donate then get tested... then show the results to my Dr.
Ah man, sorry to hear about the fire. I hope you find that engagement ring, that would cheer the Mrs. up no end. Best wishes with the search and glad the Pooch's are ok, result.
Dude, I honesty think its time you took a more traditional route to finding balance. How long can you keep this up? The doc knows you are out of balance....
He doesn't understand how estrogen can cause issues. If he did he would have been testing my estrogen the entire 1.5yrs
Hey man,
So where are things now, just to be clear?........
Daily test cyp shots?
Test @ 7**
Estro a little high?
Taking non-suicidal ai but frustrated it is not taking estro down?
Planning to drop ai before next blood tests?
Is that about right?
How are you actually feeling right now?
Alright Huge Update: This entire time, I read my chart wrong and was looking at Hemoglobin instead of RBC.
Yes my Hemoglobin has gone higher but I'm not really concerned about that... it's the RBC and Hematocrit. So let me show you what has happened:
Before I started on anything my Dr. Tested me.
Feb 2017-
Testosterone 231, (RBC 5.19 4.30 - 5.81 x10(6)/mcL), (Hematocrit 46% 38.9 - 51.6 %)
May 30th 2017-
Testosterone 147 this is while on the damn gel
Nov 1st 2017
I had switched to shots after the damn pathetic gel
Testosterone 334, The nurse had nerve to call me and tell me I'm normal now. I told her I'm not normal and she has no idea what normal is. I wasn't nice and I wasn't going to put up with that Bullshit! This is how stupid Dr.'s can be.
RBC 5.63
Hematocrit 50.3 went up also so this is where my Dr. starts getting concerned about RBC and Hematocrit.
May 24, 2018
Testosterone = 234 This is what happens when you take 200mg Test Cyp every 2 weeks and you get blood work done on the day you are to take your shot.
RBC = 5.72 4.60 - 6.10 x10(6)/mcL RBC is climbing but still in the high normal range
Hematocrit 51.8 so now it's out of the normal range... this is also related to hydration and my Dr. discusses donating blood to lower RBC and Hematocrit
The Dr. never tested my Estradiol level--Never felt normal and had no libido.
Now I take control: I begin by taking 30mg/Sustanon/daily/SubQ I know the dose is high but I wanted to get my level up quickly.
July 6th 2018 I get blood work done:
Testosterone 1271 Yes the UG Sustanon is good
Estradiol 84 very high
RBC 5.53 my Testosterone level is 5.5X higher then when my Dr. had me last yet my RBC is still normal, yes slightly higher but still in normal range.
Hematocrit 49.2 5.5X higher test level and above normal yet my Hematocrit went down. Looks like Hydration plays a huge part in this as I made sure I drank plenty of water the night before and the entire day before I got tested like around 2:30pm
So I lowered my Test level to 20mg/day took Exemestane to try to control estrogen
July 20th 2018
Testosterone 798 37% drop in Testosterone and at a reasonable normal level
Estradiol 58 30% drop in Estradiol which correlates with the drop in Test which makes me feel the AI isn't dosed correctly
RBC 5.71 now the RBC is really pushing the high normal. I think the higher Test level triggered the higher level and it showed up in this lab report.
Hematocrit 51.6 This is above normal. I had 3 beers the night before and it shows me how easily drinking can make your blood thicker.
This shows me I need to level the playing field with the RBC and Hematocrit to start over by donating blood and then monitor as my Test levels should be close to stable now. Estrogen is still an issue. Libido seams to come back if I dose enough of this most likely under dosed UG Exemestane.
This protocol is working well for me and is easy. I have no issues with daily shots. No issues with the shots at all.
I will continue to do lab work until everything is stable and my estrogen is in the low normal level. I think I will get labs done on August 3rd but I may wait til the 10th.
UPDATE: I will get labs done on August 10th. I will be off the AI 1 full week prior to testing.
Another update... When my libido tanked completely... and looking at my last result I wasn't sure if the Exemestane was working,,, so I started taking a 12.5mg doses / daily for a few days and then I wrote that I didn't think it was working... I also switched to a shot of Sustanon yesterday and then last night and this morning my drive was in high gear...
I really need to test my Estradiol to see if this UG lab stuff is actually working and if it's lowing my Estrogen and allowing my libido to rebound.
I want to retest after I donate blood... that's if they allow me to... I'm not sure if they will test for high RBC /Hematocrit first... if so I'll have to have my Dr. write a script for therapeutic phlebotomizes
Update: Seams like my libido started taking a dive when I switched back to Test Cyp script and lowered the dose. I'm not sure what's going on. Not sure if this UG Exemestane works either.
When my Total Test was 1271 my Estradiol was 84
When my Total Test was approx 800 Estradiol was 58
So when I lowered my dose I had a 37% drop in my Test level...and only a 30% drop in Estradiol... plus I started using Exemestane... So it looks like the Exemestane is bunk
Now that I have the Test level in an acceptable level where I felt good in the past... I need to get this Estradiol knocked down to a low normal range.
Now to find a decent AI...
Won’t your doc just give you a script for the aro? Otherwise there are plenty of sources on here that stock pharma aro so it won’t be too hard for you to find!
Also why aro? It’s more expensive and arguably more difficult to dose/dial in - especially with pharma tana as they are all hard coated little round pills and impossible to cut accurately - than adex?
I'm pretty sure I could get an AI from my Dr. but I want to figure out exactly what works before I give him all my info.
I chose Aromasin because it's not supposed to mess with cholesterol.
Do you have a pre-existing cholesterol issue?
No not at all,,, total = 180... proportion HDL and LDL is fine too,,, even though it's fine I just started taking CholestOff to see if my HDL can get better
I doubt very much then that on the very low dose of adex you would need to run to dial in your E2 on trt you would even need to worry about lipids. Just my 2c but seems like you’re making this awfully hard for yourself imho!
I'll be off the AI for a week before I test again. I never needed an AI before while on TRT so I don't think I'll need one now.
A great thing about doing blood work like this is I can see how small things like having a few beers can affect my health... now I'm not a big drinker at all... usually 1 beer two to three days a week after work to relax my mind. Of course I've always known alcohol can dehydrate me but it never crossed my mind that it could thicken the blood as I never thought of it that way.
Update: Had blood drawn on Friday and got the results on Tuesday.
I am taking 20mg/Day Test Cyp SubQ
Testosterone = 798= Great Ref range 250-1100
Estradiol = 58 = High Ref range < or = 39
Hemoglobin = 18.2 = High Ref range 13.7-17.1
Hematocrit = 51.6 = High Ref range 38.5 - 50
Testosterone is at a good level for me. Estrogen is still high so I'll need to continue with Exemestane.
My concern is my red blood count continues to rise but it may be because my Test level was high 2 weeks ago.
Hematocrit I believe is more controlled by how hydrated I am. The night before I went out and had a few beers and it probably dehydrated me a bit. I drank plenty of water that morning before the test but it wasn't enough.
The simple and quick solution is to donate blood. I will make sure I'm hydrated before I go to donate.
I have never donated before. I see some clinics offer different types. Whole blood, Red blood and plasma. I know whole blood will lower it... what about just donating Red blood cells? I wish my blood panel included testing for iron... https://www.webmd.com/a-to-z-guides/iron-blood-test#1
2 weeks and I'll test again.
See below for my comment on HCT/Hb. Donation may be premature and your hydration point is right.
I agree, but I'm thinking of leveling the playing field now and see how it goes a month from now when my blood builds back up to a hopefully lower level. Higher levels are associated with heart disease, stroke, heart attacks...
Update: I did get blood work done on Friday. I think I'll have results by Tuesday. I didn't take another dose of Exemestane and my libido keeps improving. I'm still on 20mg/day SubQ Test Cyp from Dr.
Blood pressure is still normal.
Update: took 12.5mg Exemestane on Tuesday... libido keeps improving... I'm planing on getting blood work done tomorrow.
I will not take more Exemestane tomorrow... I want to see where I'm at first
My upper body feels stronger, pumped and harder... I noticed my tool bags etc don't feel as heavy and they are quite heavy... soon I'll be getting back to the gym
Update: Took a second dose of 12.5mg Aromasin on Friday and I'm on 20mg/day SubQ from my script. Finally a nice libido increase this morning with much more sensitivity.
For those that may not know. There are clinical studies showing that AI's can trigger Test production even when on low dose Test... Mostly done with young boys where they want them to grow yet keep the growth plates open so they can grow. Shows that estrogen will lower then come back up into a low normal level.
I would link you to the studies but I lost hundreds of studies when my comp crashed years ago and I didn't have a backup. Can find them on pubmed.gov
Test Results are in. I don't know how to post the entire panel so here is what is important. Went to LabsMD
ESTRADIOL (84) HIGH < OR = 39 pg/mL
TESTOSTERONE, TOTAL, LC/MS/MS 1271 HIGH 250-1100 ng/dL
HEMOGLOBIN (17.4) HIGH 13.2-17.1 g/dL
HEMATOCRIT (49.2) . 38.5-50.0 %
Test level is high, which shows the gear (Sustanon) is legit and gtg
The key thing here for me and the Dr is my Hematocrit has dropped from 51 to 49.2 into a normal level but I would like to see it go lower. I recall my 2nd Dr. mentioning it to me one time that my blood was getting thick but he never said anything again about it.
My testosterone level is almost 4 X higher then when I last tested from the Dr. yet my Hematocrit has dropped into the normal level even though my testosterone level is also well above normal. This may show that it's the spike in Testosterone, not the level that can make Hematocrit level rise above normal as when I took my last shots from the Dr. I took one 200mg shot for 2 weeks.
Estrogen is the reason why I don't feel normal as it's more then double high normal range and I would like to see it around 30 or a little less.
I have begun Exemestane @ 12.5mg 2X/week for the first week. After that I'm thinking of lowing it to 6.25mg 2x/week as I don't want to crash it.
I'm going to skip 2 doses of testosterone then begin 20mg/day SubQ as the SubQ dosing is working great. Seams like skipping 2 doses is enough to lower it a bit then level it out more with the lower doses.
Because I'm taking Exemastane I may get tested again in 1 week as I don't know how well this Exemestane will work and it may work too good. It's UG stuff so who knows. I would prefer not to use an AI if I can get away with it.
Maybe the Sustanon spiked my estrogen higher then it should be, but I didn't have an issue in the past using it, but of course I'm much older now so that may also influence it.
Over all this is going well and I sort of figured if the testosterone was dosed correctly my level would be high, so 30mg of Sustanon /daily has gotten my level to 1270 out of a high 1100 scale. So I'm dialing it back by 30% so my level should be around 900 which sounds great to me which is what I knew I should have started with but I was tired of waiting.
In the end it will all work out.
100% spot on and confirmed to me by my endo and why his preference is weekly shots as opposed to bi-weekly. That said unless you have an underlying medical condition and/or high BP I wouldn’t really worry about the HCT leve unless over 54. This is my endos position. High HCT is only really a problem if caused by an underlying issue and/or in the presence of high BP. The high end of the range is too low in his view. He has me managing to 54 and donating only if I’m over that level and then no more often than every 12 weeks.
We were discussing this over in the advanced group and too many folk are donating for marginally high or approaching the upper end of the range and then every 8 weeks and this in Itself will lower HCT/Hb then cause a massive spike. It becomes a self fulfilling prophecy as guys are pulling bloods every 6 to 8 weeks and then seeing huh HCT/Hb levels and rushing off to donate where it’s the donation and corresponding rebound causing the spike and not a true response of the bone marrow to the hormones.
Rather plot the trends over time and if getting substantially and consistently over the upper end of the limit and/or BP spiking then donate and only test 8 to 12 weeks after before considering another donation.
Food for thought guys.
Edit: the point being donating too often has other issues and puts a different strain on the body and it’s complex systems and in many cases is unnecessary.
Appreciate your input...
Yea my Dr. said I should consider donating blood... but I wanted to figure this out before I do that and get to the root of the problem instead of fighting the symptoms. The logical thing was for me to take the shots like my body makes it... in small daily doses.
The best thing a young guy in his 20's should do is get his level checked and keep that info cause later on in life he may need it and he can show his Dr. what his normal level should be.
From my own experience I can say nothing feels as good as my own natural testosterone. They may say the shot is identical but it's not. Anyone else agree?
The other issue as play here and the doctors still don’t understand why is that the injectable version of testosterone we are all using are not bio identical and non bio identical testosterone seems to have a greater impact on bone marrow than bio identical forms too. The only bio identical forms available are in the gels and pellets as far as I know and gels are a nightmare achieving stable levels given huge variances in absorption levels from person to person. I haven’t used pellets as I don’t fancy an implant and there not commonly available where I am from.
My Dr. actually suggested I go to one of the local clinics and try the pellets. Says he knows men that have gone there with great success. I just don't want to spend another $200+ a month when insurance is already sky high and insurance won't cover it... such a scam
Personally having read this forum and everything you’re doing if I was you I’d be injecting between 10 and 20mg of TeatvProp daily and pulling bloods to dial in actual dose and need for AI. If you could get some test ace even better. This would as closely mimic the natural production of testosterone as possible and will remove these spikes (test and estro) from the long esters.
I would be willing to give it a try sometime in the future. First I need to get the Dr. onboard with daily Test Cyp before I experiment more as I know he will give me Test Cyp as that's what I have from him now.
Sust is not suitable for TRT due to its pharmacokinetics. This proves it.
Dude, you are playing at TRT... no bueno.
Maybe, Sustanon is making it worse... Either way, I'm lowering the dose to 20mg and I have 20 days worth of Test Cyp from the Dr. to use.
I'm not playing at TRT... I'm finding my dose cause my Dr. is taking too long and is scared of Hematocrit level getting high and I just proved him wrong and my level has already lowered even with 4 times higher test. level.
Took the Dr. 2yrs just to get me to have low T every 2 weeks so I'm not allowing him to play around when he obviously doesn't know what he's doing. Now I just need to dial my dose down and I'll be good.
But anyway, I'm just here to show my journey with my Dr and an alternative way to do TRT.
When I say playing at it, honestly, I just mean experimenting with sust. Its very simply due to the release curve. Any short ester peaks way higher than a longer one (pp or prop versus cyp, enth, decano or greater.
I love the fact you go daily, love it. But the sus peak is hurting you. Once you hit the point of aromatising beyond what you need that estro goes way up and things like prolactin will follow. Then you drop test levels but the other hormones take ages to follow down, unless beating them down with other meds, then you need to adjust them again once done.
All I mean, is that its all interconnected and there are established esters to help you out. But... I still love your daily approach. Its cool.
I see you do self blood letting to keep you're Hematocrit in line... that's a smart move...I plan on donating blood after I prove to the Dr. it was the spike in my level and not the level itself making my Hematocrit rise. Now it's still higher then what I want but it's lower then what it was when I started the daily shots. So I will donate to keep it on the lower end of the scale.
Studies have shown anti aging benefits by receiving young blood... So the vampire living forever isn't too far off... you just don't drink it... lol
Here is a link talking about a study:
https://www.nbcnews.com/health/aging/young-blood-restores-old-mice-n95816
Yea, you're right... I used Sust for trt in the past but it's been a long time and I'm sure age plays a huge part... Sust in the past did make me feel better then using Test E or C but back then I was taking 1 shot a week. Now that I'm taking daily doses I shouldn't need a spike from the Sust to boost me back up each week.
I will resume tomorrow @ 20mg/day Test Cyp from the Dr. I have 20 days worth. I will also take one more dose of 12.5mg Exemestane this Friday. I will do another blood panel on July 20th.
Could be placebo effect but I didn't feel as tired today.
i love regular subQ low dose test
keep up the good work
BP today was 111/79 P=72 so that's doing well
Update: I wanted to do blood work last week but couldn't so I actually had time to do it today. I went with https://labsmd.com/tests.php?view=all&show=2234&category=14&search=#2234 and the Panel was $72.99.
I had a hard time with their website. I would click to add to the cart. It would say it was successful but then there wasn't anything in the cart. I tried with Firefox and Chrome... On my comp and on my phone. Then it finally worked and when I tried to check out the check out button was nowhere to be found. I called and they weren't having trouble... I just about gave up when it finally worked. After that all went well... Thought I would let you know in case you have issues too... They say it can take up to 5 days for results.
Anyway, that's my update... I still don't feel normal... a few more days and I'll hopefully see what's going on.
Small update: Blood pressure is staying normal. I don't get hot flashes like I would when taking 200mg at once. Still no issues at the injection sites. Muscles are more full. Energy slightly better but not even close to feeling normal.
I started this on June 8th... I had an increase in libido then a decline... First week I used my script, and second week till now I have been using a UG supplier for Sustanon. It's possible its under dosed. I will get blood work done on Friday. I have another vial of my script now but I will wait until I get blood work done before I use it. I want to see where this Sustanon puts my level @ 30mg a day.
It's hard to be scientific when I don't know for sure if the Sustanon is properly dosed. Certainly I can adjust my dose per what blood work shows but it won't prove that's the correct mg I'm actually using. But I can without a doubt state that I'm not normal yet.
I feel your pain, I’m going through the exact same thing with my new Dr.
My TRT was test cyp @ 1.2 wk from old Doc...
It’s been 8 mo and still no drive for my wife and loss of weight, it’s tough my wife says play his game and keep complaining to him as the blood work will show him your not lying... Good luck