New to TRT advice
So I have been prescribed 200mg rest C split 3.5 days and just finished my 8th pin(4th week). I just started noticing a little more sensitive nipples(spicy nips?). It’s not really hurting too bad unless I purposely rub them but I am definitely noticing a difference compared to before. From what I’ve been reading it sounds like high E levels but I guess what I’m wondering about is is this normal while your body is adjusting to the new t levels and likely going to go away on its own or should I start looking into an AI or something or just wait until my next bloodwork? My appointment isn’t for 2 more months.
Male, 36 240lbs(have put on about 12lbs since I started but I’m assuming mostly water weight) bf ~25%
Levels when starting.
Test: 479 ng/dl
Free T: 6.4 pg/ml
Estradiol: 34.3 pg/ml
(Not sure what else might be of use but I can show if you tell me what is needed)
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Your natural levrls were excellent. Now you smashed a good thing for a clinics greed. Clinics dont care about you. Money driven hormonal death squad
Your trt dr didnt prescribe you arimidex? It's not hurting bad yet but it will. It will become so bad you'll damn near cry if something just brushes up against them SOFTLY. I've nearly backhanded my girl through the wall a few times because of this. It's all bad. Get arimidex/aromasin/nolvadex
Nope he didn’t prescribe me anything like that. To be honest I didn’t even know to ask for such a thing when I had my appointment to go over the bloodwork.
Hey man, not hating on you or anything but keep in mind test and fat don't usually mix the greatest. 25% is a little higher than recommended, and normally the higher bodyfat the more you will aromatize. You can get an aromatase inhibitor to lower your estrogen but it isn't something you'll want to take long term if you're going to cruise 200mg/week for a while. So you could lower your estrogen by pinning more frequently and lowering body fat.
What are your intentions for taking the test? I see you said TRT but 479ng/dl natural production doesn't necessitate TRT.
yeah I’ve read up a little since and have learned that higher fat levels aren’t ideal. I honestly never really expected my doctor to keep me at 200 a week I figured we’d adjust down when the time is right. I’ve been going to the gym pretty hard for a little over a year and have brought my bmi down considerably since starting and want to continue to do so. Would test cyp x3 a week at 66mg really help much over twice at 100? I know that my total test was in mid range but that free T freaked me out seeing it that low and have just been following the instructions given from the doc. I found out I have thyroid problems too and got put on NP thyroid at the same time i got prescribed test and a shitload of vitamins.
My main intention for going to get my blood work done was Just to check up on hormone levels and get a full physical.
I was referred to a hormone therapy clinic because of symptoms I was talking about with a friend (no energy, no sex drive…like at all, trouble sleeping and concentration, feeling like my gains at the gym are taking abnormally long even though I eat very clean and exercise hard and I calorie count and journal my exercises).
Right on, if you are getting this sensitivity and pain, acne, etc other high e2 symptoms feel free to lower to like 100-150 mg/week, you may aromatize high and definitely don't want to induce gyno or increase blood pressure too high, etc. And yes 3x a week will definitely help compared to twice. MWF is a good schedule.
Check out your SHBG levels for the free testosterone readings. SHBG can be lowered without TRT. Just worth a mention, I'm not persuading you away from testosterone just letting you know. When taking testosterone even though 200mg/week isn't crazy make sure you get labs to check your CBC, metabolic panel, lipid panel, E2, PSA, and ferritin. There's others but these are usually the common ones on bundle labs that will give you a good picture.
Docs/clinics honestly are not very knowledgeable with exogenous testosterone and it's kind of up to you to make sure you are doing it right. Clinics just want your money and doctors usually aren't hormone experts.
I think I’ll switch to 3x a week starting next week then since I get my prescription refilled Monday anyways. I don’t really want to mess with the dose without at least keeping my doctor in the loop but if the pain does get to the point it’s unbearable I obviously will.
I looked at my labs and didn’t see any shbg portion but maybe I just don’t really know what I’m looking for. I updated and posted my labs in the original post.
If I do get on an AI how quickly would i see results from them? Do they build up like test does would I see results fairly quick?
Also thank you for being cool about this and teaching me along the way.
You're going to a clinic. Clinics vary in structure and operations. Some are ran by doctors like endocrinologists and urologists who more specialize in hormone therapy and are more likely to have the expertise to prescribe and monitor TRT safely. However, others are ran by people who are unqualified and using an APRN to write prescriptions and are just taking the money—a pill mill if you will. Like Scooby said, 200mg is usually too high for your average joe for cruising and is probably a bad idea—it's just the highest amount they can typically get away with legally, and your average joe just wants the high dose. Most won't see high enough levels for "supraphysiologic" advantages and will just be very high natty status, and the body treats exogeneous testosterone different than natural production. Personally I am around 100mg/week split twice a week for real TRT.
Your thyroid issues can absolutely effect your free testosterone levels. Medical practices usually do not just throw you on multiple medications at once as it's hard to see which one is doing what exactly for some parameters.
Are you going to a doctor or a trt clinic? A doctor wouldn't normally prescribe someone with your natural levels trt. 200mg a week is too much for trt, unless your testosterone levels aren't going up. Do you know what your testosterone levels are at 200mg a week? Like Hazard said, lowering your dose wouldn't be a bad idea. The goal should be to find a dosage where you don't need ai, if possible.
It’s a preventative health and wellness clinic the website says hormone replacement therapy but yeah I guess testosterone is a hormone I just never gave it much thought. I haven’t had my second set of bloodwork done yet they set up an appointment at 3 months to get it checked after my levels settled down
Just for reference, I run 75mg a week. That's where I don't usually need an ai.
Oh wow! Even on such a low dose(is that considered low?) do you still split it up 2-3 times a week or just do it x1 a week?
I've seen people on Dr. prescribed trt at 80mg a week. I split it twice a week. You're going to come back at probably well over 1000ng/dl on 200mg a week.
You should run an AI if you’re getting gyno symptoms already. I aromatize like crazy myself. Some people don’t need AI but I have always needed it. You can take .25mg adex when you take your shot twice a week. If your estrogen gets too low from that, maybe just take the adex once a week. You will probably be fine with twice a week though.
I would definitely reach out to my doctor and let them know. Your estrogen levels have risen, blood work and an Ai will fix it. But you don’t want your estrogen getting way up, or down.