Peak Testosterone Forum

General Category => Testosterone, Hormones and General Men's Health => Topic started by: Balderdasher on February 16, 2015, 11:26:24 pm

Title: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: Balderdasher on February 16, 2015, 11:26:24 pm
Hey All - 

TL;DR: After a one-year post-HRT restart, my results came back better than than pre-HRT, but still not super impressive.  Considering whether to stay the course, go on low-dose (12.5 mg 3x/week) Clomid, or go back on TRT (input welcomed).  Clomid would be my preference, but towards the end of my last bout with it I began to see some floaters/tracers rarely and, of course, my SHBG on Clomid is off the charts and really hasn't come back down since.

After about 3 weeks off of arimidex, 3 months off clomid, 9 months off HCG, and ~ a year off of T Cyp., I got the following results back (note: Sleep has been hard to come by lately, and stress has been high, so I'm guessing that these most recent results are affected by that):

2-9-15
Testosterone, Serum 430 ng/dL Range: 348-1197
Sex Horm Binding Glob, Serum 59.2 nmol/L Range: 16.5-55.9
Dihydrotestosterone 48 ng/dL Range: 30 - 85
LH 3.4 mIU/mL Range: 1.7-8.6
Prostate Specific Ag, Serum 0.8 ng/mL Range: 0.0-4.0
Estradiol, Sensitive 7 pg/mL Range: 3-70 (Note: Tried to get the ultra sensitive - Doc was on board, and I even gave them the code - but got this back instead)

Fertility came back fair (better than before) with a 30 million count, low motility.

Heading in tomorrow to get a bone density scan to make sure that all of this time hanging out on the low end of the E2 spectrum hasn't done the old bones in.

Previous results include (note that all E2 tests were previously conducted with the 'standard' assay):

Original Results - ~9-2012
TT: 387 ng/dl
FT: 11.2 pg/ml

Results on Testim (1 Tube/Day) (Felt great for about a week then crashed - guessing due to E2, but no labs to prove it) - ~10-2012
TT: 551 ng/dl
FT: 12.3 pg/ml

Results 2 Weeks Post-Varicocele Repair/Clomid 50mg 3 days/week + Adex 1mg 3x/week - ~11-2012
Testosterone, Serum (004226) Testosterone, Serum 541 ng/dL Range: 348-1197
FSH, Serum (004309) FSH 10.2 mIU/mL Range: 1.5-12.4
Estradiol (004515) Estradiol 24.3 pg/mL Range: 7.6-42.6

Results Going on 100mg Test Cyp./week IM + 1mg Adex 3x/week ~12-2012
Testosterone, Serum 1143 ng/dl

Results Backed down to 50 mg Test Cyp./week IM + 1 mg Adex 2x/week ~5-2013
Serum Testosterone (ng/dL): 525 Normals: Adult Male 175 - 781 ng/dL
SHBG (nmol/L): 21.0 Reference intervals for males 20 - 50 yrs: 13.3 - 89.5 nmol/L;

Chromosomal Analysis - Normal ~8-2013

Results Back up to 100 mg Test Cyp./week IM + 1mg Adex 2x/week ~7-2013
Testosterone, Serum 945 ng/dL Range: 348-1197
Free Testosterone(Direct) 25.6 pg/mL Range: .3-26.5
Tests: (2) FSH, Serum (004309) FSH [L] 0.2 mIU/mL Range: 1.5-12.4
Tests: (3) Estradiol (004515) Estradiol 15.3 pg/mL Range: 7.6-42.6

Results Before Taper to T + HCG ~12-2013
Testosterone, Serum 1025 ng/dL 348-1197 *1
LH [L] <0.2 mIU/mL
FSH, Serum (004309) FSH [L] <0.2 mIU/mL
Estradiol 37.0 pg/mL

Results Shortly After Taper to 50 mg T Cyp + 500 iu HCG 3x/week + 1 mg Adex 2x/week ~ 2-2013
Serum Testosterone (ng/dL): 503 Normals: Adult Male 175 - 781 ng/d
LH [L] <0.2 mIU/mL 1.7-8.6
FSH [L] <0.2 mIU/mL 1.5-12.4

Results After HCG Begins to Kick In ~3-2013
Testosterone, Serum 807 ng/dL 348-1197
Free Testosterone(Direct) 13.8 pg/mL 9.3-26.5
LH [L] 0.4 mIU/mL
FSH [L] 1.2 mIU/mL
Estradiol 30.7 pg/mL

Taper to 500 iu HCG 3x/week + 50 mg clomid 3x/week + 1 mg Adex 2x/week
TSH 2.820 uIU/mL Range: 0.450-4.500
Thyroxine (T4) 8.5 ug/dl Range: 4.5-12.0
T3 Uptake 34% Range: 24-39
Free Thyroxine Index 2.9 Range: 1.2-4.9

Testosterone, Serum 705 ng/dL Range: 348-1197
LH 5.2 mIU/mL 1.7-8.6
FSH 4.2 mIU/mL  1.5-12.4
Estradiol 21.8 pg/mL 7.6-42.6

Note: Between here my LH and FSH went sky high, and my TT went to about 980 - cannot find the actual labs

Results Solo Clomid 12.5 mg 3x/Week + 1mg Adex 2x/week ~8-2014
Testosterone, Serum 742 ng/dL 348-1197
Free Testosterone(Direct) 9.7 pg/mL 9.3-26.5
LH 5.1 mIU/mL 1.7-8.6
FSH 5.7 mIU/mL 1.5-12.4
Estradiol 20.6 pg/mL 7.6-42.6

Results Solo Adex 1 mg 2x/week ~10-2014
Testosterone, Serum 619 ng/dl Range: 348-1197
Free Testosterone 6.6 pg/ml Range: 9.3-26.5
Estradiol 18.2 Range: 7.6-42.6

Results Solo Adex .25 mg 2x/week ~12-2014
Testosterone, Serum 488 ng/dL 348-1197
Free Testosterone(Direct)[L] 6.5 pg/mL 9.3-26.5
LH 4.9 mIU/mL 1.7-8.6
FSH 6.1 mIU/mL 1.5-12.4
Estradiol 7.4 pg/mL 7.6-42.6
Sex Horm Binding Glob, Serum 64.3 nmol/L 16.5-55.9

Title: Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
Post by: PeakT on February 17, 2015, 01:41:03 am
I'll just say the obvious and that is that your testosterone is not that high and with that SHBG, your free testosterone is going to be quite low.  I assume you're probably not feeling the best?
Title: Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
Post by: Balderdasher on February 17, 2015, 01:57:01 am
I'll just say the obvious and that is that your testosterone is not that high and with that SHBG, your free testosterone is going to be quite low.  I assume you're probably not feeling the best?

Definitely feeling pretty cruddy, though it's hard to decipher if it is the low T or the low E2 right now.  Really amazed that my SHBG hasn't gone down all that much since coming off the Clomid in September, and not quite sure what to do about it.  My Doc had mentioned that there is a down regulation process that just takes time, but seems like it is barely moving at all.
Title: Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
Post by: PeakT on February 17, 2015, 02:41:14 pm

Definitely feeling pretty cruddy, though it's hard to decipher if it is the low T or the low E2 right now. 

You've probably heard about that recent study that showed that both low testosterone and low estradiol were independently responsible for standard "low T" symptoms?  So it could be either or both that is making you feel lousy.
Title: Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
Post by: Balderdasher on February 18, 2015, 12:02:17 am
Actually hadn't heard of it - though having low E2 on top of low T this time around certainly feels worse than anything before.  Good info!
Title: Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
Post by: PeakT on February 18, 2015, 04:22:12 am
Actually hadn't heard of it - though having low E2 on top of low T this time around certainly feels worse than anything before.  Good info!

It was no surprise to the HRT community but seemed to send shock waves through the docs.
Title: Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
Post by: Balderdasher on February 18, 2015, 04:24:46 am
Just had a DXA scan today, everything came back solid (no osteopenia/osteoperosis) - huge relief.  They did mention that my lower back density was slightly lower than normal, but nothing to be worried about.

Now, to get that E2 back up before it does become a problem.
Title: Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
Post by: PeakT on February 18, 2015, 07:12:52 am
Just had a DXA scan today, everything came back solid (no osteopenia/osteoperosis) - huge relief.  They did mention that my lower back density was slightly lower than normal, but nothing to be worried about.

Now, to get that E2 back up before it does become a problem.

Nice work!  So did your doc work with you on that?  How did it come about?
Title: Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
Post by: Balderdasher on February 18, 2015, 03:07:30 pm
Just had a DXA scan today, everything came back solid (no osteopenia/osteoperosis) - huge relief.  They did mention that my lower back density was slightly lower than normal, but nothing to be worried about.

Now, to get that E2 back up before it does become a problem.

Nice work!  So did your doc work with you on that?  How did it come about?

Yep - I mentioned to him what I had learned here regarding the Ultrasensitive/Sensitive versus Standard E2 test and, that given my very low E2 labs, I was concerned about bone density.  He was on board immediately with ordering a DXA scan and running the ultra sensitive E2 test (even though his staff coded a sensitive test instead).  Truly a great doc, can't say enough about the guy. 

Now I'm just considering whether to go back on low dose Clomid (preferred, but worried about my SHBG shooting higher than it already is), or back on T Cyp (feel fantastic on 100mg IM/week, but concerned about fertility given my low motility and having previously run T for ~1 year without any HCG).  Was hoping Androxal would be out by now so I could give that a shot, but it's looking like that might be awhile off.

Has anyone here had any experience with SHBG levels staying high months after coming off Clomid.  If so, and you went back on Clomid, did they shoot even higher?
Title: Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
Post by: PeakT on February 21, 2015, 09:56:52 pm
I split out some discussion about whether or not quitting Arimidex could have something to do with the development of a certain kind of benign tumor:

http://www.peaktestosterone.com/forum/index.php?topic=6591.0
Title: Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
Post by: PeakT on March 01, 2015, 09:13:27 pm
Balderdasher said that the fertility doc advised him to do multiple fertility tests over many weeks and I broke out his story here:

http://www.peaktestosterone.com/forum/index.php?topic=6652.0
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on March 24, 2015, 11:43:12 pm
Just a quick update.  Three weeks after going back on TRT (50mg SubQ 2x/week +.25mg Adex 1x/week) here are my results:

Testosterone, Serum 810 ng/dL 348-1197
Estradiol, Serum, MS 13 pg/mL (LCMS LabCorp)

These labs were pulled the day after injection, four days after taking the Adex, and I was feeling pretty cruddy (likely due to the low E2).  I actually moved up to .25mg Adex 2x/week after these labs were pulled, as I thought I was experiencing high E2 symptoms.  Going to hop off the Adex (or try to) and see what happens.

Also, just out of curiosity I had an ACE (Angiotensin converting enzyme) test pulled before TRT and a few weeks after starting TRT:

Before: 40 U/L 14-82
After: 54 U/L 14-82

So it went up a bit - may have this pulled again a few months down the road to see where it goes.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: PeakT on March 25, 2015, 04:18:59 am

Before: 40 U/L 14-82
After: 54 U/L 14-82

So it went up a bit - may have this pulled again a few months down the road to see where it goes.

You got me really curious with this.  Why did you pull this?  Gimme some history here if you have time.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on March 25, 2015, 04:24:25 am

Before: 40 U/L 14-82
After: 54 U/L 14-82

So it went up a bit - may have this pulled again a few months down the road to see where it goes.

You got me really curious with this.  Why did you pull this?  Gimme some history here if you have time.

Had it pulled right around when I began experiencing low t symptoms as part of a rheumatological exam and it was normal.  After starting TRT it went sky high - not sure if it was causative, but I was curious given the rare lip tumor I had of it could somehow be connected.  Figured I would just keep an eye on it.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on April 01, 2015, 11:24:44 pm
Had a rough few days symptoms-wise, so I had some labs pulled last week.  Numbers look good, leaving me a bit perplexed; however, I have noticed that whenever I feel really off, my TSH is elevated (2+) while, when I feel great it hovers between 1.4 and 1.9.  Might be nothing given (what seem to be) healthy thyroid numbers, but I'm going to get the antibody tests pulled just in case given the relatively large range in my TSH readings over the past year (1.4 to 2.82) Labs pulled ~4 weeks after starting TRT (50mg E3.5D + .25mg Adex 1x/week) again:

TT: 1156 ng/dL
FT: 15.7 pg/mL
Estradiol, Sensitive (LabCorp): 15.8

A1C: 5.1

TSH: 2.52
Triiodothyronine,Free,Serum: 3.3 (Range 2.0 to 4.4)
T4,Free (Direct): 1.48 (Range 0.82 to 1.77)

In other news, an anti-aging Doc I'm trying out ran a Brain MRI (w and w/o contrast) on me.  Brain looks fine.  Also just got my genetic testing results back - I'm not seeing anything crazy on them, but I will be reviewing them with the Doc just to be sure.

Will be doing a pulse-ox test for apnea, a 4-point cortisol read, and thyroid antibody tests moving forward.

Title: Re: Post-HRT Taper -> Back to TRT
Post by: PeakT on April 02, 2015, 04:03:37 am
Had a rough few days symptoms-wise, so I had some labs pulled last week.  Numbers look good, leaving me a bit perplexed; however, I have noticed that whenever I feel really off, my TSH is elevated (2+) while, when I feel great it hovers between 1.4 and 1.9.  Might be nothing given (what seem to be) healthy thyroid numbers, but I'm going to get the antibody tests pulled just in case given the relatively large range in my TSH readings over the past year (1.4 to 2.82) Labs pulled ~4 weeks after starting TRT (50mg E3.5D + .25mg Adex 1x/week) again:

TT: 1156 ng/dL
FT: 15.7 pg/mL
Estradiol, Sensitive (LabCorp): 15.8

A1C: 5.1

TSH: 2.52
Triiodothyronine,Free,Serum: 3.3 (Range 2.0 to 4.4)
T4,Free (Direct): 1.48 (Range 0.82 to 1.77)

In other news, an anti-aging Doc I'm trying out ran a Brain MRI (w and w/o contrast) on me.  Brain looks fine.  Also just got my genetic testing results back - I'm not seeing anything crazy on them, but I will be reviewing them with the Doc just to be sure.

Will be doing a pulse-ox test for apnea, a 4-point cortisol read, and thyroid antibody tests moving forward.

A number of the "online internet HRT docs" have said that TRT can lower thyroid function.  And 2.54 is in that zone where you may not feel good as you noted.  There is a good chance this is it.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on April 02, 2015, 09:17:03 pm
Had a rough few days symptoms-wise, so I had some labs pulled last week.  Numbers look good, leaving me a bit perplexed; however, I have noticed that whenever I feel really off, my TSH is elevated (2+) while, when I feel great it hovers between 1.4 and 1.9.  Might be nothing given (what seem to be) healthy thyroid numbers, but I'm going to get the antibody tests pulled just in case given the relatively large range in my TSH readings over the past year (1.4 to 2.82) Labs pulled ~4 weeks after starting TRT (50mg E3.5D + .25mg Adex 1x/week) again:

TT: 1156 ng/dL
FT: 15.7 pg/mL
Estradiol, Sensitive (LabCorp): 15.8

A1C: 5.1

TSH: 2.52
Triiodothyronine,Free,Serum: 3.3 (Range 2.0 to 4.4)
T4,Free (Direct): 1.48 (Range 0.82 to 1.77)

In other news, an anti-aging Doc I'm trying out ran a Brain MRI (w and w/o contrast) on me.  Brain looks fine.  Also just got my genetic testing results back - I'm not seeing anything crazy on them, but I will be reviewing them with the Doc just to be sure.

Will be doing a pulse-ox test for apnea, a 4-point cortisol read, and thyroid antibody tests moving forward.

Hmmm, interesting.  Even with the other ma

A number of the "online internet HRT docs" have said that TRT can lower thyroid function.  And 2.54 is in that zone where you may not feel good as you noted.  There is a good chance this is it.

interesting.  Even with the other markers being (or at least seeming) normal?
Title: Re: Post-HRT Taper -> Back to TRT
Post by: PeakT on April 03, 2015, 12:14:01 am

interesting.  Even with the other markers being (or at least seeming) normal?

I would guess the answer is yes, but I don't really know.  We have only had a few guys low prolactin on here.  But it's good for any male imo to test to see if he is insulin resistant.  It simple, cheap and one of the most important things to monitor as far as general health and anti-aging.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on April 14, 2015, 02:03:39 am
Hey All -

Just got some lab work back re: Thyroid antibodies, and would appreciate if anyone could lend me their opinion in lieu of my own ability to (confidently) interpret these results:

Thyroglobulin, Antibody: <1.0 IU/mL Reference 0.0 - 0.9
Thyroid Peroxidase (TPO) Ab <6 IU/mL Reference 0 - 34

Based upon what I'm seeing it looks like I don't have any of the antibodies that might be associated with Hashimoto's, leaving me wondering how/why my TSH (and associated symptoms) could be fluctuating between 1.5 (feeling great) and 2.8 (feeling horrible).

Also had a 4-point cortisol & DHEA test pulled.  Here are the Cortisol results:

AM: 0.53 mcg/dL (Range 0.27-1.18)
Noon: 0.26 mcg/dL (Range 0.10-0.41)
Afternoon: 0.23 mcg/dL (Range 0.05-0.27) - this is often when I feel worst
Evening: 0.06 mcg/dL (Range 0.03-0.14)

All within optimal range according to the printout, which also noted that my DHEA/Cortisol ratio was within optimal range.

Dealing with some pretty heavy brain fog, blurry vision, etc type symptoms that seem to come & go randomly every couple of weeks.  As always, advice is appreciated.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: PeakT on April 14, 2015, 06:51:40 am
Hey All -

Just got some lab work back re: Thyroid antibodies, and would appreciate if anyone could lend me their opinion in lieu of my own ability to (confidently) interpret these results:

Thyroglobulin, Antibody: <1.0 IU/mL Reference 0.0 - 0.9
Thyroid Peroxidase (TPO) Ab <6 IU/mL Reference 0 - 34

Based upon what I'm seeing it looks like I don't have any of the antibodies that might be associated with Hashimoto's, leaving me wondering how/why my TSH (and associated symptoms) could be fluctuating between 1.5 (feeling great) and 2.8 (feeling horrible).

Also had a 4-point cortisol & DHEA test pulled.  Here are the Cortisol results:

AM: 0.53 mcg/dL
Noon: 0.26 mcg/dL
Afternoon: 0.23 mcg/dL
Evening: 0.06 mcg/dL

All within optimal range according to the printout, which also noted that my DHEA/Cortisol ratio was within optimal range.

Dealing with some pretty heavy brain fog, blurry vision, etc type symptoms that seem to come & go randomly every couple of weeks.  As always, advice is appreciated.

Sounds like you know what is going on (hypothyroid), but ifyou could put the ranges on the cortisol, that would be helpful.

And I don't have any other comments on the antibodies:  I think you just have to go by the lab as far as I know.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on April 14, 2015, 01:34:02 pm
Hey All -

Just got some lab work back re: Thyroid antibodies, and would appreciate if anyone could lend me their opinion in lieu of my own ability to (confidently) interpret these results:

Thyroglobulin, Antibody: <1.0 IU/mL Reference 0.0 - 0.9
Thyroid Peroxidase (TPO) Ab <6 IU/mL Reference 0 - 34

Based upon what I'm seeing it looks like I don't have any of the antibodies that might be associated with Hashimoto's, leaving me wondering how/why my TSH (and associated symptoms) could be fluctuating between 1.5 (feeling great) and 2.8 (feeling horrible).

Also had a 4-point cortisol & DHEA test pulled.  Here are the Cortisol results:

AM: 0.53 mcg/dL
Noon: 0.26 mcg/dL
Afternoon: 0.23 mcg/dL
Evening: 0.06 mcg/dL

All within optimal range according to the printout, which also noted that my DHEA/Cortisol ratio was within optimal range.

Dealing with some pretty heavy brain fog, blurry vision, etc type symptoms that seem to come & go randomly every couple of weeks.  As always, advice is appreciated.

Sounds like you know what is going on (hypothyroid), but ifyou could put the ranges on the cortisol, that would be helpful.

And I don't have any other comments on the antibodies:  I think you just have to go by the lab as far as I know.

Thanks Peak - I've been a little hesitant to acknowledge thyroid levels as being an issue, as the thought of having to deal with another hormone therapy on top of TRT has been a little overwhelming.  Still, the evidence gathered over the years is starting to point in that direction, so I'm going to consult with my Doc today to try and figure out a course of action.

Edited post above to include ranges for cortisol.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: PeakT on April 14, 2015, 04:43:44 pm
Hey All -

Just got some lab work back re: Thyroid antibodies, and would appreciate if anyone could lend me their opinion in lieu of my own ability to (confidently) interpret these results:

Thyroglobulin, Antibody: <1.0 IU/mL Reference 0.0 - 0.9
Thyroid Peroxidase (TPO) Ab <6 IU/mL Reference 0 - 34

Based upon what I'm seeing it looks like I don't have any of the antibodies that might be associated with Hashimoto's, leaving me wondering how/why my TSH (and associated symptoms) could be fluctuating between 1.5 (feeling great) and 2.8 (feeling horrible).

Also had a 4-point cortisol & DHEA test pulled.  Here are the Cortisol results:

AM: 0.53 mcg/dL
Noon: 0.26 mcg/dL
Afternoon: 0.23 mcg/dL
Evening: 0.06 mcg/dL

All within optimal range according to the printout, which also noted that my DHEA/Cortisol ratio was within optimal range.

Dealing with some pretty heavy brain fog, blurry vision, etc type symptoms that seem to come & go randomly every couple of weeks.  As always, advice is appreciated.

Sounds like you know what is going on (hypothyroid), but ifyou could put the ranges on the cortisol, that would be helpful.

And I don't have any other comments on the antibodies:  I think you just have to go by the lab as far as I know.

Thanks Peak - I've been a little hesitant to acknowledge thyroid levels as being an issue, as the thought of having to deal with another hormone therapy on top of TRT has been a little overwhelming.  Still, the evidence gathered over the years is starting to point in that direction, so I'm going to consult with my Doc today to try and figure out a course of action.

Edited post above to include ranges for cortisol.

Cortisol is just as poweful as testosterone/estradiol in causing many of the standard low testosterone symptoms.  I have no doubt that this is why some men's HRT program fails.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: PeakT on April 21, 2015, 06:14:35 am
Balderdasher has some great stats showing that his peak and trough T and E2 were nearly identical on subQ.  I split out his comments and data here:

http://www.peaktestosterone.com/forum/index.php?topic=7118.0
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on July 01, 2015, 03:55:16 am
Evening All -

Been awhile, as I've intentionally been trying to clear my head from thinking about TRT-related issues for awhile.  Just had labs drawn last Monday:

Protocol: 45mg T. Cyp E3.5D subQ

Testosterone: 962ng/dl (348-1197)
Free T: 16.9pg/ml (9.3-26.5)
E2 (Sensitive): 21 pg/ml (8-35)
E2 (Standard): 26 pg/ml (7.6-42.6)

Will be adding in HCG 500u 3/x week to maintain fertility, and to try to backfill other hormones as I am still experiencing a bit of fatigue and brain fog.  If necessary, I may add in a small amount of Adex to keep E2 from shooting up, but will aim to avoid it if at all possible. 
Title: Re: Post-HRT Taper -> Back to TRT
Post by: PeakT on July 01, 2015, 02:28:29 pm
Evening All -

Been awhile, as I've intentionally been trying to clear my head from thinking about TRT-related issues for awhile.  Just had labs drawn last Monday:

Protocol: 45mg T. Cyp E3.5D subQ

Testosterone: 962ng/dl (348-1197)
Free T: 16.9pg/ml (9.3-26.5)
E2 (Sensitive): 21 pg/ml (8-35)
E2 (Standard): 26 pg/ml (7.6-42.6)

Will be adding in HCG 500u 3/x week to maintain fertility, and to try to backfill other hormones as I am still experiencing a bit of fatigue and brain fog.  If necessary, I may add in a small amount of Adex to keep E2 from shooting up, but will aim to avoid it if at all possible.

Hey, thx for the estradiol comparison #s in the 20's.  I am probably going to copy / paste those out to another thread, because I have had questions on that.

Comment:  Don't add Arimidex imo until you get your labs.  It's just too easy to crash yourself.  I don't know of any clinic or big name HRT doc that just automatically gives an AI without pulling estradiol first.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on July 03, 2015, 12:03:48 am
Evening All -

Been awhile, as I've intentionally been trying to clear my head from thinking about TRT-related issues for awhile.  Just had labs drawn last Monday:

Protocol: 45mg T. Cyp E3.5D subQ

Testosterone: 962ng/dl (348-1197)
Free T: 16.9pg/ml (9.3-26.5)
E2 (Sensitive): 21 pg/ml (8-35)
E2 (Standard): 26 pg/ml (7.6-42.6)

Will be adding in HCG 500u 3/x week to maintain fertility, and to try to backfill other hormones as I am still experiencing a bit of fatigue and brain fog.  If necessary, I may add in a small amount of Adex to keep E2 from shooting up, but will aim to avoid it if at all possible.

Hey, thx for the estradiol comparison #s in the 20's.  I am probably going to copy / paste those out to another thread, because I have had questions on that.

Comment:  Don't add Arimidex imo until you get your labs.  It's just too easy to crash yourself.  I don't know of any clinic or big name HRT doc that just automatically gives an AI without pulling estradiol first.

Re: your comment about Arimidex - absolutely.  I was hovering around 15 pg/ml E2 for awhile and began to experience what I thought were high E2 symptoms.  I took .25mg adex and retested, and I came back at 6 pg/ml - huge crash.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: PeakT on July 03, 2015, 01:32:21 am
I think almost everything requires both labs and symptoms to be taken into account. 
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on September 05, 2015, 04:21:39 pm
Hey All -

Latest labs on 45mg T Cyp 2x/week + 500u HCG 3x/week.  Feeling some symptoms of high-ish E2 (little moodier than usual, fatigue, bit of brain fog).  Hard to tell if these symptoms are hormonal, or the result of this lingering/undiagnosed throat infection that I've had on and off for a couple of years now.

Have now been off Viagra/Cialis for about 6 months and have only experienced ED twice, so pumped to see some improvement in this area.  Being off viagra/cialis also seems to have alleviated some bloating/upset stomach issues, GERD, and stuffiness issues.  Libido has improved greatly.

Worth noting that HCG shot my peak up by ~600 ng/dl.  Strength in the gym is off the charts - setting new PRs pretty regularly.  Also, a nagging meniscus tear I had been avoiding surgery on for about a year and a half has actually almost completely healed per the latest MRI results.  Truly a godsend - back running a few times a week and, while some occasional irritation persists, finally starting to feel like I'm getting back into my normal routine.

Also, doc had me try armour thyroid 1 grain/day.  Did it for 4 days, felt pretty cruddy/high-stress, so I stopped.  Sleepy for a few days then returned to normal.  May have been worth it to give it a shot for a bit longer, but at this point I am trying to avoid additional meds whenever possible.


Trough

Tests: (1) Testosterone,Free and Total (140103)
Order Note: Clinical Information: Scheduled: 8/6/2015
Testosterone, Serum [H] 1373 ng/dL 348-1197 *1 Comment: See report
Adult male reference interval is based on a population of lean males up to 40 years old.
Free Testosterone(Direct) [H] 28.5 pg/mL (8.7-25.1)
Tests: (2) Estradiol (004515) Estradiol 39.6 pg/mL (7.6-42.6)
Roche ECLIA methodology


Peak

Tests: (3) Testosterone,Free and Total (140103)
Testosterone, Serum [H] 1496 ng/dL 348-1197 *1 Comment: See report
Adult male reference interval is based on a population of lean males up to 40 years old.
Free Testosterone(Direct) [H] 43.5 pg/mL (8.7-25.1 *2)
Tests: (4) Estradiol (004515) Estradiol 36.0 pg/mL (7.6-42.6)
Roche ECLIA methodology

Tests: (2) Thyroid Panel With TSH (000620)
TSH - 2.38 uIU/mL (0.45-4.5)
Thyroxine (T4) 8.1 ug/dL (4.5-12.0)
T3 Uptake 31% (24-39)
Free Thyroxine Index 2.5 (1.2-4.9)

WBC 5.4x10E3/uL (3.4-10.8)
RBC 5.26x10E6/uL (4.14-5.8)
Hemoglobin 16.4 gdL (12.6-17.7)
Hematocrit 48.5% (37.5-51)
MCV 92 fL (79-97)
MCH 31.2 pg (26.6-33)
MCHC 33.8 g/dL (31.5-35.7)
RDW 12.9% (12.3-15.4)
Platelets 236 x10E3/uL (150-379)
Neutrophils 55%
Monocytes 33%
Eos 2%
Basos 1%
Neutrophils (Absolute) 3.0x10E3/uL (1.4-7.0)
Lymphs (absolute) 1.8x10E3/uL (.07-3.1)
Monocytes (absolute) 0.5x10E3/uL (0.1-0.9)
Eos (absolute) 0.1x10E3/uL (0.0-0.4)
Baso (absolute) 0.0x10E3/uL (0.0-0.2)
Immature granulocytes 0%
Immature grans (Abs) 0.0x10E3/uL (0.0-0.1)


Plan
Tapering T Cyp down to 35mg 2x/week.  1st week on this protocol feeling better overall.  Drawing labs in 2 months.


Other Issues
Thinking my fatigue may be due to some sort of lingering throat infection (which, interestingly enough, began right about the same time I was diagnosed w/ Low T and experiencing symptoms) more than hormone levels.  Lymph nodes are slightly swollen all around my jaw line/under my chin and have been for about 2.5 years now, and my voice/uvula get pretty agitated when talking for any length of time.  No docs thus far have been able to nail down exactly what is going on, but one has suggested cutting off a piece of turbinate in the right nostril to try and alleviate some post nasal drip.  Have been resistant to this, but am getting to the point where I need to try something.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on November 04, 2015, 12:28:11 am
Hey Fellas -

Looking for a bit of advice on how to proceed.

Current protocol: 37mg T Cyp 2x/week SubQ (Sunday Morning/Wednesday Evening); 500IU HCG 3x/week (MWF)

Latest lab results, pulled on a trough day:

Total T: 1298 (348-1197)
Free T: 31.6 (8.7-25.1)
Estradiol: 76.6 (7.6-42.6)

Really shocked to see E2 skyrocket from my last labs, as the protocol is the roughly the same (I am now ~16 weeks in as opposed to 8), but with a lower dose of T Cyp.  Haven't been feeling particularly horrible - in fact, feeling much better as compared to the time I pulled 8 week labs.

Any suggestions re: protocol adjustments from here?  Considering adding in .5mg adex/week, and knocking the T dose down to 30mg 2x/week.  Of course, would prefer to stay off adex altogether, but not really sure if that is an option in the face of pretty ridiculous E2 numbers.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: PeakT on November 04, 2015, 01:41:07 am
Hey Fellas -

Looking for a bit of advice on how to proceed.

Current protocol: 37mg T Cyp 2x/week SubQ (Sunday Morning/Wednesday Evening); 500IU HCG 3x/week (MWF)

Latest lab results, pulled on a trough day:

Total T: 1298 (348-1197)
Free T: 31.6 (8.7-25.1)
Estradiol: 76.6 (7.6-42.6)

Really shocked to see E2 skyrocket from my last labs, as the protocol is the roughly the same (I am now ~16 weeks in as opposed to 8), but with a lower dose of T Cyp.  Haven't been feeling particularly horrible - in fact, feeling much better as compared to the time I pulled 8 week labs.

Any suggestions re: protocol adjustments from here?  Considering adding in .5mg adex/week, and knocking the T dose down to 30mg 2x/week.  Of course, would prefer to stay off adex altogether, but not really sure if that is an option in the face of pretty ridiculous E2 numbers.

Funny you bring this up.  I just wrote a page covering this:

http://www.peaktestosterone.com/estradiol_dosage_frequency

Can you back down the HCG a bit.  I got "plumped up" from just 250 IU twice per week.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on November 04, 2015, 02:20:55 am
Hey Fellas -

Looking for a bit of advice on how to proceed.

Current protocol: 37mg T Cyp 2x/week SubQ (Sunday Morning/Wednesday Evening); 500IU HCG 3x/week (MWF)

Latest lab results, pulled on a trough day:

Total T: 1298 (348-1197)
Free T: 31.6 (8.7-25.1)
Estradiol: 76.6 (7.6-42.6)

Really shocked to see E2 skyrocket from my last labs, as the protocol is the roughly the same (I am now ~16 weeks in as opposed to 8), but with a lower dose of T Cyp.  Haven't been feeling particularly horrible - in fact, feeling much better as compared to the time I pulled 8 week labs.

Any suggestions re: protocol adjustments from here?  Considering adding in .5mg adex/week, and knocking the T dose down to 30mg 2x/week.  Of course, would prefer to stay off adex altogether, but not really sure if that is an option in the face of pretty ridiculous E2 numbers.

Funny you bring this up.  I just wrote a page covering this:

http://www.peaktestosterone.com/estradiol_dosage_frequency

Can you back down the HCG a bit.  I got "plumped up" from just 250 IU twice per week.

Great page Peak, and I was wondering the same about the HCG (although my doc, who is well respected in the field, seems to feel pretty strongly that the 500iu 3x/week protocol is key for testicular maintenance).  Right now I'm at about 8% body fat, so not a lot of wiggle room there, and a little concerned that just lowering my dose won't be enough to get such a high read down.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: PeakT on November 04, 2015, 03:38:11 pm

Great page Peak, and I was wondering the same about the HCG (although my doc, who is well respected in the field, seems to feel pretty strongly that the 500iu 3x/week protocol is key for testicular maintenance).  Right now I'm at about 8% body fat, so not a lot of wiggle room there, and a little concerned that just lowering my dose won't be enough to get such a high read down.

Sure, you can make a case that is a pretty natural option.  I just don't think it seems to work that well in guys in getting them back on their feet.  Haven't seen it on here anyway.

I want to get on HCG with HRT in a few months.  I think that's a pretty smart way to do as far as keeping everything in maintenance mode and activated.  Money is a little tight right now though.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on November 06, 2015, 02:26:42 am

Great page Peak, and I was wondering the same about the HCG (although my doc, who is well respected in the field, seems to feel pretty strongly that the 500iu 3x/week protocol is key for testicular maintenance).  Right now I'm at about 8% body fat, so not a lot of wiggle room there, and a little concerned that just lowering my dose won't be enough to get such a high read down.

Sure, you can make a case that is a pretty natural option.  I just don't think it seems to work that well in guys in getting them back on their feet.  Haven't seen it on here anyway.

I want to get on HCG with HRT in a few months.  I think that's a pretty smart way to do as far as keeping everything in maintenance mode and activated.  Money is a little tight right now though.

I'm with you on the HCG, though I'm lucky in that my Doc sent me to a pharmacist who sells Pregnyl for $90 for 10,000 units. 

What don't you think seems to work well in getting guys back on their feet?
Title: Re: Post-HRT Taper -> Back to TRT
Post by: PeakT on November 06, 2015, 04:22:10 pm

I'm with you on the HCG, though I'm lucky in that my Doc sent me to a pharmacist who sells Pregnyl for $90 for 10,000 units. 

What don't you think seems to work well in getting guys back on their feet?

Okay, that was poor wording on my part.  What I have noticed is that HCG will give men a decent boost in testosterone and also restore fertility usually of course.  So, if those are your goals, then that is great.

However, what is missing is the "wow factor."  I cannot remember any man on HCG Mono saying, "Man this is great stuff!"  Of course, I'm sure it happens - I just havent seen it on here.

Now another quite common thing that I have seen - and some smart guys on here dispute this - is quite a few men with testosterone of 700 with HCG Mono and E2 of like 70 or something very high.  So then they have to pack their dose to the 500's or so and they just don't feel that great.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on November 07, 2015, 03:26:52 pm

I'm with you on the HCG, though I'm lucky in that my Doc sent me to a pharmacist who sells Pregnyl for $90 for 10,000 units. 

What don't you think seems to work well in getting guys back on their feet?

Okay, that was poor wording on my part.  What I have noticed is that HCG will give men a decent boost in testosterone and also restore fertility usually of course.  So, if those are your goals, then that is great.

However, what is missing is the "wow factor."  I cannot remember any man on HCG Mono saying, "Man this is great stuff!"  Of course, I'm sure it happens - I just havent seen it on here.

Now another quite common thing that I have seen - and some smart guys on here dispute this - is quite a few men with testosterone of 700 with HCG Mono and E2 of like 70 or something very high.  So then they have to pack their dose to the 500's or so and they just don't feel that great.

Ahhh I'm with you now - thanks for the explanation.  On both T Cyp + HCG now, so I'm thinking I'll adjust down from 500iu 3x/week to 250iu 3x/week and hang out with T Cyp at ~35mg 2x/week.  Considering adding in a bit of adex, .25mg 2x/week or so, just to get this E2 down before gyne starts to set in.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: PeakT on November 07, 2015, 09:05:08 pm
Why would you just jump into Arimidex?  Shouldn't you do this?

http://www.peaktestosterone.com/Estradiol_Dosage_Frequency
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on November 08, 2015, 12:59:31 am
Why would you just jump into Arimidex?  Shouldn't you do this?

http://www.peaktestosterone.com/Estradiol_Dosage_Frequency

Absolutely, I would much prefer to go sans-AI than to take a pharmaceutical.  My concerns are:

1) I don't have any pounds/body fat to lose
2) My dose frequency is already pretty regular (2x a week on the T cyp, 3x a week on the HCG) - definitely don't want to inject every day if I can avoid it.

So that (as far as I can tell) leaves cutting my dose, which I am dropping from 500u 3x/week to 250iu.  My concern is that this won't be sufficient to tackle an E2 level as high as 70+.  I'm also pretty freaked out at the idea of what a level that high for any extended period of time could do, especially in the way of gyne.

That said, if anyone else has ay suggestions for how I could avoid the AI, and get my E2 down relatively quickly, I'm very open to it!
Title: Re: Post-HRT Taper -> Back to TRT
Post by: PeakT on November 08, 2015, 04:36:18 am
Why would you just jump into Arimidex?  Shouldn't you do this?

http://www.peaktestosterone.com/Estradiol_Dosage_Frequency

Absolutely, I would much prefer to go sans-AI than to take a pharmaceutical.  My concerns are:

1) I don't have any pounds/body fat to lose
2) My dose frequency is already pretty regular (2x a week on the T cyp, 3x a week on the HCG) - definitely don't want to inject every day if I can avoid it.

So that (as far as I can tell) leaves cutting my dose, which I am dropping from 500u 3x/week to 250iu.  My concern is that this won't be sufficient to tackle an E2 level as high as 70+.  I'm also pretty freaked out at the idea of what a level that high for any extended period of time could do, especially in the way of gyne.

That said, if anyone else has ay suggestions for how I could avoid the AI, and get my E2 down relatively quickly, I'm very open to it!

Okay, I admit you've done your due diligence.  Just want to make sure...
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on November 08, 2015, 07:22:14 am
Why would you just jump into Arimidex?  Shouldn't you do this?

http://www.peaktestosterone.com/Estradiol_Dosage_Frequency

Absolutely, I would much prefer to go sans-AI than to take a pharmaceutical.  My concerns are:

1) I don't have any pounds/body fat to lose
2) My dose frequency is already pretty regular (2x a week on the T cyp, 3x a week on the HCG) - definitely don't want to inject every day if I can avoid it.

So that (as far as I can tell) leaves cutting my dose, which I am dropping from 500u 3x/week to 250iu.  My concern is that this won't be sufficient to tackle an E2 level as high as 70+.  I'm also pretty freaked out at the idea of what a level that high for any extended period of time could do, especially in the way of gyne.

That said, if anyone else has ay suggestions for how I could avoid the AI, and get my E2 down relatively quickly, I'm very open to it!

Okay, I admit you've done your due diligence.  Just want to make sure...

Thanks Peak - definitely on board with subscribing to as few meds as possible.  Wish someone had questioned the use of an AI the first time I tried it, certainly would have saved me a lot unwarranted headaches!
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Hydranted on November 08, 2015, 07:48:47 am
I think you're on the right track by lowering your dose of hCG.  Some guys are very prone to high estradiol levels with hCG, and it's possible that you're one of them. 

In my opinion it makes a ton of sense to figure out if that's your issue, and fixing it, before adding an AI.  While 1500IU of hCG per week isn't an astronomical dose, it's enough to cause problems for a lot of us.

I think that dropping it down to 250IU 3x per week is a good move.  If you see improvement you may even be able to titrate that dose down a little further if you need to. 

Any chance that you're injecting more testosterone than you think you are?  I'm not trying to insult your math skills, it's just interesting to see these lab values on a protocol like yours. 

I'm betting that it's the hCG that is complicating things for you, but I suppose we will figure that out pretty soon.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on November 08, 2015, 08:05:51 am
I think you're on the right track by lowering your dose of hCG.  Some guys are very prone to high estradiol levels with hCG, and it's possible that you're one of them. 

In my opinion it makes a ton of sense to figure out if that's your issue, and fixing it, before adding an AI.  While 1500IU of hCG per week isn't an astronomical dose, it's enough to cause problems for a lot of us.

I think that dropping it down to 250IU 3x per week is a good move.  If you see improvement you may even be able to titrate that dose down a little further if you need to. 

Any chance that you're injecting more testosterone than you think you are?  I'm not trying to insult your math skills, it's just interesting to see these lab values on a protocol like yours. 

I'm betting that it's the hCG that is complicating things for you, but I suppose we will figure that out pretty soon.

Yeah, it was definitely a surprise to see this read, especially considering that E2 was ~30s on the same protocol just 8 weeks or so ago.  Good point re: changing one thing at a time - always hard to keep track of the root causes when a lot of things are in flux. 

Think my math is good on the T Cyp (though please correct me if I'm wrong) - have been pulling from a 1ml vial of 200mg/ml at .17ml (calculating 34mg) 2x per week. 

Looking back a few posts ago, at 45 mg 2x/week I was at:

Testosterone: 962ng/dl (348-1197)
Free T: 16.9pg/ml (9.3-26.5)
E2 (Sensitive): 21 pg/ml (8-35)
E2 (Standard): 26 pg/ml (7.6-42.6)


After adding HCG 500u 3x/week, my results popped up to (peak levels, 8 weeks into the protocol):

Tests: (3) Testosterone,Free and Total (140103)
Testosterone, Serum [H] 1496 ng/dL 348-1197 *1 Comment: See report
Adult male reference interval is based on a population of lean males up to 40 years old.
Free Testosterone(Direct) [H] 43.5 pg/mL (8.7-25.1 *2)
Tests: (4) Estradiol (004515) Estradiol 36.0 pg/mL (7.6-42.6)
Roche ECLIA methodology


So it definitely looks like my body has taken the HCG and just run with it, with E2 just slipping out of hand the past couple of months.

Also thinking about getting E2 retested just to be sure, given the dramatic jump in a relatively short period of time.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Hydranted on November 08, 2015, 08:21:25 am
Well it definitely looks like the hCG is the "problem".  I think your dose just needs to be adjusted and some time needs to pass for things to balance out. 

1500IU of hCG is generally an unnecessarily high weekly dose to keep your fellas working properly anyway, and now there's the bonus of your hCG prescription lasting longer and saving you a bit of money!
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on November 08, 2015, 08:38:38 am
Well it definitely looks like the hCG is the "problem".  I think your dose just needs to be adjusted and some time needs to pass for things to balance out. 

1500IU of hCG is generally an unnecessarily high weekly dose to keep your fellas working properly anyway, and now there's the bonus of your hCG prescription lasting longer and saving you a bit of money!

Really appreciate the insights!  Certainly won't hurt to spread my HCG dollars out a little further.  Thanks again Peak and Hydranted.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on December 13, 2015, 07:52:57 am
Hey All -

So, after my last post I consulted with my Doc and went down to 32mg T Cyp 2x/week + 250iu HCG 3x/week + .25mg Adex 1x/week.  The results were pretty dramatic (just posting the ones that are relevant/abnormal) - drawn on a trough day for reference, though my levels tend to remain pretty stable between trough and peak.  Worth noting that during this time I was feeling fatigued, experienced decreased penile sensitivity, felt dehydrated, and had very dry lips.

CBC With Differential/Platelet
WBC - 4.6 x10E3/uL (3.4-10.8)
RBC - 5.67 x10E3/uL (4.14-5.80)
Hemoglobin - 17.9 g/dL HIGH (12.6-17.7)
Hematocrit - 52.2% HIGH (37.5-51.0)

MCV - 92 fL (79-97)
MCH - 31.6 pg (26.6 - 33.0)
MCHC - 34.3 g/dL (31.5-35.7)
RDW - 12.3% (12.3-15.4)
Platelets - 256 x10E3/uL (150-379)
Neutrophils - 60%
Lymphs - 30%
Monocytes - 9%
Eos - 0%
Basos - 1%
Neutrophils (Absolute) - 2.8 x10E3/uL (1.4-7.0)
Lymphs (Absolute) - 1.4 x10E3/uL (0.7-3.1)
Monocytes (Absolute) - 0.4 x10E3/uL (0.1-0.9)
Eos (Absolute) - 0.0 x10E3/uL (0.0-0.4)
Baso (Absolute) - 0.0 x10E3/uL (0.0-0.2)
Immature Granulocytes - 0%
Immature Grans (Abs) - 0.0 x10E3/uL (0.0-0.1)

Comp. Metabolic Panel
Glucose, Serum - 72 mg/dL (65-99)
BUN - 14 mg/dL (6-20)
Creatinine, Serum - HIGH 1.42 mg/dL (0.76-1.27)
eGFR If NonAfricn Am - 66 mL/min/1.73 (>59)
BUN/Creatinine Ratio - 10 (8-19)
Sodium, Serum - 141 mmol/L (134-144)
Potassium, Serum - 4.5 mmol/L (3.5-5.2)
Chloride, Serum - 99 mmol/L (97-108)
Carbon Dioxide, Total - 26 mmol/L (18-28)
Calcium, Serum - 9.8 mg/dL (8.7-10.2)
Protein, Total, Serum - 7.5 g/dL (6.0-8.5)
Albumin, Serum - 4.9 g/dL (3.5-5.5)
Globulin, Total - 2.6 g/dL (1.5-4.5)
A/G Ratio - 1.9
Bilirubin, Total - 0.7 mg/dL (0.0-1.2)
Alkaline Phosphates, S - 95 IU/L (39-117)
AST (SGOT) - 24 IU/L (0-40)
ALT (SGPT) - 9 IU/L (0-44)

Hormones n' Such
Testosterone, Total 721 ng/dL (348-1197)
Free Testosterone (Direct) 12.8 pg/mL (8.7-25.1)
Estradiol (Standard Assay) <5.0 pg/mL LOW (7.6-42.6)

DHEA, Serum 332 ng/dL (31-701)

TSH 1.490 uIU/mL (0.450-4.500)
Free T4 1.55 ng/dL (0.82-1.77)
Free T3 3.7 pg/mL (2.0-4.4)

Planning on:

1) Dropping Adex altogether (had a sneaking suspicion I was low E2 when labs were drawn based on PeakT's E2 symptoms page, and did this about 1.5 weeks ago)

2) Will likely up my T Cyp to 40mg 2x/week

3) Getting blood donated ASAP to knock hematocrit down

A few thoughts:

1) By just dropping HCG from 500iu to 250iu 3x/week + adding in 25mg adex 1x/week, my E2 levels (standard assay, though in the past I've not noticed much difference between sensitive and standard) dropped from 70+ to under 5 pg/mL.  For those who have followed this thread from the beginning, you'll know that my original protocol (per Doctor's orders) was 1mg Adex 3x/week.  Crazy to think now, but obviously Adex is powerful stuff.

2) Curious if my HCG may be losing its potency over time as it nears it's expiration date.  I keep it refrigerated, but usually leave it hanging on the fridge door and have wondered in the past if it worked less effectively after some time had passed based upon symptoms.

3) Also had a urine analysis come back with slightly high proteinuria levels (+1).  This, combined with the elevated creatinine levels are causing me to wonder if something is going on with the kidneys.  I had a varicocele embolization awhile back, and vaguely remember some concern that the coils could cause kidney issues (perhaps from floating into the kidneys).  Does anybody have any experience/thoughts surrounding elevated creatinine and proteinuria?
Title: Re: Post-HRT Taper -> Back to TRT
Post by: explorer on December 13, 2015, 02:27:59 pm
If you're donating, you should test ferritin and iron saturation to know how far you can/need to go.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on December 13, 2015, 08:18:33 pm
If you're donating, you should test ferritin and iron saturation to know how far you can/need to go.

Thanks explorer - just entered in the rest of my labs and noticed that they didn't draw these particular tests.  For future reference, how would I use these numbers to calculate how much to donate?

Also, just bumping to see if anyone has any opinions re: the creatinine and proteinuria.  Unsure if this would constitute an issue apart from TRT, or if it is just representative of dehydration as a result of low E2.
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on February 17, 2016, 03:57:53 am
New labs (drawn on a peak day) - going to up my Vitamin D supplementation from 2000u to 4000iu/day, drop my T Cyp from 80mg/week (split between 2 doses IM) to 75mg/week (split between two doses IM), and switch HCG from 250iu 3x/week to 350iu 2x/week.  Will donate blood in a month or so.

Hemoglobin 17.8 HIGH (Range: 12.6-17.7)
Hematocrit 52.6 HIGH (Range: 37.5-51)

Testosterone, Total 1194 (Range: 348-1197)
Testosterone, Free 38.3 HIGH (Range: 8.7-25.1)
Estradiol, Sensitive 35 (Range: 8-35)

Vitamin D, 25-Hydroxy 35.3 (Range: 30-100)
Vitamin B12 490 (211-946)
Title: Re: Post-HRT Taper -> Back to TRT
Post by: PeakT on February 17, 2016, 07:08:45 pm
New labs (drawn on a peak day) - going to up my Vitamin D supplementation from 2000u to 4000iu/day, drop my T Cyp from 80mg/week (split between 2 doses IM) to 75mg/week (split between two doses IM), and switch HCG from 250iu 3x/week to 350iu 2x/week.  Will donate blood in a month or so.

Hemoglobin 17.8 HIGH (Range: 12.6-17.7)
Hematocrit 52.6 HIGH (Range: 37.5-51)

Testosterone, Total 1194 (Range: 348-1197)
Testosterone, Free 38.3 HIGH (Range: 8.7-25.1)
Estradiol, Sensitive 35 (Range: 8-35)

Vitamin D, 25-Hydroxy 35.3 (Range: 30-100)
Vitamin B12 490 (211-946)

Wow.  Can't believe your testosterone is that high with such a low dose.  We're all different, eh?
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Balderdasher on February 17, 2016, 11:55:16 pm
New labs (drawn on a peak day) - going to up my Vitamin D supplementation from 2000u to 4000iu/day, drop my T Cyp from 80mg/week (split between 2 doses IM) to 75mg/week (split between two doses IM), and switch HCG from 250iu 3x/week to 350iu 2x/week.  Will donate blood in a month or so.

Hemoglobin 17.8 HIGH (Range: 12.6-17.7)
Hematocrit 52.6 HIGH (Range: 37.5-51)

Testosterone, Total 1194 (Range: 348-1197)
Testosterone, Free 38.3 HIGH (Range: 8.7-25.1)
Estradiol, Sensitive 35 (Range: 8-35)

Vitamin D, 25-Hydroxy 35.3 (Range: 30-100)
Vitamin B12 490 (211-946)

Wow.  Can't believe your testosterone is that high with such a low dose.  We're all different, eh?

Yeah man, I'm a high responder to both Clomid and HCG.  Only big surprise for me was the relatively low Vitamin D3 - curious if that could have contributed to low T in the first place.  Anyone have any experience with this?
Title: Re: Post-HRT Taper -> Back to TRT
Post by: PeakT on February 18, 2016, 01:39:05 am
New labs (drawn on a peak day) - going to up my Vitamin D supplementation from 2000u to 4000iu/day, drop my T Cyp from 80mg/week (split between 2 doses IM) to 75mg/week (split between two doses IM), and switch HCG from 250iu 3x/week to 350iu 2x/week.  Will donate blood in a month or so.

Hemoglobin 17.8 HIGH (Range: 12.6-17.7)
Hematocrit 52.6 HIGH (Range: 37.5-51)

Testosterone, Total 1194 (Range: 348-1197)
Testosterone, Free 38.3 HIGH (Range: 8.7-25.1)
Estradiol, Sensitive 35 (Range: 8-35)

Vitamin D, 25-Hydroxy 35.3 (Range: 30-100)
Vitamin B12 490 (211-946)

Wow.  Can't believe your testosterone is that high with such a low dose.  We're all different, eh?

Yeah man, I'm a high responder to both Clomid and HCG.  Only big surprise for me was the relatively low Vitamin D3 - curious if that could have contributed to low T in the first place.  Anyone have any experience with this?

Usually you will only get an increase of about 30%:

http://www.peaktestosterone.com/Testosterone_Vitamin-D
Title: Re: Post-HRT Taper -> Back to TRT
Post by: Cataceous on February 18, 2016, 02:05:29 am
...  Only big surprise for me was the relatively low Vitamin D3 - curious if that could have contributed to low T in the first place.  Anyone have any experience with this?

Usually you will only get an increase of about 30%:

http://www.peaktestosterone.com/Testosterone_Vitamin-D

Chances are this sort of increase only applies to guys with blood levels below 20 ng/ml; being below this threshold is what correlates with most of the bad stuff. And the correlation isn't necessarily from causality: Supplementation with vitamin D hasn't done so well in studies looking at eventual outcome, e.g. reductions in all-cause mortality and such.
Title: September 2016 Labs
Post by: Balderdasher on September 23, 2016, 04:21:33 am
Evening All -  Just had fresh labs drawn, and was hoping for some input on next steps/supplementation dosages.  Here are the highlights:

Current Protocol
40mg T Cyp 2x/week - IM (shoulder)
400iu HCG 2x/week - IM (shoulder)
6000iu Vitamin D Daily
1000mg Vitamin C Daily
Align Probiotic
Donate Blood 2x/year


Recent Labs - Fasting/Morning Draw
Glucose, Serum: 94 mg/dL (range 65-99)

Cholesterol, Total: 136 mg/dL (range 100-199)
Triglycerides: 118 mg/dL (range 0-149)
HDL Cholesterol: 31 mg/dL (range >39) Low
VLDL Cholesterol Cal: 24 mg/dL (range 5-40)
LDL Cholesterol Calc: 81 mg/dL (range 0-99)
T. Chol/HDL Ratio: 4.4 ratio units (range 0.0-5.0)

Testosterone, Serum: 1127 ng/dL (range 348-1197)
Free Testosterone (Direct): 26.3 pg/mL (range 8.7 - 25.1) High
Estradiol, Sensitive: 38.8 pg/mL (range 8-35) High

DHEA-Sulfate: 234.6 ug/dL (range 138.5-475.2)

TSH: 2.160 iIU/mL (range 0.45-4.5)

PSA: 1.0 ng/mL (range 0.0-4.0)

IGF-1: 281 ng/mL (range 88-246) High

Vitamin D, 25-Hydroxy: 59.8 ng/mL (range 30-100)

Progesterone: 0.2 ng/mL (range 0.0-0.1) High


Plan

1) Add in Calcium D-Glucarate to knock down E2

2) Add in DHEA-S to increase levels into optimal range


Questions

1) Any suggestions on Calcium D-Glucarate and DHEA-S dosages/recommended brands?

2) Not sure what to do about the elevated IGF-1/Progesterone levels (I'm leaning towards nothing).  Any thoughts?

3) Serum glucose was looking a little high - looking at past labs it seems to fluctuate here and there (usually between 80-95).  Not sure if this is anything to worry about.

4) Has anyone had any luck increasing their HDL and, if so, how did you go about it?  Mine has always been low, usually around this level.

5) Any thoughts on DIM versus Calcium D-Glucarate to control E2?

Title: Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: ghce on September 23, 2016, 05:22:39 am
My recent use of CDG at 1000mg ( 2x 500 mg in one day) caused mouth dryness and and made me feel very edgy. 500mg was ok (for me).
Will start DIM hopefully next week when my order arrives, I suspect that will be better.
Title: Re: September 2016 Labs
Post by: PeakT on September 23, 2016, 07:36:54 pm
Evening All -  Just had fresh labs drawn, and was hoping for some input on next steps/supplementation dosages.  Here are the highlights:

Current Protocol
40mg T Cyp 2x/week - IM (shoulder)
400iu HCG 2x/week - IM (shoulder)
6000iu Vitamin D Daily
1000mg Vitamin C Daily
Align Probiotic
Donate Blood 2x/year


Recent Labs - Fasting/Morning Draw
Glucose, Serum: 94 mg/dL (range 65-99)

Cholesterol, Total: 136 mg/dL (range 100-199)
Triglycerides: 118 mg/dL (range 0-149)
HDL Cholesterol: 31 mg/dL (range >39) Low
VLDL Cholesterol Cal: 24 mg/dL (range 5-40)
LDL Cholesterol Calc: 81 mg/dL (range 0-99)
T. Chol/HDL Ratio: 4.4 ratio units (range 0.0-5.0)

Testosterone, Serum: 1127 ng/dL (range 348-1197)
Free Testosterone (Direct): 26.3 pg/mL (range 8.7 - 25.1) High
Estradiol, Sensitive: 38.8 pg/mL (range 8-35) High

DHEA-Sulfate: 234.6 ug/dL (range 138.5-475.2)

TSH: 2.160 iIU/mL (range 0.45-4.5)

PSA: 1.0 ng/mL (range 0.0-4.0)

IGF-1: 281 ng/mL (range 88-246) High

Vitamin D, 25-Hydroxy: 59.8 ng/mL (range 30-100)

Progesterone: 0.2 ng/mL (range 0.0-0.1) High


Plan

1) Add in Calcium D-Glucarate to knock down E2

2) Add in DHEA-S to increase levels into optimal range


Questions

1) Any suggestions on Calcium D-Glucarate and DHEA-S dosages/recommended brands?

2) Not sure what to do about the elevated IGF-1/Progesterone levels (I'm leaning towards nothing).  Any thoughts?

3) Serum glucose was looking a little high - looking at past labs it seems to fluctuate here and there (usually between 80-95).  Not sure if this is anything to worry about.

4) Has anyone had any luck increasing their HDL and, if so, how did you go about it?  Mine has always been low, usually around this level.

5) Any thoughts on DIM versus Calcium D-Glucarate to control E2?

I've got the same thing:  always had low HDL.  If you're consuming low fat, that's not necessarily a huge issue but pull your LDL-P to make sure.  If your LDL-P is high, you've probably gone pattern B and need to start really working on it.  The fact that glucose may be creeping up indicates that this might be the case, so check all that stuff out.  I have quite a few ideas here:

http://www.peaktestosterone.com/Hdr_Diabetes_Prediabetes

I like Calcium D-Glucarate for reasons expressed here:

http://www.peaktestosterone.com/Natural_Estrogen_Blockers

But no long term studies or anything to go by, so we're all guessing to a certain extent.

And how's the libido - I'm asking for a reason.
Title: Re: September 2016 Labs
Post by: Balderdasher on September 23, 2016, 10:49:51 pm
Evening All -  Just had fresh labs drawn, and was hoping for some input on next steps/supplementation dosages.  Here are the highlights:

Current Protocol
40mg T Cyp 2x/week - IM (shoulder)
400iu HCG 2x/week - IM (shoulder)
6000iu Vitamin D Daily
1000mg Vitamin C Daily
Align Probiotic
Donate Blood 2x/year


Recent Labs - Fasting/Morning Draw
Glucose, Serum: 94 mg/dL (range 65-99)

Cholesterol, Total: 136 mg/dL (range 100-199)
Triglycerides: 118 mg/dL (range 0-149)
HDL Cholesterol: 31 mg/dL (range >39) Low
VLDL Cholesterol Cal: 24 mg/dL (range 5-40)
LDL Cholesterol Calc: 81 mg/dL (range 0-99)
T. Chol/HDL Ratio: 4.4 ratio units (range 0.0-5.0)

Testosterone, Serum: 1127 ng/dL (range 348-1197)
Free Testosterone (Direct): 26.3 pg/mL (range 8.7 - 25.1) High
Estradiol, Sensitive: 38.8 pg/mL (range 8-35) High

DHEA-Sulfate: 234.6 ug/dL (range 138.5-475.2)

TSH: 2.160 iIU/mL (range 0.45-4.5)

PSA: 1.0 ng/mL (range 0.0-4.0)

IGF-1: 281 ng/mL (range 88-246) High

Vitamin D, 25-Hydroxy: 59.8 ng/mL (range 30-100)

Progesterone: 0.2 ng/mL (range 0.0-0.1) High


Plan

1) Add in Calcium D-Glucarate to knock down E2

2) Add in DHEA-S to increase levels into optimal range


Questions

1) Any suggestions on Calcium D-Glucarate and DHEA-S dosages/recommended brands?

2) Not sure what to do about the elevated IGF-1/Progesterone levels (I'm leaning towards nothing).  Any thoughts?

3) Serum glucose was looking a little high - looking at past labs it seems to fluctuate here and there (usually between 80-95).  Not sure if this is anything to worry about.

4) Has anyone had any luck increasing their HDL and, if so, how did you go about it?  Mine has always been low, usually around this level.

5) Any thoughts on DIM versus Calcium D-Glucarate to control E2?

I've got the same thing:  always had low HDL.  If you're consuming low fat, that's not necessarily a huge issue but pull your LDL-P to make sure.  If your LDL-P is high, you've probably gone pattern B and need to start really working on it.  The fact that glucose may be creeping up indicates that this might be the case, so check all that stuff out.  I have quite a few ideas here:

http://www.peaktestosterone.com/Hdr_Diabetes_Prediabetes

I like Calcium D-Glucarate for reasons expressed here:

http://www.peaktestosterone.com/Natural_Estrogen_Blockers

But no long term studies or anything to go by, so we're all guessing to a certain extent.

And how's the libido - I'm asking for a reason.

Thanks for the insights Peak and ghce.  Re: libido, I'd say moderate - not great, not bad.  Have been a little moodier than normal, which would make sense.
Title: Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: Balderdasher on September 24, 2016, 06:53:11 pm
Hey Peak - following up on your question about libido.  Are you asking this because of my DHEA or E2 reads, or something else entirely?
Title: Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: PeakT on September 24, 2016, 08:11:54 pm
Hey Peak - following up on your question about libido.  Are you asking this because of my DHEA or E2 reads, or something else entirely?

You had hi progesterone right?  In vitro studies show this could push down DHT and, therefore, libido.
Title: Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: Balderdasher on September 24, 2016, 11:08:02 pm
Hey Peak - following up on your question about libido.  Are you asking this because of my DHEA or E2 reads, or something else entirely?

You had hi progesterone right?  In vitro studies show this could push down DHT and, therefore, libido.

Ahhhh sharp eye.  Yep, progesterone is high - not really sure what to do about it, but will look at getting DHT drawn the next time I go in for labs.
Title: Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: Balderdasher on September 28, 2016, 02:35:32 am
Added in Calcium D-Glucarate a couple of days ago and I believe that I'm already feeling some benefits, though I certainly hadn't expected to this early (and still have some doubts, given the short timeframe).  Most notable thus far is just energy levels - had a couple of nights of very light/sparse sleep, which would normally knock me down pretty good, and I've actually been pretty high energy. 
Title: Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: Balderdasher on February 08, 2017, 02:19:58 am
Mainly using this thread as a historical record/journal for those who may be going through similar situations - I seem to have run the gamut over the past 5 years.

I've hooked up with Defy, and have thus far been very impressed.  After discussing a few lingering issues (borderline high estradiol, occasional mild tiredness, occasional mild ED) with Dr. Saya after my last labs were drawn, he suggested adding in a DIM/CDG combo his office supplies (100mg CDG, 100mg DIM 2x/day) and knocking my HCG dosage from 400iu 2x/week (800iu/week total) down to 750iu split between 3 injections a week. 

I had my tonsils out shortly after our discussion, so I delayed implementing the new protocol in order to give myself a chance to recovery.  After getting back on my feet, I added in the DIM/CDG supplement per his suggestion (I'm a big believer in changing one thing at a time, and then testing prior to implementing any other changes, so I delayed switching up the HCG change).  Within a week or so I began experiencing low E2 symptoms (E.D., tiredness, etc.), so I dialed the DIM/CDG back to 1x/day and things improved within 48 hours.

~8 weeks post-change, labs came back as follow:

Testosterone, Serum 1024 ng/dL (348 - 1197)

Free Testosterone(Direct) 17.6 pg/mL (8.7 - 25.1)

Dihydrotestosterone 83 ng/dL (30-85)

Estradiol, Sensitive 29.5 pg/mL (8.0 - 35.0)

Prolactin 11.6 ng/mL (4.0 - 15.2)

Ferritin, Serum 46 ng/mL (30 - 400)


E2 is now in range, and ED (what little remained) has essentially disappeared entirely.  Will likely connect back with Defy regarding any further changes considering that most everything is looking pretty good now, thus potentially negating the need for any change to my current HCG regimen.

Given that I donate blood 2-3 times a year (in fact, I donated blood the day after these labs were drawn), I'm guessing that my ferritin may be contributing to occasional/mild tiredness.
Title: Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: PeakT on February 08, 2017, 06:38:11 am
Mainly using this thread as a historical record/journal for those who may be going through similar situations - I seem to have run the gamut over the past 5 years.

I've hooked up with Defy, and have thus far been very impressed.  After discussing a few lingering issues (borderline high estradiol, occasional mild tiredness, occasional mild ED) with Dr. Saya after my last labs were drawn, he suggested adding in a DIM/CDG combo his office supplies (100mg CDG, 100mg DIM 2x/day) and knocking my HCG dosage from 400iu 2x/week (800iu/week total) down to 750iu split between 3 injections a week. 

I had my tonsils out shortly after our discussion, so I delayed implementing the new protocol in order to give myself a chance to recovery.  After getting back on my feet, I added in the DIM/CDG supplement per his suggestion (I'm a big believer in changing one thing at a time, and then testing prior to implementing any other changes, so I delayed switching up the HCG change).  Within a week or so I began experiencing low E2 symptoms (E.D., tiredness, etc.), so I dialed the DIM/CDG back to 1x/day and things improved within 48 hours.

~8 weeks post-change, labs came back as follow:

Testosterone, Serum 1024 ng/dL (348 - 1197)

Free Testosterone(Direct) 17.6 pg/mL (8.7 - 25.1)

Dihydrotestosterone 83 ng/dL (30-85)

Estradiol, Sensitive 29.5 pg/mL (8.0 - 35.0)

Prolactin 11.6 ng/mL (4.0 - 15.2)

Ferritin, Serum 46 ng/mL (30 - 400)


E2 is now in range, and ED (what little remained) has essentially disappeared entirely.  Will likely connect back with Defy regarding any further changes considering that most everything is looking pretty good now, thus potentially negating the need for any change to my current HCG regimen.

Given that I donate blood 2-3 times a year (in fact, I donated blood the day after these labs were drawn), I'm guessing that my ferritin may be contributing to occasional/mild tiredness.

Out of curiosity, with your testosterone and DHT that high and estradiol under control, is your libido pretty high?
Title: Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: Balderdasher on February 08, 2017, 01:42:53 pm
Mainly using this thread as a historical record/journal for those who may be going through similar situations - I seem to have run the gamut over the past 5 years.

I've hooked up with Defy, and have thus far been very impressed.  After discussing a few lingering issues (borderline high estradiol, occasional mild tiredness, occasional mild ED) with Dr. Saya after my last labs were drawn, he suggested adding in a DIM/CDG combo his office supplies (100mg CDG, 100mg DIM 2x/day) and knocking my HCG dosage from 400iu 2x/week (800iu/week total) down to 750iu split between 3 injections a week. 

I had my tonsils out shortly after our discussion, so I delayed implementing the new protocol in order to give myself a chance to recovery.  After getting back on my feet, I added in the DIM/CDG supplement per his suggestion (I'm a big believer in changing one thing at a time, and then testing prior to implementing any other changes, so I delayed switching up the HCG change).  Within a week or so I began experiencing low E2 symptoms (E.D., tiredness, etc.), so I dialed the DIM/CDG back to 1x/day and things improved within 48 hours.

~8 weeks post-change, labs came back as follow:

Testosterone, Serum 1024 ng/dL (348 - 1197)

Free Testosterone(Direct) 17.6 pg/mL (8.7 - 25.1)

Dihydrotestosterone 83 ng/dL (30-85)

Estradiol, Sensitive 29.5 pg/mL (8.0 - 35.0)

Prolactin 11.6 ng/mL (4.0 - 15.2)

Ferritin, Serum 46 ng/mL (30 - 400)


E2 is now in range, and ED (what little remained) has essentially disappeared entirely.  Will likely connect back with Defy regarding any further changes considering that most everything is looking pretty good now, thus potentially negating the need for any change to my current HCG regimen.

Given that I donate blood 2-3 times a year (in fact, I donated blood the day after these labs were drawn), I'm guessing that my ferritin may be contributing to occasional/mild tiredness.

Out of curiosity, with your testosterone and DHT that high and estradiol under control, is your libido pretty high?

I'd say it is healthy, but not high.  Stress and energy really play into it more than anything I've noticed.
Title: Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: PeakT on February 09, 2017, 01:05:40 am


I'd say it is healthy, but not high.  Stress and energy really play into it more than anything I've noticed.

Couldn't agree more on the stress.
Title: Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: Balderdasher on September 30, 2017, 03:06:11 pm
Updated lab results.  Higher T numbers were surprising, given that my protocol has remained exactly the same.  Guessing this is due to these figures having been drawn two days after an injection, instead of on a trough day.

Another interesting development was the impact of Augmentin, a common antibiotic, on my energy levels and libido after a recent infection.  Energy and libido went through the roof!  I did some research, and apparently Augmentin can lower E2, so now I'm wondering if there might be some benefit to inquiring into a low-dose Adex solution, or upping my DIM intake.

Protocol: 40mg T Cyp 2x/week IM; 250iu HCG 2x/week IM; Metabolic Maintenance Complex (100mg DIM, 100mg CDG) 1x/day; Vitamin D 8000 iu/Day; Fish Oil 2g/Day

Testosterone, Total: 1385ng/dL
Free Testosterone: 28.9 pg/mL
SHBG: 53.6 pg/mL (16.5-55.9 range) - curious why this is so high
E2, Sensitive: 46.1 pg/mL (8.0-35.0 range)
PSA: 1.3ng/mL (0.0-4.0 range)
TSH: 2.040 uIU/mL (.0450-4.500 range)
DHEA-S: 311.1 ug/dL (138.5-475.2 range)

CBC, Lipids, CMP all look good as well.
Title: Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: PeakT on October 02, 2017, 12:19:37 pm
Updated lab results.  Higher T numbers were surprising, given that my protocol has remained exactly the same.  Guessing this is due to these figures having been drawn two days after an injection, instead of on a trough day.

Another interesting development was the impact of Augmentin, a common antibiotic, on my energy levels and libido after a recent infection.  Energy and libido went through the roof!  I did some research, and apparently Augmentin can lower E2, so now I'm wondering if there might be some benefit to inquiring into a low-dose Adex solution, or upping my DIM intake.

Protocol: 40mg T Cyp 2x/week IM; 250iu HCG 2x/week IM; Metabolic Maintenance Complex (100mg DIM, 100mg CDG) 1x/day; Vitamin D 8000 iu/Day; Fish Oil 2g/Day

Testosterone, Total: 1385ng/dL
Free Testosterone: 28.9 pg/mL
SHBG: 53.6 pg/mL (16.5-55.9 range) - curious why this is so high
E2, Sensitive: 46.1 pg/mL (8.0-35.0 range)
PSA: 1.3ng/mL (0.0-4.0 range)
TSH: 2.040 uIU/mL (.0450-4.500 range)
DHEA-S: 311.1 ug/dL (138.5-475.2 range)

CBC, Lipids, CMP all look good as well.

A few comments and questions:

--That free testosterone number makes no sense to me.  Use this and you'll see why.  (Notice the units.)

http://www.issam.ch/freetesto.htm

--Is that estradiol using the LC-MS/MS test? 

--Pulling TSH without T3 and T4 is pretty worthless as you probably know.  (rT3 can be important also.) But, if your energy levels are good, etc., then you're probably okay I guess.)

Title: Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: Balderdasher on October 11, 2017, 01:47:59 pm
Updated lab results.  Higher T numbers were surprising, given that my protocol has remained exactly the same.  Guessing this is due to these figures having been drawn two days after an injection, instead of on a trough day.

Another interesting development was the impact of Augmentin, a common antibiotic, on my energy levels and libido after a recent infection.  Energy and libido went through the roof!  I did some research, and apparently Augmentin can lower E2, so now I'm wondering if there might be some benefit to inquiring into a low-dose Adex solution, or upping my DIM intake.

Protocol: 40mg T Cyp 2x/week IM; 250iu HCG 2x/week IM; Metabolic Maintenance Complex (100mg DIM, 100mg CDG) 1x/day; Vitamin D 8000 iu/Day; Fish Oil 2g/Day

Testosterone, Total: 1385ng/dL
Free Testosterone: 28.9 pg/mL
SHBG: 53.6 pg/mL (16.5-55.9 range) - curious why this is so high
E2, Sensitive: 46.1 pg/mL (8.0-35.0 range)
PSA: 1.3ng/mL (0.0-4.0 range)
TSH: 2.040 uIU/mL (.0450-4.500 range)
DHEA-S: 311.1 ug/dL (138.5-475.2 range)

CBC, Lipids, CMP all look good as well.

A few comments and questions:

--That free testosterone number makes no sense to me.  Use this and you'll see why.  (Notice the units.)

http://www.issam.ch/freetesto.htm

--Is that estradiol using the LC-MS/MS test? 

--Pulling TSH without T3 and T4 is pretty worthless as you probably know.  (rT3 can be important also.) But, if your energy levels are good, etc., then you're probably okay I guess.)

Sorry for the delay Peak, missed your reply somehow.

Re: the Free T #, the units for Free T in the calculator are different from my lab results (pg versus ng), but the numbers are pretty closely aligned, so not too certain what to make of it.  When I use this calculator, it looks pretty decent: http://www.pctag.uk/testosterone-calculator/

Re: the E2 test, yep!  It is the sensitive test from Defy.

I've had the other thyroid number pulled previously and all looked good, so I've drawn back on getting them tested in detail more than once every couple of years.

As a follow up, I connected with Dr. Calkins from Defy who was fantastic.  Very knowledgeable and detail-oriented, as it seems like we've come to expect from their group.

He recommended:

1) Adding in .125mg Adex 2x/week with injection.
2) 25mg DHEA nightly.

Normally I'd hesitate to add in Adex, even in such a small amount; however, I've been experiencing some very mild high E2 symptoms, and am eager to see if this addition clears those up.

Thus, my protocol for the next 3 months will be:

1) 40mg T Cyp 2x/week injected IM
2) 250iu HCG 2x/week injected IM
3) .125mg Adex 2x/week
4) 8000iu Vit D3 daily
5) 4g Fish Oil daily
6) 25mg DHEA daily
7) Align Probiotic daily

After which I will draw labs and go from there.
Title: Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: chrisL on October 11, 2017, 07:26:36 pm
Updated lab results.  Higher T numbers were surprising, given that my protocol has remained exactly the same.  Guessing this is due to these figures having been drawn two days after an injection, instead of on a trough day.

Another interesting development was the impact of Augmentin, a common antibiotic, on my energy levels and libido after a recent infection.  Energy and libido went through the roof!  I did some research, and apparently Augmentin can lower E2, so now I'm wondering if there might be some benefit to inquiring into a low-dose Adex solution, or upping my DIM intake.

Protocol: 40mg T Cyp 2x/week IM; 250iu HCG 2x/week IM; Metabolic Maintenance Complex (100mg DIM, 100mg CDG) 1x/day; Vitamin D 8000 iu/Day; Fish Oil 2g/Day

Testosterone, Total: 1385ng/dL
Free Testosterone: 28.9 pg/mL
SHBG: 53.6 pg/mL (16.5-55.9 range) - curious why this is so high
E2, Sensitive: 46.1 pg/mL (8.0-35.0 range)
PSA: 1.3ng/mL (0.0-4.0 range)
TSH: 2.040 uIU/mL (.0450-4.500 range)
DHEA-S: 311.1 ug/dL (138.5-475.2 range)

CBC, Lipids, CMP all look good as well.

A few comments and questions:

--That free testosterone number makes no sense to me.  Use this and you'll see why.  (Notice the units.)

http://www.issam.ch/freetesto.htm

I was just going thru this thread thinking the same. I seem to be an opposite side of the response spectrum:

after 10 weeks on 200mg of test cyp and 1000ui of HCG weekly my total T is 1030 on 264-916 range!

i have only one test so far while on TRT, so there could be something wrong with the test results. and the test was not LC/MS assay. I will retest soon on 150mg of test cyp.
Title: Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: PeakT on October 12, 2017, 01:37:57 pm
Updated lab results.  Higher T numbers were surprising, given that my protocol has remained exactly the same.  Guessing this is due to these figures having been drawn two days after an injection, instead of on a trough day.

Another interesting development was the impact of Augmentin, a common antibiotic, on my energy levels and libido after a recent infection.  Energy and libido went through the roof!  I did some research, and apparently Augmentin can lower E2, so now I'm wondering if there might be some benefit to inquiring into a low-dose Adex solution, or upping my DIM intake.

Protocol: 40mg T Cyp 2x/week IM; 250iu HCG 2x/week IM; Metabolic Maintenance Complex (100mg DIM, 100mg CDG) 1x/day; Vitamin D 8000 iu/Day; Fish Oil 2g/Day

Testosterone, Total: 1385ng/dL
Free Testosterone: 28.9 pg/mL
SHBG: 53.6 pg/mL (16.5-55.9 range) - curious why this is so high
E2, Sensitive: 46.1 pg/mL (8.0-35.0 range)
PSA: 1.3ng/mL (0.0-4.0 range)
TSH: 2.040 uIU/mL (.0450-4.500 range)
DHEA-S: 311.1 ug/dL (138.5-475.2 range)

CBC, Lipids, CMP all look good as well.

A few comments and questions:

--That free testosterone number makes no sense to me.  Use this and you'll see why.  (Notice the units.)

http://www.issam.ch/freetesto.htm

--Is that estradiol using the LC-MS/MS test? 

--Pulling TSH without T3 and T4 is pretty worthless as you probably know.  (rT3 can be important also.) But, if your energy levels are good, etc., then you're probably okay I guess.)

Sorry for the delay Peak, missed your reply somehow.

Re: the Free T #, the units for Free T in the calculator are different from my lab results (pg versus ng), but the numbers are pretty closely aligned, so not too certain what to make of it.  When I use this calculator, it looks pretty decent: http://www.pctag.uk/testosterone-calculator/

Re: the E2 test, yep!  It is the sensitive test from Defy.

I've had the other thyroid number pulled previously and all looked good, so I've drawn back on getting them tested in detail more than once every couple of years.

As a follow up, I connected with Dr. Calkins from Defy who was fantastic.  Very knowledgeable and detail-oriented, as it seems like we've come to expect from their group.

He recommended:

1) Adding in .125mg Adex 2x/week with injection.
2) 25mg DHEA nightly.

Normally I'd hesitate to add in Adex, even in such a small amount; however, I've been experiencing some very mild high E2 symptoms, and am eager to see if this addition clears those up.

Thus, my protocol for the next 3 months will be:

1) 40mg T Cyp 2x/week injected IM
2) 250iu HCG 2x/week injected IM
3) .125mg Adex 2x/week
4) 8000iu Vit D3 daily
5) 4g Fish Oil daily
6) 25mg DHEA daily
7) Align Probiotic daily

After which I will draw labs and go from there.

Great to hear.  Yeah, here is something to think about with an estradiol read of 46 pg/ml with the sensitive test.  That could easily be 60+ on the old test and we all know that guys rarely felt good when they had estradiol that high.  On the other hand, Hydranted swears he feels best in the low 40's and I assume he's talking about the LC-MS/MS test.

Anyway, let us know how it goes - I'm curious if the Arimidex helps you feel better over the longer term.
Title: Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
Post by: Balderdasher on January 19, 2018, 05:15:09 am
Hey All -

Just an update for the thread - question being posted separately.

Back in September my lab results were:

Protocol: 40mg T Cyp 2x/week IM; 400iu HCG 2x/week IM; Metabolic Maintenance Complex (100mg DIM, 100mg CDG) 1x/day; Vitamin D 8000 iu/Day; Fish Oil 2g/Day

Testosterone, Total: 1385ng/dL
Free Testosterone: 28.9 pg/mL
SHBG: 53.6 pg/mL (16.5-55.9 range) - curious why this is so high
E2, Sensitive: 46.1 pg/mL (8.0-35.0 range)
PSA: 1.3ng/mL (0.0-4.0 range)
TSH: 2.040 uIU/mL (.0450-4.500 range)
DHEA-S: 311.1 ug/dL (138.5-475.2 range)

Had labs redrawn this month (same protocol except switched to Empower Pharmacy for Test Cyp and HCG and added + .125mg adex 2x/week in place of DIM/CDG):

Protocol: 40mg T Cyp 2x/week IM; 400iu HCG 2x/week IM; .125mg adex 2x/week; Vitamin D 8000 iu/Day; Fish Oil 2g/Day

Testosterone, Total: 687 ng/dL
Free Testosterone: 15.1 pg/mL
SHBG: 41.4 pg/mL (16.5-55.9 range)
E2, Sensitive: 19.8 pg/mL (8.0-35.0 range)
PSA: 1.5ng/mL (0.0-4.0 range)
TSH: 1.880 uIU/mL (.0450-4.500 range)
DHEA-S: 250.3 ug/dL (138.5-475.2 range)

As you can see, pretty similar protocol except I switched to Empower for my pharmacy and added in the Adex.