Observations after 1 month HRT

[PeakT]

Prsartist:  Sorry about the confusion in the above post.  You accidentally capitalized today, so I modified that and ended up messing up your post.  But I fixed it above.

So question for you:  how long of you have been, do you think, up at the higher testosterone level (and higher estrogen level)?

.

[Prsartist]

Don't really know, I noticed the "maximum" effect
After about 2-3 weeks and everything was great. Morning wood everyday
Things were great. Noticed a drastic drop at 4-5 weeks but only in
The ED dept.  (blue pill didnt even help) libido and other aches are a lot better.
Was tested at week 5, everything looked good except estradol at 58.

[PeakT]

Don't really know, I noticed the "maximum" effect
After about 2-3 weeks and everything was great. Morning wood everyday
Things were great. Noticed a drastic drop at 4-5 weeks but only in
The ED dept.  (blue pill didnt even help) libido and other aches are a lot better.
Was tested at week 5, everything looked good except estradol at 58.

Gotcha.  Well, that's plenty of time for everything to stabilize, so I would definitely pursue the estradiol issue with your doc.  Of course, there's no way any of us knows for sure what the underlying issue is, but you've got to work on one thing at a time to find out what is causing the problem and, in my mind, that is one place to look.  High estrogen definitely seems to cause some men problems very similar to low testosterone.  In actuality, it may be the testosterone-to-estrogen ratio that is the underlying issue, but that's really splitting hairs if you stop to think about it.

Anyway, though, to answer your primary question:  I find it hard to believe that your E2 is going to drop any more after this many weeks.  I guess testosterone does tend to lean out men, i.e. they put on a little muscle and lose a little fat.  And that will tend to pull down estrogen over the months.  But that's the only thing I can think of that would cause a gradual decline in estrogen.  So push your physician on this and find out if he's just putting you off or if this is really a documented phenomenon for men in his practice.  Your testosterone is pretty high, so maybe the leaning out occurs much more frequently in his practice - I don't know.

Let us know what you find out...

[Prsartist]

Another observation today,  this after 10 weeks of treatment
The ED issue is still a major problem (get tested again next week)
Think it's due to my last estrogen LAB of 58.

I have noticed my testicles are smaller!!!!
(it's not in my imagination)  and I do feel them ache from time to time
For no reason...   Any ideas if this is  a TRT issue?

[PeakT]

I have never heard of this but, of course, get it checked it out.  There are, of course, many things that can cause testicular pain - some serious and some not.

[Prsartist]

Thanks
I've done an Internet search since posting this
And found it is in fact a side effect of  TRT.
Good grief if it's not one thing after another for me.

I just read on another forum its indicitave of secendary
Hypogonadism.  The pituitary shuts down production of
LH & FSH due to high testosterone levels.

Can be treated with HGC (another steroid)..
Does Any of this sound familiar?

[FightLowT]

I also don't believe that the E2 is going to drop either. Why? Cause I've got a brain and realize that if it were going to drop it would have never raised in the first place. They are supposed to train these docs with cause and effect logic classes that enable them to make decisions like smart people. You could try taking DIM. Some guys have success with it while others do not. It's expensive and probably not worth the price. Zinc may also help. There is no reason though for you to have to wait another month to see if those levels are going to go down. Seriously if that claim he is making is true about the levels rising and then later falling actually happens for you then I will walk inside that docs office and tell him to pull down his pants so I can kiss his ass. Thats how confident I am about your levels not falling like he says they will. If anything I'm pretty sure they will rise some more. After all isn't that the direction they were going? upwards...I don't believe in the magical night time visits of the E2 lowering elves from the dark forest but your doctor apparently does.( at least he's willing to help)..Geez it's always something with these docs.Seems like they never truly get it all the way. Most of them seem like they cannot get on the same page as to what works except for a handful of the top guys. for instance one might believe an AI is necessary while others won't. One will understand that some guys who are secondary will benefit from HCG or clomid while another will just write a script for androgel 1.62%  .No wonder people are traveling outside of the state and paying large amounts of money out of pocket to get dialed -in by an expert....Send me an email with the icon envelope..

[Prsartist]

Well...... This is what I've subsequently found
By Dr. John Crisler regarding the estradiol issue.

"Once the method and dosing is set, by laboratory assay AND subjective report from the patient, then you may address any side effects due to elevated estrogen levels which have occurred. I do not use an AI initially, even when E2 is elevated, because some patients will actually see a drop in estrogen over baseline on follow-up."

While I personally don't believe it,  (and it's been a less than ideal month)
Not much I can do now.  Thankfully I'm going in for my 2nd blood draw Tuesday, and will
Be calling the Dr. By Thursday to get this resolved!

[Prsartist]

Here is the interesting link I pulled the quote from.

http://www.uk-muscle.co.uk/steroids-associated-drugs-articles/11279-hrt-trt-john-crisler.html

[FightLowT]

Yeah I've pretty much read everything he has written. The reason why I don't believe yours are going to go down is because you said you were doing 1 cc per week. Correct? That's a pretty hefty dose to be honest. Right on the top-side of what many docs would prescribe. Most start a guy on half that and work-up or down  .You might be around 1500ng/dl plus within a day or so after that injection. Really close to what is considered supraphysiological. Some guys depending on how their body's metabolize the T might need a higher dose but right before your next pin you said you were around 940ng/dl. Get that E2 in check and man you should really experience some benefits for body composition improvements and work-out recovery ability.

[Prsartist]

Yes you are correct about my dose and testing #'s
Do you think the 58 estradiol by itself could be causing the Ed issues?
And if my estradiol is 58 on the day before a pin, wonder what it is the day after??

[FightLowT]

The E2 definately isn't going to help. That's for sure. I would think most guys would do well between 17-30 pg/ml. Also sometimes higher T isn't necessarily the cure-all. Not that you don't need TRT but maybe not be close to the top of what is considered humanly possible. Apparently everyone has their own sweet spot. Hormones are weird things. Some guys might need to be in the 600's while others might need to be 800's. It is entirely possible that you could have significant higher E2 levels after that shot of 1cc. You could try halving the dose. Monday you would pin half the cc and then on thursday you would do the other half. That could potentially aid in E2 management as well. Some guys even inject sub-Q right into the adipose tissue and I have heard that it is surprisingly less likely to aromatize than intramuscular.

[Prsartist]

"sub-Q right into the adipose tissue"

I did seem to hit a "sweet spot" between the 2nd and 4th
Injection,  but unfortunately it didn't last.  I assumed it was from
Rising estradiol? (at least I hope it is?)

[PeakT]

"sub-Q right into the adipose tissue"

I did seem to hit a "sweet spot" between the 2nd and 4th
Injection,  but unfortunately it didn't last.  I assumed it was from
Rising estradiol? (at least I hope it is?)

Some guys really feel a big difference shortly after their testosterone is raised significantly.  My theory is that this is because in some men, it is really changing the neurohormonal soup in their brain.  I have also heard many describe what you did that things taper off rapidly after that. 

Supplements can do the same thing.  Whenever I take S-PS (phosphatidylserine), the first day is pretty dramatic and then the effect falls off rapidly.  (I haven't need S-PS since I started PMRing and meditating more.)

But realize most guys write in saying, "When am I going to feel the T therapy take effect?"  And I always say that they need to give it a few months, at least 3...

[Prsartist]

Just had my draw Tuesday, and I was on the phone
With my dr. (actually his dimwit asst.) At 9am To get the results.
Finall calls me back (at 4pm) to let me know my estradiol level was
Now at 88!!  That's about makes sense sine my baseline was 24,  5-week check
Was 58,  just about where I would expect!!

I'm so pissed, I probably shouldn't be typIng this now.  She remembered our conversation
A month ago, when I expressed my serious doubts about my estradiol level "magically" falling back to normal.  And said I could come down and pic up the anastrozole.  (not a good idea when I'm already pissed) but I went...

When I walked in the office (which is quite a drive) the 1st thing I hear is "how are you"....
PISSED!!!  She asked what happened so i told her and I'm sure everyone in the office heard my story!

(I'm paraphrasing here, leaving out a few 4 letter words that slipped out)


"You wonderful treatment center brought my sex drive back to when I was a teenager.  Then for added fun they caused complete and total ED.  When I brought up the estradiol of 58 to their attention 5 WEEKS ago, they told me that is common for it to drop all by itself, let's wait another month and see, i told her then i don't  believe it!  in the mean time now my testicles are aching and getting smaller!!

Of course my results came back today and let me tell you it's very frustrating being smarter than the Dr!  Low and behold I was right again!! Now my estradiol level is 88!  No wonder my balls hurt, their trying to shrivel away and grow a vagina".   

It was about this moment they pulled me back into a consultation office... No biggie I was about done at that point. 

The nurse practitioner who is handling my case when the Dr. Is out (which is most of the time)
Explained to me what was happening.  Gee thanks!!
I stopped her and told her I already know what and why this is happening, and that it's totally NOT ok
To cause complete ED, for a month when it should of been addressed a month ago!

She started the same old story about levels (magically) falling back to normal on their own.
I told her I don't believe a word of it, I want this fixed NOW!!  She said this anastrozole will block the estrogen conversion.

As far as my testicles aching and shrinking.  she said this too is a common side effect of TRT as my testicles have become inactive due to HRT, and that once my estradiol levels were in check they would start HCG, to keep them stimulated.  I then replied, you now think its ok for my testicles to ache for another her month, when you already know what it's going to take to correct the problem??

She then said that they don't want to introduce another med. until my estradiol is in check...
I said this better work, you don't want to see me in here earlier than my next appt!
And left..

Moral of this story is that it's imperative to monitor your estradiol levels!
Then can ruin any benefits of TRT!  If your Dr. Is not testing for it, find a new Dr.!!

Thank god for this site!  Don't think I would have been around without it!

Who would think so many Dr's are this clueless? And lack common sense. It's truly scarey!