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Author Topic: Post-HRT Taper -> Back to TRT -> Now Steady on TRT  (Read 30821 times)

PeakT

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Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
« Reply #60 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?
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Balderdasher

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Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
« Reply #61 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.
I am not a medical doctor.  All suggestions are meant to be discussed with your doctor.

Age: 30 | Height: 6ft 1in | Weight: 175

Protocol: 40mg T Cyp 2x/week + 400u HCG 2x/week.

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

Varicocele repair -> on TRT for 1 year -> tapered off T for 1 year -> back to TRT

Peak Testosterone Forum

Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
« Reply #61 on: February 08, 2017, 01:42:53 pm »


PeakT

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Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
« Reply #62 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.
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Balderdasher

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Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
« Reply #63 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.
« Last Edit: September 30, 2017, 03:12:50 pm by Balderdasher »
I am not a medical doctor.  All suggestions are meant to be discussed with your doctor.

Age: 30 | Height: 6ft 1in | Weight: 175

Protocol: 40mg T Cyp 2x/week + 400u HCG 2x/week.

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

Varicocele repair -> on TRT for 1 year -> tapered off T for 1 year -> back to TRT

Peak Testosterone Forum

Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
« Reply #63 on: September 30, 2017, 03:06:11 pm »


PeakT

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Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
« Reply #64 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.)

THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Balderdasher

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Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
« Reply #65 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.
I am not a medical doctor.  All suggestions are meant to be discussed with your doctor.

Age: 30 | Height: 6ft 1in | Weight: 175

Protocol: 40mg T Cyp 2x/week + 400u HCG 2x/week.

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

Varicocele repair -> on TRT for 1 year -> tapered off T for 1 year -> back to TRT

chrisL

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Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
« Reply #66 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.

PeakT

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Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
« Reply #67 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.
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Balderdasher

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Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
« Reply #68 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. 

I am not a medical doctor.  All suggestions are meant to be discussed with your doctor.

Age: 30 | Height: 6ft 1in | Weight: 175

Protocol: 40mg T Cyp 2x/week + 400u HCG 2x/week.

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

Varicocele repair -> on TRT for 1 year -> tapered off T for 1 year -> back to TRT

Peak Testosterone Forum

Re: Post-HRT Taper -> Back to TRT -> Now Steady on TRT
« Reply #68 on: January 19, 2018, 05:15:09 am »