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Author Topic: Post-HRT Taper -> Back to TRT -> Now Steady on TRT  (Read 30820 times)

Balderdasher

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Post-HRT Taper -> Back to TRT -> Now Steady on TRT
« 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

« Last Edit: September 23, 2016, 04:21:51 am 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

PeakT

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Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
« Reply #1 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?
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.

Peak Testosterone Forum

Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
« Reply #1 on: February 17, 2015, 01:41:03 am »


Balderdasher

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Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
« Reply #2 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.
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

PeakT

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Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
« Reply #3 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.
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.

Peak Testosterone Forum

Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
« Reply #3 on: February 17, 2015, 02:41:14 pm »


Balderdasher

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Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
« Reply #4 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!
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

PeakT

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Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
« Reply #5 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.
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 (Part Deux - the Labs) - Advice Welcomed
« Reply #6 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.
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

PeakT

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Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
« Reply #7 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?
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 (Part Deux - the Labs) - Advice Welcomed
« Reply #8 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?
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

PeakT

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Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
« Reply #9 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
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.

PeakT

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Re: Post-HRT Taper (Part Deux - the Labs) - Advice Welcomed
« Reply #10 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
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
« Reply #11 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.
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

PeakT

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Re: Post-HRT Taper -> Back to TRT
« Reply #12 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.
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
« Reply #13 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.
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

Balderdasher

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Re: Post-HRT Taper -> Back to TRT
« Reply #14 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.

« Last Edit: April 01, 2015, 11:32:17 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
« Reply #14 on: April 01, 2015, 11:24:44 pm »