# STEROIDS FORUM > HORMONE REPLACEMENT THERAPY- Low T, Anti-Aging >  From low T to high T, but still tired: suggestions?

## ZombieFred

41 years old, 6 feet, weight jumped from 198 to 260 in the last year or so with no change in diet. Unusually tired for the last 20 years, and super tired for the last couple years. Good health, not counting sub-zombie energy levels. No previous use of anabolics. TSH is about 1.5. Doctor did a random T check after we ruled out thyroid issues last year and here's what came back:

9/23/11 - Total T: 216 ng/dL (Labcorp range 348 - 1197)
9/30/11 - Total T: 188 ng/dL (re-test by urologist)
9/30/11 - FSH: 1.7 (REF 1.6 - 8)
9/30/11 - LH: 1.1 (REF 1.5 - 9.3)
9/30/11 - Prolactin: 5.3 (REF 2 - 18)

_October 2011: I get wife pregnant despite all of the above
November 2011: MRI rules out brain/pituitary tumors_

_After four weeks of 200mg shots every two weeks (blood drawn before next shot):_
1/5/12 -
337 ng/dL total T (Quest range: 250 - 1100)
70.1 pg/mL free (Quest range: 25 - 155)

_After three weeks of 200mg shots every 7 days:_
2/9/12 -
655 ng/dL total T (Quest range: 250 - 1100)
185.1 pg/mL free (Quest range: 35 - 155)

My libido is improved, but still not great. I'm more concerned with my improved but still horrible energy levels and insomnia. How long do I have to wait (or should I wait) until I feel able to function upright? Tried Provigil/Nuvigil (narcolepsy drug!) for a while last fall, but it's expensive and not much of a solution. I have noticed a decreased appetite, which is good.

I see my doctor March 1st, have plenty of T stocked up but wondering what else to ask for and how much given my labs. I have read a lot of this site, which is very helpful. The urologist and endo I saw were fairly useless, but my general doctor is understanding. I can have any labs I want done (no insurance), but I'd like to keep expenses down. I would like to check my estradiol, for one, after reading this site. Probably due for an annual blood panel anyway. Also, my wife is a pharmacy tech who gives me shots, but wants me to switch to gels so she doesn't have to. I'd rather learn to do my own shots. Our daughter is due in July and after snoozing through my thirties, I'd like to be awake in my forties.

Thoughts? Thanks in advance!

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## vinceproduction

Welcome! You've come to a great place, the vets will chime in with some better advice, but from what I've learned here over the past year is that we're all different and that some guys have to be in the very top of normal to feel good again. Like you said a full blood panel with e2 sensitive essay will be important to see as 200mg per week is a lot without an aromatase inhibitor. Again the more experienced guys will chime in soon.

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## ZombieFred

Thanks. I don't have the obvious estrogen side effects yet (sore nipples, etc.) but I'm sure an AI will be in my future along with hcg , I'm guessing. I'm thinking I should probably have my labs done before I see my doctor so we have hard data to work from.

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## HRTstudent

Not everyone gets obvious symptoms from things like high estradiol. 

I would definitely get the estradiol checked. 200mg per week is a pretty high dose. I believe Dr Crisler considers 200mg the top. And I've not heard of anyone getting over 200mg per week of testosterone that is under the care of a legitimate doctor (and not some mail order "clinic").

Also, you could try to implement HCG . But I would probably only do this once you get your estradiol checked and sorted out. If it's too high, bring it down around 20-30. If it's in that area then consider HCG.

Next, you haven't been on T therapy for a long long time yet. Also, you've only switched to the more favorable weekly protocol for 3 weeks as I understand. It usually takes about 3 weeks from what I read for people to start noticing. Ask your wife if she's noticed any changes in you. Chances are, your spouse will see changes before you do.

So, give it some time. You seem to be getting SOME improvement. And your T level is a lot better. I would not be surprised if things pick up a lot for you in a month from now.

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## zaggahamma

agree with checking e2(estradiol) as test levels dont appear to reflect where MOST would respond to 200mg of test

also check thryoid

and loss of appetite is good?

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## kelkel

ZF I agree with the above guys, especially the E2 comments. Look, you did not get yourself into this position overnight and it can't be solved overnight. Exogenous test is a huge plus but it has to be complimented with consistent exercise and a proper diet. It takes time. Your body is going to hold on to the "status quo" as long as it can until you decide to force it to change. Check out the nutrition/diet forum for some guidance also. And welcome.

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## steroid.com 1

E2 without a doubt.

Also would like to see SHBG and Albumin.

Also, Bio Available T and/or Free T.

Cortisol for sure and could be a hidden culprit. 

I'd recheck Thyroid panels as well and not just TSH also FT4, FT3, RT3.

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## Kk570h

I need help on my testosterone test results... I posted info. on Educational thread , should I repost here ?

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## steroid.com 1

> I need help on my testosterone test results... I posted info. on Educational thread , should I repost here ?


Yes and make sure to add ranges as well.

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## Kk570h

Gdevine i put a thread on http://forums.steroid.com/showthread...p&goto=newpost .

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## JohnnyVegas

I have had the same problem my entire life. I used to involuntarily fall asleep in school because I could not sleep at night. A year of TRT hasn't helped.

My doctor recently gave me Ambien to see if getting good sleep would fix my energy and motivation levels. After a few days of getting 8 - 10 hours of deep sleep I felt normal. Energy all day. So, rather than thinking that something is causing me to have insomnia AND be tired all the time, we are now considering the low energy levels as a symptom of the insomnia. I plan on doing a sleep study to learn more about what happens to me when I sleep. Hopefully it isn't apnea...I don't want to wear one of those machines. Although it would be cool to look like Bane (from Batman), I don't think my wife would find it very sexy.

Just sharing a similar experience in case something resonates. 

The test will take about four weeks to fully kick in (not sure you got a direct answer on that above). 

You should definitely have blood work done after your levels stabilize to see if you need an AI or if you need to adjust your Test dose.

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## ZombieFred

Thanks for all of the suggestions. I will try to get bloodwork done early next week and add as many tests as my budget allows. It's been four weeks now since I changed shots from every two weeks to once a week. I asked my wife about any differences this morning. She said I had more energy, but the amount is negligible, which is what I think too. I ruled out sleep apnea last year, so that's not an issue. I just have trouble staying asleep sometimes, and lately I've been taking 3-4 hour naps after downing large cups of coffee. I'm willing to ask for a week of ambien or lunesta, but I don't want to rely on pills to sleep. Maybe a week will help me get into a rhythm.

I eat pretty well already. The reduced appetite is good because my stomach doesn't burn between meals, making me feel like I need to constantly snack. I should also add we haven't had sex since Christmas. I was fine until last summer, but since then I've had trouble maintaining an erection and finishing. I don't get it, since my free T seems pretty good. Maybe the bloodwork will reveal a surprise or two. I do suspect estradiol, and like I said in my initial post, I'm 99% sure I've been suffering from low T all of my adult life. I had Crohn's disease as a teenager, but surgery fixed that when I was 20. No issues since, but the two could be related according to some theories. Yes, my last healthy year was probably 1986, and I don't expect a quick fix. I just don't want to be one of those guys who waits a year for things to improve.

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## Vettester

Welcome aboard, glad you joined. I agree with the comments from the other members, as more lab work is what's needed at this point. I would also look upstream a little at pregnenolone and DHEA, and check your vitamin B12 and D3.

Even with the LH and FSH as low as they were, it doesn't completely surprise me that you and your wife are going to have a baby. 

Looking forward to seeing more labs, and with seeing your program evolve. Be patient, it will take a little time, but you will get it all dialed in if you stay dedicated to it.

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## HRTstudent

Get that estradiol sensitive test done as soon as you can and post that up. High estradiol, I think, can be just as bad or _WORSE for some people_ as low testosterone with regard to erections/libido.

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## ZombieFred

Thanks again for all of the feedback. I do take a sublingual B12 supplement (another other vitamins) because of my surgery for Crohn's disease 20+ years ago (missing part of my colon and small intestine). Still planning on new labs tomorrow or Tuesday.

Reading through the forum, I feel super bad for everyone treated with antidepressants instead of TRT. I am "lucky" enough to have had issues with depression in my 20s, probably from Accutane, so I knew my recent issues weren't from depression. I kind of get kind annoyed when they list depression as a side effect of low T. I'd prefer something like "extreme frustration" because you're tired and can't have sex.....!

Given that my free T ten days ago was 185.1 pg/mL and that Quest labs gave me a ref range of 35 - 155, does anyone have a more definitive, updated range? Every source seems to have a different range, although not as bad as the total T ranges... There was a study in 2006 about the wide ranges in U.S. labs, titled "Wide variability in laboratory reference values for serum testosterone ." The upshot was that normal reference ranges for total T went as low as *130* and as high as *1593* ng/dL, depending on your local lab.

"Great news, your T level is 131, so you're fine."

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## HRTstudent

The ranges from lab to lab are not interchangeable. They are unique to the lab and you cannot compare your numbers to another person unless you use the same lab _and_ the same test. If that Quest lab tells you the range is 35-155 and you were 185, then you have high free T end of story (on this particular day at least).

The only "catch" here is that some labs give age-adjusted ranges. This would mean that there is a range for, say, 20-29 year old males and another range for 30-40, and so on and so on. This really is only a potential concern if you're like 50+ because usually on TRT you aim for "youthful" levels, so you could appear mid-high on the elderly range but only middle of the road on the scale/range that you actually care about.

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## ZombieFred

> The ranges from lab to lab are not interchangeable. They are unique to the lab and you cannot compare your numbers to another person unless you use the same lab _and_ the same test. If that Quest lab tells you the range is 35-155 and you were 185, then you have high free T end of story (on this particular day at least).
> 
> The only "catch" here is that some labs give age-adjusted ranges. This would mean that there is a range for, say, 20-29 year old males and another range for 30-40, and so on and so on. This really is only a potential concern if you're like 50+ because usually on TRT you aim for "youthful" levels, so you could appear mid-high on the elderly range but only middle of the road on the scale/range that you actually care about.


Is it possible to have high free T and high estradiol? Do you think my free T is dangerously high? I don't see my doctor until March 1st, but I can cut my dosage slightly until then. The range thing is frustrating (for everyone else too, I'm sure) because different labs have different ranges and (more importantly, I suspect) use different testing methods.

In that Harvard study I mentioned in my last post, "Of the 25 labs, there were 17 and 13 different sets of reference values for total and free testosterone , respectively.... Twenty-three of the 25 lab directors responded that clinically relevant testosterone reference ranges would be preferable to current standards." Amen!

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## zaggahamma

> The ranges from lab to lab are not interchangeable. They are unique to the lab and you cannot compare your numbers to another person unless you use the same lab _and_ the same test. If that Quest lab tells you the range is 35-155 and you were 185, then you have high free T end of story (on this particular day at least).
> 
> The only "catch" here is that some labs give age-adjusted ranges. This would metan that there is a range for, say, 20-29 year old males and another range for 30-40, and so on and so on. This really is only a potential coyncern if you're like 50+ because usually on TRT you aim for "youthful" levels, so you could appear mid-high on the elderly range but only middle of the road on the scale/range that you actually care about.


Hrt,
If a bloodwork result comes back at two different labs both using the same measurements (ng/dl), but use 2 different ranges are u saying that if they both come back at 222 they are not the same....222ng/dl and 222ng/dl?

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## nyjetsfan

Great feedback from the guys on here. My 2 cents in summary: double check E2, sleep apnea has been ruled out (good), continue weekly shots to keep levels stable, oh and check iron/hemo levels. High iron could be causing lethargy. If so give blood and you'll feel better. Good luck

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## ZombieFred

Got all of my new labs back today except T3. I didn't have SHBG, pregnenolone, DHEA, B12 or D tested due to cost issues (no insurance--these tests cost me around $345 at a walk-in lab place--but I did add a full basic workup to most of the tests you guys suggested. Great cholesterol. Protein and albumin were right in the middle. My TSH has gone up from 1.8 to 2.3 despite slightly increasing my dose last year. Probably related to hormone levels. (If you're treating your thyroid, you should aim for 1.5 - 2 according to the revised endo guidelines.) Still exhausted, fyi.

But . . . estradiol is through the roof! I see my doctor March 1st and will be asking for an AI and probably HCG due to shrinking walnuts (even wife has commented) and the hopes of having another baby next year.

Abnormal
Anion Gap 6 low...........range 7 - 16 mmol/L
MPV 13.1 high..............range 7.0 - 11.0 fL
Eosinophilis 7 high........range 0 - 6%
Estradiol 118.7 high......range: 0 - 39.8 pg/mL

In range
T4 total 8.8.....................range 4.5 - 12.1 ug/dL
TSH 2.320.......................range .36 - 3.74 ulU/mL
Iron 69...........................range 47 - 160 ug/dL
Cortisol, random 9.2.........range A.M. 4.3 - 22.4 ug/dL
Glucose 87.......................range 60 - 99 mg/dL
Blood Urea Nitrogen 11......range 6 - 29 mg/dL
Creatinine 0.94.................range 0.70 - 1.40 mg/dL

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## HRTstudent

> Is it possible to have high free T and high estradiol? Do you think my free T is dangerously high? I don't see my doctor until March 1st, but I can cut my dosage slightly until then. The range thing is frustrating (for everyone else too, I'm sure) because different labs have different ranges and (more importantly, I suspect) use different testing methods.
> 
> In that Harvard study I mentioned in my last post, "Of the 25 labs, there were 17 and 13 different sets of reference values for total and free testosterone, respectively.... Twenty-three of the 25 lab directors responded that clinically relevant testosterone reference ranges would be preferable to current standards." Amen!


Yes you can have high free T and high estradiol. It happens all the time and is to be EXPECTED to trend this way if you are on testosterone therapy alone (that is, with no aromatase inhibitor). Not everyone will have the same changes but the "trend" is expected to go in the same direction.

I'm not a fan of changing doses haphazardly because most of the time people are impatient and do not give their hormones enough time to change. With testosterone therapy, feeling no changes for 2 weeks is normal. Likewise happens when you change doses. A lot of people think... oh I just increased my dose and it's not helping... time to change. But these hormones don't act super quick and for some people it's even slower.




> Hrt,
> If a bloodwork result comes back at two different labs both using the same measurements (ng/dl), but use 2 different ranges are u saying that if they both come back at 222 they are not the same....222ng/dl and 222ng/dl?


If the labs use 2 different ranges it would almost certainly be because they have 2 different testing methods. Having said that, you would not expect both labs to produce the exact same result, such as 222ng/dl and 222ng/dl. 

If the tests are valid, however, you would expect both labs to show that the person has low testosterone /below normal range.




> Got all of my new labs back today except T3. I didn't have SHBG, pregnenolone, DHEA, B12 or D tested due to cost issues (no insurance--these tests cost me around $345 at a walk-in lab place--but I did add a full basic workup to most of the tests you guys suggested. Great cholesterol. Protein and albumin were right in the middle. My TSH has gone up from 1.8 to 2.3 despite slightly increasing my dose last year. Probably related to hormone levels. (If you're treating your thyroid, you should aim for 1.5 - 2 according to the revised endo guidelines.) Still exhausted, fyi.
> 
> But . . . estradiol is through the roof! I see my doctor March 1st and will be asking for an AI and probably HCG due to shrinking walnuts (even wife has commented) and the hopes of having another baby next year.
> 
> Abnormal
> Anion Gap 6 low...........range 7 - 16 mmol/L
> MPV 13.1 high..............range 7.0 - 11.0 fL
> Eosinophilis 7 high........range 0 - 6%
> Estradiol 118.7 high......range: 0 - 39.8 pg/mL
> ...


Wow you must be immune to gyno with that estradiol number!!!

Was that the sensitive test? 

If I were you I would probably call the doctor or the nurse and try to get an AI, anastrozole, and start a low dose of that, then recheck estradiol in 4 weeks.

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## zaggahamma

Ok well either way 222ng/dl is 222ng/dl and that said patient has IDENTICAL levels...yes or no? If someone states he has a level of 222 ng/dl the reference range really isn't necessary is it because we know that is low

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## ZombieFred

I asked for the sensitive estradiol test but it just says estradiol, so not sure.......?

I will try and get my doctor to get me an AI script tomorrow if his office is open and if he'll do it based on labs. Not holding my breath, though. Tomorrow will be five weeks on the 200mg shots every 7 days. If I don't hear anything from my doctor tomorrow, should I have my wife give me my regular shot or _______?

My doctor history is a little convoluted, which is why I left it out. My general doc prescribed 200mg every two weeks in October and said that would probably help any fertility issues (actually, it does the opposite, but he is a decent guy). I asked my wife's obgyn what she thought, given we were trying to conceive in October (we actually did, but didn't know until November). Her office referred me to a urologist, who checked my balls (fine) and checked my hormones and rechecked my T, which was even lower than before (down to 188 total from 216 as listed above). He said he didn't treat hormone issues, but if I needed surgery on my testicles, he was the guy. He suggested I see a fertility doc. None within 200 miles. So I made an appt with the only endo in town, who had me do an MRI to rule out a pituitary tumor (no tumor), and then gave me the same 200mg every two weeks script as my regular doc. As he requested, I rechecked my T levels after a month to find they had shot all the way up to 337.

I spent a month trying to get my endo to see me or revise my treatment in some form, and when that failed I increased the frequency from 14 days to 7 days, given how low I still was: 388 when some ranges say the upper end of normal is 1500. I made an appt to see my endo face to face, at which point he said he didn't need to see me anymore and to go back to my general doc. When I opened my mouth to go over how I felt no change after two months of treatment and pulled out a sheet of paper with side effects, he rolled his eyes. My wife the pharmacy tech saw that and said you will NOT treat my husband that way and we're out of here (go, wife!). I'm not trying to do anything on my own, but it takes weeks to get appointments, I live in a smallish town and I have tried to get advice or treatment from four doctors since September. (And did I mention I don't have insurance, lol........) At this point I do rely more on you guys than any doctor. At least I will know what to ask for, and how to justify it.

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## kelkel

Obviously your doc does not understand half-lives. If I'm reading this correctly you switched to 200mg every 7 days, right? After a period of time on this protocol BW came back at 388. Was blood pulled on day 7 prior to injection? Like was mentioned above, if your estrogen is that high you need an AI asap as your converting big time. Bring your E down and your T will come up. If your doc won't write it then use this sites sponsor. You'll have it in 2-3 days no issues. Take some time and dive into the sticky threads here to. The more knowledge you have when dealing with your doctor the better prepared he will be for your visit.

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## ZombieFred

My bloodwork was 388 after four weeks of 200mg every *14 days*. After three weeks of getting a 200mg shot every 7 days, it went up to *655* (this was two weeks ago, blood drawn the day before my next shot). The new bloodwork was drawn two days ago, but I didn't see a need to pay for new T numbers, because I had a feeling my estradiol was high, and if not that possibly my thyroid or something else.

Even so, I am blown away by my estradiol number of 118, when it should be below 39 on their scale and ideally between 20 and 30 from what I've read on here. I will try to get in touch with my doctor tomorrow, but if I can't get anything until I see him next Thursday, I will go ahead and take my usual shot tomorrow unless reducing the dose or skipping it would help in any way. I know a week doesn't seem like much, but I feel drained of energy. The weird thing is I still have a sex drive from the T, but can't do anything about it because of the E.

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## HRTstudent

Sounds like a bastard lol.... rolling his eyes at you.

Back to the point, I'm not sure if you got the sensitive estradiol assay since it doesn't say that it is. Nonetheless, it doesn't seem too far fetched to imagine you would be high on the test that matters. Honestly I have no idea how strong or weak the correlation between the sensitive assay is compared to the normal ones. I've just read numerous times from medical HRT experts that the sensitive assay is the only one to use for males on TRT. For this point, simply bring it up with your doc to ensure you get the correct test in the future.

As for controlling estradiol, without an AI you could try this. (Again, I don't advise changing things on your own and ignoring your docs advice for the reasons I stated earlier.) Smaller injections help mitigate the hormonal fluctuations seen with bolus T cypionate injections. So, you could split the dose up into 2 shots per week. That's reasonable at least in the short term I believe. Also, you could lower the dose but again... I have a hard time doing that because making lots of changes in the short term usually hampers your long term progress.

Until you get an AI, you could try zinc. I've read more than once that it can help as an AI but the effect of this is probably not huge. Is it something? Maybe. However, zinc is good for health in general and it is very very inexpensive.

As hard as it is, be patient and stick to the gameplan and get in to see that doc ASAP (or call to see if they can phone in a Rx for that anastrozole).

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## ZombieFred

> Sounds like a bastard lol.... rolling his eyes at you.
> 
> Back to the point, I'm not sure if you got the sensitive estradiol assay since it doesn't say that it is. Nonetheless, it doesn't seem too far fetched to imagine you would be high on the test that matters. Honestly I have no idea how strong or weak the correlation between the sensitive assay is compared to the normal ones. I've just read numerous times from medical HRT experts that the sensitive assay is the only one to use for males on TRT. For this point, simply bring it up with your doc to ensure you get the correct test in the future.
> 
> As for controlling estradiol, without an AI you could try this. (Again, I don't advise changing things on your own and ignoring your docs advice for the reasons I stated earlier.) Smaller injections help mitigate the hormonal fluctuations seen with bolus T cypionate injections. So, you could split the dose up into 2 shots per week. That's reasonable at least in the short term I believe. Also, you could lower the dose but again... I have a hard time doing that because making lots of changes in the short term usually hampers your long term progress.
> 
> Until you get an AI, you could try zinc. I've read more than once that it can help as an AI but the effect of this is probably not huge. Is it something? Maybe. However, zinc is good for health in general and it is very very inexpensive.
> 
> As hard as it is, be patient and stick to the gameplan and get in to see that doc ASAP (or call to see if they can phone in a Rx for that anastrozole).


I will try all of the above until I see my regular doctor next week. He is a good guy, maybe not an expert on TRT, but he doesn't roll his eyes before you get to the part about how you're taking the T he prescribed but are effectively impotent. Thanks for all the thoughtful comments from you and everyone else.

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## Vettester

> Ok well either way 222ng/dl is 222ng/dl and that said patient has IDENTICAL levels...yes or no? If someone states he has a level of 222 ng/dl the reference range really isn't necessary is it because we know that is low


Agree with you, 222ng is 222ng.

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## kelkel

Good luck ZF. Be sure to update us here please....

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## HRTstudent

> Ok well either way 222ng/dl is 222ng/dl and that said patient has IDENTICAL levels...yes or no? If someone states he has a level of 222 ng/dl the reference range really isn't necessary is it because we know that is low


Yes you could get identical levels on the test result, but all tests have a margin of error but you wouldn't typically _expect_ to get the same number on 2 different test methods/labs.

The real value of tests and why you always use ranges is because we _do_ expect that if someone is low on one test that they will also be low at another lab's test. So it's not so much that we compare the absolute number between two labs/ranges, but we compare how they stack up with regard to the more general low, mid-range, high-normal, high, supraphysiologic, etc etc.

Hope that helps clear it up for you.

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## zaggahamma

> Yes you could get identical levels on the test result, but all tests have a margin of error but you wouldn't typically _expect_ to get the same number on 2 different test methods/labs.
> 
> The real value of tests and why you always use ranges is because we _do_ expect that if someone is low on one test that they will also be low at another lab's test. So it's not so much that we compare the absolute number between two labs/ranges, but we compare how they stack up with regard to the more general low, mid-range, high-normal, high, supraphysiologic, etc etc.
> 
> Hope that helps clear it up for you.


i'm not sure i was unclear really

what i'm trying to get across is i dont need a reference range if someone gives me a total test level in ng/dl...if they tell my the measurement then i know if its low, normal, or high without the refernce range....ng/dl reference ranges are fairly similar...and 200 is always low

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## ZombieFred

Update: I've been taking 50mg of zinc all week, and I feel better. Whether it's a placebo effect or actually lowering my 118 estradiol level (on a 0-39 scale), I don't care. I'll take it. Two days in a row without falling asleep during the day is a big deal for me. 

Saw my general doctor yesterday. He had heard from other patients that my eye-rolling endo was an ass. But the rest of my visit confirmed my most cynical fears (and frustration at paying for another doctor's visit when I don't have insurance). On the plus side, my doctor admitted he didn't treat a lot of people for low T, didn't know everything, and said he would be fine with me finding a more knowledgeable doctor. But when I mentioned my high estradiol levels of 118, he said that was to be expected with the extra T. And he thought it was odd that I had gained 60 pounds in a year without changing my diet, and strange that three months of TRT had rendered me suddenly impotent and feeling like a 90 year old.

At this point he offered to prescribe anti-depressants and anti-anxiety stuff, as well as V for the impotence. After listening patiently, I said I was 100% sure I was not anxious or depressed, and he dropped the matter. He checked my male parts and said they were small. I said YEAH, I know, it's from the T. He said I should take my shots every 3 or 4 weeks instead of the every two weeks he initially prescribed. Maybe my natural levels would recover (yeah, right). As for HCG , he said only a doctor who wanted money would prescribe that, and that even thinking of HCG was crazy. I said I appreciated his honesty in admitting he didn't know everything, and left him with my labs and various excerpts of Harvard and JAMA medical studies, and Dr. Crisler's documents. He said he'd look at them.

I have plenty of T on hand, and as of today I'm taking .5mg of Letro EOD (comments?). Still taking 100mg of cyp T every four days, which I started last week. I'll retest T and estradiol in four weeks, by which time I hope to have found a new doctor via the lef site. As I said before, we're expecting our first child, but I'd like one more kid next year. And I won't tolerate small, aching testicles either.

Conclusion: I don't expect general doctors to be experts in a fairly specialized field. But it's just sad and strange how doctors would rather pump you full of unnecessary psych pill$ with harmful side effects (I know firsthand from my earlier experiences with real depression) and boner med$ when they could just treat the underlying problem. I just want my hormones in their normal ranges. That's all.

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## nyjetsfan

Most Dr's don't have the balls to perscribe test because of the negative press. It's sad really. I even had an endo that didn't realize estrogen would rise with increased test!! If your a woman and need estrogen it's ok to perscribe Estrogen, but test? Another story.

I too was perscribed Paxil for depression before I left that doc, and was diagnosed with low T from a Dr that found root cause. In reading some of the threads on here (best TRT site BTW) it boggles the mind how docs will want a patients to shoot test every 2, 3,4, weeks!!! We all have to do our own home work unfortunately.

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## ZombieFred

> Most Dr's don't have the balls to perscribe test because of the negative press. It's sad really. I even had an endo that didn't realize estrogen would rise with increased test!! If your a woman and need estrogen it's ok to perscribe Estrogen, but test? Another story.
> 
> I too was perscribed Paxil for depression before I left that doc, and was diagnosed with low T from a Dr that found root cause. In reading some of the threads on here (best TRT site BTW) it boggles the mind how docs will want a patients to shoot test every 2, 3,4, weeks!!! We all have to do our own home work unfortunately.


My doctor did find the source of my problem, which I still believe is half the battle. I spent *20 years* wondering why I was always so tired and frustrated with my sex life. We were trying to conceive at the time when he diagnosed my low T in September, and he said the TRT would probably INCREASE my borderline low fertility. As most of you know, it actually _reduces_ fertility, especially without HCG or other treatment. Taking T is a lot like the male version of the hormones in the birth control pill, except it's a lot easier to stop one egg than 15-300 million swimmers. It's sad that we end up having to do all of this medical research on our own. It's no wonder a lot of us ending up treating ourselves in whole or in part by adjusting dosages or adding the things the doctors won't give us. We can, however, tell our friends and family members that being tired and/or impotent isn't a normal part of the aging process. After all, they used to think dementia was something that just happened with age--now we know it means you have an illness that can often be treated. You don't just have to roll over and take it.

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## ZombieFred

Update with new labs:

(Old labs: Total T 655 ng/dL, free T 185 pg/mL on Feb 9, Estradiol 118 pg/mL on Feb 21)

March 22 - Taking 200 mg T cyp once a week with .5 anastrozole EOD:

Estradiol (measured on the day after T injection): 17.4 pg/mL (0-39 range)

Switched to 100 mg T cyp every four days to lower estradiol/stabilize T levels, with reduction to .5 anastrozole 2x a week:

April 19 - two days after T injection:
Total T: 755 ng/dL (250-1100 range)
Free T: 230 pg/mL (35-155 range)
Total serum estrogen: 227 pg/mL (<130 range)

To sum up, my estradiol/estrogen has gone from 118.7 pg/mL in February to 17.4 pg/mL in March to 227 pg/mL in April. Cutting back on the anastrozole wasn't a good idea in my case. I also started taking HCG in mid-March 250IU every four days, so I'm guessing that has also boosted T and (conversion to) estradiol.

I guess adjusting all of this stuff really does take forever. It would be easier if I had health insurance. These aren't the sensitive estradiol tests, either, because they cost twice as much at the walk-in lab I've been using.

I do feel better, but haven't lost any weight and still have to push myself to get up and do anything. Libido is back but orgasms are much reduced.

I have reduced injections to 80 mg every four days and resumed .5 anastrozole EOD.

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## steroid.com 1

I think you got a handle on it.

Your E2 levels have peaked, tanked and peaked again...man what a roller coaster!

Once you get your E2 dialed in you will most likely have to make adjustments in your Testosterone dosage as well. Your energy levels will come back and you will lose weight again. 

So right now, getting your E2 in order is priority #1!

Interesting that your libido is good at these levels...orgasms less intense is to be expected. 

Yes, hCG will increase natural Testosterone.

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## Dinky

Sounds like your Dr. was like mine... Just unwilling to really 'try' something new. So with sound advice, I took it upon myself to medicate.

1CC ever week broke in two's. I break a single arimdex pill into 4's (.25) and take one EOD. Heeeeere wifey!!

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## ZombieFred

> I think you got a handle on it.
> 
> Your E2 levels have peaked, tanked and peaked again...man what a roller coaster!
> 
> Once you get your E2 dialed in you will most likely have to make adjustments in your Testosterone dosage as well. Your energy levels will come back and you will lose weight again. 
> 
> So right now, getting your E2 in order is priority #1!
> 
> Interesting that your libido is good at these levels...orgasms less intense is to be expected. 
> ...


Well, libido is good but wood and orgasms are not....lol. Better, yes, but not back to like they were a couple years ago. Snoring is much worse, my pregnant wife wants to kill me on a nightly basis. Hopefully that will go away as I lose weight, get my hormones balanced, and wait for allergy season to pass. Hormones are also linked to snoring, from what I've read. Apparently women start to snore as they lose estrogen, which is funny, given that my E levels have been so high. And supposedly women don't snore as much because they have larger throats than men, so insert your own joke there.

But if anyone has tips on snoring, pass them on.

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## zaggahamma

> well, libido is good but wood and orgasms are not....lol. Better, yes, but not back to like they were a couple years ago. Snoring is much worse, my pregnant wife wants to kill me on a nightly basis. Hopefully that will go away as i lose weight, get my hormones balanced, and wait for allergy season to pass. Hormones are also linked to snoring, from what i've read. Apparently women start to snore as they lose estrogen, which is funny, given that my e levels have been so high. And supposedly women don't snore as much because they have larger throats than men, so insert your own joke there. *sorry about that* 
> 
> but if anyone has tips on snoring, pass them on.


c-pap

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## ZombieFred

I ruled out sleep apnea last year, and my wife doesn't think I have it. I'm just hoping it goes away soon.

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## Dinky

I'm sure it has a lot to do with the weight gain.

Try and not sleep on your back, and to keep from doing so, place a pillow behind your back at night to keep you from rolling onto your back.

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## ZombieFred

Still feeling a bit tired but slowly getting there. Patience is the biggest thing I've learned since starting TRT in December. I've had a few labs done since I last posted, but this is a new batch with some odd numbers.

Two tiny drops of Letro a week crushed my estrogen down to 3 in the new labs. And my TSH numbers have actually been over 2 the last couple times. Not sure why. I take Synthroid and they used to be lower. Labs drawn Friday Sept 7. I stopped Letro last week. E should be going back up now. Taking 250IU HCG 3x a week, 150mg of T cyp every 4 days, one B12 shot a week.

CBC and Metabolic panel was normal. I can post specifics if requested.

Total serum T: 950 ng/dL (348-1197)
Free T: 38.57 ng/dL HIGH (5-21)
% free T: 4.06 (1.5-4.2)

Estradiol, sens <3 pg/mL LOW (3-70)

IGF-1 229 ng/mL HIGH (64-210)

PSA 1.1 ng/mL (0-4)

Total cholestrerol 159 mg/dL (100-199)
Triglycerides 161 mg/dL HIGH (0-149)
HDL 40 mg/dL (>39)
VLDL 32 mg/dL (5-40)
LDL 87 mg/dL (0-99)

TSH 2.630 uIU/mL (.45-4.5 but really 1.5-2.0 since I take synthroid)
Thyroxine (T4) 8.5 ug/dL (4.5-12)
T3 uptake 33% (24-39)
Free thyroxine index 2.8 (1.2-4.9)

Comments appreciated!

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