39yo, Not Well for 4 years, Low T treatment began July 24th, 2015

Hello,

I am 39 years old and have been ill for about 4.5 years now...since early 2011. I will spare you guys the long story but here is where I am at..

Symptoms:
Terrible Fatigue
Drys Eyes, Red Eyes, Itchy Eyes, Photophobia
Chills (deep in my muscles & bones) nobody has heard of this after 11 doctors.
Brain Fog, (hard to find words, memory problems, disorientation)
Blood Sugar instability, dizzy at times

RECENT Labs:
Total T = 234
Free Calc T = 4.9 ng/dl
RBC = 5.6 (Before Starting TRT!!)
HGB = 17.3 (Before Starting TRT!!)
HCT = 51.5 (Before Starting TRT!!)
PLT = 145 (Kinda Low)
Vit D = 33 (LOW)
Cholesterol = 233
TPO Antibodies = 60 (mild hashimotos?)
HBA1C = 4.9 (Kinda Low)

I began using Compounded Cream at 100mg/day 3 weeks ago, and I do feel some increase in energy but not much. I am also taking Vitamin D and eating pretty well. I am just looking for anyone with a similar symptom profile who has gotten much better on TRT? And, to see if anything in my above labs jumps out to any of you that I can talk to my Doctor about? My Doc did not even mention the HCT, RBC stuff so I am afraid I am not currently in the best hands.


I also made my first you tube video about this stuff here: https://www.youtube.com/watch?v=j4FmiMWMRW8

Your symptoms are common low t symptoms, although most men (not all but most) will typically have either a decreased libido or some level of erectile dysfunction. Again, this isn't always the case but it's common.

TRT itself, one very important thing to remember about TRT is it's not like most medical practices or drugs. For example, if you're in pain you can take a pain killer and the pain goes away, it's masked. With TRT you can take testosterone but that's not going to do away with all your symptoms. TRT takes time and that is a frustrating thing for a lot of guys to hear especially since it can take a lot of time.

How much time? Most men will find the symptoms of low testosterone to be significantly improved in 8-12wks of treatment but that doesn't mean they are back to 100%. During that 8-12wk period, this is also assuming you are dialed in. By dialed in this means both your testosterone and estradiol levels are at an optimal level and stable. This means your levels aren't all over the place and equally important that the type of testosterone you're using is right for you (more on that in a bit). So the 8-12wks is assuming you're dialed in. It's generally recommended that you have followup blood work 5-8wks after starting treatment so that dosing adjustments can be made if needed. Now as far as the full benefits of TRT, this can take up to a year and that's assuming you've been consistent with treatment. It's also assuming you're getting proper rest, a good diet and healthy lifestyle. That doesn't mean you have to suffer for a year, once the benefits start happening you should be able to tell a difference but it can take a year for the full benefits. After a year it's all about maintaining what you have. Stop TRT and you'll go back to your prior low levels state and you would have to start all over again should you start again.

Types of testosterone - transdermals like creams and gels can work well for some men but they also have about a 20% fail rate, meaning in approximately 20% of men they won't work. It's not that it's bad testosterone, their body simply can't absorb it. The other issue with transdermals is that they work well but in time the body stops absorbing it as well and you end up needing more and more. Don't misunderstand, they do work well for a lot of men but you will want to be open and consider other options should you need to. Injectable testosterone, specifically Testosterone Cypionate or Testosterone Enanthate (they're virtually identical) will work in all men each time. There is no issue with absorption.

Things you'll always need to keep an eye on:

You always want to keep an eye on the thickness of your blood, hematocrit, RBC's, etc. If blood begins to get too thick you would either have to stop TRT and go back to the low level state or begin the process of donating blood periodically. Not all men need to donate blood due to TRT (majority do not) but some do. It may be a pint of blood 1-2 times per year or in some cases every 90 days.

Keep an eye on your estradiol levels. If estradiol is too low or too high this can cause some of the same symptoms as low testosterone even if your testosterone levels are perfect. If you're doctor does not measure this you will want to find a new doctor. You also want the sensitive estradiol test, not the standard as the standard is inaccurate for men. You may find supplementing with zinc keeps estradiol under control if needed or in some cases you may need an aromatase inhibitor like Anastrozole.

It's also important to keep in mind that if your testosterone levels and estradiol levels are perfect, it's still possible to have symptoms. The reason for this is you can have low testosterone and have other issues that are not testosterone related going on in your body. For example, a man has low testosterone and erectile dysfunction, he corrects the testosterone levels but still has erectile dysfunction. Often he'll become frustrated (understandably) but it could be that he also has a blood flow issue. We can have all sorts of health issues from vitamin deficiencies to thyroid issues. Maybe testosterone is the only issue and often it is but we always want to be aware that testosterone isn't the only thing going on in the body.

Lastly, always remember free testosterone is the most important number. Total testosterone is all the testosterone in the body but free testosterone is what your body has access to use. If total testosterone is high and free testosterone is low you will have low testosterone symptoms.

I hope this info helps. Please feel free to ask any questions or share anything else that comes to mind.

Hey Justin,

Dude, I am grateful for your response...I never expected that as it is more info than just about any doctor ever gave me. You are one of the nicest people I have never met :-)

Ok, I just wanted to mention a couple more things. I am a happily married father of 2 and we are done making babies...my youngest still sleeps in our bed so I feel virtually zero sexual pressure from the Misses. That being said, i do in fact have a very low libido in addition to the other complaints. I never gave that much thought since the other issues are far more debilitating.

I have always expected hormone problems in my life. I developed large breasts as a kid and have always been self conscious of them, I also am extremely hairy chest and back.shoulders. The chest flab is the last to go when I lose weight too. It seems I need to be almost down to my ideal body weight before the breasts shrink. Now I am 240 lbs with thin legs so I assume most all of my weight is in my torso, another sign of low T from what i have read.

I am up 6 pounds in just under 4 weeks on TRT. My good friend says its all muscle returning to my frame and that it will settle down...he has been on TRT for 10 years so I am always talking to him.

Again, I appreciate your feedback and the reassurance that there is still hope since I am in the early weeks of treatment. I have no objection to injections, and will be discussing EACH issue you brought up with my Doc this Friday!

If you're done with kids you may not need to bother with HCG since that's what protects fertility, but it also has other benefits. The one most talked about is preventing testicular atrophy. You take testosterone, what little testosterone you were making ceases to be produced, it doesn't need to be since you're getting it from an outside source, and as a result the testicles shrink a little, mostly just lose some of their fullness. They don't vanish. And most lowt patients who've had low t for awhile have normally already experienced gradual atrophy and may not have noticed it for a while. Anyway, testosterone atrophy itself is not a life threatening problem and presents no damage to the body. Some people just don't like it. Another benefit, the best on IMO for HCG is it can help maintain stable blood levels of testosterone in between testosterone injections. It keeps your natural testosterone production going while taking testosterone giving you small burst of natural t each week. So your levels don't go up and down as much and remain more stable.

I was a fan of HCG in TRT for a long time but now I'm a bit hit or miss about it. The most important factor in TRT is getting testosterone and estradiol levels right (testicle size can't be put into the important category) and some men will find it becomes increasingly difficult to control estrogen when using HCG as it like testosterone aromatizes. Any aromatase acitivity can be combated through AI's but long term you want to think use as little AI's as possible and simply get to a good balanced number. I did the Test and HCG injections for several years, worked fine. Then for a year my Estradiol levels started going all over the place. I've since dropped the HCG and now use only testosterone and a very low dose of anastrozole. Currently it's 60mg of testosterone cypionate 2x/wk injected SubQ and one 0.25mg capsule of anastrozole after the weeks first injection. E2 levels have come down nicely and I hope to do away with the AI in the next month or so.

Your weight gain, it's not all muscle, some will be water weight due to the testosterone conversion. For now my advice would be to stay the course and have blood work done at the 6wk mark.
At minimum the test should include:
Free & Total Testosterone
Sensitive Estradiol
CBC w/diff
And PSA if it was not included on the first one. If it was included on the first one you can hold off on that one until later on. It's good to have the PSA checked every 6mo while on treatment.

Shoot back if you have more questions and let us know how the doctor visit goes.

Quote:

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Originally Posted by Sick in SLO

Hello,

I am 39 years old and have been ill for about 4.5 years now...since early 2011. I will spare you guys the long story but here is where I am at..

Symptoms:
Terrible Fatigue
Drys Eyes, Red Eyes, Itchy Eyes, Photophobia
Chills (deep in my muscles & bones) nobody has heard of this after 11 doctors.
Brain Fog, (hard to find words, memory problems, disorientation)
Blood Sugar instability, dizzy at times

RECENT Labs:
Total T = 234
Free Calc T = 4.9 ng/dl
RBC = 5.6 (Before Starting TRT!!)
HGB = 17.3 (Before Starting TRT!!)
HCT = 51.5 (Before Starting TRT!!)
PLT = 145 (Kinda Low)
Vit D = 33 (LOW)
Cholesterol = 233
TPO Antibodies = 60 (mild hashimotos?)
HBA1C = 4.9 (Kinda Low)

I began using Compounded Cream at 100mg/day 3 weeks ago, and I do feel some increase in energy but not much. I am also taking Vitamin D and eating pretty well. I am just looking for anyone with a similar symptom profile who has gotten much better on TRT? And, to see if anything in my above labs jumps out to any of you that I can talk to my Doctor about? My Doc did not even mention the HCT, RBC stuff so I am afraid I am not currently in the best hands.


I also made my first you tube video about this stuff here: https://www.youtube.com/watch?v=j4FmiMWMRW8

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