Reply With QuoteIf you don't mind sharing, what doses of testosterone did the new doctor put you on and what estrogen blocker did he recommend and what dosage?
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TRT
Gents and Ladies, but mostly Gents:
Save Time Summary: Get your testosterone levels checked by a doctor that knows how to do testosterone replacement therapy.
Back story: 63 years old, I've been doing SS lifting for a couple of years. In the last year or so, my progress stalled and I've been doing "maintenance" lifts for a while, because I found recovery harder and harder. In addition, my libido took a vacation and I was tired a lot. Most of us put all this down to age and accept it as part of the bad of getting older.
But, and it's a big but, I went to a urologist and had my testosterone tested. It was under 200. My PSA was 3.8, which prompted the urologist to order a prostate biopsy before TRT. Clean, but he wanted an MRI. Clean too. SOP is another biopsy (different areas of the prostate). All because he said higher testosterone = higher prostate cancer risk. Finally perscribed the testosterone, twice a month injections. No other therapy or prescriptions.
Within a month my hematocrit level jumped from 49 to 58. Took me off TRT and referred my to an endocrinologist. 4 month wait where I live, because all endocrinologists do these days is treat type 2 diabetes. Finally got in, he took three minutes to look at my blood work and prescribe bromocritine because of a high prolactine test (once. never showed up in any other test). $800 and 5 minutes later, I'm outside and pissed off.
Went to another urologist, who insisted on the 2nd biopsy even though the first biopsy and the MRI indicated no problems. Fine, did it, clean again, but I'm out $1800 on this one because he was associated with the local hospital where all procedures are triple what anyone else charges. Now I'm really pissed and nothing has been solved other than the high certainty that I don't have prostate cancer.
Then, having breakfast with a friend and telling him about my issues and experience, he says "Yea, same with me. Go see this guy. You'll thank me."
Checked him out, great education and residencies. Associated with body building groups. Not an endocrinologist, his practice is aging and hormone balance. Orders blood work, reviews old and new results. I go see him and he is astounded that I did 2 biopsies and one MRI. Tells me the testosterone/prostate cancer relationship is at best loose and based on one doctors article from the 1940's. Further astounded that the endocrinologist didn't order a scan of my pituitary if he thought it was causing problems with hormone production. Spent 90 minutes with me asking about my lifestyle, my lifting program, my sex life, and my diet. Answered a ton of questions clearly both verbally and by sketching out hormone and glandular relationships, e.g. why treating testosterone levels without considering metabolism markers was pointless. Since the prolactin is only high in one test, puts me back on TRT, doubling the first urologists dose, along with an estrogen blocker and some supplements: Vitamin B, D and E, CoQ10, DHEA, Iodine/L-Tyrosine (to bump my throid activity), and a few others. No prescriptions other than the testosterone and the estrogen blocker.
Two months later recovery is much easier, energy is way up, the wife is telling me to knock it off cause I'm not getting laid every day, my hemoglobin and hematocrit levels are steady, and I've lost 4.5 lbs of body fat and gained 1.1 lbs of muscle (with no diet change). Testosterone 995, free testosterone 24.9, I don't feel particularly jumpy or aggressive and I'm restarting SS LT with new goals. Obviously we'll keep monitoring through a blood test every month and a half or so.
I can't begin to emphasize how much this has changed my life. The moral of the story is get your T tested, but find a doctor that knows what he's doing.
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If you don't mind sharing, what doses of testosterone did the new doctor put you on and what estrogen blocker did he recommend and what dosage?
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.7 milligrams of testosterone once a week.Originally Posted by Jason Pyle
Anastrozole 150mcg once a day.
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Wowsers, what a story. Makes me appreciate my anti-aging doc even more. Glad you're on a good path now!
Do you mean that you're injecting .7 ml of some testosterone solution once a week? Is it 200mg/ml of test cypionate? That would mean you're getting 140mg/week. Side note: I used to get my prescription at a compounding pharmacy for about $90 for a 10ml bottle. Check out goodrx.com - you can get the Watson branded test cypionate at Walgreens for about $43 for a 10ml bottle...
For comparison, I'm on .4ml of test cypionate (200mg/ml) twice a week for a total of 160mg/week, with a half an anastrozole tablet with each injection. My last labs came in at 903 total test, 22.2 free test and 39.0 estradial.
Anecdotally, my PSA was 2.7 last year and is down to 1.5 this year, so I don't see a correlation with testosterone injections and increased PSA. FWIW, my primary care doc said I probably had some systemic inflamation last year that caused the 2.7 reading...
BTW, if your hematocrit goes back up, I've heard the easiest thing is to just donate blood periodically. Talk with your doc about it...
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I like these videos about TRT: YouTube
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Your math is correct.
I believe that I paid $84 for a 10ml bottle at my compounding pharmacy, which also makes up the anastrozole. I'll definitely check out Wally World prices next time.
The whole PSA/Testosterone meme makes little sense. If your prostate cancer risk rises with age while your testosterone naturally goes down, how the hell does high testosterone correlate with prostate cancer risk? Wouldn't teenagers be dying of prostate cancer in huge numbers? Obviously I'm simplifying this to make a point but still....
Re phlebotomy and hematocrit levels, I do that anyway because of hemochromatosis. Unfortunately, blood banks are not allowed to use my blood because I lived in England in the first half of the 80's. Which means I was there during the whole mad cow mess. My iron rich blood gets thrown away.
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I've heard that the PSA test was not originally intended to be a screening tool. My wife (who is a research scientist) pointed out that some cancers have testosterone sensitivity and some have estrogen sensitivity. Which is probably why the estrogen blockers we use were developed as breast cancer treatments...
I'm in the same category. I was in Germany at the same time. Red Cross has permanently deferred me from donating because of that...Re phlebotomy and hematocrit levels, I do that anyway because of hemochromatosis. Unfortunately, blood banks are not allowed to use my blood because I lived in England in the first half of the 80's. Which means I was there during the whole mad cow mess. My iron rich blood gets thrown away.
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How much anastrazole is 1/2 a tablet? Milligrams wise?
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Did the Doc recommend dietary changes? Is so, what where they?
Did you test your vitamin D level? Again, if so what was it?
Tell anybody who suggest a third biopsy that you have had enough of that kind of fun!
I suggest that the wife needs to be more supportive of your situation!
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rgcone,
I'm glad you're getting great results finally, what a ride to figure out what is up. I had levels similar to yours but I'm only 47.
Higher testosterone usually causes an increase in thyroid activity anyway. Not sure why your doc wants you to supplement with iodine, DHEA, and all the other stuff. Are you on a statin? CoQ10 is necessary for that, but not otherwise. Interestingly, I was low in Vitamin D (a little) and V as well in my labs, so I supplement with those too. I wonder if its a metabolic trait for secondary hypogonadism to also be a poor absorber of B and D vitamins?
I don't take any estrogen blockers, at least not yet (5 months into my treatment). Taking that much anastrozole seems like a lot? I've heard of people taking it every other day or two pills per week, that kind of thing. It can crash your estrogen levels pretty hard.
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