# Newb to this site needing advice for TRT



## tankbuster44 (Mar 31, 2018)

Hi Guys, I have a problem that I am not getting much help from my doctor in correcting. I am 49 and have been on TRT for about 13yrs. I was told by my old doctor that my Free testosterone level was about 160 back 13yrs ago. He started me on 100mg/ml Delatestrol cypionate 2ml shot every 2 weeks. This seemed to work fine up until I changed doctors about 4 years ago. The new doctor (female) kept the same dose for me and I just noticed it never gave me the "kick" it used to after I got the 2x monthly shot. 

Fast forward to today where my testes have shrunk to raisin size and I have no real drive for anything. Sex life is ok in the sense that my wife is not exactly looking forward to it so 3x a month seems to be ok with both of us. That isn't the real issue as much as my balls are like....GONE..I don't know why I never noticed this before now...but it is really on my mind all the time.

I got my blood work back this week and she said that I should see a urologist to talk about raising my levels as she cannot think of anything other than reducing my 2ml that she gives me. 

I have been reading this forum and found a lot of interesting threads that talk about HCG being important and the LH levels as well. I am really frustrated as I started to work out again (5,7" 188Lbs) but I am finding what used to be easy for me to do before (lose weight, get strong quickly) has all but disappeared for me.

The other issue is the Urologist appointment is not until late June... (Canadian HealthCare...) so I guess I am stuck until then. I was thinking of following a friend from the USA's advice and taking some Anastrozole to counteract the effects of the injections aromatizing. I am also leary of going to one of those clinics in Canada because they all seem to prescribe Bio-Identical pellets and I am not sure that would help me. 

Here is a copy of my blood test which was taken 2 weeks AFTER my last shot just before a new one was injected. If anyone can help give me some advice on what to ask for in terms of therapy or anything else I would be thrilled. Thanks in advance.


----------



## PillarofBalance (Mar 31, 2018)

Don't start the anastrazole until you know whether your estradiol is too high. 

You should be doing the injects weekly not every other week. Just start splitting it up so you are taking 100mg every week.


----------



## tankbuster44 (Mar 31, 2018)

Thanks for the advice...I will ask my Doc to to another test of my blood for those levels. Do you think I am turning my injections into E2 too quickly? I can't understand why this did not happen fairly early in my therapy...not 8-10yrs later. I did not pay attention to my testes to be honest...but jeez louieez are they small...it almost looks like I am castrated.


----------



## BiologicalChemist (Apr 1, 2018)

Hmm no idea...try hcg


----------



## Jin (Apr 1, 2018)

tankbuster44 said:


> ..but jeez louieez are they small...it almost looks like I am castrated.



Let's compare.


----------



## DocDePanda187123 (Apr 1, 2018)

tankbuster44 said:


> Thanks for the advice...I will ask my Doc to to another test of my blood for those levels. Do you think I am turning my injections into E2 too quickly? I can't understand why this did not happen fairly early in my therapy...not 8-10yrs later. I did not pay attention to my testes to be honest...but jeez louieez are they small...it almost looks like I am castrated.



At 400mg a month I’m assuming is how much you’re taking, I doubt there will be a need for an AI. Like Pillar said, try injecting 1ml weekly instead of 2ml every other week. The boood work you posted are your trough levels. Injecting more frequently will help raise this and smoothen out your blood levels between injections. 

Your nuts shrank bc you’re taking test from a bottle. This shuts down your HPTA. The pituitary is no longer producing LH like before so there’s no stimulation for your Leydig cells in your balls to make natural testosterone hence the shrinkage. Hcg can help with this but this is more of a personal issue than a medical one meaning it’s more about cosmetics then anything that’s medically necessary. If it bothers you then take some hcg but understand this will raise your test levels so your test dose might need adjusting and hcg also will case estrogen to go up meaning you might need an AI.


----------



## tankbuster44 (Apr 1, 2018)

DocDePanda187123 said:


> At 400mg a month I’m assuming is how much you’re taking, I doubt there will be a need for an AI. Like Pillar said, try injecting 1ml weekly instead of 2ml every other week. The boood work you posted are your trough levels. Injecting more frequently will help raise this and smoothen out your blood levels between injections.
> 
> Your nuts shrank bc you’re taking test from a bottle. This shuts down your HPTA. The pituitary is no longer producing LH like before so there’s no stimulation for your Leydig cells in your balls to make natural testosterone hence the shrinkage. Hcg can help with this but this is more of a personal issue than a medical one meaning it’s more about cosmetics then anything that’s medically necessary. If it bothers you then take some hcg but understand this will raise your test levels so your test dose might need adjusting and hcg also will case estrogen to go up meaning you might need an AI.



Thanks for the advice!!  I wanted to ask you how long it takes for my balls to start growing back to a reasonable size (12yr boy size would be an upgrade:32 (11)

The other question is about the Bio-Identical pellets...what are your thoughts on them compared to the bottle??  I am in Canada and it seems any Longevity clinic I find all seem to push that angle for treatment. Would they also prescribe HCG as well or just pellets??  

In the end...I would like to get back to somewhat normal and use Testosterone for my building up instead of the way I have it now...dependent and not producing. I wish there was a local guy I could speak to about this...my doc has me scheduled with a Urologist...I don't know if that is the right guy to be seeing. I also am unsure of when to test for E2...should it be right before my next shot or in the middle ?? Thanks again for all your help....


----------



## DocDePanda187123 (Apr 1, 2018)

tankbuster44 said:


> Thanks for the advice!!  I wanted to ask you how long it takes for my balls to start growing back to a reasonable size (12yr boy size would be an upgrade:32 (11)
> 
> The other question is about the Bio-Identical pellets...what are your thoughts on them compared to the bottle??  I am in Canada and it seems any Longevity clinic I find all seem to push that angle for treatment. Would they also prescribe HCG as well or just pellets??
> 
> In the end...I would like to get back to somewhat normal and use Testosterone for my building up instead of the way I have it now...dependent and not producing. I wish there was a local guy I could speak to about this...my doc has me scheduled with a Urologist...I don't know if that is the right guy to be seeing. I also am unsure of when to test for E2...should it be right before my next shot or in the middle ?? Thanks again for all your help....



Within a week or two you should start noticing a difference. After a couple weeks they’ll max out at whatever size they’ll get to (might not get back to normal pre-TRT size). 

Pellets are a DS a better option than gels or transdermal imo. Ppl who don’t like injections do very well on pellets and it’s only a monthly injection. You have much more control with regulars IM injections though. In the end it’s up to you which you prefer.  Not all places prescribe hcg. You’ll need to ask them about it. 

Urologists and endocrinologists are are usually the best to see about TRT. They’re better studied on the endocrine system. That’s not to say everyone of them will be great doctors but generally speaking, they know more than primary care doctors.


----------



## tankbuster44 (Apr 1, 2018)

DocDePanda187123 said:


> Within a week or two you should start noticing a difference. After a couple weeks they’ll max out at whatever size they’ll get to (might not get back to normal pre-TRT size).
> 
> Pellets are a DS a better option than gels or transdermal imo. Ppl who don’t like injections do very well on pellets and it’s only a monthly injection. You have much more control with regulars IM injections though. In the end it’s up to you which you prefer.  Not all places prescribe hcg. You’ll need to ask them about it.
> 
> Urologists and endocrinologists are are usually the best to see about TRT. They’re better studied on the endocrine system. That’s not to say everyone of them will be great doctors but generally speaking, they know more than primary care doctors.



Thanks Doc...you say in a week or two I would be seeing a size difference. Would that be with HCG or just by regular injections weekly? I am a bit confused on that part of your response. I do hope they prescribe HCG...if they don't..I guess I will have to figure a way of buying some online..(any advice on that would be helpful as well)...seems a bit daunting because of so many overseas pharmacies and the difficulty in shipping to Canada. I had some benign stuff from china stopped so often i just gave up because these Canadian border services guys have nothing better to do than inspect every international package...


----------



## automatondan (Apr 1, 2018)

What Doc was trying to tell you is by using testosterone of any kind, suppresses/inhibits your body's ability to make It's own testosterone; that is why your balls have shrunk/atrophied. Changing your injection schedule to weekly will not change the atrophy of your balls... Only hcg will help revive them. But, as far as the injection schedule goes, I second Doc and POB's recommendation to switch to weekly... You will notice a big difference most likely. Also, switching to weekly will also most likely completely negate the concern of aromitization.


----------



## tankbuster44 (Apr 1, 2018)

automatondan said:


> What Doc was trying to tell you is by using testosterone of any kind, suppresses/inhibits your body's ability to make It's own testosterone; that is why your balls have shrunk/atrophied. Changing your injection schedule to weekly will not change the atrophy of your balls... Only hcg will help revive them. But, as far as the injection schedule goes, I second Doc and POB's recommendation to switch to weekly... You will notice a big difference most likely. Also, switching to weekly will also most likely completely negate the concern of aromitization.



Thanks...I figured as much when it comes to the artificial source causing the atrophy...I guess I do need HCG for sure to get out of this mindset of Raisin sized balls driving me nuts. I was told by my doc (female) that it would take just as long to grow them back as it took to shrink them....So I thought it would take years to get them back...glad to hear it won't be that long. Can you tell me when the best time to check my E2 would be? would it be accurate when checking right before a bi-weekly shot or just after?


----------



## automatondan (Apr 2, 2018)

tankbuster44 said:


> Thanks...I figured as much when it comes to the artificial source causing the atrophy...I guess I do need HCG for sure to get out of this mindset of Raisin sized balls driving me nuts. I was told by my doc (female) that it would take just as long to grow them back as it took to shrink them....So I thought it would take years to get them back...glad to hear it won't be that long. Can you tell me when the best time to check my E2 would be? would it be accurate when checking right before a bi-weekly shot or just after?



Just have them check it with your trough reading... But honestly, if you switch to once per week injections, I almost guarantee you wont have issues with e2... But it doesnt hurt to check. If I take much higher doses of test, I notice my e2 spikes a few days after my injection. But on 100 mg per week, it shouldnt be an issue at all.


----------



## Viduus (Apr 2, 2018)

Jin said:


> Let's compare.



Look whose showing off his 3XL prosthetics...


----------



## Infantry87 (Apr 2, 2018)

Welcome here


----------



## tankbuster44 (Apr 2, 2018)

automatondan said:


> Just have them check it with your trough reading... But honestly, if you switch to once per week injections, I almost guarantee you wont have issues with e2... But it doesnt hurt to check. If I take much higher doses of test, I notice my e2 spikes a few days after my injection. But on 100 mg per week, it shouldnt be an issue at all.



Thanks...I will ask for the test next time I see my Doc just before my shot. I wonder what level 100mg per week would leave me at when I am at peak level. I mean...generally I feel like shit. I don't have much energy in the last few years ..but I have been doing the bi-weekly shots for years...so I don't think my body all of a sudden didn't like doing it that way. Other bloodwork shows up as fine. I just don't seem to get much of a kick from the shots anymore like I used to get. My friend who is an ex-lifter and about 55yrs says he takes a weekly shot of 200mg and 1 pill of anastrozole on the day of injection. Seems to work great for him...he thinks I may be converting it to E2 and need a blocker...oh well...lets hope this new Clinic I am going to see this week has some new ideas. I just don't like the thought of those pellets. I saw a video and it freaked me out a bit.


----------



## DocDePanda187123 (Apr 2, 2018)

tankbuster44 said:


> Thanks...I will ask for the test next time I see my Doc just before my shot. I wonder what level 100mg per week would leave me at when I am at peak level. I mean...generally I feel like shit. I don't have much energy in the last few years ..but I have been doing the bi-weekly shots for years...so I don't think my body all of a sudden didn't like doing it that way. Other bloodwork shows up as fine. I just don't seem to get much of a kick from the shots anymore like I used to get. My friend who is an ex-lifter and about 55yrs says he takes a weekly shot of 200mg and 1 pill of anastrozole on the day of injection. Seems to work great for him...he thinks I may be converting it to E2 and need a blocker...oh well...lets hope this new Clinic I am going to see this week has some new ideas. I just don't like the thought of those pellets. I saw a video and it freaked me out a bit.



200mg a week is excessive in most cases of legitimate TRT.


----------



## tankbuster44 (Apr 3, 2018)

Is there a table that someone can reference when it comes to the mg shot they take and what it would equal to in your bloodwork? If someone was like me and producing next to nothing...would 100mg 1x a week equal to 250-350 or something like that? Or is it all up to the individual persons genetic make up that would make one guy be at 250 and another at 500? Just curious...


----------



## DocDePanda187123 (Apr 3, 2018)

tankbuster44 said:


> Is there a table that someone can reference when it comes to the mg shot they take and what it would equal to in your bloodwork? If someone was like me and producing next to nothing...would 100mg 1x a week equal to 250-350 or something like that? Or is it all up to the individual persons genetic make up that would make one guy be at 250 and another at 500? Just curious...



Dr. Scally’s anecdotal experiences shows that your weekly dose multiplied by 7-10x will roughly esotmmate blood serum levels. Of course there are many factors that can influence this. It also tends to bias towards the high side since it’s an estimate designed to dictate PCT start time. So there is no table to reference per se but that should help give you a starting ground.


----------



## tankbuster44 (Apr 3, 2018)

DocDePanda187123 said:


> Dr. Scally’s anecdotal experiences shows that your weekly dose multiplied by 7-10x will roughly esotmmate blood serum levels. Of course there are many factors that can influence this. It also tends to bias towards the high side since it’s an estimate designed to dictate PCT start time. So there is no table to reference per se but that should help give you a starting ground.



Wow...well I can say that when my trough level is 136...and I just got a shot of 200mg...that there is NO way I feel like i am at 1400-2000 level if you go by that estimate. I feel a bit better...but not nearly that much better...which makes me wonder if there are other issues or if I am just expecting too much out of the TRT. 

As I said before in a previous post...I used to feel a pretty big kick whenever I got my shot...its been a few years that it doesn't seem to do much for me. I even asked the doctor to throw away a bottle of the test and I bought a new one because I was sure they bottled the wrong amount or did something wrong. It didn't make much of a difference in the end (mostly in my head)...but there definitely was ZERO boost.

Should I be feeling a fair amount of difference after a shot? I will ask to go on weekly shots from next week onwards...I hope that makes a difference. Thanks again for all your advice...its been very comforting to get solid advice for a change.


----------



## DocDePanda187123 (Apr 3, 2018)

tankbuster44 said:


> Wow...well I can say that when my trough level is 136...and I just got a shot of 200mg...that there is NO way I feel like i am at 1400-2000 level if you go by that estimate. I feel a bit better...but not nearly that much better...which makes me wonder if there are other issues or if I am just expecting too much out of the TRT.
> 
> As I said before in a previous post...I used to feel a pretty big kick whenever I got my shot...its been a few years that it doesn't seem to do much for me. I even asked the doctor to throw away a bottle of the test and I bought a new one because I was sure they bottled the wrong amount or did something wrong. It didn't make much of a difference in the end (mostly in my head)...but there definitely was ZERO boost.
> 
> Should I be feeling a fair amount of difference after a shot? I will ask to go on weekly shots from next week onwards...I hope that makes a difference. Thanks again for all your advice...its been very comforting to get solid advice for a change.



like I said, it biases towards high and reflects peak levels not trough. You’re injecting every two weeks right now and test e/cyp half life is right around 5-7days or so which means your trough is going to be in the gutter before your next injection. You’re dozing outside of the half life. Don’t rush your changes/adjustments. Things take time to normalize. Start small. First order is to start doing 100mg weekly and go from there. Assess after 4-6wks. Talk to your doctor about what you’re doing and maybe he/she can help you or at the very least know what’s going on.


----------



## knightmare999 (Apr 7, 2018)

Jin said:


> Let's compare.



Am I too late to get in on this? 

Mine are like raisins that got hit by a shrink ray.


----------



## Jin (Apr 8, 2018)

knightmare999 said:


> Am I too late to get in on this?
> 
> Mine are like raisins that got hit by a shrink ray.



Between the near non existent nuts and losing BF I now look average in Japanese locker rooms.


----------



## BRICKS (Apr 8, 2018)

Jin said:


> Between the near non existent nuts and losing BF I now look average in Japanese locker rooms.



So you do still have your nuts.


----------



## snake (Apr 9, 2018)

BRICKS said:


> So you do still have your nuts.



Yeah! Ya got em or ya don't. You can't be half pregnant. LOL


----------



## DocDePanda187123 (Apr 9, 2018)

snake said:


> Yeah! Ya got em or ya don't. You can't be half pregnant. LOL



What if he’s got only one nut? Kinda like a unicycle????


----------



## tankbuster44 (Apr 21, 2018)

DocDePanda187123 said:


> like I said, it biases towards high and reflects peak levels not trough. You’re injecting every two weeks right now and test e/cyp half life is right around 5-7days or so which means your trough is going to be in the gutter before your next injection. You’re dozing outside of the half life. Don’t rush your changes/adjustments. Things take time to normalize. Start small. First order is to start doing 100mg weekly and go from there. Assess after 4-6wks. Talk to your doctor about what you’re doing and maybe he/she can help you or at the very least know what’s going on.



So I just saw the new Dr. on Friday. He says that since I have been on TRT for so long...the chances of me getting ANY size back is very low. He said I should have been warned by the original Dr. who started me on the 200mg bi-weekly to take an AI...since that was not done and I have been on it for 14yrs...the chances are slim to none. 

I guess I was hoping for a different answer. He said HCG works well in someone who is within a 2yr window of starting TRT....anything longer than that is useless. He is willing to try it out at least. Do you agree with his assesment??


----------



## Viduus (Apr 21, 2018)

tankbuster44 said:


> He is willing to try it out at least. Do you agree with his assesment??



Need photos to tell...


----------



## tankbuster44 (Apr 29, 2018)

Hey Guys...got my blood results back...wanted to post them here to see if anything jumps out at them. Please let me know if you think you can decipher these...Thanks in advance.


*Tumour Markers*
Prostate Specific Antigen
0.82
<4.0
ug/L
 
Methodology: Abbott Architect immunoassay.
Results should not be interpreted in isolation as
absolute evidence of the presence or absence of
malignant disease.
Changes in serial results may be misleading
unless all Total PSA results are from the same
laboratory method.
*Reproductive and Gonadal*
Estradiol
73
<162
pmol/L
 

NOTE: Fulvestrant has been shown to interfere
with estradiol testing by this direct
immunoassay. Results for patients taking
this medication may be falsely elevated to
a clinically-significant degree.

Some steroidal aromatase inhibitors are
structurally related to estradiol and may
interfere with some direct immunoassays.
Dehydroepiandrosterone [DHEA-S]
*HI*
*11.3*
< 9.7
umol/L
Testosterone
18.0
8.4 - 28.8
nmol/L
 
Total Testosterone levels may not reflect the
biologically-active testosterone when SHBG levels
are abnormal.
Testosterone Bioavailable
5.6
3.6 - 11.2
nmol/L
 
Interpret BAT results with caution in presence of
significant hypoalbuminemia.
*Bone Markers*
25-Hydroxyvitamin D
88
75 - 250
nmol/L
 
Season, race and dietary intake affect 25-Hydroxy
Vitamin D levels. Highest levels are found in
the summer months and lowest levels during the
winter.
*Referred Tests*
*Dihydroxytestosterone*
Results are pending ...


----------



## tankbuster44 (Apr 29, 2018)

No homo?? :32 (1):

That was a reply to the request for a pic...forgot to quote it...


----------

