Question to those of you on doctor prescribed HRT

[maldorf]

Last week when I met with my hematologist, I told him about how my new endo wants to drop my test dose down from 120 to 100 mg/wk because my hematocrit has been getting high. We got it down with phlebotomies, and my cardiologist seems to think that some of the problem is now due to my weak heart. He said that the body can compensate for low heart function by raising your HGB/HCT.

Anyhow, I told him how I feel crappy on the lower dose and he said that the endo should run a test on my brain chemistry to see what my body "thinks" is enough. I have never heard of that and I am wondering what he meant by that. Any of you ever had such tests? Im suspecting they test levels of things like dopamine maybe? Who knows.

He seemed surprised that the endo hadnt tested this "brain chemistry" yet. He didnt have time to sit and explain it all to me, so I am wondering if any of you know a bit about what he is talking about.

 

[SIR-LOIN]

Before mine would prescribe me therapy, he ordered an MRI of my pituitary, and basic blood tests, but nothing like that. Honestly, I sometimes think I know more than mine. When he first put me on, it was 400 mg / 3 weeks. I did that awhile and told him after about 10 days I started feeling bad, so I asked if I could do it every week or 10 days, he then put me on 200 / 2 wks. I mentioned terms such as half life, and he got a puzzled look on his face. As long as my liver, thyroid and PSA are OK on the blood tests, he gives me the finger and writes the scripts. He's about as old as God I think. I just handle my blood issues myself by giving every 60 days.

My friend I mentioned in another thread who had a heart attack, also has hematocrit issues even though he gives blood regularly. However, he continues to take 200 2 times a week. Doc told him no red meat at all, but no real sophisticated tests. I think he's on a dangerous path, but he just can't stand not being jacked.

 

[maldorf]

Before mine would prescribe me therapy, he ordered an MRI of my pituitary, and basic blood tests, but nothing like that. Honestly, I sometimes think I know more than mine. When he first put me on, it was 400 mg / 3 weeks. I did that awhile and told him after about 10 days I started feeling bad, so I asked if I could do it every week or 10 days, he then put me on 200 / 2 wks. I mentioned terms such as half life, and he got a puzzled look on his face. As long as my liver, thyroid and PSA are OK on the blood tests, he gives me the finger and writes the scripts. He's about as old as God I think. I just handle my blood issues myself by giving every 60 days.

My friend I mentioned in another thread who had a heart attack, also has hematocrit issues even though he gives blood regularly. However, he continues to take 200 2 times a week. Doc told him no red meat at all, but no real sophisticated tests. I think he's on a dangerous path, but he just can't stand not being jacked.

Funny thing is that I asked my hemotoligist/oncologist if I should stop eating red meat and he said NO. He told me that the effect on hemoglobin is so minimal that I should not worry about it at all. I suppose if you ate massive quantities every day it might be.

yeah, you buddy is really pushing his luck. Did he have a blood clot like me, or was his atherosclerosis? Did he need bypass or a stent? Mine was all blood clot and no buildup. They sucked mine out and placed no stent or anything. I later found I also have a genetic disorder than can increase clotting. Probably was the combo of the steroids and my genes that did me in. Some doc though think I might have had an angiospasm though in my artery, and that could take any one of us down. Happend when I was squating hard.

 

[speed]

he maldorf we know that the higher test does have its impacts on the blood levels, i know you have had complications before, so is the lower dose really that bad of a feeling, you alreay take coumidin and now the drug that starts with a p, id def listen to the doc and make the healthier choices, but i know you already know that, i say so i cuz i wish i could have the extra test in me from some trt but ive seen how drastically it effects my blood, ive heard that when you age your test gets lower more for a reason to take it easier on the blood, not to many older guys out there with high doses of trt, if any trt at all, it makes sense cuz its unatural to put more in when test declines at 30

 

[SIR-LOIN]

I think his was blockage and had to get at least one stent. His daughter found him on the floor almost unconscious. Dr said he'd be dead if there was much more delay. He's about the biggest bb'er around and doesnt want to let that go. Pretty scary.

 

[maldorf]

he maldorf we know that the higher test does have its impacts on the blood levels, i know you have had complications before, so is the lower dose really that bad of a feeling, you alreay take coumidin and now the drug that starts with a p, id def listen to the doc and make the healthier choices, but i know you already know that, i say so i cuz i wish i could have the extra test in me from some trt but ive seen how drastically it effects my blood, ive heard that when you age your test gets lower more for a reason to take it easier on the blood, not to many older guys out there with high doses of trt, if any trt at all, it makes sense cuz its unatural to put more in when test declines at 30

Well, I am on 120 mg/wk and he wants to go 100 mg/wk. Only problem im having is hemoglobin, but that was high even when I was off everything with a total test level of like 90. I think a lot of it is due to my heart being half dead now, and my cardiologist was the first to suggest that. My endo wont listen to anyone though and thinks he knows everything. I did feel rather crappy on the 100 mg/wk, my total test was around 500 something and now Im sitting around 800. Anyhow, my hemoglobin is down to 15.5 or so now with phelbotomies, so hopefully he will ease up a bit and continue to prescribe what Im on now. I suppose I can go back to feeling crappy again, but I dont want to unless I have to.

 

[maldorf]

I think his was blockage and had to get at least one stent. His daughter found him on the floor almost unconscious. Dr said he'd be dead if there was much more delay. He's about the biggest bb'er around and doesnt want to let that go. Pretty scary.

Yeah, thats too bad especially since he has a daughter. Ive lost about a good 30 lbs or so of muscle since I dont use steroids anymore other than the true HRT dose from my doc. For me though the choice was easy.

 

[Kaladryn]

Maldorf are you using an AI? I have a new theory based on recent bloodwork that AIs somehow increase hematorcrit.

I have always had high hematorcrit since I started HRT, I have watched my levels go up over time consistantly. Generally I'm around 53-54, I try to donate blood before it gets to 55 or higher.

I recently went and had a CBC and an E2 test done, expecting to get a VERY high hematocrit because it had been so long since I donated blood. I came back 49%, I have no idea why, I'm always at an equal level of hydration when I test. The kicker was, my E2 came back at 109 (long story on why I let it get this high).

Could too low of E2 levels drive hematocrit up? Seems possible, one test doesn't prove anything, but it does have me thinking. Also, it seems like bodybuilders have more hematocrit issues nowdays than they used to in the past, and AI use is much higher nowdays than it used to be.

 

[ramayana]

study

Maldorf are you using an AI? I have a new theory based on recent bloodwork that AIs somehow increase hematorcrit.

I have always had high hematorcrit since I started HRT, I have watched my levels go up over time consistantly. Generally I'm around 53-54, I try to donate blood before it gets to 55 or higher.

I recently went and had a CBC and an E2 test done, expecting to get a VERY high hematocrit because it had been so long since I donated blood. I came back 49%, I have no idea why, I'm always at an equal level of hydration when I test. The kicker was, my E2 came back at 109 (long story on why I let it get this high).

Could too low of E2 levels drive hematocrit up? Seems possible, one test doesn't prove anything, but it does have me thinking. Also, it seems like bodybuilders have more hematocrit issues nowdays than they used to in the past, and AI use is much higher nowdays than it used to be.

Here is a study that helps shed some light on the relationship between test, estrogen and HCT: Testosterone action on erythropoiesis does not req... [J Steroid Biochem Mol Biol. 2009] - PubMed result

 

[maldorf]

Maldorf are you using an AI? I have a new theory based on recent bloodwork that AIs somehow increase hematorcrit.

I have always had high hematorcrit since I started HRT, I have watched my levels go up over time consistantly. Generally I'm around 53-54, I try to donate blood before it gets to 55 or higher.

I recently went and had a CBC and an E2 test done, expecting to get a VERY high hematocrit because it had been so long since I donated blood. I came back 49%, I have no idea why, I'm always at an equal level of hydration when I test. The kicker was, my E2 came back at 109 (long story on why I let it get this high).

Could too low of E2 levels drive hematocrit up? Seems possible, one test doesn't prove anything, but it does have me thinking. Also, it seems like bodybuilders have more hematocrit issues nowdays than they used to in the past, and AI use is much higher nowdays than it used to be.

I am willing to bet that you are right about the AIs, and you have raised any excellent point. I am on no AIs though since my doc says there is no need and I believe he is correct. Only time I would need an AI is if I were once again running bodybiulding type doses and im on just 120 mg/wk test.
Some guys though might be having hematocrit problems exacerbated by there use of AIs. Good hypothesis, but we need to look more into that.

 

[maldorf]

Here is a study that helps shed some light on the relationship between test, estrogen and HCT: Testosterone action on erythropoiesis does not req... [J Steroid Biochem Mol Biol. 2009] - PubMed result

Well, this study seems to say that AIs would have no effect.

 

[ramayana]

Personally, I take .5mg arimidex (compounded) per week with 100mg of test/week and my e2 hovers around 47pg/ml, which is a little on the high side. My HCT stays around 47. Maldorf, you mentioned you feel like crap on 100mg/week; what is your e2 on your current regimen? The reason I ask is because I feel lousy without the addition of an AI, even at such a low dose as .5mg/week. Off note, I have read through the posts about your health issues and I really appreciate your openness and transparency in sharing such a deeply personal experience. God bless you sir.

 

[maldorf]

Personally, I take .5mg arimidex (compounded) per week with 100mg of test/week and my e2 hovers around 47pg/ml, which is a little on the high side. My HCT stays around 47. Maldorf, you mentioned you feel like crap on 100mg/week; what is your e2 on your current regimen? The reason I ask is because I feel lousy without the addition of an AI, even at such a low dose as .5mg/week. Off note, I have read through the posts about your health issues and I really appreciate your openness and transparency in sharing such a deeply personal experience. God bless you sir.

Well I had estradiol only checked 2x, they seem to not be worried about it. Both times I had it checked it was normal ( first time 17 and 2nd time it was 22).

I don't feel terrible on the 100mg/wk, but I do feel more fatigued, lower sex drive, ed problems more, etc. 120 mg/wk is pretty good. My original endo had me try 150mg/wk and I felt the best on that of course but my HCT was climbing fast on that.

 

[JUISEBOY]

Before mine would prescribe me therapy, he ordered an MRI of my pituitary, and basic blood tests, but nothing like that. QUOTE]

SL how did the MRI come out? Earlier in the year my test was at 231 then they put me on androgel (5g/day) and I went to 671 and felt good. Then a few weeks later I started feeling like crap again and my test was at 601 or so. Now they yanked me off of the androgel and will retest me in 30 days. Dependant on that they say they will order the MRI. Getting this into these things makes me a bit concerned.

 

[totalrecomp]

Well I had estradiol only checked 2x, they seem to not be worried about it. Both times I had it checked it was normal ( first time 17 and 2nd time it was 22).

I don't feel terrible on the 100mg/wk, but I do feel more fatigued, lower sex drive, ed problems more, etc. 120 mg/wk is pretty good. My original endo had me try 150mg/wk and I felt the best on that of course but my HCT was climbing fast on that.

If forced to go the 100mg route perhaps something like nettle that mildly boosts free test would allow the lower dose to still give you the quality of life that the higher dose was delivering? I know nettle has a mild effect but I always feel a difference when I take it and low dose has little to no sides. Just an idea, you know do more with less

 

[maldorf]

If forced to go the 100mg route perhaps something like nettle that mildly boosts free test would allow the lower dose to still give you the quality of life that the higher dose was delivering? I know nettle has a mild effect but I always feel a difference when I take it and low dose has little to no sides. Just an idea, you know do more with less

Im am always open to alternatives, and if that truly does work then I would go that route.

 

[totalrecomp]

Im am always open to alternatives, and if that truly does work then I would go that route.

Whatever happens I hope it works out for you, it's too bad the docs can't be more of a team on this one.

 

[SIR-LOIN]

Before mine would prescribe me therapy, he ordered an MRI of my pituitary, and basic blood tests, but nothing like that. QUOTE]

SL how did the MRI come out? Earlier in the year my test was at 231 then they put me on androgel (5g/day) and I went to 671 and felt good. Then a few weeks later I started feeling like crap again and my test was at 601 or so. Now they yanked me off of the androgel and will retest me in 30 days. Dependant on that they say they will order the MRI. Getting this into these things makes me a bit concerned.

The MRI showed nothing wrong. I got on Agel too, and my numbers were about the same as you, and I also started feeling bad after about 3 weeks. They retested me and I was still around 600, but felt like it was 0. I requested injectables, which he did, but was 400 / 3 weeks and administered in the office only. I eventually talked him into every two weeks and got him to let me self administer to avoid the trips to the office. When I told him the difference in cost of the cyp vs the gel it wasn't hard to convince him.

 

[ronnieron]

Yesterday I finally got my doc to write me a script for test cyp, its 200 mg every 2 weeks. He only wrote me a script for 1ml, with 1 refill and wants me to come back before the third shot for blood work, is this normal? I hope he does not plan on just giving me a couple of doses and thinks my test is going to stay that high. He originally wanted me to come to the office and I had to convince him that I did not have a regular ride to come to the doc every 2 weeks.

 

[Kaladryn]

it cracks me up that doctors want to do cyp E2W or E3W when the halflife of cyp if 8 days.

From the package insert for depo-testosterone:

http://www.pfizer.com/files/products/uspi_depo_testosterone.pdf

The half-life of testosterone cypionate when injected intramuscularly is approximately
eight days.