Doctor Prescribed TRT: Need Advice

[Rutdipper]

Hello, New to the forum, looking for some help & advice.

Just a quick back ground im a former pro level athlete, my sport caused lots of injuries surgeries & especially head Injuries...I stopped my sport almost 5yrs ago, im 29yrs old now, I’ve struggled physically for about 5yrs now, constant headaches (almost 24hrs a day) zero energy, zero recovery, rapid vision change/blurry vision, gaining fat, low muscle...the list goes on...The headaches have been so bad that it’s been main focus of treatment of trying to live normal life.

but finally about 9 months ago I had my blood work checked & results came with Low T....level was 201 ng/dL (just as I Imagined) Head injuries are thought to have damaged my pituitary.

I should note that I had my levels check about 5yrs ago at age 24 when I first started feeling bad & levels were 401 / Prolactin levels were 21 ng/ml, I don’t have my past estrogen levels unfortunately.


The doctor started me at 50mg injections & over the summer slowly bumped up dosage to 100mg which im at now.

After 6 months of treatment at 100mg injection my levels are now 598 ng/ml

I feel slightly better but nothing to write home about.

The next issue I see that my doctor is brushing off is my Estrodiol level is 57 pg/ml & Prolactin level is 22....which my prolactin has been around the 20-22 level for several years now according to my past tests. My doctor is telling me these numbers are fine & need no extra treatment, his only recommendation is to lower my test injection since my estrogen is high, but with the 100mg and my test level only being at 598 I don’t want to do that, plus I’ve only started to feel a slight improvement when I finally reached the 100mg...which was basically a argument to get him to raise it to.


So with these numbers I’ve posted do any of you guys see any issues with these? I’m hoping to get some advice. I feel that TRT is the right treatment for me but I feel there is so much room for improvement & I have a lot of hope of finally feeling a little better after all these years.

Thank you guys, any further questions for me let me know

Thank you!

 

[CJ]

Hello, New to the forum, looking for some help & advice.

Just a quick back ground im a former pro level athlete, my sport caused lots of injuries surgeries & especially head Injuries...I stopped my sport almost 5yrs ago, im 29yrs old now, I’ve struggled physically for about 5yrs now, constant headaches (almost 24hrs a day) zero energy, zero recovery, rapid vision change/blurry vision, gaining fat, low muscle...the list goes on...The headaches have been so bad that it’s been main focus of treatment of trying to live normal life.

but finally about 9 months ago I had my blood work checked & results came with Low T....level was 201 ng/dL (just as I Imagined) Head injuries are thought to have damaged my pituitary.

I should note that I had my levels check about 5yrs ago at age 24 when I first started feeling bad & levels were 401 / Prolactin levels were 21 ng/ml, I don’t have my past estrogen levels unfortunately.


The doctor started me at 50mg injections & over the summer slowly bumped up dosage to 100mg which im at now.

After 6 months of treatment at 100mg injection my levels are now 598 ng/ml

I feel slightly better but nothing to write home about.

The next issue I see that my doctor is brushing off is my Estrodiol level is 57 pg/ml & Prolactin level is 22....which my prolactin has been around the 20-22 level for several years now according to my past tests. My doctor is telling me these numbers are fine & need no extra treatment, his only recommendation is to lower my test injection since my estrogen is high, but with the 100mg and my test level only being at 598 I don’t want to do that, plus I’ve only started to feel a slight improvement when I finally reached the 100mg...which was basically a argument to get him to raise it to.


So with these numbers I’ve posted do any of you guys see any issues with these? I’m hoping to get some advice. I feel that TRT is the right treatment for me but I feel there is so much room for improvement & I have a lot of hope of finally feeling a little better after all these years.

Thank you guys, any further questions for me let me know

Thank you!

How many days after your shot was the bloodwork done?

Your dose is 100mg per WEEK, correct?

 

[j2048b]

I apologize in advance but if ur honestly a prior pro level athlete, u should have the best care money can buy....

But on the other hand id handle the prolactin issue..... E2 is irrelevant honestly at that level, id leave it alone, and a lot will disagree with me, but currently in the field a lot of people are airing towards now keeping ur e2 levels a tad high die to how the estrogen allows certain pathways to stay open etc... A lot of studies on that ill have to look up and post

Id look at dhea and progesterone levels as well as thyroid

 

[Rutdipper]

I apologize in advance but if ur honestly a prior pro level athlete, u should have the best care money can buy....

But on the other hand id handle the prolactin issue..... E2 is irrelevant honestly at that level, id leave it alone, and a lot will disagree with me, but currently in the field a lot of people are airing towards now keeping ur e2 levels a tad high die to how the estrogen allows certain pathways to stay open etc... A lot of studies on that ill have to look up and post

Id look at dhea and progesterone levels as well as thyroid

To answer question above this yes...100mg a week.

& You would think, but unfortunately not always the case, depends on sport....

& thank you for the advice, what should I be telling my doctor to take to try & lower Prolactin? My current doctor if I don’t hold his hand/ help give him a solution, he basically won’t do anything (I’m currently looking for new endo)

& i’ll Have my Dhea & progesterone levels checked, honestly never heard of them.

I do see on my last blood work TSH is 2.92 uiU/mL

in 2017 TSH was 1.02

 

[Rutdipper]

Another level I see that’s off standard chart is Cortisol my level is 6.7 ug/dL normal range on my test shows 10-25

would that hat have a negative effect on me in any way?

 

[Jin]

What type of doctor are you seeing?

 

[Beserker]

Interview doctors until you find one that is willing to up the dosage, and treat all symptoms with an open mind. You shouldn’t put up with a stubborn doc for one second.

Cortisol that low may indicate hypocortisolism which would absolutely have negative effects.

You need a top notch Endo IMO

 

[Jin]

Interview doctors until you find one that is willing to up the dosage, and treat all symptoms with an open mind. You shouldn’t put up with a stubborn doc for one second.

Cortisol that low may indicate hypocortisolism which would absolutely have negative effects.

You need a top notch Endo IMO

Agree with the Viking. if you do have damage to the pituitary gland you really need to be treated by an Endo.

 

[Rutdipper]

Interview doctors until you find one that is willing to up the dosage, and treat all symptoms with an open mind. You shouldn’t put up with a stubborn doc for one second.

Cortisol that low may indicate hypocortisolism which would absolutely have negative effects.

You need a top notch Endo IMO

thank you very much for the advice.

to answer the questions...I’m seeing an Endo just a very lazy stubborn one I guess.

 

[Beserker]

29 is too young to feel like you’re describing... all the best on recovery. Welcome to the board, hope you stick around.

 

[Rutdipper]

29 is too young to feel like you’re describing... all the best on recovery. Welcome to the board, hope you stick around.

Thank you sir...I appreciate that

 

[CJ]

Yeah, I also think that finding a new Endo would be a smart move. By your accounts, it seems like your current Dr is just going through the motions, and not really taking head trauma into account.

A fresh set of eyes on the problem could bring a new perspective.

Best of luck!

 

[ripper]

Is doc giving the shot or are you doing it at home? I've had two TRT docs and even with similar dosing, with the first I was experiencing a lot of sides due to estrogen which he wouldn't prescribe anything for and wanted to lower the dose (had the impression he didn't really know what he was doing).

The second lets me do the shots at home -- I broke up the weekly dose and do a few 1/10's of a cc ED or EOD which made a huge difference in the way I feel and which made my estrogen related sides more manageable. Second doc, when asked about anti-e's, recommended taking DIM. I was a bit put off by that at first, but after adding it in at 300mg morning and night, I've been very pleased with how my TRT treatment is going. I use the Nutricost brand.

 

[Rutdipper]

Is doc giving the shot or are you doing it at home? I've had two TRT docs and even with similar dosing, with the first I was experiencing a lot of sides due to estrogen which he wouldn't prescribe anything for and wanted to lower the dose (had the impression he didn't really know what he was doing).

The second lets me do the shots at home -- I broke up the weekly dose and do a few 1/10's of a cc ED or EOD which made a huge difference in the way I feel and which made my estrogen related sides more manageable. Second doc, when asked about anti-e's, recommended taking DIM. I was a bit put off by that at first, but after adding it in at 300mg morning and night, I've been very pleased with how my TRT treatment is going. I use the Nutricost brand.

yes my doctor is giving the injection once weekly...& that’s interesting, I’m not against giving injection myself.

& hmm DIM...I had to google it, I see I can get it on Amazon, have you done bloodwork to see that it works & how much it’s lowered your estrogen?

thanks

 

[Rutdipper]

Hey Guys, little update on further blood work testing.

new results are:

Cortisol taken at 8am 18 ug/dL I then was given an injection of something & waited an hour to retest which result was 23.9 ug/dL ....normal is >=18

Prolactin surprised me with a 12 pg/ml as it’s always been high except for this random test

last test was Estrogen and it’s jumped up even higher to 84 pg/ml seems way to high

still at 100mg test inj once a week. Test levels starting around 590. Personally would like to try and get that number a littler higher just to see how I feel overall & get the estrogen level down.

any suggestions for these new test, maybe something I don’t see?

thanks again

 

[SFGiants]

Hey Guys, little update on further blood work testing.

new results are:

Cortisol taken at 8am 18 ug/dL I then was given an injection of something & waited an hour to retest which result was 23.9 ug/dL ....normal is >=18

Prolactin surprised me with a 12 pg/ml as it’s always been high except for this random test

last test was Estrogen and it’s jumped up even higher to 84 pg/ml seems way to high

still at 100mg test inj once a week. Test levels starting around 590. Personally would like to try and get that number a littler higher just to see how I feel overall & get the estrogen level down.

any suggestions for these new test, maybe something I don’t see?

thanks again

If you are only taking 100mg a week of test and only that then there might be something else going on, other issues maybe causing all this.

If the estradiol test wasn't a sensitive test (Estradiol Sensitive) then those numbers are not as true as they really are.

 

[Rutdipper]

If you are only taking 100mg a week of test and only that then there might be something else going on, other issues maybe causing all this.

If the estradiol test wasn't a sensitive test (Estradiol Sensitive) then those numbers are not as true as they really are.

it was Estradiol sensitive.

& that’s correct I’m only on the 100mg of test.

 

[Beserker]

Interesting, I’m on 100/week and that gets me low 800s and E2 in range or very slightly up. Everyone is different... but, There may be something underlying here like SFG said..