Post-HRT labs...crazy results...should I worry?

[Sonny]

Hi All,

I decided to end my foray into HRT due to a persistent problem with dizziness that has not gone away. It may not even be the HRT, but at this point, the docs (and I agree) feel that variables need to be minimized. I am on 2 other meds for bipolar disorder, so we think there is an interaction...very weird, but I had to make a change.

After a lengthy discussion with my Endo, he agreed that going cold turkey on HRT was not in my best interest. Initially, he talked about treatment using Clomid, but given my background, I told him I was scared of the potential emotional problems it might cause. He agreed to give me a 10 week course of Nolvadex to get my system back online. We are doing a 40mg-20mg-10mg taper of Nolvadex over 10 weeks. I showed him Swale's PCT protocol.

This was my last HRT lab before stopping. It consisted of ~300 iu/night of HCG. (no Test Cyp) I had been on this protocol for about 10 weeks.
Total T: 560 (241-827)
Free T: 12.2 (9.0-27)
E2: 48 (13-54)
LH: <0.2 L (1.5-9.3)

My last dosage of HCG was on Friday Aug 19th. I started Nolvadex @ 40mg/day (20mg in the morning + 20mg in the evening) on Saturday Aug 20th. This lab was done on the morning of Wednesday Aug 24th:
Total T: 56 L (241-827)
Free T: Pending
E2: 10 L (13-54)
LH: 0.8 L (1.5-9.3)

I was shocked to see these numbers, but I figured I'd take them with a grain of salt since I only had 4 days of "post-treatment" before the labs. The other thing is that I feel pretty good! I would imagine that with results like the above, I'd feel like death. I don't feel fantastic, but my energy levels are ok, mood is ok, etc. I almost feel like the blood used in this latest lab wasn't mine. The only clue that it is mine is that the LH has come up...barely.

Thoughts?

Sonny

[SPE]

I'm at a loss as to why your Total Testosterone took such a hit when you were only on an HCG protocal...

[Glaim]

Originally Posted by SPE

I'm at a loss as to why your Total Testosterone took such a hit when you were only on an HCG protocal...

Maybe he was primary? E2 looks elevated in the first one and I would guess that your dizziness is associated with that.

[Sonny]

That lab prior to stopping HRT was the only lab I've ever done where E2 has been on the high side. It has almost always been in the high 20's. There didn't seem to be a correlation between E2 and dizziness. I had dizziness when E2 was in the teens and when it was 48, too.

Here is my bloodwork history from the beginning. Before I started TRT, my Test levels were low, but LH and FSH were both in the middle of the range.



Sonny

[mranak]

Thank you for posting this information. This is evidence to me that hCG is somewhat supressive, even though it can be of aid in recovery as well. I expect that your testosterone levels will indeed recover while using the Nolvadex, although they very likely might drop down to pre-HRT levels a few weeks after you discontinue.

Keep us informed of your progress.

[Sonny]

mranak: I think anything that sends your LH and FSH to zero can be classified as "suppressive". People using HCG as a recovery aid generally only use it at the start of recovery and then stop using it and switch to Nolvadex/Clomid alone. That is the impression I got when I researched how to discontinue. Since I had been on HCG monotherapy for 10 weeks leading up to "the end", just stopping HCG and switching to a SERM seemed like the logical answer.

I have lab work again in about 1.5 weeks, so we'll see what happens. I have a standing order for Total T, Free T, E2, DHT, and LH. I get them tested every 2 weeks until the end of December.

Sonny

[pmgamer18]

Sonny I maybe way off base here but did you ever have you blood tested for the count some men on TRT have to give a pint of blood because " I can't think of the name" but this could make you feel dizzy.
Phil

[SWALE]

First, I'd have the labs redrawn.

[Cryptochid]

Sonny

You sound like your history is aliegned to mine. After I found the correct administration and dosage of HRT, the bipolar meds were able to be stopped, as depression has ceased.

As for the dizziness....(and i dont know if its in cinjunction with tinnitus), I now find that my meds claer up the problem within one day (using stemitel), whereas when my T was low, 3 weeks of stemitel still wouldnt work for me. I would eventually require a stemitel IM Injection.

I would also explore, through a neurologist, a MRI to eliminate a cranial nerve abnormality.

In short, getting the T levels correct, has eliminated dizziness, tinnitus, and bipolar meds. Hope this helps

Crypto http://mc2.vicnet.net.au/home/cjdhgh/index.html

[Sonny]

Crypto: Thanks for the info. Very interesting indeed. I don't think this is the end of the road for TRT for me...it's just a break. I was born completely deaf in my left ear and have balance problems when I hear loud noises in that ear. I've also had Bell's Paulsy (complete paralysis of the muscles in one side of the face) 3 times since I was in high school...every time on the left side. So who knows, maybe something is up.

Swale: The labs are being re-done.

Thanks,
Sonny

[Sonny]

I got retested. This time, I had 10 days of Nolvadex at 40mg/day under my belt:

Total T: 93 L (241-827)
Free T: Pending
E2: 14 ok (13-54)
LH: 2.6 ok (1.5-9.3)
FSH: 2.2 ok (1.6-8.0)

As you can see, he had FSH run on the re-test. I'm encouraged to see better results. LH is rising and FSH is in range, too. I'm not sure what the Endo is gonna say, but should my levels be higher given what I am doing? He may want to switch me to Clomid or add some to what I'm doing (it was his first choice). Is there any benefit to that?

Sonny

[mranak]

Very good. LH has come up significantly, pretty much as should be expected. I would have expected total testosterone to be a bit higher, but at least it is moving in the right direction. The Free T will be more informative. Are you still waiting on Free T for the test you listed in your first post at the top of this thread?

I would have expected recovery to come more quickly after your hCG protocol, so this is especially interesting to me.

Curious: do they have you taking Neurontin or one of the so-called 'mood stabalizers" for the bipolar? Of course, you don't need to disclose this if you don't want.

[Sonny]

mranak: Thanks for the post, bro. Still waiting on Free T and DHT. I will have both tomorrow, I think. I'm on lithium and klonopin for BPD. I'm on very small doses of each one. Lithium is dosed from 600mg to 2700mg day depending on the situation. I'm at 600mg/day...minimal dose. It's not uncommon for people to take 2mg or more of klonopin per day...I don't know how they do that! I'm on .75 mg/day.

I've seen blood test results (I think Kroms' was posted awhile back) of people on Clomid for 5-7 days that have LH and FSH at the top of the spectrum. I get tested again on Wednesday. If things continue in this upward trend, I think I'll leave it alone.

Thoughts?

Sonny

[mranak]

Originally Posted by Sonny

...for BPD.

Do you have borderline personality disorder? Or bipolar? Two different things. My wife has BPD: borderline personality disorder, although she was once improperly diagnosed with bipolar.

[Sonny]

mranak:

I don't have a clear cut diagnosis...bipolar is the closest fit. I've had recurring problems with depression and anxiety, but never a classic manic or hypomanic episode. Sometimes there is bad anxiety/agitation before the depression and the docs consider that a form of mania. This is why the agitation that I experience with overly high doses of Test is dangerous (for me). The nature of this problem coupled with low levels of Test made me think I had found the cure. I hope to get the dizziness resolved and I'll try again someday.

I was planning on stepping the Nolvadex down after 3 weeks, but it looks like that might not be a good idea. I'll have to get my doc to give me more...assuming he doesn't want to take me off of Nolva and put me on Clomid. I've considered selegiline as well, but neither my endo or my p-doc can tell me if it is HPTA suppressive. I don't want to take any chances.

Cheers,
Sonny

[mranak]

Clomid does have a reputation for being more effective with the HPTA, but Nolva is effective regardless and some people get visual problems while taking the clomid. I don't see any problem with continuing the Nolva at 40mg for a while longer. But taper it down slowly before you discontinue.

[Sonny]

Lab results after 18 days on Nolvadex @ 40mg/day.

Total T: 203 L (241-827)
Free T: Pending
E2: 11 L (13-54)
LH: 6.3 (1.5-9.3)

I'm encouraged that levels are coming up. LH made a nice jump over the last week or so.

Sonny

[SWALE]

I'd get serial LH measurements across a few hours. I would expect to see LH above normal range by now. As we know, LH production is pulsatile, and it has a very short half-life, so we have to keep this in mind when looking at but a single measurement.

[mranak]

SWALE, it isn't even 7am on a Saturday morning. Have you lost your ability to sleep in after a long week of work?

Sonny: To prove SWALE's point about LH, on another board I just read a message about a guy that was worried because his LH was extremely low (nearly zero he said) about a month after finishing PCT. Somebody asked him about his total and free testosterone. He said something like, "oh, those are fine." Well, obvously he caught LH at a bad time because an LH level of, say, 0.2 isn't going to raise your testosterone to normal levels.

[Sonny]

I'm sending strippers to both of you guys.

Thanks!

Sonny

[Sonny]

This is after 31 days on Nolvadex @ 40mgs:

Total T: 535 (241-827)
Free T: Pending
E2: 25 (13-54)
LH: 15.7 (1.5-9.3)

I'm gonna stay at 40mg for another week and then start tapering off.

Phew! It took longer than I expected to get my levels back up, but it appears to be working.

Sonny