Dr Visit this morning

[Prospect]

Hello Meso! Been on 200 mg a week TRT for roughly 4 years now. Had my 6 month blood work done recently and Dr called me yesterday and said I needed to schedule an appointment with him before he would give me my 6 month refill. Here are the concerns I think he has. Liver tested high average is 17-59 I tested 80, estrogen is high average is 19-69, I tested 89. Testosterone tested in range at 637 on day 7 of last injection.
I currently take .5 mg of arimidex every 7 days. Hoping I can suggest to up my arimidex to .5 every 3.5 days but not sure about how to lower liver totals. What would you all suggest to the Dr in this situation? I’m afraid he’s going go try and lower my test

 

[Mac11wildcat]

Estrogen is a tad high for sure. Adjust arimidex and retest.

The liver values however aren’t alarming.

Can try NAC and TUDCA, but usually it’s just time away from orals, alcohol, etc.

 

[Eman]

Liver values fluctuate constantly. Not hydrated quite enough, hard workout, some alcohol, etc are all reasons it could have been high in that snapshot of time. The likelihood that it was caused by testosterone, of which you have a normal reading, is nil. I don't even think that liver value would be considered a mild elevation.

Your AI would probably be better to take .25mg every 3.5 days instead of taking every 7. By the time your blood work was drawn you probably hadn't taken the AI for a few days and the estro rose.

I would do your best to just stay firm with the guy. Tell him you're not comfortable changing your dose without proper evidence, and this isn't it. You are not going to be pleased to endure a hormonal rollercoaster just so he can treat some numbers that are most likely unrelated to his treatment. I would also add that you don't appreciate being drug into his office so he can get his insurance charge and your copay just to waste your valuable time with questionable diagnostics.

 

[proken]

Liver values fluctuate constantly. Not hydrated quite enough, hard workout, some alcohol, etc are all reasons it could have been high in that snapshot of time. The likelihood that it was caused by testosterone, of which you have a normal reading, is nil. I don't even think that liver value would be considered a mild elevation.

Your AI would probably be better to take .25mg every 3.5 days instead of taking every 7. By the time your blood work was drawn you probably hadn't taken the AI for a few days and the estro rose.

I would do your best to just stay firm with the guy. Tell him you're not comfortable changing your dose without proper evidence, and this isn't it. You are not going to be pleased to endure a hormonal rollercoaster just so he can treat some numbers that are most likely unrelated to his treatment. I would also add that you don't appreciate being drug into his office so he can get his insurance charge and your copay just to waste your valuable time with questionable diagnostics.

Agreed.

 

[Mac11wildcat]

.25 e3d for sure. Apologize for not catching that. was once every 7 days the protocol you were told to use?

 

[Prospect]

Liver values fluctuate constantly. Not hydrated quite enough, hard workout, some alcohol, etc are all reasons it could have been high in that snapshot of time. The likelihood that it was caused by testosterone, of which you have a normal reading, is nil. I don't even think that liver value would be considered a mild elevation.

Your AI would probably be better to take .25mg every 3.5 days instead of taking every 7. By the time your blood work was drawn you probably hadn't taken the AI for a few days and the estro rose.

I would do your best to just stay firm with the guy. Tell him you're not comfortable changing your dose without proper evidence, and this isn't it. You are not going to be pleased to endure a hormonal rollercoaster just so he can treat some numbers that are most likely unrelated to his treatment. I would also add that you don't appreciate being drug into his office so he can get his insurance charge and your copay just to waste your valuable time with questionable diagnostics.

Thanks for your response. I will indeed mention the dehydration. My Dr is just a general family Dr that knows little about TRT. Probably just saw the levels were elevated and figured he better act like he’s worried/concerned. Also yes the AI was taken 6-7 days before the bloodwork was done. I will also mention dividing it up to E3.5 days. I will let you all know how the appointment goes. Thanks again

 

[Prospect]

.25 e3d for sure. Apologize for not catching that. was once every 7 days the protocol you were told to use?

Yes every 7 days. The pills are so small
It’s a bitch cutting them in half to get .5. If I try and cut them into 1/4 it will end up being in powder form. Thanks for your responses Big Mac

 

[Mac11wildcat]

Yes every 7 days. The pills are so small
It’s a bitch cutting them in half to get .5. If I try and cut them into 1/4 it will end up being in powder form. Thanks for your responses Big Mac

That’s a ridiculous suggestion for adex use. How the fuck do these doctors stay doing this.

 

[Eman]

That’s a ridiculous suggestion for adex use. How the fuck do these doctors stay doing this.

I can see it being useful in very specific circumstances if someone is exceedingly sensitive to estrogen being raised. It would only make sense if you were doing a once weekly pin and taking the AI to hinder that initial estrogen spike but not push it too low later in the week... which sounds sort of like what this guy is experiencing, but I highly doubt the doctor designed the dosing that way knowingly.

 

[Mac11wildcat]

I can see it being useful in very specific circumstances if someone is exceedingly sensitive to estrogen being raised. It would only make sense if you were doing a once weekly pin and taking the AI to hinder that initial estrogen spike but not push it too low later in the week... which sounds sort of like what this guy is experiencing, but I highly doubt the doctor designed the dosing that way knowingly.

Are half lives and elimination really that hard to understand or do they just not give a fuck?

 

[Eman]

Are half lives and elimination really that hard to understand or do they just not give a fuck?

It's just not something a lot of doctors know much about unless they are specialists, even then it's hit and miss I think. Plus, they are very much risking their medical license if they don't go by the book to T.

If you think this shit is sad, look through the testosterone subreddit. I can't even read it anymore... makes me sick to read.

 

[Prospect]

Turns out my Dr called me in not due to the mildly high estrogen or liver levels but he was concerned with my creatinine levels. Normal range is .7-1.3 and I tested 1.5. From the numbers they don’t seem to be high enough for a concern but told me to drink more water. I told him I took a creatine supplement but he told me that wouldn’t affect it. A brief search it looks like creatine indeed does along with protein which I eat a lot of like all of you. Appreciate him being concerned but felt like a waste of my time and money to hear that.

 

[Old]

AST can be stuff other than liver including strenuous work/exercise or heart issues. What is ALT?

High creatine and/or protein intake will raise it blood levels. So will strenuous work/exercise. What are your BUN and eGFR?

 

[Prospect]

They both appear to be at the upper end but over the last few years haven’t really went up much. Thanks for the response