Advice on Acne and Wacky Levels

[JwE]

Hi All,

Just had some blood work done to check on a few things that I suspected to be off and looking for some advice from you guys. Tried to provide the right level of detail.

Recent Blood Work

Date: 12/12/2019
Testosterone, Free and Total 660
Free Testosterone (Direct) 24.9
Estridol, Sensitive 7.2
DHEA-Sulfate 127.4
DIHYDROTESTOSTERONE 28


Main Concerns/Objectives:

• Want to be stable so I can go on my second Blast Cycle. Any thoughts based on my bloodwork?
• Currently have very bad back acne which started after my first Blast Cycle and want to get rid of that. (Dermatologist has me on 20mg of Accutane, topical retnoid and peroxide wash). Have tried many other options and am very clean. I can Accutane is working but its been several months and I still have alot of acne on my back.
• Estridiol is very low. Have had a hard time determining the correct dose. Even though there is lots of advice here I struggle on coming up with a formula that works for me. I am wondering if the low estrogen is the cause of acne.
• Noticed my Free T is in rang which is strange since Total T seems low. Maybe a non-issue though.

All the details I can think of below...


Backgound:
Have been on TRT for about 2 years due to very low T and everything has been fairly stable. Blood work done every few months. Have always noticed DHEA and DHT to be low. Was on Propecia in the past but stopped that over 6 months ago. Figured this influenced DHT and it did rise but has now returned to low again. Estrogen seems to be pretty sensitive as well.

Currently on .25mg of Anstrozole and 56mg of cypionate every 3 days. I actually reduced from 60mg every 3 days to see if that would help with acne.

Observations:
DHEA-Sulfate is always low: 28, 66, 67, 28
Pregnenolone low when checked 8/2/2019: <10
-- started taking Prenenolone @ 12.5mg thinking it would help and also influence DHEA. DHEA is now at 127.4

Last full labs below for reference

10/22/2019
Testosterone, Free and Total 937
Free Testosterone (Direct) 22.3
Estridol, Sensitive 34.5
SHBG, Serum 24.8
DHEA-Sulfate 66.6
DIHYDROTESTOSTERONE 67

TSH 3.26
Prostate-Specific Ag, Serum(PSA) 0.4
IGF-1

White Blood Count(WBC) 6.9
Red Blood Count(RBC) 5.66
Hemoglobin 17.1
Hemoglobin A1c
Hematocrit 49.4
MCV 87
MCH 30.2
MCHC 34.6
RDW 13.5
Platelets 316
Neutrophils 51
Lymphocytes 28
Monocytes 8
Eosinophils(EOS) 12
Basophils 1
Neutrophils(absolute) 3.5
Lymphs(absolute) 1.9
Monocytes(absolute) 0.6
Eosinophils(EOS)(absolute) 0.9
Basophils(absolute) 0.1
Urea Nitrogen (BUN) 20
BUN/Creatine Ratio 18
Calcium 9.5
Carbon Dioxide, Total 22
Chloride 99
Creatine 1.14
Globulin, Total 2.8
Glucose 92
Potasium 4.2
Protein, Total 7.3
Sodium 138
eGFR If NonAfrican Am. 79
eGFR If African Am. 92
Albumin 4.5
Prolactin 8.95
Albmin/Globulin Ratio (A/G) 1.6
Bilirubin, Total (TBIL) 0.6
Alkaline Phosphatase 75
AST(SGOT) 33
ALT (SGPT) 40
Gamma Glutamyl Transpeptidase(GGT)
Cholesterol, Total 122
Triglycerides 37
HDL Cholesterol 66
VLDL Cholesteral Cal. 7
LDL Cholesterol Calc 49

 

[Mobster]

What does the doc who does the TRT say?

 

[JwE]

In regards to the low E I’m calling them today. It’s never been this low before so it’s a new issue but will report back on what they say.

In regards to acne they have put me on clyndamycin and tamoxifen in the last. clydamycin didn’t help at all and I don’t think it’s something I can take while being on accutane. They also stated to lower the dose or come off all together. I just hate to do that since I feel 100% better compared to the old me.

 

[stevesmi]

i've been doing this a long time and i can't tell you the amount of people that come to me because their doctors fucked them up

1. you should have never been using propecia/fina. if you read my prior posts i have a strict ideology against this drug and docs hand it out like candy without explaining the risks. yes it can have PERMANENT effects that will last years.

2. a proper TRT dose (you are NOT on that) does not require an AI. your doctor is either trying to make more $$$ off of you over prescribing drugs or he is an idiot. either way you need to take control of what you put in your body, not be a robot and do what your doc tells you. as it stands now he is giving you TOO Much test and throwing drugs at the issue. he is putting your heart at risk, your prostate at risk, and yes increasing your chance of cancer as you age

 

[JwE]

Thx Steve.

Agreed on point 1. Unfortunately I started taking Propecia back when I was in my late 20’s and was probably on it for about 10 years before I realized the harm it was causing. I truly believe that is why my system is all jacked up now but can’t go back now. Stopped taking it about a year back and haven’t lost anymore hair. Kicker is, maybe I never need the crap.

On point 2. Any recommendations on getting to the correct dose? I didn’t think my TT was that high and assumed I was on the correct dose and did not question my doctor. Although my FT is high comparison to the range. I like dosing every 3 days since I understand my levels will be more consistent. I’ve seen many reference 140mg a week so I could start there. Yes, I could go to my doctor but honestly would rather figure it out myself. I don’t feel they understand what I actually need here.

 

[stevesmi]

you want your T levels level. somewhere between 500-750 area at most. and with that you won't need an AI

a lot of people make the mistake of running too much for TRT, they don't know that they are opening themselves up to heart issues and prostate issues bigtime. those million cancer cells in your prostate are going to get fueled.

 

[cbbram]

If you're having that many side effects you need to rethink using steroids. SARMS would be a better option.

www.esarms.com

 

[JwE]

Stopped taking it about a year back and haven’t lost anymore hair. Kicker is, maybe I never need the crap. .

Clarification on propecia, I stopped 1 year back but then wondered if going back on it would help reduce acne assuming DHT had spiked. Didn’t help of course and was stupid. Have been fully off for 6 months.

 

[JwE]

Make sense and aligns with my thought of not wanting to be on an AI all the time.

- - - Updated - - -

If you're having that many side effects you need to rethink using steroids. SARMS would be a better option.

www.esarms.com

Definitely an option instead of going on cycle. Not sure I can come off TRT though given how low my testosterone actually is naturally. I have considered trying to do a restart and just see where my levels end up. If not sustainable then add testosterone slowly back in without an AI to see if I can balance.

 

[JwE]

One thought is to drop cyp to .25ml/50mg E3D and phase out the AI. See if I can run like that for a while. Ends up at about 116mg a week. Just need to get myself right first. To many things going on at once.

 

[RickRock]

Test level looks fine but you are taking too much ai. Drop that shit

 

[JwE]

Test level looks fine but you are taking too much ai. Drop that shit

Thanks bro. I've been trying to educate today on getting rid of Arimidex altogether. I have had my suspicions that Arimidex caused alot of issues for me but the doc has always reassured me that I need to be on it.

Any advice on coming off? Should I just drop completely? Or should i stager.

 

[JwE]

Test level looks fine but you are taking too much ai. Drop that shit

Thanks bro. I've been trying to educate today on getting rid of Arimidex altogether. I have had my suspicions that Arimidex caused alot of issues for me but the doc has always reassured me that I need to be on it.

Any advice on coming off? Should I just drop completely? Or should i stager.

 

[Mobster]

Lower the dose vs drop it full stop.

 

[harrywho]

Are you seeing a specialist? U should change docs...

In Australia standard trt protocol is 1000mg testosterone undeconate injection once every 10 weeks... A very long acting test ester.
Some specialists will even prescribe hcg to go along with that, and extra hcg can increase estrogen.

But as stated trt is supposed to be Ur levels in the natty reference range where no ai is required.

Injecting e3d like that sounds horrible as trt for life...
Just do it once a week. Or better yet, change damn doctors and get on test undeconate...

Propecia is yeh a terrible idea, and can leave u with low dht for life, dht is what makes u want to fuk.
U could use proviron or masteron, but then that's another can of worms because they lower estrogen.

My advice, ur doctor is hopeless... This has been going on for 2 years, now u have to take accutane a horrible drug.... Take control and see a better doctor.

1 injection every 10 weeks... Then they will monitor blood levels... And get u dialed in properly, whether that's slightly increasing that injection frequency, or adding in hcg to increase estrogen ect.
A specialist endocrinologist... Don't play this game another day, get an appointment.

 

[brandontx]

This didn't work for me. I get peak of 700 and trough of 500 which is a decent Natty range slowly creeps my estrogen sky high. For no ai I would probably have a 500/300 range. That seems low.

 

[JwE]

Are you seeing a specialist? U should change docs...

In Australia standard trt protocol is 1000mg testosterone undeconate injection once every 10 weeks... A very long acting test ester.
Some specialists will even prescribe hcg to go along with that, and extra hcg can increase estrogen.

But as stated trt is supposed to be Ur levels in the natty reference range where no ai is required.

Injecting e3d like that sounds horrible as trt for life...
Just do it once a week. Or better yet, change damn doctors and get on test undeconate...

Propecia is yeh a terrible idea, and can leave u with low dht for life, dht is what makes u want to fuk.
U could use proviron or masteron, but then that's another can of worms because they lower estrogen.

My advice, ur doctor is hopeless... This has been going on for 2 years, now u have to take accutane a horrible drug.... Take control and see a better doctor.

1 injection every 10 weeks... Then they will monitor blood levels... And get u dialed in properly, whether that's slightly increasing that injection frequency, or adding in hcg to increase estrogen ect.
A specialist endocrinologist... Don't play this game another day, get an appointment.

Thanks for taking the time here...Interesting information. Definitely looking for a better doctor someone who actually cares about my well being versus just being another number. In the meantime I’m going to lower my AI a bit and test again in a few weeks. Hoping to get to no AI if possible. Injecting every three days is a bit bothersome but the idea was to have stable bloods. Obviously not the case here. I’ll worry about DHT later and just focus on estrogen at the moment.

 

[JwE]

This didn't work for me. I get peak of 700 and trough of 500 which is a decent Natty range slowly creeps my estrogen sky high. For no ai I would probably have a 500/300 range. That seems low.

What didn’t work for you? No AI? What was your estradiol with no AI?

 

[RickRock]

Thanks bro. I've been trying to educate today on getting rid of Arimidex altogether. I have had my suspicions that Arimidex caused alot of issues for me but the doc has always reassured me that I need to be on it.

Any advice on coming off? Should I just drop completely? Or should i stager.

I'd half your dosage to start amd see how that goes, but honestly you probably dont need it. Your previous numbers where your estradiol was in the 30s is ideal

 

[harrywho]

Thanks for taking the time here...Interesting information. Definitely looking for a better doctor someone who actually cares about my well being versus just being another number. In the meantime I’m going to lower my AI a bit and test again in a few weeks. Hoping to get to no AI if possible. Injecting every three days is a bit bothersome but the idea was to have stable bloods. Obviously not the case here. I’ll worry about DHT later and just focus on estrogen at the moment.

You'll have to do somthing drastic or you'll keep going around the merry go round...

Also once week injection should be quite consistent...
Some trt doctors put patients on 250 test e, or sustanon every 3 weeks... Now that's stupid.

I inject 250 test e once per week.

 

[JwE]

Just a quick update. Lowered my AI to .10mg twice each week and already see a huge improvement in acne. I’m actually planning to remove it all together and then get bloodwork to see what’s going on. Haven’t experienced any negative side effects yet either and keeping a close eye on that.

Doctor advised I lower my dose to .25mg twice a week but I am going further to see if it is even needed. In retrospect I should have started TRT with no AI to see if it was needed.

Will continue to make small tweaks to the overall program to see how far down I can go to get a solid baseline.

 

[gearhead]

Just a quick update. Lowered my AI to .10mg twice each week and already see a huge improvement in acne. I’m actually planning to remove it all together and then get bloodwork to see what’s going on. Haven’t experienced any negative side effects yet either and keeping a close eye on that.

Doctor advised I lower my dose to .25mg twice a week but I am going further to see if it is even needed. In retrospect I should have started TRT with no AI to see if it was needed.

Will continue to make small tweaks to the overall program to see how far down I can go to get a solid baseline.

bro .10 of arimidex or aromsin?

 

[JwE]

bro .10 of arimidex or aromsin?

Arimidex. Original dose was .25 Arimidex each injection. Which is E3D.

 

[Mobster]

Make sure you're not replacing acne for gyno issues.

 

[stevesmi]

acne is triggered by hormonal fluctuations so sounds like you found a sweet spot for AI

 

[JwE]

Make sure you're not replacing acne for gyno issues.

Thx Mobster. Yes, that is at the forefront of my mind. I’ll take acne over man boobs any day! I’m hoping to balance this out overtime and will lower my TRT dose if that makes sense as well. Next labs should give a new picture.

 

[JwE]

acne is triggered by hormonal fluctuations so sounds like you found a sweet spot for AI

I hope that’s the case!

Although I have aspirations to blast cycle it is more important to get balanced. That is why I started this journey to begin with. I used to have natural low ~200 levels of TT and low single digit FT levels ~8 so I know I need to get focused and get baselined.

Really appreciate everyone’s support.

 

[harrywho]

Adex is no good for twice weekly dosing. It's only good for eod dosing.

This is because the way adex works compared to aromasin.
Adex will lower it, but if u dnt take doses eod or at worst e3d, the estrogen that was lowered rebounds back up and will cause fluctuations.

Aromasin u can take tiny doses once or twice a week and it will lower it, and the estrogen will slowly rise back up, but not rebound back.
If that makes sense.

 

[JwE]

Adex is no good for twice weekly dosing. It's only good for eod dosing.


This is because the way adex works compared to aromasin.
Adex will lower it, but if u dnt take doses eod or at worst e3d, the estrogen that was lowered rebounds back up and will cause fluctuations.

Aromasin u can take tiny doses once or twice a week and it will lower it, and the estrogen will slowly rise back up, but not rebound back.
If that makes sense.

Makes sense. So the way I see it. I was aiming for .20mg per week. If I divide that by 7 days and multiple that by 3 days I get .857mg. So I’ll just take .8mg every injection which is e3d. I have liquid form Adex that I make from the 1mg pill. It works well. I can then get labs to see where I’m at.

Again, aiming to get off entirely.

 

[brandontx]

What didn’t work for you? No AI? What was your estradiol with no AI?

Yes, taking no ai didn't seem to work for me. My test would be 700 the day after the shot and would probably drop to 500 a few days after that. My estrogen went from 20 to 45 and I began having side effects.

 

[JwE]

Yes, taking no ai didn't seem to work for me. My test would be 700 the day after the shot and would probably drop to 500 a few days after that. My estrogen went from 20 to 45 and I began having side effects.

Gotcha. Thanks for the follow-up. Well I will know soon how it works out in my situation.