1 Month Into TRT w/ Updated Bloodwork

Pharma / TRT Testosterone Replacement
1

So after spending 9 months agonizing whether I should do TRT, I pulled the trigger on August 2nd with my first injection. For background on my situation see this thread:
https://forums.t-nation.com/t/39-y-o-bloodwork-does-trt-make-sense/255339

So in late July I had my consult with Defy Medical (Dr. Saya). He prescribed me Test Cyp, twice a week, 64mg per injection. Also prescribed me metformin, 500mg twice a day.

In general I feel better. Morning erections have come back. I have more energy. Going better at the gym. Less of that lethargy feeling during the day. The only negatives I have observed is that my balls ache every now and then. And the metformin gives me a little gas.

As you will see in the bloodwork comparison below, my total test has gone from 323 to 689 and my free Test has gone from 5.1 to 13. However, a few things surprised me:

  1. My fasting glucose unchanged at 88 even after nearly 1 month on Metformin ?
  2. Big decline in cortisol - I wonder why?
  3. Iron has plummet. Very odd. Does this normal on TRT? Should I change anything in my diet?
  4. I was shocked that my hemoglobin, red blood cells and hematocrit actually went down during TRT. Isn’t the opposite supposed to happen?

So, here are my questions:

  1. The top end of the reference range for Total Test is 1,100. I want higher than 689. Do you think its crazy for me to ask for a higher dosage? I am currently on 64mg 2x per week. What would you increase the dose to?

  2. Should I increase the dosage of Meformin? My glucose hasn’t budged.

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2

If you go up on dose do increments of 20mg and give yourself enough time to see if it’s right. I’m sure 130mg will put you in the 800 range at least. I didn’t have the positives you’re having at closer to 110mg so that’s a plus for you as it may not take long to get you dialed in.

TRT uses more iron than when not on TRT so that could be it. My hematocrit went from 38 pre-trt to 47 (185mg trt) so yours going down is interesting but since it’s only been about a month it is probably too early to really know how TRT is going to effect you. Your natural levels are probably just shutting off (I noticed the balls sucking up around the 4th or 5th week) and about 3 months in I didn’t notice any weird feeling in my nuts anymore. So maybe it’ll just go away for you on its own as well. Just be sure you are patient before changing shit.