T Nation

2 Months In. First Labs Are Concerning

T Replacement
#1

Hello, just got my first labs (approx. 2 months) after starting TRT and a few numbers are concerning. I’m on a starter dose 100/mg per week split up in two weekly injections (0.25ml each). Just got an appointment with my doctor, but feeling a little concerned because my Estradiol and T are way high, as are my hemoglobin and hematocrit, for what I thought a 100mg/week protocol would do. Any advice is appreciated, new to all this and concerned. thank you!

55 year old
6’4 197lbs

Testosterone Cypionate 200 mg/ml

Labs pre-T (12/2020)
SHBG 52.9
Free T 4.99
Test 341
Estradiol 24 (pg/ml)
Free T3 3.03 (pg/ml)
Free T4 0.94 (ng/dl)

Labs (2/17/2021)
Hemoglobin 18.4 High g/dL (range 13.0-17.7 01)
Hematocrit 53.7 High % (range 37.5-51.0)
Testosterone 1305 ng/dl
Free T 23.9 pg/ml
Estradiol 76.7 pg/ml (range 7.6-42.6)

They did not test T3/T4 on these new labs.

Thank you again.

#2

Chill out. T is good, and E is fine. It will lower itself eventually and if it doesnt there is no harm being done. T goes up so does E. HCT, is no big deal when you start TRT, drink water and dilute your plasma. Next time you test,drink water and watch the number drop. E is not the evil some guys make it out to be. Do not change your dose or add an AI to bring things into range. Docs truly dont understand these things. They go by ranges that have been lowered and lowered over the years. The real question is how do you feel? And did you test at peak or trough?Those numbers are not that concerning.

#3

Theses aren’t the recognized reference ranges for hematocrit, 54% is the top end of the ranges, what you re seeing are lab ranges which vary from lab company to lab company.

Normal ranges for hematocrit for men is 40 to 54%.

#4

Exactly. Thicker blood creates wider passages, which equals more flow and vascularity. So HCT of 53 fasted with no water could equal 48 after a glass of water. This is what I noticed when I tested my HCT levels again after resulting with 53, no water.

#5

I also was experiencing some sensitivity in my nipples, not areola, but the nipple. Went down somewhat after the first month, but still a bit sensitive…

Again, thank you all.

#6

Hi middleages, thank you for the feedback. To be honest, I am not feeling a huge bump overall. I have gained some weight (about 8 lbs - both muscle and some fat). In fact, I was suspecting that my dose was too low and my T would come in slightly higher than before. I did get my labs about 3 days after an injection (that according to instructions from doc). I drink a ton of water in general, but will continue. Again, I appreciate all the insights here, you guys are amazing!

#7

Keep drinking plenty, and what youre seeing is a snapshot fasted with no water. Nipple itchyness and sensitivity is not any kind of gauge. Gyno is defined by a puffy pubescence appearance. Not lumps or sensitivity. What is you SHBG? 56
That’s high! It will continue to lower during TRT. The less SHBG the more Free T. What this means is that your 1300TT is not all being used and its bound. Meaning that you have more T that your body has no access to, so symptom resolution will take some time. I have an SHBG of 16 and my T levels are 1500. So I have more TT and Im using it to build muscle, have good heart health, and my favorite libido and erection quality is great. So stay the course. SHBG needs to come down.

#8

SHBG was not tested in these new labs apparently. Was not on the lab results sheet. I was fasting prior to labs and drinking water up until the time for my draw. My one nipple did increase a bit in size (the nipple only, not areola).

So, you think stay the course, no change in protocol, etc.

Again, I’m not feeling a big bump in energy (not that’s it was in the tank before), and having small increase in strength (nothing to write home about). I though at 1300, I would of felt like a gorilla. Also, my goal has always been before starting to have moderate and healthy levels, while achieving some realistic improvements in the gym, based on diet and consistency.

#9

You listed SHBH but Ive never heard or seen that before, perhaps its a typo SHBG

#10

Yes, typo…sorry

#11

So your SHBG is high. Imagine you had a nice Turbo S but the power was locked away via software. All you can get out of it is180hp, but you boast 600hp. You will eventually keep lowering SHBG overtime and that unlocks the extra ponies.

#12

I guess my question relative to SHBG (the number listed 52.9, was PRE starting T), how do I “flash” my software to open up that additional HP? What is the discriminator to making that number come down? Is it just time for my body to adjust? Additional meds mixed into the protocol?

Thank you again.

#13

Exogenous T will lower it over time. Some use Boron to help lower it sooner than later. Took me about 6 months to notice it went from 23 to 16 so not sure at what rate yours will drop. With this info, Im sure you can find some answers online, or others will chime in.