T Nation

2 Months on TRT, First Lab Results

Hello, 32 year old here. Started TRT 12/21/18 after being diagnosed with low T (161 ng/dl). Doctor started me on 200mg test cyp per week, administered every 3.5 days. After a hiccup in late December missing an injection by a day, I decided to change to 85mg every 3 days (for consistency), which equals 198/week averaged out. Injected SubQ with 5/8" syringe E3D in evenings, taken with 85mg Anastrazole Liquid also E3D.

Prior blood work results:
Testosterone, Total: 161 ng/dl
Estradiol, sensitive: 22 pg/mL
SHBG: 25
Hemoglobin: 14.8
Hematocrit: 44.5

Bloodwork 2/26/2019 results: TRT/Anastrazole dosed every 3 days at 11pm (72 hours between injections). Blood work was drawn 34 hours after last injection. Was this too soon?
Testosterone, Total: 1650 ng/dl
Estradiol, sensitive: 37 pg/mL
SHBG: 32
Hemoglobin: 16.6
Hematocrit: 49.5

Based on these results, I need to reduce my T dosage significantly. This should bring down the T which is too high and also the E2, which is also too high. SHBG at 32, I dont know what this means. Whether I should change to weekly injections or not. Sex drive is fine, upgraded from pre-TRT but not really a transformation.

I think the H/H is okay. However, I am also very concerned with the health of my thyroid. I have started supplementing with iodized salt in the past 6 weeks. As far as symptoms, I have noticed alot of dry skin and overall extreme tiredness. What should I test to see how my thyroid is behaving?

If anyone has any experience and can help shine some light on my blood work or lower thyroid I would really appreciate it! Looking forward to dialing in the dosing so everything works out. I have been lurking on this site for a while and learning alot.

E2 is not too high. Just go by how you feel, not your numbers. They don’t matter.

Normally we see SHBG decrease on TRT, sometime we see an increase probably do to insulin resistance which TRT can improve within days, being overweight can also suppress SHBG. Your estrogen becomes high when symptoms are experience, so don’t overly focus on labs.

High estrogen can make you fatigued, sleepy, lazy, unmotivated, irritable. I would expect to see estrogen even higher on once weekly injections. You just need to decrease dosage, once weekly is known to increase hematocrit more than a twice weekly protocol. These really high levels could be causing your thyroid to lag behind, suggest a thyroid panel checking Free T3, Free T4, Reverse T3 and antibodies.

Two months into TRT is still very early and major changes take 6-12 months gradually improving for years. TRT doesn’t act quickly like party drugs, hormones must repair tissue and that takes time.

See if you can get rid of the AI completely.

You know what the top of TRT looks and feels like now you need to find the bottom so in time you will know what works best for you. I would try 100mg/wk and no AI do a mini blood test in 6 weeks and see what that looks and feels like.
These are the normal steps for getting dialed in. It will take time.
Good luck

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Thyroid worked wonders with me. Just get the thyroid panel at discounted labs. Make sure you check free t3. T4 and all that comes with it. Thyroid can cause chronic fatigue and you won’t feel any benefit from trt until thyroid is optimal. I did trt for 3 months and only had increase libido. I felt better the day I took my first thyroid t4/t3 dose. I feel much better than I did before and during the 3 months of trt. Still more room to improve but I can’t complain.