T Nation

2 Months on TRT, Unexpected Results?

Hi,

Im 40 and started TRT 2 months ago and I have been put on Test Cyp at 100mg E7D Sub-Q.

Feelings wise honestly I can’t say I feel any difference now than before starting TRT other than I am more tired, I can’t really say I have noticed any gains in the gym either, so all my low t symptoms are still there.

I am 5”10 180lb and have gained 13lb since starting TRT 8 weeks ago which was a shock, it looks to be fat and probably water retention as my daily calories havent changed for over a year or more but I am currently trying to lose that excess fat.

I honestly didn’t expect my SHBG and e2 to drop since starting, I would have thought they would have gone up given the extra T in the system… but I guess injecting E7D is creating a trough that is too low?

These are my pre TRT labs I used as a baseline before starting.

Red Blood Cells
Haemoglobin 150 g/L (Range: 130 - 170)
Haematocrit 0.440 L/L (Range: 0.38 - 0.5)
Red Cell Count 4.73 x10^12/L (Range: 4.4 - 5.8)
MCV 93 fl (Range: 81 - 98)
MCH 31.7 pg (Range: 27 - 33)
MCHC 341 g/L (Range: 300 - 350)
RDW 12.5 % (Range: 11.5 - 14.4)
White Blood Cells
White Cell Count 8.4 x10^9/L (Range: 3 - 10)
Neutrophils 4.64 x10^9/L (Range: 2 - 7.5)
Lymphocytes 2.85 x10^9/L (Range: 1.2 - 3.65)
Monocytes 0.55 x10^9/L (Range: 0.2 - 1)
Eosinophils 0.27 x10^9/L (Range: 0 - 0.4)
Basophils 0.07 x10^9/L (Range: 0 - 0.1)
Clotting Status
Platelet Count 271 x10^9/L (Range: 150 - 400)
MPV 9.6 fl (Range: 7 - 13)
Kidney health
Urea 7 mmol/L (Range: 2.5 - 7.8)
Creatinine 87 umol/L (Range: 59 - 104)
eGFR 88.73 ml/min/1.73m2 (Range: ? 60)
Liver health
ALP 83 IU/L (Range: < 130)
ALT 20.2 IU/L (Range: < 50)
GGT 21 IU/L (Range: 10 - 71)
Proteins
Total Protein 76.5 g/L (Range: 60 - 80)
Albumin 45.1 g/L (Range: 35 - 50)
Globulin 31.4 g/L (Range: 19 - 35)
SHBG 37 nmol/L (Range: 18.3 - 54.1)
Diabetes
HbA1c 33.12 mmol/mol (Range: 20 - 42)
Cholesterol Status
Total Cholesterol 4.92 mmol/L (Range: 0 - 5)
LDL Cholesterol 2.55 mmol/L (Range: < 3)
Non HDL Cholesterol 2.89 mmol/L (Range: < 4)
HDL Cholesterol 2.03 mmol/L (Range: ? 1)
Total Cholesterol : HDL 2.42 ratio (Range: < 4)
Triglycerides 0.74 mmol/L (Range: < 1.7)
Muscle health
Creatine Kinase 144 IU/L (Range: 39 - 308)
Iron Status
Ferritin 156 ug/L (Range: 30 - 400)
Thyroid Hormones
TSH X 4.44 mIU/L (Range: 0.27 - 4.2)
Free T3 4.54 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 17.400 pmol/L (Range: 12 - 22)
Hormones
Hormone Phase Men Phase
FSH 6.23 IU/L (Range: 1.5 - 12.4)
LH 6.42 IU/L (Range: 1.7 - 8.6)
Oestradiol 90.3 pmol/L (Range: 41 - 159)
Testosterone 8.5 nmol/L (Range: 8.64 - 29)
Free Testosterone - Calc. 0.197 nmol/L (Range: 0.2 - 0.62)
Prolactin 227 mU/L (Range: 86 - 324)
Prostate
PSA - Total 0.942 ug/L (Range: < 2)
Other
Sodium 140.7 mmol/L (Range: 133 - 146)

After spotting my TSH I had a follow up test with my Dr that showed 2.6 a week ago, this matches some old tests I had from 2006 where it was 2.4. I also intermittently supplement with iodine drops, although they are 2mg per drop I use half a drop 3 or 4 times a week.

These are my labs 2 months on TRT.

Proteins
Albumin 45.3 g/L (Range: 35 - 50)
SHBG 20.4 nmol/L (Range: 18.3 - 54.1)
Hormones
FSH X <0.3 IU/L (Range: 1.5 - 12.4)
LH X <0.3 IU/L (Range: 1.7 - 8.6)
Oestradiol 68 pmol/L (Range: 41 - 159)
Testosterone 16.1 nmol/L (Range: 8.64 - 29)
Free Testosterone - Calc. 0.414 nmol/L (Range: 0.2 - 0.62)
Free Androgen Index 78.92 Ratio (Range: 24 - 104)
Prolactin X 524 mU/L (Range: 86 - 324)
Adrenal Hormones
DHEA Sulphate 7.420 umol/L (Range: 2.41 - 11.6)

I am also concerned about my prolactin as this may be the cause for the weight gain since starting, plus i don’t want leaky nipples… but from reading other posts this could be a tumour or other medication or just feelings of love/closeness before the bloodtest, but given my levels were fine pre TRT and I am not on any other medication other than multivitamins I will see how it is again in 6 weeks and speak to the Dr if needed.

One last thing, I don’t know if this would impact absorbing the testosterone but since week 4 onwards I get a red rash and lump after injections, but it goes away after a few days. I believe this is an allergy to the oil?

Thanks in advance.

SHBG is low, TRT can lower SHBG. Your hormone levels are likely swinging on weekly injections, you need at least EOD dosing for TRT to work. Your Total T levels are still low and need to be at least 600 or Free T high normal.

The carrier oil may be causing problems, T-cyp comes in cottonseed and grapeseed oils, enanathe comes in sesame seed oil.

Supplementing iodine has rendered TSH for diagnostic purposes useless and is why it’s elevated. You need to retest thyroid after months of stopping iodine, suspect a problem with high Free T4 in relation to Free T3, this is why you should test Reverse T3 next time around.

TSH <2.5 is usually good but not always, closer to 1.0 is normal and 95% of the population is <1.5. Prolactin is too high, pituitary tumours can cause high prolactin, you should have had an MRI. I’m not seeing any cortisol testing. Iron status is great.

Are you using alcohol wipes and allowing it to dry before injecting?

Thanks for the reply, appreciate the advice.

I spoke to the Dr who was ok with changing to E3.5D at 75mg and seeing how it goes, and also possibly swapping to Test E down the line if needed due to the rash I am getting.

I also asked about the oil and its grapeseed.

Do you think Test E would suit a twice weekly protocol better than Test Cyp given the slightly shorter half life of E?

Regarding prolactin I will see how that is in another 6-8 weeks and if its still high then we will see what we can do, but given it was normal before starting TRT 2 months ago something TRT related has caused it wouldn’t you think? Can TRT cause a tumour to grow in 2 months?

Cortisol has been tested a month ago so wasn’t on this latest test, it was 293 nmol/l with a range of 138-635, this was a 9am test.

I am using alcohol wipes before injecting and I didn’t let it dry, but I will test that on the next injection to see if it makes a difference.

Thanks

These esters are very close, the half life only differs by a couple of days, these esters can be dosed just about anyway you prefer and is dose dependent, if levels are low add more T. It is known that aromatisation of exogenous testosterone and estrogen stimulated prolactin release.

I am not aware that TRT can cause tumor growth, only that it can help trigger prolactin release if the tumor is present. You will likely need to manage prolactin while on TRT.

Cabergoline is used for those with high prolactin. We really need to see what cortisol is over the entire day, I have seen cortisol levels drop midday or later in the day causing problems.

Try IM.

It is still really early. Remember we are not doing cycle dosages so it takes longer.