T Nation

35, 3 Months on TRT, Need Recommendations on Results


#1

Hello, need some advice.

I started T Replacement therapy about 3 month ago, working with an endo who seems like they are not as knowledgeable as I would like in St Louis.

I have some test results and discussing options with my doctor but need some help making sense of it all.

I first started my first 30 days with Test @ 1/2 of a 200MG/ML bottle every 2 weeks (100 MG) did see any results and still had low test results. After the first 30 days doctor upped my dose to 1 full bottom (200MG) every 2 weeks, and I am feeling great and the results show it too. Now I’m being told my free testosterone is too high and wants to lower my dosage, also my SHBG is low, thinking due to me being overweight.

Wanted to see if I can get some advice, I have my test results below, both at Labcorp:

30 days after my 100MG per 2 week dosage:

Test; 181.4 (range 348-1197 ng/dL)
Test Free: 7.6 (5-21 ng/dL)
Test Free %: 4.19 (1.5-4.20%)
SHBG: 13.4 (16.5-55.9)

2 weeks after uping my dosage to 200MG per every 2 weeks:
**Blood work was taken 4 days after my injection

Test: 887.8 (range 348-1197 ng/dL)
Test Free: 40.93 (5-21 ng/dL)
Test Free %: 4.61 (1.5-4.20%)
SHBG: 10.1 (16.5-55.9)

As you can see the increase dosage really helped, I feel great! but now I am being told by my doctor he is concerned my free testosterone is too high, my SHBG is too low, and we need to decrease my dosage.

Looking over the data I’m wondering:

  1. is this due to the numbers being taken only 4 days after I injected? and the rest of my cycle, like let’s day day 14 of 14 is much lower?
  2. even though my free test has increased the percentage has not?
  3. my low SHBG has always been there? due to my weight?

is the right course of action to lower my dosage?

should I seek a 2nd doctor opinion? if so does anyone know of a good doctor in the St. Louis area?

is have a high amount of free or a high total test making me feel better? (my free test has always been in the “range” though on the low side)

any advice or comments will help, thanks guys


#2

Anyone can take a stab? Sorry if these results are not extensive per the recommendation, my doctor does not seem to know as much on this topic as I would like


#3

Hi there. Your dosing schedule is skewing your labs. 200 mg every two weeks is not an appropriate TRT regiment - although that’s what they are preaching in med school.

You need to split the dose into two weekly injections every 3.5 days apart (50 mg per). Your T levels will normalize and you won’t have abnormally high Free T. Your doctor should realize that 4 days after a 200 mg dose your free t level will be through the roof. No need to change the dose - just the schedule.


#4

Your doctor has no idea what he is doing, he is fumbling around. You need to start learning in self-defense. You cannot be passive with male hormone care!

Self-inject T 50mg twice a week, subq with #29 1/2" 0.5ml insulin syringe, pinch up skin fold over upper leg, inject into fold with needle parallel to muscles below.

Do labs always half-way between injections, time of office visit can be wrong.

When you inject every two weeks, T levels get very high then fall and can be very low. The biggest determinator of your lab results is lab timing and such lab results are useless.

On TRT you need these labs:
TT
FT
E2
PSA if >40
CBC
hematocrit
AST/ALT

What were your pre-TRT labs:
FSH?
LH?
prolactin?
E2?

Please read all of the following material.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.