T Nation

39 TRT 2 Month Checkup - Questions...


#1

First I would like to say thanks to all for the wealth of information on the site, it has been very helpful and informative. I mainly wanted to share my experience so far and to take in any suggestions/comments that you all may have.

Below is 1 of 3 tests that I had completed over a 3 mos period prior to starting TRT. The last test was the most in depth completed of the 3 tests, all had low or borderline low T results of 189,330,274. Further below is the most recent after 2 mos of treatment. My current protocol was 200mg Enanthate 1x wk w/ 1mg Anastrozole combined into the injection (this was suppposed to be a slow release, but after my last results I am not sure it is working as intended, see latest test results below, Estradiol was 68.5 pg/ml), I also take 350iu’s of HCG 2x per week, 2 days before and after my T injection.

After the latest labs we are reducing my dose and splitting it to 2x per week, also switching to pill form of anastrozole 3x per week (not sure the dosage yet). Any suggestions on getting my Estrogen under control? After two months I definitely feel better, not really experiencing any estrogen sides other than some pretty serious joint pain occasionally but it only seems to last a few days and then subsides.

My T levels were still pretty high even on day 6 before my next injection. I also donated blood today due to my increased hematocrit. Are there any timelines on how long it takes to get everything dialed in or is it just a constant battle to keep everything in the proper range? Thanks for any input or suggestions.

CMP14+LP+TP+TSH+CBC/D/Plt+P…
Glucose, Serum 95 mg/dL 65 - 99 01
Hemoglobin A1c 5.4 % 4.8 - 5.6 01
Increased risk for diabetes: 5.7 - 6.4
Diabetes: >6.4
Glycemic control for adults with diabetes: <7.0
BUN 14 mg/dL 6 - 20 01
Creatinine, Serum 1.07 mg/dL 0.76 - 1.27 01
eGFR If NonAfricn Am 88 mL/min/1.73 >59
eGFR If Africn Am 101 mL/min/1.73 >59
BUN/Creatinine Ratio 13 8 - 19
Sodium, Serum 139 mmol/L 134 - 144 01
Potassium, Serum 4.4 mmol/L 3.5 - 5.2 01
Chloride, Serum 102 mmol/L 97 - 108 01
Carbon Dioxide, Total 23 mmol/L 18 - 29 01
Calcium, Serum 9.2 mg/dL 8.7 - 10.2 01
Protein, Total, Serum 6.8 g/dL 6.0 - 8.5 01
Albumin, Serum 4.4 g/dL 3.5 - 5.5 01
Globulin, Total 2.4 g/dL 1.5 - 4.5
A/G Ratio 1.8 1.1 - 2.5
Bilirubin, Total 0.5 mg/dL 0.0 - 1.2 01
Alkaline Phosphatase, S 66 IU/L 39 - 117 01
AST (SGOT) 25 IU/L 0 - 40 01
ALT (SGPT) 23 IU/L 0 - 44 01
Vitamin B12 680 pg/mL 211 - 946 01
Vitamin D, 25-Hydroxy 33.6 ng/mL 30.0 - 100.0 01
Cholesterol, Total 189 mg/dL 100 - 199 01
Triglycerides 125 mg/dL 0 - 149 01
HDL Cholesterol 43 mg/dL >39 01
VLDL Cholesterol Cal 25 mg/dL 5 - 40
LDL Cholesterol Calc 121 High mg/dL 0 - 99
LDL/HDL Ratio 2.8 ratio units 0.0 - 3.6
TSH 2.010 uIU/mL 0.450 - 4.500 01
Thyroxine (T4) 7.4 ug/dL 4.5 - 12.0 01
T3 Uptake 29 % 24 - 39 01
Free Thyroxine Index 2.1 1.2 - 4.9
Prostate Specific Ag, Serum 0.4 ng/mL 0.0 - 4.0 01
Insulin-Like Growth Factor I 141 ng/mL 83 - 233 02
Testosterone, Serum 274 Low ng/dL 348 - 1197 01
Free Testosterone(Direct) 7.5 Low pg/mL 8.7 - 25.1 02
LH 7.4 mIU/mL 1.7 - 8.6 01
FSH 2.2 mIU/mL 1.5 - 12.4 01
Sex Horm Binding Glob, Serum 24.6 nmol/L 16.5 - 55.9 01
Estradiol 25.4 pg/mL 7.6 - 42.6 01
Roche ECLIA methodology
. 01
CBC, Platelet Ct, and Diff 01
WBC 5.5 x10E3/uL 3.4 - 10.8 01
RBC 5.23 x10E6/uL 4.14 - 5.80 01
Hemoglobin 15.4 g/dL 12.6 - 17.7 01
Hematocrit 45.4 % 37.5 - 51.0 01
MCV 87 fL 79 - 97 01
MCH 29.4 pg 26.6 - 33.0 01
MCHC 33.9 g/dL 31.5 - 35.7 01
RDW 13.0 % 12.3 - 15.4 01
Platelets 261 x10E3/uL 150 - 379 01
Neutrophils 63 % 01
Lymphs 28 % 01
Monocytes 8 % 01
Eos 1 % 01
Basos 0 % 01
Neutrophils (Absolute) 3.4 x10E3/uL 1.4 - 7.0 01
Lymphs (Absolute) 1.6 x10E3/uL 0.7 - 3.1 01
Monocytes(Absolute) 0.4 x10E3/uL 0.1 - 0.9 01
Eos (Absolute) 0.1 x10E3/uL 0.0 - 0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 01
Immature Granulocytes 0 % 01
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1 01
Thyroxine (T4) Free, Direct, S
T4,Free(Direct) 1.23 ng/dL 0.82 - 1.77 01
Triiodothyronine,Free,Serum 3.4 pg/mL 2.0 - 4.4 01

Fast forward two mos., my latest results below…

CBC With Differential/Platelet
WBC 8.7 x10E3/uL 3.4 - 10.8 01
RBC 5.79 x10E6/uL 4.14 - 5.80 01
Hemoglobin 16.7 g/dL 12.6 - 17.7 01
Hematocrit 50.2 % 37.5 - 51.0 01
MCV 87 fL 79 - 97 01
MCH 28.8 pg 26.6 - 33.0 01
MCHC 33.3 g/dL 31.5 - 35.7 01
RDW 12.7 % 12.3 - 15.4 01
Platelets 271 x10E3/uL 150 - 379 01
Neutrophils 69 % 01
Lymphs 21 % 01
Monocytes 6 % 01
Eos 3 % 01
Basos 1 % 01
Neutrophils (Absolute) 6.0 x10E3/uL 1.4 - 7.0 01
Lymphs (Absolute) 1.9 x10E3/uL 0.7 - 3.1 01
Monocytes(Absolute) 0.5 x10E3/uL 0.1 - 0.9 01
Eos (Absolute) 0.3 x10E3/uL 0.0 - 0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 01
Immature Granulocytes 0 % 01
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1 01
Testosterone,Free and Total
Testosterone, Serum 1416 High ng/dL 348 - 1197 01
Comment:
Adult male reference interval is based on a population of lean males
up to 40 years old.
Free Testosterone(Direct) >50.0 High pg/mL 8.7 - 25.1 02
Estradiol 68.5 High pg/mL 7.6 - 42.6 01
Roche ECLIA methodology

Thanks again everyone.


#2

Please read these stickies then respond:

  • advice for new guys
  • things that damage your hormones
  • protocol for injections

Your first TRT was stupid. Caused high hematocrit.

Hematocrit getting high. Keep testing that. First TRT may have cause a problem and this may resolve.

State exactly what your protocol is. In mg’s and iu’s/

Suggested protocol:
50mg T twice a week, 100mg/week
0.5mg anastrozole at time of injection
250iu hCG EOD

or

T 100mg/week in EOD divided doses
anastrozole 1mg/week in EOD divided doses
250iu hCG EOD

The above may allow hematocrit to improve.

Estradiol 68.5 is very high. Cannot suggest new anastrozole dose, need more specifics from you.

Thyroxine (T4) Free, Direct, S
T4,Free(Direct) 1.23 ng/dL 0.82 - 1.77 01
Triiodothyronine,Free,Serum 3.4 pg/mL 2.0 - 4.4 01
TSH 2.010 uIU/mL 0.450 - 4.500 01
Thyroxine (T4) 7.4 ug/dL 4.5 - 12.0 01
T3 Uptake 29 % 24 - 39 01
Free Thyroxine Index 2.1 1.2 - 4.9

TSH should be closer to 1.0
TSH can be elevated by not using iodized salt.
Your body temperatures may be low, check as per the thyroid basics sticky.
fT3 should deliver normal body temperatures. If temps are low, suspect that rT3 is blocking fT3.
rT3 could raise TSH if iodine intake is adequate

LH was unusually high and relative to FSH. Test LH/FSH again [once] while on TRT. If LH and FSH are not both near zero, there is a problem.
Were your testes physically examined?

Your vit-D25 is lowish. Find 5,000 vit-D3, tiny oil based capsules.