T Nation

6 Months on TRT, Blood Labs

My description:
I’m thin, around 150lbs, and about 6’1". I’m paralyzed (at 18) so I get moderate exercise with some heavy lifting with my upper body weekly. I had no problems getting erections before the age of 30.

Pre TRT Labs
Total T : 301 264-916
Free T : 12.2 8.7-25.1
Prolactin : 9.6 4.0-15.2
E2 : 25.1 7.6-42.6
SHBG : 15.1 16.5-55.9
Symptoms: Low (NO) Libido, ED, tiredness
Suggestion: 100mg 1Xweek cypionate

6 months on TRT (day before injection)
Total T : 189 264-916
Free T : 4.9 8.7-25.1
Prolactin : 6.5 4.0-15.2
E2 : 22.4 7.6-42.6
SHBG : 13.7 16.5-55.9
Symptoms: (No change) Low (NO) Libido, ED, tiredness
Suggestion: 1.25ml 1Xweek (What is that in mg?)

He suggested I do my labs a couple of days after my injection next time which makes sense, but I haven’t had a bit of change since starting TRT. I have in the last week started an EOD regimen to see if anything changes. I also started more cardio exercise.

I would do 12mg daily injections if I were you, your SHBG is really low.

That is incredible. Yes, it does make sense if the object is to see your levels at a decent range so everyone can feel good about the number. Meanwhile, you are very low towards the end of the week and, above all, “haven’t had a bit of change since starting TRT”.

If it is 200mg/mL, 250mg. Before more than doubling your dose, I would go with 75mg twice a week.

Ok. I’ve been on 100mg per week for the last 6 months, but the new script reads:

Cyp 200mg/ml vial
1.25 ml IM Q1WK

The dosing is confusing me a bit to be honest. I could use a good explanation of dosages. In the office, he (urologist) talked about going up to 150 mg and I suggested testing my thyroid. I also suggested seeing an endocrinologist if this new dose doesn’t help.

200mg per mL, so 1 mL would contain 200mg of the testosterone cypionate

0.25 mL would contain 1/4 of the above, 50 mg

1.25 mL would be 250mg, a pretty high weekly dose for TRT

150mg would be 0.75 mL

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Thanks, man. That really clarified things. So he did jump me from 100mg to 250mg. That does seem a bit excessive.

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Looks like he did.

I’ve been doing the daily injections for almost a month and my day starts out pretty good injecting around 21mg (150/week) at 6:30am, but by around 4pm I’m feeling bloated and tired. My next round of labs are in 2 months. Does this sound like an estrogen spike? I feel bloated, but I am distended also. Could low SHBG be the culprit even doing daily injections? My doctor wanted me to go up to 250mg/week, but I’m nervous about doing so.

That’s too much for a daily protocol.

I have to clarify. I just started the 21mg dose about a week ago because I hadn’t felt any change after almost 3 weeks at 14mg (100mg/week). So my history is 6 months 100mg 1xweek to 3 weeks 14mg daily to 1 week 21mg daily. I didn’t feel as bloated at 14mg daily, but there also was no change in symptoms. We are checking thyroid in 2 months.

CBC after 6 months

WBC 6.30 4.6-10.2
RBC 4.50 4.69-6.13
Hemoglobin 14.1 14.1-18.1
Hematocrit 42.1 43.5-53.7
MVC 93.6 80-97
MCH 32 27-31.2
MCHC 34.2 31.8-35.4
RDW 12 11.5-14.8

You’re not supposed to feel big changes 3 weeks into a protocol, your supposed to feel tired and bloated. You need to spend at least 6 months with your Free T high normal 24 hours a day, 7 days a week.

It takes 6 weeks for the half lives to build in your system, sometimes 8 weeks to start feeling good. You must get Free T to high normal and keep it there to see benefits, so far your labs are all low.

You’ll need a thyroid panel checking TSH, Free T3, Reverse T3 and antibodies.

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can you give us all your opinion on where we need to be with the Thyroid levels …

There normal thyroid labs and optimal thyroid labs, young men with no health problems see TSH <2.5 closer to 1.0, Free T3 high normal, Reverse T3 <15 ng/dL and ideally you want antibodies at zero.

My TSH has always been <1.0, usually between .5-.8.

apprecaiey the info and this is exactly why i asked … i have read so many guys say/post “doctor says Test is ‘normal’ so trt is a no go” and while the numbers are in range there is a problem … i have been in this boat as well. But i havent heard this as much in regards to thyroid levels and “in range” vs “optimal” … i want thing running top notch, including thyroid

The can’t get the negative flawed prostate cancer and cardiovascular risk studies out of the back of the mind, so they tend to not prescribe TRT. When the FDA put out with the cardiovascular risk studies out in the media, prescriptions for TRT made a dramatic drop and men who where on TRT were taken off.

It had the intended effect big pharma and the doctors was looking for, the one treatment that prevents and treats disease will continue to be a thorn in big pharma side.

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You are seeing an E2 spike. Daily injections are unlikely to do anything magical for you ,your initial protocol was probably fine ,just too low of a dose. I boat almost within hours of a dose without an AI. It takes months for that to calm down, if it ever does. You are changing too many things at once. Change your dose OR your injection schedule, both at once was a mistake.
What is your injury location? My brother is C4-5 at 18 years of age.

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Your focus is skewed. Focus on free t. Your levels are so low on the free t . Estrogen might not be an issue.

Get into the free t 20s and adjust dose accordingly. Change frequency if you have real e2 sides and backed up by labs. I’m around 40-50 and fine.

I take supplements to help optimize liver function. This helps with estrogen. You should add supplements to support a healthy trt.

I take vitamin d, b6, boron, magnesium, Preg, dhea. I take zinc every couple days.

If your only taking T and expecting a miracle your mistaken. Fitness, diet, optimize all body functions or at least make sure they are performing well. All of this helps your body manage estrogen and labido also improves. I hope I’m making sense . We just want to help.

I would add less stress and anxiety also helps a ton. So meditate or find a hobby to distract you through the next couple months. Pick up reading. Ping pong. Anything but idle thoughts.

It took me 3 months to start feeling better. Only when I optimized my thyroid and other hormones did it all come together. I thought I had estrogen problems week 3 and had sides. Overtime they dissipated as my body got used to the hormonal influx and levels balanced out. Now it’s all coming together. I feel fantastic.

You might not need thyroid, but you had better check. Without a strong thyroid TRT is a waste of time. Only labido will get better. I took a thyroid pill and 1 hour later I felt my fatigue and tiredness dissipate. Literally 1 hour later. Ever since then I’ve been improving. Small things can make a big difference.

Listen to @systemlord his guidance is sound. If I had listened to him fully 3-4 months ago (get thyroid optimized - my tsh was high) I probably would of found relief within 2 months not 3/4.

I consulted my new doc a month + ago and first thing he said was thyroids going to help me allot. This entire process will take 3-4 months. Sit back and let it work. System told me this day 1 months before.

Marathon not a sprint.

Are you sure the doc didn’t mean 125 mg? It would make more sense than 1.25 mL if you’ve been on 100 mg that he would bump you to 125 mg. Just saying. And a brief E2 spike really won’t bother you. One thing at a time. Change only one thing at a time.

Ya doubling dose Does not sound right. I would check with doc and verify the ml and dose in mg both.