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6 Weeks Bloodwork - Confused by Results

Had my first bloods drawn 6 weeks after beginning TRT with 140 mg/wk Test-C injected EOD. No other drugs were used. I only had total test, free test and E2 drawn since it was taking a while to get into my doctor so I paid out of pocket.

6-weeks using TRT labs:
Testosterone, total: 808 ng/dl (264-916)
Testosterone, free: 36.3 pg/ml (9.3-26.5)
Estradiol, sensitive (LC/MS/MS): 25.6 pg/ml (8.0-35.0)

Pre-TRT labs:
Total Test: 205 ng/dL (300-1200)
SHBG: 31 nmol/L (20-60)
Free Test: 4.1 ng/dL (9-30)
Estradiol: 30 pg/mL (10-50)
LH: 3.3 mlu/ml (1.5-9.3)
fT3: 3.2 pg/mL (2.8-4.4)
fT4: 1.1 ng/dL (0.9-1.7)
PSA: 0.5 ng/mL (0-2.5)
Prolactin: 14.1 ng/mL (2-18)
Progesterone: 1.0 ng/mL (0-1)
Hct 42.9% (40-50%)
Hgb 14.3 (14-17)

As far as how I feel, no negative sides except its a bit harder to sleep (I use melatonin to counter this). I have a bit more energy and libido is up a bit, but don’t feel amazing like some guys report.

My questions are:

  1. Why did my E2 drop after starting TRT? I was not taking an AI, just testosterone.
  2. Why is my free test so high relative to my total test? I didn’t have SHBG drawn, but the results imply a much lower SHGB than my original reading of 31. Did my SHBG really drop by that much? I was supplementing boron (3mg/day) so may have impacted this.
  3. Should I up the dose given my E2 is fine, or is going higher pushing it given my high free test level? Is it healthy in the long-run to have a free test level >35?


You used the sensitive E2 testing method the second time around where before you used the Roche ECLIA methodology, you can tell the difference by looking at the ranges. TRT isn’t like party drugs where the full effect is immediate, hormones must interact with and repair tissue.

I never seen any thyroid labs posted, low thyroid function would see little or no improvements on TRT. TSH, Free T3 and Reverse T3 being the most important, the latter two must be balance with Free T3 at least mid-range and Reverse T3 <15 ng/dL.

If you sleep quality doesn’t improve in the near future perhaps the supraphysical Free T is causing issues with sleep, maybe you just need more time on this protocol.

This is more than likely and a good decision to choose an EOD protocol that would probably had been force upon you once you realized SHBG had indeed decreased.

In general higher testosterone is healthy and cardioprotective, lowering the Free T levels too low and you take away the benefits to your heart, but some do not feel right with Free T very high.

You have higher testosterone than at any point in your life, no natural man has Free T levels this high naturally. Most men would kill to have these numbers, especially the estrogen lower in relation to high normal Total T, perfect hormone levels.

The question is are they perfect for you, time will tell. It wouldn’t hurt to have an iron panel, ferritin included with any thyroid testing, cortisol as well.

Onset of effects of testosterone treatment and time span until maximum effects are achieved

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Thank you systemlord for your detailed reply!

I will do the labs you suggested and circle back.

I realized I actually had cortisol tested twice recently, however both prior to TRT:

Cortisol (evening): 7.1 mcg/dl (6-23)
Cortisol (morning): 16.7 mcg/dl (4-22)

Are you suggesting I have this checked a third time, post-TRT?

What’s the rationale behind the iron/ferritin tests? I never have donated blood, although I guess my Hct/Hgb are both at the lower end of the range. Only asking because I looked into it and both are quite expensive out-of-pocket tests.

Thanks again.

I had never donated blood before I became iron and ferritin deficient. You can become iron deficient if you have IBS. gut issues or GI bleeding.

There are lots of ways you can become iron deficient. I started TRT with borderline iron deficiency and 2.5 years later turned into critical iron deficiency.

If you have CBC labs showing MCV and MCH, that’s may be enough. My labs showed MCV and MCH both bottomed out which is what lead to the investigation of more iron testing.

@nickwren1324 I too take 140 a week (40mg EOD).

I’ve been on this protocol since January. In March my total T was 604. Just 1 week ago, it was 1192.

We are all different for sure, but it’s taken me about 6 months to get here. These things definitely take time.

Interesting. Were you using Test-Cypionate? Given its half-life, levels should be stable after a month: https://steroidcalc.com/

But I guess there could have been a number of other influencing factors for you between March and today.

I’m feeling no negative side effects after 6 weeks at 140/wk and my E2 is only 25, so I’m going to bump up my dose to 175/wk (50mg EOD) to see what happens.

@nickwren1324 - Yup, Test Cypionate. No idea what happened. I was taking 120mg a week before January and most every blood test I’ve had (even in March on 140mg a week) my TT was between 600 - 680… Then boom, 1192! Haha.

Good luck on your journey and hope upping the dose helps.