6 Weeks into TRT, Protocol/Bloodwork Questions

46 yr old 5’ 9" 200lbs

Pre-TRT: exhausted, losing muscle and strength, exercise just beats me up and makes me feel worse, mental clarity is “fuzzy”, no morning wood, body aches and pains

Total T = 317 ng/dL (348-1190) [followed up a week later with 292 ng/dL for confirmation]
Free T = 6.0 ng/dL (9.6-26.5)
Bio avail T = 149 ng/dL (225-950)
SHBG = 33.7 nmol/L (16.5 - 55.9)

Weekly IM Test Cyp at 200/180/160/160/160

Blood pulled before week #5 injection (trough):
Total T = 575
Free T = 11.8
Bio avail T = 278
SHBG = 35.7
E2 = 13.5 pg/ml (7.6 - 42.6) using Roche ECLIA

Feeling more energized, mental clarity is great, able to exercise a bit more and feel decent afterwards, morning wood 2 or 3 times a week

Told by the doc that I have room to increase, but we will take it slow and see how E2 reacts. Dosage increased to 170 for 6th week until next blood draw in 5 weeks.

Question #1: Does this seem like a decent protocol (dosage, frequency, etc)? I am feeling better and don’t have any noticeable side effects. Eventually I would like to do my own injections and experiment with a higher injection frequency.

Question #2: Is my E2 low? Unfortunately it was not assayed pre-treatment. Plus, I don’t think I received the sensitive E2 test. I was told E2 should be 25-35 during treatment. I asked why mine was low and answer was “your body is adjusting.” Does my SHBG play a role here?

All and all I am happy with the progress. I just wonder if I am missing anything that the more experienced men can point out. Thanks.

I’m curious which lab was used for these tests - the reference ranges you have would have put me in the hypogondal category, but my reference ranges kept me cresting the bottom of ‘normal’.

Sorry, I don’t have much for advice here - someone who has more experience likely can advise though.

Lab used was LabCorp

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Yes it is low, an adult males normal healthy estrogen is 20>.

No, your dose isn’t high enough and you may be a bit low on aromatase enzymes. Your testicles don’t produce estrogen anymore, so you only get it from aromatase rather than both when natural.

In reality your doctor doesn’t really know why your estrogen is low, but doesn’t want you to know he doesn’t know.

That would be low for me. Might be fine for you, if you feel good

That’s the problem, there is no standardisation for hormone testing. Labcorp is the 800 pound gorilla and sets the standards. That’s why there are guidelines, <300 qualifies for TRT regardless of the lab ranges.

But even then the guidelines are evolving (sadly not all doctors are) and TRT can be prescribed <345 when symptoms are present.

There are studies showing men have low-T symptoms <400, but the truth is everyone is different do to many factors like CAG repeat lengths which is the androgen sensitivity. Someone with a long CAG repeat length will need more testosterone than a man with a short CAG repeat length.

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I guess I will follow my E2 levels through this process and see if I feel better with higher levels. Thanks.

In your experience, do you think I will see a significant increase in E2 after 5 weeks of the increased dose of 170?

I know I wouldn’t have a problem getting estrogen 20> in no time at all after 6 weeks on a new protocol. I have measured it at 49, 52, 70 and 90 pg/mL depending on the dosage.

Personally I think your Free T levels are underwhelming and getting it higher should easily get you more estrogen. It’s good news that you actually feel good at these levels which could only mean you can get away with lower levels and still function decently.

I expect more morning erections once you get both Free T and estrogen higher.

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Any chance you know where I can find these studies? I’ve done some digging and cannot find anything regarding ranges for someone in my age group. The reference ranges all seem to be 17 and under, 18-55 and 55+ but I might be able to convince my Dr if I throw some studies at her. Will still probably get another test and pay laborious of pocket just for their reference ranges

Littered across Excelmale. I used to have it on my computer, but lost all my data.

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I does, especially since it seems to be helping you. However, I would probably look at increasing it.

It is, would expect it to be in the 20s given your total testosterone level. You do not need the “sensitive” E2 test. SHBG plays a role in the bioavailability of androgens and estrogens.

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