T Nation

Bloodwork 1 year after TRT. Any Advice? MUST READ!

Been working out for 10 years. Age 30. 2 years ago I did HRT for 6 months. Did bloodwork three times before, middle and after. Accurately dosed everything from hCG to anastrozole. KSMAN posts helped a lot. Gained a lot of muscle and gave my body a 3D look that wasn’t achievable by only eating healthy and training. Off TRT now because it’s too much work if you wanna do it correctly.

Recently I experience mild ED so decided to do a blood work and here are my results. I only posts the important stuff. Everything else is normal.

From what I see I can tell that I need to take anastrozole to reduce E2 to 22 and also take Vit-D to increase my D levels. Any comment on my TT and FT levels??

TSH —0.60— 0.40-4.50 mIU/L EN
T4, FREE —1.3— 0.8-1.8 ng/dL EN
T3, FREE —3.1— 2.3-4.2 pg/mL EN
VITAMIN B12 —1531 H— 200-1100 pg/mL EN
FSH —4.7— 1.6-8.0 mIU/mL EN
LH —5.3— 1.5-9.3 mIU/mL EN
ESTRADIOL —27— < OR = 39 pg/mL EN
TESTOSTERONE, TOTAL . —431— 250-1100 ng/dL
TESTOSTERONE, FREE —76.8— 35.0-155.0 pg/mL
VITAMIN D,25-OH,TOTAL,IA —22 L— 30-100 ng/mL EN

@deanis55 @iron_yuppie

@zeek1414 @studhammer

Thank you

So you are completely natural for 18 months at this point and you want to take an AI? That is crazy. Your E2 is fine. The 22 number is a fantasy. If you go this route you will fuck yourself up.


Those are rock bottom levels as far as Free T goes, we see men seeking TRT with higher Free T levels. The difference between low normal and high normal SHBG is a 50% reduction in Free T levels. If your familiar with KSman you would know by now normal isn’t a very useful term to describe hormone levels, instead you should focus on optimal which tends to be in the high normal or higher.

They say ED is a sign of things to come as far as heart health is concerned. I’m not sure about targeting an E2 of 22, SHBG levels play a big part in Free E2 levels. While it may be alright for a lower SHBG guy to target an E2 of 22 and have plenty of Free E2 to go around, a higher SHBG guys would need higher E2 to equal the same Free E2 level.

You’re right below the threshold for cardiovascular risk of 440, the risk is higher for those men with ED mild or not.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

After first TRT cycle I was able to manage and get to 22 levels. Felt really well once I hit that. I have the lab work for then.

Post it. Doubtful it was your E2 that made you feel better. Was T higher/lower? What about everything else? So many things at play.

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Thanks for the response. Yes deff looking for optimal not normal. Do not know about my SHBG since I didn’t test that. I’m going to supplement with Vit-D3 for a month and do lab work again. If I do not see a major improvement I will try to HPTA restart and if no improvement will get back on TRT. Honestly the main reason for getting off TRT was a mild hair loss and I like my hair lol!

OK let me find it. I have like 10 bloodwork from the past. I think it was because of E2 I tested my E2 and it was abnormally high or low (I was taking too much anastrozole at some point).

Most people on TRT dont need an AI. It comes with its own host of side effects.

——————First Lab - Baseline - 2016-09-25————————

Estradiol, Sensitive Estradiol, Sensitive 20.5 ******8.0-35.0 pg/mL

Testosterone, Free/Tot Equilib Testosterone, Serum 423 *****348-1197 ng/dL

Testosterone,Free 20.71 *****5.00-21.00 ng/dL

% Free Testosterone 3.96***** 1.50-4.20 %

TSH 2.010 *****0.450-4.500 uIU/mL

Thyroxine (T4) 7.3 *****4.5-12.0 ug/dL

T3 Uptake 34 *****24-39 %

Free Thyroxine Index 2.5 *****1.2-4.9

——————Second Lab - Mid TRT - 2017-01-04————————

Estradiol, Sensitive Estradiol, Sensitive 29.0 ******8.0-35.0 pg/mL

Testosterone, Free/Tot Equilib Testosterone, Serum >1500 *****348-1197 ng/dL

Testosterone,Free >52.80 *****5.00-21.00 ng/dL

% Free Testosterone 3.52***** 1.50-4.20 %

TSH 1.210 *****0.450-4.500 uIU/mL

Thyroxine (T4) 7.2 *****4.5-12.0 ug/dL

T3 Uptake 35 *****24-39 %

Free Thyroxine Index 2.5 *****1.2-4.9

——————Third Lab - Post TRT - 2017-03-15 ————————

Estradiol, Sensitive Estradiol, Sensitive 23.8 ******8.0-35.0 pg/mL

Testosterone, Free/Tot Equilib Testosterone, Serum 814 *****348-1197 ng/dL

Testosterone,Free 16.77 *****5.00-21.00 ng/dL

% Free Testosterone 2.06***** 1.50-4.20 %

TSH 0.296 *****0.450-4.500 uIU/mL

Thyroxine (T4) 8.4 *****4.5-12.0 ug/dL

T3 Uptake 34 *****24-39 %

Free Thyroxine Index 2.9 *****1.2-4.9

My question is do I need a HPTA restart since my FSH and LH numbers are normal? or Do I need to jump on TRT?

Depends on how you feel man. I don’t think TRT is the answer to mild ED.

What was your TRT protocol and why did you find it so difficult?


Restarts don’t work, my advice is don’t waste your time.

You are only 30 years old man. Do a restart. Get the hell out of this TRT forum and go to the Pharma and talk to guys who know what they are talking about. Tag guys like; iron_yuppie, studhammer, zeek1414, deanis55, alphagunner
Read my lips (((Restarts Work))).


Do not take an AI, your e2 is absolutely fine where it is.

You could try a restart, though your LH and FSH aren’t exactly low so i cant imagine it making the increases your looking for to your T down the line.

How long have you experienced low T? Was the TRT prescribed by a doc?

There are guys here a hell of a lot more experienced then myself that will also be able to chime in on this.

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Yes it was prescribed by a doc. It’s been almost two years now.

yeah @hrdlvn is right. Pharma forum can better guide you through a restart.

Yah go to Pharma they have the voodoo down to a science haha. Good luck

OK guys I have an update on my status which might be the case for many of you guys. Based on my blood test that I posted my T levels are pretty low but I knew that I don’t wanna be on TRT anymore because I’m only 30 and I didn’t experience any optimal health issue or low T prior to 2 years ago. I got tested for Prolactin too just to find out if that is causing low libido and it came back normal around 7. Read all the KSMAN sticky’s and a lot of wiki articles here and there. Thyroid is working fine, prolactin fine, LH and FSH fine, Estradiol fine.

So I decided to add Vitamin D 5000 IU to my diet and guess what?? My libido is to the roof now, ED is almost gone, Hard erection, Losing fat easier and I’m more lean now, around 12% body fat compared to 18% a month ago. Generally feeling way better now, hair loss is decreased, I’m not moody anymore and very energetic in my gym sessions.

My advice to guys with similar problems is that don’t give up too easy and don’t jump to TRT right away. Test and log everything, add vitamins one by one. There’s a lot more things to consider after jumping on TRT wagon and makes everything way harder ( I’m not saying TRT is bad). But use it as your last shot!!

I also added Omega 3 to my diet which has helped me with critical thinking and everyday mood.

I just came back from my vacay in caribbean and after sunbathing for one week noticed a tremendous improve in libido, energy level and erections which shows that I need to increase Vit D to 10000 IU or get more sun on a daily basis which is not too hard in LA ;).

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