T Nation

Bloodwork Doubled in 2 Weeks, Halved 2 Months Later

Hello all, so this is going to be a little bit of a long topic with likely a lot of rambling due to my formatting skills but I will try to do my best.

Back Story:
I am a 28 y/o male. Back in June of 2021 I noticed my libido and ability to function in bed had dropped significantly. I found a company online called “renew vitality” they sent me to get labs at labcorp informed me that my Test levels were 360 and set me up with a doctor. I seen said doctor and was informed that TRT was the best solution considering my symptoms and T level. I was prescribed Finasteride .5 dailty for hair loss, anastrozole 1mg on injection days to combat estrogen, and 200mg a week of Test Cyp. 2 100mg shots per week Sundays and Thursdays.

Primary Care doctor
After being on Test for several months and doing a routine check up with my primary care doctor she informed me that she thought 200mgs was excessive and especially heinous that i was doing 2 100mg shots per week so she wanted to get labs which I will attach pictures of. They are kinda hard to read so I’ll type out what I can.

1st Lab taken 9-2-21
Test- 637
Free Test- 17.0
No estrogen info on the lab

2nd Lab taken 9-16-21
Test - 1288
Free Test - 30.9
Estradiol - Less than 5

at this point I was taking the 200mg per week my PCD then informed me that this was too high and I should go down to 1 shot per week (100mg) the following lab is doing 1 shot per week

3rd lab 11-16-21
Test-607
Free Test-17.7
Estradiol- 21.7

my question being as far as the first two labs go I was on 200mg per week for both why is there such a difference in Test levels the only thing that was different was me not being fasted for the Blood work.

my next question my estradiol was less than 5 on my 2nd set of labs is that too low?

I’m back at two shots per week now just because I felt better with the two shots. Im getting bloodwork tomorrow at labcorp so I can order the next 15 week supply from renew vitality. I’m not a fan of paying north of $700 every 15 weeks for this medication but I want my life back in order and dont know what else to do being as I dont have health insurance. If i stick to two shots per week should i scale down on the anastrozole so my e2 will come up? is twice a week overkill?

I was also never shown how to do my IM shots I was just told by the doctor where to stick it in my quad. I’ve found that sometimes my sticks are clean no pain no blood and other times when i aspirate the needle only air comes in the syringe yet when i pull the needle out a stream of blood will follow not a lot but noticeable. did i miss the muscle and hit a vein/nerve am i wasting my shot when i do this?

and my last concern I was roughly 200 pounds before i started TRT i now fluctuate 222-226lbs. Iv’ve never been this heavy in my life is that due to the T? The anastrozole? I have a fair amount of muscle and workout 4 times per week the same as before the weight just seems like alot. Ive also noticed that when I first got on T my sex life was way better but it seems like its taking a dive again.

If you made it this far im sorry for my incoherent rambling and questions I just don’t know where to go from here.

Others will weigh in, but timing of injections will be one question that comes up as it will affect your T Levels.

It is a poor protocol. Ideally, you would start on 1 shot of 100 mg per week with no AI that is followed up with blood tests. Dosage would be adjusted based on your blood tests.

Again, others more knowlegeable than I will give you advice, but I wanted to let you know that it is time to start looking for a new provider based on poor protocol and excessive costs.

When were your labs drawn relative to the injections? If consistent with one another, it seems the testosterone in not being absorbed evenly. Not sure.

Yes

Eliminate the anastrozole.

Are you retaining fluid? Gain any muscle?

I’d think about taking 75mg twice weekly without any anastrozole. I’d talk it over with the doctor. As for the finasteride, that’s your call.

If all you have is a Total T measurement to justify TRT, then this is a T-Mill. A good responsible doctor would do more tests to determine if things can be turned around, something in your favor at an age of only 28.

The Free T, SHBG, LH and FSH should have been tested because if you have low SHBG (<20), a Total T at 360 isn’t as bad as having the same Total T and high SHBG therefore binding up more of the active portion of testosterone.

This isn’t a surprise, the half-life of cypionate is underappreciated and is closer to 5 days and a big difference between peak and trough can cause problems for some men.

The fact your doctor recommend going from two to one shots per week after saying you feel better on two shots is a sign he/she isn’t a good choice to be managing your TRT. All that was needed is to lower your dosage, if you feel better injecting twice weekly, then you should be doing just that.

Most guys need 120-150mg weekly to be fully optimized.

A normal healthy estrogen level is 20-35 pg/mL and can run higher on TRT.

You should be aware that this drug can cause permanent mental and physical side effects for life!

Do your research.

I definitely haven’t been happy with how I’ve been handled or my treatment has went so far. I’ve gotten more information off of this post then I have in the totality of my treatment plan. Unfortunately I work 6 days a week out of state so getting to a doctor back home or my PCD is impossible. Renew Vitality, albeit probably a T-mill an expensive one at that just became the easiest option.

I think I’m gonna scale myself back to 150mg a week and eliminate the anastrozole unless i get symptoms of having too high of E2 or my next bloodwork reflects that.

I’ve looked up Finasteride more and the sexual side effects especially the long term ones worry me I’m gonna stop asap just need to find something else to combat my DHT.

I’m leaving the house to get bloodwork now, I’ll post it as soon as I get it back.

Thanks for the reply, the first lab was about 4 days after my last injection it was actually the day of my second injection but I had not done it yet. The second lab was the day after an injection. i wasnt aware that there could be that much of a difference.

If I eliminate the anastrozole should I get bloodwork in say 2 weeks and see what my estradiol levels are then?

My muscle levels are pretty much the same, maybe a few pounds difference. I’ve been at the high end of my natural ability for years so I don’t think the test would make too much of a difference. Definitely could be retaining more water. anything I can do about that to dry out some?

75mg twice a week sounds like more of a sweet spot honestly

I’m leaving to go get more bloodwork now, Ill update when I get home.

My primary Care doctor isnt working with me at all to say the least. They feel as if i’m using this for the sole reason of Lifting and don’t take it serious. I work out of state currently and renew vitality just became the easiest option due to me working 6 days a week.

That’s going to be a challenge because all drugs that partially block the conversion of T->DHT all have similar side effects. It’s not so much about suppressing levels into a deficiency that causes these issues, it’s interfering with the natural process of converting hormones that causes the problems.

Accutane being one of the oldest drugs to combat acne, men and women have permanently lost libido do to taking accutane as teenagers going into adulthood with asexuality. There are some members that have chosen to live with low-T just so they can have a full head of hair which I think is crazy.

You’re going to have to choose between your hair or TRT.

Really can’t compare them then, different stages of release from your shot.

These are peak levels, or maybe even levels building up to peak, normally labs are done at trough. Your doctor is doing TRT wrong if he is directing treatment and basing decisions on peak levels.

I would not just for that. Wait until your regular evaluation.

Your doctor should be able to determine whether or not you are retaining water.

Sounds good thanks for your replies.

TRT it is. I dont care enough about my hair to deal with the potential damages Finn can cause. Thanks for your replies.

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You injected T on top of your natural production. So when you tested, levels were higher than before. You then shut down your endogenous production and tested again, levels should be lower of course. This should help make some sense of your labs.

You will still see variations even after being shut down, so if you think TRT is a set and forget therapy, you would be mistaken.

I posted my labs from Friday, in this thread just waiting on mod approval. If you could help me make sense of them. I’m currently looking for a new doctor.