T Nation

Bloodwork, First Time on TRT

35 years of age.
68 kg
178 cm tall.

this is my first time on TRT (Testogel, basicly the same as Androgel, 50 mg a day)
i have been on it since may 29. (monotherapy)

previous total testosterone results have been between 11 nmol/l (317 ng/dl) and 20 nmol/l (577 ng(dl)

My reasons for getting on it;

  • Sleep problems (hard time falling asleep, keep waking up every 10 minutes, a sleep study showed that i woke 19 times a night)
    -brain fog
    -weak erections (have morning wood, but erections while having sex are weak and go often go soft quickly)
    -no muscles (even though i have been lifting weights for over 20 years)
    -no body hair (that includes very little facial hair)
    -no concentration/focus
    -no drive

My erections have gotten better since i started, sleep is still terrible, no muscle gains, but feel better overall, more positive, more drive.

To be fair, even women, who by their nature have low testosterone, can gain muscle with sufficient training. You may not be able to gain optimal amounts of muscle with low T, but you can still gain a good amount.

e.g. I’ve moved my squat from 150lb to 365lb over the past few months with total T in the mid 200 range.

TRT aside, try changing up your training program. I highly recommend http://startingstrength.com/

as you probably can imagine, 20 years is a LONG time! i have tried many training programs, different diets and so on, yes starting strength also, i gained some strength, but quickly stalled, and gained lots of fat.

i’m a typical skinny fat, wide hips with fat storage, weak arm/shoulder/chest development

Where are you located?

Your estradiol E2=180pmol/L is a big problem. You would be a lot better near E2=80 pmol/L , also risk of gyno!

Transdermal T has the highest T–>E2 conversion potential. Injected T is least T–>E2 and least cost.

You need, if possible, 0.5mg anastrozole twice per week.
E2=80pmol/L is a good target.

You may need some extra iodine. Are you using iodized salt? Can you get it there?

Do not test LH/FSH again always–>zero

You need to be checking hematocrit and RBC on TRT as these can get too high for some guys on TRT.

TRT leads to small testes for almost all guys and high risk of infertility. That can be prevented by hCG injections or a SERM.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

Thanks Ksman!

i actually have hematocrit results from a previous blood test, but this is from a couple of months before the TRT. it was high then at: 0,56 (range- 0,40-0,50) does not say anything about unit.

note that these tests were not done fasting, and not in the early morning, but more mid day



Your RBC and HTC were a problem before TRT and TRT can make things worse. You should test again now.

HTC is a dimensionless ratio. Blood is centrifuged and is ratio of packed cells to remaining fluid. High HTC can cause flow problems.

fT3=6.1 was rather strange well above mid-range.

Ferritin was a bit low, better near 60-80.

Thanks again Ksman!
i am located in Norway

i am getting a new test tomorrow!

i will speak to the doc about Anastrazole, but i am kind of worried about my T dropping when using it, as i see lots of people do.

i still think my free t is not optimal, and i have considered upping the testogel to 10 mg a day (5mg two times a day) instead of 5mg

what kind of symptoms would high ft3 cause?

would that make my E2 even worse?

as for Transdermals vs injections, i read several placed that transdermals do not aromatize, but obviously that is bs

my doc want me off TRT because it didnt help me sleep, as that was my main health issue.

he thinks my free t level is fine at 3,7 nmol/l (range 2,3-9,9)

i have had chronic insomnia for over 15 years, can these t3,t4 levels be the explanation ksman?

what can i do about it?

on androgel my s-test level is 26. shbg 40.