T Nation

Bloodwork Is Back, Any Suggestions?

Greetings guys,

I’m 39 years old, have been on TRT for 5 months now, I have had some up and down during the therapy. My main complaint has been random low moods and crazy anxiety, almost like wanting to jump out of my own body type of anxiety. Symptoms improved after I reduced my dosage and frequency. I went from 70mg T twice a week to 30mg Testonero EOD (or 120mg per week), I’m also doing 150IU of HCG EOD. There are some days that I feel great and calm, and I start to feel that I’m “dialed in” but some other days that the anxiety and low mood comes back, it’s a little frustrating. Any ideas what could be causing my symptoms or anything that I should be looking into?

Today’s bloodwork:

Estradiol, Sensitive 43.4 pg/mL
Sex Horm Binding Glob, Serum 17.0 nmol/L
Triiodothyronine (T3), Free 3.8 pg/mL
T4,Free(Direct) 1.44 ng/dL
TSH 1.840 uIU/mL
Testosterone, Total 735.5 ng/dL
Free Testosterone(Direct) 23.2 pg/mL

Supplements:
Magnesium: 360mg daily

Zinc: 30mg daily

Pregnenalone: 20mg daily

Fish oil: 3,200mg daily

There’s your problem you got tons of Free E2 welcome to ((( anxiety city )))
With an SHGB that low you need an E2 between 20-26 anything over 30 you will hate how it makes you feel.
My recommendation start taking an AI or drop your T dose even more. Me I’d start the anastrozole at about .25mg/wk. Best of luck to you.

Ya I haven’t experienced this. Maybe it is e2. Like this guy said ^. I would lower dose a little and see if that helps. Or inject more often. Why take an ai if it can be managed with one tweak. Sounds like it’s not an everyday issue.

Sounds like you just need to drop it a little. Do these issues arise a couple days after your shot?

Thank you for the response thus far. It happens randomly, I’m not sure exactly what triggers the symptoms. I’m currently doing 30mg EOD for a total of 120mg per week. I will drop it down to 20mg EOD for a total of 80mg per week.

is 80mg per week too low to maintain testosterone levels in TRT? I just haven’t heard anyone going below 100mg per week.

You did not put the ranges in for these. Are they standard LabCorp ranges?
You Free T number is the one to get dialed in.
Keep it as high as you can without going over range is the trick. Once you know that amount then look at E2 and see if it needs an adjustment. Get both in a good range and you are there. Its really not very hard just take a little time and patience.

Low SHGB guys don’t need half the TT high SHGB guys do so yes 80mg/wk is a very acceptable amount to run.

HCG is also know to raise E2 you might consider reducing that dose as well. I have had great success with 800iu/wk. I do a subQ twice a week with 400iu’s

Why are you using hCG? If not for fertility (actively trying to conceive) or to prevent testicular atrophy, I would d/c it.

thanks HRDLVN, yes these are LabCorp ranges. I updated the table to include those.

Today’s bloodwork:
Estradiol, Sensitive 43.4 pg/mL 8.0 - 35.0
Sex Horm Binding Glob, Serum 17.0 nmol/L 16.5 - 55.9
Triiodothyronine (T3), Free 3.8 pg/mL 2.0 - 4.4
T4,Free(Direct) 1.44 ng/dL 0.82 - 1.77
TSH 1.840 uIU/mL 0.450 - 4.500
Testosterone, Total 735.5 ng/dL 264.0 - 916.0
Free Testosterone(Direct) 23.2 pg/mL 8.7 - 25.1

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Thanks for the response highpull. I introduced HCG to increase testicular size and reduce pain that I was feeling when they were shrunk. They are 70-80% back the original size prior to starting TRT.

Your dosage is too high, SHBG is low. Lower your dosage a 15% and retest in 6 weeks. HCG is going to increase estrogen, there are tradeoffs to using it.

A lot of guys find that when dropping HCG, life improves.

OK, I was thinking discontinuing hCG would help.

To big of a drop. why dont you just do 27mg (total of 9mg) and see if that helps. sounds like your borderline perfect and need like a 1% change? someone more experienced can guide. you feel good at these levles and dont want to drop it so much that your levels drop and you feel bad. Ive noticed that dosing is not linear. you can have medium levels at 100, and go to 120 and have 30% higher levels. same goes for when dropping it. be careful.

Try boron, magnesium. physio a resideant endo here on the boards posted a topic on this and it should help. Instead of changing dose or ai you could just try optimzing the liver and thus clearing estorgen more effectively. zink, fish oil are known to help. For boron read up on the topic physio posted so you understand what thats about.

Lowering your HCG dose would help but then your T levels drop. you would want to increae T to compensate for HCG loss if that were the case. Many guys here have issues with hcg sides. I wonder if thats what your experienceing. I feel like hell on hcg. like i was going mad. super fatigued and just dry mentally. Anyways, pay attention next dose. see if the sides happen day after or day of your dosing hcg.

This and HCG could be the problem. Preg can affect mood for sure.

Maybe reduce preg to 5 mg daily. I would not at this point fuck around with the dosage and injection frequency.

Bad esp with your numbers and the supplements you are taking.
We don’t even know if it’s his e2 causing his mood issue. It can be pregnenolone and HCG doing that.

With your thinking that his lowish shbg will cause high free e2 then why isn’t his free t above range?

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Because his TT is only 750
High Free E2 has nothing to do with Free T.
High Free E2 is caused by high E2 with little SHGB to bind it up. You feel Free T you also feel FreeE2 and high Free E2 is not fun for anyone. He has two choice lower his T dose which isn’t great since his TT is only 750 or start a micro dose of anastrozole. Then his E2 and Free E2 will be in check and he can run his current or higher TT. It pretty simple.

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Only… This is trt.

I just differ with your assessment. His free t is upper range which is excellent. He has room to lower dose a bit. If It was me though, I would change the preg and HCG treatment. And if he’s taking dhea that could be changed too.

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I have no issues with your suggestion. This guys has two options. We have layed them both out so he can pick one give it a try and if he doesn’t like that he has a second choice. win win in my book.

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What is your experience with Preg and dhea? I don’t notice much from my doses. Preg is 100mg and dhea is 25mg.

Never took. My Dr who is a urologist does not suggest dhea said it will raise e2.
Preg I just see no point unless it’s below range.
If dhea goes below range then I may supp it a bit.

My dheas was below mid level last check.

I also read physio state he also does not usually recommend dhea preg supplementation.

If an not mistaken adrenals have a role in production. So if levels are low there may be other issues to investigate.

Found it. Basically what my Dr said.

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Thanks. I didn’t notice any benefit at all. Will
Probably let them go and wait till another test months out to see if I actually need it.

My body reacts to dhea fast. I took it for a week and I was above range…

My pregnenalone was at 42 ng/dL, which is considered low, that’s why I started supplementing it. I noticed that my memory improved and I want to believe that it help with my anxiety a bit actually. My DHEA was 549.6 ug/dL, the range 102.6 - 416.3ug/dL. I did not supplement DHEA because it was already high enough.

Thanks

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