T Nation

Decreased Total Test After 8 Weeks of Increased Dose


#1

After 15 weeks on TRT I am perplexed. My original total test prior to TRT was 373Ng/DL, I was placed on 120 Mg Test weekly and decided to do 2 injections weekly as suggested in a prior post. After 1 month my total test was 688Ng/DL, however I did not feel optimal. My Urologist decided to up the dose of Test to 160 mg weekly with .5MG of Anastrozole with each injection total 1 MG weekly. Fast forward 8 weeks and my total Test decreased to 594NG/DL. My Doctor prescribed 1000 Units of HCG every other day along with keeping the Test at 160 MG weekly. See below labs from (Quest Diagnostics.) Only good thing from recent labs is that Estradiol is down to 21 from 46. If anyone has any explanation, suggestions or input it would be much appreciated.

(Labs on 11/20/17)

total Test 688 ng/dL range 250-827 (ng/dL)

Free Test 1.89 ng/dL range 0.87-5.47 (ng/dL)

Hemoglobin 13.8 g/dL range 13.2-17.1 (g/dL)

Hematocrit 41.2 range 38.5-50.0 (%)

LH .2 mlU/Ml. Range 1.5-9.3 (mIU/mL

PSA .7 Range < OR = 4.0 (ng/mL

FSH .7 mlU/ml range 1.6-8.0 (mIU/mL)

SHBG 21 nmol/l. Range 10-50 (nmol/L)

Estradiol 46 Pg/ml. Range < OR = 39 (pg/mL)

(Labs on 1/22/18)

LH
<0.2 L
1.5-9.3 mIU/mL

HEMOGLOBIN
14.9
13.2-17.1 g/dL

HEMATOCRIT
44.0
38.5-50.0 %

TESTOSTERONE, TOTAL, MALES (ADULT), IA
594
250-827 ng/dL

ESTRADIOL
21
< OR = 39 pg/mL

PSA, TOTAL
0.9
< OR = 4.0 ng/mL

SEX HORMONE BINDING GLOBULIN
19
10-50 nmol/L

_


#2

Your body start metabolizing test at a faster rate and SHBG went down which is expected. Measuring FT score directly you might as well measure the distance from the earth to the moon with a ruler, you’re supposed to calc your TT and SHBG then equals FT, 2-3% is normal. TRT made your SHBG low just like it did with me.

Free Testosterone
19.2 ng/dL = 2.78 %
Bioavailable Testosterone
449 ng/dL = 65.3 %


#3

Systemlord can you elaborate in VERY basic terms, i’m New to this and confused? What are you suggesting in terms of the protocol, is it wrong, and if so what can I do about it?


#4

Your protocol ends up be right when you feel your best, numbers are important only after you find your sweet spot. Some guys are lucky to hit their sweet spot on the first try, I hit it many months ago and never knew it. Your FT is plentiful and is more important than your total T numbers, we low SHBG guys tend to have higher FT numbers than those who’s SHBG is midrange or higher.

TRT lowers SHBG a little which is fine unless you’re a guy who’s SHBG is already at rock bottom, my SHBG before TRT was mid 20’s and now rests 18-20 nmol/L. My main point is measuring FT directly is inaccurate, we normally measure our FT numbers using an SHBG calculator using Total T and SHBG, input those and you get your FT numbers which I listed for you. FT numbers in the 2-3 percent are optimal, yours are closer to 3 percent which is great.

Your E2 levels are fantastic, Hemoglobin and Hematocrit are perfect, all levels are perfect. In short those labs are excellent and I would love to have your numbers in 4 weeks when I draw my labs. Spend at least a few months in these numbers and gauge how you feel, then later if you prefer to increase dose a little to see how you feel in the 700-800 ranges you’ll already have an idea how you felt before.

I wish I knew where in the ranges I was naturally.

Sorry for the confusion.


#5

Thank you for the clarification. The point I should have elaborated on more is at
I don’t feel optimal or even close. With regards to my numbers, Is this the best it is gonna get for me? Would going up on the Test make any difference, or do you think adding the HCG will help with feeling a little more optimal. I did a protocol 2 years ago and had my numbers around 1070 TT and SHBG 21 on 150 MG of Test and I felt great. I stopped treatment reluctantly as I changed insurance carriers and they wouldn’t cover TRT. Are these numbers even in the wrelm for me anymore or should I be greatful with the numbers I have?


#6

How long did it take to start feeling great at the higher numbers 2 years ago? Even if you are one of those who do better higher in the range you shouldn’t have any symptoms at those numbers, how do your thyroid numbers look?

I did notice your hematocrit isn’t even midrange so it’s logical to assume your body can handle more T, at 550-600 ng/dL my hematocrit I’m at 46% (40.0.-50.0 %), hematocrit and hemoglobin are biomarkers for doctor to find out where in the ranges most guys fit.

Though 8 weeks isn’t nearly enough time to reach maximal benefits of TRT by a longshot, more T is probably a good move forward. HCG is different for everyone, you may find it beneficial, feel nothing or find its effects wane after a time.