T Nation

Feedback on TRT Protocol and Lab Work

I have been hanging around this site for a while but this is my first post. I have learned a lot from reading on here and was hoping yall could provide me with some guidance. I have been on TRT for about 1 ½ years now and I still don’t feel like I have it dialed in. I will say I do feel much better than my pre TRT days and I am grateful for that but I still feel tired most of the time, have low libido, and lack motivation.

Info about myself. I’m a 35 yo male 5’11 200lbs and fluctuate between 10-12% bf. I workout 3-4 days a week. I was first diagnosed with low T at the age of 31 from lab work. I tired multiple things over the next few years to optimize my T and increase in naturally to no avail.

Currently I self inject IM test cyp .25cc (50mg) twice a week for a total of .5cc (100mg) a wk. My E was low prior to starting TRT but after 3 months came back at 88. I started anastrazole at 1mg a week with no effect on my E. My doctor titrated the anastrazole up and I’m currently taking 1mg MWF for a total of 3mgs a week. I recognize that this is a large dose compared to what most people take but I have been on this dose for approx 6 months and it consistently keeps my E in the upper 20s. I also take 50mg of micronized slow release pregnenolone every morning. I tried DHEA and for the first few weeks I felt great on it, like it was the missing ingredient, but after that it started causing increased heart rate and low mood. It also seemed to readily convert to E as it made my E spike up again. On lab test my DHEA comes back in the low-normal range but every time I’ve tried to reincorporate it I have the above effects.

I also take the following supplements:
Ubiquinol (lab test a year ago showed low c0Q10 levels but it is now in the high normal range)
Fish oil
Krill oil
Vit D (lab test a year ago showed VitD level at 29 but after supplementation my last level was 72)

Before Bed:
Magnesium citrate 600mg
Opti Zinc 30mg
B6 20mg

My recent lab tests are as follows:

TSH 2.46 (0.40-4.50 mIU/L)
T4 total 4.3L (4.5-12.0 mcg/dL)
Free T4 index 1.5 (1.4-3.8)
T3 uptake 35 (22-35%)
Free testosterone 100.8 (46-224 pg/ml)

Total testosterone 865 (270-1070 ng/dL)
Estradiol 28 (< or = 39pg/mL)
Sex Hormone Binding Globulin 52H (10-50 nmol/L)

DHEA 128 (61-1636 ng/dL)
WBC 4.9 (3.8-10.8)
RBC 4.91 (4.2-5.8)
HgB 15.7 (13.2-17.1)
HCT 46.8 (38.5-50)
MCV 95.4 (80-100)
MCH 32.1 (27-33)
MCHC 33.6 (32-36)
RDW 16.1H (11-15)
PLT 318 (140-400)
MPV 8.2 (7.5-11.5)
Absolute Neutrophils 3268 (1500-7800)
Absolute Lymphocytes 1073 (850-3900)
Absolute Monocytes 363 (200-950)
Absolute Eosinophils 167 (15-500)
Absolute Basophils 29 (0-200)

PSA 0.8 (0.1-3.9)

If there are other lab results that you need let me know. Any feedback would be appreciated.

Need these labs:
fasting glucose
fasting cholesterol

SHBG is rather high and E2 causes this. This will lead to lower FT levels.

TSH is too high, should be nearer to 1.0
fT3 is too low, should be mid-range or a bit higher as should be T3, fT3, t4, fT4

Thyroid labs should be:
AM Cortisol etc

You have low thyroid function.

  • have you stopped taking iodized salt?
  • any iodine+selenium in your multi-vits?

List all supplements, drugs [Rx and OTC] and other medical issues.

Your resistance to anastrozole suggests:

  • liver problems
  • use of a SERM [Clomid, Nolvadex etc]

Anastrozole cannot control T–>E2 inside the testes.

Have your testes become smaller and softer?
Have they ever been checked for cancer?

Please follow these links in 2nd post of 1st forum topic:

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • thyroid basics explained