First Blood Work After Starting TRT

Hello All,
I looking for some input on my Total T and Free T after just over 3 months on TRT treatment. I already had an appointment with my regular doctor at the same time that I was being sent by clinic to get 3 month blood. So Monday did blood with family doc and going to get clinic work done on this Monday.
I asked family doc to include a T test in the blood work, why not.
Just some facts on what and how much I’m taking. Clinic original suggested
200 ml per week of Cyp .I felt that was a little much to start with and did 160 ml a week in two 80ml shots every 3.5 day. With that stated, my results came bake with Total T at 1096 and Free T at 25.5. Thats from original clinic Blood Work of Total T 225 and for the life of me I dont know why they didnt have a FreeT on that work. But since I had blood work done 4 months prior with regular doc I had a Free T at 10.2.
What I’d like to ask is two things: 1. Does Total and Free have any correlation to each other in regards to If one is this the other should be this, obviously not a definitive # in percentage or a formula. 2. From your experiences what are your thoughts on these #'s. Appreciate any thoughts.

The Free T is where he rubber meets the road, so this is the biomarker to better gauge symptoms or lack there of. Neither the Free T, calculated or using the more accurate essays, is perfect or can you cross compare due to different testing methodologies and different normal ranges.

My advice, pick a lab company and testing methodologies and stick to it on future testing so you can better compare past, present and future protocols.

The Total T will be higher when SHBG is higher, independent of Free T. An example, as men age, the Total T and SHBG increase, while the Free T decreases.

As for your protocol as you have laid out, syringes are typically .5-3 ml, so it’s hard to imagine anyone injecting 80 ml or 8 vials in one shot. Most multi use vials in the USA are 100-200 mg/10 ml.

Not really. One man’s total testosterone can be higher than another, but the one with lower total testosterone can have higher free testosterone. Higher sex hormone binding globulin (SHBG) will decrease free testosterone levels. If you could only test one thing, free testosterone would be it.

By the way, as men age, total testosterone decreases and with that, free testosterone will decrease. That is bad enough, but SHBG tends to increase with age, driving free testosterone down even more.

I’m guessing your free test of 25.5 is around the top of the range, a nice increase from 10.2. Your total testosterone increase was nice as well, but the free test is the one that matters. So, the numbers are fine. If you are happy with your results, all is good.

Typo mistake on the quantity. I meant to say I’m doing 80 mg twice a week for 160 mg a week vs the 200 mg originally prescribed. Thanks for reply

Thanks HighPull. Here’s something else I want to throw at you. I realize it may be a little difficult to answer without having other results such as my Estradiol #'s, which I will get with my clinic work next week, but here it goes anyway. This is a real life look at the last 3 months, without knowing the #'s associated with Total or Free T. Feeling wise. I definitely had a positive increase in both my “feeling or well-being” along with my Libido about week 6-10 , along with a higher intensity when lifting and the want to lift.
I’ve tried to do as much homework as I could going into starting treatment and also while I’ve been using it. The 2 most important thing for me in regards to using TRT and being committed to the out of pocket expense is : 1. I optimize the potential of something that I’m consciously choosing to inject into my body. When I say optimize I dont equate that to an amount or milligram #, rather the right amount or sweet spot just for Me. 2. How do I best go about finding that right “sweet spot” without throwing darts in the dark? Are there specific types of blood test or specific markers in a blood test that are an “absolute need” to be able to show the bodies overall response to Test supplementation? I’m 57 and in for the long haul, and the quicker I can understand the Blacks and Whites the less time I will spend in the Grey Zone. I hate the Grey Zone. LOL
Sorry for being long winded. Much Appreciated Mike

There’s no shortcut to finding optimal hormone levels for a particular person, experimentation is the only way. So for now, get out your dart board, turn out the lights and start throwing.

In the not so distant future, testing for CAG repeats long/short will allow us to detect the sensitivity level at the T receptor. So if a person has a long CAG repeat, with normal testosterone, they can have testosterone deficiency.

So far testing CAG repeats is very limited and not available to the general public.

As far as not wanting to be in the gray zone, given your age, keeping your Free T at the top 25 percentile or higher is of great importance. This study below should narrow down your search for optimal levels of free testosterone.

You’re welcome.

Generally, optimal levels are thought to be around the high normal levels. However, there is no one size fits all. Rather than focus on numbers, go more by how you feel. Of course, some, once they increase testosterone and feel better, or even great, wonder if they would feel even better if they increased the dose. More is not necessarily better. I’ve had guys unilaterally double their dose. Then, they’re pissed when they cannot get a refill.

I follow total testosterone, free testosterone, estradiol, CBC, CMP and lipids. PSA more or less dependent on the individual. Others as indicated.

God luck, sounds as though you are off to a good start.

Just got back to reading responses. Thanks to you both. I received my first blood work results back from clinic since I started. My total T is 1033 and there is no free T results. Does that seem strange to anyone that a clinic that is in the business of prescribing T to their patients doesn’t look to test your free T as part of the analyzing process?
My Estradiol is at 35.8 up from 16.8 from 4 months ago. Just to be clear, I have not taking the GONADORELIN they prescribed as I wanted to see where my levels feel before treating something that wasn’t a problem.
Also they recommended donating blood as my Hematocrit are at 46.6 from 40.3.
Do you guys thinks the blood donation is warranted at these #'s, and is the 35.8 Estradiol level say anything to in regards to either taking the GONADORELIN or still hold off to next round of test? Plus am I wrong for thinking my free T should be included in this blood work? Once again much appreciated!

It’s not strange, this clinic is has their own way of doing things, it might not be the best way about doing it, but none the less this is how they do things.

They are likely trying to keep costs down, profits up by doing only the absolute minimum lab testing.

A clinic prescribing gonadoreline is a red flag, because most cases of low-T are secondary, a pituitary failure, and so gonadoreline won’t do anything other than increase profits and take your money.

No way! You can have your hematocrit at 52% and still not require a blood letting. You risk crushing your ferritin levels by donating blood if you do it too frequently. Mine are halved after donating 500 ml of blood, which take three and a half weeks to recovery.

A slight elevation in hematocrit and hemoglobin is actually healthier, provided you don’t have any medical problems that could be exacerbated by thicker blood.

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Thanks systemlord, always informative content attached. Wanted to mention that after my last “Sweet Spot Dark Dart Throwing” post I dropped my dose from 160mg/ 80 twice a week to 120mg/ 60 twice a week to see what if any change in mood or Libido occurs, only 2 weeks so far. Since as you said that one size doesn’t fit all, I figure I try going down a bit first.
Since my nature is to be an over analyzer about everything ( ask my ex wife) lol, Im curious about what you may think of this hypothesis. Since I really felt a noticeable difference between weeks 6-10 of starting, especially with Libido and the want to workout and intensity while doing so. Is it possible that you can go right through your “sweet spot” as your levels of your total T, free T, Estradiol are steadily increasing. While that may sound somewhat like an obvious yes answer, really what I’m wondering is how long should you wait after changing dose to see if the direction of the change (+/-) has changed the levels of the before mentioned key factors before making another change in the search for the “sweet spot”.
Thoughts and inputs always appreciated.

You’re not going to get the sweet spot, your levels will still vary. Constantly changing your dosages is like hitting the pause button on progress. Get your levels to where you feel good, live your life and don’t make TRT an obsession.

The longer you’re on therapy, the more benefits you’ll receive.