First Labs Since Starting TRT 3 Months Ago

Hello all,

I want to report back on my TRT results to date. I started mid December 2018, so i’ve been on treatment for about 3 months. As far as symptoms, I’ve had depression, anxiety, low energy, poor physical performance and low libido. I spent a couple of years working on my thyroid through various medications and finally landed on a combination of T4/T3 and 600 mg of iodine daily. That helped the depression and anxiety to some degree but I still had plenty of symptoms. I went to defy and started on 160 mg test split into 3 shots subq per week. I was also told to take DHEA and anastrozol at .125 2x per week. I admit I have been irregular with the AI. I’ve been trying to avoid taking it. Long story short, I did not have much symptom relief and at 6 weeks bumped up my dose to 200 mg per week and also started taking l-tyrosine. This has helped a great deal with energy, motivation, physical activity, depression and anxiety. My libido has improved a little but not much. I’ve only taken the AI when I felt high estrogen symptoms, mostly when I got irritable for no reason. My questions are as follows:

  1. Should I measure lab progress by tracking free test or bioavailable? I tried an online calc and apparently I need to input my total which is unknown.

  2. How can I reduce my reverse T3?

  3. Would HCG help libido?

  4. Would increasing my test dose help?

  5. Should I look into danazol to lower SHBG further? Or stinging nettle/boron?

  6. Should I even care about my SHBG since my free test is almost 20 points above range?

  7. Is my high level of estrogen causing low libido?

Starting pre TRT:

Total Testosterone - 827 ng/dl (264-916 ng/dl)

Free Direct - 16.5 pg/ml (8.7-25.1 pg/ml)

DHEA - 259.0 ug/dL (102.6-416.3 ug/dL)

SHBG - 63.9 nmol/L (16.5 - 55.9 nmol/L)

% Free Testosterone (Dialysis) - 1.4%

Post TRT 3 months:

Total Testosterone - over 1500ng/dl but test did not show actual number (264-916 ng/dl)

Free Testosterone (direct) - 48.4 pg/ml (8.7-25.1 pg/ml)

DHEA - 600.6 ug/dL (102.6-416.3 ug/dL)

Estradiol, Sensative - 77.3 pg/ml (8.0-35.0 pg/ml)

Free T3 - 5.2 pg/mL (2.0-4.4 pg/mL) (labs drawn after taking my meds)

Reverse T3 - 21.8 ng/dL (9.2-24.1 ng/dL)

SHBG - 56 nmol/L (16.5 - 55.9 nmol/L)

Calculated % Free Testosterone - not sure how to calculate this since i dont know my exact total.

Lots of questions. To reduce rt3, you could drop the t4 and increase the t3. The t4 you are taking is being converted to rt3.

To be honest, your pre trt levels seemed pretty good. Mid range for free t.

I would not bother messing with shbg.

Your e2 is pretty high. I would try to lower it. This forum is probably the most anti ai of the ones I’ve been to, but you are more than double the top end of the range. The amount of ai prescribed is pretty low. I would start with that, and you can adjust on your next blood work.

Thanks! My free test averaged around 12 for 2 years, the last labs were the highest. I’ll look into dropping the t4 and going to t3 when I speak with Defy again.

The correct treatment for high Reverse T3 is T3 only treatment, otherwise you convert T4 ->Reverse T3. Your very high Free T is why estrogen is a problem, Free T->E2. Bring Free T down to high normal (20-25.1 pg/ml) and E2 will decrease.

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