First Labs Since Starting TRT, Test Is a Little Low for the Dose

Pharma / TRT Testosterone Replacement
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Hey guys, I had my first set of bloodwork done which included hormones + lipid panel, CMP, TSH, T3/T4, Hemoglobin A1C, CBC, SHBG, Iron, PSA, etc. Most everything came back in normal ranges except for my iron levels and HDL, and I had some general questions about my protocol and how to tell if I can optimize this. I’m 6’5 and 279 lbs - I’ve actually been able to lose weight easier since starting this six weeks ago (I started at 290).

I had these bloods done at the beginning of week 6, about 48 hours after my last injection. I’m prescribed 160mg/week of test cyp injected every 3.5 days so this is pharma grade stuff here. I have noticed a bigger boost in mood/confidence and a bit higher energy levels, and have seen some of my lifts go up at the gym but at 160mg a week I’m really surprised that my test is rather low comparitively.

Hormones:
Total Test: 741 ng/dl (was 344 ng/dl)
Testo Free: 139 pg/ml (was 67.3 pg/ml)
Estradiol: 44.4 pg/ml (was 17.3 pg/ml)
SHBG: 28 (was 23)
Prolactin 10.8 ng/ml (was 9.1 ng/ml)

CBC:
RBC: 5.69 (was 5.45)
HGB: 16.6 (was 15.8)
HCT: 52% (was 46%) → cause of concern?
Platelets: 301 (was 267)

Lipids:
Cholesterol: 148 mg/dl (was 157)
HDL: 37 mg/dl (was 45 mg/dl) ref range is >40
LDL: 95 mg/dl (was 88 mg/dl)

Iron:
Iron: 60 ug/dl (was 87 ug/dl)
Iron Sat: 17% (no ref for before) ref range is 20-55%

I can post the full labs here if needed but everything else is in range. What I am a little concerned about is my HCT and my low iron. I do take 3g of Kratom a day to unwind and I’ve heard that sometimes Kratom can cause iron deficiency. I cut it out of my diet already so we’ll see how that goes.

Do you think based on my estrodiol/SHBG and CBC that I may be able to try and increase to 180mg a week? It looks like the 17:1 ratio of Test:Estrodiol I’ve seen on here is pretty spot on for me. I’d like to try and optimize my TRT dosage though if I’m only getting 750 total test and have already taken the plunge to get on TRT, that seems awfully low considering other people on here are getting into the four figures on that dose.

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Goal of trt is to get your test in range. It is in range.

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Chasing/comparing TT numbers is kind of pointless. Further, your SHBG is on the lower side so your labs are going to show a lower TT than others while FT would be perfectly adequate. Last

Some are but they shouldn’t be. Is your goal TRT or taking a legal route for a PED? TRT wise you appear to be on the proper path and still optimized just not to PED levels.

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The HCT isn’t a concern at this level, the international cutoff on TRT is 54% which then requires either a blood donation and or dosage reduction. I’ve had mine at 55% and my hematologist wasn’t concerned because I wasn’t symptomatic and my blood pressure was amazing (110/64) before the phlebotomies.

Currently mine is 52.2%. I also take 140 mg iron daily because TRT significantly decreases my ferritin.

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Thanks for all of the input guys. Did you find that supplementing iron increased your HCT?

I hear you guys about the TRT dosage. It’s tempting to continue to go a little higher to try and get to 800-900 though if I’m going through the effort of doing it. I’m already seeing a benefit 6 weeks in but I’d like to try and optimize the levels if possible - although wouldn’t higher T make a higher risk for hair loss? I guess the question is how much higher. Could I eek out another 100-200 total T without much more risk?

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A little bit. When I was iron deficient, hematocrit was 49 and compared to now, is 51%. I’m currently at 52.2% due to being dehydrated, due to a new blood pressure medicine which I’ve since stopped.

So a 2% increase taking 140 mg or five capsules (28 mg each) of iron. That’s a lot of iron.

I needed ferritin 80> to really start feeling the affects of TRT. The low iron is absolutely holding your progress back.

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Hmm. I’ll look into this. I mean if I have the same reaction as you that’ll put my hemocrit at 54%. Granted I live at around 6,000ft elevation so maybe it’s not as bad.

What supplement do you recommend? Heard some things about desiccated liver