Have a T Prescription, Unsure If I Should Fill It

Hello everyone,

I am 29 years old and my most recent Total T was 378 ng/dL with free T of 7.0 pg/mL (another test with a different company in same month/time of day showed 502 total and 9.63 free)

My symptoms have been low energy, lack of libido, lack of enthusiasm for life/depression, anxiety, and erectile dysfunction (but I think the ED is psychological because it’s only a problem when I have a girl with me. Works fine when I’m by myself, and I still get morning wood).

I recently had a consultation with Defy Medical and got prescribed 150mg Test C/week (over 3 injections), 350 iu HCG 3x a week, Anastrozole 0.125mg 3x a week, and DHEA 25mg by mouth every night.

I’ve been having some serious second thoughts about this based on the following reasons:

  1. I work for the military in Korea, so while I can receive the medications at my military shipping address, the sensitive estradiol blood test is not available in Korea. This concerns me because I know balancing E2 is one of the most important aspects of TRT.

  2. 150mg/week sounds like a high starting dose and goes against the adage of “start low and start slow” that I’ve heard others like Dr. John Crisler advise. The reason for it I was told is that my SHBG is high (46.38 nmol/L) so I need more T to have an effect.

  3. I’m not sure it’s a good idea to start on an anti-E off the bat. I’ve always read it’s something to use only when you see symptoms of high E.

I am currently leaning toward not starting TRT due to the reasons above, however I’m not fully decided either way. I am hoping to hear what other people think as well. Thank you for your help.

My historical blood test results through the military have been the following:

July 2018: 378 ng/dl; 7.0 pg/ml free

May 2017: 448 ng/dl; 6.6 pg/ml free

December 2016: 376.6 ng/dl

June 2016: 370 ng/dl; 6.0 pg/ml free

I also had a blood test done by a private clinic in Korea in July 2018, with the following results:

Total T: 502 ng/dl

Free T: 9.63 pg/ml (range 5.4 to 40)

Estradiol (E2) (not the sensitive test): 20.78 pg/ml

Total Estrogen: 119.88 pg/ml

DHEA-Sulfate: 205.34 ug/dl

SHBG: 46.38 nmol/L (range 18.30 to 54.10)

PSA: 0.60 ng/ml

TSH: 2.090 IU/ml

FSH: 2.69 mIU/ml

LH: 4.65 mIU/ml

Free T3: 3.22 pg/ml

Free T4: 1.57 ng/dl

Prolactin: 14.76 ng/ml

HDL: 61.6 mg/dl (H)

LDL: 63 mg/dl

Triglycerides: 42 mg/ml

BUN: 24.1 mg/dl (H)

Insulin: 3.39 mIU/L

Vitamin D: 46.18 ng/ml

Cortisol: 16.52 ug/dl

Albumin: 4.92 g/dl

Progesterone: 0.29 ng/ml

IGF-BP3: 2052.85 ng/ml

IGF-1: 143.96 ng/ml (L)

Hemoglobin: 14.5 g/dl

Hematocrit: 45.6 g/dl

RBC: 4.73

WBC: 5.68

  1. I wouldnt worry to much about which test you can get for E2. I have always used the standard, non sensitive test and I have a perfect sense of where my e2 is at. Someone on here also did a comparison, and they aren’t too far off, with the non sensitive test sometimes showing a slightly inflated number. Your e2, on the non sensitive is kinda low.

  2. Yes, 150 a week is a little high Higher SHBG needs higher doses. You are going to a well respected physician and I would follow what the doc told you. THAT BEING SAID… I have a very similar SHBG and I am using 100 mg right now, No ai or hcg, and I am absolutely zeroed. I feel great. So more isn’t always better. I am not advising you to do anything other than follow your doctors orders btw…

  3. You are already ahead of the game if you ask me. AI’s are garbage, and have caused ME personally, nothing but problems. My TRT didn’t work until I stopped messing with my E2.
    With high SHBG, you will likely crash your e2 easier. That’s the case for me. Anytime I use ANY supplement that increases liver function, I tank my E2 (not cool btw, super detrimental) Calcium D glucarate, Sam-E.

That’s just my input from a fellow HIGH shbg guy. I run urually 50-60, but have been as low as 37 and as high as 70 (when I was taking some medications that made it higher)

Also Educate yourself on what increases SHBG.

Certain meds, diet, IF, Keto…

I believe all you need is a little perspective.

I don’t think you understand the implications of low testosterone, it’s life threatening and your levels are in the range of disease state. Remain in these ranges long enough and heart disease, cardiovascular disease on the short list is a sure outcome.

I believe your higher starting dose is based off your low Free T in relation to your Total T which are affected by your SHBG level. Studies show men with high normal testosterone levels are 30% less likely to die than those in the middle ranges, go a step lower and mortality rate is even higher.

I feel like death when my Free T is midrange, I need Free T to be high normal to feel good.