T Nation

Help Understanding My Labs

Blood test from March 25th 2021 - Non-Fasted

I’m a 38yr old male, been on test gel for 18 months.
Sleeping well but starting to feel that familiar lack of energy, libido, mood…

I’m thinking of moving from my PCP to go see Dr Rotman. But wanted the forums inputs on my labs beforehand.
I’m training frequently (5days a week) but find that I am missing both the results and the motivation from my early 30’s. I used to lift weights get strong, feel good, want to lift more weights. Now every trip to the gym is a real chore.

I realize this is probably a case of the COVID blues - but I wanted to check.

Seen really helpful posts from:
Hoping they can help me.

Free testosterone = 137.0
Total testosterone = 1018

How concerned should I be about my Cholesterol?

Total = 197
LDL = 127
HDL = 47
Non-HDL = 150

I would say not at all.

According to Pfizer, who makes and sells Lipitor, you should be on a statin.

  1. If HighPull says not to worry about your cholestorol, it’s safe not to worry about it.

  2. Everything else looks good. You look like a healthy man on paper.

I saw that you’re looking to change providers. What’s the motivation? What feeling are you looking for?

I personally was looking to feel confident, get jacked, and have a strong libido, in that order. But everyone’s looking for something different from TRT.

I didn’t feel good on 160mgs/wk, which put me around 1000-1200 total T. I didn’t even feel like I was on TRT. Switched providers and went 220/wk, which put me at 1400 total T. Still didn’t feel good. Nowadays, I cruise on 300-350, no AI, and feel pretty good right there. SO RECKLESS AND DANGEROUS!!! some might say. I’ve been at that dose for over a year now and, between my GP doc and TRT doc, had every lab run known to man. I than lower SHBG, I’ve seen no negative impacts. I’ve had a couple bouts with high blood pressure while experimenting with NPP, but this resolved upon ceasing the NPP. Other than that, no risks to my health have manifested.

With your total and free T levels, you likely won’t feel superhuman. You won’t feel that unless you just about double your free T numbers. You’re just at the top of the normal human being range. Which means you’ll feel like a normal human being. When you’re well fed and well rested, you’ll feel good. When you’re not, you won’t. When you train 5days a week, you will feel burnt out(assuming you’re training with any intensiveness at all). If you’re looking to feel superhuman, you’ll need superhuman T levels.

Not telling you what to do or recommending anything, but I didn’t start to feel superhuman until I got on 300+mgs a week. That’s when I started to get very strong libido, high confidence, and recovered quickly from hard training. If I hadn’t played around with AI doses and just left them alone, I probably would have stayed on 300mgs/wk forever. As it was, in my foolishness, I kept playing with AI dosing, thinking that I could feel even better if i could just get E2 in range. As a result, I never really felt great. Lots of highs and lows. In hindsight, I should have just done 300 forever and left E2 alone. It would have saved me months of rollercoastering.

What’s my point? If you don’t feel good, tell your provider you’d like to try more. If he won’t give you more, switch providers. And don’t use AIs. Find the max amount of Test you can tolerate without using an AI and just stay there. You gotta find what makes you feel good. It won’t involve AIs, I can tell you that. I’m not anti-AI, so I hope I haven’t invoked the members of that fight club, but I just think that the negatives outweigh the positives and while they are sometimes necessary, their use should be avoided, if possible.

I’d be remiss if I also didn’t add that there’s a small chance you need less testosterone. A rare breed of individuals exist that need very little and actually report feeling better at lower doses. It’s worth it to try and discover if you are one of these rare few because medical community seems to agree that minimum effective dose has the lowest risk.

I am very open about my experiences and love to help people. If you have any questions at all please don’t hesitate to ask.

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Firstly thank you for such a thorough reply - really helpful. I have a made an appointment with a TRT doc for next week to dig a little deeper into increasing the dose in a controlled manner.

The feeling I am after…
feel mobile, get jacked, and have a strong libido, in that order :slight_smile:
After a knee reconstruction and various back injuries I am just starting to feel like the Tin Man. I have a pretty extensive stretching and mobility routine but I just feel like I am rusting shut.

The last time I felt good I was on a self sourced cycle before being diagnosed with low T.
I suspect I was running much higher numbers than the gel can achieve.

So to be blunt - Superhuman sounds pretty damn good. Just roll back the clock about 8 years would be ideal.

I’ll let you guys know what the doc says.

Thanks for the honest heads up about the lower numbers. I don’t think I am that rare breed as I have gradually moved through the Total test numbers over the last 18 months.
original diagnosis 105… after 3 months on the gel 450… now at 18 months 1018.

So I feel i have a broad sense of what the different levels feel like. None of it compares to the self administered route. Just trying to find a balance between results and safe methodology.

Hats off to you Sir! I remember when you weren’t feeling well. Glad you saw a way out of it.

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Plenty of nay sayers when it comes larger doses. If you start at 200mg stick with that and dont add a thing. Dont start changing things because you dont feel different the first few weeks. TRT takes time. Im 1.5 years in and it took me a full year to go from 160mg to 220mg. The changes are now evident, and consistency is what got me there.

I was able to do this at the lower doses. Actions I took:

  1. At the advice of my chiropractor, I stopped eating sugar and dairy(they cause inflammation)
  2. Also at the advice of my chiropractor, I started taking a brisk walk, followed by a full body stretching routine, every other day.
  3. I started using a massage gun every night after a hot shower. Mine is a “Tapping Pro” about $150 on Amazon.
  4. I balanced my workouts more, making sure to do equal amounts of pushing and pulling, extension and flexion.

Please do. Wishing you the best.

Thanks Middle Ages. Your advice at the time was sound. Thank you for trying to help me. I was just too neurotic to follow it. It doesn’t appear OP has that problem. He seems to adhere to doctors orders well. I think a solid increase in his dose will help him tremendously because I felt much like he describes at the lower doses, too.

When you start something and aren’t getting what you expect out of it, it’s very hard to stay the course. It’s like the gym newbie who program hops. So I tried changing things every couple weeks. All I learned is what doesn’t work.

When a friend referred me to a doc willing to almost double my dose, it was an entirely different world.

I was apprehensive at first, but I checked out Danny Bossa’s claim one day that Testosterone has never once been proven to cause harm. Turns out he’s right.

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Danny Bossa had sound advice, he was met with tons of resistance and he fought back, which is what did him in. He knows what he’s talking about. His method is what got me to a better place too. Once he got banned the void has been slowly getting filled with the opposite of what he preached. Oh well. Glad you’re on the up and up

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Hi All,

So I got the Theragun message tool and that has been helping with my hips/pelvis. I still wake up very tight and do an ab routine to get moving. Thinking of getting a new mattress as I worry this one might be too soft.

I also adopted the hamstring warm up and glute activation protocol as per the Matt Wenning warm ups on YouTube. I’m still in quite a lot of discomfort but hoping consistency will work this out.

Just went to see Dr Rotman. Took bloods etc and looked at my levels from March that I posted here.
I am currently on a gel that contains 50mg test per 5 gram tube.
I was not prescribed a HCG with this and the Dr felt this was a mistake.

Does everyone use a HCG along with their test?

Doc has prescribed 0.5ml weekly as a subq injection and a daily clomiphene pill.
This has just happened - so I haven’t received any of the medication yet.
Does this sound overly conservative to anyone else?

Heading back to him in 3 weeks for follow up bloods.

Why clomiphene?

.5 is 100 a week. Many test the top of the range and even over with this amount.

What frequency?

Btw I’ve seen dr rotman for 2 years

Your Free T is almost exactly average (average based on your lab’s range is 135), so you definitely won’t feel superhuman at those levels.

Keep in mind though that Testosterone is not the only hormone that matters. Your HGH/IGF-1 levels could be low also, which supposedly (I’m about to start GH myself) has a huge impact on energy levels and recovery from workouts, sleep quality, etc…particularly if you’re deficient.
I believe that’s partly why a 40yo won’t feel as good as a 20yo even with the same Test levels.

My personal theory as to why some need extremely high levels of Test to feel good, is that the Test is making up for other deficiencies. There was an article where the guy explained how higher Test levels will create an excitatory state in your brain which will make you feel great but isn’t sustainable, which (again imo) is probably why certain men report losing the benefits of TRT after years of use.

When I started TRT I was all about Testosterone. “Test is good, more Test is better, Test is good for everything, etc…”. As time goes by I’m starting to realize that while Test is great and important for many things, there are many other hormones that are important. Your thyroid, neurosteroids such as Pregnenolone and DHEA, HGH, Cortisol, etc…

That’s why I personally don’t buy into the idea of blasting more and more Test until symptom resolution. You might feel your symptoms are resolved on 300mg/week of Test, but you’re probably making up for other deficiencies and there are probably some serious long term problems waiting for you. Keep in mind that not everything shows up on a blood test. Neuro toxicity and left ventricular hypertrophy among others.

High levels of androgens are neurotoxic and lead to neurodegeneration, even from Testosterone. I don’t think we can link to other forums but google “androgens neurodegeneration r…”, where “r…” is the name of a famous forum. It should be the first link.

My advice would be do a more complete hormonal pannel. Look at GH/IGF-1 at your age, and the other stuff I mentioned. If you get on TRT you could see benefits from it by pushing your FT to the top of the range, but if you get there and don’t feel the resolution of every single negative symptom in your life, I would strongly advise you to look at other hormones in which you could be deficient and not raise your dose more and more until all those symptoms are gone.

Testosterone does certain things, but not others. Don’t use it to solve all your problems. There’s a typical human tendency to use oversimple models to deal with the complexity of our environment. Don’t make that mistake. Testosterone is only one, albeit important, hormone.

EDIT: Just saw your protocol, is doesn’t make sense to me. Why add the Clomid? Minimize the number of drugs you take. The beauty of TRT is that Test is a bio-identical hormone your body and brain are already designed to know how to work with. Same with GH, Pregnenolone and DHEA.
Clomid is not in that category and you don’t need it. I would drop the Clomid and start at 50mg 2x/week (100mg/week total) IM injections. Start with what’s known to work, subQ doesn’t work for some people, I felt terrible on it and so do many others. You might need to go to more frequent injections to feel really stable, but 2x/week is a good start imo.

Am i right in thinking SubQ is into fat and slower releasing than IM?
I’m happy to inject either way and said so to the Dr, he said the glute injection benefit was a myth from body building.

CLOMID - This may be because of the following I verbally described:

  1. I’m 38 - been on gel for 18 months but plan on having kids in 2 years.
  2. I previously had gynecomastia - surgically removed. Before starting TRT.

I suspect its in response to comment 2.

and the HCG discussion is response to comment 1.

thank you @disciplined_trt - all valid points that I take on board.
At the three week mark when I do the follow up bloods I will ask about the HGH/IGF-1.
Is the HGH available through your Dr in the United States?

Like you say; more might not always be more, as I started down this TRT road I always knew it would be a balancing act.

I received my prescription.

Test Cypionate 2000mg/10ml
Clomiphene 50mg pill once per day.
Anastrozole Tab 1MG - Take 0.5 twice per week.

I wasn’t expecting an AI and it wasn’t discussed during the appointment.
Any advice?

Also - the Doc said take half of my prescribed Test to start… what is that on the syringe?
Can it really be 1/2 - that seems so little. Surely it is 1ml?
please help!!

I can answer about the testosterone.

1ml=200 mg

So you need to inject a total of .5 ml per week. So if you doing 1x per week it’s .5 cc on syringe.

Looks like he gave you enough to inject up to 200 a week. But stick with .5 ml like dr said.

I don’t know of many protocols with t and clomid and ai. I would do what dr said and keep us posted.