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Help with Labs and Feeling Crappy

So I’ve been on TRT for about 9 months now. For the first six months I felt pretty good and for the last 3 I have been struggling with feeling good. I had originally started on 140mg injecting once a week. Staying on this protocol i had elevated hematocrit and had to donate blood every 3 months to keep it in check. After a few months on this I started to develop bad acne but test levels were good and so was my e2. Clinic dropped my dose down to 100mg and redid bloods and my test was back down to 500ng/dl but my hematocrit was well within range and acne disappeared. So we brought it back up to 120mg and stayed on that for a bit to get my test levels back up also added HCG 2 times a week at 350iu.

Libido went up big time and I felt great for a bit but that brought back acne soon enough. So after that I found a great urologist to take over my treatment.

He bumped me back up to 140mg and went to twice a week injections and started taking .25 of AI once a week. I felt great again and my strength started going up in the gym. After of being on this for 6 weeks I started to get heart palpitations and my hematocrit shot up higher than its ever been and I just didnt feel that great.

These were my labs at that point:

Testosterone Total
1082.0
249.0 - 836.0 ng/dL

SHBG
24.09
16.50 - 55.90 nmol/L

Free Testosterone, Calculated
28.02
2.29 - 20.70 ng/dl

Bioavailable Testosterone
744 High
15 - 575 ng/dL

Hgb
18.0

HCT
55.8

Estradiol
40.2
11.3 - 43.2 pg/mL

Prolactin
8.3
4.0 - 15.2 ng/mL

T3 Uptake
32.94
24.00 - 39.00 %

Free Thyroxine (FT4)
1.08
0.93 - 1.77 ng/dl

TSH
1.590
0.450 - 4.500 uIu/mL

Vitamin D
33.4
30.0 - 100.0 ng/mL

Sleep has been shitty, I crash in the afternoon right after I eat lunch. Very aware of my heartbeat when I relax, bit of anxiety and my sex drive is not that great.

Before this current protocol my e2 never got over 29 and now its pushing the upper range. Could e2 be the culprit of all of this ? Any help would be great!

Probably get off of the AI and also the HCG. Both are known to make people feel like shit. Give that 8 weeks at 60mg x 2 a week and see where you stand. Also you need to get onto a D3 supplement. You are deficient. And fix your sleep.

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I dropped both 4 weeks ago and donated blood right after those labs. Felt better for about a week and all the symptoms came back again. Maybe I just can’t handle the higher test levels that I’m getting?

Give it 8 weeks and then reassess.

Some guys don’t do well on infrequent dosing, I see it a lot on these forums and your case is typically around here. Your SHBG is on the lower end and total testosterone doesn’t need to be on the high end of the range to have sufficient free testosterone.

You need smaller more frequent injections to keep total testosterone around midrange or slightly higher and to keep levels from dropping too low. This is why weekly injections will not work for you and I don’t think twice weekly will work either, it might be a little better, but you need greater control over hormone levels.

All your symptoms are from hormone levels that are too high. You also need to lower your dosage significantly if you are going to inject more frequently, less equals more of more frequent dosing. You may be paying a heavy price using HCG and AI’s, TRT in isolation is so much better.

Interesting…I’m on twice weekly now of 120mg e3.5d so dropping the dose to say 100mg a week and taking roughly 32 mg every two days may be a better approach?

I think the 32mg every other day would be better, you’ll aromatase less and push testosterone high and estrogen lower.

I just took my 60mg shot this morning so just wait 3 days and do 32mg and keep that up from there on.

Just a reminder that when you make ANY change in your protocol you cannot accurately assess those changes for 8 weeks as your body adjusts. Don’t change horses in the middle of the stream.

Going to wait another 3-4 weeks and do bloods then change. When it comes to the vitamin d I take 5000iu daily and I’m still at the very bottom of the range. I guess I should bump it up To 10,000.

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Some people, like me, are genetically unable to convert sunlight into vitamin d. I take 10,000 iu a day and get it to around 63.