T Nation

Interpretation Challenge

Been self admin TRT for about 3 months and recent hormone check looks abit shocking. Comments and advice please. UK based

Been on 50mg of test prop EOD , results I got back.


471.0 nmol/L 7.60 - 31.40


31 pmol/L 0.00 - 191.99

docs note - ‘I see your testosterone has increased from entirely normal levels in March 2017 (23nmol/L) to what we might call ‘sky-high’ at 471nmol/L which is 15 times the upper limit of normal for men.’

Obviously I want what we all want high but safe levels of T. For now I’m doing 40mg of test prop EOD and seeking advice.I thought 50mg of test prop was a good round about way to get there , why am I 15 times the upper ‘normal’ limit?

30 years old
premature bald head , full facial hair , some chest hair
Had pubertal Gyno , operated on few years ago
Keto diet 6 days a week , a lot of caffeine
Training weights and cardio 5 days a week
Testes don’t ache but have shrunk since TRT , also chest acne.

will post blood work doctors note

Doctors Note
You have normal red cells.
You have an elevated level of eosinophils. This is commonly seen in allergy and in diseases like asthma and eczema. If you have any of these conditions then I would not worry about this result. It can also be caused by intestinal parasites, if you are experiencing any bowel symptoms then I recommend checking a stool sample for ova, cysts and parasites.
The slight increase in basophils is not a cause for concern.
You have normal clotting cells.
Your CRP level is normal, suggesting low levels of inflammation within the body.
Your kidney function is normal with no sign of underlying disease.
Your CK level is high, indicating either having high muscle mass, or engaging in heavy exercise or a protein rich meal prior to testing. Yours is only slightly increased and is not a cause for concern. The rest of your liver function is normal.
You have normal protein and calcium levels.
Your uric acid level does not place you at risk of gout.
Your HbA1c is normal indicating that you do not have diabetes.
Your iron levels are high and suggest a possibility of iron overload. Iron can go on to accumulate in some of your organs. If you are taking iron supplements I recommend reducing your intake. I also recommend a ferritin blood test to investigate this further.
Your cholesterol profile is reasonable with healthy levels of protective HDL cholesterol. However the benefits of this may be offset by your increased unhealthy LDL cholesterol level.
You may want to try the mediterranean diet which has proved to be effective in decreasing LDL cholesterol

I cannot read the labs and ranges are not shown.

You are injecting 175mg T per week and levels should not be extreme. If some injected into a vein, levels will jump.

I figured out the formatting…

Avoid iron fortified foods and vitamins. Read labels.
Iron can be up from large muscle injury, as well as CK.

You should not have split your case again. See August 10th thread.

Most do well with 1mg anastrozole for every 100mg injected T. A few are over-responders who need 1/4th that amount and no way to know in advance. For most, E2=22pg/ml - 80 pmol/L is a good target.

Why is E2 so low? Should be near 80 pmol/L.

Sorry , its a poor copy and paste job , ill use this thread , and try tidy it up.

So is 31.40 nmol/L a healthy limit or is that some soft and cautious official guidline? i have no idea why im 15 times , or why my E2 is so low , am i going to mess my self up carrying on at these levels?

My 23andme account says im genetically predisposed to hemochromatosis , im a blood donor as of yesterday.

So plan for now is stay at 50mg of prop EOD and start 1mg anastrozole for every 100mg injected and get retested in a month or two.

any comments or suggestions appriciated

Did you take note of KSman’s suggestion that you might have injected into a vain? When did you inject was it the day of our blood test or the day before? 175mg T per week is not an unusually high dose. I cant see how your T levels are even possible. There is a missing piece of information here, You are taking vastly more than you are saying or your test is wrong

I inject in all the typical sites , delts , glutes, thighs , as far as im aware its hard to hit a vein , i dont recall when i took the last shot before the sample was taken.
Ive gone back and checked im measuring right , test prop , 100mg test per 1ml , fill syringe to 0.5 ml , EOD.
When taking the blood sample i was struggling to fill the vials with the finger pricks , so had to cut my finger with a knife. Unless that tamperd with the readings somehow or cutting yourself creates a surge of test i dont know.
Perhaps ill have to go see someone and get them to take sample.

Im not a doctor but your results are crazy and your methods unorthodox. Get another blood test, let them draw the blood

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T 7.6-31.4 range is from a normal distribution of T levels in the sample population of males used to develop this data. Some labs have these ranges age adjusted and other labs can have different ranges. The ranges are typically meant to capture 95% of the sample group with only 5% arbitrarily “abnormal”. With TRT, this allows that only 5% of a population can be low-T when with advancing age, almost all will be low.

Better results Back this time. No clue what happend with last results.
Been on 50mg test prop EOD , 1mg of anastrozole per 100mg of prop. Blood Sample was taken 2 days after last injection , with test levels recorded as they are then , what would they be at there peak? @KSman @verne

              RESULT UNIT RANGE

TESTOSTERONE 31.5 nmol/L 7.60 - 31.40
FREE-TESTOSTERONE(CALCULATED) 0.563 nmol/L 0.30 - 1.00
17-BETA OESTRADIOL <18.4 pmol/L 0.00 - 191.99
SEX HORMONE BINDING GLOB 50.3 nmol/L 16.00 - 55.00

Doctors note

'Certainly you are now back in very much safer territory with your testosterone Kevin, with your total T just topping outside the normal range and with a mid range normal free T.

However your oestradiol is really low, and with your testosterone use, I wonder if you are using something to try to control your oestradiol. Most of the time this is really not necessary at physiological levels of testosterone.

As men we do need some oestradiol - if it is too low you can lose libido, despite a normal testosterone, and you can lose penile erections, as well as increasing the possibility in the long term of thinning of your bones.’

My plan now is to quit the Anastrozole , though my oestrodiol levels were low before that anyway and wonder anyway of getting them in a more healthy range? And maybe drop the Test to 40mg EOD?

any comments appriciated

I would lay off the Anastrozole for a few weeks and then see how things are, you may not even need an AI. I’m on 100mg T-cyp split twice weekly and in the 7 months since starting this protocol I’ve never experienced high E2. Amazing you got to the top of the range on only 100mg of Test. You might require more Test in order to bring that SHBG down as it’s still on the high side, surprised you doctor hasn’t upped the dose do to the high SHBG.

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Im in the UK so doing this on my own. My E2 was low before the AI , just thought id try because i was having some acne issues , that could be diet related though. If anything i need an E2 boost!
Im on 175mg per week of test prop. Your suggesting more to deal with high SHBG? i know nothing about SHBG , ill do some googling.
But that is still in range and my test is just out of range , and thats my test levels and the low point with my next shot due .


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good article , i get it now. But why do you think more test is the way?

If you were to retest SHBG and it was still high, larger doses are the only thing that can bring it down.

apparantly supplementing boron after 4 weeks can decrease SHBG by 30%. And as that article said , reducing stress and cortisol is an avenue to look at.
Im allready outside of range with test so id imagine more could lower SHBG as you say but have other negative side effects.