I’m 29, 5’8", 140lbs, and started TRT slightly more than a month ago using one of the online dealers. Before total test was in the 300s and e2 was 19.
I suspect the low numbers were from high cortisol, which I’ve been struggling to fix for the past few years. (To give more background, I’ve had insomnia since I was a kid, and usually have trouble digesting food.)
So I start TRT. One injection of 100mg cypionate a week, a daily clomid, and a once a week AI.
After the first week in, I start feeling hot all the time. Dropped the house temp to 65F and yet I still wake up in the middle of the night feeling hot. Couldnt figure out if it was just muscle gain or high e2. But it seemed to get worse, so I do a lab test (through Quest Diagnostics, not labcorp). Take in mind that I did this test at a bad time. It was the day after my third injection, so most docs will probably be like “wtf this is useless”. But the results were surprising:
Total test: 1840 ng/dL (250-1100 normal)
Free test: 392.6 pg/mL (35.0-155.0 normal)
Estradiol: 93 pg/mL (<29 normal)
All numbers too high. I googled a bit, and a lot of studies I looked at gave the idea that the day after an injection, total test levels tended to be 300 above what they were immediately before injection. So napkin math says this is equivalent to a baseline of 1500, which is more than I’m looking for. I dont want to be some ripped hulk, just want good levels. Somewhere in the 800-1000 range.
I talk to doc, and he says its fine, keep doing the protocol, donate blood (because hematocrit went up a bit), and take two AI doses a week instead of one.
I think thats an absurd answer and that I should lower the dosage. So I do another blood test the morning before my fifth injection:
Total test: 1560 ng/dL (250-1100 normal)
Free test: 312.8 pg/mL (35.0-155.0 normal)
Estradiol: 38 pg/mL (<29 normal)
E2 went down at least, but I still think that total test is way too high. I email doc and the only response I get is that I should continue current protocol. He doesnt answer any of my questions, and doesnt explain his reasoning at all, which really pisses me off.
So I guess my question is: Is this really an acceptable number? I figure if I lower the dosage, I’d get a decent number while also reducing the need for an AI and bloodletting (for hematocrit). Are there other attributes that matter more than total test? Maybe the numbers spike more in the first month? And what about my weight? I’m 140lbs. Shouldnt I start with less than the average starting dose, since most people weigh way more than me?
I’d also like to know if these numbers indicate that clomid on its own is good enough for me and I dont need injections. Perhaps I merely have secondary hypogonadism due to high cortisol, and clomid clears that up and gets my balls running in top gear. Some of my old labs indicate low LH and FSH, so that conclusion could be logically sound.
So far I’ve switched to do twice a week injections of 50mg. (In my first convo with doc, he said twice a week injections were acceptable, but then put “once a week” on the prescription and said to follow it exactly). But idk if thats low enough, because my understanding is thatll keep the baseline consistent and decrease e2, but wont actually drop the total test numbers at the end of the week.
And also, if I adjust dosage, how should I adjust the AI dosage to match? Additionally, how long after a change should I wait to do a blood test to see its effects?
So far I have very low confidence in the doc. Literally every interaction I’ve had with this company has left me feeling pissed off, and I figure theyre just pill pushers that just want their $200/month.
I really think my logic makes more sense. But I also dont want to anything wrong and then fuck myself up. So what do you guys think?