When I started reading that your Total T was towards the higher end and Free T lower, I immediately started scanning for your SHBG levels, imagine my surprise.
Let me first say you sir hold the record for the most efficient SHBG I have ever seen, maybe a little too efficient for your own good. See there is a variability in the stickiness of a SHBG from person to person.
I’ve seen guys in the 70’s with good Free T levels and guys in the low 40’s with bottom end Free T levels, but yours takes the crown as the stickiest SHBG around at 33 and your Free T is almost bottomed out which leaves little doubt.
Total T is bound to SHBG and not bioavailable, it doesn’t influence anything in the body, Free T is bioavailable and is the portion of testosterone circulating in the blood and does all the amazing stuff, like build muscle, libido etc.
Your Free T percentage is 2.05 %, just barely within normal (2-3%), you wouldn’t be the first to complain of symptoms at the bottom percentile. This is what I call double confirmation testosterone is low.
What should be happening here is your pituitary gland should be increasing LH and therefore testosterone do to the low Free T, that’s not happening is lazy pituitary gland. Sometimes we see men with total T in the 2000’s, LH very higher and SHBG 246 is that once instance, Free T extremely low.
When I was diagnosed with low testosterone I had low Vit D, started TRT and Vit D corrected itself, however whenever I change dosages, it drops again for a couple of weeks until my testosterone become stable again which takes 6 weeks. Also note some people Vit D drops in the colder months and increases in summer time.
Considering all your levels twice weekly or an EOD protocol may be needed, T-cypionate causes spikes in estrogen, yours is already elevated near the top and Free T is low, when Free T gets to high normal estrogen will likely double. When that happens, not always, but most of the time it kills libido and erectile strength, bloating/water retention and causes mood problems.
I have issues with weight and therefore estrogen, for that reason I inject my small doses EOD, on a twice weekly protocol estrogen is very high and intolerable. There are some who really have trouble with estrogen, these guys do very well on daily dosing using insulin syringes of course which is what everyone should be using anyway.
More frequent dosing can also lower CBC labs across the board. You need to find out if there may be a cause for high CBC labs, or get used to donating blood on TRT. I wouldn’t donate too often or ferritin can be depleted. Normally we see high CBC labs in men who are injecting too much testosterone, yet your Free T is low.
Sleep apnea can cause high hematocrit as the body attempts to compensate for a lack oxygen throughout the body during sleep.