T Nation

Labs After Sub-Q TRT, E2 & Hematocrit Skyhigh!

Hi all,

I just received my lab results taken one month after switching to my new sub-Q protocol:

62.5mg sub-Q T enanthate 2 X week (total 125mg EW) + 250IU sub-Q HCG 2X week (total 500IU EW).
both injected at the same evening, each of them in a different place in the abdomen.

I’m 23, healthy and trying eating healthy - low carbs/high protein/moderate good fats.
eating 200 grams of cruciferous vegetables every day (broccoli/cleavage).
supplementing daily with fish oil, vit C, multivitamin (no iron), zinc, magnesium, TMG, creatine, MSM, & 5000IU vit-d.
training regularly in the gym.

blood was taken on 10/02/2014, the morning of my scheduled day for the first weekly evening injection:

DHEA SO4 7.78 UMOL/L ( 7.60- 17.40) (…)
ESTRADIOL(E2) 196.42 PMOL/L ( 0.00- 146.10) (…)

FSH < 0.8 ( 1.40- 18.10)
LH < 0.2 ( 1.50- 9.30)
PROLACTIN 178.86 MU/L ( 45.00- 375.00) (……)
TESTOSTERONE 33.31 NMOL/L ( 8.40- 28.70) (…)

FREE ANDROGEN INDEX 86.20 ( 30.00- 150.00) (……)
SHBG 41.10 NMOL/L ( 13.00- 71.00) (…

FREE T4 13.20 PMOL/L ( 9.00- 19.00) (……)
FREE T3 3.00 PMOL/L ( 2.66- 5.70) (
TSH 2.03 UIU/ML ( 0.35- 4.94) (…*…)

WBC 4.60 K/UL ( 4.00- 10.00) (…)
NEUTROPHILS 2.60 K/UL ( 1.80- 6.60) (.
NEUTROPHILS % 57.30 % ( 46.00- 68.00) (……)
LYMPHOCYTES 1.50 K/UL ( 1.10- 3.50) (.
LYMPHOCYTES % 32.00 % ( 15.00- 45.00) (……)
MONOCYTES 0.40 K/UL ( 0.08- 0.90) (…
MONOCYTES % 8.80 % ( 2.00- 9.00) (…)
EOSINOPHILS 0.10 K/UL ( 0.00- 0.60) (.
EOSINOPHILS % 1.50 % ( 0.00- 6.00) (.…)
BASOPHILS 0.00 K/UL ( 0.00- 0.15)
BASOPHILS % 0.40 % ( 0.00- 1.50) (.
RBC 5.38 MU/L ( 4.30- 6.00) (……)
HEMOGLOBIN 17.30 G/DL ( 13.50- 17.50) (…
HEMATOCRIT 49.90 % ( 38.00- 50.00) (…)
MCV 92.80 FL ( 80.00- 98.00) (…
MCH 32.10 PG ( 27.00- 33.00) (….)
MCHC 34.60 G/DL ( 32.00- 35.50) (…
PLATELETS 161.00 K/UL ( 150.00- 400.00) (…)
MPV 7.80 FL ( 6.50- 11.50) (.
RDW 13.80 % ( 11.00- 16.00) (…*…)

a few questions came up:

  1. ESTRADIOL -it is way above normal range! what should i do? i thought that SC injection should lower it.
    is Arimidex/anastrozole the only solution? what exactly should I ask my doc, and what is the recommended dosage?

  2. I currently have no place to get an AI, would taking dim(diindolylmethane) or Indole-3-carbinol may help?

  3. should I consider changing my protocol (HCG dosage/frequency)?

  4. HEMATOCRIT - very high. with androgel I never got those high numbers.
    does it mean I must donate blood? is it a regular donation or RBC only donation? I never done this before.
    are there other ways of decreasing it?

  5. HEMOGLOBIN -very high too. is it correlated with HEMATOCRIT? same questions for it.

  6. DHEA SO4 - it is almost bellow range, what does that indicate? should I look into it?

  7. how are my T / FREE ANDROGEN INDEX / SHBG values?

  8. lastly - what do my TSH/T3/T4 indicate about my thyroid?
    from measurements I took for a week I’m getting 36.0 celsius (96.8 fahrenheit) every morning in bed before getting up.
    am I iodine deficient? noting again that I’m eating 200 grams of cruciferous vegetables each day (which may interfere with iodine intake).

sorry I have so many questions,
I appreciate any help.

Your Hct, Hgb, and RBC values are great. They aren’t skyhigh but rather are what you would want to see in a healthy male with a solid androgen level. My Hgb, Hct, and RBC was that high before I even began TRT. If you were 80 or 90 I wouldn’t expect numbers that high but you’re 23. At 52% Hct you would want to be on careful monitoring, at 54% it’s often best to discontinue but at 49% you’re ideal.

Keep in mind that other factors like hydration status are needed to evaluate blood values. You haven’t supplied any critical information like BUN, creatinine, Na, Cl to make a more informed judgement.

As for the AI, you need one, especially at that level of TT and your rate of conversion to E2. With a number that high a good Endo should be fairly easy to convince. Losing body fat and reducing your Testosterone would help somewhat.

Your MCV is on the high side, are you a recreational smoker, have asthma, allergies, or live at a high elevation?

Ugh I hate seeing doctors prescribe T to early 20yrs olds!!! You probably have secondary hypogonadism and TRT will make this disorder worse for you.

Your estrogen is too high as the above poster said, you DO need an AI. Recommend Aromasin to them at least 12.5mg/day starting and perhaps up to 25mg if it doesn’t decrease.

Your thyroid, though t4 and tsh are good, t3 is worrisome. Estrogen does affect the conversion of the storage hormone t4 into the active form t3. So lowering that should help. If not I would look into testing reverse t3. P.S. cruciferous vegetables are goitrogens (prevents the thyroid from taking up iodine), so please cook your vegetables to prevent this and/or supplement with iodine.

DHEA is perhaps on the lower end because your body has shut down its own production of sex hormones but, that is my theory. If you are truly concerned supplementing with dhea will not damage anything.

You mention HCG so you are on HCG? If so good…

Your numbers don’t appear to be as bad as you think other than your estradiol, but like C27 said you didn’t provide a lot of info needed. My big question is have you grown a Vagina yet, do you have any high E2 symptoms?

thanks for the quick replays,

more info about me:
I have pretty low body fat - around 10%, and I actually drink a lot (water, no alcohol at all :slight_smile: ).

thanks for the tip about cruciferous, I plan on supplementing with iodine 300 mcg/day.
I know it’s a low dose comparing to iodine load of 50 MG or so, do you think I need to go there?

about MCV - well i don’t smoke, have asthma, allergies, or live at a high elevation.
what does the high value indicate and should I worry?

thanks for the the info about Hct and Hgb, just another detail - I have pretty low blood pressure (95/60 and less) and pulse (60),
does it matter?

I’m actually on HCG , as my protocol again is:
62.5mg sub-Q T enanthate 2 X week (total 125mg EW) + 250IU sub-Q HCG 2X week (total 500IU EW).
both injected at the same evening, each of them in a different place in the abdomen.

I’m now considering injecting the HCG a day before the T instead of both together (did it for convenience only),
would it make much of a difference E2 wise?

and I’m somewhat unsure if the HCG dose is effective, is the a way to tell?
blood test values or even something with pregnancy test I think I once read…

about high E2 - well I currently don’t have high E2 symptoms, but should i worry about gyno? what are the indicators that thing get worse?

should I have obtain a SERM just to have a quick treatment if a gyno will occur, and if so which one is recommended?

many say the optimal E2 is about 22(pg/ml) while mine is 53, but again I understand that T is high too?
what is ratio of E2/T or E2/free T that I should seek?
as for lowering my T dose - as long as that ratio is in place what’s bad in having a bit more of both?
any long term health considerations?

from an online calculator i got this values (from SHBG+FAI):
free testosterone - 0.705 nmol/L = %2.12
bioavailable testosterone - 16.5 nmol/L = %49.6

just for my understanding - should i seek lowering SHBG to have more free T?
how do I effect it?

thanks again for the help.

Testo, I was asking out of curiosity about the MCV relationship to a stressor. The value isn’t too high but typically the higher it goes the more adaptation to hypoxia is going on. For example a 90 year old woman with severely low hematocrit and COPD will have a high MCV.

I think you should add an AI and retest your values after about 6 weeks. If you remain at the same T and hCG doses your TT is going to go up and possibly your Hct as well. You could reduce the T slightly once you adjust to the AI

thanks for the quick response,

I recently started taking natural way’s “DIM plus” once daily each evening,
and also shifted my HCG shots a day back - a day before my T shot E3D.
hope they both help lowering the E2, I’ll do another lab test soon.

I’ll appreciate any help about the questions and concerns I wrote in my previous post, mainly -
is my thyroid performing well?
how to tell if HCG dose is effective?
what are the symptoms of high E2, and from what level there is a risk of gyno?

what is ratio of E2/T or E2/freeT that I should seek?

and as for lowering my T dose - as long as that ratio is in place what’s bad in having a bit more of both?
any long term health considerations?
I do think I benefit from the higher T levels.

thanks again.

any help guys?

I think your confusing HCG with AI. You need an AI to get your E2 levels down into the 20-30 range. 50 is high, though many can operate this high and be asymptomatic. There is some dispute about optimum E2 levels, but this forum (KSMan et al) and Life Extension protocols cite the 20-30 range.

I don’t think HCG has a direct effect on E2 levels; it is mainly used to keep your boys at their normal size, keep them active in their role of producing testosterone, and maintain sperm count.

thanks for the replay knobby22,

I’m planning to take another blood test tomorrow morning, and I actually have an important question:

tomorrow I’m planning to take the blood test,
and today’s evening is my weekly first HCG injection (as tomorrow is the weekly first T injection).

just a reminder - my protocol is:
62.5mg sub-Q T enanthate 2 X week (total 125mg EW)
250IU sub-Q HCG 2X week (total 500IU EW), a day before The T injection day.

should I inject the HCG today or not?

on the one hand injecting it today will obviously affect the blood test tomorrow morning (which is mainly to check the high E2 values I got in the last test),
but on the other hand - not injecting it today meaning that the values I’ll get in the test tomorrow will not reflect the real E2 blood values that I normally have with my protocol - and that is what I really want to find out…

I know the recommendation is to take blood test on the day of the weekly T shot - before the shot (and that’s what I do),
but what about the HCG?

thanks for the help.

From hCG to E2 is a long metabolic pathway that won’t be realized in a matter of hours. Go ahead and administer your normal dosing schedule and take the test. You’re better off getting numbers based on your trt protocol than trying to manipulate the results for some other purpose.

Almost everything you said is wrong buddy.

50 E2 is not high, specially not if you have a high TT. Mine is 70 and feel amazing. I feel like shit if down to 20.

HCG has a direct effect on E2. In fact 90% of it becomes aromatized …

He does not need an AI.

Lower your test to 100mg 3 times a week (33.3 MON-WED-FRI). This will lower both your Hematocrit and E2

Alternatively keep your test levels but inject daily with daily 100iu HCG. This should also lower it and you will have more androgens than before

Stay away from read meat and iron rich food. Do steady state cardio 45 minutes a day.


Got me reading and investing in a 7 year old dead thread lol

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