I have been on TRT since 2015 due to low T levels. At the same period of testing then I also did a bone density scan which revealed low bone density, which was one of the main reasons motivating me to start TRT as I did not have any effects of low T. I did not check Vitamin D levels at that time but I suspect that it might have been borderline low for all my life.
A couple of weeks ago I re-did the bone density scan, which showed a further bone loss. The density of L4 vertebrae was at -2.9 which was even lower than pre-TRT. I have been taking around 3000 IU of Vitamin D plus 800 mg Calcium and 400 mg Magnesium daily for the duration of TRT. Last blood test shows the Testosterone level at 22.9 nmol/mL (range 10 - 30). and Vitamin D still on the lower side at 33 (range 30 - 100). I’m adding a 10,000 IU Vitamin D + high K2 dose to my daily supplements as from next week.
I am using 1000mg of Testosterone Undecanoate (Nebido) every 10 weeks. The previous test result was taken at the 9th week so average T levels would be somewhat higher. I am now reducing the injection period to 8 weeks to maintain slightly higher levels. I also take 500 mg of Anastrazole bi-weekly. E2 level was at 18 pg/mL.
What could be causing this loss, since TRT increased T plus more Vitamin D, Calcium, Magnesium plus many other supplements while also lifting regularly?
I am thinking that lowish Vitamin D might be a culprit, but also suspecting that low E2 is contributing. Pre-TRT I used to have average E2 levels around 32 pg/mL. Apart from this, all other markers have improved.
Thanks for any feedback.