T Nation

My Long TRT Journey

Long story here so I’ll try and keep it shorter

About me:
Age: 35
Height: 5-8
Weight: 195
Composition: Muscular but not ripped. Have some abs showing. Carry more weight around stomach and love handles. Legs are pretty lean.
Hair: full head
Beard: can grow one but it’s thin
Diet: usually beef, some whole milk, oatmeal, butter, chicken, olive oil, veggies here and there. More carbs in workout days. Less on off days.
Workout: lift 3 days a week.

When I was 21-22 I had all the usual symptoms of low t. Finally got my GP to run labs. Total test was 102 ng/dL repeat test a week later. 98.

Went to endocrinologist. Was put on androgen and synthroid. Felt good for a long time.

Tried to stop (ignorance) and everything dwindled back down. It’s been so long I can’t even remember why I stopped other than I just wanted to see if lifestyle changes would make a difference.

Fast forward to 3 years ago. Felt bad again so got levels drawn. Can’t remember what they were but was on a compounded cream. I think they were in the 300’s. I’ll have to look at the dose.

Still felt bad as of late so went to urologist. Total was 297 ng/dL.

Placed on 200mg/ 2 week shots test Cypionate (yeah I know, but it got my foot in the door). Waited it out until he wrote the script so that I could move to 100mg E6D.

Here are latest labs after 8 weeks of that.

Total Testosterone: 1350 ng/dL
Free Testosterone: 39.8 pg/ml (8.7-25.1)
SHBG: 37.8 nmol/L
DHT: 86 ng/dL (30-80)
E2 Sens: 52.6 pg/ml (8-35)
DHEA-S: ug/dL (102.6- 416.3)

Thyroid:
TSH: 3.850 mcUI/ml (was taking iodine)
FT3: 4.0 pg/ml (2.0-4.4)
FT4: 1.29 ng/dL (.82-1.77)
RT3: 22.1 ng/dL (9.2-24.1)
T4: 6.4 ug/dL (4.2-13)
T3: 119 ng/dL (55-170)

CBC:
RBC 6.73 million/uL (4.63-6.08)
Hemoglobin: 18.3 g/dL (13.7-17.5)
Hematocrit: 56.4% (40.1-51)
WBC: 5 K/uL (4.2-9.1)
Platelets: 243 K/uL (163-369)

ALT: 42 Units/L (12-78)
AST: 23 Units/L (5-37)

Thoughts on where to go from here? Doctor is obviously concerned with the high hematocrit. Althiugh I’m terrible about drinking enough water.

Not sure if iodine supplementation would increase TSH that much. RT3 seems elevated. Although other thyroid stuff seems good I guess.

I feel pretty dang good right now. Libido is great, no signs of high E other than some slight redness on my ears. Strength is good. Recovery is good. Erections are good. Only negative right now is maybe some decreased morning wood. It comes and goes.

Started HCG 250 iu day before pin and 2 days before that. That was not on board when those labs were drawn.

My doctor is fantastic (not the urologist) and allows me a lot of leeway in finding a good protocol. She really wants to look at the complete picture.

You need to break up your shots into smaller ones, this will lower hematocrit, RBC, and hemoglobin.

Try 45mg twice weekly, this should lower all CBC numbers. I decrease my rt3 by diet alone, cut out milk, cereal and eat mostly whole foods.

It would be a good idea to donate blood, see if you can get a script for a double red blood cell donation.

Thanks for the quick response!

Splitting it was one of the things I was going to talk to my doctor about. Any reasoning behind the 45 twice weekly vs leaving it at an even 50? Or is the slightly lower dose an effort to further bring down the CBC numbers since I have some room for my levels to drop a little?

Doctor already told me to go donate blood so I’ll get on that soon.

When splitting your doses up when you need levels to decrease, you need to decrease dose 10-15%. I am concerned about CBC labs as well.

You just may end up needing even less than 45mg twice weekly as you’re very sensitive to testosterone.

You can’t run your Free T level that high above the range you will turn your blood to tar.
You need to drop your dose until your Free T is in range on your peak day. You can only donate blood for so long before you’ll crash your ferritin. Mine crashed in 5 donations 56 days apart.
I have been told you lose about 25% of your ferritin with each pint donated. An for some reason newly formed red blood cells carry no ferritin.

If you start donating blood you need to add ferritin to your blood tests. You can’t die from a T overdose but you can die from a 0 ferritin.

We all love Free T in the high 30’s Yes it does make you feel good but you can’t run blast levels all year long.

FreeT-39

I’ll second what the others said. Lower your dose a little and increase frequency. You’re too high right now.

I will also add, with the diet that you outlined, did you get lipids run with those tests? Keep a close eye on cholesterol levels. I say this because your diet (and your stats / workout routine) sound almost exactly like mine before I started TRT. I wound up having to pull a 180 and am now taking corrective actions to bring lipids in line.

Thanks for all the responses!

Yep forgot to post the lipids

Definitely not great but not terrible.

Yeah not too terrible but not great man. TRT will help with lipids over time, but just like you can’t out train your diet, you can’t expect optimizing your hormones to overcome bad eating either.

Do yourself a favor and supplement your new-found hormonal optimization with a super clean diet and ramped up intensity on the exercise. When you get all three of those in line brother, your body will surprise you and be capable of amazing things.

Just finished donating whole blood. Had never donated before so I couldn’t do a double red. Talked to my doctor and she is good with the dosing as recommended. 45mg twice a week. Any problem with doing 45 E3D? I prefer to keep a regular schedule of injecting in the morning.

Re diet: I’ll drop the milk, oatmeal, and butter. That’s about the extent of my processed food consumption aside from the occasional night out.

I appreciate the responses!

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45 e3d is the same as twice a week I think. I guess 3.5 but what does that entail. Do I wait exactly 3.5 days and wake up at midnight? Lolll

I was thinking more like 7a/7p, but I get your point. Basically pointless in doing that.

I do daily. Today I realized “why not fill 3 syringes at a time” that way I don’t have to deal with it every morning for 10 mins…

If you like regular schedules, then do something like Saturday night and Wednesday morning. A few hours here or there, or even a day is really not going to make that much of a difference with Cyp or E.

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One further suggestion would be to try and regulate the red meat intake. I’m a huge beef fan (burgers and steaks), and pork is my crack, but man they do a number on your health long term. Try to eat as much lean meat as you can, and take in a lot of fish with good omega 3’s. You’ll keep yourself in the green in the lipids category.

Yeah beef is basically a daily thing. I could eat chili every meal and be happy. More variety would do me some good. Havent been taking fish oil.

So new protocol, diet, smarter training (what’s cardio) hopefully will show some improvement in 6-8 week retest.

I appreciate all the feedback!