T Nation

New To TRT: Bloodwork and Protocol Questions

Hello -

First, this site has been a wealth of knowledge after I found out I had Low T! Thank you for this wonderful resource.

48YO diagnosed with Low T back in March during my annual physical. I was complaining of poor sleep, day time lethargy, decreased libido, poor erections, increased abdominal fat, even though I exercise and watch the diet. I asked to have my T levels checked (had never had it tested previously). My PCP doesn’t do any TRT therapy so was referred to an endo. On April 2 I saw the endo and received the following test results:

Total T was 210 ng/dL (264-916 RR);
Free T was 33 pg/mL (33-227 RR);
Bioavailable T was 77 ng/dL (131-682 RR);
SHBG was 46.8 nmol/L (19.3-76.4 RR);
FSH was 8.10 IU/L (1.4-18.1 RR)
LH was 4.80 mIU/mL (1.5-9.3 RR)
TSH was 2.50 mIU/L (0.35-5.50 RR);
Prolactin was 5.50 ng/mL (2.0-18.0 RR)
E2 was 33 pg/mL (12-56 RR).

I wanted to try conservative therapy, rather than full TRT, and was put on a protocol of 12.5 mg clomiphene EOD and 500 iu hCG EOD.

After one month I was retested and the following lab results were:
Total T was 597 ng/dL (264-916 RR);
Free T was 93 pg/mL (33-227 RR);
Bioavailable T was 220 ng/dL (131-682 RR);
SHBG was 49.8 nmol/L (19.3-76.4 RR);
E2 was 41 pg/mL (11-43 RR)

Overall, libido and erections have returned to a very good state, workouts are more productive and much less daytime lethargy. Sleep duration and quality have improved, but only slightly.

My questions are:
1.) Is that a reasonable level to get from one month on the the Clomid/hCG protocol?
2.) Do I need to be concerned about the E2 level?
3.) Could I benefit from a “booster” mini dose of testosterone cypionate?


No such thing as a booster t shot. Any size shot will disrupt you hpta and begin shutting you down. If you are done having kids just go for real TRT not another drug that either makes most guys feel like shit or leaves them permanently damaged with long term use.

Thanks for the reply. I haven’t had any negative experience with clomid but I’m sure everyone reacts to meds differently. Why do you say clomid can leave you permanently damaged?

I believe you’re counting your chickens before they hatch, most men feel good on clomid initially and a decline months later.

Your Free T isnt really considered optimal, still on the lower end which isnt good for health long term. The heart needs healthy testosterone, yours is bottomed out.

You are effectively a guinea pig taking clomid long term, only in the years to come can you tell us of any consequences.

I’m pretty sure it damages your eyes. Leaves you with permanent floaters amongst other issues that you can read about on t nation from men with first hand experience

Back on May 30, I wanted to see if using test cyp would make me feel better than the Clomid/hCG protocol I was on. I was feeling pretty good at the time but just wanted to see if actual test would make a bigger difference.

My doc gave me the go ahead and prescribed 100mg test cyp per week. Now, reading these forums, I decided to split the dose to 50mg Monday mornings, and 50mg Thursday evenings to try and keep the E2 in check. I’ve been administering it subq and also taking 500IU hCG 3X week.

Fast forward to today and I’m not sure it’s made that much difference as the previous protocol. In fact, as of last Tuesday 6/25/19, I feel more low energy, lethargic now and almost feel “fluish”, but without a fever and appetite is good. Just kind of an all over malaise and achiness.

I will say that sleep quality has improved, i.e. getting more deep and REM sleep (I have a device that goes under the mattress that measures heart rate, respiration, movement and is a lower end model used in sleep labs).

Any explanation as to why I’m feeling like this? I’m not due for new labs until early August.


Google “Test Flu”, or search for it here. It’s a thing, it goes away.

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Interesting! And thanks for the reply.

I searched the forum but kept coming up with E2 related issues.

Do you know how long it takes to go away?

That’s individual, but probably a week or so.

Damn. I’ve been using Test Cyp since May 30. Felt fine for the first three 1/2 weeks.

I wonder if it’s taken this long to build up and now I’m feeling the effects.

Sounds about right. It’ll go away, and then if you bump it up later at some point it’ll come back briefly. My totally unsupported bro science opinion is that you finally have enough free T to stimulate good production of catecholamines and it gives you a bit of a rush whie you adjust. No study exists to support that idea, at least that I’m aware of.

Thanks, man! I really appreciate the insight!

I find the “bro-science” here to be more informative than a lot of doctors.