T Nation

Opinion on Latest Bloodwork?

I have been on TRT for 11 months. I have tried once a week when I started at 120mg and my trough was 410 with Estradiol of 8.8. I adjusted up to 140mg and did every other day and went to 1001 with Estradiol of 19.5. After that I went to 3X per week at 180mg. Total T 1342 and Estradiol of 36. Didn’t really feel optimized on any of these. Main issue is libido. For my recent labs I went back to 140mg and tried daily shots. Still not feeling great. My Estradiol seems low compared to my total test.

TT - 1247
FT - 22
Estradiol - 24.5
Hematocrit - 48

My doc wants me to drop to 120mg. Not sure what to do at this point. Didn’t really see any benefit from daily shots so doing back to 3X per week. Just can’t decide if I should drop to 120mg or increase to 160mg - 180mg. Except for libido I feel ok but not awesome. I really thought my workouts would be much better.

I’m 5’10, 185 and fairly fit. 49 next month and have been lifting since I was 12. Best lifts when I was younger and much heavier (242) are BP-385, SQ - 505, DL 570. Currently BP-235, SQ - 305, DL-410. These are about the same as when I started TRT 11 months back when my TT was 254. Maybe have increase a little 5-10 pounds but not much.

If I was you, and Im not, and if there were no doctor involved, I would get my FT to 30 and see how I feel. I realize your doc is looking at TT and seeing it high but he should be looking at FT and knowing there is room to grow there.

Also, are you eating to grow and fueling your workouts? Getting enough sleep? So you snore? How about thyroid?

I eat at maintenance levels. I’m pretty content with my weight at 185 at 5’9 1/2. When I started TRT I was 177 and got as high as 194 before setting between 185-188.

I sleep 6 hours a night. I don’t toss and turn and rarely wake during the night. I get up without an alarm clock. Ideally I would sleep more but I just wake up. I don’t find myself sleepy during the day or needing a nap. I do snore. Haven’t had thyroid tested recently but no issues last time tested.

Am i the only one thinking his E2 is really really low for that TT?

No SHBG test?

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SHBG was not tested. How can I improve the ratio? If I increase my dosage Estradiol should go up but so will TT. Is it because I dose daily. Will the ratio improve if I go to 3X per week?

Generally decease the frequency of the shots, but you’ve been there.

My E2 was at its highest, and subsequently the T:E ratio was 15%, on EOD shots.

Add some pregnenolone and dhea into the mix daily. 50mg preg in the morning first thing, and 25mg dhea at night. This MAY increase E2.

Ive had a lousy libido since about 25. I did use the old Twinlab NorAndro pills and some 1AD back in the day. Nothings been right since then. I’m now 42 and still never ever feel horny.

My hunch is your SHBG is very high and you’ll likely need weekly shots, higher doses… 200mg i’d try if possible…

Not ideal for sleep especially with snoring. Maybe try a mouthguard or something. Just a thought.

As far as TSH…what we usually ask people to do is throw up their full labs with ranges so we can see. Saying “no issue” means little.

15%? If my TT is 1247 that would put E2 at 187. Did you mean 5%?

I thought daily dosing would bring my E2 down. Based on my my labs this is the lowest it has been as a ratio of TT when I went to daily dosing.

No… MY ratio was 15%, which is where you want to be apparently. (my TT was 766 divided by my E2 of 49).

Daily dosing brought my E2 down TOO far and i felt lifeless. Like unemotional. Like a robot. Maybe you feel this way now? Like not affectionate with a woman, etc.

The fact your FT and E2 are low after pretty large doses tells my your SHBG is likely high. Which would mean you’d need higher doses less frequently.

@highpull and @systemlord are the best guys to ask advice. They seem to know their stuff.

I would try maybe 200mg once a week. See how you respond. I think you’ll need larger doses in some capacity.

Caveat: I can get my TRT to where i feel great mentally. Great speaking. Crisp thoughts, great morning/night wood. BUT, libido still isn’t there, and neither are the erections that occur with it. SO, my point is, maybe TRT isn’t going to fix libido.

I see… TT 15X E2. Not the same as 15%. Using that formula my E2 would be 85 which seems way too high.

When I started at 120mg once per week I had very oily skin. My head, hands, everywhere just felt oily and sweaty and had a lot of back acne so I decided to break it into smaller doses.

I’m starting to think the same about libido. That is the main reason I got on it though so now I am questioning whether I should even continue. Looking back I can’t really say I feel significantly better than pre TRT where my TT was between 250-310.

NO.

Your TT is 1247. Divide that by your E2 of 24 and you get 52%. This means your E2 is really low. The theory is you should do better with an E2 of around 75.

Wait. Now I’M confused.

Someone else needs to chime in here about the ratio thing.

That’s not 52%, that’s 52X. 52% is .52. But I get what you are saying. TT should be about 15X E2.

Yes^

I, for some reason, always use a % afterwards. But it’s just a range.

So you want to be around 15-20 for a range using the ratio theory.

Mine, on EOD at 30mg is 766TT divided by 49E2, for a range of 15.

I did try buspar, which seemed to help my libido, but only for about a week, and the feeling went away.

May be something to try. It’s a fairly safe and common anxiety med.

My contract with my clinic runs out in a month but since I don’t use all the test so I have enough left for 4-5 months. Enough to run 2 more 8-10 week trials. At this point I am not sure what to do. My TT is already pretty high but E2 and FT are on the lower side. If I decrease my frequency to 2-3X per week that should give me a better ratio of TT/E2. What I can’t decide is if I should go up in dose or down. With my TT at 1200+ not sure I should go up. If I go down and decrease frequency my TT/E2 ratio might improve but won’t my FT drop? Everyone seems to think FT of at least 25-30 is best.

I’m somewhat in the same boat, having extra test to play around with.

If i were you, i would try and get that FT up to 25-30. Most say thats where it should be. I wouldn’t worry about the TT number, because it seems like your test is being bound up by SHBG.

Its so much trial and error its beyond frustrating.

I think I am going to go with 150mg per week split into 3 doses. Only a 10mg per week increase but also decreasing the frequency. I’ll give that a try for 8 weeks and if that doesn’t work I’ll go up a little more.

Not if you have the matching TT. Its all about the ratio.

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