Questions About 6 Month Labs

Hi I am 33 and i have been on trt for the past 6months. I have a questions about my recent lab results. I currently take 220mg of Test cyp once weekly along with 1mg of Anastrozole taken twice a week. I have done the iodine loading since being on trt and my morning and daytime temps have improved. I live in a rural area so the only place nearby that i can go to for trt requires me to come in to the office for my shots, that is the reason why i do once weekly shots.
Here are my initial labs from 6 months ago

FSH 3.7 mIu/ml range 1.6-8.0 mIu/ml
LH 3.2 mIu/ml range 1.5-9.3 mIu/ml
Prolactin 3.5 ng/ml range 2.0-18.0 ng/ml
TSH 1.34 miu/ml range .4-4.5 mIu/ml
Estradiol 34pg/ml range <or =39 pg/ml
SHBG 24 nmol/l range 10-50 nmol/l
Total Test 239 ng/dl range 250-827 ng/dl

Here are my current labs
Total Test 1189 ng/dl range 250-827 ng/dl
Estradiol 15 pg/ml range < or = 39 pg/ml
SHBG 19 nmol/l range 10-50 nmol/l

Now my current labs were taken on the 7th day after my last shot right before i got my next shot. My estradiol seems low, I am not sure how to readjust my Anastrozole amount to raise it up closer to the 22 mark. Also is my SHBG low? i Know this correlates with the estradiol. I am just looking for a little insight and I have more info on the process i went through as well if needed.

With low SHBG you need to inject twice weekly and you’ll likely have better control over your estrogen. My SHBG was 18 last time I check and am about to start injections twice weekly myself. You need to learn to inject at home as it’s more of a hassle to drive to doctor’s office than it is to just do it yourself.

Cut back to 1 mg Anastrozole per week to raise E2 maybe?

I wish that was a option for me but the doctor I see will not give me a prescription so I can do the shots myself.

When I was on 1mg of anastrozole I had high e2 symptoms, itchy nipples, tenderness, etc.

Anastrozole Dosing once we know E2 number after being on anastrozole for some time

nd = new dose
e2 = current e2 lab results

new dose(nd) ≈ old dose(e2/22)

In your case:

  • nd ≈ 2mg(15/22)
  • nd ≈ 2*.6818
  • nd ≈ 1.3636 mg/wk
  • you should divide the dose 2x per week so 1.3636/2 = .6818
  • back to this number coincidentally because you had been taking 2mg/week

Roughly .7 mg of Anastrozole 2x per week would get you in the ballpark of 22pg/ml

You can be more exact by dissolving your Anastrozole in vodka and administering by the drop

Search the forum for “anastrozole vodka” and you’ll get details on how to do that

I think that your T dose is too high as well. After 7 days your levels are dropped and peaked higher. Do the calculated anastrozole dose change. Any T dose reduction will need similar drop in anastrozole and you can stack two calculated changes.

Why can’t you self-inject? Does doc let diabetics inject? There are alternative to your local doctor in USA. Then you could do labs timed better as well.

How small are testes getting? Are you OK with permanent loss of fertility?

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

I am going to do the calculated drop in Anastrozole. When i was on 200mg once a week my trough value was 728ng/dl. I feel better now then i did at that level. The doctor that I use does not allow self injecting with trt only. He gave me some excuse about people abusing the system. I have begun the search for a new doctor that is more in tune to listening to their patients.
The testes have shrunk about 25%. I am not wild about the infertility part. I have asked them about HCG and the doc seemed clueless about why i would want it.

It might have more to do with charging for the doctor’s visit. It also sounds like he’s not a very trusting doctor.