T Nation

Seeking Help Dialing in Protocol. Detailed Labs Included

Hi All,

First and foremost thank you for clicking on this topic. Attached are my lab results since I started the TRT journey and below I have provided a little context around each testing date. I’m 25 years old and I’m really seeking some help in getting things dialed in. The practitioner that I go to isn’t the most knowledgeable on TRT best practices so I frequent this forum often for insight. Still unsure if I am on the right track regarding my TRT so I wanted to reach out to the community directly. Any and all feedback would be greatly appreciated on all of the figures not just test and estrogen. Thanks again and I look forward to hearing from you all soon.

  • First Blood Draw 6/14/2017

    • Testosterone level: 626 (348-1197)
    • Doc says because still in the “normal range” he wouldn’t allow treatment
    • I waited ~9 months and reached back out indicating I still wasn’t feeling well. He refers me to a specialist and we test again.
  • Second Blood Draw 3/05/18

    • Testosterone level: 646 (264-916)
    • Estradiol: 23.1
    • He lets me start treatment
    • Protocol: 200mg test cypionate weekly + 400iu HCG on the 2 days before my shot (would like to preserve some fertility)
  • Third Blood Draw 4/10/2018 - Conducted on trough day

    • Testosterone level: 986 (264-916)
    • Estradiol level: 39.3 (7.6-42.6)
  • Fourth Blood Draw 8/27/2018 - Conducted on trough day

    • Testosterone level: >1500 (264-916)
    • Estradiol level: 71.5 (7.6-42.6)
    • Protocol up until this point:
      • 200mg test cypionate 1 time weekly: (I initially reduced the HCG to 400iu time weekly for a bit and then eliminated it all together)
    • Doc notices estrogen is high so prescribed anastrozole 1mg weekly. I read on forums about the stuff so I first decided to lower my dosage, increase frequency, and re-incorporate HCG
    • Protocol update: 60mg test 2 times weekly + 250iu HCG 2 times weekly at time of test injection
  • 5th Blood Draw - Scheduled for 12/17/18 (Was supposed to be in October but the nurse mishandled the sample and they couldn’t run the test)

Kind regards,

What was your free t? And what are your symptoms?
I personally would not even think about trt at these levels.

Your symptoms could be from other causes.

Your doctor never tested free testosterone, the free hormone circulating in the blood, total testosterone is bound to SHBG and isn’t bioavailable. So if total testosterone is in the normal range and you have low testosterone symptoms, SHBG would then expect to be elevated binding up the majority of your testosterone and therefore free testosterone would be low.

Your SHBG should have been tested, increasing the injection frequency may very well lower estrogen. Low thyroid function has the same symptoms as low testosterone.

Doctors caught up chasing reference ranges may not be able to think objectively because they have been taught to treat the reference ranges and ignore the symptoms. You tell the doctor you feel off, he/she looks at the reference ranges and says everything looks fine.

The references ranges include many who had thyroid dysfunction and subclinical hypothyroidism, so treating the ranges doesn’t work out well for the patient. Add to that the reference ranges keep changing.

There are studies showing symptoms long before dipping below the normal ranges.