TRT 90 Days In, Feedback on Labs?

[chi-town55]

Started TRT 90 days ago and was comparing blood work. The stats and regiment is as follows:

55yo male 5'11 175lbs
Blood Pressure (current) = 125/73 during the workday, 90/61 in the evening
Resting Pulse - 72
Workout 4x/week push-pull split

Test Cyp/Anastrozole 200mg/.5mg/ml - Compounded 1x/week
.5ml/HCG 2x - 1x after Test injection, then another 3.5 days later

Labs 0 days, 90 days

Total Test 351, >1500 ng/dL
Estradiol 13.9, 23.4 pg/mL
LH 7.6, ---
Creatinine 1.37, 1.57 mg/dL
EGFR 58,49
WBC 4.6, 6.0 K/CMM
RBC 5.09, 5.56 M/uL
Hemoglobin 14.8, 16 g/dL
Hematocrit 43.7, 47.8 %
Platlets 275, 247 k/uL

PSA - ran between 2.5 - 3.27 ng/mL over the past 5 years, at 0 days it was 2.5, 3.3 most recently

Included the labs results that seem to have changed the most. The Dr. dropped the Anastrozole from 1.0mg/ml to .5mg/ml before the 90 day blood test. Would have thought he would want to see the PSA and Estradiol before changing it..? Said he wanted it below 40, so was ok.

Said he was OK with Total Test >1500 if I'm have not sides or problems...wondering what Free T is?

But blood work was not run to look at Free T or SHBG, LH

Basically feel good, no side effects other than a little oily skin. Does it make sense to try and optimize Free T to help with lean muscle growth? and how would I look at the relationship with Estradiol vs. the current levels.

Any feedback, red flags, advice, etc.. is welcome....always interested in knowing what I don't know!

[KSman]

You actually have not explained how much T you are injecting. Labs suggest 200mg/week.

I can assume that you are inject 500iu hCG 1000iu/ml.

Please do not report dosing in volumes.

Inject 200mg twice a week. Subq will absorb slower and provide steadier levels.
Do labs always half-way between injections to eliminate lab changes that are from lab timing.

E2 is good! But may change with injections twice a week.

Use Quest Diagnostics for T and you can see past >1500, otherwise no point in testing TT.

Should be testing FT!

On TRT, HPTA is shutdown and FSH/LH-->Zero. Do not test LH or FSH.

Blood looks OK.

[chi-town55]

Thanks for your reply, here's a little more detail...

Injecting 1cc/ml once per week (Monday) of the Test Cyp/Anastrozole 200mg/.5mg/ml
Injecting 50 units of HCG; 1x Monday after Test and 1x Thursday.

**Just noticed the HCG script is now HCG/Theanine 5000iu/100mg - Injecting 50 units on Mon and Thurs.
Adding Theanine was not discussed....any reason you think this is added??

I asked about injecting test 2x/week but was told not to. Reason being they say T levels continue to escalate rather than establish a more steady state over time. Does the subQ make up for that?

Dr. won't run Free T, says its unnecessary.....have to source that elsewhere....What would be a target range?

Testicle shrinkage is about 50%..is that normal with that HCG dose/frequency?

Thanks for the tip on Quest regarding T....will do

FYI, this is the complete recent lab panel.

CBC With Differential/Platelet
WBC 6.0 x10E3/uL 3.4 - 10.8
RBC 5.56 x10E6/uL 4.14 - 5.80
Hemoglobin 16.0 g/dL 12.6 - 17.7
Hematocrit 47.8 % 37.5 - 51.0
MCV 86 fL 79 - 97
MCH 28.8 pg 26.6 - 33.0
MCHC 33.5 g/dL 31.5 - 35.7
RDW 13.4 % 12.3 - 15.4
Platelets 247 x10E3/uL 150 - 379
Neutrophils 58 %
Lymphs 29 %
Monocytes 9 %
Eos 3 %
Basos 1 %
Neutrophils (Absolute) 3.5 x10E3/uL 1.4 - 7.0
Lymphs (Absolute) 1.7 x10E3/uL 0.7 - 3.1
Monocytes(Absolute) 0.5 x10E3/uL 0.1 - 0.9
Eos (Absolute) 0.2 x10E3/uL 0.0 - 0.4
Baso (Absolute) 0.1 x10E3/uL 0.0 - 0.2
Immature Granulocytes 0 %
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1
Comp. Metabolic Panel (14)
Glucose, Serum 103 High mg/dL 65 - 99
BUN 19 mg/dL 6 - 24
Creatinine, Serum 1.57 High mg/dL 0.76 - 1.27
eGFR If NonAfricn Am 49 Low mL/min/1.73 >59
eGFR If Africn Am 57 Low mL/min/1.73 >59
BUN/Creatinine Ratio 12 9 - 20
Sodium, Serum 143 mmol/L 134 - 144
Potassium, Serum 4.5 mmol/L 3.5 - 5.2
Chloride, Serum 103 mmol/L 96 - 106
Carbon Dioxide, Total 25 mmol/L 18 - 29
Calcium, Serum 9.4 mg/dL 8.7 - 10.2
Protein, Total, Serum 6.5 g/dL 6.0 - 8.5
Albumin, Serum 4.3 g/dL 3.5 - 5.5
Globulin, Total 2.2 g/dL 1.5 - 4.5
A/G Ratio 2.0 1.2 - 2.2
Bilirubin, Total 0.4 mg/dL 0.0 - 1.2
Alkaline Phosphatase, S 85 IU/L 39 - 117
AST (SGOT) 27 IU/L 0 - 40
ALT (SGPT) 18 IU/L 0 - 44

[KSman]

Injecting 50 units of HCG

50iu on an insulin needle is 0.5ml and you do not know the iu/ml. If 5000iu in 5ml solution, you are injecting 500iu hCG. If in doubt, ask the pharmacist.

Theanine is added to hCG, B-12 to mine, so compounding pharmacies can sell hCG. They cannot sell straight hCG because FDA now prevents selling a drug that has been otherwise commercially available.

"I asked about injecting test 2x/week but was told not to. Reason being they say T levels continue to escalate rather than establish a more steady state over time. Does the subQ make up for that?"

Sounds like bullshit.

"Testicle shrinkage is about 50%..is that normal with that HCG dose/frequency?"
Do not know the dose yet. There should be no shrinkage. Is hCG good? If you do not get a positive with a home pregnancy test, hCG is probably not there, under doses or damaged in transit.

Blood looks good.
If fasting, glucose=103 means that you have to look at insulin sensitivity issues, diet and lifestyle.
Total proteins seem weak for TRT, diet lacking proteins?

[chi-town55]

Thanks for clarify the units, make sense now....
It's a 5000iu dry vial and I mix with 5ml of bacteriostatic water to. -->50 units 2x/week = 500iu HCG

I'll get a home preg test to verify the HCG presence....thx

Blood tests are typically EOD 5pm Friday's....can't explain the glucose reads, previous 5 years ran 85-88 mg/dl.

Total proteins, previous 5 yrs ran 6.6-7.1 and was 6.6 at day zero for TRT

I've always been lean and maintain ~2500 cal/day maintain intake, which seem to hit the mid-line for my BMR and activity level (desk job/day...workout 4x eve's/week) metabolism feels pretty high. After starting TRT dropped belly fat to a 1" pinch.

However I do seem to get low at times during the night, can't eat too late otherwise reflux and I'm lactose intolerant. Always felt I had a protein metabolism issue, no diag, I do know that if I would eat a teaspoon of honey, rotted my stomach immediately....sensitivity flag?

Any tests/methods for checking protein metabolism?

Thanks for the input, don't want to waste you're time...!!

[KSman]

I'll get a home preg test to verify the HCG presence....thx

Your wife or GF will be amused!

You might need more protein. Do you get hungry between meals and snacks do not help? That can be protein hunger and you might try whey shakes. Protein is not down from a GI bleed, CBC looks too good. Perhaps prior meals were not high on protein.

[chi-town55]

Well my wife know's the engineer in me wouldn't pass up the opportunity to perform such a test to verify and out come! I'm more interested in how the checkout clerk where I purchase it will respond!

I need to workout the protein level issue. I try to target .8 - 1g/lb of body weight daily. I've always suspected a protein metabolism/uptake issue since I was young. Always a hard gainer body type, and a slow gut...therefore pounding quality calories is always a challenge.

? What data lead you to the conclusion I was metabolizing the T very quickly? ....high TT?
And if I switch to 2x/wk T injections would it be worth it to risk the E2 since its seems to be at an acceptable level now?