T Nation

TRT Bloodwork Help

New member here! Great Forum you all have with lots of info! Im a 38 year old man that started TRT due to initial total T results being 201. I didn’t know much about what to do but my doctor prescribed to me 200mg/1ml of Test C once a month. I started the injection and started to feel good but crashed pretty hard around day 10. Got moved to taking every 2 weeks. Did my injection again and same thing crashed. Explained to my doctor that I would like to do weekly injections to prevent the crashing feel and now im on 200mg/1ml per week and feel very good! Great libido, good energy, less anxiety and worries.

Had my lab work done a couple of times before but they didn’t say much other then total T. I requested from my PCP to have full blood work done and I just received it. Could you all take a look at this and tell me if I need to speak to my doctor about any issues along with what needs to happen moving forward? Im trying to get all the info I can and I appreciate your help! One thing you will notice is my Estrogen levels are stupid high! But I think she did a basic Estrogen test and didn’t do a sensitive one so my guess is the Estrogen levels are incorrect. I would think with the levels they detected, I would be feeling very bad! But no…I have no acne, no lack of energy or mood issues. Very happy and out going! Here are my results. Thank you again everyone for your help! Also, this blood work was pulled first thing in the morning on day 7 of my schedule so technically this would be the day I do my injection. If any other info is needed please let me know! Just posting what I see most people doing on this forum :slight_smile:

TSH - 1.18
FSH - 0.36
LH - < 0.20
Estradiol - 135 pg/ml (Says High)
Total T - 1065 ng/dl
Free T - 265.6 ng/dl
PSA - 0.930
GLU - 98 mg/DL
CHOL - 183 mg/DL
VLDL - 30 mg/DL
HDL - 27 mg/DL (Says Low)

You are feeling great. I would not change anything. I do know some with E2 levels over 100 and they are doing fine. Don’t rely on the number, rely on any signs or symptoms.

You do not need FSH and LH testing any longer.

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Thank you! I just find the test for Estrogen to be a bit high IMO. I would like to bring it down some. One thing I did notice is after about 2-3 weeks, my weight gradually went up totaling 10 pounds. After about 12 weeks of TRT, the weight is starting to come back down. I am a heavier guy as well around 250 lbs. Im also noticing my belly fat going away but just the biggest things I have noticed is much better libido, more energy, and the positive mood change!

That’s the increased E2. You’ll adjust to it. Be careful messing with it, especially since you are doing so well. Check this out:

Thank you! Im watching this video now. I was thinking of asking my doctor for an AI to help bring it down just a bit but im thinking this test for E was incorrect. I read up on here, that most of you all get a sensitive E test done. Mine was done via immunoassay test not GCMS. Will a sensitive test be that much more accurate for telling me what my E2 levels are?

No do not inquire about an AI, the solution to estrogen related problem is much simpler to deal with by injecting smaller doses more often, I had the same problems (70 pg/mL LC/MS/MS Sensitive) as you and am working with a very competent private doctor who put me on 21mg every 2 days and estrogen dropped by 50%!

My testosterone and estrogen levels are very steady and are almost static with only minor fluctuations, before estrogen was high 3 days after an injection and lower at my next injection.

Your estrogen levels may or may not be falsely elevated, that’s why I personally prefer the LC/MS/MS method.

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Yea my test for E has the same note underneath it that you pictured above. I just see so many people recommend E2 levels to be somewhere around 22 but I would think with my levels I would have acne all over, sleep all day, and be very moody but im not getting any side effects at all. Hopefully my doctor doesn’t look at my levels and freak out and take me off of TRT or reduce my amount I take a week. I like this dosage and even though my Total and Free T is up high, I feel great! Heck I even get better sleep now since starting TRT. Everything is just much better since starting this. Im a Navy veteran and this has been crucial for my overall health. All the meds the VA has tried to give me has been a fail or very ineffective until I started TRT. Its crazy how hormone levels can affect so much especially overall quality of life!

SHBG levels dictate free hormone levels, so if SHBG is higher, free estrogen is lower. If SHBG is higher then you can get away with a higher estrogen levels because the majority isn’t bioavailable.

My SHBG is on the lower end (22) and that means free hormones, Free T and Free E2 are very high, so an estrogen of 40 would be too high for me and may not be for a high SHBG man. I’m willing to bet your estrogen is actually lower on the LC/MS/MS method.

If you feel great, change nothing. An AI would ruin you and take you down a path to misery. The VA is not a good fit for TRT, I’ve seen a lot of veterans come here with with incredible horror stories.

I don’t see a measurement for SHGB on my blood work. Im trying to understand how a higher SHGB Man can tolerate a higher estrogen level. I need to do some more research for sure. As far as the VA, they aren’t seeing me as of now for my TRT regimen. I have a doctor out in town thats handling this. She just doesn’t know much as you can tell from my first post she originally wanted to give me 1 injection a month lol! That didn’t work I could tell by the 2nd injection I was on! I hated that crashing feel I got.

Good point though on my SHGB being high and able to handle higher Estrogen levels. I plan to discuss that with my doctor but most importantly, im with you all on exactly what you say when overall if I feel great then why mess with anything! Just getting prepared for my meeting with her to explain some reasons as to why my estrogen levels may be that high and how I feel overall. Along with that, I do plan to get another test just for Estrogen but this time im gonna do it as highpull pictured above. Going to get both IA and LC/MS/MS tests done to get a more accurate number.

There was a study published in 2005 that showed poor results on 200mg every 2 weeks let alone once a month. Doctors really have no fu***** clue what their doing, all they do is read the prescription label which states 200mg every 2-3 weeks, whoever wrote this information on the labels was not qualified enough to make such a suggestion. At the time little was known about TRT and the only doctors that knew better were are private practice doctors noone thought to ask.

Look at figure 1, graph B, 6 days after injections levels were below the therapeutic ranges. The fact that 200mg every 2 weeks was suggested is insane!

Hormone profiles after intramuscular injection of 200mg testosterone enanthate every 2 weeks in patients with hypogonadism

If anyone watches the video posted up by highpull and would like to scroll through to a good section in regards to my question, go to the 23 min mark of the video. Great info!

Yea every 2 weeks let alone once a month was insane! That graph shows how Test E drops off but I wonder how Test C looks like as the half life of Test C I believe is much longer. Either way, doing 1 injection every 7 days feels much better to where im not on a crazy up and down wave.

2 days half life difference between Test E (10 days) and Test C (12 days).

You COULDN’T inject 21mg of Test every 2 DAYS of Sustanon like myself and be static levels, it would work more so with something like Cyp, Enanthate or Propionate. I personally would like to see you accomplish that Systemlord if i was to send you these Sustanon bottles and see if you can manage it.

But having a 4 ester combination being static on E2D shots would be impossible rightfully? just wondering if you can come in & give your intake on that bro.

You have a nice Dr. 1065 is at the top of the range. Some Dr.s would try and lower the dose. I’ve been on topical hel for a long time. With any blood test, I would also have an ALT/AST done. It’s not related to TRT, but it caught my liver being affected by energy drinks.

My doctor hasn’t seen these high of levels yet. I mean its up there but does it matter if its that high? Does high T hurt you at all? Overall even with the high number, I think the most important thing is how I feel and how my internal organs are working with this dosage. I don’t see any other issues with my blood work so I don’t understand why anyone would want to change things up. I would rather ride a wave thats on the upper end then go up and down a lot more. Just my opinion but I will talk to her!

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I also had my ALT/AST tests done.

ALT - 51
AST - 39

Both of these numbers are within range on the upper part of the scale but still within range they set forth

Got my sensitive Estrogen test done. Levels came up high at 55.7. Guess it’s time to look into taking an AI.