T Nation

TRT for 10 Months - Looking for Feedback on Current Lab Results


#1

Gents,

Below are my recent lab results. Apologized if I ramble up front, but would like to get some feedback. This is where I’m at with my TRT journey. I’ve been injecting 100ml Test Cyp once per week since Feb 17. Bottomline, I’m not 100% sold on TRT and I’m thinking about coming off, but I’m concerned about what will happen. I’m wondering if I’m missing something with my protocol etc… My current doctor only is concerned about Total T and Free T — nothing else. I have reached out to another Dr’s Office and they seem pretty wide open on treatment protocols. I don’t feel too sporty at this time, and to be honest I probably feel the same as I did when I started TRT in Feb 17. So my thoughts are why stick with it. There is a lot that I’ve learned on my own research that makes me a little sceptical with my current doc. I thought I would experience a lot of good things, but so far I have pimples, low libido, and can’t drop an LB to save my life.

46 years old
238 lbs
23% BF
Cardio & Strength Training 5-6 days per week

Lab results below via LabCorps:

Testosterone, Serum 620 ng/dL (first lab in Jan 17 was 284 total t) – Range: 264 - 916

Free Testosterone: 13.9 pg/mL – Range: 6.8 - 21.5

Dihydrotestosterone: 47 ng/dL – Range: 30-85

DHEA-Sulfate: 26.1 – Range: 71.6 - 375.4

TSH: 6.080 – Range: 0.450 - 4.500

LH: 0.1 – Range: 1.7 - 8.6

Estradiol, Sensitive: 34.8 – Range: 8.0 - 35.0

Sex Horm Binding Glob, Serum: 12.9 – Range: 16.5 - 55.9


#2

More than likely your problems are related to your TSH, and also your SHBG being so low, you should be injecting EOD or ED.

Your DHEAS is low too. I know some people on TRT supplement with it.

I would say get yourself dialed in better before you start deciding to get off. For sure though, with that low SHBG, you should be injecting EOD or ED.


#3

This^^^^^

I to have low SHBG and was put on weekly injections by my doctor, it wasn’t until I took things into my own hands and starting injection EOD that I started noticing big improvements. Your SHBG is so low you should be injecting every day because you’re excreting most of your test into your urine (dumping) via your kidneys. This is why you don’t feel much different, you getting less than half of you test at best which end up being about the same as you had before starting TRT.

Your doctor has failed you putting you on a protocol designed for someone with mid to high SHBG. Injecting more often will raise TT and FT and keep you from excreting most of your test, but since your low SHBG it will take you a lot longer to get dialed in and feeling better. I’ve been on TRT for almost 8 months and am still not 100 percent. You need better care and you current doctor is cutting it! Balancing hormones is an art form, most doctors believe TRT is just prescribing testosterone and calling it a day, that’s wrong.


#4

You have hypothyroidism and your E2 is elevated. Your thyroid is begging for medication immediately. As for E2 a lot of it has to do with the low SHBG. With lower SHBG your total test will be lower than your free test and all that free test will convert to E2. So either inject more frequently with the same total weekly dosage and or get on an AI.


#5

Thanks! So do you think injecting twice a week and an AI I will see a difference? Also, with the low SHBG – should I attack this with a clean diet.


#6

If you are doing once weekly move to twice a week with the weekly dose cut in half (if you take 1ml of 100mg once weekly switch to 0.5ml off 100mg twice weekly and consider subQ injection) and an AI (target e2 is around 24. Below 20 low E symptoms tend to appear, and 30 and above tend to give high e2 symptoms in most men.). The movement to twice weekly will assist in raising your SHBG. Large spikes of T will lower your SHBG. With that said, your thyroid should be a huge focus. See an endo with regard to your hypothyroidism as soon as possible as this will blunt increases in the feeling of healthiness.


#7

This is a clear case of hypothyroidism and further effort is required. This problem might be from iodine deficiency caused by not using iodized salt and/or vitamins that list iodine+selenium. Can also be or progressed to a thyroid auto immune disease state and your doctor can run a panel for that.

We often see damage from training in a state of low-T and low thyroid function because natural energy levels are low and training is fueled by will power and adrenalin which causes adrenal fatigue. The fact that we are seeing such a very low level of your adrenal hormone DHEA [DHEA-S] makes your adrenal state more suspect. To further understand this, please have lab for ‘AM Cortisol’ and do this at 8AM or 1 hour after waking up.

Find [in USA] 25mg DHEA in vitamin display shelves. Rx in other parts of the world. Seems to be getting available in Canada.

See the thyroid basics sticky noting references to:

  • stress
  • illnesses, infections, inflammation, chronic
  • adrenal fatigue
  • Wilson’s book

Please evaluate overall thyroid function via oral body temperatures - see below.

Your E2 is too high, you need anastrozole to manage near E2-22pg/ml.

Suggest:

  • self inject T 50mg twice a week, subq with #29 1/2" 0.5ml insulin syringes
  • 0.5mg anastrozole at time of injections
  • 250iu hCG subq EOD to preserve testes

When you inject once a week, T levels peak then drop and then labs represent only one moment in time. Suspect that you did labs on day 7.

Low thyroid function also promotes fat gain and thwarts fat loss.

Post all labs, not just hormones.

Thyroid labs:
TSH
fT3
fT4 [please not T3, T4]
thyroid immune panel

If you are iodine deficient and start supplementing iodine, there is real risk if selenium deficient and a supplement is critical. Find a high potency B-complex multi-vit with trace elements including 150mcg iodine and 150-200 mcg selenium.

Please read the stickies found here: About the T Replacement Category

  • 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.


#8

Hey. I read the stickys. I have iostat that will expire in a few months. Those are Potassium Iodide 130 mg. Can you use this to do a IR?


#9

Cut in half or smaller.

The elemental iodine in the iostat pills is billions of years old, well older than the solar system, dispersed from supernova explosions. There is no expiry. There is a product expiry date because of regulations and they make something up.


#10

KSman,

Thx for the reply and recommendations – much appreciated and I will read. I am with a new clinic and based on my labs below is the protocol they are putting me on and other labs they want me to get to address my thyroid issue.

  1. 0.25ml Test Cyp every (M, W, F) subq

  2. 300iu HTC every (M, W, F) subq

  3. 0.125 AI (1 to 2 times per week), but only take it if I’m experiencing high E2 symptoms.

  4. 25mg DHEA daily

Additionally, I’m getting complete thyroid panel and once they have that back they are going to determine treatment meds/protocol.


#11

You cannot take AI once a week, half-life will not go there.

Ones T dose does not depend on any way with what your T labs were.

75mg T cyp per week might not need an AI. But most here regard that dose as inadequate. However, you had E2=34.8 on TRT before and AI looks like a hard requirement.

Please note that I regard your TSH=6.08 as a really big problem. Please follow my thyroid related points.


#12

Maybe my wires are crossed. 25ml is 75ml per week.


#13

Right! Thanks. Changing that post.


#14

Thanks for all the information. I appreciate reading your threads… i should have asked the question, and still can give the clinic a call, but why do you think they put me on such a low dose of Test Cyp?

They agreed with you on the TSH, thus is why I"m getting a complete thyroid panel.


#15

KSman,

You have any recommendations on a product?

“Find yourself a high potency B-complex multi-vit with trace elements including 150mcg iodine and 150-200 mpg selenium”


#16

You are in USA. Life Extension Two per Days are relatively complete. Buy direct or amazon probably. There are lots of other good products and I am only listing what I have in my house and do not endorse these as any better or worse.