T Nation

Worried After 6 Months on TRT


#1

Age:58 , Been weight training in the gym for 35 yrs. I train 5 days a week and eat a high protein diet . 5’7 200lbs.
I’m stumped and want to understand what happened before going back to the urologist with my questions. Been reading, but this is all too new to me. All help is appreciated.

Started with just Test. cyp. 100mg. every 14 days. 6 mo. ago. (no hcg or anything else.) Dr. had me go to 5 days 100mg. about 2 mo. ago. and recent testosterone level dropped from 391ng./dl. to now 336ng./dl. since.
I did donate blood the day before lab (3/18/17) work because of high hematocrit level from my primary care physician lab work weeks prior to this.

As of 3/19/17 Dose 100mg. average every 5 days. Also had a cortisone shot the day before this lab work.

Testosterone 336 ng/dL 250 - 1100 ng/dL
Free Testosterone 74.2 pg/mL 46.0 - 224.0 pg/mL
Testosterone, Bioavailable 159.0 ng/dL 110.0 - 575.0 ng/dL
Sex Hormone Binding Globulin 15 nmol/L 22 - 77 nmol/L
Albumin, Serum 4.7 g/dL 3.6 - 5.1 g/dL
TSH 0.75 uIU/ML 0.35 - 4.9 uIU/ML
CBC as of 3/19/17
WBC 16.9 K/UL 4.0 - 11.0 K/UL
RBC 5.65 M/UL 4.40 - 5.60 M/UL
HGB 17.1 G/DL 13.5 - 17.5 G/DL
HCT 49.7 % 40.0 - 51.0 %
MCV 88 FL 80 - 97 FL
MCH 30.3 PG 27.0 - 33.0 PG
MCHC 34.4 G/DL 32.0 - 36.0 G/DL
Platelet 188 K/UL 150 - 400 K/UL
RBC Dist Width 13.2 % 12.0 - 14.5 %

Labs into therapy as of 10/27/16

Testosterone 391 ng/dL 250 - 1100 ng/
Free Testosterone 75.2 pg/mL 46.0 - 224.0 pg/mL
Testosterone, Bioavailable 164.4 ng/dL 110.0 - 575.0 ng/dL
Sex Hormone Binding Globulin 19 nmol/L 22 - 77 nmol/L
Albumin, Serum 4.8 g/dL 3.6 - 5.1 g/dL
Estradiol 17 PG/ML 11 - 44 PG/ML
CBC
WBC 8.0 K/UL 4.0 - 11.0 K/UL
RBC 5.41 M/UL 4.40 - 5.60 M/UL
HGB 16.2 G/DL 13.5 - 17.5 G/DL
HCT 47.5 % 40.0 - 51.0 %
MCV 88 FL 80 - 97 FL
MCH 29.9 PG 27.0 - 33.0 PG
MCHC 34.1 G/DL 32.0 - 36.0 G/DL
Platelet 165 K/UL 150 - 400 K/UL
RBC Dist Width 13.2 % 12.0 - 14.5 %


KSman is Here
#2

200mg/week, or 100mg 2/week


#3

Beginning was 100mg every 14 days, now 100mg every 5days.


#4

I would increase your dose.


#5

One problem I had recently with 5 day 100mg. was the high levels HCT and HGB, so how can I increase the dose now ?

CBC as of 2/7/17 before Phlebotomy

WBC 7.0 K/UL 4.0 - 11.0 K/UL

RBC 5.91 M/UL 4.40 - 5.60 M/UL

HGB 17.5 G/DL 13.5 - 17.5 G/DL

HCT 52.3 % 40.0 - 51.0 %

MCV 88.5 FL 80 - 97 FL

MCH 33.8 PG 27.0 - 33.0 PG

MCHC 33.5 G/DL 32.0 - 36.0 G/DL

Platelet 164 K/UL 150 - 400 K/UL

Thanks for your much needed help


#6

Man, Is this test for real? I would increase the dose… RBC was just a little bit above, just a little is what I aways want it to be. Increasing the dose will not kill you…, you cannot live with this 390 range… you don’t do TRT to be 58 yo test levels… you do TRT to optimize your hormone levels, you don’t want to feel like a 58 yo, you want to feel like 30 at least.

you can increase the dose by reducing the space between the days. Every 4 or 3 days would be good, of course, if you don’t mind injecting more frequently.


#7

Every lab needs E2 checked.

You are one of the few who are T hyper-metabolizers. Typically for those, 300mg per week is required to get where others are at 100mg/week. The effective half-life is then also reduced. So injecting once a week or E5D does not work.

When you do the labs matters. You can get any number you want, simply change lab timing. Always do labs halfway between injections. Time of office visit can be wrong. Be consistent so observed changes are not lab timing artifacts.

Ask for this:

  • Self inject T 85-86mg EOD with a #29 1/2" 0.5ml insulin syringe
  • Take 1/4mg anastrozole at time of injections
  • 250iu hCG SC EOD at time of injections if you want to preserve size of testes

The goal is to get near E2=22pg/ml
May need to increase anastrozole!
To get small amounts of anastrozole, dissolve 1mg/ml in vodka and dispense by the drop or volume.

Your low SHBG is worrying. Do you have diabetes? [symptom]
Your low SHBG will keep TT lower as there will be less SHBG+T

With effective TRT, there will be more hematocrit.

PSA tested?
DRE normal?

Do not expect much from Euro’s

See last paragraph in this post to eval your thyroid. Important.

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

  • advice for new guys
  • 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.