Blood test/dosage help

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Wuplur

New Member
I am new to TRT and was mainly interested in starting it to fix my fatigue. I just always seem to be so tired. I signed up with Helix MWR and I am at the end of my 5th week and haven’t noticed any changes yet. Is it too soon or do you think my dosage is too small. I was thinking to request for them to up the dosage but wasn’t sure if that was a good idea since I haven’t had my follow up blood test yet.
 

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Defy Medical TRT clinic doctor

madman

Super Moderator
Was your thyroid even checked? You need to post your pre-trt labs with ranges...................look like your tt/free t are on the lower end but what is shocking is that your e2 seems low and was it tested using the standard assay or sensitive assay?They prescribed you an aromatase inhibitor right of the bat let alone a starting testosterone dose of 200mg/week wow that is a large starting dose would not be surprised if your testosterone levels are really high at your 6 week follow up work. Even though your e2 seems low I bet they prescribed the ai because your test dose of 200mg/week is very high for a starting trt dose and your e2 may skyrocket ! Or are you being prescribed 0.3ml (twice weekly) of 200mg/ml which would be 60 mg testosterone every 3.5 days and if that is the case the use of an aromatase inhibitor would be detrimental as your e2 seems low pre-trt?

You need to post lab ranges with your blood work!
 

Wuplur

New Member
So this is my pre trt blood test and I don't think they schedule the next bloodtest till you reach 3 months. The aromatase is integrated in the testosterone vial. You had it right the 2nd time. I'm prescriped .3ml twice a week of 200mg. I believe they told me the T3 & T4 was my thyroid test. He did mention that my cortisol level was low and recommended I purchase a-drenal off amazon to help with that. Is the 3.5 days really that important? I inject in the afternoon every Mon & Thurs
 

madman

Super Moderator
So this is my pre trt blood test and I don't think they schedule the next bloodtest till you reach 3 months. The aromatase is integrated in the testosterone vial. You had it right the 2nd time. I'm prescriped .3ml twice a week of 200mg

I think using the ai is a big mistake especially if your e2 is low as you will crash your estradiol and end up with low e2 symptoms which are terrible. Hard to believe clinics still prescribed an aromatase inhibitor mixed in with an ai......senseless. Your lab work should be done 6 weeks after starting your protocol as it takes roughly 6 weeks for your testosterone levels to stabilize and you need to know how that particular dosage/protocol is going to affect your total t/free t, estradiol, dht and it is good to know your shbg and of course a complete cbc including hematocrit/hemoglobin which are critical and also if you experience any relief from your low t symptoms and whether you notice an improvement in your overall well being. Waiting 3 months is too long to wait when starting a protocol you want to know after 6 weeks in case your dose of testosterone/injection frequency needs to be changed as it may be too high or too low and what if any improvements of your low t symptoms you are experiencing
 

Wuplur

New Member
12616AEA-1D47-4475-B1A4-3024F21204A3.jpeg
They took my 2nd blood test on tues and I finally got the results today and am a bit surprised. Is it really possible for my testosterone to jump up that high on what I thought was a small dose? Does it make a difference that I took my shot on Mon & this was just a day after that? I still haven't really noticed any changes as far as fatigue but I have noticed my libido increase a little and my body seems to be a little more toned, but that could just be in my head. Should I just stop TRT cause I'm sure I can't/shouldn't increase it higher than it is, right? Especially if I'm not really feeling any different. And should I put more focus on why my cortisol level is so low? The Dr. recommended a supplement for me to take but it didn't seem to do anything for my cortisol level. The owner of Helix stated that my SHBG was really high, which could be causing a delay in why I'm not feeling any different. Could that be true?
 
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Vince

Super Moderator
Looks like you may have the wrong estradiol test, is it the sensitive estradiol test for men. When were your labs done, on injection day before you injected.
 
Hi wuplur, Sept 18th to Nov 30th. That is not very long. TRT is not instant like taking an asprin and your head ache goes away.
If you are like me your body has been jacked up for years. It going to take a lot of time even after you get yout TRT dialed in.

It doesn't help your E2 is so low. You should consider stopping the AI for a few weeks then start back at half rate.
You also didn't draw your blood at the correct time to find your trough(lowest T lvl)

hth I'm rooting for you.
 

Wuplur

New Member
I injected Mon night and the test was done Tues night. Not sure if it’s a sensitive test. Would it be a completely different range for the estradiol results? Cause at this point it looks pretty low when compared to the range they gave me of 10-50.
 

Wuplur

New Member
The Dr. should be calling me soon to go over my results and I'll talk to him about the AI. The testosterone I was taking had the AI already in it so it could not be separated. I was reading about the medicine 1/2 life and everyone was saying something about the dosage doubles at 40 days I think it was so that's why people tend to start feeling better around 4-6 weeks and when I got to that point and wasn't really noticing anything then I figured my dose might just be too low. In Sept were my numbers really that “jacked up”? What would be the correct time to draw blood cause it's been about 2 1/2 months and I've just been so curious what this stuff was doing to be if anything so I was pretty shocked to see how high it was especially since I was requesting more.
 

TheDude

Member
The Dr. should be calling me soon to go over my results and I’ll talk to him about the AI. The testosterone I was taking had the AI already in it so it could not be separated. I was reading about the medicine 1/2 life and everyone was saying something about the dosage doubles at 40 days I think it was so that’s why people tend to start feeling better around 4-6 weeks and when I got to that point and wasn’t really noticing anything then I figured my dose might just be too low. What would be the correct time to draw blood cause it’s been about 2 1/2 months and I’ve just been so curious what this stuff was doing to be if anything so I was pretty shocked to see how high it was especially since I was requesting more.

Dose doesn't double in 40 days. With Test Cyp, you're bloods levels will normalize in 40 days. That's why it's best to wait 6 weeks at a minimum to make any changes to protocols because you won't have an idea how it's really working until then.
 

Wuplur

New Member
Ok, I must have understood that wrong. I can't find the actual article I was reading but thisexplained it pretty similar.
6B24ED3A-3953-4704-B377-9A35A85EC361.jpg
 

Wuplur

New Member

Vince

Super Moderator
Dose doesn't double in 40 days. With Test Cyp, you're bloods levels will normalize in 40 days. That's why it's best to wait 6 weeks at a minimum to make any changes to protocols because you won't have an idea how it's really working until then.

Laps were done at the wrong time. Labs need to be done on injection day before you inject. You do need the right estradiol test, it can make a big difference in your levels.
 

Wuplur

New Member
That makes sense. From what I read, trt should max around 1200 for total t right? So is that where I should be at my minimum (right before next shot) or at my maximum (right after a shot)? Because I initially wanted them to increase my dosage but if I'm at 1352 already then they would actually need to decrease it right?
 
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I started Oct 2, So it's been almost 10 weeks, have I not waited long enough? To where I should be feeling something different. I would think jumping from 400 to 1300 I would feel something and in result just feel a little discouraged now.

Hi Wuplur, 10 weeks is plenty long enough I usually wait 6 weeks when I am wondering how things are doing.
I have heard you don't feel total T just free T and Free T is effected by lots of other thinks like SHGB.
 

madman

Super Moderator
View attachment 4324
They took my 2nd blood test on tues and I finally got the results today and am a bit surprised. Is it really possible for my testosterone to jump up that high on what I thought was a small dose? Does it make a difference that I took my shot on Mon & this was just a day after that? I still haven't really noticed any changes as far as fatigue but I have noticed my libido increase a little and my body seems to be a little more toned, but that could just be in my head. Should I just stop TRT cause I'm sure I can't/shouldn't increase it higher than it is, right? Especially if I'm not really feeling any different. And should I put more focus on why my cortisol level is so low? The Dr. recommended a supplement for me to take but it didn't seem to do anything for my cortisol level. The owner of Helix stated that my SHBG was really high, which could be causing a delay in why I'm not feeling any different. Could that be true?

If you injected on Monday and had your blood work done 24 hrs later than the 1352 ng/dl test levels would be near your peak levels as test levels tend to peak 24-48 hrs after injection. If your shbg is high than you would do better on a once weekly injection with a larger dose of testosterone as this will help lower your shbg.
 

madman

Super Moderator
That makes sense. From what I read, trt should max around 1200 for total t right? So is that where I should be at my minimum (right before next shot) or at my maximum (right after a shot)? Because I initially wanted them to increase my dosage but if I’m at 1352 already then they would actually need to decrease it right?

One does not necessarily try to aim for a total t number near or at the high end of the physiological range. Total t is important but free t is what really matters and not everyone needs to have a trough in the 900-1200 ng/dl range as symptom relief and overall well being and of course blood work with blood markers in a healthy range is what really is of utmost importance. Understand that there are many men with troughs in the 600-800 ng/dl range with a healthy free t level and of course other hormones in check especially estradiol. Sure some men feel much better having their trough numbers at or near the higher end of the physiological range 900-1200 ng/dl but is not a given. Testosterone is a powerful hormone and it is always better to start low/go slow when starting trt let alone adjusting a protocol and do not get caught up in chasing numbers as low t symptom relief/overall well being is what matters and for some that may mean mid-normal testosterone levels where as others high/normal. If you are injecting every 3.5 days as an example Monday morning/Thursday evening than you should do your injection Thursday evening and have your blood work done Monday morning before your next injection to get your trough. Also understand that injecting every 3.5 days with smaller doses of testosterone you are smoothing out your peaks/troughs and your levels will be more stable as oppose to once weekly injections with a larger dose where your peaks will be extreme following the first 24-48hrs post injection and than by the end of the week 7 days later your levels will be much lower.
 

Wuplur

New Member
One does not necessarily try to aim for a total t number near or at the high end of the physiological range. Total t is important but free t is what really matters and not everyone needs to have a trough in the 900-1200 ng/dl range as symptom relief and overall well being and of course blood work with blood markers in a healthy range is what really is of utmost importance. Understand that there are many men with troughs in the 600-800 ng/dl range with a healthy free t level and of course other hormones in check especially estradiol. Sure some men feel much better having their trough numbers at or near the higher end of the physiological range 900-1200 ng/dl but is not a given. Testosterone is a powerful hormone and it is always better to start low/go slow when starting trt let alone adjusting a protocol and do not get caught up in chasing numbers as low t symptom relief/overall well being is what matters and for some that may mean mid-normal testosterone levels where as others high/normal. If you are injecting every 3.5 days as an example Monday morning/Thursday evening than you should do your injection Thursday evening and have your blood work done Monday morning before your next injection to get your trough. Also understand that injecting every 3.5 days with smaller doses of testosterone you are smoothing out your peaks/troughs and your levels will be more stable as oppose to once weekly injections with a larger dose where your peaks will be extreme following the first 24-48hrs post injection and than by the end of the week 7 days later your levels will be much lower.

I was trying to prevent the extreme peaks that I have heard about, which is why I followed the 2 a week protocol. I never got too strict as far as the 3.5 days though. I do it mon & thurs night and figured I don't feel any different anyways that didn't think the timing was that important. I told myself if I did start feeling the ups & downs then I would do the 3.5 days. But you think 1 a week would actually work better for me? It's not that I was chasing numbers, I just know that they consider 1200 being the top of the scale and when I saw 1300 and I still wasn't really noticing anything, I kinda got discouraged because I'm paranoid and didn't wanna up the dosage just to feel better and have some kinda adverse effect at the same time. Is my SHBG really THAT high to be delaying positive effects? The Dr. should be calling me soon to go over these results. I'll bring up the 1 shot a week. Anything else you think I should ask him about? I REALLY APPRECIATE ALL THE ADVISE GUYS!
 

Wuplur

New Member
Spoke to the Dr. today and he said getting my lab done at this time is fine because it just shows where my peak is at and if I want to take the next one right before a shot that way we’ll know where my low is at. I asked about the anti estrogen and he said they are required to give one with the testosterone and they can not separate it but he has me on the lowest dose. He said as long as my estrogen stays above 10 I’ll be fine but he would like to see it around 20. He wants to keep my trt dose where it’s at and he thinks I’m still feeling fatigue due to my cortisol level being so low. For this, he prescribed 5mg of hydrocortisone, which after reading some of the side effects I’m feeling a little uncomfortable about that.
 
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