Blood test feedback after 5 weeks on TRT

[haze1972]

Received my blood test after being on TRT for the first time. My protocol was Test E 40mg 2xweek every 3.5 days on Tuesdays and Fridays. My blood Test was performed on Tuesday before my subq shot so on through end.
My Total was 700, Free 35 pg/ml and estradiol 45 pg/ml.
Question since this was on my through test should my TT spike way above 700 after I do my regular shot? Also is my estradiol on the high end? should I be concerned about it especially since the reading was done before my first shot of the week knowing the estrogen follows testosterone?
Any feedback would be appreciated.

PS: I have primary hypogonadism and my pervious TT was extremely low of 17 so in 5 weeks of 80mg a week I have gone up to 700.

 

[Blackhawk]

Incomplete info...

Most important is the free T level, what lab method was used and the reference range. 35pg/ml means very different things with different assays. What was the exact Free T test, was it free direct or equilibrium dialysis ultrfiltration? It also matters who did the test. Quest's values/refernce range is different from Labcorps... etc. What is the reference range?

Yes, your level is higher at peak. "Spike" on a 3.5 day schedule is probably significant not huge like weekly or every other week. Do you have symptom swings on a twice weekly schedule following your protocol?

E2 is controversial. I view it as a bit high, but any need to do something depends on whether you have any high E2 symptoms.

 

[haze1972]

Thanks for the prompt response
on my report all it says is Testosterone Free serum 35 pg/ml and range is 15-50 pg/ml will have to speak to the lab to find out the things you mentioned.

Regarding my estrogen the only symptom I have is slightly senstive or sore nipples but it seems this feeing comes and go and is usually felt more after my shot, can this be that my body is trying to dial in since its my first time on TRT? will this resolve on it own or should i try Dim or other ways to help control my estrogen?

 

[Systemlord]

My Total was 700, Free 35 pg/ml and estradiol 45 pg/ml.
Question since this was on my through test should my TT spike way above 700 after I do my regular shot?

Yes, your trough levels is higher, maybe 900-1000 ng/dL and estrogen estrogen a little higher.

should I be concerned about it especially since the reading was done before my first shot of the week knowing the estrogen follows testosterone?

You’re not going drop dead from high testosterone, the only concern should be the hematocrit, hemoglobin and symptoms or lack thereof.

If you estrogen is balanced, and the levels are the result of your protocol, dim can have the potential to create an imbalance.

 

[t_spacemonkey]

my e2 runs constantly at 50/60 (labcorp) and I have zero e2 issues.

 

[Systemlord]

on my report all it says is Testosterone Free serum 35 pg/ml and range is 15-50 pg/ml

Being in range isn’t the same thing as being optimal or healthy, obviously many men with have problems at an estrogen of 15, ED and osteoporosis, and at 50 in natural men, this can have a negative impact on the pituitary gland and therefore testosterone.

 

[haze1972]

Being in range isn’t the same thing as being optimal or healthy, obviously many men with have problems at an estrogen of 15, ED and osteoporosis, and at 50 in natural men, this can have a negative impact on the pituitary gland and therefore testosterone.

so besides the number game ones symptoms should be the deciding factor on going forward with changes

 

[Blackhawk]

Thanks for the prompt response
on my report all it says is Testosterone Free serum 35 pg/ml and range is 15-50 pg/ml will have to speak to the lab to find out the things you mentioned.

Regarding my estrogen the only symptom I have is slightly senstive or sore nipples but it seems this feeing comes and go and is usually felt more after my shot, can this be that my body is trying to dial in since its my first time on TRT? will this resolve on it own or should i try Dim or other ways to help control my estrogen?

Free T is in good physiological range. Some do better higher or lower, it's individual. If you feel good, you're good.

But the type of test is important. do you know what lab? I do not recognize this range. For your future reference Free T eqilibrium dialysis from Total T LC/MS/MS is good, otherwise you can use

Vermeulen calculator: Free & Bioavailable Testosterone calculator

or tru T calculator: TruT Free Testosterone Calculator by FPT

There is controversy over these. Free T measurement is still not standardized to perfection.

 

[Blackhawk]

so besides the number game ones symptoms should be the deciding factor on going forward with changes

Yes

 

[Blackhawk]

Oh, also at 5 weeks, labs and dosage decisions may be slightly premature. You are not completely settled in. 6-8 weeks for stable blood level on new dose, longer for the body to adjust to the new levels. I personally usually wait at least 8 weeks after any dosage change

 

[Bremster]

For years I injected .5 ml cyp twice per wee, my total T hung around 1000. Then, just for a lark, I add 50 iu hcg twice per week and my T shot up to 2300. My E2 also shot up, for me that’s bad, trouble having an orgasm. So, thanks to the many contributors to this forum, I reduced
my cyp to .2 twice per week kept my Hcg the same and my T came down to 1300, I don’t know what my E2 because the doctor staff made a mistake on the blood test prescription, but it is high. Trouble with orgasms so I am flying blind, and I added anastrozole, 1/2 mg twice per week, hopefully my E2 will come down.

 

[Blackhawk]

For years I injected .5 ml cyp twice per wee, my total T hung around 1000. Then, just for a lark, I add 50 iu hcg twice per week and my T shot up to 2300. My E2 also shot up, for me that’s bad, trouble having an orgasm. So, thanks to the many contributors to this forum, I reduced
my cyp to .2 twice per week kept my Hcg the same and my T came down to 1300, I don’t know what my E2 because the doctor staff made a mistake on the blood test prescription, but it is high. Trouble with orgasms so I am flying blind, and I added anastrozole, 1/2 mg twice per week, hopefully my E2 will come down.

E2 test... If you are in the US, you can order your own labs. Look at lab tests in the menu bar above.

 

[haze1972]

Yes, your trough levels is higher, maybe 900-1000 ng/dL and estrogen estrogen a little higher.

You’re not going drop dead from high testosterone, the only concern should be the hematocrit, hemoglobin and symptoms or lack thereof.

If you estrogen is balanced, and the levels are the result of your protocol, dim can have the potential to create an imbalance.

Should I lower my dose due to high estrogen since I am having some gyno symptoms?.
May bring the dose down to 35mg 2x week.

 

[Systemlord]

I am having some gyno symptoms?.

What gyno symptoms are you experiencing?

 

[aneuman]

Should I lower my dose due to high estrogen since I am having some gyno symptoms?.
May bring the dose down to 35mg 2x week.

I am not on TRT so take this with a grain of salt, if you feel fine (mood, libido, arousal, and performance, pain and anxiety free, etc) and your CBC is good (HCT, HGB, etc, I'd keep this treatment for 3 months and then test again.

Nipple sensitivity is not necessarily gynecomastia. If you don't have a growth underneath the nipple, which I've been told can be painful, then it's not something you need to worry about. Your estradiol level is good, unless you have other symptoms.

With any exogenous hormonal treatment, your body is going to be thrown out of balance, this means that other hormones will be high, low, etc, and that will cause symptoms. It takes time for the body to find a new balance.

You've probably heard the phrase that "better is the enemy of good". Trying to chase "optimal" values can sometimes be counter-productive, and then again, what's "optimal"? There are values that are optimal for you individually, no one here can tell you what they are.

My advice, go with symptoms and blood work, give it time, and if it ain't broke, don't fix it.

Good luck.

 

[haze1972]

What gyno symptoms are you experiencing?

I have had gyno (enlarged and puffy breast) since many years but after starting TRT within 2 weeks starting I have sensitive/sore nipples. BTW I am 5 10 and weight 198 pounds with most of my fat around the stomach and back so I seem to aromatizing more due to excessive fat I believe.

 

[Systemlord]

Sensitive, sore nipples doesn’t mean it’s gyno, I’ve gotten intense burning sensations before, fluid retention in breasts, but never got gyno.

You need a particular gene to get gyno.

 

[haze1972]

Sensitive, sore nipples doesn’t mean it’s gyno, I’ve gotten intense burning sensations before, fluid retention in breasts, but never got gyno.

You need a particular gene to get gyno.

so have fatty breast showing under the T-shirt is not gyno?

 

[Systemlord]

so have fatty breast showing under the T-shirt is not gyno?

Fluid retention isn’t gyno, gyno is usually always very pointy. It’s hard to tell without pictures. Type in Google “gyno” for comparison.

 

[haze1972]

Fluid retention isn’t gyno, gyno is usually always very pointy. It’s hard to tell without pictures. Type in Google “gyno” for comparison.

just seen some pictures some pictures are very simmilar to what I have I believe, mine is sometimes puffy and sometimes pointy only time is only time when they look whole is during exercise espicialy doing pushups